Search

Zuccagnia punctata Cav. (Fabaceae) is a medicinal aromatic shrub, a monotypic species with a wide distribution in Argentina. Two morphotypes were found in Valles Calchaquíes, one with yellow fruits (YF) and other with red-brown fruits (RBF). The color of fruits varies between individuals within a population, with some plants producing red-brown fruits and other yellow fruits. The cytogenetic differentiation was determined using root tips. Leaves and fruits were used to analyze chemical composition by HPLC-DAD and HPLC/MS/MS. The number of chromosome (2n = 24) was reported for the first time for the genus. The yellow fruits and red-brown fruits morphotypes showed different karyotypes. The compounds common to both morphotypes were identified in leaves and fruits as chalcones, compounds with biological activity and biomarkers used for quality control of Z. punctata products. Two chemotypes related to the color of the fruits, were detected. An anthocyanin, cyanidin 3-glucoside was found in red-brown fruits (4.75 mg.g-1 fruits) but not in yellow fruits. These is the first report on yellow fruits morphotype of Z. punctata and on presence of anthocyanins in Z. punctata red-brown fruits morphotype. This work contributes to the knowledge of Z. punctata, a native plant from Argentina with high economic potential to promote the regional economy.

Saccharose (SA) and citric acid (CA) were used as additives in P-doped CoMo/Al2O3 catalysts (Mo, Co and P at 12, 3, and 1.6 wt%, respectively) intended to be applied in guaiacol hydrodeoxygenation (HDO). One-pot impregnating solutions were prepared by MoO3 digestion in aqueous H3PO4, followed by C4H6CoO4•4H2O addition. Organics were added (SA/Co=1, CA/Co=2) at two different preparation stages to assess the effect of that step on catalysts properties. Method I: SA or CA was added in as-prepared Co-Mo-P impregnating solution, followed by pore-filling impregnation of alumina support. Method II: SA or CA at aforementioned concentrations was impregnated on the pristine carrier, followed by drying (120 °C, 2 h). Co-Mo-P phases were further deposited on modified supports through corresponding one-pot solutions. All materials were dried (120 °C) but not calcined. Cobalt complexation by CA and Mo-blue LMCT complex formation (SA-modified solids) were identified (UV-vis, oxidic samples). Partially reduced molybdenum (Mo6+ => Mo5+, by XPS) was observed after either organics addition that effect being more evident in SA-modified solids. Materials were gas-phase sulphided (H2S/H2 10%, 400 °C, 2 h) then studied by HR-TEM. Co-Mo-P phases impregnation in one-pot solution simultaneously deposited with SA rendered the materials of the highest MoS2 dispersion.

This research aimed to determine the learning behaviors of the children with late language emergence. This study specifically sought to determine the parents’ experience when facilitating their language learning intervention to their children. Thus, it aims to identify the struggles and rewarding instances of the participants as they teach their child to grow with language. The researcher used a qualitative approach to uncover the trends in thoughts and opinions and to dive deeper into the problem. The participants were chosen personally by the researcher and all of them is encountering the same problem being their child is a late talker. The findings of this study showed that the participants observed that their children has a common behavioral patterns and behavioral learnings. This shows that late talkers has the same manner of keeping up with the pace and has and identical way of learning when it comes to language acquisition. This paper evaluated the struggles, experiences, and rewarding instances of parents when facilitating the learning of their late talker children.

Introduction: Tuberous sclerosis complex (TSC) is a genetic multisystem disorder with prominent skin involvement. Multiple ungual fibromas, also known as Koenen tumors (KTs), are one of the major diagnostic criteria and occur approximately in 50% of patients with TSC. They are disfiguring, painful, and challenging to treat as they frequently recur. There are 2 previous cases in the literature of KTs as the only clinical sign of TSC. Case Presentation: A 56-year-old male patient with intellectual disability presented with a history of ungual growths that had gradually increased in size and number for 20 years. The diagnosis of KTs was established on clinical grounds, without the requirement of histological confirmation. No additional clinical evidence of TSC was found. Complete surgical excision of the tumors located in the proximal nail matrix, periungual folds, and nail bed of each toe was successfully performed. Discussion: The association between KTs and intellectual disability with TSC supported the clinical diagnosis. To date, there is no standard first-line treatment for KTs. Complete surgical excision up to the proximal base of the tumor offers satisfactory results in terms of functionally and esthetic appearance and could be considered the preferred therapeutic modality for patients with severe functional and cosmetic impairment. Prompt recognition of the many signs and symptoms associated with TSC is important to achieve early diagnosis, preventing further complications.

Autonomy and unmanned systems have evolved significantly in recent decades, becoming a key routine component for various sectors and domains as an intrinsic sign of their improvement, the ocean not being an exception. This paper shows the transition from the research concept to the commercial product and related services for Unmanned Surface Vehicles (USV). Note that it has not always been easy in most cases due to the limitations of the technology, business, and policy framework. An overview of current trends in USV technology looking for a baseline to understand the sector where some experiences of the authors are shown in this work. The analysis presented shows a multidisciplinary approach to the field. USV's capabilities and applications today include a wide range of operations and services aimed at meeting the specific needs of the maritime sector. This important consideration for USV has yet to be fully addressed, but progress is being made.

Marine growth has been observed to cause a drop in the horizontal and vertical velocities of underwater gliders, thus making them unresponsive and needing immediate recovery. Currently, no strategies exist to correctly identify the onset of marine growth for gliders and only limited data sets of biofouled hulls exist. Here, a field test has been conducted to first investigate the impact of marine growth on the dynamics and power consumption of underwater gliders and then design an anomaly detection system for high levels of biofouling. A Slocum glider was deployed first for eight days with drag stimulators to imitate severe biofouling; then, the vehicle was redeployed with no additions to the hull for further 20 days. The mimicked biofouling caused a speed reduction due to a significant increase in drag. Additionally, the lower speed causes the steady-state flight stage to last longer and the rudder to become less responsive; hence, marine growth results in a shortening of deployment duration through an increase in power consumption. As actual biofouling due to p. pollicipes occurred during the second deployment, it is possible to develop and test a system that successfully detects and identifies high levels of marine growth on the glider, blending model- and data-based solutions using steady-state flight data. The system will greatly help pilots replan missions to safely recover the vehicle if significant biofouling is detected.

Resume Introduction Le poumon de jacuzzi (PJ) est une pneumopathie d’hypersensibilite (PHS) liee a l’inhalation de mycobacteries non tuberculeuses (MNT) lors d’exposition a un jacuzzi. Le debat etiologique n’est pas completement tranche dans la litterature. Methode Etude observationnelle de 14 cas de PJ diagnostiques au Centre Hospitalier Universitaire (CHU) de Besancon entre 2004 et 2018 selon les criteres diagnostiques utilises en clinique. Resultats Cette cohorte correspondait a des PHS de type I (inflammatoire), avec un cas de PHS de type II (fibreuse). L’alteration de la diffusion du monoxyde de carbone etait presente pour 86 % des examens (n = 12/14) et 84 % des lavages bronchoalveolaires etaient hyperlymphocytaires (n = 11/13). L’enquete environnementale avait permis l’identification d’une MNT dans 93 % des cas (n = 13/14), principalement Mycobacterium avium. Les precipitines vis-a-vis de MNT etaient positives dans 10 % des cas (n = 2/20). Trois individus ont recu une corticotherapie et aucun une antibiotherapie. L’eviction antigenique ameliorait la symptomatologie dans tous les cas. Conclusions Notre cohorte renforce l’hypothese que le PJ est une PHS, principalement de type I dans sa presentation. L’eviction antigenique (MNT) est la base du traitement. Le diagnostic est difficile vis-a-vis des tests immunologiques peu contributifs. L’enquete environnementale pourrait faciliter l’identification des MNT. La prevention du PJ passe par une education du clinicien et du patient.

The family of Fabaceae has been fundamental into the traditional nutrition in South America, including Chile, however in this country has reduce consumption of legumes between children in school age. This investigation pursued establish the impact over nutritional and no nutritional composition of chilean beans ( Phaseolus vulgaris ) exposed to cook and germination. The results obtained has shown the cooked samples has decreased the contain of iron and also diminished in total minerals from ashes analysis, instead the germinated samples increased both. Total proteins determined by Kjeldahl method exhibit no change for cooked and germinated beans in relation to control without treatment, while phytic acid increased and lectins decreased with the action of cook or germination of P.vulgaris . All the analysis was supported by statistical assessment and suggest the beans germination is a good alternative to improve the variety of recipes available to prepare beans in other attractive presentations on the subject of promote the children intake.

Purpose Expanded research on the biomedical applications of graphene has shown promising results, although interactions between cells and graphene are still unclear. The current study aims to dissect the cellular and molecular effects of graphene nanocomposite in photothermal therapy against cancer, and to evaluate its efficacy. Methods In this study, a reduced graphene oxide and iron oxide (rGO-Fe3O4) nanocomposite was obtained by chemical synthesis. The nanocomposite was fully characterized by Raman spectroscopy, TEM, VSM and thermal profiling. Cell-nanocomposite interaction was evaluated by confocal microscopy and viability assays on cancer cell line HeLa. The efficacy of the thermal therapy and changes in gene expression of Bcl-2 and Hsp70 was assessed. Results The resulting rGO-Fe3O4 nanocomposite exhibited superparamagnetic properties and the capacity to increase the surrounding temperature by 18-20°C with respect to the initial temperature. The studies of cell-nanocomposite interaction showed that rGO-Fe3O4 attaches to cell membrane but there is a range of concentration at which the nanomaterial preserves cell viability. Photothermal therapy reduced cell viability to 32.6% and 23.7% with 50 and 100 µg/mL of nanomaterial, respectively. The effect of treatment on the molecular mechanism of cell death demonstrated an overexpression of anti-apoptotic proteins Hsp70 and Bcl-2 as an initial response to the therapy and depending on the aggressiveness of the treatment. Conclusion The results of this study contribute to understanding the interactions between cell and graphene and support its application in photothermal therapy against cancer due to its promising results.

Alumina-lantana (2.5, 5, 7.5 and 10 wt% La) mixed oxides of suitable texture to be applied as supports of catalysts for hydrodesulfurization of FCC naphtha-range oil-derived distillates were prepared by rare-earth pore-filling impregnation through corresponding nitrate. Co, Mo and P were deposited on binary carriers by one-pot simultaneous impregnation method used during commercial hydrotreating catalysts preparation. Materials were characterized by N2 physisorption, XRD, SEM–EDS, adsorbed CO2 FTIR (basicity measurements), Raman and UV–vis spectroscopies. Sulfided catalysts were studied by chemical composition (EDAX) and HR-TEM. In general, amount and strength of surface basic sites increased with rare-earth content in binary carriers at 5 wt% and higher. Deposited molybdates dispersion augmented with lanthanum content in carriers. However, progressively increasing rare-earth loading on supports was detrimental on gas-phase thiophene HDS (523–563 K, steady-state fixed-bed plug-flow reactor operating at atmospheric pressure). Hardly sulfidable tetrahedral Mo species could be originated by decomposition of heteropolymolybdates originally present in one-pot acidic (pH ~ 1.9) Co–Mo–P solutions by impregnating at basic conditions in pores of La-modified carriers. At isoconversion (~ 10%) rare-earth containing sulfided CoMo catalysts had decreased yield to fully saturated n-butane as to the material supported on pristine alumina.

Pt (0.5, 1 and 1.5 wt%) was impregnated by incipient wetness on SBA-15 and corresponding Ga-modified (3, 5, 10 and 20 wt%) composites. Gallium nitrate was incorporated directly during the mesoporous siliceous network synthesis. Materials were characterized by N2 physisorption, X-ray diffraction, Fourier transformed infrared spectroscopy, scanning electron microscopy and transmission electron microscopy. SBA-15 had surface area greater than 800 m²/g that decreased by Ga incorporation in binary materials. It seemed that tetrahedral gallium was well-incorporated into mesoporous silica walls. Pt dispersion slightly diminished (as to that on SBA-15) by augmenting Ga concentration in composites. Corresponding pore size maxima shifted to lower diameters (as to that of non-impregnated supports) after platinum loading suggesting Pt crystals inside pores of SBA-15 and Ga-modified carriers. Large cubic platinum crystals were observed over all prepared materials probably due to sintering (during calcining at 500 °C) of metallic particles weakly interacting with the carriers surface. After materials annealing (500 °C under static air) metallic platinum was evidenced (by XRD) pointing out to noble metal reduction that could be facilitated by decomposition of organic remains from Si alkoxide used during supports synthesis which presence was ascertained by FTIR.

Although a high prevalence of COVID-19-associated pulmonary aspergillosis has been reported, it is still difficult to distinguish between colonization with Aspergillus fumigatus and infection. Concomitantly, similarities between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and hypersensitivity pneumonitis were suggested. The objective of this study was to investigate retrospectively if precipitin assays targeting A. fumigatus could have been useful in the management of SARS-CoV-2 patients hospitalized in an Intensive Care Unit (ICU) in 2020. SARS-CoV-2 ICU patients were screened for Aspergillus co-infection using biomarkers (galactomannan antigen, qPCR) and culture of respiratory samples (tracheal aspirates and bronchoalveolar lavage). For all these patients, clinical data, ICU characteristics and microbial results were collected. Electrosyneresis assays were performed using commercial A. fumigatus somatic and metabolic antigens. ELISA were performed using in-house A. fumigatus purified antigen and recombinant antigens. Our study population consisted of 65 predominantly male patients, with a median ICU stay of 22 days, and a global survival rate of 62%. Thirty-five patients had at least one positive marker for Aspergillus species detection. The number of arcs obtained by electrosyneresis using the somatic A. fumigatus antigen was significantly higher for these 35 SARS-CoV-2 ICU patients (P 0.01, Welch's t-test). Our study showed that SARS-CoV-2 ICU patients with a positive marker for Aspergillus species detection more often presented precipitins towards A. fumigatus. Serology assays could be an additional tool to assess the clinical relevance of the Aspergillus species in respiratory samples of SARS-CoV-2 ICU patients. Lay Summary This study showed retrospectively that precipitin assays, such as electrosyneresis, could be helpful to distinguish between colonization and infection with Aspergillus fumigatus during the management of severe acute respiratory syndrome Coronavirus-2 (SARS CoV-2) patients in an intensive care unit.

Congenital kidney and urinary tract anomalies are the most common cause of chronic kidney disease in the first three decades of life. Stenosis of the ureteropelvic junction may cause dilation of the collecting system in the fetal kidney. This study aimed to determine hydronephrosis due to congenital ureteropelvic stenosis treatment outcome according to the age of the intervention.We conducted a retrospective descriptive study that included pediatric patients with hydronephrosis secondary to ureteropelvic junction stenosis operated by the Anderson-Hynes open pyeloplasty method from 2010 to 2016. Patients were divided into two groups: group A, children1 year of age, and group B, children1 year of age. We analyzed ultrasonographic parameters, renal function, and clinical data. Inferential statistics were used with the Mann-Whitney U-test and XWe included 52 patients: group A (n = 16, 30%) and group B (n = 36, 70%). The male sex predominated, and mainly the left renal unit. The most important surgical finding was stenotic segment. The median right glomerular filtration rate was 24.1 mL/min (19.0-34.5) pre-surgical and 38.2 mL/min (35.9-41.09) post-surgical in group A (p = 0.028), and 28.4 mL/min (18.5-35.0) pre-surgical and 37 mL/min (35.7-46.0) post-surgical in group B (p = 0.003). The median left glomerular filtration rate was 30 mL/min (21.4-39.0) pre-surgical and 40.0 mL/min (37.7-44.6) post-surgical in group A (p = 0.005) and 18.4 mL/min (14.2-29.2) pre-surgical and 37 mL/min (33.1-38.5) post-surgical in group B (p0.001).Correction of ureteropelvic stenosis before one year of age results in better renal function than a later correction.Las anormalidades congénitas del riñón y del tracto urinario son la causa más frecuente de enfermedad renal crónica en las primeras décadas de la vida. La estenosis de la unión ureteropiélica puede ocasionar restricción del flujo urinario desde la pelvis renal hacia el uréter, y es la causa más común de dilatación del sistema colector en el riñón fetal. El objetivo de este estudio fue determinar los resultados del tratamiento de la hidronefrosis por estenosis ureteropiélica congénita según la edad de la intervención.Se llevó a cabo un estudio retrospectivo descriptivo incluyendo pacientes pediátricos con hidronefrosis secundaria a estenosis de la unión ureteropiélica sometidos a pieloplastia abierta de Anderson-Hynes en el periodo 2010-2016. Se formaron dos grupos: A, pacientes1 año, y B, pacientes1 año. Se analizaron parámetros clínicos, ecosonográficos y de función renal. Se utilizó estadística inferencial con las pruebas U de Mann Whitney, χSe incluyeron 52 pacientes: 16 en el grupo A (30%) y 36 en el grupo B (70%). Predominó el sexo masculino, y principalmente la unidad renal izquierda. El hallazgo quirúrgico más importante fue el segmento estenótico. La mediana de la tasa de filtración glomerular derecha prequirúrgica fue de 24.1 ml/min (19.0-34.5) y la posquirúrgica fue de 38.2 ml/min (35.9-41.09) en el grupo A (p = 0.028), frente a 28.4 ml/min (18.5-35.0) y 37 ml/min (35.7-46.0), respectivamente, en el grupo B (p = 0.003). La mediana de la tasa de filtración glomerular izquierda prequirúrgica fue de 30 ml/min (21.4-39.0) y la posquirúrgica fue de 40.0 ml/min (37.7-44.6) en el grupo A (p = 0.005), frente a 18.4 ml/min (14.2-29.2) y 37 ml/min (33.1-38.5), respectivamente, en el grupo B (p0.001).La corrección de la estenosis ureteropiélica antes de 1 año de edad resulta en una mejor función renal que la corrección tardía.

The revised European consensus on sarcopenia definition and diagnosis (EWGSOP2) includes the SARC-F questionnaire, the most valid and consistent sarcopenia screening tool, as the mandatory first step. Our aim was the translation, cross-cultural adaptation, and validation of the SARC-F questionnaire as a culturally-responsive Spanish-language version for the European population. Cross-sectional descriptive study, applying the two-step WHO methodology for translation and cross-cultural adaptation of health questionnaires, and harmonization with the Mexican-Spanish version. European Union Geriatric Medicine Society recommendations for SARC-F validation in European languages were considered. Outpatient clinics of a university hospital. Inclusion criteria: stable, ambulatory (including aids), community-dwelling population ≥65 years old. The self-reported 5-item SARC-F questionnaire was administered; scores ≥4 indicated sarcopenia. Sensitivity, specificity, accuracy-likelihood ratios, predictive values, and kappa statistics were calculated and consecutively compared with European Working Group on Sarcopenia in Older People (EWGSOP) and EWGSOP2 criteria. This Spanish version, administered in an average 70s, has adequate internal consistency (Cronbach alpha=0.779). For the validation study, 90 (43.3%) of 208 potentially eligible subjects (81.4 ± 5.9 years old, 75.6% women) were included. SARC-F identified 51 (56.7%) subjects with sarcopenia and 39 (43.3%) without the disease. Prevalence was 17.8% per EWGSOP and 25.6% per EWGSOP2 (58% accuracy and fair agreement: sensitivity, 783%; specificity, 50.8%). SARC-F is a feasible tool, suitable for bedside assessment in community-dwelling older patients. Wide diffusion of this culturally-responsible SARC-F Spanish version is expected as EWGSOP2 is adopted and sarcopenia assessment is broadly implemented in Spain.

Background/Context On September 5, 2017, U.S. President Donald Trump ordered an end to former President Barack Obama's 2012 immigration policy of Deferred Action for Childhood Arrivals (DACA), placing some 800,000 undocumented immigrants—including thousands of postsecondary students—in danger of deportation. Mere hours after President Trump's announcement, postsecondary leaders across the United States began releasing official statements in support of DACA. Aside from a postsecondary institution's extolling of core values, it is important to investigate how these official institutional statements addressed the most critical, at-risk constituency on their college campus: DACA students themselves. Purpose The purpose of this study was to analyze post-DACA rescission statements made by executive leaders of U.S. institutions of higher education to learn whether these statements addressed the most important audience of these statements—DACA students—and whether institutions of higher education provided these students the resources they needed in their time of crisis. Research Design The data were collected from each institution of higher education's website from September 5 to September 7, 2017. The sample included 218 official institutional (two-and four-year, public and private) statements made by executive leaders at these institutions. Data analysis included deductive attribute coding and quantitative content analysis techniques such as average word count and grade-level readability measures. Findings The post-DACA rescission statements greatly varied in length (longest = 1,118 words; shortest = 50 words) and were unreadable by postsecondary students of average reading ability, as the average statement was written above the 15th-grade reading level. Only 54% of all statements addressed DACA students, with negligible variance (0.5%) between public and private institutions. Only 51.9% of all statements provided resources for DACA students. Of those statements, 99.1% of resources were institution-provided, whereas 20.4% were community-provided, with private institutions (12.9%) offering more community-provided resources than public institutions (7.5%). Conclusions Institutions of higher education may want to consider best practices when composing crisis communication, primarily that crisis communication should focus on addressing the populations most affected by the crisis. Once the crisis communication is composed, that communication could be audited for its readability by the intended audience. Moreover, institutions of higher education may learn from the Virginia Tech massacre and apply it to their crisis management and communication strategies, namely by providing both institution-based and community-based resources to those most affected by the crisis. Finally, institutions of higher education may consider differentiating their crisis communication across multiple platforms such as social media, email, text message, and their institutional website to ensure that all stakeholders are aware of the potential solutions and resolutions to the crisis, in order to avoid miscommunication and a lack of organizational transparency while maintaining organizational integrity and honesty.

We present an optical phased array parameter analysis for automotive and handheld device applications and preliminary results from a 1×16 silicon optical phased array using p-i-n phase shifters built on a 300-mm industrial platform to reach high-speed operation and low power consumption at a 1.55𝜇𝑚 wavelength. Using 2 𝜇𝑚-spaced grating antennas OPA with theoretical beam steering range of 48°, we demonstrate a beam steering range of ±4° while average power consumption after the beam-shape optimization is measured to be 12.6 mW. Experimental setup, beam forming and scanning are discussed and a final analysis on future large-scale OPA integration is made.

Marine growth has been observed to cause a drop in the horizontal and vertical velocities of underwater gliders, thus making them unresponsive and needing immediate recovery. Currently, no strategies exist to correctly identify the onset of marine growth for gliders and only limited datasets of biofouled hulls exist. Here, a field test has been run to investigate the impact of marine growth on the dynamics of underwater gliders. A Slocum glider was deployed first for eight days with drag stimulators to simulate severe biofouling; then the vehicle was redeployed with no additions to the hull for a further 20 days. The biofouling caused a speed reduction due to a significant increase in drag. Additionally, the lower speed causes the steady-state flight stage to last longer and thus a shortening of mission duration. As actual biofouling due to p. pollicipes happened during the deployment, it was possible to develop and test a system that successfully detects and identifies high levels of marine growth on the glider using steady-state flight data. The system will greatly help pilots re-plan missions to safely recover the vehicle if significant biofouling is detected.

Objective To determine the prevalence of varying classes of obesity in patients undergoing tracheostomy and the associated complication rates as compared with nonobese patients. Study Design A retrospective chart review was performed from 2012 to 2018 on all patients who underwent open tracheostomy by the Department of Otolaryngology–Head and Neck Surgery. Setting All tracheostomies were performed at a single tertiary care center. Methods Patients were classified by body mass index (BMI) according to the World Health Organization classification system: underweight (40). Charts were reviewed for patient demographic information, Charlson Comorbidity Index score, surgical indication, operative time, tracheostomy tube type, and postoperative complications. Results A total of 387 patients (mean ± SD BMI, 31.3 ± 14.2) were identified per the inclusion/exclusion criteria. Of patients with BMI >30 (n=153), 34.6% were categorized as obesity class I, 29.4% as class II, and 35.9% as class III. The most common indication for tracheostomy was malignancy in nonobese patients (41.5%) and respiratory failure for obese patients (58.2%). Operative time was significantly longer in obese patients, and most of these patients required an extended-length tracheostomy tube. Patients with a BMI >40 had higher rates of multiple postoperative complications or death ( P = .009). Underweight patients also had a higher rate of complication than normal-overweight patients ( P = .016). Conclusion Class III and underweight patients had higher rates of postoperative complications, which should be taken into consideration during perioperative counseling.

Examine the association between marginalization and fluorosis with caries experience in Mexican rural children aged 8-12, in Oaxaca, Mexico.Cross-sectional study of 283 rural schoolchildren selected from two locations with high and medium levels of marginalization where the water fluoride concentration ranged from 2.0 to 2.5 ppm/F. Caries was evaluated using the DMFT index and dental fluorosis with the Thylstrup-Fejerskov Index (TFI). Socioeconomic data were collected from participants' parents, with data on the children's characteristics collected from them via a questionnaire.The prevalence of caries was 72.4% (DMFT ≥1) in the permanent dentition. The prevalence of fluorosis was 98.0% (TFI ≥4=71.4%). 54.8% of the children brushed their teeth two or more times daily. In logistic regression children living in high levels of marginalization were more likely to present caries (OR=2.11, 95% CI 1.13 - 3.93) than children living in medium levels. Children with severe fluorosis (TFI ≥4) (OR=1.93, 95% CI 1.06 - 3.53) were more likely have caries than those with TFI ⟨3.Rural children with a high level of marginalization and fluorosis (TFI ≥4) were more likely to present caries. Poor oral hygiene and low dental service levels were found in both marginalized areas. Populations with medium/high marginalization are more susceptible to caries.

Purpose Expanded research on the biomedical applications of graphene has shown promising results, although interactions between cells and graphene are still unclear. The current study aims to dissect the cellular and molecular effects of graphene nanocomposite in photothermal therapy against cancer, and to evaluate its efficacy. Methods In this study, a reduced graphene oxide and iron oxide (rGO-Fe3O4) nanocomposite was obtained by chemical synthesis. The nanocomposite was fully characterized by Raman spectroscopy, TEM, VSM and thermal profiling. Cell-nanocomposite interaction was evaluated by confocal microscopy and viability assays on cancer cell line HeLa. The efficacy of the thermal therapy and changes in gene expression of Bcl-2 and Hsp70 was assessed. Results The resulting rGO-Fe3O4 nanocomposite exhibited superparamagnetic properties and the capacity to increase the surrounding temperature by 18–20°C with respect to the initial temperature. The studies of cell-nanocomposite interaction showed that rGO-Fe3O4 attaches to cell membrane but there is a range of concentration at which the nanomaterial preserves cell viability. Photothermal therapy reduced cell viability to 32.6% and 23.7% with 50 and 100 µg/mL of nanomaterial, respectively. The effect of treatment on the molecular mechanism of cell death demonstrated an overexpression of anti-apoptotic proteins Hsp70 and Bcl-2 as an initial response to the therapy and depending on the aggressiveness of the treatment. Conclusion The results of this study contribute to understanding the interactions between cell and graphene and support its application in photothermal therapy against cancer due to its promising results.

Infections of enterobacteria producing extended-spectrum -lactamases place a heavy burden on health systems. Little is known in osteoarticular infections, so this work studied the prevalence of these infections in a third-level hospital.Prevalence study in patients of a Traumatology Service during 2016, with infection criteria provided by the CDC in Atlanta, Georgia. The VITEK® 2 AST-N272 (bioMérieux) system was used for bacterial identification at the species level and for antimicrobial susceptibility tests.7.85% (n = 86) were reported with osteoarticular infections; 22.09% (n = 19) were by enterobacteria BLEEs. An average of 77.1 days of hospitalization (SD 37.7) (46-200 days); isolation of the microorganism occurred 15 days after entry. Sixteen (84.2%) patients had osteomyelitis, three (15.8%) had a prosthetic knee or hip infection. The average number of treatment days was 60 days (21-129 days). Eighteen patients (94.7%) were discharged with resolution of their infectious picture; one patient died with infection over aggregated pneumonia due to carbapenem-resistant K. pneumoniae.The prevalence of osteoarticular infections by enterobacteria BLEEs could not be accurately calculated, but we consider it to be within what is expected, infection control measures require higher standards and there is a lack of development programs to use antimicrobials rationally to control the emergence of these pathologies.Las infecciones por enterobacterias productoras de -lactamasas de espectro extendido (BLEEs) ocasionan una gran carga a los sistemas de salud. Poco se conoce de las infecciones osteoarticulares, por lo que este trabajo estudió la prevalencia de estas infecciones en un hospital de tercer nivel.Estudio de prevalencia en pacientes de un servicio de traumatología durante 2016, con criterios de infección proporcionados por el CDC de Atlanta, Georgia. Se utilizó el sistema VITEK® 2 AST-N272 (bioMérieux) para la identificación bacteriana a nivel de especie y para las pruebas de susceptibilidad antimicrobiana.Se reportaron 7.85% (n = 86) con infecciones osteoarticulares; 22.09% (n = 19) fueron por enterobacterias BLEEs. Con un promedio de 77.1 días de hospitalización (DE 37.7) (46-200 días); el aislamiento del microorganismo se produjo 15 días posteriores al ingreso; 16 (84.2%) pacientes presentaron osteomielitis, tres (15.8%) tuvieron infección protésica de rodilla o cadera. El promedio de días de tratamiento fue de 60 días (21-129 días); 18 pacientes (94.7%) fueron dados de alta con resolución de su cuadro infeccioso; un paciente falleció con infección sobreagregada por neumonía debida a K. pneumoniae resistente a carbapenémicos.La prevalencia de infecciones osteoarticulares por enterobacterias BLEEs no se pudo calcular con precisión, pero consideramos que se encuentra dentro de lo esperado, las medidas de control de infecciones requieren tener estándares más elevados y falta desarrollar programas de uso racional de antimicrobianos para controlar la aparición de estas patologías.

Silicon photonic modulators are a key component for electro-optic transmitters within data centers. Electro-refractive modulators relying on free carrier plasma dispersion in a Mach-Zehnder interferometer (MZI) have become the most popular solution. Among the different electrical configurations, PN silicon modulators show a high bandwidth but at the price of a low efficiency. Accumulation–based capacitive modulators are an alternative, allowing to reduce the modulator power consumption. Additionally, strained SiGe exhibits a stronger plasma dispersion effect than silicon for holes. In this work we study the behavior of capacitive modulators with a thin layer of strained SiGe. The modulator fabrication process is based on the standard process flow with only few add-ons. In the first demonstration we show that the thin SiGe layer improved the modulator efficiency by 25%. In addition, further improvement is possible by optimization of the SiGe deposition condition to maximize the SiGe layer stress.

Saccharose (SA) was used as organic additive in simultaneously impregnated P-doped NiMo/Al2O3 hydrodesulfurization (HDS) catalysts (Mo, Ni and P at 12, 3, and 1.6 wt%, respectively). One-pot impregnating solutions were prepared by MoO3 digestion (∼353 K) in diluted aqueous H3PO4, followed by 2NiCO3·3Ni(OH)2·4H2O addition. Saccharose (SA, SA/Ni = 0.5, 1–3) was dissolved in originally emerald-green impregnating solutions which changed to cobalt blue by room-temperature aging (2–4 days, depending on SA concentration) due to Mo-blue formation by partial molybdenum species reduction. After sulfiding of samples impregnated with SA shorter MoS2 slabs of enhanced stacking were observed (by HR-TEM). Ni and Mo dispersion and nickel sulfidability (as determined by XPS) increased with the amount of organic modifier. Enhanced hydrodesulfurization activity in dibenzothiophene HDS was registered for catalyst obtained from Mo-blue precursor as to that of corresponding materials obtained from conventional emerald-green NiMoP impregnating solutions (with or without SA). However, in solids at high saccharose content (SA/Ni = 3) enhanced “NiMoS” phase amount was not reflected in improved activity. Probably, excessive amount of carbonaceous deposits from SA residua decomposition during catalyst activation provoked partially plugged porous network (as determined by N2 physisorption) in sulfided formulations. That fact seemed to limit accessibility of reactant molecules to surface active sites. Mo-blue precursor obtained through monosaccharides partial reduction seemed to play decisive role in obtaining HDS catalysts of improved properties. Saccharose results a highly soluble, cheap and non-toxic environmentally-friendly additive to produce catalysts of enhanced HDS activity.

BACKGROUND Dual antiplatelet therapy represents the standard of care for the treatment of patients with acute coronary syndrome (ACS). Ticagrelor is a direct-acting P2Y12 inhibitor and does not require metabolic activation. The objective was to assess whether the chewed 180 mg of ticagrelor loading dose (LD), compared to conventional oral administration, increases platelet inhibition and reduces high on-treatment platelet reactivity (HTPR) in patients with ACS. METHODS AND RESULTS Single-center randomized clinical trial in patients with ACS. We measured platelet reactivity and % platelet aggregation (%IPA) using VerifyNow P2Y12 (Accumetrics) at baseline, 30 minutes, 1, 4 and 24 hours after LD. HTPR was defined as ≥208 PRU and/or % platelet inhibition ≤15%. We studied 40 consecutive patients (Pts.), 21 Pts. in the swallowed ticagrelor group and 19 Pts. in the chewed ticagrelor group. At 30 minutes, platelet reactivity was 180.81 ± 64.16 PRU vs. 117 ± 58.62 PRU p CONCLUSION Chewed ticagrelor allowed a significant reduction in platelet reactivity and HTPR from the first 30 minutes and the first hour.

Mg-doped alumina carriers at various alkaline earth contents (0.5–8 wt%) were prepared by incipient wetness impregnation of corresponding nitrate on sol-gel Al2O3 support. Pt (1 wt%) supported catalysts were obtained by pore-filling deposition from H2PtCl6·6H2O on magnesium-modified carriers. Prepared materials were characterized by N2 physisorption, infrared (IR) and UV–vis spectroscopies and temperature-programmed reduction. Textural properties of alumina substrate were not significantly affected by MgO deposition at any content suggesting well-dispersed magnesia patches. According to CO2 adsorption analyzed by IR, surface basic properties of mixed supports were clearly enhanced with alkaline earth concentration. Reduction temperature of Pt4+ species slightly shifted to lower values by augmenting Mg content in binary supports pointing out to weakening of noble metal-mixed carriers interaction. Reduced (at 623 K, under hydrogen flow) noble metal catalysts were tested in liquid-phase naphthalene hydrogenation in tri-phasic slurry batch reactor (T = 523 K, P = 3.92 MPa). The reduced Pt catalysts supported over the binary carrier at 2 wt% Mg content had the best properties in both naphthalene conversion and consecutive tetralin hydrogenation. Nevertheless, addition of the basic additive at higher loading in the support resulted detrimental on saturating properties of corresponding noble metal-based catalyst. Selectivity to preferred cis-decalin isomer decreased over Pt materials by increasing alkaline-earth concentration in the carrier.

This paper is aimed to overview, including derived preliminary-results, glider missions carried out in waters of the Macaronesia region, connecting Portugal mainland and the archipelagos of Madeira and Canary Islands, within the framework of H2020-AtlantOS and Interreg Atlantic iFADO projects. The missions conducted represents the first attempt in this context aiming to stablish glider endurance-lines across the area, to increase ocean-observation capability from a sustainable and cost effective perspective by the use of cutting-edge technologies, and at the same time, to contribute to the regional marine-monitoring strategy in support to the main international ocean-observations programs and initiatives.

The aim of this study was to identify the relationship between Molar Incisor Hypomineralization (MIH) severity and cavitated carious lesions in schoolchildren. This crosssectional study included 506 schoolchildren selected from public schools. The prevalence and severity of MIH was evaluated using the European Academy of Pediatric Dentistry criteria (EAPD), while the prevalence and severity of caries was evaluated by applying the ICDAS (International Caries Detection and Assessment System). The prevalence of MIH was 42.4%, with a severity of 21.7% mild, 7.7% moderate, and 13.0% severe. Prevalence was 61.6% for incipient lesions and 34.0% for cavitated lesions. The prevalence of ICDAS II ≥4 lesions was higher in schoolchildren with MIH than in those without MIH (55.8% vs. 44.2%, p0.001). In the multinomial model, children with MIH in the moderate/ severe category were more likely (OR=3.28; CI95% 1.01 - 10.6, p0.048) to present cavitated lesions. The presence of MIH at mild levels was not associated with cavitated carious lesions. A high prevalence of MIH was observed. Moderate and severe levels of MIH were associated with cavitated carious lesions. To prevent dental caries, it is important to identify MIH in children, particularly in the moderate and severe categories.El objetivo de este estudio fue identificar la asociación entre la severidad de la Hipomineralización IncisivoMolar (HIM) y las lesiones cavitadas de caries en escolares. Estudio transversal que incluyó a 506 escolares seleccionados de escuelas públicas. La prevalencia y la severidad de HIM se evaluó utilizando los criterios de la European Academy of Pediatric Dentistry (EAPD), mientras que la prevalencia y severidad de caries se evaluó mediante los criterios del ICDAS (International Caries Detection and Assessment System). La prevalencia de HIM fue del 42.4%, por severidad: 21.7% leve; 7.7% moderado y 13.0% severo. La prevalencia de lesiones incipientes fue de 61.6% y 34.0% para lesiones cavitadas de caries. La prevalencia de ICDAS II ≥4 lesiones fue mayor en escolares con HIM que en aquellos sin HIM (55.8% vs 44.2%, p0.001). En el modelo multinomial, los niños con HIM en la categoría moderada / severa tienen mayor probabilidad (RM = 3.28; IC95% 1.0110.6, p0.048) de presentar lesiones cavitadas de caries. La presencia de HIM en niveles leves no se asoció con la presencia de lesiones cavitadas de caries. Se observó una alta prevalencia de HIM. Los niveles moderados y severos de HIM se asociaron con lesiones cavitadas de caries. Para prevenir la caries dental, es importante identificar la HIM en los niños, particularmente en las categorías moderada y severa.

NiMo/Al 2 O 3 catalysts were obtained by one-pot simultaneous impregnation of Mo, Ni and P (at 12, 3 and 1.6 wt%, respectively) over alumina. Citric acid (CA) was added (Ni/CA=1 mol ratio) to determine its influence over molybdenum species, as nickel precursor used was complexated Ni acetate. Three different preparation methodologies were used: (a) modification of calcined (400 °C) NiMo/Al 2 O 3 by CA impregnation, (b) CA deposition directly onto Al 2 O 3 carrier, prior to Ni-Mo-P impregnation, (c) simultaneous Ni-Mo-P-CA deposition on alumina support. Materials were characterized by N 2 physisorption, infrared and UV-vis spectroscopies, temperature-programmed reduction and thermal analysis (TG-DTG), and tested in liquid-phase benzothiophene (BT) conversion in batch reactor. CA deposition over calcined NiMo/Al 2 O 3 resulted in diminished proportion of refractory Mo 6+ (t) tetrahedral species but also in octahedral Mo 6+ (o) reducible at higher temperature, as to those over non-modified NiMo/alumina. That was reflected in lower hydrodesulfurizating (HDS) ability. The highest BT HDS activity (70% increase, as to the conventional calcined formulation with no organic additive) was found when CA was impregnated over bare alumina prior to Ni-Mo-P deposition. In that case, decreased interaction between deposited molybdenum and nickel species and the support was evidenced, that due to surface “passivation” from citric adsorption/decomposition on alumina surface. On the other hand, simultaneous Ni-Mo-P-CA deposition, where low pH of impregnating solution (pH~1.4) devoided citric acid ionization, (then, no Mo-citrate complex formation) was ineffective in providing catalyst of enhanced HDS activity.

Background. Phosphoric acid is the traditional etching agent; self-etching adhesives and Er:YAG laser are alternative methods. Knowledge of deciduous enamel etching is required.Aim. To evaluate primary enamel microhardness, structure, and morphology after phosphoric acid, self-etching, and Er:YAG laser etching.Design. Seventy primary incisors were assigned to five groups (n=14): I (control), II (35% phosphoric acid), III (self-etching adhesive), IV (Er:YAG laser at 15 J/cm2), and V (Er:YAG laser at 19.1 J/cm2). Microhardness was evaluated by Vickers indentation. Chemical composition was analyzed by energy dispersive X-ray spectroscopy and morphological changes by scanning electron microscopy. One-way ANOVA, Kruskal–Wallis, Mann–WhitneyU, and Pearson bivariate correlation were employed (α=0.05).Results. Vickers microhardness showed differences and no correlation with Ca/P ratio. Group II showed differences in carbon, oxygen, and phosphorus atomic percent and group V in Ca/P ratio. Morphological changes included exposed prisms, fractures, craters, and fusion.Conclusions. Enamel treated with phosphoric acid showed different chemical characterization among groups. Self-etching and Er:YAG laser irradiation at 19.1 J/cm2showed similar microhardness and chemical characterization. Er:YAG laser irradiation at 15 J/cm2maintained microhardness as untreated enamel. Er:YAG laser irradiation at 19.1 J/cm2enhanced mineral content. Morphological retentive changes were specific to each type of etching protocol.

PERSEUS (Protection of European Borders and Seas Through the Intelligent Use of Surveillance) was selected as a demonstration project in the FP7 Security call FP7-SEC-2010-1. Its goals were to define and demonstrate a European concept for maritime surveillance systems and to deploy it across the Mediterranean and Atlantic Ocean. The systems were set to operate in a real-life environment by exercising a comprehensive set of maritime surveillance cross-border scenarios between 2013 and 2015. During its 4.5 years, it involved 32 partners from 12 countries with a budget of 42M€. PERSEUS is set in the EUROSUR policy context. EUROSUR is the information exchange framework designed to improve the management of Europe's external borders. It aims to support member states by increasing their situational awareness and reaction capability in combating cross-border crime, tackling irregular migration, and preventing loss of migrant lives at sea. However, it also is in the reality of the existing national and regional systems operated by each member state to monitor its own maritime space. The PERSEUS project delivered successful results in three different domains. Some of them are a validated solution enabling shared surveillance of maritime borders (operational); an architecture, domain, target vision, and processes contributing to EUROSUR (integration); and recommendations and lessons learned toward evolving collaborative maritime surveillance policies (best practices). The line followed by PERSEUS using autonomous maritime surveillance systems such as the Wave Glider (http://www.liquidr.com) opens new research lines for future collaboration opportunities.

Composite coatings of niobium nitride containing bismuth inclusions were deposited using a dual magnetron sputtering system with independent power suppliers for each targets; Bi and Nb. The deposition was performed under and Ar/N2 atmosphere at a 2.3 flow rate ratio, which allows the stoichiometric NbN phase to be obtained. The aim of this work was to evaluate the effect of increasing concentrations of Bi, proposed as a lubricous second phase, in the structural, mechanical and tribological properties of niobium nitride (NbN) coatings, searching for a reduction in the coefficient of friction but trying to keep hardness values larger than the tool steels (>10 GPa). The power applied to the Nb target was fixed, while the power on the Bi target was increased; obtaining Bi atomic percentage values of 1.7, 4.9 and 8.4 at%. The Bi inclusions showed different sizes and distribution in the volume and surface of the coatings. The results indicated a reduction in the hardness from 30 GPa of the NbN coating to 13.9 GPa for the highest Bi concentration. However, a more significant reduction was observed for the coefficient of friction (CoF) from 0.8 of the NbN to 0.3 for Bi concentrations between 4.9 and 8.4 at%.

The Macaronesia is a vast area playing a key role in the East boundary of the Central North-Atlantic Ocean-circulation system. Despite a significant research activity in ocean monitoring for decades using a wide range of observing systems and methodologies, the area is still under-sampled, mainly due access and coverage constrains, as well as the observation sustainability. Ocean gliders offer a new approach in terms of capacity and sustainability, allowing undertake ocean-monitoring in spatiotemporal scales hitherto unavailable. The present work shows preliminary results from the latest mission with buoyancy-driven and surface ocean gliders in the area, whose main goal focuses on to improve and expand ocean observation capabilities strengthening glider endurance lines between archipelagos, as part of the global ocean-observation strategy conducted by the Marine & Maritime Network (R3M), as contributing party aligned with the European and international efforts in the North Atlantic basin.

The supercapacitors currently existing on the market are produced from activated and pyrolyzed wood, plants and from oil and phenolic resins (aerogels and cryogels)1. New ways to store energy are being explored, as example, carbon nanostructures due to their high surface area can convert capacitors (low storage capacity with quick charge/discharge) to supercapacitors which combine the advantages of capacitors and batteries (high storage capacity with quick charge/discharge)2, 3.

The development of reliable alternatives to conventional hospitalization in patients with cancer would have great clinical and economical value. The aim of the present study was to assess the feasibility of a home-based nursing intervention model as a safe alternative for the management of acute medical complications in cancer patients who would otherwise require conventional hospitalization. From October 2013 to October 2014, we prospectively evaluated the outcomes of consecutive acute medical episodes treated at home under the home-based intervention program named the Bridge Project (BP). Episodes were classified as “avoided hospitalization in outpatients” (AHO) vs. “reduced hospitalization in inpatients” (RHI). The primary end-point was to assess the rate and causes of BP intervention failure (unplanned hospital readmission or death). Two hundred and forty-six consecutive episodes (52 % AHO and 48 % RHI) involving 203 patients (55 % male; mean age 63 years) were enrolled. The main conditions managed at home were non-neutropenic infections (40 %), febrile neutropenia (20 %), and cancer-related complications (28 %). The median duration of the BP intervention was 5 days (range 1–16 days). No deaths were reported at home. Unplanned hospital readmissions occurred in 9 % of episodes (14 % in AHO vs. 4 % in RHI; p = 0.001). Five of the 22 readmitted patients (22.7 % of the BP failures; 2.5 % of the whole series) died during hospitalization. The BP intervention burden was 1353 days, representing a potential saving of 14 % of days of hospitalization during the study period. The BP is a safe intervention which can potentially avoid or reduce the length of hospitalization in selected cancer patients with acute medical complications. Our findings support further development of innovative home-based clinical approaches to promote potentially avoidable hospitalization in this setting.

NiMo/Al2O3 catalysts, obtained by one-pot simultaneous impregnation, were modified by saccharose (SA, at Ni/SA = 1 mol ratio) addition. To address the influence of stage of saccharide impregnation on the hydrodesulphurization activity of sulphided catalysts, three different preparation methodologies were followed: (a) modification of already calcined (400 °C) NiMo/Al2O3 by SA impregnation; (b) SA deposition directly onto the alumina support, prior to Ni + Mo impregnation; (c) simultaneous Ni + Mo + SA deposition. Materials were characterized by N2 physisorption, X-ray diffraction, infrared (IR) spectroscopy, UV-vis spectroscopy, and temperature-programmed reduction (TPR), and tested on liquid-phase dibenzothiophene (DBT) conversion (batch reactor, T = 320 °C, P = 7.2 MPa, n-hexadecane as solvent). The last methodology resulted in the catalyst with the highest DBT hydrodesulphurization (HDS) activity, on a pseudo-first order kinetic constant basis. A decreased proportion of tetrahedral Mo6+ species due to diminished interaction with the carrier, increased reducibility of octahedral Mo6+, and Ni complexation as well seemed to play determining roles in the trends of the activity observed. Simultaneous saccharose addition during NiMo phase impregnation required no additional preparation steps to efficiently integrate the organic modifier.

Compensation effects were found in isopropanol dehydration over alumina (A), titania (T) and corresponding mixed oxides (Al/Ti = 2 and 25 mol ratio, AT2 and AT25, respectively) synthesized by low-temperature sol–gel. Prepared materials (calcined in the 573–1173 K) range were characterized by several techniques (N2 physisorption, XRD, thermal analysis and SEM). In general, Al2O3 had the highest reaction rate (at 473 K) in propylene formation meanwhile both mixed oxides had much lower activity. TiO2 had minimal dehydrating activity that, nevertheless, was the highest intrinsic one (in areal basis). Constable plots were obtained for materials annealed at various temperatures, but for titania series. A clear isokinetic temperature (Tθ) was observed for alumina series whereas for AT25 materials, a Tθ pole was registered but for the sample calcined at the most severe condition. Meanwhile, two Tθ poles were identified for AT2 solids, the first one corresponding to materials calcined at moderate temperature whereas the other set apart solids annealed under severe conditions. As expected, no isokinetic temperature was observed in Arrhenius plots corresponding to alcohol dehydration over TiO2 materials.

Contains fulltext : 177598.pdf (Publisher’s version ) (Closed access) OBJECTIVES: Excessive fluid therapy in patients with sepsis may be associated with risks that outweigh any benefit. We investigated the possible influence of early fluid balance on outcome in a large international database of ICU patients with sepsis. DESIGN: Observational cohort study. SETTING: Seven hundred and thirty ICUs in 84 countries. PATIENTS: All adult patients admitted between May 8 and May 18, 2012, except admissions for routine postoperative surveillance. For this analysis, we included only the 1,808 patients with an admission diagnosis of sepsis. Patients were stratified according to quartiles of cumulative fluid balance 24 hours and 3 days after ICU admission. MEASUREMENTS AND MAIN RESULTS: ICU and hospital mortality rates were 27.6% and 37.3%, respectively. The cumulative fluid balance increased from 1,217 mL (-90 to 2,783 mL) in the first 24 hours after ICU admission to 1,794 mL (-951 to 5,108 mL) on day 3 and decreased thereafter. The cumulative fluid intake was similar in survivors and nonsurvivors, but fluid balance was less positive in survivors because of higher fluid output in these patients. Fluid balances became negative after the third ICU day in survivors but remained positive in nonsurvivors. After adjustment for possible confounders in multivariable analysis, the 24-hour cumulative fluid balance was not associated with an increased hazard of 28-day in-hospital death. However, there was a stepwise increase in the hazard of death with higher quartiles of 3-day cumulative fluid balance in the whole population and after stratification according to the presence of septic shock. CONCLUSIONS: In this large cohort of patients with sepsis, higher cumulative fluid balance at day 3 but not in the first 24 hours after ICU admission was independently associated with an increase in the hazard of death.