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ObjectivesTo evaluate the impact of aspirin resistance on the incidence of preeclampsia and maternal serum biomarker levels in pregnant individuals at high-risk of preeclampsia receiving low dose aspirin (LDA).Study designWe performed a secondary analysis of a randomized, placebo-controlled trial of LDA (60 mg daily) for preeclampsia prevention in high-risk individuals (N = 524) on pregnancy outcomes and concentrations of PLGF, IL-2, IL-6, thromboxane B2 (TXB2), sTNF-R1 and sTNF-R2 from maternal serum.Main outcome measuresLDA-resistant individuals were defined as those having a TXB2 concentration >10 ng/ml or

El labio y el paladar hendido son las malformaciones congénitas craneales más comunes. Ocurren en aproximadamente 1,7 de cada 1000 nacidos vivos. A pesar de que es probable que exista un subregistro, se estima que en Colombia la prevalencia de esta condición corresponde a 3,27 de cada 10.000 habitantes. La atención integral para estas malformaciones requiere múltiples intervenciones por un equipo multidisciplinario especializado desde el embarazo hasta la edad adulta. Idealmente, estos servicios deben estar organizados alrededor de las necesidades del paciente, prestándose por medio de un equipo interdisciplinario de expertos, ubicados en un solo lugar y que se comuniquen directamente entre sí para tomar decisiones de manera conjunta.

Summary: Background: Surgical care holds significant importance in healthcare, especially in low and middle-income countries, as at least 50% of the 4.2 million deaths within the initial 30 days following surgery take place in these countries. The Lancet Commission on Global Surgery proposed six indicators to enhance surgical care. In Colombia, studies have been made using secondary data. However, strategies to reduce perioperative mortality have not been implemented. This study aims to describe the fourth indicator, perioperative mortality rate (POMR), with primary data in Colombia. Methods: A multicentre prospective cohort study was conducted across 54 centres (hospitals) in Colombia. Each centre selected a 7-day recruitment period between 05/2022 and 01/2023. Inclusion criteria involved patients over 18 years of age undergoing surgical procedures in operating rooms. Data quality was ensured through a verification guideline and statistical analysis using mixed-effects multilevel modelling with a case mix analysis of mortality by procedure-related, patient-related, and hospital-related conditions. Findings: 3807 patients were included with a median age of 48 (IQR 32–64), 80.3% were classified as ASA I or II, and 27% of the procedures had a low-surgical complexity. Leading procedures were Orthopedics (19.2%) and Gynaecology/Obstetrics (17.7%). According to the Clavien–Dindo scale, postoperative complications were distributed in major complications (11.7%, 10.68–12.76) and any complication (31.6%, 30.09–33.07). POMR stood at 1.9% (1.48–2.37), with elective and emergency surgery mortalities at 0.7% (0.40–1.23) and 3% (2.3–3.89) respectively. Interpretation: The POMR was higher than the ratio reported in previous national studies, even when patients had a low–risk profile and low-complexity procedures. The present research represents significant public health progress with valuable insights for national decision-makers to improve the quality of surgical care. Funding: This work was supported by Universidad del Rosario and Fundación Cardioinfantil-Instituto de Cardiología grant number CTO-057-2021, project-ID IV-FGV017.

PurposeThe diagnosis of endometriosis often takes several years, delaying appropriate care while patients suffer from pelvic pain, dysmenorrhea, and dyspareunia. Understanding whether residents in obstetrics and gynecology (OB/GYN) are being adequately exposed to and trained in the diagnosis and management of the disease is important for improving care.MethodsWe conducted an online cross-sectional survey of OB/GYN residents to investigate their comfort level and familiarity with endometriosis diagnosis and management. Residency program directors and coordinators of 20 OB/GYN residency programs in California, USA were emailed to disseminate the 31-question, anonymous survey in January to February 2023. Responses were collected using Redcap and analysis was conducted using STATA.Results67 residents answered at least one non-demographic question and were included. A resident response rate was not calculated because we were unable to determine how many programs distributed the survey. 84% of residents felt they could recognise symptoms of endometriosis but over 30% of senior residents were not comfortable with sonographic diagnosis of endometrioma. Approximately one third of residents felt comfortable managing hypoestrogenic symptoms, osteoporotic risks, and add-back progestin for certain hormonal therapies. Academic-hospital based residents had significantly more exposure to attendings prescribing long-acting reversible contraception, GnRH antagonists, and GnRH agonists but there were no significant differences in trainee prescribing practices or comfort. More respondents would feel comfortable medically managing endometriosis (52%) than surgically managing the disease (26%) if they were in practice today, with only 39% of PGY3-4 residents feeling comfortable surgically managing endometriosis.ConclusionThere is considerable room for improvement in the education of residents in the diagnosis and medical and surgical management of endometriosis.

Abstract Although the characterization of the sticking and aggregation probability is essential to the description of volcanic ash dispersal and sedimentation, there is still no general model describing the sticking probability of volcanic ash. Experiments of dry particle–plate collisions in an enclosed box were carried out to characterize quantitatively the sticking efficiency of volcanic particles and silica beads in a limit case scenario where the mass of one of the particles is much greater than the others. Silica beads and volcanic particles from a Sakurajima Vulcanian eruption were filmed impacting a glass plate with a High-Speed Camera. The sticking probability is calculated from an equation depending on the particle diameter, impact velocity, and two experimental parameters (a, q). Particle size was found to dominantly control the sticking probability, with small particles more likely sticking on the glass plate than large particles. These experiments represent a significant step forward in the quantification of the sticking efficiency of fine volcanic ash (

Introduction and Objectives: Chronic alcohol consumption is the main cause of alcohol-related liver disease (ARLD) ranging a spectrum characterized by inflammation and progressive fibrosis. Currently, abstinence is the main treatment for ARLD; for this reason, it becomes indispensable to evaluate therapeutic alternatives as methyl group donors which have the potential to influence the development and progression of the disease. To evaluate the effect of chronic alcohol consumption coupled with methyl-group donor supplementation on metabolic and histologic features and gene expression of proinflammatory cytokines in a murine model of ARLD. Materials and Patients: : 24 male C57BLC/6J mice divided into groups with conventional diet (ND n=8); alcohol-induced liver-injury induced with ad libitum consumption of a 20% ethanol-aqueous drink and a 45%-fat diet (OH n=8) for 18 weeks; or latter diet for 10 weeks, plus 8 weeks of this diet and methyl group (OH +METMIX n=8). This protocol is in the process of being approved by the CUCS Ethics, Research and Biosafety Committees. Results: Serum biochemical studies and histological analysis performed in the methyl-donor supplemented group (OH+ METMIX) -zinc sulfate, methionine, vitamin B12, folic acid, betaine and choline- showed a significant decrease in body weight, epididymal and visceral fat (p

The stemborers of the genus Diatraea are the pest with the greatest impact on sugarcane production systems in Colombia. To understand the calling behavior of virgin females of Diatraea saccharalis (Fabricius, 1794) (Lepidoptera: Crambidae), two preliminary tests were established during twenty-four continuous hours in the laboratory. These were set up using females of one and two days old respectively under controlled conditions of temperature and relative humidity (25 °C - 50%) and photoperiod 12h (L): 12h (D). The variables evaluated were onset hours, call duration, and sexual gland exposure number. With previous test results, we determined the slot time when females call and thus, we were able to establish a new trial to evaluate the same variables in females one, two, and three days old (n=30), with inverted photoperiod. The calling behavior was evidenced from the fifth to the eleventh hour of scotophase. Calling duration varied between 30 and 210 min, with the percentage of females calling during 30 min being higher. 37% of the one day old females called only once. These basic studies allow the understanding of sexual behavior of this, which leads to creating tools that can be included on D. saccharalis integrated pest management.

Introducción: La enseñanza en enfermería debe transitar desde una perspectiva tradicionalista, centrada en el docente, a un enfoque que esté centrado al estudiante. Esto último promueve el aprendizaje autónomo, donde el docente actúa como mediador, no como fuente de conocimiento. Objetivo: Identificar la necesidad de usar guías y videos de simulación clínica para el aprendizaje autónomo de estudiantes de enfermería de la Universidad de Cundinamarca. Materiales y Métodos: Investigación bajo el paradigma positivista, de diseño descriptivo, con enfoque cuantitativo, de corte transversal, durante el primer trimestre de 2020. Población 376. Se realizó un muestreo intencional no probabilístico, conformado por 95 estudiantes de enfermería. Los datos se obtuvieron mediante una encuesta autoadministrada y anónima. Se realizó una evaluación descriptiva de los datos. Resultados: El 75 % de los estudiantes demostró un nivel alto de necesidad de usar guías y videos para su aprendizaje autónomo, consideran un mayor grado de seguridad y claridad al realizar procedimientos en las prácticas simuladas, 62 % aseguró que es una herramienta pertinente para el aprendizaje de enfermería. Conclusiones: Se demostró alta necesidad de guías y videos de simulación clínica para el aprendizaje autónomo en estudiantes de enfermería. Estos recursos fomentan la motivación, seguridad y habilidades para el cuidado, reduciendo riesgos en prácticas clínicas. La actualización periódica es crucial para garantizar su utilidad e innovación.

El género Diatraea Guilding, es considerado el de mayor importancia económica en los sistemas productivos de caña de azúcar en Colombia. Debido al desconocimiento del comportamiento sexual, a la amplia distribución de Diatraea saccharalis (Fabricius, 1974) y a la variación geográfica de la composición de su feromona sexual, el objetivo de este trabajo fue comprender el comportamiento sexual de esta especie, evaluando el comportamiento de cópula de adultos vírgenes de uno y dos días de edad en laboratorio. Adicionalmente se construyó un etograma para entender el comportamiento sexual de adultos vírgenes de un día de edad. Los estudios fueron realizados bajo condiciones controladas de temperatura y humedad relativa (25 ± 2 °C, y 60 ± 10% de H.R.) y fotoperiodo 12h:12h. El inicio de la cópula se observó desde la sexta hora de escotofase y se mantuvo hasta la décima hora, con una duración entre 30 y 120 minutos. Las parejas evaluadas copularon solamente una vez y no se observó nueva exposición de la glándula por parte de hembras ya copuladas. El acto principal que da inicio al proceso de cópula es el llamado de la hembra, después del cual se desencadenan comportamientos de activación, vuelo, acercamiento, contacto y cópula con una probabilidad de este último de 1.0.

Abstract Introduction: Pseudohypoparathyroidism (PHP) is a heterogeneous group of rare endocrine disorders characterized by resistance to the parathyroid hormone. There are few reports on PHP in Colombia, so the publication of the present case contributes to increase the interest in its research in the clinical setting. Case presentation: An 18-year-old male with a history of hypothyroidism diagnosed at 4 months of age, stunted growth, delayed puberty, obesity, brachydactyly, pathologic fractures, femoral osteochondroma, insomnia, paresthesia, and chronic constipation was referred to the endocrinology service of a tertiary care center in Bogotá (Colombia) after being hospitalized following a seizure episode. On admission, laboratory tests revealed hypocalcemia, hyperphosphatemia, 25-hydroxy vitamin D in the range of insufficiency and elevated PTH. Imaging studies showed heterotopic ossifications and calcifications of the basal ganglia. A genetic study confirmed the diagnosis of PHP1A, so treatment was started with calcium, cholecalciferol and phosphorus chelators, leading to a satisfactory course. Both the patient and his first-degree relatives received genetic counseling and interdisciplinary assessment. Conclusion: Although PHP type 1A is an unrecognized complex genetic disorder, it has a critical clinical importance within the differential diagnoses of hypocalcemia. Without prompt diagnosis and treatment, patients may experience serious and potentially fatal metabolic consequences.

La clarificación de las conductas que implican la comisión de un crimen internacional continúa plenamente abierta al debate. En particular, los matrimonios forzados están dando lugar a una acalorada discusión académica y práctica por si deben ser catalogados como crimen de lesa humanidad. Y si quedarían englobados en unos u otros enunciados que definen este delito (esclavitud sexual u otros actos inhumanos). Esta cuestión se debe analizar con base en dos criterios: Primero, lo que recoge la práctica normativa internacional, mediante la apropiada interpretación de las normas adoptadas y los presupuestos básicos que configuraron su elaboración. Segundo, lo que deriva de los criterios jurisprudenciales en materia de matrimonios forzados aplicados por una gran variedad de tribunales penales internacionales. El análisis exige apresar la perspectiva concerniente a los delitos de violencia y esclavitud sexual; y todo desde el enfoque del sector de la protección internacional de los derechos humanos. En síntesis, el propósito del trabajo es precisar si los matrimonios forzados están ganando autonomía conceptual y normativa en el orden internacional.

Se expone un estudio en dos escuelas rurales de Uruguay cuyo objetivo fue identificar modos de presentación de los conocimientos cotidianos en el aula y describir prácticas de enseñanzas que los consideren y los relacionen con los escolares desde el marco interpretativo del constructivismo y la psicología cultural. Se seleccionaron dos escuelas unidocentes cercanas entre sí y con características similares en relación a entorno geográfico y características socioproductivas de las familias, pero con la diferencia de que en una de ellas se presentaba un proyecto de centro vinculado a las actividades productivas rurales. La metodología de investigación fue cualitativa por medio del método etnográfico, utilizando como técnicas de recolección de la información las observaciones y las entrevistas tanto a niños como a maestras. Se construyeron las siguientes categorías de análisis: características y condiciones de aparición y presentación de los conocimientos cotidianos; prácticas de enseñanza que toman en consideración los conocimientos cotidianos y las relaciones entre conocimientos cotidianos y escolares establecidas en el aula. Los resultados destacan que los conocimientos cotidianos se encuentran presentes de diferentes modos, ya sea por presentación espontánea de los niños o por prácticas de enseñanza docentes que fomentan relaciones con diferentes niveles de complejidad. Ello permite concluir que, a pesar de las diferencias en las actividades de enseñanza, ambas escuelas funcionan como comunidades de práctica donde se negocian significados.

Traffic lights are critical in regulating traffic flow and modulate the level of service and road user safety. As suggested by studies conducted with pedestrians, traffic light spacing and signal congruency could also impact a driver's decision-making process. However, requirements related to designing signalized intersections do not always consider the spacing between two consecutive traffic lights or the congruency of the information displayed. Here, using a classic traffic psychology paradigm, we developed a hybrid Go/No-go Flanker PC-based task to explore how traffic light spacing and signal congruency modulate drivers’ decisions in urban intersections. Real images of road intersections were edited to reproduce two specific conditions between traffic lights. Specifically, we manipulated both spacing (short vs. long) and congruency (congruent [e.g., red-red/green-green steady light] vs. incongruent [e.g., red-green/green-red steady light]). We found that incongruent information, displayed on short spacing traffic signals, delayed drivers’ responses without being detrimental to their decision-making processes. The results of this exploratory study could offer guidance to transportation engineers to simplify traffic light information readability and increase drivers’ awareness of traffic conditions and road safety.

We undertook multi-proxy analyses on two sediment cores from Lago Pato, a small lake basin at 51°S topographically separated from Lago del Toro in Torres del Paine (TdP), to provide insights into glacier dynamics and lake-level change in the TdP and Última Esperanza region over the last ∼30,000 cal a BP (30 ka). Lago Pato is situated in a region overridden by the Southern Patagonian Ice Field during the Last Glacial and in a transitional climatic zone of Southern Patagonia sensitive to seasonal- to millennial-scale changes in the Southern Hemisphere Westerly Winds (SWW). Results show that a deep ice-dammed and enlarged palaeolake encompassed Lago del Toro and Lago Pato c. 30–20 ka after the ice had retreated from local-Last Glacial Maximum (l-LGM) limits at c. 48–34 ka and during the build-up to the global-Last Glacial Maximum (g-LGM), c. 26–19 ka. Gaps in both sediment records between c. 20–13.4 ka and c. 20–10 ka suggest hiatuses in sediment accumulation during the g-LGM and Antarctic Cold Reversal (ACR) readvances and/or removal by lake lowering or flushing during the Late Glacial–early Holocene. The palaeolake level dropped from >100 m a.s.l. to ∼40–50 m a.s.l. towards the end of the ACR c. 13.4–13.0 ka, creating a shallower glaciolacustrine environment dammed by an ice tongue in the Estancia Puerto Consuelo–Última Esperanza fjord. Further lowering of the enlarged palaeolake level occurred when the ice thinned to

ObjectiveTo ascertain the role of inflammation in the response to ocrelizumab in primary-progressive multiple sclerosis (PPMS).MethodsMulticenter prospective study including 69 patients with PPMS who initiated ocrelizumab treatment, classified according to baseline presence [Gd+, n=16] or absence [Gd-, n=53] of gadolinium-enhancing lesions in brain MRI. Ten Gd+ (62.5%) and 41 Gd- patients (77.4%) showed non-evidence of disease activity (NEDA) defined as no disability progression or new MRI lesions after 1 year of treatment. Blood immune cell subsets were characterized by flow cytometry, serum immunoglobulins by nephelometry, and serum neurofilament light-chains (sNfL) by SIMOA. Statistical analyses were corrected with the Bonferroni formula.ResultsMore than 60% of patients reached NEDA after a year of treatment, regardless of their baseline characteristics. In Gd+ patients, it associated with a low repopulation rate of inflammatory B cells accompanied by a reduction of sNfL values 6 months after their first ocrelizumab dose. Patients in Gd- group also had low B cell numbers and sNfL values 6 months after initiating treatment, independent of their treatment response. In these patients, NEDA status was associated with a tolerogenic remodeling of the T and innate immune cell compartments, and with a clear increase of serum IgA levels.ConclusionBaseline inflammation influences which immunological pathways predominate in patients with PPMS. Inflammatory B cells played a pivotal role in the Gd+ group and inflammatory T and innate immune cells in Gd- patients. B cell depletion can modulate both mechanisms.

Abstract Background Ureaplasma urealyticum is a fastidious bacteria which lacks a cell wall. Extragenital infections are rare in immunocompetent adults. There are few literature reports of perinephric abscess. We present a case of non-resolving multifocal “culture-negative” abscesses in a hypogammaglobulinemic adult female due to U. urealyticum. Case presentation 66-year-old female with a one-week history of fever, malaise and new right hip and leg pain. Past medical history was notable for chronic pancytopenia secondary to in remission B cell follicular lymphoma, ESRD on intermittent hemodialysis with bilateral nephrostomy tubes and Crohn’s. CT abdomen/pelvis revealed a small left perinephric hematoma and proximal right femur fluid collection. Persistent right thigh pain led to additional ultrasound with anterior thigh collection and CT revealed an irregular rim-enhancing fluid collection in the left posterior pararenal space. Antimicrobial therapy included ertapenem and vancomycin followed by meropenem, trimethoprim-sulfamethoxazole, daptomycin and metronidazole in setting of persistent culture-negative results and clinical deterioration. Following detection of U. urealyticum by 16S rDNA PCR in both left pararenal and right trochanteric bursa abscesses doxycycline was started. Despite this, the patient died four days later. Conclusions Disseminated infection by U. urealyticum has been documented in immunocompromised adult patients with few reports of perinephric abscess. We propose that ascending genitourinary route led to perinephric abscess. The multiple disseminated fluid collections make it highly suspicious for hematogenous spread given the lack of radiographic enhancement to suggest contiguous spread. Diagnosis and treatment of U. urealyticum-disseminated infection is extremely challenging as culture is laborious and not routinely performed. Furthermore, the lack of cell wall renders beta-lactams and vancomycin ineffective and therefore requirement for “atypical” coverage. Early diagnosis and treatment are key to prevent further complications and death.

Se realizó el análisis palinológico de las flores presentes en el cultivo de café en Pasuncha (Cundinamarca), se recolectaron las flores presentes en este hábitat para extraer su polen, identificarlo y compararlo con el pan de abejas recolectado en las colmenas de abejas Apis mellifera. Se evidenció que Apis visita las plantas Cuphea racemosa en un 60.1%, Bidens pilosa en un 8.9%, Coffea arabica en un 4.4%, Critonia morifolia en un 3.8%, Gouania polígama en un 3.4%, Hedyosmum racemosum en un 2.4% y otras en un 17%. Se recolectaron e identificaron cinco especies que visitaron las flores de café durante la primera floración de 2016, de estas fueron identificadas: Apis mellifera, Paratrigonaeutaeniata y TrigonaAmalthea; Apis tiene su mayor actividad de colecta de polen de café entre las 8 a. m. y las 12 p. m.

Abstract Here we present the physiological features of Pseudomonas extremaustralis strain USBA-GBX-515 (CMPUJU 515), isolated from soils in Superparamo ecosystems, > 4000 m.a.s.l, in the northern Andes of South America, as well as the thorough analysis of the draft genome. Strain USBA-GBX-515 is a Gram-negative rod shaped bacterium of 1.0–3.0 μm × 0.5–1 μm, motile and unable to form spores, it grows aerobically and cells show one single flagellum. Several genetic indices, the phylogenetic analysis of the 16S rRNA gene sequence and the phenotypic characterization confirmed that USBA-GBX-515 is a member of Pseudomonas genus and, the similarity of the 16S rDNA sequence was 100% with P. extremaustralis strain CT14–3T. The draft genome of P. extremaustralis strain USBA-GBX-515 consisted of 6,143,638 Mb with a G + C content of 60.9 mol%. A total of 5665 genes were predicted and of those, 5544 were protein coding genes and 121 were RNA genes. The distribution of genes into COG functional categories showed that most genes were classified in the category of amino acid transport and metabolism (10.5%) followed by transcription (8.4%) and signal transduction mechanisms (7.3%). We performed experimental analyses of the lipolytic activity and results showed activity mainly on short chain fatty acids. The genome analysis demonstrated the existence of two genes, lip515A and est515A, related to a triacylglycerol lipase and carboxylesterase, respectively. Ammonification genes were also observed, mainly nitrate reductase genes. Genes related with synthesis of poly-hydroxyalkanoates (PHAs), especially poly-hydroxybutyrates (PHBs), were detected. The phaABC and phbABC operons also appeared complete in the genome. P. extremaustralis strain USBA-GBX-515 conserves the same gene organization of the type strain CT14–3T. We also thoroughly analyzed the potential for production of secondary metabolites finding close to 400 genes in 32 biosynthetic gene clusters involved in their production.

We aimed to evaluate the effects of mental workload variations, as a function of the road environment, on the brain activity of army drivers performing combat and non-combat scenarios in a light multirole vehicle dynamic simulator. Forty-one non-commissioned officers completed three standardized driving exercises with different terrain complexities (low, medium, and high) while we recorded their electroencephalographic (EEG) activity. We focused on variations in the theta EEG power spectrum, a well-known index of mental workload. We also assessed performance and subjective ratings of task load. The theta EEG power spectrum in the frontal, temporal, and occipital areas were higher during the most complex scenarios. Performance (number of engine stops) and subjective data supported these findings. Our findings strengthen previous results found in civilians on the relationship between driver mental workload and the theta EEG power spectrum. This suggests that EEG activity can give relevant insight into mental workload variations in an objective, unbiased fashion, even during real training and/or operations. The continuous monitoring of the warfighter not only allows instantaneous detection of over/underload but also might provide online feedback to the system (either automated equipment or the crew) to take countermeasures and prevent fatal errors.

The functional validity of the signal obtained with low-cost electroencephalography (EEG) devices is still under debate. Here, we have conducted an in-depth comparison of the EEG-recordings obtained with a medical-grade golden-cup electrodes ambulatory device, the SOMNOwatch + EEG-6, vs those obtained with a consumer-grade, single dry electrode low-cost device, the NeuroSky MindWave, one of the most affordable devices currently available. We recorded EEG signals at Fp1 using the two different devices simultaneously on 21 participants who underwent two experimental phases: a 12-minute resting state task (alternating two cycles of closed/open eyes periods), followed by 60-minute virtual-driving task. We evaluated the EEG recording quality by comparing the similarity between the temporal data series, their spectra, their signal-to-noise ratio, the reliability of EEG measurements (comparing the closed eyes periods), as well as their blink detection rate. We found substantial agreement between signals: whereas, qualitatively, the NeuroSky MindWave presented higher levels of noise and a biphasic shape of blinks, the similarity metric indicated that signals from both recording devices were significantly correlated. While the NeuroSky MindWave was less reliable, both devices had a similar blink detection rate. Overall, the NeuroSky MindWave is noise-limited, but provides stable recordings even through long periods of time. Furthermore, its data would be of adequate quality compared to that of conventional wet electrode EEG devices, except for a potential calibration error and spectral differences at low frequencies.