Search

Abstract Background The ventilatory physiopathology of patients with interstitial lung disease (ILD) remains poorly understood. We aimed to personalize a mechanical simulator to model healthy and ILD profiles ventilation, and to evaluate the effect of spontaneous breathing on respiratory mechanics at rest and during exercise. Methods In a 2-compartment lung simulator (ASL 5000®), we modeled 1 healthy and 3 ILD profiles, at rest and during exercise, based on physiological data from literature and patients. Measurements were: tidal volume, end-expiratory lung volume, driving pressure, transpulmonary driving pressure, dynamic alveolar strain, mechanical power, and time lag of inspiratory flow between compartments 1 and 2. Results Healthy and ILD models were validated: maximum differences between real and simulated tidal volume were 5% (96 ml) and 6% (54 ml) at rest and during exercise respectively, considered clinically negligible. When we simulated lung inhomogeneity (compliance in compartment 1 > compartment 2), tidal volume, end-expiratory lung volume, driving pressure and mechanical power increased in compartment 1 and decreased in compartment 2. Driving transpulmonary pressure and dynamic alveolar strain increased in compartment 2 and decreased in compartment 1. Time lag of inspiratory flow between compartments 1 and 2 was positively correlated with a difference of compliance between compartments (r = 0.98, CI95% (0.9106; 0.9962), p

Phylogenetic analyses showed that the virus responsible for a May 2024 Oropouche fever outbreak in Cuba was closely related to viruses from Brazil in 2023. Pools of Ceratopogonidae spp. biting midges and Culex quinquefasciatus mosquitoes were positive for Oropouche viral RNA. No cases were severe. Virus extension to new areas may increase case numbers and severity.

Abstract Background Chest physiotherapy for airway clearance is not recommended in children hospitalized with bronchiolitis. The updated Cochrane meta-analysis suggests that slow expiratory techniques could slightly improve clinical severity, but the evidence certainty is low and the clinical significance of this change is unknown. We investigated whether the prolonged slow expiration technique (PSET) would impact the 24-h food intake of these children. Methods We conducted a two-arm double-blind randomized controlled trial. Hospitalized children aged from 1 to 12 months, bottle-fed or diversified and referred for airway clearance were included. Both groups received upper airway clearance at inclusion and standard treatments. The experimental group received PSET including rhinopharyngeal unclogging and targeted unprovoked cough. The primary outcome was the 24-h food intake. Clinical severity, vomit episodes and sleep quality were also recorded. An ordinary least squares linear regression for quantitative variables was modelled for between-group comparisons. Results From January 9, 2019, to December 1, 2022, 42 children were randomized with a 1:1 ratio (mean age: 5.0 (± 2.9) months). The 24-h food intake did not differ between groups (estimate: 1.8% (95%CI -7.0 to 10.6); p = 0.68). PSET had no effect on SpO2, clinical severity, RR and HR at the follow-up assessments (5 min, 30 min and 24 h after intervention), nor on the number of vomit episodes, total sleep time and SpO2 during sleep. Conclusions PSET did not affect food intake or the 24-h course of bronchiolitis more than standard treatment in children hospitalized for moderate bronchiolitis. Trial registration NCT03738501 registered on 13/11/2018, Slow Expiratory Technique to Improve Alimentation in Children With Bronchiolitis (BRONCHIOL-EAT); https://classic.clinicaltrials.gov/ct2/show/NCT03738501.

Objective: There are many potential barriers to an individual's readiness and ability to use telehealth, including technology access, trust and knowledge. This qualitative study was a partnership between Jefferson and Esperanza Health Center (EHC), focused on addressing barriers to digital readiness among the Latino population served by EHC. Methods: We conducted semi-structured interviews with Latino patients to assess their experiences with technology and willingness to learn more about technology for healthcare. Interviews were transcribed, coded, and analyzed using a content analysis approach. Results: We completed 28 interviews. Most interviews (n = 23, 82 %) were conducted in Spanish. Barriers to using health technology included forgetting passwords, platforms not being available in multiple languages, and lacking digital skills. Conclusion: Participants identified a need and interest in receiving support to develop technological skills needed to access health information and engage in digital health services. Future work is needed to develop patient-centered interventions to support the digital health readiness needs of underserved populations. Innovation: Healthcare systems and community health organizations can partner to build the capacity of community members to identify barriers in digital health use. These partnerships have the potential to empower communities to create culturally sensitive interventions that aim to increase digital health literacy.

Revisión de Libros, negocios y educación: la empresa editorial de Rudolph Ackermann para Hispanoamérica en la primera mitad del siglo XIX de E. Roldán Vera

Charged particle velocity-space diffusion in a prescribed one-dimensional turbulent electric field is investigated through numerical trajectories in phase-space and compared against quasi-linear theory (QL), including resonance broadening (RB). A Gaussian spectrum electric field of variable amplitude E is studied in conjunction with two plasma dispersion relations, namely, the Langmuir and ion-acoustic dispersion. A first parameter scan shows that RB effects become significant for a Kubo number K of a few percent. A Kubo number scan shows that diffusion increases as a power law of D∝K3∝E3/2 for large Kubo numbers. Moreover, at large Kubo numbers, transport processes include significant diffusion measured at velocities much higher than the resonant region, where QL and RB predict negligible diffusion. For times much larger than the trapped particle flight time τb and the autocorrelation time τ0, the velocity distribution departs from a Gaussian. Nevertheless, measurements show that the variance increases linearly in time, with a Hurst parameter of H∼0.5, where the diffusion scales as K5/2∝E5/4 and K3/2∝E3/4 for small and large Kubo number, respectively.

Abstract This crossover study evaluated DNA methylation changes in human salivary samples following single sprint interval training sessions performed in hypoxia, with blood flow restriction (BFR), or with gravity‐induced BFR. Global DNA methylation levels were evaluated with an enzyme‐linked immunosorbent assay. Methylation‐sensitive restriction enzymes were used to determine the percentage methylation in a part of the promoter of the gene‐inducible nitric oxide synthase (p‐iNOS), as well as an enhancer (e‐iNOS). Global methylation increased after exercise (p 0.05). Conversely, the methylation of e‐iNOS increased from 0.6 ± 0.4% to 0.9 ± 0.8% after exercise (p = 0.025; dz = 0.41), independently of the condition (p > 0.05). Global methylation correlated with muscle oxygenation during exercise (r = 0.37, p = 0.042), while e‐iNOS methylation showed an opposite association (r = −0.60, p = 0.025). Furthermore, p‐iNOS methylation was linked to heart rate (r = 0.49, p = 0.028). Hence, a single sprint interval training increases global methylation in saliva, and adding BFR tends to increase it further. Lower muscle oxygenation is associated with augmented e‐iNOS methylation. Finally, increased cardiovascular strain results in increased p‐iNOS methylation.

Background: The aim of this study is to report the radiological glenoid modifications and clinical outcomes at 3 years mean follow-up of hemi shoulder arthroplasty (HA) with pyrocarbon (PYC) humeral head. Our hypothesis was that the PYC implants would provide good outcomes without major glenoid erosion. Additionally, we hypothesized that HA-PYC allowed for remodeling of the bone. Methods: Patients underwent HA with PyC humeral head for treatment of primary or secondary osteoarthritis, excluding post-traumatic cases. All patients had a Constant Score assessed preoperatively and at the last follow-up. Preoperative and postoperative computed tomography scans at the last follow-up were performed to achieve 3-dimensional reconstructions of the scapulae. Deformities of the glenoid surface were analyzed as a distance differential between postoperative and preoperative to investigate potential bone remodeling vs. glenoid erosion. The subluxation index (SLI) was measured. Results: We included 41 patients implanted with a HA-PYC. Average age at the time of implant was 63.8 (40 to 79 years). All patients were followed for ≥2 years with an average follow-up of 36.3 months (24 to 60 months). Constant Scores increased from 34 at baseline to 80 at the last follow-up points on average (P

Abstract Introduction Pruritus is a prevalent symptom, described as one of the most bothersome of psoriasis. Specific itch management remains a challenge, for which hydrotherapy could be used as adjunct care to medical treatment. Therefore, we assessed the immediate and longer-term benefit of 3 weeks of Avène thermal spring water hydrotherapy on chronic pruritus in patients in addition to their usual psoriasis and/or pruritus management. Methods Twenty-six patients suffering from chronic pruritus due to psoriasis were evaluated before and after 3 weeks of hydrotherapy with a 3 and 6 month follow-up. A control group (18 patients) did not undergo hydrotherapy and continued to follow their usual skin management. Pruritus was assessed according to the numeric rating scale (NRS, pruritus intensity), the visual dynamic pruritus score (vDPS, change in pruritus intensity), and the 5-D itch scale (pruritus characteristics). Psoriasis severity was measured using the psoriasis area and severity index (PASI) score. The “itchy quality of life” (ItchQoL) scale was used to assess quality-of-life (QoL) impact related to itch. Pruritus and psoriasis gene and protein biomarkers were measured in lesional and nonlesional skin. Results Pruritus measurements (NRS, vDPS, and 5-D itch scale) indicated an immediate and long-lasting positive effect of hydrotherapy compared with control patients. The psoriasis area and severity index (PASI) was decreased by 40.0% by hydrotherapy, which was sustained over 6 months. The ItchQoL also improved directly after hydrotherapy, which was still much improved even 6 months later. Analysis of gene and/or protein biomarkers revealed a significant decrease of inflammation biomarkers (IL-8, IL-1α, IL-1RA, and RANTES), of psoriasis biomarkers (PI3, S100A7, and IL-17), and of pruritus biomarkers (IL-31, TRPV1, and CGRP1). Conclusions These findings demonstrated an immediate and long-lasting improvement of pruritus in patients with psoriasis who underwent Avène thermal spring water hydrotherapy, indicating that this would be a good complementary therapy in the management of this disease. Trial Registration NCT03023254.

Discrete mathematics brings interesting problems for teaching and learning proof, with accessible objects such as integers (arithmetic), graphs (modeling, order) or polyominoes (geometry). Many problems that are still open can be explained to a large public. The objects can be manipulated by simple dynamic operations (removing, adding, 'gluing', contracting, splitting, decomposing, etc.). All these operations can be seen as tools for proving. In this paper we particularly explore the field of 'discrete optimization'. A theoretical background is defined by taking two main axes into account, namely, the epistemological analysis of discrete problems studied by contemporary researchers in discrete optimization and the design of adidactical situations for classrooms in the frame of the Theory of Didactical Situations. Two problems coming from ongoing research in discrete optimization (the Pentamino Exclusion and the Eight Queens problems) are developed and transposed for the classroom. They underscore the learning potentialities of discrete mathematics and epistemological obstacles concerning proving processes. They emphasize the understanding of a necessary condition and a sufficient condition and problematize the difference between optimal and optimum. They provide proofs involving partitioning strategies, greedy algorithms but also primal-dual methods leading to the concept of duality. The way such problems can be implemented in the classroom is described in a collaborative study by mathematicians and mathematics education researchers ("Maths à Modeler" Research Federation) through the Research Situations for the Classroom project.

Abstract Background Few specific methods are available to reduce the risk of diaphragmatic dysfunction for patients under mechanical ventilation. The number of studies involving transcutaneous electrical stimulation of the diaphragm (TEDS) is increasing but none report results for diaphragmatic measurements, and they lack power. We hypothesised that the use of TEDS would decrease diaphragmatic dysfunction and improve respiratory muscle strength in patients in ICU. Methods We conducted a controlled trial to assess the impact of daily active electrical stimulation versus sham stimulation on the prevention of diaphragm dysfunction during the weaning process from mechanical ventilation. The evaluation was based on ultrasound measurements of diaphragm thickening fraction during spontaneous breathing trials. We also measured maximal inspiratory muscle pressure (MIP), peak cough flow (PEF) and extubation failure. Results Sixty-six patients were included and randomised using a 1:1 ratio. The mean number of days of mechanical ventilation was 10 ± 6.8. Diaphragm thickening fraction was > 30% at the SBT for 67% of participants in the TEDS group and 54% of the Sham group (OR1.55, 95% CI 0.47–5.1; p = 0.47). MIP and PEF were similar in the TEDS and Sham groups (respectively 35.5 ± 11.9 vs 29.7 ± 11.7 cmH20; p = 0.469 and 83.2 ± 39.5 vs. 75.3 ± 34.08 L/min; p = 0.83). Rate of extubation failure was not different between groups. Conclusion TEDS did not prevent diaphragm dysfunction or improve inspiratory muscle strength in mechanically ventilated patients. Trial registration: Prospectively registered on the 20th November 2019 on ClinicalTrials.gov Identifier NCT04171024.

Pandemics in the last two centuries have been initiated by causal pathogens that include Severe Acute Coronavirus 2 (SARS-CoV-2) and Influenza (e.g., the H1N1 pandemic of 2009). The latter is considered to have initiated two prior pandemics in 1918 and 1977, known as the “Spanish Flu” and “Russian Flu”, respectively. Here, we discuss other emerging infections that could be potential public health threats. These include Henipaviruses, which are members of the family Paramyxoviridae that infect bats and other mammals. Paramyxoviridae also include Parainfluenza and Mumps viruses (Rubulavirus) but also Respiratory Syncytial virus (RSV) (Pneumovirus). Additionally included is the Measles virus, recorded for the first time in writing in 1657 (Morbillivirus). In humans and animals, these may cause encephalitis or respiratory diseases. Recently, two more highly pathogenic class 4 viral pathogens emerged. These were named Hendra Henipavirus (HeV) and Nipah Henipavirus (NiV). Nipah virus is a negative-sense single-stranded ribonucleic acid ((−) ssRNA) virus within the family Paramyxoviridae. There are currently no known therapeutics or treatment regimens licensed as effective in humans, with development ongoing. Nipah virus is a lethal emerging zoonotic disease that has been neglected since its characterization in 1999 until recently. Nipah virus infection occurs predominantly in isolated regions of Malaysia, Bangladesh, and India in small outbreaks. Factors that affect animal–human disease transmission include viral mutation, direct contact, amplifying reservoirs, food, close contact, and host cell mutations. There are different strains of Nipah virus, and small outbreaks in humans limit known research and surveillance on this pathogen. The small size of outbreaks in rural areas is suggestive of low transmission. Person-to-person transmission may occur. The role that zoonotic (animal–human) or host immune system cellular factors perform therefore requires analysis. Mortality estimates for NiV infection range from 38–100% (averaging 58.2% in early 2019). It is therefore critical to outline treatments and prevention for NiV disease in future research. The final stages of the disease severely affect key organ systems, particularly the central nervous system and brain. Therefore, here we clarify the pathogenesis, biochemical mechanisms, and all research in context with known immune cell proteins and genetic factors.

Purpose: To evaluate whether levels of cortisol, a stress-related hormone, predicted response to intensive speech-language intervention for individuals with chronic aphasia (IWA). Secondary analyses explored baseline cortisol levels, change following intervention, association between cortisol levels and aphasia severity, self-reported communicative distress, and chronic stress. Method: Afternoon salivary cortisol levels were measured in 14 IWA during the first and last weeks of a 4-week intensive speech-language intervention epoch. Behavioral outcome measures were collected pre- and postintervention. Results: Cortisol levels did not significantly predict treatment response in this sample of IWA, although a positive trend was present. Baseline cortisol levels were not abnormally elevated, did not change from pre- to postintervention, and were not significantly correlated with any of the behavioral outcome measures. Discussion: Although afternoon salivary cortisol levels did not robustly predict treatment response in this participant sample, future studies may be warranted that include IWA with elevated levels of cortisol at pretreatment.

The rise in university bilingual science courses is explained by a certain phenomenon, the internationalization of higher education. Bilingual Argument Mapping (BAM) -- the ability to construct argument maps using two languages -- is a key aspect of bilingual scientific literacy. An argument map is a visual representation of argument structure. The problem is that little is known about how to foster BAM in this type of course. The goal of this study was to explore the possibility of using formal and informal formative assessment (FIFA) -- a type of assessment for learning in which feedback is both preplanned and instantaneous --, to support undergraduates' BAM. The data consist of the bilingual argument maps constructed by forty-four students (27 females and 17 males, 18-23 years old) in Colombia during a university Spanish-English bilingual science course. Results indicate that FIFA helped the participants' creation of valid and coherent argument maps in Spanish, in English and in a hybrid version using code-switching as response to argumentative questions related to the scientific topics covered in the course. The potential contributions of FIFA and its implications are discussed in light of research and theory of bilingual science education.

Recent studies show that the exploration of ways to involve students in effective bi/multilingual science education is gaining attention at all educational levels. Introducing students to the construction of bilingual scientific argument maps--visual representations of scientific argument structure using two languages--contributes to the quality of bilingual science education as they are a key aspect of bilingual scientific literacy; however, very little is known about how to promote the construction of these maps in bilingual science courses. Here we provide evidence for the claim that peer feedback and instructor feedback can be integrated to support the construction of bilingual scientific argument maps. A pedagogical strategy that integrates both peer feedback and instructor feedback was implemented in a university bilingual science course with 29 students (23 females and 6 males, 18-24 years-old) in Colombia. Results show that the strategy effectively supported the construction of scientific argument maps in Spanish and English. Implications for research and practice are discussed.

Background: Infective endocarditis (IE) is a serious condition which is difficult to diagnose and to treat, both medically and surgically. Objectives: The objective of this study was to evaluate the impact of the SARS-CoV-2 pandemic on the management of patients with IE. Methods: We conducted a single-centre retrospective study including patients hospitalized for IE during the pandemic (Group 2) compared with the same period the year before (Group 1). We compared clinical, laboratory, imagery, therapeutic, and patient outcomes between the two groups. Results: A total of 283 patients were managed for possible or definite IE (164 in Group 1 and 119 in Group 2). There were more intravenous drug-related IE patients in Group 2 (p = 0.009). There was no significant difference in surgery including intra-cardiac device extraction (p = 0.412) or time to surgery (p = 0.894). The one-year mortality was similar in both groups (16% versus 17.7%, p = 0.704). The recurrence rate was not significantly different between the two groups (5.9% in Group 2 versus 9.1% in Group 1, p = 0.311). Conclusions: The SARS-CoV-2 pandemic did not appear to have had a negative impact on the management of patients with IE. Maintenance of the activities of the endocarditis team within the referral centre probably contributed to this result. Nevertheless, the high proportion of intravenous drug-addicted patients in the pandemic cohort suggests that the SARS-CoV-2 pandemic had a major psychosocial impact.

We define a q-linear path in a hypergraph H as a sequence (e_1,...,e_L) of edges of H such that |e_i ∩ e_i+1 | ∈ [[1, q]] and e_i ∩ e_j = ∅ if |i − j| > 1. In this paper, we study the connected components associated to these paths when q = k − 2 where k is the rank of H. If k = 3 then q = 1 which coincides with the well-known notion of linear path or loose path. We describe the structure of the connected components, using an algorithmic proof which shows that the connected components can be computed in polynomial time. We then mention two consequences of our algorithmic result. The first one is that deciding the winner of the Maker-Breaker game on a hypergraph of rank 3 can be done in polynomial time. The second one is that tractable cases for the NP-complete problem of "Paths Avoiding Forbidden Pairs" in a graph can be deduced from the recognition of a special type of line graph of a hypergraph.

Context: COVID-19 related to SARS-CoV-2 infection generates inflammation with increased reactive oxygen species production. Drug treatment and others factors could influence systemic oxidative stress during pathogenic insult. Aims: To determine the redox status in COVID-19 patients with different clinical conditions and explore the relationship between redox and hematological hemochemical variables. Methods: In this comparative longitudinal study, blood samples were drawn from 160 individuals divided into four groups: COVID-19 asymptomatic, COVID-19 symptomatic (low and moderate symptoms), COVID-19 convalescent, and presumable healthy subjects. Demographic, redox, hematological, and hemochemical indices were assessed. Statistical analyses compared the median values of each variable and explored individual, simultaneous indices, and multivariate alteration. Results: Relative to the healthy group, acute COVID-19, and convalescent groups had significant differences in global damage indices and antioxidant status (p

Si bien existe una abundante cantidad de trabajos relaciones con el estudio del libro antiguo novohispano, es poco lo que se ha hecho para el conocimiento de las relaciones de textos e imágenes y de la presencia de grabados en los impresos mexicanos. Considerando lo anterior, el objetivo central del trabajo fue conocer las posibles usos y funciones de las imágenes en los impresos novohispanos religiosos (vírgenes y santos) y en obras de otros campos del conocimiento pero que cuentan con imágenes religiosas del siglo XVII. Para establecer el cuerpo de obra de esta investigación se revisaron diversos acervos digitales de los que se eligieron 40 libros de John Carter Brown Library y de la Biblioteca Nacional de México, respectivamente. La aproximación metodológica de este estudio es cuanti-cualitativa, los resultados obtenidos nos ofrecen las principales tendencias para el estudio de la imagen religiosa en los libros impresos novohispanos del siglo XVII, aportando nuevas informaciones de un aspecto poco explorado de la riqueza y diversidad del patrimonio documental del país.