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Pain is the most commonly reported symptom by both adult and pediatric patients, the International Association for the Study of Pain (IASP) defines pain as "An unpleasant sensory and emotional experience associated with, or similar to that associated with, actual tissue damage or potential. Pain can have a significant negative impact on quality of life in the context of human disease, in temporality physiological pain is usually acute and pathological pain is usually chronic. Nociceptors are specialized nerve fibers for pain, they are found in the skin, organ of movement, they are classified as myelin fibers that are called Aδ; and unmyelinated fibers or C fibers. Nociceptors can be stimulated by biological agents, electrical, thermal, mechanical and chemical stimuli, once the stimulus is received it will be transmitted to the brain. One of the pillars of anesthesia is analgesia, that is to say, inhibiting pain. In this bibliographic review, the aim is to explain the molecular bases, emphasizing the main membrane receptors activated in the presence of pain.

The Foreign Object Debris (FOD) is an important topic to discuss in aeronautics as it not only involves safety but also can produce huge economic losses in airports. It is considered FOD any object that should not be in the place it is and as a consequence of this can be a risk to aircrafts or workers. The total cost of FOD to the aerospace industry is calculated to be approximately 4 billion dollars per year. Although new technologies are being implemented, it is a field that still has enhancements to be made. This project is intended to improve the detection of FOD in airports with AI technology applied through a drone with object recognition algorithms that allow to meet the frequencies of inspection and search of operational areas at a low cost of implementation and operation compared to other current detection technologies. The project develops the necessary system architecture to carry out FOD inspections at airports. It comprises studying the requirements, characteristics of the devices involved in the process, and adapting the configuration and parameters of the equipment (drone and camera) to ensure feasibility across all categories of runways. A method for data acquisition, management, and transmission is proposed to determine the position and obtain real-time images of the detected objects. Topics such as the Ground Base Station (GBS), drone tracking, charging station, flight plans, and routes are also addressed. To complete the designed system architecture, an AI model is trained using a FOD database, which will be responsible for obtaining detections during inspections. A new FOD database has also been developed to expand the currently available database. The project's obtained structure is tested through drone flights that simulate real-world applications. The results obtained reveal a functional model with potential for real-world application, but with two current limitations: inspection time and the open nature of FOD. Proposals and new approaches are presented to address these restrictions in future studies Objectius de Desenvolupament Sostenible::11 - Ciutats i Comunitats Sostenibles

Background Viruses are constantly changing as a result of mutations, and new viral variants are expected to appear over time. The virus that causes coronavirus disease 2019, severe acute respiratory syndrome coronavirus 2, is not excluded from this condition. Patients with some types of immunodeficiency have been reported to experience symptoms that vary from mild to severe, or even death, after being infected with severe acute respiratory syndrome coronavirus 2. We report a case of a woman with severe hypogammaglobulinemia who developed a prolonged and fatal severe acute respiratory syndrome coronavirus 2 infection. Case presentation A 60-year-old mestizo female with a previous history of severe hypogammaglobulinemia manifested by recurrent pulmonary infections and follicular bronchiolitis. She received a monthly treatment of intravenous immunoglobulins and was admitted after report of a neurological manifestation related to a left thalamic inflammatory lesion, for a duration of 2 weeks of hospitalization, indicated for the study of her neurological condition, including brain biopsy. Both on admission and 1 week later, nasopharyngeal polymerase chain reaction tests for severe acute respiratory syndrome coronavirus 2 were performed and reported negative. In the third week of hospitalization, she developed pulmonary symptoms, and a positive test result for severe acute respiratory syndrome coronavirus 2 was evidenced. On Day 3, the patients’ condition worsened as the infection progressed to respiratory failure and required mechanical ventilation. On Day 8 after the coronavirus disease 2019 diagnosis, the polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2 showed persistent detection of the virus. Various bacterial coinfections, including Klebsiella pneumoniae and Enterobacter cloacae, were diagnosed and treated. On Day 35, her pulmonary symptoms worsened, and the results of the severe acute respiratory syndrome coronavirus 2 polymerase chain reaction test remained positive. On Day 36, despite all the respiratory support, the patient died. The severe acute respiratory syndrome coronavirus 2 virus was sequenced at the beginning and 8 days after the onset of the disease, and the strain, without obvious mutations in the gene that encodes spike protein, was identified. Conclusions This clinical case showed persistent severe acute respiratory syndrome coronavirus 2 detection after 35 days of infection in a patient with severe hypogammaglobulinemia. The sequencing of the virus showed no mutations on the spike protein at 8 days, indicating that, in this case, the persistence of the viral detection was associated with immunodeficiency instead of changes in the viral components.

Objetivo: Describir las características clínicas, microbiológicas y los desenlaces de las bacteriemias primarias por S. pneumoniae ocurridas en población pediátrica hospitalizada en instituciones de alta complejidad, pertenecientes a la Red Neumocolombia (2017-2019). Metodología: Estudio observacional, descriptivo, longitudinal, exploratorio con alcance analítico, en donde se tomó información de las historias clínicas con hemocultivos positivos para S. pneumoniae sin otro foco infeccioso, realizados en los hospitales pediátricos, reportados a la Red Neumocolombia (2017-2019). Resultados: Durante el periodo de estudio se analizó información de 51 registros, 62,7% fueron hombres, la mediana de edad fue 25 meses (RIC 9-49). El síntoma predominante fue fiebre (78,4%), se reportó vacunación con Vacuna Neumocócica Conjugada decavalente (PCV-10) en 47%. El serotipo más frecuente fue 19A (39,4%). El porcentaje de resistencia antibiótica fue: eritromicina 43%, penicilina 25.4%, cefotaxima 11,7%. Los factores relacionados al ingreso a Unidades de Cuidado Intensivo Pediátrico (UCIP) fueron: dolor pleurítico (OR27,9; IC95%3,13 – 248,16 p=0,03), tos (OR6,04; IC95%1,46 – 24,88; p=0,013), dolor abdominal (OR 6,5; IC95%1,85 – 22,80; p=0,003), dificultad respiratoria (OR12; IC95%2,95 – 48,77 p=0,001), tirajes (OR22,71; IC95%4,65 – 141,90 p=0,001), cianosis (OR8,69; IC95%1,95 – 38,65 p=0,004), hipotermia (OR42,62; IC95%4,77 – 380,74 p=0,001), serotipo 19A (OR3,9;IC95%1,10 – 13,81 p=0,035). La letalidad fue del 11,7%. Conclusión: Después de la introducción de la vacuna PCV10 en Colombia en el año 2012 se reportaron cambios en la epidemiologia, con disminución de los serotipos vacunales, y aumento en el serotipo 19A, siendo uno de los factores que intervienen en el ingreso a UCIP por bacteriemia primaria. Se reporta aumento en la resistencia por eritromicina, penicilina y cefotaxima.

Context: Malva spp. have been widely used in the world as traditional remedies. In Ecuadorian markers Malva sylvestris and Malva pseudolavatera are the species most commercialized. However, the scientific information about M. pseudolavatera is little. Aims: To determine the chemical composition and antioxidant capacity of the aqueous extracts of the leaves of both species. Methods: Aqueous extracts were partitioned with butanol and the fractions obtained were analyzed by GC/MS. Total extracts were evaluated as antioxidants using FRAP, DPPH and ABTS assays. Results: Differences in the chemical composition were found between the extracts. Both extracts showed the presence of polysaccharides, phenolic acids and fatty acids, but in M. sylvestris were identified polyols, which there was not observed in M. pseudolavatera. The aqueous extracts showed free radical scavenging and ferric reducing power capacities in vitro assays, being M. sylvestris the most promissory antioxidant, possibly due to the presence of polyols in the extract. In the present research were reported 39 phytochemical compounds by first time for the specie M. pseudolavatera. Conclusions: Aqueous extracts of the leaves of M. sylvestris and M. pseudolavatera showed antioxidant capacity associated with the presence of phenolic acids, polysaccharides and flavonoids in the extracts.

Xiphidium caeruleum Aubl. is traditionally used in Cuba as an analgesic, anti-inflammatory, antilithiatic and diuretic remedy. Here we studied the pharmacognostic parameters of the leaves of X. caeruleum, the preliminary phytochemical composition, diuretic activity and acute oral toxicity of the aqueous extracts from the leaves of plants collected in the vegetative (VE) and flowering (FE) stages. The morphological characteristics and physicochemical parameters of leaves and extracts were determined. The phytochemical composition was assessed by phytochemical screening, TLC, UV, IR and HPLC/DAD profiles. The diuretic activity was evaluated in Wistar rats and compared to furosemide, hydrochlorothiazide and spironolactone. Epidermal cells, stomata and crystals were observed on the leaf surface. Phenolic compounds were identified as the main metabolites, including phenolic acids (gallic, caffeic, ferulic and cinnamic acids) and flavonoids (catechin, kaempferol-3-O-glucoside and quercetin). VE and FE showed diuretic activity. The activity of VE was similar to furosemide, and the activity of FE resembled spironolactone. No acute oral toxicity was observed. The presence of flavonoids and phenols in VE and FE may explain at least in part the traditional use and provide some insight into the reported ethnomedical use as a diuretic. Because of the differences in polyphenol profiles between VE and FE, further studies should be carried out to standardize the harvesting and extraction conditions in order to use X. caeruleum leaf extract as herbal medicine.

[EN] Bilateral systems of teleoperation are useful in a wide range of tasks that can be dangerous or inaccessible for a human operator. However, when time varying delays appear in the communication channel, perfect transparency can no longer been sured. Instead, other control objectives may be pursued, such as the kinematic correspondence between the local and the remote robots. Furthermore, since most of the commercially available robots are not equipped with velocity sensors, to guarantee a certain level of transparency or kinematic correspondence the controller can not rely on velocity measurements. This article is focused on presenting the experimental results of a robust scheme to time delays for non-linear manipulators connected through a communication channel. The main advantages of the control scheme are: i) it is not necessary to know the dynamic parameters of the manipulators; ii) it is not necessary to impose restrictions in the behavior of the human operator and the remote surface; iii) an estimation of velocities is obtained through a second order linear filter; iv) a term that guarantee force tracking is added to the scheme as well. In order to show good performance, we report a set of experiments that have been carried out between different cities in Mexico using the Internet as a communication channel., [ES] Los sistemas bilaterales de teleoperación son útiles en una amplia gama de tareas que pueden resultar peligrosas o inaccesibles para un humano. Sin embargo, cuando aparecen retardos variantes en el tiempo en el canal de comunicación, ya no se puede garantizar una transparencia perfecta. En cambio, se pueden perseguir otros objetivos de control, como la correspondencia cinemática entre los robots local y remoto. Además, dado que la mayoría de los robots disponibles comercialmente no están equipados con sensores de velocidad, para garantizar un cierto nivel de transparencia o correspondencia cinemática, el controlador no puede depender de las mediciones de velocidad. Este artículo está enfocado en presentar los resultados experimentales de un esquema robusto ante los retardos en el tiempo para manipuladores no lineales conectados a través de un canal de comunicación. Las ventajas principales del esquema propuesto son: i) no es necesario conocer los parámetros dinámicos de los manipuladores, ii) no es necesario imponer restricciones acerca del comportamiento del operador humano y de la superficie remota, iii) se obtiene una estimación de velocidades através de un filtro lineal de segundo orden, iv) un término que garantiza el seguimiento de fuerza fue agregado al esquema. Con el objetivo de mostrar el buen desempeño del esquema propuesto, se reportan un conjunto de experimentos que se han llevado a cabo entre diferentes ciudades de México utilizando Internet como canal de comunicación., Este trabajo ha sido apoyado por la DGAPA–UNAM bajo la donación IN117820. Finalmente el último autor agradece a CONACyT por la donación CB-282807.

Immunosuppressive treatments have improved graft and patient survival rates, but can increase the incidence of post-transplant infections.To analyze data from kidney transplant patients and describe the pathogens responsible for the infections they experience.Longitudinal, analytical, observational study of 103 patients who underwent kidney transplantation. The follow-up period was 5.07 ± 1.28 years.Overall mortality rate was 10.68% and graft loss rate was 14.56%. Regarding recipient risk of death, the Cox regression model showed a hazard ratio (HR) of 5.66 for positive bacterial cultures and 2.22 for positive extended-spectrum beta-lactamase (ESBL)-producing strains; as for graft loss, HR was 4.59 in those with positive bacterial cultures and 4.25 in those who were positive for ESBL-producing strains.Significant death risk was found in kidney transplant recipients with positive bacterial cultures and an increased risk of graft loss in those with positive bacterial cultures and in those who were positive for ESBL-producing Enterobacteriaceae isolates. The rate of ESBL-producing Enterobacteriaceae is high, and stricter strategies are therefore necessary to control the use of antibiotics.Los tratamientos inmunosupresores han mejorado las tasas de supervivencia del injerto y del paciente, pero pueden incrementar las infecciones postrasplante.Analizar los datos de pacientes con trasplante renal y describir las bacterias responsables de las infecciones que presentan.Estudio observacional, longitudinal y analítico de 103 pacientes sometidos a trasplante renal. El periodo de seguimiento fue de 5.07 ± 1.28 años.La tasa de mortalidad fue de 10.68 % y la de pérdida del injerto de 14.56 %. Respecto al riesgo de muerte del receptor, el modelo de regresión de Cox mostró un cociente de riesgo (HR, hazard ratio) de 5.66 en los pacientes con cultivo bacteriano positivo y de 2.22 en aquellos con cepas productoras de betalactamasas de espectro extendido (BLEE); en cuanto a la pérdida del injerto, el HR fue de 4.59 en quienes tuvieron cultivo bacteriano positivo y de 4.25 en aquellos con cepas productoras de BLEE.Se encontró riesgo significativo de muerte en receptores de trasplante renal con cultivo bacteriano positivo y mayor riesgo de pérdida del injerto en aquellos con cultivo bacteriano positivo y aislamiento de cepas productoras de BLEE. La tasa de enterobacterias productoras de BLEE es alta, por ello son necesarias estrategias más estrictas para controlar del uso de antibióticos.

settingsOrder Article Reprints Open AccessArticle Thermal Analysis of a Parabolic Trough Collectors System Coupled to an Organic Rankine Cycle and a Two-Tank Thermal Storage System: Case Study of Itajubá-MG Brazil by Gaylord Carrillo Caballero 1,2,Yulineth Cardenas Escorcia 3,Luis Sebastián Mendoza Castellanos 4,Ana Lisbeth Galindo Noguera 4,Osvaldo José Venturini 2,Electo Eduardo Silva Lora 2,Elkin I. Gutiérrez Velásquez 5 andAnibal Alviz Meza 6,*ORCID 1 Research Group en Energías Alternativas y Fluidos (EOLITO), Universidad Tecnológica de Bolívar (UTB), Cartagena 130002, Colombia 2 Excellence Group in Thermal Power and Distributed Generation-NEST, Institute of Mechanical Engineering, Universidade Federal de Itajubá, Itajubá 37500-000, Brazil 3 Research Group GIOPEN, Energy Department, Universidad de la Costa (CUC), Barranquilla 080016, Colombia 4 Research Group in Resources, Energy and Sustainability (GIRES), Faculty of Energy Engineering, Universidad Autónoma de Bucaramanga (UNAB), Bucaramanga 680008, Colombia 5 Faculty of Mechanic, Electronics and Biomedical Engineering, Universidad Antonio Nariño, Medellin 050005, Colombia 6 Research Group en Deterioro de Materiales, Transición Energética y Ciencia de datos DANT3, Facultad de Ingeniería, Arquitectura y Urbanismo, Universidad Señor de Sipán, Chiclayo 14002, Peru * Author to whom correspondence should be addressed. Energies 2022, 15(21), 8261; https://doi.org/10.3390/en15218261 Received: 5 October 2022 / Revised: 28 October 2022 / Accepted: 31 October 2022 / Published: 4 November 2022 Download Browse Figures Versions Notes Abstract This study examined an Organic Rankine Cycle powered by a parabolic trough collector and a two-tank thermal storage system based on the development of a mathematical model, for the conditions of the city of Itajubá in Brazil. First, geometrical optics and heat transfer models of the collector–receiver set were used to determine the thermal equilibrium of the solar thermal collector system and parameters such as the efficiency of the solar field, heat and optical losses, and thermal energy of the outlet fluid. Next, the thermal equilibrium of the Organic Rankine Cycle was found in order to establish its operational parameters. Finally, the behavior of the thermal storage system was analyzed through its modeling. Once the characterization of the storage system was completed, the integrated operation of the proposed system was evaluated. Given Itajubá’s weather conditions, the results indicate that an electricity generation system can be implemented with the Solel UVAC Cermet selective coating for the absorber tube, water as the heat transfer fluid, and R-245fa as the working fluid. Based on the solar irradiation profile (1 March 2019), the parabolic trough collectors provided 63.3% of the energy required by the Organic Rankine Cycle to generate 7.4 kW, while the thermal storage system provided 36.4% of the energy demanded by the power generation block. Additionally, the results demonstrate the main conclusions that the turbine’s efficiency was influenced by parameters such as rotational speed, which is affected by the turbine inlet temperature, which, in turn, depends on the behavior of the solar irradiation profile onsite.

Assembling an effective medical response for an overwhelming number of casualties has become a priority worldwide. Terrorist attacks have been part of the Colombian contemporaneous history. On February 7, 2003, a terrorist car bomb explosion occurred inside a private club in Bogotá, causing the largest number of casualties of all terrorist attacks for over 15 years. The present study analyses the hospital and prehospital responses to this mass casualty event by characterizing the patterns of injury, resource allocation, and outcome in a tertiary-level hospital where most of the casualties were treated.This is a retrospective chart review of the patients brought to a single hospital (La Clínica del Country), which was the nearest to the terrorist attack. Demographics, severity of injury, patterns of injury, prehospital care, and outcomes were determined from the hospital medical records and government registries.Of the 240 victims, 35 died at the explosion site (immediate mortality 17%). The 205 survivors were dispersed throughout the city, of whom 63 patients came to La Clínica del Country hospital. Most of these patients were evaluated only clinically and deemed not serious. The main mechanism of trauma was blunt (81.4%). The mean injury severity score (ISS) was 5.6 ± 8.3. Ten patients required emergent surgical intervention and 14 patients were admitted. The in-hospital mortality was 20%.This mass casualty event was a true test for the Colombian emergency medical system and disaster preparedness. The medical response and resource optimization resulted in an overall mortality rate similar to those observed in the recent European and North American bombings. Despite the limited resources, the continuous challenge of terrorist's attacks in Colombia made the country feel the need for training and preparing the healthcare professionals, allowing effective delivery of medical care.La organización de una respuesta médica efectiva a un número excesivo de víctimas de ataques terroristas se ha convertido en una prioridad en el mundo. Los ataques terroristas han sido parte de la historia colombiana contemporánea. El 7 de Febrero de 2003, un carro bomba explotó en el interior de un club privado en Bogotá, resultando en el ataque terrorista con mayor numero de víctimas durante los últimos 15 años. El objetivo de este estudio es determinar la respuesta del sistema pre y hospitalario a un ataque terrorista masivo, caracterizar los patrones de lesión, utilización de recursos y desenlaces en un hospital de primer nivel, donde la mayoría de las víctimas fueron atendidas.Este es un estudio retrospectivo de la revisión de 43 historias clínicas de 63 pacientes que fueron llevados al hospital privado más cercano después de un ataque terroristas. La información demográfica, la severidad, el patrón de las lesiones y los desenlaces fueron determinados a partir de las historias clínicas y los registros gubernamentales.Treinta y cinco personas murieron en la escena y 205 personas fueron lesionadas (mortalidad inmediata de 17%). 63 pacientes fueron transferidos a nuestros hospitales. La mayoría de los pacientes fueron valorados clínicamente y no tenían lesiones serias. El principal mecanismos de trauma fue cerrado. El promedio de ISS fue 5.6 ± 8.3. Diez pacientes requirieron intervenciones quirúrgicas de urgencia y 14 fueron admitidos al hospital. La mortalidad crítica fue de 20%.Este incidente fue un verdadero examen a nuestro sistema médico de emergencias y plan de desastres hospitalario. Nuestro sistema médico optimizó los recursos resultando en una mortalidad crítica similar a la de las bombas ocurridas en Europa y Norte América. El desafío permanente de confrontar los ataques terroristas en Colombia ha proporcionado entrenamiento y preparación para asegurar un cuidado médico efectivo, aun con recursos limitados.Ataque terrorista, Bomba, Evento con lesionados masivos, Respuesta medica.

Issue/Problem The social, ecological, health and economic crisis exacerbated by COVID-19 is a challenge of extraordinary magnitude and complexity for global public health. Part of the response to these challenges requires strong public health institutions. Description of the problem Component 18 of the Government of Spain’s Recovery, Transformation and Resilience Plan proposes the creation of a Spanish Agency of Public Health (SAPH), a centre of excellence to perform surveillance and health system preparedness functions in the face of new or emerging public health threats. The government has opened the debate on what design and functions it should have. Results SESPAS, the Spanish Society of Public Health and Public Administration, set out a proposal for the design and organization of the future Spanish Agency for Public Health [SAPH]. A large working group, made up of experts from various fields of public health and from its ten federated scientific societies, has designed the SAPH proposal. The scope of the public health functions to be assumed include: the strategic planning of the State’s public health (including health security), the prioritisation of public health policies and communication strategies, the assessment of the population’s health status and social conditions, the guarantee of the transversality and horizontality of health policies (health and health equity in all State policies), as well as their verticality (serving as an enriching link between the European Union level and the administrations of the Autonomous Communities and local authorities). The proposal also include 11 recommendations on the main elements to be taken into account in the establishment of the future SAPH. Lessons COVID19 pandemic has highlighted the need of creating strong public health institutions. Spain is giving its first steps toward the creation of the SAPH, which constitute a key step in addressing the current and future challenges of public health in Spain. Key messages • Spanish Public Health Agency is an opportunity to transform health policies and to improve the health of the Spanish population. • Strengthening public health starts with building national institutions that ensure comprehensive and integrated health policies.

Progeny of

Mucosal innate immunity functions as the first line of defense against invading pathogens. Members of the IL-1 family are key cytokines upregulated in the inflamed mucosa. Inflammatory cytokines are regulated by limiting their function and availability through their activation and secretion mechanisms. IL-1 cytokines secretion is affected by the lack of a signal peptide on their sequence, which prevents them from accessing the conventional protein secretion pathway; thus, they use unconventional protein secretion pathways. Here we show in mouse macrophages that LPS/ATP stimulation induces cytokine relocalization to the plasma membrane, and conventional secretion blockade using monensin or Brefeldin A triggers no IL-36γ accumulation within the cell. In silico modeling indicates IL-36γ can pass through both the P2X7R and Gasdermin D pores, and both IL-36γ, P2X7R and Gasdermin D mRNA are upregulated in inflammation; further, experimental blockade of these receptors’ limits IL-36γ release. Our results demonstrate that IL-36γ is secreted mainly by an unconventional pathway through membrane pores formed by P2X7R and Gasdermin D.