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The influence of surface topography on cellular behaviour and its importance for the development of three-dimensional scaffolds for bone tissue engineering are a topic of growing interest. To date, the introduction of topographical patterns into the surface of 3D porous ceramic scaffolds has proven difficult, due partly to the brittle nature of ceramic materials as well as the currently available fabrication technologies. In this study, a grooved pattern was introduced into the surface of 3D multilayer porous ceramic scaffolds by the chemical etching technique. The patterned scaffolds were characterised by X-Ray Diffraction (XRD), Scanning Electron Microscopy with Energy Dispersive X-Ray Spectroscopy (SEM-EDX) and Digital Holographic Microscopy (DHM). Their bioactivity was also evaluated in vitro by immersion in simulated body fluid (SBF) for 12 h, 1, 7, 14 and 21 days. Scaffolds were constituted mainly with a mixture of the calcium pyrophosphate (Ca2O7P2) and β-tricalcium phosphate (Ca₃(PO₄)₂) phases. The pyrophosphate on the external layer was dissolved as a result of the etching process, leaving grooves on the surface. Ridges and grooves were nano-/micrometric, with dimensions of around 900 nm–1.5 μm in width and 200 nm–300 nm in depth. Moreover, the mechanical properties and bioactive capacity of the patterned scaffolds were not affected by chemical etching, making them suitable to be used in bone tissue engineering.

Resumen Objetivo Evaluar el efecto del glaucoma en la funcion visual, la calidad de vida en los ninos y la calidad de vida percibida por los cuidadores en ninos de hasta 16 anos. Material y metodos Se diseno un estudio observacional y prospectivo. Se aplico el cuestionario GQL-15 (Glaucoma Quality of Life) a los ninos y a los cuidadores, y el cuestionario VFQ-25 (Visual Functioning Questionnarie) a los ninos. Se registraron diferentes variables de la historia clinica que podrian influir en la calidad de vida y la funcion visual. Resultados Se incluyo a un total de 24 pacientes con una edad media de 9,13 ± 3,08 anos, de los cuales 3 tenian afectacion unilateral y 20 presentaban glaucoma congenito primario. Los padres reportaron una peor calidad de vida que los ninos: el resultado de la encuesta GQL-15 fue de 32,30 ± 11,56 puntos en los ninos y de 37,52 ± 14,59 puntos en los cuidadores (p = 0,001). El parametro que mas se relaciono con la calidad de vida y la funcion visual fue el defecto medio del campo visual en el mejor ojo. Se encontro una correlacion estadisticamente significativa entre el resultado de GQL-15 y el defecto medio del campo visual (ninos: R = 0,63; p Conclusiones El dano funcional visual producido por el glaucoma tiene un impacto importante en la calidad de vida y en la funcion visual de los ninos con glaucoma, si bien la calidad de vida percibida por los cuidadores es peor que la percibida por el nino.

Type 1 diabetes (T1D) is a growing chronic disease. Evidence of whether the healthcare setting affects management and glycemic control is scarce. We evaluate outcomes in patients with T1D in private and public healthcare settings in Mexico, registered in the National T1D Registry in Mexico (RENACED-DT1).Biochemical parameters, diabetes education, and treatment were analyzed considering the data registered in the last visit. Development of chronic complications was determined during follow-up.We included 1,603 patients; 71.5% (n = 1,146) registered in the public system, and 28.5% (n = 457) in a private institution. Patients in the public setting had higher HbA1c (8.6%, IQR: 7.3%-10.5% vs 7.7%, IQR: 7.0%-8.8%; p 0.001). Indicators of diabetes education, glucose monitoring, and use of insulin-pumps were lower in the public setting. Patients in the public setting were at higher risk of diabetic chronic kidney disease, retinopathy, and neuropathy. Diabetes knowledge was a mediator between type of healthcare setting and the likelihood of achieving glycemic control.Patients registered in public healthcare settings have an adverse metabolic profile and higher risk of complications. Social factors need to be addressed in order to implement multidisciplinary measures focused on diabetes education for patients with T1D in Mexico.

Resumen Caso clinico Mujer de 22 anos que presento vision borrosa despues de un episodio de parada cardiorrespiratoria recuperada, objetivandose en la exploracion una AV de «cuenta dedos» en AO sin alteracion oftalmologica ni de via visual y asociada a aparente falta de conciencia del deficit, junto con una resonancia magnetica que mostro cambios isquemicos en ambos lobulos occipitales, diagnosticandose de ceguera de Anton-Babinski. Discusion La ceguera de Anton-Babinski es un cuadro poco frecuente que debe sospecharse en perdidas visuales poco congruentes y se debe a lesion habitualmente isquemica en el territorio cerebral descrito, manifestandose con baja vision no percibida por el paciente («confabulacion visual»), pudiendo ser diagnosticada como perdida visual no organica, o incluso patologia psiquiatrica.

Clinical case A 22 year-old woman complained about blurred vision after an episode of recovered cardiorespiratory arrest. She had bilateral low visual acuity (“count fingers”) and no ophthalmological or visual pathways changes. She also had an apparent lack of awareness of the deficit. The magnetic resonance imaging (MRI) showed ischaemic changes in both occipital lobes. As a result, she was diagnosed with Anton–Babinski syndrome. Discussion This is a rare disease that should be suspected in strange or poorly congruent visual loss. It is usually due to an ischemic injury in this region of brain, manifesting itself with low vision not perceived by the patient (visual confabulation). It can simulate a non-organic visual loss or psychiatric disease.

The Prestige oil spill crisis (2002–2003), one of the worst oil spills that affected the Atlantic Spanish coastal line, pointed out that some management tools are needed in the form of laws, regulations and technical procedures. In particular, the issues are contingency planning and prevention against marine pollution and prediction for a proper response. In that background, the Catalan local government approved the CAMCAT (2004), a Regional contingency plan against marine pollution, to be framed within the (Spanish) National Contingency Plan. The CAMCAT contemplated the implementation of a Regional Forecasting System for the North-Western Mediterranean area, intended to help Catalan Authorities during any pollution emergency. The Laboratory of Maritime Engineering (LIM/UPC) has been responsible for the implementation of this Regional CAMCAT Forecasting System that is based (nested) on existing larger Forecasting Systems/Products, and it integrates several coastal observational data. The present paper is aiming to make an overview of the several scientific and technical activities related to the implementation and validation of the CAMCAT System.

To evaluate the effect of glaucoma on visual function, as well as quality of life in children and quality of life perceived by caregivers in children up to 16 years of age.An observational and prospective study was designed using the questionnaire GQL-15 (Glaucoma Quality of Life) and conducted on children and caregivers. The questionnaire VFQ-25 (Visual Functioning Questionnaire) was conducted on children. Different variables of the clinical history that could influence the quality of life and visual function were recorded.The study included 24 patients with a mean age of 9.13±3.08 years, and included 3 with unilateral involvement, and 20 diagnosed with primary congenital glaucoma. Parents reported a worse quality of life than children. The result of the GQL-15 survey was 32.3±11.56 points in children and 37.52±14.59 points in caregivers (P=.001). The parameter most related to quality of life and visual function was the mean deviation (MD) of the visual field in the best eye. A statistically significant correlation was found between the result of GQL-15 and the mean deviation of the visual field (children: R=0.63, P.01, caregivers: R=0.81, P.001).Functional loss has an impact on the quality of life and visual function in children with glaucoma, although the quality of life perceived by the caregivers is worse than that perceived by the child.

A 22 year-old woman complained about blurred vision after an episode of recovered cardiorespiratory arrest. She had bilateral low visual acuity («count fingers») and no ophthalmological or visual pathways changes. She also had an apparent lack of awareness of the deficit. The Magnetic Resonance Imaging (MRI) showed ischaemic changes in both occipital lobes. As a result, she was diagnosed with Anton-Babinski syndrome.This is a rare disease that should be suspected in strange or poorly congruent visual loss. It is usually due to an ischaemic injury in this region of brain, manifesting itself with low vision not perceived by the patient (visual confabulation). It can simulate a non-organic visual loss or psychiatric disease.

espanolIntroduccion: la sedacion profunda con propofol controlada por endoscopista en las diferentes unidades de endoscopia ha sido un tema de continua controversia a lo largo de los ultimos anos, origen de conflictos de intereses entre las distintas sociedades cientificas de Anestesiologia y Gastroenterologia. Numerosos estudios han demostrado ya la eficacia, eficiencia y escasa aparicion de complicaciones en la sedacion controlada por un endoscopista formado frente al anestesiologo. Material y metodos: hemos revisado en nuestra base de datos el porcentaje de complicaciones cardiorrespiratorias graves en nuestra unidad, en el periodo comprendido entre 2011 y 2016, en las distintas exploraciones endoscopicas que realizamos (gastroscopia, colonoscopia, colangiopancreatografia retrograda endoscopica [CPRE] y ecoendoscopia [USE]) y cuya sedacion es controlada por un endoscopista. Resultados: se llevo a cabo el analisis de 33.195 exploraciones durante el periodo de estudio. Obtuvimos un 0,13% de complicaciones cardiorrespiratorias, la mayor parte de ellas desaturaciones graves (la mayoria respondieron a la apertura de la via aerea asociada a la interrupcion de la infusion del farmaco, precisando la necesidad de ambu en contadas ocasiones). No existieron diferencias estadisticamente significativas entre los diferentes grupos excepto en edad media, riesgo por tipo de exploracion y riesgo ASA, donde la CPRE presento una p EnglishIntroduction: deep sedation with propofol monitored by an endoscopist in different endoscopy units is a controversial subject and the source of conflicts of interest between the various scientific societies of Anesthesiology and Gastroenterology. Many studies have already demonstrated the efficacy, efficiency and low incidence of complications associated with sedation when under the control of a trained endoscopist vs an anesthesiologist. Material and methods: the rate of severe cardiorespiratory complications during various endoscopic examinations (gastroscopy, colonoscopy, endoscopic retrograde cholangiopancreatography [ERCP] and endoscopic ultrasound [EUS]) where sedation was controlled by an endoscopist within our unit, from 2011 to 2016, was reviewed. Results: during the study period, 33,195 examinations were analyzed. The rate of cardiorespiratory complications was 0.13% and the majority were severe desaturations. Most cases responded to an opening in the airway associated with the interruption of drug infusion and an ambu bag was required in a few cases. There were no statistically significant differences between the different groups, except for mean age, risk by type of examination and ASA risk, where the difference between ERCP and the rest of examinations was statistically significant. Conclusion: there is a high level of evidence in the scientific literature suggesting that sedation controlled by a trained endoscopist is safe, effective and efficient. However, further prospective studies are required in order to confirm this conclusion due to the fact that the majority of studies to date are retrospective

Objetivo: Evaluar el efecto del glaucoma en la función visual, la calidad de vida en los niños y la calidad de vida percibida por los cuidadores en niños de hasta 16 años. Material y métodos: Se diseñó un estudio observacional y prospectivo. Se aplicó el cuestionario GQL-15 (Glaucoma Quality of Life) a los niños y a los cuidadores, y el cuestionario VFQ-25 (Visual Functioning Questionnarie) a los niños. Se registraron diferentes variables de la historia clínica que podrían influir en la calidad de vida y la función visual. Resultados: Se incluyó a un total de 24 pacientes con una edad media de 9,13 ± 3,08 años, de los cuales 3 tenían afectación unilateral y 20 presentaban glaucoma congénito primario. Los padres reportaron una peor calidad de vida que los niños: el resultado de la encuesta GQL-15 fue de 32,30 ± 11,56 puntos en los niños y de 37,52 ± 14,59 puntos en los cuidadores (p = 0,001). El parámetro que más se relacionó con la calidad de vida y la función visual fue el defecto medio del campo visual en el mejor ojo. Se encontró una correlación estadísticamente significativa entre el resultado de GQL-15 y el defecto medio del campo visual (niños: R = 0,63; p < 0,01 y cuidadores: R = 0,81; p < 0,001). Conclusiones: El daño funcional visual producido por el glaucoma tiene un impacto importante en la calidad de vida y en la función visual de los niños con glaucoma, si bien la calidad de vida percibida por los cuidadores es peor que la percibida por el niño. Objective: To evaluate the effect of glaucoma on visual function, as well as quality of life in children and quality of life perceived by caregivers in children up to 16 years of age. Material and methods: An observational and prospective study was designed using the questionnaire GQL-15 (Glaucoma Quality of Life) and conducted on children and caregivers. The questionnaire VFQ-25 (Visual Functioning Questionnaire) was conducted on children. Different variables of the clinical history that could influence the quality of life and visual function were recorded. Results: The study included 24 patients with a mean age of 9.13 ± 3.08 years, and included 3 with unilateral involvement, and 20 diagnosed with primary congenital glaucoma. Parents reported a worse quality of life than children. The result of the GQL-15 survey was 32.3 ± 11.56 points in children and 37.52 ± 14.59 points in caregivers (P = .001). The parameter most related to quality of life and visual function was the mean deviation (MD) of the visual field in the best eye. A statistically significant correlation was found between the result of GQL-15 and the mean deviation of the visual field (children: R = 0.63, P < .01, caregivers: R = 0.81, P< .001). Conclusions: Functional loss has an impact on the quality of life and visual function in children with glaucoma, although the quality of life perceived by the caregivers is worse than that perceived by the child.

End-functionalized polyesters have been synthesized by ring-opening polymerization (ROP) of ϵ-caprolactone (CL) initiated with five different ruthenium derivatives in the presence of a series of alcohols as transfer agents. Mechanistic studies were performed for ROP of CL with RuCl2(PPh3)3 (I), TpRuCl(PPh3)2 (II), and TpRuCl(PHPh2)(PPh3) (III) as catalysts in the presence or absence of benzyl alcohol (BzOH). Obtained molecular weights are proportional to CL/BzOH ratio, but there is not a direct relationship with CL/ruthenium complex ratios. 1H and 13C NMR spectroscopy revealed the existence of benzyl ester end-groups. Catalysis involves (a) dissociation of ruthenium complexes, (b) coordination of the lactone CL, (c) coordination of the BzOH with the formation of a metal alkoxide, (d) transfer from the alkoxyl ligand to the coordinated lactone, and (e) ring-opening of CL by oxygen-acyl bond cleavage. The proposed mechanism is supported by 1H, 13C, and 31P NMR, gel permeation chromatography (GPC), and MALDI-TOF analysis of the polymers. © 2006 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 44: 6926–6942, 2006

We report results (numerical and experimental) indicating control of observed oscillatory dynamics in an electrochemical system under the influence of superimposed sinusoidal forcing. By varying the frequency and amplitude of the external forcing (control parameters) not only were the chaotic dynamics converted to periodic states (controlling chaos via entrainment), but the period-1 (P1) behavior could also be transformed to oscillatory dynamics of higher periodicity (for example: P2). Therefore for appropriate values of control constants and nature of the unperturbed (periodic and/or chaotic) dynamics, a final state of either lower (chaos→P1) or higher complexity (P1→P2) can be attained. Since no prior information regarding the system dynamics is required for implementation of the forcing control it is thus relevant for application to real systems.

We report numerical and experimental results indicating successful stabilization of unstable steady states and periodic orbits in an electrochemical system. Applying a continuous delayed-feedback technique not only periodic and chaotic oscillations are suppressed via stabilization of steady-state solutions but also the chaotic dynamics can be converted to periodic behavior. In all cases the feedback perturbation vanishes as a target state is attained.

Long-Term Oncologic Outcomes in Colon Cancer Patients With “Bridge to Surgery” Stenting. Comparative Study With TNM Matched Controls Francisco Igea, Sergio Maestro, Rocio Silvana Castillo, Antonio Perez Millan, Henar Nunez, Rosa Eva Madrigal, Esther Saracibar, Javier Barcenilla Complejo Hospitalario de Palencia, Palencia, Spain Background: Expandable metal stents are frecquently used as a bridge to surgery in colon cancer occlusions. Recently worse oncologic outcomes have been described comparing stented patients with control group matched by TNM staging (1). This could be a serious limitation for continuing stenting occluded colon cancers. At present moment,there are no randomized, prospective data. Aims: Compare oncologic outcomes of patients stented vs controls matched by age,sex,TNM stage and year of diagnosis. Methods: We reviewed all our colon cancer patients stented as bridge to surgery during the period nov 1999 nov 2007. A control group of colon cancer patients matched by sex , age, TNM staging and year of diagnosis was extracted from our database. All the patients were treated in our institution by the same surgeons and oncologysts. Global survival and presence of disease at 3 and five years were compared. Results: Population and TNM stagin carachteristics are reflected in Table 1. We found 41 stent patients and 73 non-stented matched controls. Stage IV was finally excluded in this study because serious difference in treatment approach between both groups. Three year survival in groups II & III was 65,7 % in stented group vs 75% in control group (ns.). Presence of disease was 13 % vs 7,8% in control group. Results at five years follow up in stage II & III are summarized in table 2 No significant difference was observed between both groups. Conclusions: 1) There are no significant diference in survival and disease free survival at 3 and five years in our experience 2)Prospective randomized studies are needed to elucidate this point(1)World J Surg. 2009 Jun;33(6)1281-6. Oncologic outcomes of selfexpanding metallic stent insertion as a bridge to surgery in the management of left-sided colon cancer obstruction: comparison with nonobstructing elective surgery. Kim JS,et al.

This article presents a case study of development of a Payments for Ecosystem Services (PES) program related to drinking water in the city of Copán Ruinas, Honduras. The methodology used for the design and the implementation of this program is based on an integrated and adaptive management approach. It includes the following elements: general diagnostic, definition of objectives, analysis of enabling conditions, technical design, implementation and evaluation. This paper presents the empirical results of the application of this methodology and, in particular, highlights the application of a performance-based payment system to remunerate local peasants in accordance to their land use decisions. Este artículo presenta el desarrollo de una iniciativa de pagos por servicios ecosistémicos relacionados con la provisión de agua potable en la comunidad de Copán Ruinas, Honduras. La metodología para diseñar e implementar este programa se basa en un enfoque integral y de gestión adaptativa, compuesto por varios componentes: definición de objetivos y diagnóstico general, análisis de condiciones habilitadoras, diseño técnico del programa, implementación y evaluación. El artículo presenta la aplicación de este enfoque y los resultados obtenidos en términos del diseño e implementación inicial del programa de pagos. Un resultado particularmente interesante tiene que ver con la construcción de un sistema de pagos basados en desempeño en donde los finqueros reciben pagos diferenciados de acuerdo al tipo y cantidad de cambios que logran en los sistemas productivos. La idea es que los pagos envíen señales acerca de cuáles cambios y usos del suelo son más deseables en términos de mejoramiento de la calidad y disponibilidad de agua para consumo humano.

The present study investigated stress, as measured by a standardized life events scale, in Hansen's disease (HD) patients and as compared to renal patients and non-illness controls. Statistical analyses indicated that experimental groups were well matched on variables of age, sex, and marital status. Regarding analyses of the life events scale, significant differences were found across groups for negative change scores and total change scores. Post-hoc analyses revealed that the outpatient HD group and the renal group were significantly different from the non-illness controls. The results are viewed as support for the hypothesis that HD patients are similar to other chronic illness groups in terms of psychosocial characteristics.

The psychosocial ramifications of the loss of sensation are subtle and often are not perceived. One hundred Hansen's disease patients were interviewed concerning their experiences of living with sensory loss on their hands and feet. Their responses to the questions may assist medical practitioners in the treatment of the effects of the disease.

Recent data on fertility in Mexico have allowed identification of the most likely of 2 alternative population projections through the year 2010. The projection assumes an increase in life expectancy for men and women respectively from 64.08 and 70.47 in 1980-85 and 77.00 in 2005-10. The migration assumption is that there will be a net loss of 529,274 Mexicans every 5 years. The total fertility rate is expected to decline from to 2.7. The total population was projected at 82.8 million in 1988, 104.0 million at the end of the century, and 123.2 million in 2010. The 0-14 age group will decline from 44.23% of the population in 1980 and 40.33% in 1985 to 31.41% in 2000 and 29.50% in 2010. The proportion aged 15-64 will increase from 52.45% in 1980 and 56.22% in 1985 to 63.96% in 2000 and 64 75% in 2010. The proportion of the population in localities with under 2500 inhabitants is expected to remain stable at about 24.3 million persons. Mexico City, Guadalajara, Monterrey, and Puebla will have a combined population of 35 million by the year 2000. In 2010, the Federal District and the State of Mexico which includes Mexico City are expected to contain 29.3% of the total population. The projected population increase over the next 22 years is 40.4 million, 16% greater than the national population in 1960. The implications for providing food and consumer goods, and especially for improving the quality of life are serious. The relative demand for primary and secondary education and for maternal-child health care will decline, but the demand for jobs and for family planning services will increase as the proportion of the population in the economically active age groups increases.

We report experimental control of complex (periodic and chaotic) oscillatory dynamics in an electrochemical system by applying a nonfeedback control method. By choosing an appropriate frequency for the periodic modulation of an accessible control parameter (e.g., circuit potential) not only are the chaotic dynamics converted to regular periodic behavior (controlling chaos) but also the character of the oscillatory dynamics is altered (for example, 11 → 10). This is different from previously reported experiments involving simple entrainment of oscillatory dynamics, since in our experiments the frequency of sinusoidal modulation is chosen such that the existing unstable dynamics are targeted and subsequently stabilized. Consequently, the maximum amplitude of the control signal is less than ±5% of its base value. Since resonant control strategy can be easily implemented without a complicated precontrol procedure it seems relevant for applications to real systems.