Three cases of kyphoplasty performed in the lateral position due to significant comorbidities.

Background: More than 700,000 people suffer from vertebral compression fractures attributed to osteoporosis, metastatic disease, or trauma each year in the United States, and undergo kyphoplasty. They are typical. These often undergo kyphoplasty to treat resultant pain or new neurological deficits. Here, we present three patients who, due to significant comorbidities, underwent kyphoplasty performed in the lateral decubitus rather than the prone position. Case Description: Three females, two with metastatic cancer and one with osteoporosis, presented with lumbar compression fractures and new accompanying pain and/or neurological deficits. Due to significant accompanying comorbidities, kyphoplasty was safely and effectively performed in all three patients utilizing the lateral decubitus rather than the prone position. Conclusion: Although vertebral kyphoplasties are typically performed in the prone position, here, we present three patients who, due to significant comorbidities, safely and effectively underwent kyphoplasties performed in the lateral decubitus position.

Intraocular Lens Unfurling Time Exponentially Decays with Increased Solution Temperature.

Purpose: Intraocular lens (IOL) unfurling can be a rate-limiting step in cataract surgery, limiting operative efficiency. Furthermore, inefficient unfurling has important implications for clinical outcomes. We examine the effects of solution temperature on IOL unfurling time using three in vitro models of the ocular environment. Methods: IOLs were injected into a 6-well plate filled with balanced salt solution (BSS), dispersive ophthalmic viscoelastic device (OVD), or cohesive OVD. Experiments were also performed in a plastic eye filled with dispersive or cohesive OVD. IOL unfurling time was recorded against the temperature of the respective solution. Results: IOL unfurling time decayed exponentially as solution temperature increased in all experiments, including the BSS-filled 6-well plate, the OVD-filled 6-well plate, and the OVD-filled plastic eye. IOLs failed to unfurl within 10 min at 10°C, below the glass transition temperature of the tested IOLs. Increasing solution temperature from 20°C to 30°C decreases IOL unfurling by greater than 2 min. Further heating to 40°C did not significantly decrease IOL unfurling time. Conclusion: Increased solution temperature rapidly decreases IOL unfurling time in vitro. IOLs do not unfurl within a clinically acceptable timeframe at or below their glass transition temperature. Increased BSS and/or OVD temperature may be a potential method to decrease IOL unfurling time in cataract surgery. However, future research is needed to elucidate potential consequences of warmed BSS and/or OVD on post-operative outcomes. This study demonstrates the potential for temperature regulation to decrease cataract surgery operative time and provides preliminary evidence to justify future clinical validation of this relationship.

During cataract surgery, a prosthetic intraocular lens (IOL) is inserted into the eye once the clouded lens is removed. The IOL must then unfurl before the procedure can proceed. When IOLs fail to unfurl or unfurl slowly, this can delay the operation and may even cause post-operative complications. Thus, we studied the effect temperature may have on IOL unfurling time to optimize this segment of the operation. We injected IOLs into solutions of saline (balanced salt solution) or ophthalmic viscoelastic device (OVD), two fluids injected into the eye during surgery. In both a well plate and a plastic eye, we found that increasing the temperature of the solution significantly affected IOL unfurling time. Specifically, heating the solution from refrigeration to room temperature decreased unfurling time from over 10 min to less than four. Heating to physiological temperature further decreased unfurling time to less than a minute. Our results show promise for potentially utilizing heated BSS and/or OVD to accelerate IOL unfurling and decrease cataract surgery operative time.

Sustainable Refining of Vegetable Oil Made Easy with a Designer Phospholipase C Enzyme.

The increasing demand pressures the vegetable oil industry to develop novel refining methods. Degumming with type C phospholipases (PLCs) is a green technology and provides extra oil. However, natural PLCs are not active under the harsh conditions used in oil refining plants, requiring additional unit operations. These upfront capital expenditures and the associated operational costs hinder the adoption of this method. Here, we present a process based on ChPLC, a synthetic PLC obtained by consensus sequence design, possessing superior thermal stability and catalytic properties. Using ChPLC, crude soybean oil degumming was completed at 80 °C in 30 min, the temperature and residence time imposed by the design of existing oil refining plants. Remarkably, an extra yield of oil of 2% was obtained using 60% of the dose recommended for PLCs marketed today, saving upfront investments and reducing the operational cost of degumming. A techno-economic analysis indicates that, for medium size plants, ChPLC reduces the overall cost of soybean oil enzymatic degumming by 58%. The process presented here facilitates the implementation of enzymatic technologies to oil producers, regardless of their processing capacity, bringing potential annual benefits in the billion-dollar range for the global economy.

Epileptic Encephalopathy with Variants in the PHACTR1 and AFF2 Genes: A Case Report.

Developmental and epileptic encephalopathy 70 (DEE70) is an epileptic encephalopathy associated with multiple neurological abnormalities and global developmental delay, among other characteristics. It has recently been established that it is caused by a heterozygous variant of the PHACTR1 gene, with currently four cases reported in the literature. This article presents a case report of a patient with DEE70 with a heterozygous variant in the PHACTR1 gene, who also presents a hemizygous variant in the AFF2 gene, associated with FRAXE syndrome. A phenotypic comparison is made between this case and the four other previously reported cases with variants in the PHACTR1 gene. In addition, the possible participation of the PHACTR1 and AFF2 genes in the clinical characteristics of the individual is discussed.

Profilaxis para sangrado gastrointestinal en pacientes del servicio de medicina interna de un hospital universitario / Gastrointestinal bleeding prophylaxis in internal medicine patients of a univeristy hospital

Introducción: Los medicamentos antiulcerosos son utilizados frecuentemente en pacientes hospitalizados, sin embargo, a menudo este uso no está indicado. Objetivo: Describir la frecuencia de prescripción e indicación de medicamentos para prevenir el sangrado gastrointestinal en pacientes hospitalizados. Materiales y métodos: Estudio de corte trasversal, descriptivo, prospectivo del servicio de Medicina Interna de la Sociedad de Cirugía de Bogotá- Hospital de San José de Bogotá, Colombia. Se excluyeron pacientes con diagnóstico de sangrado gastrointestinal o antecedente de alergia a los medicamentos antiulcerosos. Se recolectaron datos demográficos, así como fármacos prescritos. Se determinó si la indicación del fármaco era adecuada y se identificó el tipo de error de prescripción. Resultados: Se incluyeron 179 pacientes, 102 (57%) mujeres. Promedio de edad de 61,3 años (±20,2). El principal diagnóstico de ingreso fue enfermedad infecciosa 76 (42,4%). Del total de pacientes, 165 (92,17%) recibieron medicamento para prevención del sangrado gastrointestinal. La indicación fue adecuada en 75 pacientes (41,89%). El error más frecuente fue el uso en pacientes de bajo riesgo de sangrado, 101 (97,1%). Conclusión: Un alto porcentaje de los pacientes recibió medicación para la prevención del sangrado gastrointestinal. En aproximadamente la mitad de estos no estaba indicada.

Introduction: Anti-ulcer medications are frequently used in hospitalized patients, yet their use is not usually indicated. Objective: To describe the frequency of prescription and indication of medications to prevent gastrointestinal bleeding in hospitalized patients. Materials and methods: A cross-sectional, descriptive, prospective study was carried out in the Internal Medicine service of the Surgery Society of Bogota-San Jose Hospital of Bogota (Colombia). Excluded patients were those with either a gastrointestinal bleeding diagnosis or a history of allergy to anti-ulcer medications. Demographic data and information regarding prescribed medications were collected. It was determined whether the medicine indication was adequate and the type of prescription error was identified. Results: 179 patients were included in the study, 57% (102) of which were women. The average age was 61.3 (±20.2) years old. Infectious disease was the main admission diagnosis (76; 42.4%). A 92.17% (165) of the total number of patients received medications to prevent gastrointestinal bleeding. This indication was adequate for 75 (41.89%) patients. The most frequent error was their use in bleeding low-risk patients (101; 97.1%). Conclusion: A high percentage of patients received medication to prevent gastrointestinal bleeding. However, in about half of these patients it was not indicated.

Predicting Perceived Exhaustion in Rehabilitation Exercises Using Facial Action Units.

Physical exercise has become an essential tool for treating various non-communicable diseases (also known as chronic diseases). Due to this, physical exercise allows to counter different symptoms and reduce some risk of death factors without medication. A solution to support people in doing exercises is to use artificial systems that monitor their exercise progress. While one crucial aspect is to monitor the correct physical motions for rehabilitative exercise, another essential element is to give encouraging feedback during workouts. A coaching system can track a user's exhaustion and give motivating feedback accordingly to boost exercise adherence. For this purpose, this research investigates whether it is possible to predict the subjective exhaustion level based on non-invasive and non-wearable technology. A novel data set was recorded with the facial record as the primary predictor and individual exhaustion levels as the predicted variable. 60 participants (30 male, 30 female) took part in the data recording. 17 facial action units (AU) were extracted as predictor variables for the perceived subjective exhaustion measured using the BORG scale. Using the predictor and the target variables, several regression and classification methods were evaluated aiming to predict exhaustion. The results showed that the decision tree and support vector methods provide reasonable prediction results. The limitation of the results, depending on participants being in the training data set and subjective variables (e.g., participants smiling during the exercises) were further discussed.

Consistency and validity of the inventory of callous- unemotional traits in a multi-centric community sample.

The purpose of this research was to validate the Inventory of Callous Unemotional Traits in a multi-centric community sample of Colombian children and adolescents aged between 9 and 18 years. An adapted version to the Colombian Spanish was applied to 903 school students without significant medical background (neurotypical behavior), and 118 with a clinical history of internalizing or externalizing conditions. A group of specialized judges approved the content validity of the instrument in terms of relevance and intelligibility, but concept factorial validity was low for the uncaring and callousness factors. Exploratory factor analysis confirmed the existence of three dimensions (uncaring, unemotional, and callousness), but only 17 out of 24 items demonstrated adequate psychometric statistics. The consistency for the 17-item Colombian adaptation was acceptable (α = .78). Goodness-of-fit calculated through confirmatory analysis was satisfactory for a bifactor structure (model C). Neurotypical participants showed lower total scores in comparison to the other groups. Participants with internalizing conditions had higher unemotional traits, while those with externalizing behaviors more commonly presented uncaring behaviors. This study is important for psychopathy research in Colombia as provides a validated adaption of the most used instrument to assess callous-unemotional traits in children and adolescents.

Machine Learning Approach for Fatigue Estimation in Sit-to-Stand Exercise.

Physical exercise (PE) has become an essential tool for different rehabilitation programs. High-intensity exercises (HIEs) have been demonstrated to provide better results in general health conditions, compared with low and moderate-intensity exercises. In this context, monitoring of a patients' condition is essential to avoid extreme fatigue conditions, which may cause physical and physiological complications. Different methods have been proposed for fatigue estimation, such as: monitoring the subject's physiological parameters and subjective scales. However, there is still a need for practical procedures that provide an objective estimation, especially for HIEs. In this work, considering that the sit-to-stand (STS) exercise is one of the most implemented in physical rehabilitation, a computational model for estimating fatigue during this exercise is proposed. A study with 60 healthy volunteers was carried out to obtain a data set to develop and evaluate the proposed model. According to the literature, this model estimates three fatigue conditions (low, moderate, and high) by monitoring 32 STS kinematic features and the heart rate from a set of ambulatory sensors (Kinect and Zephyr sensors). Results show that a random forest model composed of 60 sub-classifiers presented an accuracy of 82.5% in the classification task. Moreover, results suggest that the movement of the upper body part is the most relevant feature for fatigue estimation. Movements of the lower body and the heart rate also contribute to essential information for identifying the fatigue condition. This work presents a promising tool for physical rehabilitation.

Cloning and Production of Thermostable Enzymes for the Hydrolysis of Steryl Glucosides in Biodiesel.

Vegetable oil-derived biodiesels have a major quality problem due to the presence of precipitates formed by steryl glucosides, which clog filters and injectors of diesel engines. An efficient, scalable, and cost-effective method to hydrolyze steryl glucosides using thermostable enzymes has been developed. Here, methods to discover, express in recombinant microorganisms and manufacture enzymes with SGase activity, as well as methods to treat biodiesel with such enzymes, and to measure the content of steryl glucosides in biodiesel samples are presented.

Conocimiento y adaptación de válvulas de habla a traqueostomía por parte de fonoaudiólogos colombianos / Knowledge of colombian speech- language pathologists and adaptation of tracheostomy speaking valves

El propósito de este estudio fue describir el conocimiento que poseen los fonoaudiólogos colombianos acerca de las válvulas de habla y determinar si las emplean como parte del manejo de usuarios con traqueostomía así como las variables que puedan influir en su uso. Para ello, se distribuyó un formulario digital a fonoaudiólogos egresados en Colombia. Las preguntas se agruparon en cinco secciones a partir de las cuales se ajustaron varios modelos lineales generalizados para determinar la influencia de variables como la ciudad, la experiencia profesional, los posgrados, la población, el escenario de atención y la presencia de equipos de traqueostomía en la adaptación de las válvulas. Las preguntas abiertas se analizaron a partir de tendencias temáticas en las respuestas de los participantes. El cuestionario fue respondido por 27 fonoaudiólogos de distintas latitudes con variedad en el nivel posgradual. La totalidad de los encuestados conoce el insumo; de estos, el 66.66% manifestó haber adaptado válvulas y ratifica su beneficio fisiológico. Solo un 33.33% indica que el proceso administrativo para ordenar el insumo fue sencillo. Ninguna de las variables predictoras fue significativa para explicar la adaptación de válvulas de habla (p>0.05). Este estudio plantea que los fonoaudiólogos conocen las válvulas de habla y sus beneficios. Adicionalmente, advierte que las variables estudiadas no tienen influencia significativa en la adaptación del dispositivo. Por último, ratifica que los procesos administrativos relacionados con órdenes médicas y autorizaciones pueden tener un rol desfavorable para lograr acceder a estos insumos

The purpose of this study was to describe the knowledge that Colombian speech-language pathologist have about sepaking valves and to determine whether they use them as part of the management of tracheostomized clients, as well as the variables that may influence their use. To do this, a digital form was distributed to graduated speech therapists in Colombia. The questions were grouped into five sections from which several generalized linear models were adjusted to determine the influence of variables such as city, professional experience, postgraduate degrees, population, setting of care and the presence of tracheostomy teams in the adaptation of the valves. Open questions were analyzed based on thematic trends in the participants' responses. The questionnaire was answered by 27 speech- language pathologists from different latitudes with a variety at the postgraduate level. All of the respondents know the device; of these, 66.66% stated that they had adapted valves and confirmed their physiological benefit. Only 33.33% indicated that the administrative process to order the device was simple. None of the predictor variables was significant to explain the adaptation of speaking valves (p> 0.05). This study suggests that speech- language pathologists are aware of speaking valves and their benefits. Additionally, it warns that the variables studied have no significant influence on the adaptation of the device. Finally, it confirms that the administrative processes related to medical orders and authorizations may play an unfavorable role in gaining access to these supplies.

A novel lecithin:cholesterol acyltransferase for soybean oil refining provides higher yields and extra nutritional value with a cleaner process.

The growing demand for food and biofuels urges the vegetable oil processing industry to adopt cleaner technologies to mitigate the environmental pollution caused by chemical refining processes. Over the past decade, several enzymatic methods have proven to be efficient at reducing the generated waste, but improving the benefit-cost ratio is still necessary for the widespread adoption of this technology. In this work, we show that lecithin:cholesterol acyltransferase from Aeromonas enteropelogenes (LCATAE) provides a higher extra-yield of soybean oil than a type A1 phospholipase (PLA) enzyme currently commercialized for soybean oil deep degumming. Our model indicates that crude soybean oil treated with the new enzyme generates 87% more neutral oil from phospholipids than the widely used PLA, with the corresponding reduction in waste and byproducts generation. The refined oil retains the phytosterols naturally present in crude oil, enriching its nutritional value. The results presented here position LCATAE as a promising candidate to provide the green solutions needed by the industrial oil processing sector. Key points • Selected LCAT gene candidates were expressed in E. coli. • Aeromonas enteropelogenes LCAT hydrolyzes all the phospholipids present in crude soybean oil. • The LCAT enzyme provides a higher yield of neutral oil than commercial PLA enzymes and generates less waste. • The degummed oil retains sterols with high nutritional value.

Predictores psicológicos del riesgo suicida en estudiantes universitarios / No disponible

Este trabajo muestra los factores de riesgo y predictores psicológicos asociados a la conducta suicida en estudiantes universitarios en Manizales y Medellín (Colombia). Participaron 1408 estudiantes y se utilizaron las escalas de riesgo suicida de Plutchik, desesperanza y depresión de Beck e impulsividad de Barratt. Se encontró un factor de riesgo suicida del 23,2%. El análisis de regresión binaria muestra que la depresión (OR = 1,2), impulsividad (OR = 1,04), desesperanza (OR = 1,1), intento de suicidio (OR = 31,5), enfermedad mental e intento de suicidio en la familia (OR = 2,2; OR = 2,1) explican entre el 41% y el 62% de la varianza del riesgo suicida. Mediante el análisis de modelado de ecuaciones estructurales se establecieron tres modelos explicativos que muestran que la enfermedad mental e intento de suicidio en la familia (modelo 1), impulsividad (modelo 2) y antecedentes de intento de suicidio por parte del estudiante (modelo 3) son variables mediadoras del riesgo suicida. El mayor efecto total se produjo en el modelo 3, que explica en un 62,7% la variación del riesgo suicida

This work shows the risk factors and psychological predictors associated with suicidal behavior in university students in Manizales and Medellín (Colombia). The sample comprised 1408 students. Plutchik's suicide risk, Beck's despair and depression and Barratt impulsivity scales were used. A suicide risk factor of 23.2% was found. Binary regression analysis shows that depression (OR = 1.2), impulsivity (OR = 1.04), hopelessness (OR = 1.1), suicide attempt (OR = 31.5), mental illness and family suicide attempt (OR = 2.2, OR = 2.1) explain between 41% and 62% of the variance of suicide risk. Through a structural equation modeling analysis, three explanatory models were established that show mental illness and suicide attempt in the family (model 1), impulsivity (model 2), and a history of suicide attempt by the student (model 3) are suicide mediating variables. The greatest total effect occurred in model 3, which explains 62.7% of the variation in suicide risk

Restoration and conservation of anatomic pieces.

In this study, a restoration process was developed with potassium hydroxide (KOH), in order to improve each of the structures for their posterior fixation, through the use of new methods such as the Chilean conservative fixative solution (SFCCh), with exceptional results. Restore anatomical pieces corresponding to corpse and organs, being these last set with the SFCCh. In this work dealt with processes of restoration with potassium hydroxide, sodium chloride, and sodium hypochlorite, the process began with the cleanliness and suture of the structures for subsequent fixing in Chilean conservative fixative solution, making use of a corpse and different anatomical parts. Work based on items found in the database, Elsevier, Science Direct, ProQuest, and MEDLINE. At the end of the process of restoration and conservation of the anatomical pieces, was observed an improvement in muscle pigment with decrease of rigidity in the specimen, additionally a recovery of appearance in the vascular-nervous elements was achieved. The organs were much more malleable and the structures facilitate the identification of specific details, its subsequent immersion in SFCCh allows the longer preservation of the obtained results. The restoration with potassium hydroxide allows the improvement in the appearance of the different anatomical structures and simultaneously to facilitate its study. The SFCCh is an alternative that replaces partially the use of formaldehyde. In addition, it presents toxicity reduction.

Feasibility study: Towards Estimation of Fatigue Level in Robot-Assisted Exercise for Cardiac Rehabilitation.

Socially Assistive Robotics (SAR) has shown to be an important tool to assist patients in physical rehabilitation. SAR is used to provide feedback about patient's state and performance to users and health professionals, therefore, patients are monitored by means of sensor interfaces. In this context, aiming to avoid over-training conditions, one of the most important parameter to monitor is the fatigue level. However, it is usually measured by subjective scales such as Borg scale, thus, there is a need to develop systems that are able to estimate fatigue with greater accuracy. It has been demonstrated that fatigue can be associated to the decreasing performance of the exercise. Hence, this work carried out a study to determinate which temporal and kinematic features are related to the fatigue level during a sit-to-stand test. The procedure consisted of sitting down and standing up from a chair while kinematic data were measured by a Kinect sensor, in order to relate kinematic data and fatigue. Results show that temporal features (time stand-to-stand and time sit-to-stand) and 3 kinematic features (max vertical-velocity of the spin base, max knee-flexo-extension velocity, and max hip-flexo-extension velocity), have a significant correlation with the fatigue level $(p \lt 0.05)$.

VECTOS: An Integrated System for Monitoring Risk Factors Associated With Urban Arbovirus Transmission.

In Colombia, as in many Latin American countries, decision making and development of effective strategies for vector control of urban diseases such as dengue, Zika, and chikungunya is challenging for local health authorities. The heterogeneity of transmission in urban areas requires an efficient risk-based allocation of resources to control measures. With the objective of strengthening the capacity of local surveillance systems to identify variables that favor urban arboviral transmission, a multidisciplinary research team collaborated with the local Secretary of Health officials of 3 municipalities in Colombia (Giron, Yopal, and Buga), in the design of an integrated information system called VECTOS from 2015 to 2018. Information and communication technologies were used to develop 2 mobile applications to capture entomological and social information, as well as a web-based system for the collection, geo-referencing, and integrated information analysis using free geospatial software. This system facilitates the capture and analysis of epidemiological information from the Colombian national surveillance system (SIVIGILA), periodic entomological surveys-mosquito larvae and pupae in premises and peridomestic breeding sites-and surveys of knowledge, attitudes, and practices (KAP) in a spatial and temporal context at the neighborhood level. The data collected in VECTOS are mapped and visualized in graphical reports. The system enables real-time monitoring of weekly epidemiological indicators, entomological indices, and social surveys. Additionally, the system enables risk stratification of neighborhoods, using selected epidemiological, entomological, demographic, and environmental variables. This article describes the VECTOS system and the lessons learned during its development and use. The joint analysis of epidemiological and entomological data within a geographic information system in VECTOS gives better insight to the routinely collected data and identifies the heterogeneity of risk factors between neighborhoods. We expect the system to continue to strengthen vector control programs in evidence-based decision making and in the design and enhanced follow-up of vector control strategies.

Industrial uses of phospholipases: current state and future applications.

Phospholipids play a central role in all living organisms. Phospholipases, the enzymes aimed at modifying phospholipids, are consequently widespread in nature and play diverse roles, from lipid metabolism and cellular signaling in eukaryotes to virulence and nutrient acquisition in microbes. Phospholipases catalyze the hydrolysis of one or more ester or phosphodiester bonds of glycerophospholipids. The use of phospholipases with industrial purposes has constantly increased over the last 30 years. This demand is rapidly growing given the ongoing improvements in protein engineering and the reduction of enzymes manufacturing costs, making them suitable for industrial use. Here, a general overview of phopholipases A, B, C, and D and their industrial application is presented along with potential new uses for these enzymes. We draw attention to commercial phospholipases used to improve the emulsifying properties of products in the baking, egg, and dairy industries. On the other hand, the improvement of oil degumming by phospholipases is thoroughly analyzed. Moreover, recent developments in enzymatic biodiesel production and the use of phospholipases for the synthesis of phospholipids with pharmaceutical or nutritional value are reviewed.

Uso de recursos TIC en la enseñanza de las matemáticas: retos y perspectivas / Use of resources TIC in the education of the mathematics: challenges and perspectives / Uso de recursos de TIC no ensino de matemática: desafios e perspectivas

RESUMEN El presente artículo muestra la revisión de literatura en cuanto al uso de recursos tecnológicos en procesos de enseñanza - aprendizaje de las matemáticas en distintos contextos de formación con el fin de identificar cuáles son los aspectos teóricos y tecnológicos que se deben tener en cuenta para la creación de estos recursos, cuál ha sido el impacto de su aplicación y cuáles son los retos y perspectivas que se presentan en este campo de trabajo. Se hizo una revisión de 33 referencias seleccionadas después de una búsqueda en bases de datos aplicando ciertos criterios de inclusión y de exclusión y también una revisión de otros trabajos referenciados en estas mismas. Se concluye que el uso de este tipo de recursos en clases de matemáticas tiene un impacto positivo en los estudiantes, sin embargo hace falta realizar estudios que profundicen más respecto a este impacto en periodos más amplios de tiempo. Se plantea que para lograr aprendizajes significativos de la matemática utilizando recursos tecnológicos es necesario articular en los currículos de formación las competencias comunicativas y tecnológicas, no solo en los estudiantes sino también en los docentes quienes deben transformar los métodos tradiciones de enseñanza de esta área.

ABSTRACT The present article shows the literature review to the use of thecnological resources, these in the mathematics processes of education - learning in different academic training context. In order to identify first of all which are the theoretical and technological aspects that must be taken into consideration for the creation of these resources; second which has been the impact of its application and third which are the challenges and perspectives that are presented in this field work. After a search on the databases one revision of 33 selected references were made applying certain inclusion and exclusion criteria. Beside, one revision of other similar reference works were made selected references were made applying certain inclusion and exclusion criteria. Beside, one revision of other similar reference works were made. It follows that the use of this kind of resources in mathematic classes have a positive impact on students learning. However, it is necessary to have additional studies which emphasize in this impact for longer period of time. It is argued that in order to achieve meaningful learning of mathematic knowledge through technological resources it is necessary to articulate the communicative and technological competences in the curriculum design, not only in the students but also in the teachers who must transform the teaching methods of this area.

RESUMO Este artigo apresenta uma revisão da literatura sobre o uso de recursos tecnológicos no ensino - aprendizagem da matemática em diferentes contextos de formação, a fim de identificar os aspectos teóricos e tecnológicos que devem ser considerados para a criação são desses recursos, qual tem sido o impacto de sua aplicação e quais os desafios e perspectivas que surgem nesse campo de trabalho. Uma revisão de 33 referências selecionadas foi feita após uma busca em bases de dados aplicando certos critérios de inclusão e exclusão e também uma revisão de outros trabalhos referenciados neles. Conclui-se que o uso desses recursos nas aulas de matemática tem um impacto positivo sobre os alunos, no entanto estudos devem aprofundar mais sobre este impacto sobre longos períodos de tempo. Argumenta-se que, para alcançar a aprendizagem significativa da matemática usando recursos tecnológicos necessários para articular nos currículos de formação competência comunicativa e tecnológico, não só estudantes, mas também professores que devem transformar as tradições desta métodos de ensino da área.

Latent tuberculosis infection is associated with increased unstimulated levels of interferon-gamma in Lima, Peru.

BACKGROUND: We previously reported increased unstimulated blood levels of interferon-gamma in persons with latent tuberculosis infection (LTBI) in the United States, suggesting enhanced immune activation in LTBI. To investigate this further in a TB-endemic setting, we assessed interferon-gamma levels in persons with and without LTBI in Peru. METHODS: We analyzed data from patients with and without a recent type 1 (spontaneous) acute myocardial infarction (AMI) who were enrolled from two public hospital networks in Lima, Peru, and underwent LTBI testing using the QuantiFERON® TB Gold In-tube (QFT) assay. Participants with a positive QFT test were defined as having LTBI, whereas participants with a negative QFT test were defined as non-LTBI. Unstimulated interferon-gamma was quantified via enzyme-linked immunosorbent assay in the QFT nil-tube, which does not contain antigens. We compared unstimulated interferon-gamma levels between LTBI and non-LTBI groups using the Wilcoxon rank sum test. We used proportional odds modeling for multivariable analysis. RESULTS: Data from 214 participants were included in this analysis. Of those, 120 (56%) had LTBI. There were no significant differences in age, sex and comorbidities between LTBI and non-LTBI participants, except for recent AMI that was more frequent in LTBI. LTBI participants had higher unstimulated interferon-gamma levels compared to non-LTBI participants (median, interquartile range; 14 pg/mL, 6.5-52.8 vs. 6.5 pg/mL, 4.5-15; P<0.01). LTBI remained associated with higher unstimulated interferon-gamma levels after controlling for age, sex, recent AMI, history of hypertension, diabetes mellitus, dyslipidemia, end stage renal disease, malignancy, obesity, and tobacco use (adjusted odds ratio, 2.93; 95% confidence interval, 1.8-4.9). In a sensitivity analysis that excluded participants with AMI, the association between unstimulated interferon-gamma and LTBI remained present (adjusted odds ratio; 3.93; 95% confidence interval, 1.9-8.2). CONCLUSIONS: LTBI was associated with higher unstimulated interferon-gamma levels. These data suggest ongoing immune activation in LTBI.

The production, properties, and applications of thermostable steryl glucosidases.

Extremophilic microorganisms are a rich source of enzymes, the enzymes which can serve as industrial catalysts that can withstand harsh processing conditions. An example is thermostable ß-glucosidases that are addressing a challenging problem in the biodiesel industry: removing steryl glucosides (SGs) from biodiesel. Steryl glucosidases (SGases) must be tolerant to heat and solvents in order to function efficiently in biodiesel. The amphipathic nature of SGs also requires enzymes with an affinity for water/solvent interfaces in order to achieve efficient hydrolysis. Additionally, the development of an enzymatic process involving a commodity such as soybean biodiesel must be cost-effective, necessitating an efficient manufacturing process for SGases. This review summarizes the identification of microbial SGases and their applications, discusses biodiesel refining processes and the development of analytical methods for identifying and quantifying SGs in foods and biodiesel, and considers technologies for strain engineering and process optimization for the heterologous production of a SGase from Thermococcus litoralis. All of these technologies might be used for the production of other thermostable enzymes. Structural features of SGases and the feasibility of protein engineering for novel applications are explored.

Pilot-scale process development for low-cost production of a thermostable biodiesel refining enzyme in Escherichia coli.

Biodiesels produced from vegetable oils have a major quality problem due to the presence of steryl glucosides (SGs), which form precipitates that clog filters and cause engine failures. Recently, we described an enzymatic process for removing SGs from biodiesel. However, industrial adoption of this technology was hindered by the cost of the steryl glucosidase (SGase) enzyme used. Here we report the development and validation at the pilot scale of a cost-efficient process for manufacturing the SGase. First, we tested various low-cost carbon sources for the Escherichia coli producing strain, ultimately developing a fed-batch fermentation process that utilizes crude glycerol as a feedstock. Next, we designed an efficient process for isolating the SGase. That process uses a novel thermolysis approach in the presence of a non-ionic detergent, centrifugation to separate the solids, and ultrafiltration to concentrate and formulate the final product. Our cost analysis indicates that on a large scale, the dose of enzyme required to eliminate SGs from each ton of biodiesel will have a manufacturing cost below $1. The new process for manufacturing the SGase, which will lead to biodiesels of a higher quality, should contribute to facilitate the global adoption of this renewable fuel. Our technology could also be used to manufacture other thermostable proteins in E. coli.