[Diagnostic performance of biliopancreatic endosonography in patients with intermediate risk of choledocholithiasis]. / Rendimiento diagnóstico de la endosonografía biliopancreática en pacientes con riesgo intermedio de coledocolitiasis.

OBJECTIVE: Determine the sensitivity and specificity of the ESBP for diagnosis in patients with intermediate risk of choledocholithiasis, referred to the specialized surgical Gastroenterology center of Unión de Cirujanos SAS - Oncologists of the West Zentria group - Manizales - Colombia between March 01, 2020 to January 31, 2022. MATERIALS AND METHODS: Retrospective cross-sectional study in patients with intermediate risk for choledocholithiasis. The diagnostic performance of ESBP was calculated and confirmed with ERCP. Negative ESBPs were followed up by telephone. RESULTS: 752 cases with ESBP were analyzed, of which 43.2% (n=325) were positive and 56.8% (n=427) were negative. ERCP was performed in positive cases who accepted the procedure (n=317); 73.5% (n:233) were positive for choledocholithiasis, 25.8% (n=82) tumors and 0.6% (n=2) biliary roundworms. Patients with positive ESBP underwent ERCP. S= 98.3% (95% CI: 95.7-99.5) was obtained; E= 88.1% (95% CI: 79.2-94.1); PPV = 95.8% (95% CI: 92.4-98.0); NPV = 94.9% (95% CI: 87.4-98.7). The AUC of ESBP was 0.9319 (95% CI 0.8961-0.967). CONCLUSION: In patients with intermediate risk for choledocholithiasis, ESBP is a useful diagnostic option in the study of pancreatic pathologies, extrahepatic biliary tree, and the identification of biliary microlithiasis; Therefore, it also allows us to complement it with a therapeutic intervention such as ERCP in a single time.

Rendimiento diagnóstico de la endosonografía biliopancreática en pacientes con riesgo intermedio de coledocolitiasis / Diagnostic performance of biliopancreatic endosonography in patients with intermediate risk of choledocholithiasis

RESUMEN Objetivo: Determinar la sensibilidad y la especificidad de la endosonografía biliopancreática (ESBP) para diagnóstico en pacientes con riesgo intermedio de coledocolitiasis, derivados a un centro especializado de Gastroenterología quirúrgica de Unión de Cirujano SAS - Oncólogos de Occidente grupo Zentria - Manizales - Colombia entre el 01 de marzo de 2020 al 31 de enero de 2022. Materiales y métodos: Estudio retrospectivo transversal en pacientes con riesgo intermedio para coledocolitiasis. Se calculó el rendimiento diagnóstico de la ESBP y se confirmó con CPRE. Se hizo seguimiento telefónico a los ESBP negativas. Resultados: Se analizaron 752 casos con ESBP de los cuales el 43,2% (n=325) fue positivo y el 56,8% (n=427) fue negativo. Se practicó CPRE en los casos positivos que aceptaron el procedimiento (n=317); el 73,5% (n=233) fueron positivos para coledocolitiasis, el 25,8% (n=82) tumores y el 0,6% (n=2) áscaris biliares. Pacientes con ESBP positiva fueron intervenidos con CPRE. Se obtuvo S= 98,3% (IC 95%: 95,7-99,5); E= 88,1% (IC 95%: 79,2-94,1); VPP = 95,8% (IC 95%: 92,4-98,0); VPN = 94,9% (IC 95%: 87,4-98,7). El AUC de ESBP fue de 0,9319 (IC 95% 0,8961-0,967). Conclusión: En pacientes con riesgo intermedio para coledocolitiasis, la ESBP es una opción diagnostica útil en el estudio de patologías pancreáticas, árbol biliar extrahepático, y la identificación de microlitiasis biliares; por lo que nos permite además poder complementarla con una intervención terapéutica como la CPRE en un solo tiempo.

ABSTRACT Objective: Determine the sensitivity and specificity of the ESBP for diagnosis in patients with intermediate risk of choledocholithiasis, referred to the specialized surgical Gastroenterology center of Unión de Cirujanos SAS - Oncologists of the West Zentria group - Manizales - Colombia between March 01, 2020 to January 31, 2022. Materials and methods: Retrospective cross-sectional study in patients with intermediate risk for choledocholithiasis. The diagnostic performance of ESBP was calculated and confirmed with ERCP. Negative ESBPs were followed up by telephone. Results: 752 cases with ESBP were analyzed, of which 43.2% (n=325) were positive and 56.8% (n=427) were negative. ERCP was performed in positive cases who accepted the procedure (n=317); 73.5% (n:233) were positive for choledocholithiasis, 25.8% (n=82) tumors and 0.6% (n=2) biliary roundworms. Patients with positive ESBP underwent ERCP. S= 98.3% (95% CI: 95.7-99.5) was obtained; E= 88.1% (95% CI: 79.2-94.1); PPV = 95.8% (95% CI: 92.4-98.0); NPV = 94.9% (95% CI: 87.4-98.7). The AUC of ESBP was 0.9319 (95% CI 0.8961-0.967). Conclusion: In patients with intermediate risk for choledocholithiasis, ESBP is a useful diagnostic option in the study of pancreatic pathologies, extrahepatic biliary tree, and the identification of biliary microlithiasis; Therefore, it also allows us to complement it with a therapeutic intervention such as ERCP in a single time.

Endosonographic Characteristics of Subepithelial Lesions of the Upper Digestive Tract: Experience of a Referral Center in Colombia

Introduction: Subepithelial lesions (SELs), described as bulges or masses covered by healthy-looking mucosa, are usually found incidentally during endoscopic studies. They are typically asymptomatic and are estimated to be identified in 1% of esophagogastroduodenoscopies performed. Materials and methods: A descriptive study was conducted with retrospective data collection. We included all patients treated at the Unión de Cirujanos, a referral gastroenterology unit of the Coffee Region in Manizales, between January 2020 and January 2022, who underwent endoscopic ultrasonography to study subepithelial-looking lesions located in the esophagus, stomach, and duodenum. Results: 152 endoscopic ultrasounds were performed, finding 108 SELs; 66.6% of the patients were women, and the average age was 58. Most SELs were located in the stomach (78.7%), the antrum being the most frequent location. The average diameter of the gastric SELs was 14.6 mm, and 47% of the lesions depended on the fourth echolayer; the most frequent presumptive diagnoses were gastrointestinal stromal tumor (GIST; 65.8%) and lipoma (11.7%). Conclusions: SELs of the GI tract originate in the muscularis mucosae, submucosa, or muscularis propria. They are most frequently located in the stomach, and their characterization usually requires endoscopic ultrasonography and histopathology. Treatment of these lesions remains controversial due to their low frequency, histological variety, and low malignant potential.

Introducción: las lesiones subepiteliales (LSE), descritas como abultamientos o masas cubiertas por mucosa de aspecto sano, se encuentran usualmente de manera incidental durante estudios endoscópicos; suelen ser asintomáticas y se estima que se identifican en el 1% de las esofagogastroduodenoscopias realizadas. Métodos: se realizó un estudio descriptivo con recolección retrospectiva de la información. Se incluyeron todos los pacientes atendidos en Unión de Cirujanos, unidad de gastroenterología de referencia del Eje Cafetero ubicada en la ciudad de Manizales, entre enero de 2020 y enero de 2022, a quienes se les realizó ultrasonografía endoscópica como parte del estudio de lesiones de aspecto subepitelial localizadas en el esófago, estómago y duodeno. Resultados: se realizaron 152 endosonografías y se encontraron 108 lesiones subepiteliales, 66,6% de los pacientes eran mujeres y el promedio de edad fue 58 años. La mayoría de las LSE se localizaron en el estómago (78,7%) y, de estas, la localización más frecuente fue el antro; el diámetro promedio de las LSE gástricas fue de 14,6 mm y el 47% de las lesiones eran dependientes de la cuarta ecocapa; los diagnósticos presuntivos más frecuentes fueron el tumor del estroma gastrointestinal (GIST; 65,8%) y lipoma (11,7%). Conclusiones: las LSE del tracto gastrointestinal se originan en la muscular de la mucosa, submucosa o muscular propia, de manera más frecuente se localizan en el estómago y su caracterización suele requerir la realización de ultrasonografía endoscópica y estudio histopatológico. El tratamiento de estas lesiones sigue siendo controversial debido a su baja frecuencia, variedad histológica y bajo potencial maligno.

Recent Advances in Batteryless NFC Sensors for Chemical Sensing and Biosensing.

This article reviews the recent advances in the field of batteryless near-field communication (NFC) sensors for chemical sensing and biosensing. The commercial availability of low-cost commercial NFC integrated circuits (ICs) and their massive integration in smartphones, used as readers and cloud interfaces, have aroused great interest in new batteryless NFC sensors. The fact that coil antennas are not importantly affected by the body compared with other wireless sensors based on far-field communications makes this technology suitable for future wearable point-of-care testing (PoCT) devices. This review first compares energy harvesting based on NFC to other energy-harvesting technologies. Next, some practical recommendations for designing and tuning NFC-based tags are described. Power transfer is key because in most cases, the energy harvested has to be stable for several seconds and not contaminated by undesired signals. For this reason, the effect of the dimensions of the coils and the conductivity on the wireless power transfer is thoroughly discussed. In the last part of the review, the state of the art in NFC-based chemical and biosensors is presented. NFC-based tags (or sensor tags) are mainly based on commercial or custom NFC ICs, which are used to harvest the energy from the RF field generated by the smartphone to power the electronics. Low-consumption colorimeters and potentiostats can be integrated into these NFC tags, opening the door to the integration of chemical sensors and biosensors, which can be harvested and read from a smartphone. The smartphone is also used to upload the acquired information to the cloud to facilitate the internet of medical things (IoMT) paradigm. Finally, several chipless sensors recently proposed in the literature as a low-cost alternative for chemical applications are discussed.

Smart Spread Spectrum Modulated Tags for Detection of Vulnerable Road Users with Automotive Radar.

In recent years, there has been a significant increase in the number of collisions between vehicles and vulnerable road users such as pedestrians, cyclists, road workers and more recently scooter riders, especially in urban streets. This work studies the feasibility of enhancing the detection of these users by means of CW radars because they have a low radar cross section. Since the speed of these users is usually low, they can be confused with clutter due to the presence of large objects. To this end, this paper proposes, for the first time, a method based on a spread spectrum radio communication between vulnerable road users and the automotive radar consisting of modulating a backscatter tag, placed on the user. In addition, it is compatible with low-cost radars that use different waveforms such as CW, FSK or FMCW, and hardware modifications are not required. The prototype that has been developed is based on a commercial monolithic microwave integrated circuit (MMIC) amplifier connected between two antennas, which is modulated by switching its bias. Experimental results with a scooter, under static and moving conditions, using a low-power Doppler radar at a 24 GHz band compatible with blind spot radars, are provided.

Evaluación del equilibrio y la marcha como factor de riesgo de caídas en adultos mayores

Introducción: Los adultos mayores por naturaleza presentan deterioro progresivo de las capacidades físico-cognitivas, donde se ven afectadas facultades como el equilibrio y la marcha, condicionando el aumento del riesgo de sufrir caídas. Objetivo: Evaluar el equilibrio y la marcha en una muestra de adultos mayores pertenecientes al consultorio del médico de la familia No. 21, del Policlínico Comunitario Docente Julio Antonio Mella, de la provincia Camagüey. Métodos: Se realizó un estudio descriptivo de diseño transversal. El universo estuvo constituido por 468 adultos mayores y se seleccionó una muestra intencionada de 100 de ellos, según los criterios de inclusión y exclusión. La observación y la entrevista fueron las fuentes primarias de la investigación. Las historias de salud familiar e individual fueron la fuente secundaria, además de un formulario con las siguientes variables: grupos etáreos, sexo, nivel educacional, comorbilidades, consumo de medicamentos, antecedentes de caídas, evaluación del equilibrio, evaluación de la marcha y la evaluación del riesgo de caídas, aplicando la escala de Tinetti. Resultados: Existió mayor frecuencia en los adultos mayores de 70-79 años, del sexo femenino y con nivel educacional preuniversitario. Predominó la hipertensión arterial (consumiendo entre uno y tres medicamentos) y con antecedentes de hasta dos caídas anteriores. Se demostraron alteraciones en la evaluación del equilibrio y la marcha, según la escala de Tinetti, el grupo de pacientes presentó un riesgo moderado de sufrir caídas, con una mayor predisposición para el sexo femenino. Conclusiones: El grupo de adultos mayores evaluados presentó alteraciones en la evaluación del equilibrio y la marcha, con un moderado riesgo de sufrir caídas, evitando así las consecuencias que tiene cada precipitación si no se toman las medidas efectivas al respecto.

Introduction: Older adults, by nature, present progressive deterioration of physical-cognitive abilities where faculties such as balance and gait are affected, conditioning the increased risk of falling. Objective: To evaluate balance and walk in a sample of older adults belonging to the family doctor's office No.21, of the Julio Antonio Mella Community Teaching Polyclinic, in the Camagüey province. Methods: A descriptive study of cross-sectional design was carried out. The universe consisted of 468 older adults and an intentional sample of 100 was selected according to inclusion and exclusion criteria. The primary source of the research being the observation and the interview, the secondary source the family and individual health histories and a form with the following variables: age groups, sex, educational level, comorbidities, medication use, history of falls, evaluation of balance, gait evaluation and evaluation of the risk of falls, applying the Tinetti scale. Results: There was a greater frequency in adults aged 70-79 years, female and with a pre-university educational level. Arterial hypertension predominated, consuming between one and three medications and with a history of up to two previous falls. Alterations in the evaluation of balance and gait were demonstrated, showing according to the Tinetti scale that the sample presents a moderate risk of suffering falls with a greater predisposition in the female sex. Conclusions: The group of elderly adults evaluated present alterations in the evaluation of balance and gait, with a moderate risk of falling, with its consequences if effective measures are not taken in this regard.

Visualizing the historical COVID-19 shock in the US airline industry: A Data Mining approach for dynamic market surveillance.

One of the purposes of Artificial Intelligence tools is to ease the analysis of large amounts of data. In order to support the strategic decision-making process of the airlines, this paper proposes a Data Mining approach (focused on visualization) with the objective of extracting market knowledge from any database of industry players or competitors. The method combines two clustering techniques (Self-Organizing Maps, SOMs, and K-means) via unsupervised learning with promising dynamic applications in different sectors. As a case study, 30-year data from 18 diverse US passenger airlines is used to showcase the capabilities of this tool including the identification and assessment of market trends, M&A events or the COVID-19 consequences.

Reservoritis secundaria a infección por citomegalovirus: reporte de caso y revisión de la literatura / Pouchitis secondary to cytomegalovirus infection: Case report and literature review

Resumen La proctocolectomía total con reservorio ileal es el procedimiento quirúrgico de elección para la colitis ulcerativa refractaria (CUR) al tratamiento médico y la reservoritis es la complicación más frecuente y puede afectar hasta al 50% de los pacientes en los primeros 5 años del procedimiento. Aunque la etiología no está bien establecida, su presentación podría estar relacionada con disbiosis como resultado de la estasis fecal en individuos genéticamente susceptibles y con una respuesta inmunitaria alterada. Los síntomas típicos de reservoritis como diarrea, dolor abdominal, tenesmo, urgencia, incontinencia fecal y, menos frecuentemente, sangrado rectal no son específicos y el diagnóstico debe confirmarse mediante una evaluación endoscópica e histológica. La infección por citomegalovirus es infrecuente como causa de reservoritis; sin embargo, debe considerarse en pacientes con reservoritis refractaria al manejo antibiótico inicial. Las pruebas diagnósticas incluyen pruebas serológicas como la medición de anticuerpos, antigenemia y proteína C-reactiva (PCR) en sangre. El tratamiento de elección es el ganciclovir, medicamento de administración endovenosa que puede inducir complicaciones graves como mielosupresión, neutropenia y trombocitopenia. Se recomienda el seguimiento endoscópico posterior al tratamiento para asegurar la cicatrización mucosa, especialmente cuando hay sospecha de enfermedad de Crohn o compromiso del asa aferente en la endoscopia inicial.

Abstract Total proctocolectomy with ileal pouch is the surgical procedure of choice for ulcerative colitis refractory to medical treatment, and pouchitis is the most frequent complication. It can affect up to 50% of patients in the first five years of the procedure. Although the etiology is not well established, its manifestation could be related to dysbiosis resulting from fecal stasis in genetically susceptible individuals with altered immune responses. Typical symptoms of pouchitis, such as diarrhea, abdominal pain, tenesmus, urgency, fecal incontinence, and, less commonly, rectal bleeding, are nonspecific, and the diagnosis must be confirmed by endoscopic and histologic examination. Cytomegalovirus infection is an infrequent cause of pouchitis; however, it should be considered in patients with pouchitis refractory to initial antibiotic management. Diagnostic tests include serological tests such as the measurement of antibodies, antigenemia, and C-reactive protein (CRP) in blood. The treatment of choice is ganciclovir, an intravenous drug that can induce severe complications such as myelosuppression, neutropenia, and thrombocytopenia. Post-treatment endoscopic follow-up is recommended to ensure mucosal healing, especially when there is suspicion of Crohn's disease or involvement of the afferent loop on initial endoscopy.

Battery-Less NFC Potentiostat for Electrochemical Point-of-Care Sensors Based on COTS Components.

This work studies the feasibility of using a battery-less Near-Field Communication (NFC) potentiostat for the next generation of electrochemical point-of-care sensors. A design based on an NFC microchip, a microcontroller, and a custom potentiostat based on an operational amplifier is presented. A proof-of-concept prototype has been designed and used to quantify glucose concentration using commercial glucose test strips from chronoamperometry measurements. The device is harvested and the sensor is read using a mobile phone. The prototype uses an antenna loop covered with ferrite sheets to ensure stable operation of the electronics when the mobile phone is used as reader. The use of ferrite reduces the detuning caused by the proximity of the metal parts of the mobile phone. A comparison with a commercial glucometer device is provided. Results obtained using a commercial glucometer and those provided by the proposed potentiostat show an excellent agreement.

Long-Range Wireless System for U-Value Assessment Using a Low-Cost Heat Flux Sensor.

The present study exposes an economical and easy-to-use system to assess the heat transfer in building envelopes by determining the U-value. Nowadays these systems require long wires and a host to collect and process the data. In this work, a multi-point system for simultaneous heat flux measurement has been proposed. The aim is to reduce the long measurement time and the cost of thermal isolation evaluations in large buildings. The system proposed consists of a low-cost 3D-printed heat flux sensor integrated with a LoRa transceiver and two temperature sensors. The heat flux (HF) sensor was compared and calibrated with a commercial HF sensor from the Fluxteq brand.

Role of Sirtuins in the Pathobiology of Onco-Hematological Diseases: A PROSPERO-Registered Study and In Silico Analysis.

The sirtuins (SIRT) gene family (SIRT1 to SIRT7) contains the targets implicated in cellular and organismal aging. The role of SIRTs expression in the pathogenesis and overall survival of patients diagnosed with solid tumors has been widely discussed. However, studies that seek to explain the role of these pathways in the hematopoietic aging process and the consequences of their instability in the pathogenesis of different onco-hematological diseases are still scarce. Therefore, we performed a systematic review (registered in PROSPERO database #CRD42022310079) and in silico analysis (based on GEPIA database) to discuss the role of SIRTs in the advancement of pathogenesis and/or prognosis for different hematological cancer types. In summary, given recent available scientific evidence and in silico gene expression analysis that supports the role of SIRTs in pathobiology of hematological malignances, such as leukemias, lymphomas and myeloma, it is clear the need for further high-quality research and clinical trials that expands the SIRT inhibition knowledge and its effect on controlling clonal progression caused by genomic instability characteristics of these diseases. Finally, SIRTs represent potential molecular targets in the control of the effects caused by aging on the failures of the hematopoietic system that can lead to the involvement of hematological neoplasms.

Impacto de la pandemia COVID-19 en endoscopistas digestivos: un estudio iberoamericano / Impact of the COVID-19 pandemic on digestive endoscopists: an Ibero-American study

Introducción: la pandemia por el SARS-CoV-2 o COVID-19ha causado inmensas afectaciones a la población mundialy ha puesto al personal de la salud en primera plana porser los responsables de su manejo. Los médicos se hanvisto afectados en muchos aspectos (laboral, económico,salud física y mental), siendo importante identificar estasalteraciones. El objetivo de este trabajo fue evaluar lasimplicaciones que la pandemia ha tenido en los endoscopistas de nuestro país, comparándolo con la región y conun país europeo.Métodos: durante el mes de junio de 2021 se aplicó unaencuesta electrónica bajo el método de muestreo no probabilístico en la que participaron endoscopistas de la Asociación Colombiana de Endoscopia Digestiva (ACED); deEspaña y de Suramérica, evaluando el impacto de la pandemia en la práctica profesional, económica y académicay en la salud física y mental de los encuestados.Resultados: el 69,9 % de los encuestados informó disminución en el número de procedimientos. El 77,2 % de losparticipantes de Colombia informaron una caída en susingresos. El 43,8 % manifestó deterioro en la relación médico-paciente. El 56,5 % consideró que la pandemia ha afectado de forma negativa el entrenamiento de los residentes.La infección por COVID-19 se presentó en el 24,7 % de losendoscopistas y el 19,2 % perdió algún familiar. El 70,9 %de los encuestados informó cambios emocionales relacionados especialmente con tristeza y depresión. (AU)

Role of Polygenic Risk Score in Cancer Precision Medicine of Non-European Populations: A Systematic Review.

The development of new screening methods and diagnostic tests for traits, common diseases, and cancer is linked to the advent of precision genomic medicine, in which health care is individually adjusted based on a person's lifestyle, environmental influences, and genetic variants. Based on genome-wide association study (GWAS) analysis, rapid and continuing progress in the discovery of relevant single nucleotide polymorphisms (SNPs) for traits or complex diseases has increased interest in the potential application of genetic risk models for routine health practice. The polygenic risk score (PRS) estimates an individual's genetic risk of a trait or disease, calculated by employing a weighted sum of allele counts combined with non-genetic variables. However, 98.38% of PRS records held in public databases relate to the European population. Therefore, PRSs for multiethnic populations are urgently needed. We performed a systematic review to discuss the role of polygenic risk scores in advancing precision medicine for different cancer types in multiethnic non-European populations.

Ergonomics in digestive endoscopy: Prevalence, types of musculoskeletal disorders, and risk factors in endoscopists in Colombia / Ergonomía en endoscopia digestiva: prevalencia, tipos de trastornos musculoesqueléticos y factores de riesgo en endoscopistas de Colombia

Abstract Introduction: The practice of digestive endoscopy is a physically demanding activity, with musculoskeletal disorders present in 39 % to 89 % of endoscopists, associated with "excessive use" maneuvers. Due to a lack of knowledge of this problem in endoscopists in Colombia, the main objective is to determine the prevalence, types, and risk factors of musculoskeletal disorders in specialists and graduate students. The secondary objective is to identify the occupational impact, treatments used, and importance of prevention and education in ergonomics. Materials and methods: Analytical cross-sectional observational study. Electronic survey methodology, open from June 1 to 30, 2021. Purposive sampling of 450 endoscopists from four scientific associations and eleven graduate programs, including 50 questions in six groups according to the objectives. We validated 203 responses, with 131 confirmations of musculoskeletal disorders, the group on which the analysis was performed. Results: Global prevalence of musculoskeletal disorders of 64.5 % and prevalence in graduate students of 58.6 %. There was more significant involvement of the upper limbs (right shoulder, left thumb, right elbow), followed by lower back, neck, knees, and hips. Graduate students reported pain in the right hand/fingers (right thumb) and the lower back. There was no significant difference due to work factors, but there was a tendency for more reports when increasing the volume of procedures and years of professional practice. The labor impact showed 78 % absenteeism. The most used treatments were medication, physiotherapy, and rest; 93.8 % had not received ergonomic education. However, there is a positive perception (74.1 % to 90.9 %) of receiving formal training. Discussion: The prevalence reflected the health and safety problem for the endoscopist. Demographic risk factors plus those of the endoscopic practice give rise to an individualized risk framework that enables endoscopists to understand learning and training as a way to prevent musculoskeletal disorders in themselves and their work team.

Resumen Introducción: la práctica de la endoscopia digestiva es una actividad físicamente exigente, con trastornos musculoesqueléticos presentes en el 39 % a 89 %, asociados con maniobras de "uso excesivo". Debido al desconocimiento de este problema en endoscopistas de Colombia, el objetivo principal fue determinar la prevalencia, tipos y factores de riesgo del trastorno musculoesquelético en especialistas y estudiantes de posgrado. El objetivo secundario fue identificar el impacto laboral, los tratamientos utilizados y la importancia atribuida a la prevención y educación en ergonomía. Metodología: estudio observacional de corte transversal analítico. Metodología de encuesta electrónica, abierta del 1 al 30 de junio de 2021. Muestreo intencionado a 450 endoscopistas de 4 asociaciones científicas y 11 programas de posgrado, en el que se incluyeron 50 preguntas en 6 grupos según los objetivos. Se validaron 203 respuestas, con 131 confirmaciones de trastornos musculoesqueléticos, grupo al cual se le realizó el análisis. Resultados: prevalencia global de trastornos musculoesqueléticos de 64,5 % y prevalencia en estudiantes de posgrado de 58,6 %. Hubo mayor afectación de miembros superiores (hombro derecho, pulgar izquierdo, codo derecho); luego, en la espalda baja y cuello; y en las rodillas y caderas. En estudiantes de posgrado se registró dolor en la mano-dedos derechos (pulgar derecho) y en la espalda baja. No hubo diferencia significativa por aspectos laborales, pero hubo tendencia a un mayor reporte al aumentar el volumen de procedimientos y años de práctica profesional. El impacto laboral mostró 78 % de ausentismo laboral. Los tratamientos más empleados fueron medicamentos, fisioterapia y reposo. El 93,8 % no había recibido capacitación ergonómica y hay percepción positiva (74,1 % a 90,9 %) de recibir una didáctica formal. Discusión: la prevalencia evidenció el problema de salud y seguridad para el endoscopista. Los factores de riesgo demográficos más los propios de la práctica endoscópica generan un marco de riesgo individualizado que le permite al endoscopista entender el aprendizaje y la capacitación para prevenir trastornos musculoesqueléticos en sí mismo y su equipo de trabajo.

Spoofing Attacks on FMCW Radars with Low-Cost Backscatter Tags.

This work studies the feasibility of using backscatter-modulated tags to introduce false information into a signal received by a frequency-modulated continuous-wave (FMCW) radar. A proof-of-concept spoofing device was designed in the 24 GHz ISM band. The spoofing device was based on an amplifier connected between two antennas, and modulation was carried out by switching the amplifier bias. The use of an amplifier allowed us to increase the level of spoofing signal compared with other modulated backscattering methods. The simulated and experimental results show that our method has the ability to generate a pair of false targets at different ranges and velocities depending on the modulation frequency of the chosen tag, since sidebands appear due to this modulation. Countermeasures to detect the spoofing attack based on changes in the slope of the frequency sweep between frames are also proposed.

Impact of the COVID-19 pandemic on digestive endoscopists: an Ibero-American study.

INTRODUCTION: the COVID-19 pandemic has seriously affected the world population, and has put health personnel in the spotlight as they are tasked with its management. Given their important role in the current health crisis, physicians have been heavily affected in terms of their professional practice, financial conditions and physical and mental health. The objective of this study was to determine the consequences of the COVID-19 pandemic for Colombian endoscopists and compare the effects on endoscopists from South America and from Spain. METHODS: in June 2021, an electronic survey was sent to 292 endoscopists from Colombia, South America and Spain to determine the impact of the pandemic on their professional practice, economic situation, physical and mental health, and training of the residents under their charge. Participants were recruited via convenience sampling. RESULTS: a reduction in the number of endoscopic procedures was reported by 69.9 % of the respondents, and 72.3 % of endoscopists in Colombia stated that their income had decreased. Regarding the doctor-patient relationship, 43.8 % of the respondents believed it had worsened. In addition, 70.9 % reported having experienced changes in their emotional state, especially those related to feeling sad or depressed, and 56.5 % reported that the pandemic had negatively affected the training of residents. Finally, 24.7 % of endoscopists tested positive for COVID-19, and 19.2 % reported the death of a family member due to COVID-19. CONCLUSION: the COVID-19 pandemic has had a negative impact on the professional practice, financial situation and physical and mental health of Ibero-American endoscopists. These problems must be identified in a timely manner to develop and implement strategies aimed to prevent their occurrence.

Linfoma folicular duodenal primario: reporte de caso y revisión de la literatura / Primary duodenal follicular lymphoma: Case report and literature review

Resumen Los linfomas primarios del tracto gastrointestinal son infrecuentes; sin embargo, son la presentación extranodal más común de los linfomas no Hodgkin. El 30 % de los linfomas no Hodgkin corresponde a linfomas foliculares y, a su vez, cerca del 10 % de los linfomas foliculares se origina en el tracto gastrointestinal. Se han descrito factores de riesgo para el desarrollo de linfomas gastrointestinales como infección por Helicobacter pylori, inmunosupresión posterior a trasplante de órganos sólidos, enfermedad inflamatoria intestinal e infección por virus de la inmunodeficiencia humana (VIH). El linfoma duodenal folicular se reconoció como una variante del linfoma folicular en 2016 según la clasificación de la Organización Mundial de la Salud (OMS), al considerar que se trata de una condición con características biológicas y clínicas particulares. Su diagnóstico suele ser incidental o se pueden presentar síntomas leves e inespecíficos. El grado histológico suele ser bajo y el curso clínico, benigno; por lo que en gran parte de los casos se ha adoptado el manejo expectante como una opción. Otras terapias con similar efectividad son la radioterapia, el uso de rituximab y la inmunoquimioterapia. No existe a la fecha suficiente evidencia para generar un protocolo único de manejo para esta patología.

Abstract Primary gastric lymphomas are rare diseases; however, they are the most common extranodal presentation of non-Hodgkin lymphomas. 30% of non-Hodgkin lymphomas correspond to follicular lymphomas and at the same time, nearly 10% of follicular lymphomas are produced in the gastrointestinal tract. Risk factors for gastric lymphomas such as Helicobacter pylori infection, immunosuppression after solid organ transplantation, inflammatory bowel disease, and human immunodeficiency virus (HIV) infection were described. Follicular duodenal lymphoma was recognized as a variant of follicular lymphoma in 2016 according to the World Health Organization (WHO) classification, considering that it is a condition with special biological and clinical characteristics. Its diagnosis is usually incidental or mild and nonspecific symptoms may occur. The histological grade is usually low, and the clinical course is benign; Therefore, in most cases, expectant treatment has been adopted as an option. Other therapies with similar effectiveness are radiotherapy, the use of rituximab, and immunochemotherapy. There is not enough evidence to date to generate a single management protocol for this pathology.

Smart Face Mask with an Integrated Heat Flux Sensor for Fast and Remote People's Healthcare Monitoring.

The COVID-19 pandemic has highlighted a large amount of challenges to address. To combat the spread of the virus, several safety measures, such as wearing face masks, have been taken. Temperature controls at the entrance of public places to prevent the entry of virus carriers have been shown to be inefficient and inaccurate. This paper presents a smart mask that allows to monitor body temperature and breathing rate. Body temperature is measured by a non-invasive dual-heat-flux system, consisting of four sensors separated from each other with an insulating material. Breathing rate is obtained from the temperature changes within the mask, measured with a thermistor located near the nose. The system communicates by means of long-range (LoRa) backscattering, leading to a reduction in average power consumption. It is designed to establish the relative location of the smart mask from the signal received at two LoRa receivers installed inside and outside an access door. Low-cost LoRa transceivers with WiFi capabilities are used in the prototype to collect information and upload it to a server. Accuracy in body temperature measurements is consistent with measurements made with a thermistor located in the armpit. The system allows checking the correct placement of the mask based on the recorded temperatures and the breathing rate measurements. Besides, episodes of cough can be detected by sudden changes in thermistor temperature.

Car2Car Communication Using a Modulated Backscatter and Automotive FMCW Radar.

This work proposes the use of a modulated tag for direct communication between two vehicles using as a carrier the wave emitted by an FMCW radar installed in the vehicle for advanced driver assistance. The system allows for real-time signals detection and classification, such as stop signal, turn signals and emergency lights, adding redundancy to computer video sensors and without incorporating additional communication systems. A proof-of-concept tag has been designed at the microwave frequency of 24 GHz, consisting of an amplifier connected between receiving and transmitting antennas. The modulation is performed by switching the power supply of the amplifier. The tag is installed on the rear of the car and it answers when it is illuminated by the radar by modulating the backscattered field. The information is encoded in the modulation switching rate used. Simulated and experimental results are given showing the feasibility of the proposed solution.

Simultaneous analysis of ALK, RET, and ROS1 gene fusions by NanoString in Brazilian lung adenocarcinoma patients.

BACKGROUND: Gene fusions have been successfully employed as therapeutic targets for lung adenocarcinoma. However, tissue availability for molecular testing of multiples alterations is frequently unfeasible. We aimed to detect the presence of ALK, RET, and ROS1 rearrangements by a RNA-based single assay in Brazilian lung adenocarcinomas and to associate with clinicopathological features and genetic ancestry. METHODS: From a FFPE series of 444 molecularly characterized lung adenocarcinomas, 253 EGFR/KRAS wild-type cases were eligible for gene rearrangement analysis. Following RNA isolation, ALK, RET, and ROS1 rearrangements were simultaneously analyzed employing the ElementsXT Custom panel (NanoString Technologies). Rearrangements were further associated with clinicopathological features and genetic ancestry of the patients. RESULTS: The NanoString platform was performed in subset of 142 cases. Gene fusion results were conclusive for 94.4% (n=134) cases (failure rate =5.6%). ALK rearrangements were observed in 21 out of 134 cases, and associated with younger, never smokers, metastatic disease, and metastases in the central nervous system. RET and ROS1 fusions were detected in two and one out of 134 cases, respectively. Genetic ancestry was not associated with gene fusions. Overall, considering all cases for which a molecular analysis was conclusive (EGFR/KRAS/ALK/RET/ROS1), ALK fusions frequency was observed in 6.5% (21/325), RET in 0.6% (2/325), and ROS1 in 0.3% (1/325). CONCLUSIONS: This study successfully used a RNA-based single assay for the simultaneous analysis of ALK, RET, and ROS1 fusions employing routine biopsies from Brazilian patients lung adenocarcinoma allowing an extensive molecular testing for actionable rearrangements contributing to guide clinical strategies.