The HEV Ventilator: at the interface between particle physics and biomedical engineering.

A high-quality, low-cost ventilator, dubbed HEV, has been developed by the particle physics community working together with biomedical engineers and physicians around the world. The HEV design is suitable for use both in and out of hospital intensive care units, provides a variety of modes and is capable of supporting spontaneous breathing and supplying oxygen-enriched air. An external air supply can be combined with the unit for use in situations where compressed air is not readily available. HEV supports remote training and post market surveillance via a Web interface and data logging to complement standard touch screen operation, making it suitable for a wide range of geographical deployment. The HEV design places emphasis on the ventilation performance, especially the quality and accuracy of the pressure curves, reactivity of the trigger, measurement of delivered volume and control of oxygen mixing, delivering a global performance which will be applicable to ventilator needs beyond the COVID-19 pandemic. This article describes the conceptual design and presents the prototype units together with a performance evaluation.

Effects of Octenidine on the Formation and Disruption of Dental Biofilms: An Exploratory In Situ Study in Healthy Subjects.

Dental biofilms are highly structured, complex multispecies communities that, if left untreated, lead to severe oral complications such as caries and periodontal diseases. Therefore, antibiofilm agents are often recommended for both preventive and therapeutic measures. However, biofilm management can be challenging due to the low sensitivity of biofilms to antimicrobial treatments. Octenidine dihydrochloride (OCT) is a highly effective antibacterial agent. Because the OCT antibiofilm efficacy has not been studied in situ, this exploratory crossover study aimed to evaluate the effects of OCT mouth rinsing on biofilm formation and on the disruption of mature biofilms. Moreover, a comparison to the gold-standard chlorhexidine (CHX) was conducted. The biofilms were formed intraorally by 5 healthy volunteers on enamel specimens fixed to acrylic splints. For biofilm formation analysis, OCT, CHX, or water rinses were applied for 30 s every 12 h. The samples evaluation took place at 24-and 48-h time points. For biofilm disruption analysis, sample assessment was performed before and directly after the first OCT or CHX rinse on 48-h mature biofilms. A second rinse was carried out 12 h later. The last assessment was applied to 72-h mature biofilms. The biofilms were analyzed by fluorescence microscopy and transmission electron microscopy. The results showed OCT significantly reducing biofilm formation and bacterial vitality in situ. Simultaneously, the biofilm thickness was strongly decreased. Moreover, a single application of OCT to a 48-h mature biofilm induced substantial biofilm disruption. In addition, the efficacy of OCT compared favorably to CHX. These findings show that OCT rinses prevent biofilm formation and disrupt preexisting mature biofilms formed by healthy subjects. This work suggests that OCT might be used for dental biofilm management as a part of the medical treatment of oral diseases. Future studies with a larger subject heterogeneity and number are needed to confirm the observed OCT effects.

Could low fat mediterranean diet improves competitive anxiety in young sailors?: cross-sectional study according to the STROBE statement / ¿Puede la dieta mediterránea, baja en grasas, mejorar la ansiedad competitiva en regatistas jóvenes?: Estudio transversal según el manifiesto STROBE / ¿Pode a dieta mediterrânea, baixa em grassas, melhorar a ansiedade competitiva em regatistas jovens ?: Estúdio transversal como o mani esto STROBE

In dinghy sailing, there are many factors all of which affect to sailor performance: experience, training, nutrition and psychological condition. The main aim of this report was to know sailor's anxiety levels according to eating habits, nutritional condition, training, experience and type of vessel. 77 Laser (4.7 and Radial) and 470 sailors filled up CSAI-2 and PREDIMED questionnaires to determine competitive state anxiety and low fat diet adherence. They showed higher BMI the sailors with higher low fat diet adherence, higher experience, higher ranking position and Radial's sailors. Under-16 sailors showed less competitive anxiety. Overweight sailor got less cognitive anxiety. Sailors who trained more times per week got best results. Sailors with higher BMI will get best results with strong wind because they will keep the boat horizontal more easily. Radial's sailors have higher BMI due to their age. Under-16 sailors show less competitive anxiety due to lower demand for results. Overweight sailor show less cognitive anxiety due to lower expectations. Sailors who train more times per week get best results. Low fat Mediterranean diet not seem conditioned competitive anxiety in sailors. Sailing performance seems to be conditioned by sailor weight, wind conditions, training frequency and experience (AU)

En vela hay muchos factores que afectan al rendimiento del regatista, cómo la experiencia, el entrenamiento, la nutrición y el estado psicológico. El objetivo de este estudio fue conocer los niveles de ansiedad en regatistas según hábitos alimentarios, estado nutricional, entrenamiento, experiencia y tipo de embarcación. Participaron 77 regatistas de clase Laser (4.7 y Radial) y 470, rellenaron los cuestionarios CSAI-2 y PREDIMED, para determinar estado de ansiedad competitivo y adherencia a la dieta baja en grasa. Mostraron mayor IMC los regatistas con mayor adherencia a la dieta baja en grasas, mayor experiencia, mejor clasificación, y los de clase Radial. Los sub-16 presentaron menor ansiedad competitiva. Los regatistas con sobrepeso obtuvieron menor ansiedad cognitiva. Los regatistas que realizaban más entrenamientos por semana obtuvieron mejores resultados. Los regatistas con mayor IMC obtendrán mejores resultados con viento fuerte, debido a que mantendrán el barco horizontal con mayor facilidad. Los regatistas de clase Radial tienen mayor IMC debido a su edad. Los regatistas sub-16 muestran menos ansiedad competitiva debido a menor exigencia de resultados. Los regatistas con sobrepeso presentan menor ansiedad cognitiva debido a una menor expectativa. Los regatistas que entrenan entre semana obtienen mejores resultados. La dieta baja en grasa no parece condicionar la ansiedad competitiva de los regatistas. El rendimiento en la navegación parece estar más condicionado por el peso del regatista, las condiciones de viento, la frecuencia de entrenamiento y la experiencia (AU)

Em vela há muitos fatores que afetam ao rendimento do velejadores, como a experiência, o treinamento, a nutrição e o estado psicológico. O objetivo deste estudo era saber os níveis de ansiedade em velejadores de acordo com hábitos alimentares, estado nutricional, enquanto treinando, experimente e faça tipo. Eles participaram 77 velejadores de Laser de classe (4.7 e Radial) e 470, eles encheram os questionários CSAI-2 e PREDIMED, determinar estado competitivo de ansiedade e aderência à baixa dieta em gordura. IMC maior mostrou os velejadores com mais aderência para a baixa dieta em experiência gordurosa, maior, classificação melhor, e esses de classe Radial. Esses substituto-16 eles apresentaram ansiedade menor competitiva. Os velejadores com sobrepeso obtiveram cognitiva de ansiedade menor. Os velejadores que você / eles levaram a cabo mais treinamentos por semana obtiveram resultados melhores. Os velejadores com mais IMC obterão resultados melhores com vento forte, porque eles manterão o navio horizontal com mais facilidade. Os velejadores de classe Radial têm IMC maior devido à idade deles/delas. Os velejadores substituto-16 eles mostram competitivo menos ansiedade devido a demanda menor de resultados. Os velejadores com preponderante apresenta cognitiva de ansiedade menor devido a uma expectativa menor. Os velejadores que treina entre semana obtém resultados melhores. A baixa dieta em gordura não parece condicionar a ansiedade competitiva do velejadores. O rendimento na navegação parece ser condicionado mais pelo peso do velejador, as condições de vento, a frequência de treinar e a experiência (AU)

A GOOD TREATMENT OPTION FOR PATIENTS WITH CHARCOT OSTEOARTHROPATHY OF THE FOOT.

Abstract BACKGROUND: METHODS: RESULTS: CONCLUSIONS:

Congenital proptosis secondary to orbital teratoma. Clinicopathological study.

CASE REPORT: A newborn male with right proptosis secondary to a retroocular mass. Ophthalmological examination also showed corneal ulcer and perforation, iris hernia, total ophthalmoplegia, chemosis and eyelid retraction. The histopathology diagnosis was mature teratoma. DISCUSSION: Teratomas are tumors composed of a mixture of mature tissues consisting of 3 germ layers. Congenital teratomas of the orbit are very rare and should be included as a possibility in cases with a primary tumor in the orbit.

Regulation of proteinases during mouse peri-implantation development: urokinase-type plasminogen activator expression and cross talk with matrix metalloproteinase 9.

Trophoblast cells express urokinase-type plasminogen activator (PLAU) and may depend on its activity for endometrial invasion and tissue remodeling during peri-implantation development. However, the developmental regulation, tissue distribution, and function of PLAU are not completely understood. In this study, the expression of PLAU and its regulation by extracellular matrix proteins was examined by RT-PCR, immunocytochemistry, and plasminogen-casein zymography in cultured mouse embryos. There was a progressive increase in Plau mRNA expression in blastocysts cultured on gestation days 4-8. Tissue-type plasminogen activator (55 kDa) and PLAU (a triplet of 40, 37, and 31 kDa) were present in conditioned medium and embryo lysates, and were adsorbed to the culture plate surface. The temporal expression pattern of PLAU, according to semi-quantitative gel zymography, was similar in non-adhering embryos and embryos cultured on fibronectin, laminin, or type IV collagen, although type IV collagen and laminin upregulated Plau mRNA expression. Immunofluorescence revealed PLAU on the surface of the mural trophectoderm and in non-spreading giant trophoblast cells. Exogenous human plasminogen was transformed to plasmin by cultured embryos and activated endogenous matrix metalloproteinase 9 (MMP9). Indeed, the developmental expression profile of MMP9 was similar to that of PLAU. Our data suggest that the intrinsic developmental program predominantly regulates PLAU expression during implantation, and that PLAU could be responsible for activation of MMP9, leading to localized matrix proteolysis as trophoblast invasion commences.

Matrix metalloproteinases 2 and 9 in central nervous system and their modification after vanadium inhalation.

Vanadium (V) derivatives are well-known environmental pollutants and its toxicity has been related with oxidative stress. Toxicity after vanadium inhalation on the substantia nigra, corpus striatum, hippocampus and ependymal epithelium was reported previously. The purpose of this study was to analyse the role of matrix metalloproteinases 2 (MMP-2) and 9 (MMP-9) in the changes observed in brain tissue after chronic V inhalation. Mice were exposed to vaporized, vanadium pentoxide 0.02 m in deionized water for 1 h twice a week, and killed at 1 h, 1, 2 and 4 weeks after exposure. The brain was removed and the olfactory bulb, prefrontal cortex, striatum and hippocampus were dissected and the MMP content was obtained by zymography. The results showed that MMP-9 increased in all the structures at the end of the exposure, although in the hippocampus this increment was evident after 1 week of exposure. When MMP-2 was analysed in the olfactory bulb and prefrontal cortex it remained unchanged throughout the whole exposure, while in the hippocampus it increased at week 4, while in the striatum MMP-2 increased from the second week only, through the whole experiment. These results demonstrate that V increased MMPs in different structures of the CNS and this change might be associated with the previously reported modifications, such as dendritic spine loss and neuronal cell death. The modifications in MMPs could be related with blood-brain barrier (BBB) disruption which was reported previously. Oxidative stress might also be involved in the activation of these gelatinases as part of the different mechanisms which take place in V toxicity in the CNS.

Cólico nefrítico, teratoma ovárico y radiografía simple de aparato urinario / Nephritic colic, ovarian teratoma and urinary tract x-ray

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[Vasectomy: study of 300 interventions. Review of the national literature and of its complications]. / La vasectomía: estudio de 300 intervenciones. Revisión de la literatura nacional y de sus complicaciones.

OBJECTIVES: The aims of this paper are: 1. To study the demand and reasons why of the vasectomy in area 12 of Valencian Community. 2. To analyse the adverse effects of our series and the predictable risk factors. 3. To review the adverse effects in the national series. 4. To review the adverse effects referred to in international publications. PATIENTS AND METHODS: A retrospective study was made of 300 patients who had submitted themselves to a vasectomy between january 1992 and december 2000. All the clinical dossiers were reviewed according to 10 pre-established variables. age, number of offspring, reasons why, pre-vasectomy anticontraceptives; date of operation, type of anaesthesia used, pathologic anatomy, semen analysis after vasectomy, adverse effects and their possible causes (risk factors). The basic statistic study was done using a data base of Microsoft Access and the interpretations of the different variables using a table of Excel. RESULTS: The demand for contraceptive attention (vasectomy) is the 8th cause for external urological consulting and the 4th for urological local ambulatory surgery of our area. 300 operations were done during that period. The average age of the patients was 37.5 years old (ranging from 25 to 51). The number of offspring ranged from 1 to 7, with a promedia of 2.41 children/patient. The reasons why were: voluntary family planning (86%), medical illnesses of the female which contraindicated gestation (9%), genetic reasons (4.33%) and social-sanitary problems (0.66%). Contraceptive methods used by 71.63% are known: The widest-used method being IUD (49.74%) and the preservative (25.88%). 30 patients (10%) had adverse effects, 29 patients having light adverse effects. The most frequent were: 12 orchiepididymitis (4%), 5 spermatic granulomas (1.66%), 3 chronic scrotal pain (1%), 2 scrotal haematoma (0.66%) and 2 bleeding (0.66%). There was one serious complications and of all the cases mentioned above only one needed hospitalization (impetigo-sepsis) and another needed surgery due to a spermatic granuloma. There were no pregnancies or post-vasectomy court cases. 81% of the patients had been declared azoospermic within 45 to 60 days after the vasectomy in one or two consecutive semen analysis. CONCLUSIONS: The vasectomy is a safe and simple way for male sterilization. It's the most widely done urologic operation in Spain. The technique isn't extent of adverse effects (0 to 18%) and its seriousness varies from a simple ecchymosis to Fournier's gangrene, endocarditis or sepsis. A doctor would be considered negligent if he/she didn't inform the patient about the remote possibility of a spontaneous recanalisation of the vas deferens leading to renewed fertility (failure of the vasectomy). It is imperative to give post-vasectomy information where the patient must continue using his habitual anticonceptive method until the azoospermia shown in 2 semen analysis confirm the sterility of the patient so that the urologist has no legal problem.

[MIR family medicine program: cross-professional interaction in a complex reality]. / Programa MIR de medicina familiar: una interacción transprofesional en una realidad compleja.

OBJECTIVE: To find the view of trainers (tutors and teaching assistants) of third-year family and community medicine (FCM) residents concerning their own teaching activity in areas such as training, the skills and qualities required to be a teacher and the inter-professional relationships that are current and that are needed in a primary care teaching team. DESIGN: Qualitative study developed between June 2000 and May 2002. Sample design with a volunteer population. SETTING: FCM teaching unit under the Primary Care Administration of Murcia. PARTICIPANTS AND/OR CONTEXTS: Tutors and teaching assistants in the FCM residents' programme. METHOD: Semi-structured interview for information gathering. Contents analysis to construct results on the basis of the semiological analysis of the textual discourse. Systematic return of the results. RESULTS: Belonging to the teaching team is the highest motivation for taking part in teaching. It gives the tutors more benefits (affective, care load) than difficulties (organisational adaptation). The tutor profile is sustained by his/her scientific-technical and personal qualities; that of the nurse, by his/her community qualities. Collaboration between nurse and tutor is informal and the teaching strategies most employed by tutors are guidance, guide-lines and encouragement of residents' autonomy. Nurses collaborate with teaching by transmitting a model of professional development and facilitating teamwork. CONCLUSIONS: The complexity of the training process stands out. Postgraduate FCM training is cross-professional, not exclusively circumscribed by the tutor-resident teaching relationship. The qualitative paradigm is shown to be useful for obtaining a vision of the teaching process from the perspective of different actors.

Insecticidal paint and fumigant canisters for Chagas' disease control: community acceptance in Honduras.

This study assessed public acceptance for two new vectorial control techniques for Chagas' disease: insecticidal paint and fumigant canisters. The study compared the two with traditional fenitrothion insecticide spraying. An experimental field study was performed in an endemic area of central Honduras from August to November 1992, a year after the initial application of the treatments. The objectives of the study were to determine the acceptability of the tools on the part of the population whose homes were treated, and on the part of the personnel applying the treatments. The sample size was drawn up according to a uniform protocol applied in six Latin American countries. For this study a total of 651 persons were surveyed in 15 rural communities. Along with the surveys, focus groups were used to collect information to learn the reasons for accepting or rejecting particular treatments. The survey was done with heads of households. Focus groups were done with heads of households and also with the field operators who applied the treatments. The research showed that insecticidal paint had a low level of community acceptance (28.8%). Field operators strongly disliked the paint because of problems with its transport, application, unpleasant smell, and very low effectiveness against triatomines and pest insects. The traditional insecticide was more acceptable to the community (93.9%) and to the field operators, especially for its strong effect against the triatomines and pest insects. The results showed that in order to increase the public acceptance for insecticidal paint, it would be necessary to make the paint easier to transport and apply and to increase its effectiveness. Because of their very low effectiveness, fumigant canisters did not represent an acceptable alternative for triatomine vector control. A public educational effort should be a component of any new control method developed.

[Chagas disease in the central region of Honduras: knowledge, beliefs, and practices]. / La enfermedad de Chagas en la zona central de Honduras: conocimientos, creencias y prácticas.

From November to December 1991 and in March 1993 a survey was conducted in 17 rural communities located in Central Honduras. The communities belonged to two areas where Chagas' disease is endemic. In one of them, disease control activities had been conducted. A total of 849 adults, one in each of an equal number of households, was interviewed. The objective of the survey was to investigate and compare in both locations knowledge about Chagas' disease and its routes of transmission, measures aimed at avoiding the presence of triatomines within households, beliefs surrounding the vector and its control, and the population's sources of information about the disease. A 23-item questionnaire was tested and precoded. Almost 100% of the subjects who were surveyed were able to identify the vector and to describe its habits, but only 30.1% knew that Triatoma is the vector for the disease and only about 6% associated it with a chronic heart condition. Around 47.9% of survey subjects indicated that eliminating triatomines from households is a personal responsibility, although 78% identified as the control measure the institutional application of insecticides. Personal contact between a health worker and community members was the chief source of information for those who mentioned having heard of Chagas' disease (41.0%). These results suggest that health education should be included as a component in the planification of control programs. The role played by triatomines in disease transmission should be emphasized, as well as the importance of carrying out household improvements, with community participation, as an effective and sustainable measure. To achieve greater impact, this component should be developed through interpersonal communication channels.