SGLT2i treatment during AKI and its association with major adverse kidney events.

Background: The association between the administration of sodium-glucose cotransporter 2 inhibitors (SGLT2is) during acute kidney injury (AKI) and the incidence of major adverse kidney events (MAKEs) is not known. Methods: This retrospective cohort study included patients with AKI and compared the outcomes for those who were treated with SGLT2is during hospitalization and those without SGLT2i treatment. The associations of SGLT2i use with MAKEs at 10 and 30-90 days, each individual MAKE component, and the pre-specified patient subgroups were analyzed. Results: From 2021 to 2023, 374 patients were included in the study-316 without SGLT2i use and 58 with SGLT2i use. Patients who were treated with SGLT2is were older; had a greater prevalence of diabetes, hypertension, chronic heart failure, and chronic kidney disease; required hemodialysis less often; and presented stage 3 AKI less frequently than those who were not treated with SGLT2is. Logistic regression analysis with nearest-neighbor matching revealed that SGLT2i use was not associated with the risk of MAKE10 (OR 1.08 [0.45-2.56]) or with MAKE30-90 (OR 0.76 [0.42-1.36]). For death, the stepwise approach demonstrated that SGLT2i use was associated with a reduced risk (OR 0.08; 0.01-0.64), and no effect was found for kidney replacement therapy (KRT). The subgroups of patients who experienced a reduction in the risk of MAKEs in patients with AKI treated with SGLT2is were those older than 61 years, those with an eGFR >81, and those without a history of hypertension or DM (p ≤ 0.05 for all). Conclusion: The use of SGLT2is during AKI had no effect on short- or medium-term MAKEs, but some subgroups of patients may have experienced benefits from SGLT2i treatment.

Descripción de las intervenciones broncoscópicas en estenosis traqueales posterior a infección por COVID-19 / Description of Bronchoscopic Interventions in Post-COVID Tracheal Stenosis

Introducción: La infección por SARS-CoV-2 puede presentar síndrome de distrés res-piratorio agudo con requerimiento de ventilación mecánica prolongada y retraso en la realización de traqueostomía. Esto trae como consecuencia un incremento en casos de estenosis traqueal y la necesidad de métodos menos invasivos para su abordaje. Métodos: Estudio descriptivo de corte transversal, desde marzo 2020 hasta diciem-bre 2021 en el Hospital Universitario Nacional de Colombia, en adultos con estenosis traqueal postintubación asociado SARS-CoV-2. Se realizó análisis univariado entre los grupos con infección o no por SARS-CoV-2 como control, y reintervención, grado de estenosis, uso de inyección intramucosa con dexametasona intratraqueal o múltiples estenosis como desenlaces de importancia. Se usó test exacto de Fisher, t Student y Man-Whitney según la naturaleza de variables. Se consideró p estadísticamente significativo menor a 0.05.Resultados: Se identificaron 26 pacientes, 20 tenían COVID-19 y 6 no. Se encontraron diferencias en edad (p=0,002), epilepsia (p=0,007) y estenosis múltiple (p= 0,04). En 85% de los casos se utilizó láser blue más dilatación con balón pulmonar, en 35% inyección intramucosa con dexametasona intratraqueal y reintervención en 35%, sin diferencias significativas entre grupos. Conclusiones: Se observó un incremento tres veces mayor de pacientes con estenosis múltiple en el grupo de infección por COVID-19, así mismo se encontró que el método más utilizado en este grupo para la recanalización fue el uso de láser blue más dilatación con balón pulmonar y la innovación en el uso de inyección intramucosa.

Introduction: SARS-CoV-2 infection can lead to acute respiratory distress syndrome with a prolonged need for mechanical ventilation and delayed tracheostomy, resulting in an increase in cases of tracheal stenosis and the necessity for less invasive approaches.Methods: A descriptive cross-sectional study was conducted from March 2020 to December 2021 at the Hospital Universitario Nacional de Colombia, focusing on adults with post-intubation tracheal stenosis associated with SARS-CoV-2. Univariate analysis was performed between groups with or without SARS-CoV-2 infection as a control, considering reintervention, degree of stenosis, use of intratracheal steroids, or multiple stenoses as important outcomes. Fisher's exact test, Student's t-test, and Mann-Whit-ney test were employed based on the nature of variables. A p-value less than 0.05 was considered statistically significant.Results: A total of 26 patients were included, with 20 having COVID-19 and 6 without. Significant differences were found in age (p=0.002), epilepsy (p=0.007), and multiple stenosis (p=0.04). In 85% of cases, laser blue plus balloon pulmonary dilation was used, intratracheal dexamethasone in 35%, and reintervention in 35%, with no significant differences between groups.Conclusions: A threefold increase in subglottic stenosis was observed during the SARS-CoV-2 pandemic, with more instances of multiple stenosis and predominantly the use of laser blue plus balloon pulmonary dilation as a successful recanalization technique. There was a higher use of intratracheal dexamethasone in this group compared to oth-er pathologies causing tracheal stenosis.

Role of a LORELEI- like gene from Phaseolus vulgaris during a mutualistic interaction with Rhizobium tropici.

Reactive oxygen species (ROS), produced by NADPH oxidases known as RBOHs in plants, play a key role in plant development, biotic and abiotic stress responses, hormone signaling, and reproduction. Among the subfamily of receptor-like kinases referred to as CrRLK, there is FERONIA (FER), a regulator of RBOHs, and FER requires a GPI-modified membrane protein produced by LORELEI (LRE) or LORELEI-like proteins (LLG) to reach the plasma membrane and generate ROS. In Arabidopsis, AtLLG1 is involved in interactions with microbes as AtLLG1 interacts with the flagellin receptor (FLS2) to trigger the innate immune response, but the role of LLGs in mutualistic interactions has not been examined. In this study, two Phaseolus vulgaris LLG genes were identified, PvLLG2 that was expressed in floral tissue and PvLLG1 that was expressed in vegetative tissue. Transcripts of PvLLG1 increased during rhizobial nodule formation peaking during the early period of well-developed nodules. Also, P. vulgaris roots expressing pPvLLG1:GFP-GUS showed that this promoter was highly active during rhizobium infections, and very similar to the subcellular localization using a construct pLLG1::PvLLG1-Neon. Compared to control plants, PvLLG1 silenced plants had less superoxide (O2-) at the root tip and elongation zone, spotty hydrogen peroxide (H2O2) in the elongation root zone, and significantly reduced root hair length, nodule number and nitrogen fixation. Unlike control plants, PvLLG1 overexpressing plants showed superoxide beyond the nodule meristem, and significantly increased nodule number and nodule diameter. PvLLG1 appears to play a key role during this mutualistic interaction, possibly due to the regulation of the production and distribution of ROS in roots.

Prevalencia de Metástasis torácicas en pacientes con cáncer de Tiroides en el Instituto Nacional de Cancerología entre 2016 y 2019, en Bogotá, Colombia / Prevalence of Thoracic Metastases in Patients with Thyroid Cancer at the National Cancer Institute between 2016 and 2019 in Bogotá, Colombia

RESUMEN Introducción: El cáncer de tiroides es la neoplasia endocrina más prevalente y el tercer tumor más frecuente en las mujeres colombianas. Tiene buen pronóstico en ausencia de metástasis. Los pulmones son el tejido más comprometido por metástasis en pa cientes con cáncer de tiroides. El objetivo del trabajo fue describir la prevalencia de las metástasis torácicas en pacientes con cáncer de tiroides en un centro de referencia en cáncer de la ciudad de Bogotá entre 2016 y 2019. Material y métodos: El estudio fue de corte transversal con muestreo no probabilístico de casos consecutivos en pacientes mayores de 18 años con cáncer de tiroides que asistieron a consulta externa de del Instituto Nacional de Cancerología entre 2016 y 2019. Resultados: Se incluyeron 241 pacientes; 53 presentaron metástasis torácicas. Dentro de los pacientes con metástasis el promedio de edad fue de 59,6 años (DE ± 12,7), 77,3% fueron mujeres, y el 90,5% presentó carcinoma papilar. La prevalencia de metástasis torácicas fue del 21,9%. Las comorbilidades más frecuentes fueron hipertensión arterial (32,08%). El síntoma más frecuente fue la disnea en un 15%. El 34% presentaron tirog lobulina mayor de 38 ng/mL y un 22% tenían anticuerpos antitiroglobulina detectables. Las variables asociadas a metástasis torácicas fueron la edad (p = 0,002), el peso (p = 0,019), adenopatías cervicales (p = 0,007), presencia de disnea (p = 0,004) y tiroglobulina mayor de 38 ng/mL (p < 0,001). La presencia de adenopatías cervicales se encontró en el 86% de los pacientes con metástasis, lo que sugiere que se trata de un marcador de riesgo de metástasis. Conclusiones: El presente estudio permite establecer datos locales, cuyos resultados promueven futuros estudios prospectivos que identifiquen variables asociadas y factores pronósticos en pacientes con cáncer de tiroides.

ABSTRACT Introduction: Thyroid cancer is the most prevalent endocrine neoplasm and the third most common tumor in Colombian women. It has a good prognosis in the absence of metastasis. The lungs are the most affected tissue by metastasis in patients with thyroid cancer. The objective of this work was to describe the prevalence of thoracic metastases in patients with thyroid cancer in a cancer reference hospital from Bogotá, between 2016 and 2019. Materials and methods: The study was cross-sectional, with non-probabilistic sampling of consecutive cases in patients older than 18 with thyroid cancer who were attended at the National Cancer Institute between 2016 and 2019. Results: 241 patients were included in the study; 53 had thoracic metastases. The mean age of patients with metastasis was 59.6 years (SD ± 12.7); 77.3% were female and 90.5% showed papillary carcinoma. The prevalence of thoracic metastases was 21.9%. The most common comorbidity was arterial hypertension (32.08%). The most common symptom was dyspnea, with 15%. 34% of patients had thyroglobulin of more than 38 ng/ml and 22% had detectable anti-thyroglobulin antibodies. Variables associated with thoracic metastases were age (p = 0.002), weight (p = 0.019), cervical adenopathies (p = 0.007), presence of dyspnea (p = 0.004), and thyroglobulin values greater than 38 ng/ml (p < 0.001). Cervical adenopathies were found in 86% of patients with metastasis, suggesting the fact that they are a risk marker for metastasis. Conclusions: This study allows us to establish local data, whose results promote future prospective studies that identify associated variables and prognostic factors in patients with thyroid cancer.

Methemoglobinemia in Hemodialysis Patients due to Acute Chlorine Intoxication: A Case Series Calling Attention on an Old Problem.

INTRODUCTION: Hemodialysis uses municipal water that must be strictly purified and sterilized to be used for that procedure. Large amounts of decontaminants are often used, such as chlorine, and if these compounds are not subsequently removed they can be transferred to the blood of patients causing complications including methemoglobinemia. METHODS: In this case series study, dialysis patients in one unit were evaluated. We reviewed clinical characteristics and laboratory findings obtained on the day when the water supply was disinfected with chlorine, with the aim to quantify methemoglobin concentrations. Our objective was to characterize the clinical presentation and management of patients who presented with methemoglobinemia on a specific index day. We also reviewed reported cases in the literature regarding this underreported complication. RESULTS: Eight patients who presented with chlorine intoxication were evaluated. The methemoglobin concentrations were between 1.3% and 7.9% (reference value 0-1%). We believe this to be caused by water containing 0.78 mg/L of total chlorine. Seven patients presented with cyanosis, 4 with dizziness, 6 with dark brown blood, 4 with dyspnea, and 4 with headache and hemolytic anemia. Subjects were treated with supplemental oxygen, methylene blue, intravenous vitamin C, blood transfusions, and increased doses of erythropoietin. No patient died, and all continued with their usual hemodialysis sessions. CONCLUSION: Acute chlorine intoxication transferred by the water used during hemodialysis sessions can present with methemoglobinemia accompanied by cyanosis, oxygen desaturation, and hemolytic anemia. Chlorine levels should be carefully monitored in the water used for hemodialysis treatment.

TETRASPANIN 8-1 from Phaseolus vulgaris plays a key role during mutualistic interactions.

Arbuscular mycorrhizal (AM) fungi and rhizobia form two of the most important plant-microbe associations for the assimilation of phosphorus (P) and nitrogen (N). Symbiont-derived signals are able to coordinate the infection process by triggering multiple responses in the plant root, such as calcium influxes and oscillations, increased reactive oxygen species (ROS), cytoskeletal rearrangements and altered gene expression. An examination was made of the role of tetraspanins, which are transmembrane proteins that self-organize into tetraspanin web regions, where they recruit specific proteins into platforms required for signal transduction, membrane fusion, cell trafficking, and ROS generation. In plant cells, tetraspanins are scaffolding proteins associated with root radial patterning, biotic and abiotic stress responses, cell fate determination, plasmodesmata and hormonal regulation. Some plant tetraspanins, such as Arabidopsis thaliana TETRASPANIN 8 and TETRASPANIN 9 (AtTET8 and AtTET9) are associated with exosomes during inter-kingdom communication. In this study, a homolog of AtTET8, PvTET8-1, in common bean (Phaseolus vulgaris L. var. Negro Jamapa) was examined in roots during interactions with Rhizobium tropici and Rhizophagus irregularis. The promoter of PvTET8-1 contained several cis-acting regulatory DNA elements potentially related to mutualistic interactions, and PvTET8-1 was transcriptionally activated during AM fungal and rhizobial associations. Silencing it decreased the size and number of nodules, nitrogen fixation, and mycorrhizal arbuscule formation, whereas overexpressing it increased the size and number of nodules, and mycorrhizal arbuscule formation but decreased nitrogen fixation. PvTET8-1 appears to be an important element in both of these mutualistic interactions, perhaps through its interaction with NADPH oxidase and the generation of ROS during the infection processes.

Using Hyper as a molecular probe to visualize hydrogen peroxide in living plant cells: An updated method.

Reactive oxygen species (ROS) are highly reactive reduced oxygen molecules that play a myriad of roles in animal and plant cells. In plant cells the production of ROS results from aerobic metabolism during respiration and photosynthesis. Therefore mitochondria, chloroplasts, and peroxisomes constitute an important source of ROS. However, ROS can also be produced in response to many physiological stimuli such as pathogen attack, hormone signaling, abiotic stresses or during cell wall organization and plant morphogenesis. The study of ROS in plant cells has been limited to biochemical assays and use of fluorescent probes, however, the irreversible oxidation of the fluorescent dyes prevents the visualization of dynamic changes. We have previously reported that Hyper 1 is a biosensor for H2O2 and consists of a circularly permutated YFP (cpYFP) inserted into the regulatory domain of the Escherichia coli hydrogen peroxide (H2O2) sensor protein OxyR rendering it an H2O2-specific quantitative probe (Bilan & Belousov, 2018; Hernandez-Barrera et al., 2015). Herein we describe an updated protocol for using the improved new version of Hyper 2 and Hyper 3 as a dynamic biosensor for H2O2 in Arabidopsis with virtually unlimited potential to detect H2O2 throughout the plant and under a broad range of developmental and environmental conditions (Bilan et al., 2013).

Using DCP-Rho1 as a fluorescent probe to visualize sulfenic acid-containing proteins in living plant cells.

Among the biologically relevant reactive oxygen species (ROS), hydrogen peroxide (H2O2) has special properties. H2O2 can diffuse across membranes, has a low reactivity, and is very stable. Deprotonated cysteine residues in proteins can be oxidized by H2O2 into a highly reactive sulfenic acid derivative (-SOH), which can react with another cysteine to form a disulfide. Under higher oxidative stress the sulfenic acid undergo further oxidation to sulfinic acid (Cys-SO2H), which can subsequently be reduced. The sulfinic acid can be hyperoxidized to sulfonic acid (Cys-SO3H), whose reduction is irreversible. Formation of sulfenic acids can have a role in sensing oxidative stress, signal transduction, modulating localization and activity to regulate protein functions. Therefore, there is an emerging interest in trying to understand the pool of proteins that result in these sorts of modification in response to oxidative stress. This is known as the sulfenome and several approaches have been developed in animal and plant cells to analyze the sulfenome under different stress responses. These approaches can be proteomic, molecular, immunological (i.e., antibodies), or expressing genetically encoded probes that specifically react to sulfenic modifications. In this chapter, we describe an additional approach that allows visualization of sulfenic modification in vivo. This is newly developed fluorescent probe DCP-Rho1 can be implemented in any plant cell to analyze the sulfenic modification.

Hierarchy of Lifshitz Transitions in the Surface Electronic Structure of Sr_{2}RuO_{4} under Uniaxial Compression.

We report the evolution of the electronic structure at the surface of the layered perovskite Sr_{2}RuO_{4} under large in-plane uniaxial compression, leading to anisotropic B_{1g} strains of ϵ_{xx}-ϵ_{yy}=-0.9±0.1%. From angle-resolved photoemission, we show how this drives a sequence of Lifshitz transitions, reshaping the low-energy electronic structure and the rich spectrum of van Hove singularities that the surface layer of Sr_{2}RuO_{4} hosts. From comparison to tight-binding modeling, we find that the strain is accommodated predominantly by bond-length changes rather than modifications of octahedral tilt and rotation angles. Our study sheds new light on the nature of structural distortions at oxide surfaces, and how targeted control of these can be used to tune density of state singularities to the Fermi level, in turn paving the way to the possible realization of rich collective states at the Sr_{2}RuO_{4} surface.

Mental health Narrative Community-Based Group Therapy in violence-displaced Afro-Colombians: a randomized controlled trial.

This study aims to evaluate the effect of a mental health Narrative Community-Based Group Therapy (NCGT) in Afro-Colombian violence survivors. A randomized controlled trial was conducted in Buenaventura and Quibdó, Colombia. Afro-Colombian adults (n=521) were randomly allocated to a NCGT (n1=175), a wait-control group (n2=171) or a Common Elements Treatment Approach (CETA, n3=175). The CETA was described separately given conceptual/methodological differences. Lay psychosocial community workers delivered the NCGT. Symptoms were assessed before and after intervention/wait with culturally adapted mental health symptoms and gender-specific functionality scales. Intent to treat analysis and mean difference of differences were used for comparisons. In Buenaventura, a significant reduction in functional impairment (mean difference: -0.30, 95% Confidence Interval [95% CI]: -0.55, -0.05) and depression (mean difference: -0.24, 95% CI: -0.42, -0.07) were found, with small and moderate effect size, respectively. In Quibdó, functionality improved significantly (mean difference: -0.29, 95% CI: -0.54, -0.04, small effect size). Even though differences in depression and anxiety were not significant, there were reductions in symptoms. The NCGT is effective in improving daily functioning among violence victims in the Colombian Pacific and has the potential to reduce symptoms of depression. Further exploration is required to understand the effects of a narrative group therapy for mental health in Afro-Colombian populations.Trial Registration: ClinicalTrials.gov number: NCT01856673 (https://clinicaltrials.gov/ct2/show/NCT01856673).

The devil is in the details: Variable impacts of season, BMI, sampling site temperature, and presence of insects on the post-mortem microbiome.

Background: Post-mortem microbial communities are increasingly investigated as proxy evidence for a variety of factors of interest in forensic science. The reported predictive power of the microbial community to determine aspects of the individual's post-mortem history (e.g., the post-mortem interval) varies substantially among published research. This observed variation is partially driven by the local environment or the individual themselves. In the current study, we investigated the impact of BMI, sex, insect activity, season, repeat sampling, decomposition time, and temperature on the microbial community sampled from donated human remains in San Marcos, TX using a high-throughput gene-fragment metabarcoding approach. Materials and methods: In the current study, we investigated the impact of BMI, sex, insect activity, season, repeat sampling, decomposition time, and temperature on the microbial community sampled from donated human remains in San Marcos, TX using a high-throughput gene-fragment metabarcoding approach. Results: We found that season, temperature at the sampling site, BMI, and sex had a significant effect on the post-mortem microbiome, the presence of insects has a homogenizing influence on the total bacterial community, and that community consistency from repeat sampling decreases as the decomposition process progresses. Moreover, we demonstrate the importance of temperature at the site of sampling on the abundance of important diagnostic taxa. Conclusion: The results of this study suggest that while the bacterial community or specific bacterial species may prove to be useful for forensic applications, a clearer understanding of the mechanisms underpinning microbial decomposition will greatly increase the utility of microbial evidence in forensic casework.

Interactions of the molecular assembly of polysaccharide-protein systems as encapsulation materials. A review.

Studying the interactions of biopolymers like polysaccharides and proteins is quite important mainly due to the wide number of applications such as the stabilization and encapsulation of active compounds in complex systems. Complexation takes place when materials like proteins and polysaccharides are blended to promote the entrapment of active compounds. The interaction forces between the charged groups in the polymeric chains allow the miscibility of the components in the complex system. Understanding the interactions taking place between the polymers as well as between the wall material and the active compound is important when designing delivery systems. However, some features of the biopolymers like structure, functional groups, or electrical charge as well as extrinsic parameters like pH or ratios might affect the structure and the performance of the complex system when used in encapsulation applications. This work summarizes the recent progress of the polysaccharide/protein complexes for encapsulation and the influence of the pH on the structural modifications during the complexation process.

Electronically driven spin-reorientation transition of the correlated polar metal Ca3Ru2O7.

The interplay between spin-orbit coupling and structural inversion symmetry breaking in solids has generated much interest due to the nontrivial spin and magnetic textures which can result. Such studies are typically focused on systems where large atomic number elements lead to strong spin-orbit coupling, in turn rendering electronic correlations weak. In contrast, here we investigate the temperature-dependent electronic structure of [Formula: see text], a [Formula: see text] oxide metal for which both correlations and spin-orbit coupling are pronounced and in which octahedral tilts and rotations combine to mediate both global and local inversion symmetry-breaking polar distortions. Our angle-resolved photoemission measurements reveal the destruction of a large hole-like Fermi surface upon cooling through a coupled structural and spin-reorientation transition at 48 K, accompanied by a sudden onset of quasiparticle coherence. We demonstrate how these result from band hybridization mediated by a hidden Rashba-type spin-orbit coupling. This is enabled by the bulk structural distortions and unlocked when the spin reorients perpendicular to the local symmetry-breaking potential at the Ru sites. We argue that the electronic energy gain associated with the band hybridization is actually the key driver for the phase transition, reflecting a delicate interplay between spin-orbit coupling and strong electronic correlations and revealing a route to control magnetic ordering in solids.

Self-Powered Photodetectors Based on Core-Shell ZnO-Co3O4 Nanowire Heterojunctions.

Self-powered photodetectors operating in the UV-visible-NIR window made of environmentally friendly, earth abundant, and cheap materials are appealing systems to exploit natural solar radiation without external power sources. In this study, we propose a new p-n junction nanostructure, based on a ZnO-Co3O4 core-shell nanowire (NW) system, with a suitable electronic band structure and improved light absorption, charge transport, and charge collection, to build an efficient UV-visible-NIR p-n heterojunction photodetector. Ultrathin Co3O4 films (in the range 1-15 nm) were sputter-deposited on hydrothermally grown ZnO NW arrays. The effect of a thin layer of the Al2O3 buffer layer between ZnO and Co3O4 was investigated, which may inhibit charge recombination, boosting device performance. The photoresponse of the ZnO-Al2O3-Co3O4 system at zero bias is 6 times higher compared to that of ZnO-Co3O4. The responsivity ( R) and specific detectivity ( D*) of the best device were 21.80 mA W-1 and 4.12 × 1012 Jones, respectively. These results suggest a novel p-n junction structure to develop all-oxide UV-vis photodetectors based on stable, nontoxic, low-cost materials.

A randomized controlled trial of a transdiagnostic cognitive-behavioral intervention for Afro-descendants' survivors of systemic violence in Colombia.

BACKGROUND: Exposure to violence has negative consequences on mental health. Armed-conflict in Colombia has widely affected Afro-descendants in the Pacific region. Evidence regarding effectiveness of mental health interventions is lacking in low-income settings, especially in areas with active conflict. The objective of this study is to evaluate an individualized Common Elements Treatment Approach (CETA), a transdiagnostic psychotherapy model based on Cognitive-Behavioral Therapy, for adult trauma survivors. METHODS AND FINDINGS: A referred sample of 521 adult Afro-descendants from Buenaventura and Quibdó, Colombia, experiencing significant sadness, suffering or fear (score>0.77 in Total Mental Health Symptoms), with history of traumatic experiences, and with associated functional impairment were randomly allocated to CETA intervention, standby group without intervention, but under monthly monitoring, or a Narrative Community-Based Group Therapy. CETA was provided by trained Lay Psychosocial Community Workers without previous mental health experience, supervised by psychologists, during 12-14 weekly, 1.5-hour sessions. Symptoms were assessed with a locally validated survey built based on the Hopkins Symptom Checklist, the Harvard Trauma Questionnaire, the PTSD CheckList-Civilian Version, a qualitative study for additional general symptoms and a gender-specific functional impairment scale. CETA was compared with the control group and the intervention effects were calculated with mixed models using intention to treat analysis. Participant completion of follow-up was 75.1% and 13.2% voluntarily withdrew. Reduction in post-traumatic stress symptoms was significant in both municipalities when comparing intervention and control groups (mean difference), with a with a moderate effect size in Buenaventura (Cohen's d  =  0.70) and a small effect size in Quibdó (d = 0.31). In Buenaventura, the intervention also had significant effects on depression (large effect size d = 1.03), anxiety (large effect size d = 0.80) and functional impairment (moderate effect size d = 0.70). In Quibdó, it had no significant effect on these outcomes. Changes in Total Mental Health Symptoms were not significant in neither city. CONCLUSIONS: This trial suggests that CETA, can be effective in improving depression, anxiety, post-traumatic stress and function among victims of systematized violence in low-income and active conflict settings. Nonetheless, the difference of effectiveness between the two cities of intervention may indicate that we cannot assume that a mental health intervention known to be effective in one setting will be effective in another, even in similar circumstances and population. This may have special importance when implementing and reproducing these types of intervention in non-controlled circumstances. Further research should address these concerns. Results can be of use by governmental decision-makers when defining mental health programs for survivors. TRIAL REGISTRATION: ClinicalTrials.gov NCT01856673 (https://clinicaltrials.gov/ct2/show/NCT01856673).

Successful treatment of ventriculitis caused by Pseudomonas aeruginosa and carbapenem-resistant Klebsiella pneumoniae with i.v. ceftazidime-avibactam and intrathecal amikacin.

PURPOSE: A patient with carbapenem-resistant Klebsiella pneumoniae infection is described, and treatment options are discussed. SUMMARY: Few antibiotics to treat carbapenem-resistant Enterobacteriaceae (CRE) infection are available, and treatment is further complicated by the limited ability of many antibiotics to penetrate into the cerebrospinal fluid (CSF). Currently, there is a lack of clinical data on the treatment of central nervous system CRE infections, and therapy is based on case reports, case series, and small retrospective studies. A patient was admitted to the emergency department with intracranial hemorrhage and ventriculitis due to traumatic injury. A ventriculostomy and, subsequently, a ventriculoperitoneal (VP) shunt were placed. After approximately a month of treatment with various antibiotic regimens, the patient's VP shunt was externalized, and a CSF culture speciated carbapenem-resistant K. pneumoniae and Pseudomonas aeruginosa. The patient was then switched to i.v. ceftazidime-avibactam and intrathecal amikacin therapy. His CSF cultures were sterile 3 days after initiation of those antibiotics, and subsequent CSF cultures resulted in no growth. After the patient was treated with intrathecal amikacin 30 mg daily for 4 weeks and i.v. ceftazidime-avibactam 2.5 g every 8 hours for 6 weeks, the ventriculitis resolved, the external ventricular drain was removed, and he was transferred to a long-term care facility for rehabilitation. CONCLUSION: A man with ventriculitis caused by P. aeruginosa and carbapenem-resistant K. pneumoniae was successfully treated with i.v. ceftazidime-avibactam and intrathecal amikacin.

One-step nondestructive functionalization of graphene oxide paper with amines.

Direct functionalization of prefabricated free-standing graphene oxide paper (GOP) is the only approach suitable for systematic tuning of its mechanical, thermal and electronic characteristics. However, the traditional liquid-phase functionalization can compromise physical integrity of the paper-like material up to its total disintegration. In the present paper, we attempted to apply an alternative, solvent-free strategy for facile and nondestructive functionalization of GOP with 1-octadecylamine (ODA) and 1,12-diaminododecane (DAD) as representatives of aliphatic amines, and with 1-aminopyrene (AP) and 1,5-diaminonaphthalene (DAN) as examples of aromatic amines. The functionalization can be carried out under moderate heating at 150-180 °C for 2 h in vacuum, and proceeds through both amidation and epoxy ring opening reactions. Comparative characterization of pristine and amine-modified GOP samples was carried out by means of Fourier-transform infrared, Raman, and X-ray photoelectron spectroscopy, thermogravimetric and differential thermal analysis, scanning electron and atomic force microscopy. In addition, we compared stability in water, wettability, electrical conductivity and elastic (Young's) modulus of GOP samples before and after functionalization. The highest content of amine species was obtained in the case of GOP-ODA, followed by GOP-DAD, GOP-AP and GOP-DAN. The functionalization increased mechanical and thermal stability, as well as the electrical conductivity of GOP. The magnitude of each effect depends on the structure of amine employed, which allows for tuning a given GOP characteristic. Morphological characterization showed that, compared to pristine graphene oxide paper, amine-modified mats become relatively ordered layered structures, in which individual GO sheets are organized in a near-parallel fashion.

Comparación de dos metodologías utilizadas para la determinación del síndrome metabólico en población adulta / Comparison of two methodologies used for determining metabolic syndrome in adult population

Introducción. El síndrome metabólico se caracteriza por la aparición simultánea o secuencial de diversas alteraciones metabólicas e inflamatorias a nivel molecular, celular o hemodinámico, asociadas a resistencia a la insulina y adiposidad de predominio visceral. Diferentes grupos de expertos, como la International Diabetes Federation (IDF) y el National Cholesterol Education Program (NCEP), han tratado de elaborar criterios para su diagnóstico. Objetivo. Establecer los niveles de concordancia de los criterios de diagnóstico para el síndrome metabólico. Material y métodos. El estudio incluyó 357 individuos. Se hizo el análisis descriptivo de variables cualitativas y de resultados de laboratorio y medición antropométrica para la determinación de la prevalencia de síndrome metabólico, según las definiciones de los dos grupos mencionados. Se utilizaron concordancia kappa y regresión logística, para la comparación de las metodologías. Resultados. Las prevalencia del síndrome metabólico, según la International Diabetes Federation, es de 19,9 % y por el Adult Treatment Panel (ATP) III fue de 10,4 %. La estimación de concordancia entre los criterios diagnósticos de la Federación y los del Panel fue escasa (fair agreement) κ=0,3997; IC95%: 0,28-0,52). Conclusiones. En la población trabajadora que participó en este estudio, la prevalencia del síndrome metabólico se presentó en mayor porcentaje utilizando la definición de la International DiabetesFederation y fue más alta en los hombres que en las mujeres. Los criterios diagnósticos para el síndrome metabólico deben usarse teniendo en cuenta la población en estudio, así como el sexo y la edad.

Introduction: Metabolic syndrome is characterized by the simultaneous or sequential appearance of various metabolic and inflammatory changes at molecular, cellular or hemodynamic level associated with the presence of insulin resistance and dominant visceral adiposity. Different expert groups, including the International Diabetes Federation and the National Cholesterol Education Program, have tried to develop criteria for its diagnosis. Objective: To establish diagnostic criteria concordance levels for metabolic syndrome.. Materials and methods: A total of 357 people were part of the study. We performed a descriptive analysis of qualitative variables, and laboratory and anthropometric measurement results to determine the prevalence of metabolic syndrome according to the International Diabetes Federation and National Cholesterol Education Program - ATP III definitions. We used kappa concordance and logistic regression for the comparison of methodologies.. Results: The prevalence of metabolic syndrome was 19.9% according to the International Diabetes Federation, and 10.4% using the National Cholesterol Education Program - ATP III. The estimate of agreement between the two diagnostic criteria of the International Diabetes Federation and the National Cholesterol Education Program - ATP III was fair (low) (κ=0.3997, CI 95% 0.28-0.52).. Conclusions: In the working population who participated in this study, the obtained prevalence of metabolic syndrome occurred at a higher rate using the International Diabetes Federation definition, being higher in men than in women. The use of diagnostic criteria for metabolic syndrome must take into account the study population as well as sex and age.

Factores de riesgo asociados al suicidio en nariño (Colombia): estudio de casos y controles / Risk factors for suicide in nariño, Colombia: a matched case-control study

Introducción: Según la OMS, en el 2020 aproximadamente 1,53 millones de personas se suicidarán y de 10 a 20 veces más lo intentarán. En el Departamento de Nariño (Colombia) se han venido presentado tasas sostenidas que superan el promedio nacional, y de estas muertes el 55% ha ocurrido en jóvenes entre los 15 y 24 años de edad, un patrón de comportamiento que difiere del descrito en otras partes del mundo, donde predominan los suicidios de adultos mayores. Objetivo: Determinar los factores individuales, familiares y sociales asociados en la ocurrencia del suicidio en el Departamento de Nariño. Metodología: Estudio de casos y controles entre 101 individuos, quienes se suicidaron (casos), y 112 muertos por lesiones no intencionales (controles), apareando por edad, municipio de residencia y fecha del suicidio. La información se tomó del familiar más cercano, mediante un cuestionario estructurado-con técnica de autopsia psicológica y recolección de los síndromes psiquiátricos más importantes (depresión, ansiedad, psicosis y consumo de sustancias psicoactivas)—. Resultados: En la muestra, el 70% de casos y controles corresponden a los hombres. En el modelo de regresión logística condicionada permanecieron los siguientes predictores como efecto independiente en el riesgo de suicidio: falta de práctica religiosa activa, escolaridad menor de 11 años, diagnóstico psiquiátrico previo, intento de suicidio previo, presencia de estrés agudo y depresión. Conclusiones y recomendaciones: Este estudio es uno de los pocos estudios analíticos realizados en Colombia. Además, con sus hallazgos es posible desarrollar un programa municipal de prevención de suicido en jóvenes de Pasto, Nariño...

Introduction: The WHO has estimated that approximately 1,53 millions of suicidal events and more than 10 to 20 times of suicide attempts will occurred by 2020 worldwide. Sustained rates of suicide exceeding the national average of 55% of these deaths mainly occurred in young people between 15 and 24 years, in the Department of Nariño. This differs from the international pattern where suicide is predominantly in older adults. Objective: To determine individual, family related and social factors associated with the occurrence of suicide in the Department of Nariño. Methods: A matched case-control study. A sample of 101 individuals, who committed suicide (cases), and 112 deaths from unintentional injury (controls), were matched for age, municipality of residence and date of suicide. The information for both (cases and controls) was collected from the nearest relative. A structured questionnaire —includes the psychological autopsy technique and screening of major psychiatric syndromes (depression, anxiety, psychosis, and psychoactive substance was used). Results: In the study sample, 70% of both cases and controls were male. When examine the conditional logistic regression model, Lack of religious practice, under 11 years of formal education, previous mental disease diagnosis, previous suicide attempt, presence of acute stress, and depression, are remained independent significant predictors to the effect on risk of suicide. Conclusions and Recommendations: This analytical study is one of the kind developed in Colombia. This study provided evidence to develop a municipal youth suicide prevention program in Pasto, Nariño...

Diagnóstico institucional en base a las normas de calidad en la unidad educativa 1o de mayo de la Ciudad de El Alto

El trabajo trata de sistematizar un informe diagnóstico basado en normas de calidad ISO para la educación que nos da parámetros necesarios para desarrollar procesos de auditoría educativa, en las instituciones en busca de la calidad de la Enseñanza Aprendizaje