Innovation in surgical trauma care education: assessment of a Panamerican Trauma Society online surgical skills course hosted by the Spanish Surgical Association.

PURPOSE: Incorporating surgical skills education in trauma care is essential for young surgeons and surgical trainees. This study describes an innovative e-learning course for teaching trauma care surgical skills in an international cooperative setting. Furthermore, it aims to offer valuable insights on enhancing e-learning practices. METHODS: The Panamerican Trauma Society and the Spanish Surgical Association have joined forces to launch an online course focusing on advanced trauma care surgical skills. This report provides an in-depth examination of the project and scrutinizes participant feedback through a post-course survey. The survey thoroughly evaluates their satisfaction level, the usefulness of the course content, and their view on its clinical relevance. RESULTS: Three hundred eighty-two surgeons from 16 countries completed an online course. Three hundred seventy-nine of them responded to the post-course survey. The mean age was 36, with 64% females and 36% males. The course consisted of 9.9 h of academic content, including 5 h of video lectures and 4.9 h of live discussions. Ninety-seven percent of the participants were practicing general and acute care surgeons, and only 2% were exclusively dedicated to trauma surgery. Sixty-one percent of participants highly valued real-time interaction with faculty, and 95% believed their trauma surgical skills would improve. Additionally, 93% of the participants were satisfied or very satisfied with the e-learning experience. CONCLUSIONS: The use of video-based instructional materials has revolutionized surgical education. With online courses in trauma surgery, surgeons can now improve their skills and better prepare themselves to handle severe trauma cases. This innovative approach to surgical education has proven to be very effective and can potentially enhance patients' quality of care.

BMP-7, MMP-9, and TGF-ß tissue remodeling proteins and their correlations with interleukins 6 and 10 in chronic rhinosinusitis.

INTRODUCTION: Chronic rhinosinusitis without nasal polyposis (CRSsNP) and Chronic rhinosinusitis with nasal polyposis (CRSwNP) present distinct tissue remodeling processes. The proteins involved in the process of tissue remodeling have their production and activity related to the inflammatory environment they are. This study aimed to evaluate the protein expression of BMP-7, MMP-9, TGF-ß in chronic sinusitis with and without nasal polyposis and their relations with IL-6 and IL-10. METHODS: Cross-sectional observational study with 86 participants was divided into three groups: patients with CRSwNP (n = 34), patients with CRSsNP (n = 26), and a control group (CG) without inflammatory disease of the nasal mucosa (n = 26). The primary outcomes were the concentrations of BMP-7, MMP-9, TGF-ß, IL-6, and IL-10. Secondary outcomes were the correlations of these markers. RESULTS: The TGF-ß dosage was elevated in the CRSsNP group and reduced in the CSwNP group. The dosage of IL-6 was higher in the CSwNP group, and the IL-10 dosage lower in the groups with sinusitis, and IL-10 was positively correlated with BMP-7 in all groups. There was a negative correlation between IL-6 and IL-10 in all groups observed. The correlation between MMP-9 and interleukins was lost in the CRSsNP group. There was a positive correlation between TGF-ß and IL-6 in the CG, and negative in the CRSsNP group. CONCLUSION: An inflammation shown in rhinosinusitis with an increase in IL-6 and decrease in IL-10 when compared with the control group; only TGF-ß was altered in the tissue remodeling process when compared with BMP-7 and MMP-9 in rhinosinusitis. There is a loss of correlation between tissue remodeling proteins and interleukins studied in CRSsNP.

Optimization-Based Design of Metal-Organic Framework Materials.

Metal-organic frameworks (MOFs) are a class of porous materials constructed from metal or metal oxide building blocks connected by organic linkers. MOFs are highly tunable structures that can in theory be custom designed to meet the specific pore geometry and chemistry required for a given application such as methane storage or carbon capture. However, due to the sheer number of potential materials, identification of optimal MOF structures is a significant challenge. In this contribution we describe an automated technique for MOF design based on mathematical optimization. Optimization is performed on linkers represented by abstract space-filling shapes, in order to generalize the desirable geometric parameters describing linkers, and optimal shapes are projected to real molecules to illustrate realistic MOFs exhibiting the calculated properties. Six examined topologies of MOF and two distinct geometrical pore properties relevant to guest adsorption phenomena are explored. We demonstrate that the optimal shapes of linkers depend on both the topology and the property of interest and moreover that synthetically challenging linkers are not necessary to achieve the most promising candidate materials.

Addressing challenges of identifying geometrically diverse sets of crystalline porous materials.

Crystalline porous materials have a variety of uses, such as for catalysis and separations. Identifying suitable materials for a given application can, in principle, be done by screening material databases. Such a screening requires automated high-throughput analysis tools that calculate topological and geometrical parameters describing pores. These descriptors can be used to compare, select, group, and classify materials. Here, we present a descriptor that captures shape and geometry characteristics of pores. Together with proposed similarity measures, it can be used to perform diversity selection on a set of porous materials. Our representations are histogram encodings of the probe-accessible fragment of the Voronoi network representing the void space of a material. We discuss and demonstrate the application of our approach on the International Zeolite Association (IZA) database of zeolite frameworks and the Deem database of hypothetical zeolites, as well as zeolitic imidazolate frameworks constructed from IZA zeolite structures. The diverse structures retrieved by our method are complementary to those expected by emphasizing diversity in existing one-dimensional descriptors, e.g., surface area, and similar to those obtainable by a (subjective) manual selection based on materials' visual representations. Our technique allows for reduction of large sets of structures and thus enables the material researcher to focus efforts on maximally dissimilar structures.

Situación Nutricional de Escolares. Unidad Educativa "Santiago Mariño", Municipio Linares Alcántara, Estado Aragua, Año 2005 / Nutritional Status of Pupils in "Santiago Mariño", Educational Unit, Linares Alcantara Municipality Aragua State, Venezuela, 2005

Con el objetivo de conocer la situación nutricional de los alumnos de la unidad educativa "Santiago Mariño", fué realizada en el año 2005 una evaluación antropométrica de 236 escolares, a los cuales se les pesó, talló y tomó su edad en años cumplidos. El déficit de peso para la edad fue de 10,1%, de los cuales 5,9%, presentan peso deficiente o desnutrición global y 4,2% están a riesgo de desnutrición. El déficit de peso para la talla, fue de 18,3%, lo cual significa que los mismos presentan desnutrición aguda. El indicador talla para la edad registró un déficit de 5,1%, significando 1,7% de desnutrición crónica y 3,4% a riesgo de desnutrición. Las niñas tienen una probabilidad de 2,9 veces más de presentar exceso de talla para la edad que los varones (p>0.05). Según el Indice de Masa Corporal 13,6% de los alumnos sufren déficit nutricional y 3,4% obesidad.

As to assess the nutritional status of the pupils in "Santiago Mariño" school, an anthropometric evaluation was performed during 2005 on 236 students, determining height, weight and checking their exact age. 10.1% of the sample showed weight deficit according to age, among them, 5.9% had defficient weight or global undernowrishment and 4.2% were on risk. Weight deficit according to height was 18.3% which implies acute under nourishment. Indicator size / age showed a 5.1% deficit which means 1.7% of cronic undernourishment and 3.4% of risk. Female pupils have a 2.9% higher probability of reporting excess of height according to age in comparison with boys (1>0.05). According to Mass Corporal index nutritional deficit was assessed in 13.6% of the pupils and obesity in 3.4%.

A implementação de programa de triagen auditiva neonatal universal em um hospital universitário brasileiro / Universak newborn hearing screeening program assessment in a Brazilian university

Objetivo: avaliar os resultados de implementação do Programa de Triagem Auditiva Neonatal Universal (PT aNU) no Hospital Universitário da Universidade de São Paulo (HU-USP), São Paulo, SP. Casuística e Métodos: Programaou-se a avaliação universal por triagem auditiva...

Acción antihipertensiva de felodipina: efectos en reposo, ejercicio y durante la actividad diaria / Antihypertensive action of felodipine: effects during rest, exertion and everyday activity

Se estudió la acción antihipertensiva de la felodipina, antagonista del transporte transmembranal del calcio de segunda generación, en un grupo de 20 pacientes portadores de hipertensión arterial primaria de grado leve y moderado. El estudio comprendió el control clínico periódico, la detección de efectos colaterales, y las variaciones de presión arterial, frecuencia cardíaca y, en las situaciones indicadas, parámetros derivados (producto presión por frecuencia, cargas sistólicas y diastólicas, curva circadiana), comparando contra placebo. Felodipina se administró en dosis de 2.5 a 5 mg cada 12 horas por un período de 8 a 12 semanas. La acción antihipertensiva se estudió en diferentes situaciones: reposo, posición sentada y de pie, actividad diaria, sueño y esfuerzo físico calibrado, por medio del control en consultorio, monitoreo de presión en las 24 hs. y prueba presora ergométrica. Felodipina redujo en forma significativa los valores tensionales, normalizándose en 85 por ciento de los pacientes, sin modificar la frecuencia cardíaca. Efectos colaterales (edema maleolar) aparecieron en 5 pacientes (25 por ciento), siendo de intensidad leve

Encuesta epidemiológica de hipertensión arterial en Montevideo: prevalencia, factores de riesgo, plan de seguimiento / Epidemiologic survey of arterial hypertension in Montevideo: prevalence, risk factors, follow-up plan

Se presentan los resultados de un análisis de la encuesta sobre hipertensión arterial (HA) realizada en Montevideo, Uruguay en 1986. Se encuestaron 1.392 personas. La prevalencia estandarizada de HA en la población de Montevideo fue 20 por ciento. Entre los hipertensos (n=402), 71 por ciento tenía cifras elevadas de presión arterial en el momento de la encuesta. En el análisis multivariado, las variables significativamente asociadas a HA, ordenadas según su importancia, fueron: edad, obesidad, antecedentes familiares de HA, nefropatía, diabetes, personalidad ansiosa y sedentarismo. La estimación de riesgo de HA en una persona menor de 40 años, sin ninguno de los factores considerados en este análisis, es de 1.67 por ciento. Si tiene antecedentes familiares de HA, el riesgo aumenta a 4,7 por ciento. Si además presenta todos los factores potencialmente reversibles (obesidad, personalidad ansiosa y sedentarismo), la probabilidad de HA llega a 34,9 por ciento. Los resultados, para una persona entre 40 y 60 años, son 13.3, 31.7 y 83.6 por ciento y para una persona mayor de 60 años, son 33.6, 60.4 y 97.7 por ciento respectivamente. En un plazo mayor de 5 años se realizará una segunda encuesta a las mismas personas para estudiar incidencia de HA, evolución, morbilidad y mortalidad de la población de hipertensos