Infrared thermography for normal endothelial function screening.

BACKGROUND: Endothelial dysfunction (ED) suspicion will allow to prevent accelerated atherosclerosis and premature death. OBJECTIVE: To establish the usefulness of thermography for endothelial function screening in adults with cardiovascular risk factors. MATERIAL AND METHODS: Cross-sectional, analytical diagnostic test. A brachial arterial diameter (BAD) increase < 11% at one-minute post-ischemia meant probable ED and was confirmed if BAD was ≥ 11% post-sublingual nitroglycerin. Thermographic photographs of the palmar region were obtained at one minute. Descriptive statistics, ROC curve, Mann-Whitney's U-test, chi-square test, or Fisher's exact test were used. RESULTS: Thirty-eight subjects with a median age of 50 years, and with 624 thermographic measurements were included. Nine had ED (flow-mediated vasodilation [FMV]: 2.5%). The best cutoff point for normal endothelial function in subjects with cardiovascular risk factors was ≥ 36 °C at one minute of ischemia, with 85% sensitivity, 70% specificity, positive and negative predictive values of 78 and 77%, area under the curve of 0.796, LR+ 2.82, LR- 0.22. CONCLUSION: An infrared thermography-measured temperature in the palmar region greater than or equal to 36 °C after one minute of ischemia is practical, non-invasive, and inexpensive for normal endothelial function screening in adults with cardiovascular risk factors.

ANTECEDENTES: La sospecha de disfunción endotelial (DE) permitirá prevenir la aterosclerosis acelerada y la muerte prematura. OBJETIVO: Establecer la utilidad de la termografía en el cribado de la función endotelial en adultos con factores de riesgo cardiovascular. MATERIAL Y MÉTODOS: Estudio transversal analítico de prueba diagnóstica. El incremento del diámetro de la arteria braquial < 11 % a un minuto posisquemia significó probable DE, confirmada si el diámetro fue ≥ 11 % posnitroglicerina sublingual. Se obtuvieron fotografías termográficas al minuto de la región palmar. Se aplicó estadística descriptiva, curva ROC, pruebas U de Mann-Whitney, chi cuadrada o exacta de Fisher. RESULTADOS: Se incluyeron 38 sujetos, mediana de edad de 50 años, con 624 mediciones termográficas; nueve presentaron DE (vasodilatación mediada por flujo de 2.5 %). El mejor punto de corte para la función endotelial normal en sujetos con factores de riesgo cardiovascular fue ≥ 36 °C al minuto de isquemia, con sensibilidad de 85%, especificidad de 70%, valores predictivos positivo y negativo de 78 y 77%, área bajo la curva de 0.796, razón de verisimilitud positiva de 2.82 y razón de verisimilitud negativa de 0.22. CONCLUSIÓN: La medición de la temperatura en la región palmar mediante termografía infrarroja ≥ 36 °C tras un minuto de isquemia es práctica, no invasiva y económica para el cribado de la función endotelial normal en adultos con factores de riesgo cardiovascular.

Termografía infrarroja en la detección de la función endotelial normal / Infrared thermography for normal endothelial function screening

Resumen Antecedentes: La sospecha de disfunción endotelial (DE) permitirá prevenir la aterosclerosis acelerada y la muerte prematura. Objetivo: Establecer la utilidad de la termografía en el cribado de la función endotelial en adultos con factores de riesgo cardiovascular. Material y métodos: Estudio transversal analítico de prueba diagnóstica. El incremento del diámetro de la arteria braquial < 11 % a un minuto posisquemia significó probable DE, confirmada si el diámetro fue ≥ 11 % posnitroglicerina sublingual. Se obtuvieron fotografías termográficas al minuto de la región palmar. Se aplicó estadística descriptiva, curva ROC, pruebas U de Mann-Whitney, chi cuadrada o exacta de Fisher. Resultados: Se incluyeron 38 sujetos, mediana de edad de 50 años, con 624 mediciones termográficas; nueve presentaron DE (vasodilatación mediada por flujo de 2.5 %). El mejor punto de corte para la función endotelial normal en sujetos con factores de riesgo cardiovascular fue ≥ 36 °C al minuto de isquemia, con sensibilidad de 85%, especificidad de 70%, valores predictivos positivo y negativo de 78 y 77%, área bajo la curva de 0.796, razón de verisimilitud positiva de 2.82 y razón de verisimilitud negativa de 0.22. Conclusión: La medición de la temperatura en la región palmar mediante termografía infrarroja ≥ 36 °C tras un minuto de isquemia es práctica, no invasiva y económica para el cribado de la función endotelial normal en adultos con factores de riesgo cardiovascular.

Abstract Background: Endothelial dysfunction (ED) suspicion will allow to prevent accelerated atherosclerosis and premature death. Objective: To establish the usefulness of thermography for endothelial function screening in adults with cardiovascular risk factors. Material and methods: Cross-sectional, analytical diagnostic test. A brachial arterial diameter (BAD) increase <11 % at one-minute post-ischemia meant probable ED and was confirmed if BAD was ≥ 11 % post-sublingual nitroglycerin. Thermographic photographs of the palmar region were obtained at one minute. Descriptive statistics, ROC curve, Mann-Whitney’s U-test, chi-square test, or Fisher’s exact test were used. Results: Thirty-eight subjects with a median age of 50 years, and with 624 thermographic measurements were included. Nine had ED (flow-mediated vasodilation (FMV): 2.5 %. The best cutoff point for normal endothelial function in subjects with cardiovascular risk factors was ≥ 36 °C at one minute of ischemia, with 85 % sensitivity, 70 % specificity, positive and negative predictive values of 78 and 77 %, area under the curve of 0.796, LR+ 2.82, LR- 0.22. Conclusions: An infrared thermography-measured temperature in the palmar region greater than or equal to 36 °C after one minute of ischemia is practical, non-invasive, and inexpensive for normal endothelial function screening in adults with cardiovascular risk factors.

Dataset of phase-resolved images of internal, corona, and surface partial discharges in electrical generators.

This article presents the data collection process for the classification of partial discharges in electrical generators using PNG format images. The data were collected through field measurements on over 40 generators in various locations in Colombia, in addition to utilizing a partial discharge simulator provided by Omicron Energy. Throughout the collection process, special attention was given to the accuracy and coherence of the images, avoiding deformations and distortions that could impact the nature of partial discharges. Emphasis was placed on achieving high resolution in phase-resolved patterns (PRPD) to effectively correlate them with the adjacent physical phenomenon. The analysis focused on classifying the images according to the type of partial discharge, identifying them as internal, surface, or corona discharges. The obtained pulse patterns are represented in RGB color, which aids in assessing the repeatability of pulses across their distribution. These data hold potential for the development of pattern classification software for generator monitoring systems. They enable the training and validation of classification algorithms, simplifying the automated detection and analysis of partial discharges in electrical generators. Their applicability extends beyond the electrical industry and can be valuable in other fields requiring complex signal and pattern analysis. The article highlights the rigorous data collection process and precise analysis conducted to obtain a valuable set of PNG format images for partial discharge classification. These data have significant potential in advancing pattern classification software, driving progress in the monitoring and analysis of electrical generators.

The design, implementation, and impact of an automated patient-reported outcome data collection and adverse event surveillance tool: a randomized trial.

BACKGROUND: Incorporating patient-reported outcome measures into routine clinical care can improve the patient experience, increase engagement, and establish a structured method for gathering adverse event (AE) data. Systematically collecting this information on a large scale can also inform new solutions for removing treatment barriers like medication nonadherence. This study evaluated whether implementing a patient-reported outcome data collection and adverse event surveillance tool would result in greater treatment continuation for patients receiving care on a telehealth platform. METHODS: We used iterative plan-study-do-act cycles to evaluate how this data collection and surveillance tool-a short prompt for patients to provide information on treatment satisfaction and side effects-impacted treatment continuation, the outcome of interest. We tested two cycles in n = 2,000 patients receiving care for erectile dysfunction on a telehealth platform as a randomized controlled trial, and accounted for incidents where true randomization was not possible during implementation. The first cycle tested the tool alone, while the second cycle tested the tool in conjunction with a messaging template system that provided standardized side effect counseling. RESULTS: Compared to patients in the control group, patients in the intervention group were more likely to refill their prescription over the duration of the study period (75% vs. 71%, Kaplan Meier log-rank test, p = 0.04). Receiving standardized counseling as part of the AE response system was positively associated with treatment continuation (p = 0.0005). CONCLUSIONS: Prompting patients to report side effects and outcomes outside of routine clinical visits has the potential to improve quality of care in virtual treatment. TRIAL REGISTRATION: This trial has been retrospectively registered as a clinical trial (ClinicalTrials.gov Identifier: NCT05895539, registered June 8, 2023).

Early Detection of Vascular Obstruction in Microvascular Flaps Using a Thermographic Camera.

BACKGROUND: In microsurgical reconstruction, vascular obstruction occurs in approximately 20% of patients. Close monitoring is central to their care. Clinical/Doppler detection of vascular obstruction could be enhanced by thermography. METHODS: A diagnostic test design included consecutive cases of hospitalized patients, ≥18 years old, who underwent surgery with free flaps. Two researchers separately evaluated patients with clinical/Doppler methods and thermographic camera hourly for 24 hours, every 2 hours for the next 24 hours, and then every 3 hours until discharge. The gold standard was visualization of thrombus or vascular obstruction during surgical reintervention. Sensitivity, specificity, positive/negative predictive value (PPV/NPV), and a delta temperature receiver operating characteristic (ROC) curve were calculated. RESULTS: A total of 2,364 tests were performed with a thermographic camera in 40 patients (31 females, 9 males) aged 50.12 ± 9.7 years. There were 28 deep inferior epigastric perforator, 5 anterolateral thigh, 3 radial, 2 scapular, 1 fibular, and 1 anteromedial thigh flaps included. Six (15%) had postoperative vascular obstruction (5 venous and 1 arterial). One flap developed partial necrosis and one total necrosis (overall survival 97.5%). ROC curve (area 0.97) showed the best results at ≥ 1.8°C of difference to the surrounding skin. Considering two consecutive positive evaluations, the sensitivity was 93%, specificity 96%, PPV 57%, and NPV 99%. The thermal imaging camera allows to identify the obstruction between 2 and 12 hours before the clinical method. CONCLUSION: Utilizing a thermographic camera can reduce detection time of vascular obstruction by several hours in microvascular free flaps that include the cutaneous island. This method proves useful for early diagnosis of postoperative vascular obstruction.

Bayesian methods applied to the generalized matching law.

We demonstrate the usefulness of Bayesian methods in developing, evaluating, and using psychological models in the experimental analysis of behavior. We do this through a case study, involving new experimental data that measure the response count and time allocation behavior in pigeons under concurrent random-ratio random-interval schedules of reinforcement. To analyze these data, we implement a series of behavioral models, based on the generalized matching law, as graphical models, and use computational methods to perform fully Bayesian inference. We demonstrate how Bayesian methods, implemented in this way, make inferences about parameters representing psychological variables, how they test the descriptive adequacy of models as accounts of behavior, and how they compare multiple competing models. We also demonstrate how the Bayesian graphical modeling approach allows for more complicated modeling structures, including hierarchical, common cause, and latent mixture structures, to formalize more complicated behavioral models. As part of the case study, we demonstrate how the statistical properties of Bayesian methods allow them to provide more direct and intuitive tests of theories and hypotheses, and how they support the creative and exploratory development of new theories and models.

[Perioperative management protocol of patients undergoing microsurgical flaps in main healthcare centers]. / Protocolo de manejo perioperatorio de procedimientos microquirúrgicos en hospitales de concentración.

Microsurgery is one of the most fertile and innovative area in reconstructive surgery. Today it is considered an indispensable technique in plastic surgery with flaps survival rates over 95% in main healthcare centers. The factors involved in achieving these results are: the improvement of the surgical technique, adequate patient selection and careful perioperative care. Perioperative care starts at the initial assessment of the patient where it's very important to consider the indications and contraindications of these procedures. We use this type of reconstruction when we face complex and extensive defects, they are mostly of the times, difficult or impossible to reconstruct with other techniques. Antibiotic prophylaxis should begin an hour before initial incision. Free flap procedures are classified as maximum risk for venous thromboembolism so it's essential to indicate an appropriate prophylaxis. Normothermia, proper fluid management and judicious use of transfusions and vasopressor are a fundamental part of intraoperative care. Postoperative monitoring of these flaps is essential for early detection of vascular thrombosis in order to save the transferred tissue.

La microcirugía es una de las áreas más fértiles e innovadoras con las que cuenta la cirugía reconstructiva; los factores que han intervenido para lograr estos resultados son: el perfeccionamiento de la técnica quirúrgica, la adecuada selección de los pacientes y los minuciosos cuidados perioperatorios a los que son sometidos estos pacientes. Los cuidados perioperatorios comienzan desde la valoración inicial del paciente donde es muy importante considerar las indicaciones y contraindicaciones de estos procedimientos. Recurrimos a este tipo de reconstrucción cuando nos enfrentamos a defectos complejos y/o extensos, que son difíciles o imposibles de reconstruir con otras técnicas. La profilaxis antibiótica debe comenzar una hora antes de la incisión inicial. Los colgajos libres se clasifican como procedimientos con riesgo máximo para tromboembolismo venoso, por lo que es indispensable indicar una adecuada profilaxis. La normotermia, un adecuado manejo de líquidos, así como un uso juicioso de las transfusiones y de vasopresores son parte fundamental de los cuidados transoperatorios. La monitorización posquirúrgica de estos colgajos es fundamental para detectar tempranamente trombosis vascular y poder salvar el tejido transferido.

Coordinación en ratas: Ajuste a restricciones interdependientes / Coordenação em ratos: Ajuste a restrições interdependentes / Coordination in rats: Adjustment to interdependent restrictions

El estudio del ajuste conductual a entornos donde las interacciones entre los individuos y sus consecuencias son interdependientes ha derivado en procedimientos que limitan la interacción y restringen la operante a la simple simultaneidad de acciones sobre operandos individuales. En este estudio se evaluó una metodología alterna, en la que se expuso a pares de ratas a ir de un lugar a otro. El acceso al alimento fue contingente al trabajo individual o conjunto, en función de las posibilidades de interacción directa, determinadas por la ubicación de los sujetos. Se identificó coordinación únicamente en las diadas expuestas a interacción directa. El protocolo propuesto permite estudiar el ajuste a pagos interdependientes producto de patrones de acción conjunta.

The study of behavioral adjustment to environments in which interactions among individuals and their consequences are interdependent has resulted in procedures that limit interaction and restrict the operant to the simple simultaneity of actions on individuals' operands. This study evaluated an alternative methodology in which pairs of rats were made to go from one place to another. Access to food was contingent upon individual or joint work, depending on the possibilities of direct interaction determined by the location of the subjects. Coordination was identified only in the pairs that had direct interaction. The suggested protocol makes it possible to study the adjustment to interdependent payoffs resulting from joint action patterns.

O estudo do ajuste de conduta a ambientes nos quais as interações entre os indivíduos e suas consequências são interdependentes deriva em procedimentos que limitam a interação e restringem a operante à simples simultaneidade de ações sobre operandos individuais. Neste estudo, avaliou-se uma metodologia alterna, na qual se expôs a pares de ratos a ir de um lugar a outro. O acesso ao alimento foi contingente ao trabalho individual ou conjunto, em função das possibilidades de interação direta, determinadas pela localização dos sujeitos. Identificou-se coordenação unicamente nas díades expostas à interação direta. O protocolo proposto permite estudar o ajuste a pagamentos interdependentes produto de padrões de ação conjunta.

Sensitivity and specificity of the Yang Tobin Index to predict extubation success in critical patients / Sensibilidad y especificidad del Índice Yang Yobin para predecir el éxito del destete de la ventilación mecánica en pacientes críticos

Background: The Yang Tobin Index (Y/T) is a simple and objective measure to predict successful extubation. There are no Colombian studies supporting the use of Y/T as a predictor of successful ventilator weaning. Objective: To estimate the sensitivity and specificity of Y/T as predictor of weaning and to evaluate the association with clinical and socio-demographic characteristics in adult patients at the intensive care unit. Methods: Retrospective study. We analyzed a database of 332 records of patients under mechanical ventilation (MV) for more than 48 hours, from January 2006 to December 2007, with spontaneous breathing trial and measurement of Y/T before extubation. Results: The sensitivity of Y/T was 98.6%, specificity 9.6%, positive predictive value 85.4%, negative predictive value 55.5%. The cumulative incidence of successful extubation was 84%. The greater incidence of unsuccessful extubation was associated with COPD (46.2%). The MV time period showed a direct proportional relationship with failed extubation (p=0.186). Conclusions: The Y/T index is not a good predictor of success of extubation in the study population. No association was found between clinical and sociodemographic characteristics of the population, with respect to the sensitivity and specificity of the Y/T as a predictor of success.

Introducción: El índice Yang Tobin (Y/T), es una medida sencilla y objetiva para predecir éxito en la extubación. A nivel nacional no existen estudios que sustenten el uso del índice como predictor de éxito de extubación. Objetivos: Estimar la sensibilidad y especificidad del índice de Y/T y evaluar la relación con las características clínicas y demográficas en pacientes adultos en una unidad de cuidado intensivo. Métodos: Estudio retrospectivo; se analizó la información consignada en 332 formatos de ventilación mecánica de los pacientes que recibieron soporte ventilatorio invasivo por más de 48 horas desde enero de 2006 a diciembre de 2007, con prueba de respiración espontánea y medición del índice Y/T antes de la extubación. Resultados: La sensibilidad del Y/T fue 98.6%, especificidad 9.6%, valor predictivo positivo 85.4%, valor predictivo negativo 55.5%. La incidencia acumulada de extubación exitosa fue 84%. La mayor incidencia acumulada de extubación no exitosa se asoció con EPOC (46.2%). El tiempo de ventilación mecánica mostró una relación directamente proporcional con extubación no exitosa (p=0.186). Conclusiones: El índice Y/T no es un buen predictor de éxito de la extubación en la población de estudio. No se encontró asociación entre características clínicas y sociodemográficas de la población, con respecto a la sensibilidad y especificidad del Y/T como predictor de éxito.

Observaciones conductuales en el viaje de Darwin abordo del Beagle / Behavioral observations in Darwin's voyage of the Beagle

Although Darwin's writings have been analyzed in detail by science historians, the role of behavior in the development of the theory of evolution has not been properly addressed. In this study we select, describe and analyze behavioral observations by Darwin during the Voyage of the Beagle. The context of the voyage, its route, objectives, and characteristics are presented. A classification of different types of observations on diverse types of behavior in multiple species is proposed.

Si bien la obra de Darwin ha sido analizada en detalle por historiadores de la ciencia, el papel de la conducta en el desarrollo de la teoría de la evolución no ha sido suficientemente abordado en este tipo de estudios. En este estudio se extraen, describen y analizan las observaciones de comportamiento realizadas por Darwin en El viaje del Beagle. Se presenta el contexto del viaje y se describe la ruta, objetivos y características del mismo. Se lleva a cabo una clasificación de los diferentes tipos de observación y los diferentes tipos de comportamiento de múltiples especies presentadas por Darwin.