Incremental Healthcare Costs of Diabetes Mellitus in a Middle-Income Country Using Administrative Healthcare Data.

OBJECTIVES: To estimate the incremental medical cost of diabetes mellitus using information from administrative databases in Colombia. METHODS: We carried out a retrospective cohort study with administrative health databases from Colombian population affiliated in the contributory health insurance scheme. We used an operative definition to select the cohort with diabetes. Incremental cost and cost ratio of diabetes were estimated using an inverse probability weighting of treatment approach to find the causal effect of having the disease. Weights were calculated by a propensity score method using a Random Forest model. The flexibility of this machine learning algorithm allows to have a better specification and bias reduction. Additionally, we reported incremental costs and cost ratios with confidence intervals using bootstrapping and analyzed costs by age groups and complications associated with diabetes. RESULTS: The estimated prevalence of diabetes was 2834 per 100 000 cases, in 2018. The group with diabetes was comprised 634 015 people and the control group 1 524 808. The calculated annual direct medical cost was $860, for which the incremental cost was $493 and the cost ratio 2.34. The incremental annual cost for some type of complication ranges from $1239 to $2043, renal complication being the most expensive. Incremental cost by age groups ranges from $347 to $878, being higher in younger people. CONCLUSIONS: Although the cost of diabetes in Colombia ranges among the global averages and is similar to other Latin-American countries, a greater incremental cost was found in patients with renal, circulatory, and neurologic complications.

Semaglutide Effects on Metabolic Outcomes in Diabetes Mellitus Patients - Real World Study.

Purpose: Diabetes is a public health problem that requires strategies to impact glycemic control and reduce the risk of long-term medical complications. Pharmacological management is a necessary treatment for this disease. Therefore, semaglutide is an essential tool to achieve the treatment targets. The present study aimed to evaluate the semaglutide effects on a cohort with type 2 diabetes mellitus (T2DM) in Colombia. Materials and Methods: The cohort included 49 patients with T2DM that have been treated in a specialized care center. Their glycemic outcomes, weight, renal function, and adverse events were evaluated through a 3-, 6- and 12-month follow-up. Results: Significant differences were observed in the outcome evaluation: reduction of glycated hemoglobin levels (MD -2.74 CI -1.95 to -3.52 in 6 months), fasting plasma glucose levels, body weight (MD -7.11 CI -5.97 to -8.24), and the albumin-to-creatinine ratio. The results were maintained throughout the treatment period. The adverse event rate was 16.3%, predominating gastrointestinal events. Conclusion: This real-world evidence shows the efficacy of semaglutide in achieving treatment goals in patients with T2DM.

Evaluation of the safety profile of the quadrivalent vaccine against human papillomavirus in the risk of developing autoimmune, neurological, and hematological diseases in adolescent women in Colombia.

BACKGROUND: Cervical cancer eradication is one of the main goals for 2030 by the World Health Organization, which can only be achieved with high vaccination rates against Human Papilloma Virus. In Colombia, more and better scientific evidence is required to increase confidence in vaccination. The objective of this study is to evaluate the safety profile of the quadrivalent vaccine against HPV in the risk of developing autoimmune, neurological, and hematological diseases in adolescent women in Colombia. METHODS: We designed a cohort study based on national HPV vaccination records and incident diagnostic data for the diseases of special interest during 2012 and 2021. We included adolescent women between 9 and 19 years old and compared vaccinated and non-vaccinated cohorts using an Inverse Probability of Treatment Weighting (IPWT) method for each scenario disease and follow-up period (180 and 360 days). FINDINGS: The Odds Ratio (OR) of developing diseases of interest was estimated during two follow up periods, 180 and 360 days after the follow-up index date (Vaccination Day). The OR for developing rheumatoid arthritis was 4·4; CI95% (1·74 - 11·14), juvenile idiopathic arthritis was 2·76 IC95% (1·50 - 5·11), idiopathic thrombocytopenic purpura was 2·54 IC95% (1·28 - 5·02) and thyrotoxicosis was 2·86 IC95% (1·03 - 7·95), when comparing the vaccinated versus unvaccinated population. However, the temporal distribution of cases incident did not reveal a clear difference between the cohorts, since the rate of appearance of new cases has a constant linear behavior for the two groups. INTERPRETATION: For rheumatoid arthritis, juvenile idiopathic arthritis, idiopathic thrombocytopenic purpura, and thyrotoxicosis; the application of the vaccine had an effect on the development of the disease. Nevertheless, our results should be interpreted with caution and be further studied, considering that the biological plausibility of the events occurred without a clear temporal pattern in relation to the exposure to the vaccine.

Latin American Cerebral Palsy Register (LATAM-CPR): study protocol to develop a collaborative register with surveillance of children with cerebral palsy in Latin American countries.

INTRODUCTION: Cerebral palsy (CP) is one of the leading causes of childhood disability globally with a high burden in low-income and middle-income countries (LMICs). Preliminary findings from the global LMIC CP Register (GLM CPR) suggest that the majority of CP in LMICs are due to potentially preventable causes. Such data are lacking in the Latin American region. Generating comparable epidemiological data on CP from this region could enable translational research and services towards early diagnosis and early intervention. We aim to establish a Latin American multicountry network and online data repository of CP called Latin American Cerebral Palsy Register (LATAM-CPR). METHODS AND ANALYSIS: The LATAM-CPR will be modelled after the GLM CPR and will support new and emerging Latin American CP registers following a harmonised protocol adapted from the GLM CPR and piloted in Argentina (ie, Argentine Register of Cerebral Palsy). Both population-based and institution-based surveillance mechanisms will be adopted for registration of children with CP aged less than 18 years to the participating CP registers. The data collection form of the LATAM-CPR will include risk factors, clinical profile, rehabilitation, socioeconomical status of children with CP. Descriptive data on the epidemiology of CP from each participating country will be reported, country-specific and regional data will be compared. ETHICS AND DISSEMINATION: Individual CP registers have applied ethics approval from respective national human research ethics committees (HREC) and/or institutional review boards prior to the establishment and inclusion into the LATAM-CPR. Ethical approval for LATAM-CPR has already been obtained from the HREC in the two countries that started (Argentina and Mexico). Findings will be disseminated and will be made publicly available through peer-reviewed publications, conference presentations and social media communications.

Colonic Anastomoses Reinforced With Ethyl-2-Cyanoacrylate Compared With Polydioxanone Sutures Alone in Fecal Peritonitis: An Experimental Study in Wistar Rats.

INTRODUCTION: The use of tissue adhesives has been proposed as an anastomosis reinforcement; however, their efficacy has not been evaluated in a contaminated environment. The objective of this study was to determine if the use of sutures reinforced with ethyl-2-cyanoacrylate for colonic anastomoses in the presence of fecal peritonitis, in a murine animal model, decreases the frequency of dehiscence. METHODS: Wistar rats were used. Fecal peritonitis was established until reaching 18 hours of evolution. Then, resection and anastomosis of the colon were performed with only polydioxanone (PDS) sutures in the control group and reinforcement with ethyl-2-cyanoacrylate in the experimental group. The dehiscence frequency and burst pressure were evaluated six days after the anastomosis was performed. RESULTS: We included 30 Wistar rats, all males, with a median age of five months and an average weight of 350.43 g. Anastomotic dehiscence was observed in 53.33% of the control group, in contrast with 13.33% of the experimental group (p = 0.020). There was no significant difference in burst pressure between the two groups. CONCLUSION: The use of ethyl-2-cyanoacrylate, in an experimental murine animal model, as reinforcement in colonic anastomoses in the presence of fecal peritonitis decreases the frequency of anastomotic dehiscence, although it does not increase resistance to burst pressure.

Sindrome de burnout, estado nutricional y conducta alimentaria en trabajadores de la salud / Burnout syndrome, nutritional status and eating behavior in health workers

Introducción: El síndrome de Burnout o agotamiento profesional aparece como una respuesta al estrés crónico en eltrabajo, con secuelas negativas a nivel individual y general. Objetivo: Determinar la presencia del síndrome de bur-nout, estado nutricional y conducta alimentaria en los traba-jadores de la salud. Materiales y Métodos: Estudio transversal, descriptivo y observacional. Para identificar la presencia del síndrome de Burnout se aplicó el cuestionario Maslach Burnout Inventory.La evaluación del estado nutricional se realizó por medio dela toma de datos antropométricos y la conducta alimentaria se identificó con el cuestionario semi-cuantitativo de frecuen-cia de consumo de alimentos. Resultados: La muestra de investigación estuvo constituida por 142 mujeres y 91 varones que representaron el60,9% y 39,1% respectivamente. La conducta alimentaria secaracterizó por un consumo insuficiente de lácteos, hortalizas,frutas, carnes, panes y cereales. Con respecto a las caracte-rísticas antropométricas relacionadas al estado nutricional seencontró que el mayor porcentaje de investigados presentanuna prevalencia de exceso de peso del 78% y un riesgo car-diovascular del 91%. En las 3 subescalas que valora la pre-sencia del síndrome de burnout se pudo observar que tantoen los componentes de cansancio emocional y despersonali-zación son bajos, reflejando un 60,9% y 53,6% respectiva-mente. Mientras que la dimensión de realización personal esalta, evidenciando un 63,1%.Conclusiones: En la población de estudio no existen indicios de presencia de síndrome de burnout, sin embargo, un menor porcentaje de trabajadores de la salud presentan can-sancio emocional (19,3%), despersonalización (25,8%) ybaja realización personal (19,7%). Por lo cual se recomienda, buscar estrategias para reducir la carga administrativa y disminuir el nivel de agotamiento laboral en quienes lo padeceny prevenirlo en aquellos que presenten factores de riesgo (AU)

Introduction: Burnout syndrome or professional exhaustion appears as a response to chronic stress at work, withnegative consequences at an individual and general level. Objective: Determine the presence of burnout syndrome, nutritional status and eating behavior in health workers. Materials and methods: Cross-sectional, descriptive and observational study. To identify the presence of Burnout syndrome, the Maslach Burnout Inventory questionnaire was applied. To assess the nutritional status, anthropometric datawere taken and eating behavior was identified with the semi-quantitative questionnaire on frequency of food consumption. Results: The research sample consisted of 142 womenand 91 men who represented 60.9% and 39.1% respectively. The eating behavior was characterized by an insufficient con-sumption of dairy products, vegetables, fruits, meats, breadsand cereals. Regarding the anthropometric characteristics re-lated to nutritional status, it was found that the highest per-centage of those investigated had a prevalence of excessweight of 78% and a cardiovascular risk of 91%. In the 3 sub-scales that assess the presence of burnout syndrome, it wasobserved that both the emotional exhaustion and deperson-alization components are low, reflecting 60.9% and 53.6%respectively. While the dimension of personal fulfillment ishigh, evidencing 63.1%.Conclusions: In the study population there are no indica-tions of the presence of burnout syndrome, however, a lowerpercentage of health workers present emotional exhaustion(19.3%), depersonalization (25.8%) and low personal fulfillment (19.7%). Therefore, it is recommended to seek strategies to reduce the administrative burden and reduce the levelof job burnout in those who suffer from it and prevent it inthose who present risk factors (AU)

Clinical and Biochemical Profile Associated with Renal Recovery after Acute Kidney Injury in A Mexican Population: Retrospective Cohort Study.

Background and Objectives: Our primary objective was to study the clinical and biochemical characteristics associated with acute kidney injury (AKI) remission in a group of Mexican patients. Materials and methods: We retrospectively enrolled 75 patients who were diagnosed with AKI and separated the sample into two groups: nonremitting patients (n = 27, 36%) vs. remitting patients (n = 48, 64%). Results: We found significant relationships between nonremitting AKI and previous diagnosis of chronic kidney disease (p = 0.009), higher serum creatinine (Cr) at admission (p < 0.0001), lower estimated glomerular filtration rate (eGFR) (p < 0.0001), maximum serum creatinine during hospitalization (p < 0.0001), higher fractional excretion of sodium (FENa) (p < 0.0003) and 24-h urine protein (p = 0.005), higher serum potassium on admission (p = 0.025), abnormal levels of procalcitonin (p = 0.006), and increased risk of death (p = 0.015). Conclusion: Chronic kidney disease (CKD), lower eGFR, higher levels of serum creatinine during hospitalization, higher FENa and 24-h urine protein, abnormal levels of procalcitonin, and higher serum potassium on admission were associated with nonremitting AKI. These findings may facilitate the rapid identification of patients at risk for nonremitting AKI based on clinical and biochemical characteristics. Furthermore, these findings may inform the design of timely strategies for the vigilance, prevention, and treatment of AKI.

Pneumocystis jirovecii Colonization in Mexican Patients with Chronic Obstructive Pulmonary Disease.

The prevalence of colonization by Pneumocystis jirovecii (P. jirovecii) has not been studied in Mexico. We aimed to determine the prevalence of colonization by P. jirovecii using molecular detection in a population of Mexican patients with chronic obstructive pulmonary disease (COPD) and describe their clinical and sociodemographic profiles. We enrolled patients discharged from our hospital diagnosed with COPD and without pneumonia (n = 15). The primary outcome of this study was P. jirovecii colonization at the time of discharge, as detected by nested polymerase chain reaction (PCR) of oropharyngeal wash samples. The calculated prevalence of colonization for our study group was 26.66%. There were no statistically significant differences between COPD patients with and without colonization in our groups. Colonization of P. jirovecii in patients with COPD is frequent in the Mexican population; the clinical significance, if any, remains to be determined. Oropharyngeal wash and nested PCR are excellent cost-effective options to simplify sample collection and detection in developing countries and can be used for further studies.

The Entrapment and Concentration of SARS-CoV-2 Particles with Graphene Oxide: An In Vitro Assay.

Previous studies have suggested that graphene oxide (GO) has some antiviral capacity against some enveloped viruses, including SARS-CoV-2. Given this background, we wanted to test the in vitro antiviral ability to GO using the viral plaque assay technique. Two-dimensional graphene oxide (GO) nanoparticles were synthesized using the modified Hummers method, varying the oxidation conditions to achieve nanoparticles between 390 and 718 nm. The antiviral activity of GO was evaluated by experimental infection and plaque formation units assay of the SARS-CoV-2 virus in VERO cells using a titrated viral clinical isolate. It was found that GO at concentrations of 400 µg/mL, 100 µg/mL, 40 µg/mL, and 4 µg/mL was not toxic to cell culture and also did not inhibit the infection of VERO cells by SARS-CoV-2. However, it was evident that GO generated a novel virus entrapment phenomenon directly proportional to its concentration in the suspension. Similarly, this effect of GO was maintained in assays performed with the Zika virus. A new application for GO nanoparticles is proposed as part of a system to trap viruses in surgical mask filters, air conditioning equipment filters, and air purifier filters, complemented with the use of viricidal agents that can destroy the trapped viruses, an application of broad interest for human beings.

Desarrollo y aplicación de un protocolo de evaluación de los movimientos generales de Prechtl en lactantes. De la teoría a la práctica / Development and application of a protocol for the evaluation of Prechtl's general movements "from theory to practice"

Introducción. Las guías internacionales plantean que la evaluación de los movimientos generales en los recién nacidos puede ser una herramienta altamente predictiva para el diagnóstico temprano de la parálisis cerebral. Su uso en países en desarrollo como Colombia es limitado, por ello el diseño de un protocolo de evaluación de los movimientos generales permitiría optimizar el acceso de poblaciones de riesgo a esta herramienta. Objetivos. Desarrollar un protocolo de evaluación de los movimientos generales y los desenlaces en el desarrollo de los niños con riesgo de parálisis cerebral después de los 14 meses y evaluar su aplicabilidad en niños con dificultades de acceso a los servicios de salud. Métodos. El protocolo se planteó con un esquema de valoración de cuatro etapas. Según la edad al momento de ingreso al programa, se realizaron ajustes para la valoración, el análisis y el seguimiento de los pacientes. Los videos, que fueron grabados según las recomendaciones publicadas en la literatura médica relacionada con la metodología utilizada, fueron evaluados por profesionales certificados. Resultados. Se reporta el protocolo sugerido para la evaluación cualitativa y semicuantitativa de los movimientos generales y se presentan los resultados de su aplicación en 11 niños incluidos en la prueba piloto. Este protocolo, que fue diseñado con base en una revisión de la literatura y la experiencia de dos de los investigadores, incluye información para grabar los videos, realizar la evaluación médica, aplicar la evaluación cualitativa de Prechtl de los movimientos generales del recién nacido y el examen neurológico infantil Hammersmith. Conclusión. La evaluación de los movimientos generales constituye una herramienta valiosa para la valoración del riesgo de parálisis cerebral en lactantes. La utilización de un protocolo garantiza una evaluación seriada y sistemática, por lo que es conveniente implementar su uso en centros de atención primaria y mejorar la accesibilidad a estas herramientas.

Introduction. International guidelines set up that the evaluation of the general movements in newborns could be a highly predictive tool for the early diagnosis of cerebral palsy. Their use in developing countries such as Colombia is limited; thus, the design of a protocol for the evaluation of general movements would allow to optimize the access of at-risk populations to this tool. Objectives. To develop a protocol for the evaluation of the general movements and outcomes in the development of the children at risk of presenting cerebral palsy after 14 months of age and assess its applicability in children with difficult access to healthcare services. Methods. The protocol was raised using a four-stage evaluation scheme. According to the age at the time of entry into the program, adjustments were made for the assessment, analysis and follow-up of the patients. The videos, which were recorded according to the recommendations published in the medical literature related to the methodology used, were evaluated by certified professionals. Results. The suggested protocol for the qualitative and semiquantitative evaluation of the general movements is reported and the results of its application in 11 children included in the pilot test are presented. This protocol, which was designed based on a literature review and the experience of two of the researchers, includes information to record the videos, perform the medical evaluation, apply the Prechtl´s qualitative evaluation of the general movements of the newborn and the Hammersmith infant neurological evaluation. Conclusion. The evaluation of the general movements constitutes a valuable tool for the assessment of the risk of cerebral palsy in infants. The use of a protocol guarantees a serial and systematic evaluation; therefore, it is convenient to implement its use in primary care centers and improve the accessibility to these tools.

Seizures following COVID-19 vaccination in Mexico: A nationwide observational study.

The COVID-19 pandemic led to the development and emergency approval of an array of effective vaccines against SARS-CoV-2. Given the relatively small number of patients included in vaccine trials, postapproval epidemiological surveillance is crucial to detect infrequent vaccine-related adverse events. We conducted a nationwide retrospective descriptive study evaluating the incidence of seizures among recipients of SARS-CoV-2 vaccines in Mexico from December 24, 2020 (date of administration of first doses nationwide) to October 29, 2021. Among 81 916 351 doses of any vaccine that were administered, we documented seizures in 53 patients, of which 31 (60%) were new onset seizures. The incidence rate of seizures per million doses was highest for mRNA-1273 (Moderna) with 2.73 per million, followed by BNT162b2 (Pfizer-BioNTech) with 1.02 per million, and Ad5-nCoV (CanSino) with 1.01 per million. Thus, we found that seizures following SARS-CoV-2 vaccination are exceedingly rare events.

Evolutionary and Gene Expression Analyses Reveal New Insights into the Role of LSU Gene-Family in Plant Responses to Sulfate-Deficiency.

LSU proteins belong to a plant-specific gene family initially characterized by their strong induction in response to sulfate (S) deficiency. In the last few years, LSUs have arisen as relevant hubs in protein-protein interaction networks, in which they play relevant roles in the response to abiotic and biotic stresses. Most of our knowledge on LSU genomic organization, expression and function comes from studies in Arabidopsis and tobacco, while little is known about the LSU gene repertoire and evolution of this family in land plants. In this work, a total of 270 LSU family members were identified using 134 land plant species with whole-genome sequences available. Phylogenetic analysis revealed that LSU genes belong to a Spermatophyta-specific gene family, and their homologs are distributed in three major groups, two for dicotyledons and one group for monocotyledons. Protein sequence analyses showed four new motifs that further support the subgroup classification by phylogenetic analyses. Moreover, we analyzed the expression of LSU genes in one representative species of each phylogenetic group (wheat, tomato and Arabidopsis) and found a conserved response to S deficiency, suggesting that these genes might play a key role in S stress responses. In summary, our results indicate that LSU genes belong to the Spermatophyta-specific gene family and their response to S deficiency is conserved in angiosperms.

Exploring interactions between Beauveria and Metarhizium strains through co-inoculation and responses of perennial ryegrass in a one-year trial.

Perennial ryegrass (Lolium perenne L.) possesses a high level of nutritional quality and is widely used as a forage species to establish permanent pastures in southern Chile. However, the productivity of most such pastures is limited by various environmental agents, such as insect pests and drought. In this context, our work stresses the need for elucidating the ability of fungal endophytes to establish interactions with plants, and to understand how these processes contribute to plant performance and fitness. Therefore, we evaluated the colonization and impact of two native strains of the endophytic insect-pathogenic fungus (EIPF) group isolated from permanent ryegrass pastures in southern Chile. Roots and seeds of ryegrass and scarabaeid larvae were collected from nine different ryegrass pastures in the Los Ríos region of southern Chile to specifically isolate EIPFs belonging to the genera Beauveria and Metarhizium. Fungal isolations were made on 2% water agar with antibiotics, and strains were identified by analyzing the entire internal transcribed spacer (ITS) 1-5.8S-ITS2 ribosomal DNA region. Four strains of Beauveria and 33 strains of Metarhizium were isolated only in scarabaeid larvae from ryegrass pastures across four sites. Experimental mini-pastures that were either not inoculated (control) or co-inoculated with conidia of the strains Beauveria vermiconia NRRL B-67993 (P55_1) and Metarhizium aff. lepidiotae NRRL B-67994 (M25_2) under two soil humidity levels were used. Ryegrass plants were randomly collected from the mini-pastures to characterize EIPF colonization in the roots by real-time PCR and fluorescence microscopy. Aboveground biomass was measured to analyze the putative impact of colonization on the mini-pastures' aboveground phenotypic traits with R software using a linear mixed-effects model and the ANOVA statistical test. Seasonal variation in the relative abundance of EIPFs was observed, which was similar between both strains from autumn to spring, but different in summer. In summer, the relative abundance of both EIPFs decreased under normal moisture conditions, but it did not differ significantly under water stress. The aboveground biomass of ryegrass also increased from autumn to spring and decreased in summer in both the inoculated and control mini-pastures. Although differences were observed between moisture levels, they were not significant between the control and inoculated mini-pastures, except in July (fresh weight and leaf area) and October (dry weight). Our findings indicate that native strains of B. vermiconia NRRL B-67993 (P55_1) and M. aff. lepidiotae NRRL B-67994 (M25_2) colonize and co-exist in the roots of ryegrass, and these had little or no effect on the mini-pastures' aboveground biomass; however, they could have other functions, such as protection against root herbivory by insect pests.

Síndrome de Dressler: el retorno de una enfermedad olvidada / Dressler's syndrome: the return of a forgotten entity

Resumen El síndrome de Dressler es una enfermedad infrecuente que fue descrita por primera vez en 1956 por el doctor William Dressler. Corresponde a un cuadro de pericarditis secundaria, en ocasiones asociada a efusión pericárdica de aparente etiología autoinmunitaria, que hace parte de los síndromes de lesión poscardiaca. Se presenta un caso de síndrome de Dressler en un paciente joven.

Abstract Dressler's syndrome is a rare entity which was first described in 1956 by Dr. William Dressler. It consists of secondary pericarditis, at times associated with pericardial effusion with an apparently autoimmune etiology, which is one of the post-cardiac injury syndromes. We present a case of Dressler's syndrome in a young patient.

Screening of COVID-19 cases through a Bayesian network symptoms model and psychophysical olfactory test.

The sudden loss of smell is among the earliest and most prevalent symptoms of COVID-19 when measured with a clinical psychophysical test. Research has shown the potential impact of frequent screening for olfactory dysfunction, but existing tests are expensive and time consuming. We developed a low-cost ($0.50/test) rapid psychophysical olfactory test (KOR) for frequent testing and a model-based COVID-19 screening framework using a Bayes Network symptoms model. We trained and validated the model on two samples: suspected COVID-19 cases in five healthcare centers (n = 926; 33% prevalence, 309 RT-PCR confirmed) and healthy miners (n = 1,365; 1.1% prevalence, 15 RT-PCR confirmed). The model predicted COVID-19 status with 76% and 96% accuracy in the healthcare and miners samples, respectively (healthcare: AUC = 0.79 [0.75-0.82], sensitivity: 59%, specificity: 87%; miners: AUC = 0.71 [0.63-0.79], sensitivity: 40%, specificity: 97%, at 0.50 infection probability threshold). Our results highlight the potential for low-cost, frequent, accessible, routine COVID-19 testing to support society's reopening.

Comparison of ROX and HACOR scales to predict high-flow nasal cannula failure in patients with SARS-CoV-2 pneumonia.

The pandemic of SARSCov2 infection has created a challenge in health services worldwide. Some scales have been applied to evaluate the risk of intubation, such as the ROX and HACOR. The objective of this study is to compare the predictive capacity of the HACOR scale and the ROX index and define the optimal cut-off points. Study of diagnostic tests based on a retrospective cohort. Composite outcome was the proportion of patients that needed endotracheal intubation (ETI) or died of COVID19 pneumonia. Discrimination capacity was compared by the area under the curve of each of the two scales and the optimal cut-off point was determined using the Liu method. 245 patients were included, of which 140 (57%) required ETI and 152 (62%) had the composite end result of high-flow nasal cannula (HFNC) failure. The discrimination capacity was similar for the two scales with an area under receiver operating characteristic curve of 0.71 and 0.72 for the HACOR scale for the ROX index, respectively. The optimal cut-off point for the ROX index was 5.6 (sensitivity 62% specificity 65%), while the optimal cut-off point for the HACOR scale was 5.5 (sensitivity 66% specificity 65%). The HACOR scale and the ROX index have a moderate predictive capacity to predict failures to the HFNC strategy. They can be used in conjunction with other clinical variables to define which patients may require invasive mechanical ventilation.

Dataset on in-vitro study of chitosan-graphene oxide films for regenerative medicine.

Chitosan (CS) is well-known for its biological properties, especially its ability to induce tissue cicatrization. However, considerable research proved that CS presents a high inflammatory response and poor mechanical properties. For these reasons, we decided to use chitosan (CS) functionalized GO by a covalent bond (CS-GO). Due to the resistant structure of the GO and the high presence of oxygen functional groups on it, it will enhance the biocompatibility of the material. The data obtained in this investigation aimed to prove the possible application of CS-GO in regenerative medicine. For this reason, it was performed an In vitro analysis using brine shrimp to prove materials biocompatibility and gingival fibroblasts for a cell growth test.

Synthesis and fabrication of films including graphene oxide functionalized with chitosan for regenerative medicine applications.

Graphene oxide (GO) has recently gained attention as a scaffold reinforcing agent for tissue engineering. Biomechanical and biological properties through a synergistic effect can be strengthened when combined with other materials such as chitosan (CS). For that reason, chitosan was used for Graphene Oxide (GO) functionalization through an amide group whose formation was evident by bands around 1600 cm-1 in the FTIR analysis. Furthermore, bands located at 1348 cm-1 (D band), 1593 cm-1 (G band), and 2416 cm-1 (2D band) in the RAMAN spectrum, and the displacement of the signal at 87.03 ppm (C5) in solid-state 13C-NMR confirmed the amide formation. Films including the CS-GO compound were prepared and characterized by thermogravimetric analysis (TGA), where CS-GO film presented a lighter mass loss (~10% less loosed) than CS due probably to the covalent functionalization with GO, providing film thermal resistance. The CS-GO films synthesized were implanted in Wistar rats' subdermal tissue as a first approximation to the biological response. In vivo tests showed a low inflammatory response, good cicatrization, and advanced resorption at 60 days of implantation, as indicated by histological images. It was evidenced that the covalent union between CS and GO increased biocompatibility and the degradation/resorption capacity, demonstrating tissue regeneration with typical characteristics and tiny remnants of implanted material surrounded by a type III collagen capsule. These results show the potential application of the new synthesized films, including the CS-GO compound, in tissue engineering.