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In many species, individuals of the same sex exhibit different mating behaviours, a phenomenon known as alternative mating tactics (AMTs). These AMTs may occur in species in which morphology prevents individuals from adopting different tactics (fixed expression of AMTs) as well as in species in which individuals can alternate between them (flexible expression of AMTs). Regardless of the way different mating tactics are expressed, a key point to understanding the selective forces driving AMT evolution relies on identifying differences in the reproductive success between tactics. Empirical studies often indicate that individuals adopting the main tactic (generally the more aggressive) have higher mating success than those adopting the secondary tactic. However, while this is expected for species showing flexible expression of AMTs, the same should not hold for species showing fixed expression of AMTs. In species with fixed expression of AMTs, individuals adopting each tactic have morphological specialisations in acquiring mates that may be responsible for eliminating differences in reproductive success between tactics. Despite such expectations, a comprehensive investigation across species regarding differences in the reproductive success of AMTs is lacking. Using a meta-analytical approach, we investigated if there is a difference in the reproductive success between tactics and whether this difference is related to how these tactics are expressed (fixed or flexible). We focused on males since information on reproductive success for females with AMTs is still scarce. We hypothesised that (i) males adopting the main tactic have higher reproductive success than males adopting the secondary tactic, and (ii) the difference in reproductive success between tactics will be higher in species with flexible rather than fixed expression of AMTs. When all species were pooled, we found that males adopting the main tactic had a similar reproductive success to males adopting the secondary mating tactic. However, this trend changed between species with fixed and flexible expression of AMTs. In species with flexible expression of AMTs, males exhibiting the main tactic have higher mating success than those adopting secondary tactics, while in species with fixed expression of AMTs, males adopting distinct tactics have similar reproductive success. Thus, the widespread assumption that males adopting the main tactic have higher reproductive success than males adopting the secondary tactic may be restricted to species in which individuals can alternate between tactics during their lifespan. However, we found that most data on the reproductive success of males adopting AMTs is restricted to short reproductive windows and may not reflect differences in lifetime reproductive success between tactics. Therefore, we highlight the importance of examining the selective pressures associated with fixed and flexible expression of AMTs on lifetime reproductive success to attain a deeper understanding of AMT evolution.
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A wearable glove-based sensor is a portable and practical approach for onsite detection/monitoring of a variety of chemical threats. Herein, we report a flexible and sensitive wearable sensor fabricated on the nitrile glove fingertips by stencil-printing technique. The working electrodes were modified with multiwalled carbon nanotubes (MWCNTs)/poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) for sensitive and real-time analyses of hazardous or chemical treats, as picric acid (PA) explosive, diazepam (DZ) as drug-facilitated crimes and the emerging pollutant 4-nitrophenol (4-NP). The multi-sensing platform towards PA, 4-NP, and DZ offers the ability of in-situ qualitative and quantitative analyses of powder and liquid samples. A simple sampling by touching or swiping the fingertip sensor on the sample or surface under investigation using an ionic hydrogel combined with fast voltammetry measurement provides timely point-of-need analyses. The wearable glove-based sensor uses the square wave voltammetry (SWV) technique and exhibited excellent performance to detect PA, 4-NP, and DZ, resulting in limits of detection (LOD) of 0.24 µM, 0.35 µM, 0.06 µM, respectively, in a wide concentration range (from 0.5 µM to 100 µM). Also, we obtained excellent manufacturing reproducibility with relative standard deviations (RSD) in the range of 3.65%-4.61% using 7 different wearable devices (n = 7) and stability in the range of 4.86%-6.61% using different electrodes stored for 10 days at room temperature (n = 10), demonstrating the excellent sensor-to-sensor reproducibility and stability for reliable in-field measurements. The stretchable sensor presented great mechanical robustness, supporting up to 80 bending or stretching deformation cycles without significant voltammetric changes. Collectively, our wearable glove-based sensor may be employed for analyses of chemical contaminants of concern, such as explosives (PA), drugs (DZ), and emerging pollutants (4-NP), helping in environmental and public safety control.
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Diazepam , Técnicas Eletroquímicas , Nanotubos de Carbono , Nitrofenóis , Dispositivos Eletrônicos Vestíveis , Nanotubos de Carbono/química , Nitrofenóis/análise , Técnicas Eletroquímicas/instrumentação , Técnicas Eletroquímicas/métodos , Diazepam/análise , Eletrodos , Humanos , Limite de Detecção , Substâncias Explosivas/análise , Polímeros/química , PicratosRESUMO
This study presents the development of gas sensors based on the PEDOT:PSS@ZnO hybrid active layer slot-die printing aqueous ink. Two different zinc oxide (ZnO) nanoparticles were studied to form the nanocomposites, as well as the use of glass and PET substrates to manufacture the devices. Despite the influence of the morphology of the active layer, all device variations studied here exhibited high response values for methanol gas at room temperature, in addition to presenting good repeatability, reversibility, and the possibility of technology transfer to flexible substrates. Furthermore, PEDOT:PSS@ZnO showed good selectivity to methanol compared to ethanol, ammonia, and CO2. The best devices showed responses greater than 700% in detecting methanol.
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Nanocomposites are materials of special interest for the development of flexible electronic, optical, and mechanical devices in applications such as transparent conductive electrodes and flexible electronic sensors. These materials take advantage of the electrical, chemical, and mechanical properties of a polymeric matrix, especially in force sensors, as well as the properties of a conductive filler such as silver nanowires (AgNWs). In this work, the fabrication of a force sensor using AgNWs synthesized via the polyol chemical technique is presented. The nanowires were deposited via drop-casting in polyvinyl alcohol (PVA) to form the active (electrode) and resistive (nanocomposite) sensor films, with both films separated by a cellulose acetate substrate. The dimensions of the resulting sensor are 35 mm × 40 mm × 0.1 mm. The sensor shows an applied force ranging from 0 to 3.92 N, with a sensitivity of 0.039 N. The sensor stand-off resistance, exceeding 50 MΩ, indicates a good ability to detect changes in applied force without an external force. Additionally, studies revealed a response time of 10 ms, stabilization of 9 s, and a degree of hysteresis of 1.9%. The voltage response of the sensor under flexion at an angle of 85° was measured, demonstrating its functionality over a prolonged period. The fabricated sensor can be used in applications that require measuring pressure on irregular surfaces or systems with limited space, such as for estimating movement in robot joints.
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INTRODUCTION: health promotion policy requires the identification of barriers to the adoption of public policies. Paraguay's national healthcare system is inequitable, expensive, and inefficient. The Ministry of Public Health and Social Welfare (MSPyBS) is the entity responsible for covering the needs of a significant portion of the population. In January 2022, the MSPyBS financed the purchase of titanium elastic nails through a National Public Tender for Osteosynthesis Materials (LPN 02/22) to provide them for free in the pediatric service. Using research as a tool, we seek to analyze the impact of the implementation of LPN 02/22 at the Trauma Hospital, believing that this action would help streamline administrative and bureaucratic processes, making them more efficient with the assistance of the hospital's human resources. MATERIAL AND METHODS: a retrospective, analytical, and comparative study conducted at a high-complexity trauma center in Asunción, Paraguay. Patients aged 4 to 14 years with an indication for stabilization with elastic nails were included. Demographic data, the mechanism of injury, time elapsed from hospital arrival to surgical treatment, length of hospital stay, and the average hospital cost were analyzed based on the daily expense of pediatric patient hospitalization. RESULTS: 52 patients, divided into 25 cases in 2021 before implementation and 27 cases after implementation. The time elapsed from hospital arrival to definitive treatment was six days in the pre-implementation period, with an average stay from admission to discharge of 7.4 days. After implementation, the time from hospital arrival to definitive treatment was 4.3 days, and the average discharge time for the Post group was six days. The potential savings per patient amount to 332 dollars, offset by the institution's implant supply cost of 197 dollars, resulting in an approximate savings of 135 dollars per patient for the ministry. CONCLUSIONS: we view the implementation of free titanium elastic nails for pediatric femur fracture patients positively. We encourage the institution to continue with similar policies and strive to achieve even greater benefits for users.
INTRODUCCIÓN: la política de promoción de la salud requiere la identificación de los obstáculos para la adopción de políticas públicas. El sistema nacional de salud de Paraguay es inequitativo, caro e ineficiente. El Ministerio de Salud Pública y Bienestar Social (MSPyBS) es el ente que cubre las necesidades de gran parte de la población. El MSPyBS en Enero del 2022 financió, mediante la Licitación Pública Nacional de Materiales de Osteosíntesis (LPN 02/22), la compra de clavos elásticos de titanio para disponer de su uso gratuito en el Servicio de Pediatría; usando a la investigación como herramienta, buscamos analizar el impacto de la implementación de la LPN 02/22 en el Hospital de Trauma, creyendo que esta acción ayudaría a dinamizar los procesos administrativos y burocráticos, haciéndolos más eficientes con la ayuda de los recursos humanos del hospital. MATERIAL Y MÉTODOS: estudio retrospectivo, analítico y comparativo, realizado en un centro de trauma de alta complejidad de Asunción, Paraguay. Fueron incluidos los pacientes con edad comprendidas entre cuatro y 14 años, con indicación de estabilización con clavos elásticos. Se analizaron los datos demográficos, el mecanismo de trauma, el tiempo transcurrido desde la llegada al hospital hasta el tratamiento quirúrgico, así como el tiempo de estadía hospitalaria. Se evaluó el costo hospitalario promedio, basados en el gasto diario de la internación de un paciente pediátrico. RESULTADOS: cincuenta y dos pacientes, separados en 25 casos en el 2021 previo a la implementación y 27 casos posterior a la implementación. El tiempo transcurrido desde la llegada al hospital hasta el tratamiento definitivo fue de seis días para la etapa previa a la implementación; el promedio desde el ingreso hasta el alta fue de 7.4 días. Desde la implementación se tuvo un transcurso de 4.3 días desde la llegada al hospital hasta el tratamiento definitivo. El egreso del grupo Post tuvo un promedio de seis días. El ahorro probable en relación con cada paciente es de 332 dólares; a esto debemos contrarrestar el monto que paga la institución para la provisión del implante (197 dólares), por lo que el ahorro del ministerio sería de aproximadamente 135 dólares por cada paciente. CONCLUSIONES: vemos como positiva la implementación de la gratuidad de los clavos elásticos de titanio en los pacientes en edad pediátrica con fractura de fémur. Alentamos a la institución a seguir con políticas similares y tratar de lograr mayores beneficios para los usuarios.
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Fraturas do Fêmur , Humanos , Criança , Estudos Retrospectivos , Adolescente , Pré-Escolar , Feminino , Masculino , Fraturas do Fêmur/cirurgia , Fraturas do Fêmur/economia , Paraguai , Tempo de Internação/estatística & dados numéricos , Pinos Ortopédicos , Fixação Interna de Fraturas/métodos , Fixação Interna de Fraturas/economia , Fixação Interna de Fraturas/instrumentação , Custos Hospitalares/estatística & dados numéricos , Centros de Traumatologia/organização & administração , TitânioRESUMO
This work presents the evaluation of the electrical behavior of a flexible photoconductor with a planar heterojunction architecture made up of organic semiconductor films deposited by high vacuum evaporation. The heterojunction was characterized in its morphology and mechanical properties by scanning electron microscopy and atomic force microscopy. The electrical characterization was carried out through the approximations of ohmic and SCLC (Space-Charge Limited Current) behaviors using experimental J-V (current density-voltage) curves at different voltages and under different light conditions. The optimization of the photoconductor was carried out through annealing and accelerated lighting processes. With these treatments, the Knoop Hardness of the flexible photoconductor has reached a value of 8 with a tensile strength of 5.7 MPa. The ohmic and SCLC approximations demonstrate that the unannealed device has an ohmic behavior, whereas the annealed device has an SCLC behavior, and after the optimization process, an ohmic behavior and a maximum current density of 0.34 mA/mm2 were obtained under blue light. The approximations of the device's electron mobility (µn) and free carrier density (n0) were performed under different light conditions, and the electrical activation energy and electrical gap were obtained for the flexible organic device, resulting in appropriate properties for these applications.
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The papain-like protease (PLpro) found in coronaviruses that can be transmitted from animals to humans is a critical target in respiratory diseases linked to Severe Acute Respiratory Syndrome (SARS-CoV). Researchers have proposed designing PLpro inhibitors. In this study, a set of 89 compounds, including recently reported 2-phenylthiophenes with nanomolar inhibitory potency, were investigated as PLpro noncovalent inhibitors using advanced molecular modeling techniques. To develop the work with these inhibitors, multiple structures of the SARS-CoV-2 PLpro binding site were generated using a molecular sampling method. These structures were then clustered to select a group that represents the flexibility of the site. Subsequently, models of the protein-ligand complexes were created for the set of inhibitors within the chosen conformations. The quality of the complex models was assessed using LigRMSD software to verify similarities in the orientations of the congeneric series and interaction fingerprints to determine the recurrence of chemical interactions. With the multiple models constructed, a protocol was established to choose one per ligand, optimizing the correlation between the calculated docking energy values and the biological activities while incorporating the effect of the binding site's flexibility. A strong correlation (R2 = 0.922) was found when employing this flexible docking protocol.
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Abstract Objective: To examine the prevalence and characteristics of dysphagia and suck-swallow-breath incoordination as phenotypes of oral feeding difficulties. Method: A cross-sectional study with secondary data collected consecutively over 2 years from October 2020 to October 2022 to measure the prevalence of swallowing and oral feeding difficulty in preterm infants using Flexible endoscopic evaluation of swallowing examination at the tertiary Integrated Dysphagia Clinic. Results: The prevalence of swallowing disorders was 25 % and the prevalence of suck-swallow-breath incoordination was 62.5 %. The significant risk factor that may show a possible correlation with oral feeding difficulty was mature post-menstrual age (p = 0.006) and longer length of stay (p = 0.004). The dominant percentage of upper airway abnormality and disorder were retropalatal collapse (40 %), laryngomalacia (42.5 %), paradoxical vocal cord movement (12.5 %), and gastroesophageal reflux disease (60 %). The dominant characteristic of oral motor examination and flexible endoscopic evaluation of swallowing examination was inadequate non-nutritive sucking (45 %), inadequate postural tone (35 %), and inadequate nutritive sucking (65 %). Conclusion: Dysphagia in preterm infants is mostly observed in those with mature post-menstrual age, longer length of stay, and the presence of gastroesophageal reflux disease with inadequate non-nutritive sucking and nutritive sucking abilities. Suck-swallow-breath incoordination is primarily observed in those with immature post-menstrual age, a higher prevalence of cardiopulmonary comorbidity, and a higher prevalence of upper airway pathologies (laryngomalacia, paradoxical vocal cord movement) with inadequate nutritive sucking ability.
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OBJECTIVE: To examine the prevalence and characteristics of dysphagia and suck-swallow-breath incoordination as phenotypes of oral feeding difficulties. METHOD: A cross-sectional study with secondary data collected consecutively over 2 years from October 2020 to October 2022 to measure the prevalence of swallowing and oral feeding difficulty in preterm infants using Flexible endoscopic evaluation of swallowing examination at the tertiary Integrated Dysphagia Clinic. RESULTS: The prevalence of swallowing disorders was 25 % and the prevalence of suck-swallow-breath incoordination was 62.5 %. The significant risk factor that may show a possible correlation with oral feeding difficulty was mature post-menstrual age (p = 0.006) and longer length of stay (p = 0.004). The dominant percentage of upper airway abnormality and disorder were retropalatal collapse (40 %), laryngomalacia (42.5 %), paradoxical vocal cord movement (12.5 %), and gastroesophageal reflux disease (60 %). The dominant characteristic of oral motor examination and flexible endoscopic evaluation of swallowing examination was inadequate non-nutritive sucking (45 %), inadequate postural tone (35 %), and inadequate nutritive sucking (65 %). CONCLUSION: Dysphagia in preterm infants is mostly observed in those with mature post-menstrual age, longer length of stay, and the presence of gastroesophageal reflux disease with inadequate non-nutritive sucking and nutritive sucking abilities. Suck-swallow-breath incoordination is primarily observed in those with immature post-menstrual age, a higher prevalence of cardiopulmonary comorbidity, and a higher prevalence of upper airway pathologies (laryngomalacia, paradoxical vocal cord movement) with inadequate nutritive sucking ability.
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Transtornos de Deglutição , Refluxo Gastroesofágico , Laringomalácia , Lactente , Recém-Nascido , Humanos , Transtornos de Deglutição/epidemiologia , Transtornos de Deglutição/etiologia , Recém-Nascido Prematuro , Laringomalácia/complicações , Estudos Transversais , Unidades de Terapia Intensiva Neonatal , Comportamento de Sucção , Fatores de Risco , Ataxia/complicaçõesRESUMO
In this article, the degradability by Aspergillus niger and Aspergillus clavatus of three bio-based polyurethane (PU) foams is compared to previous degradability studies involving a Pseudomonas sp. bacterium and similar initial materials (Spontón et al. in Int. Biodet. Biodeg. 85:85-94, 2013, https://doi.org/10.1016/j.ibiod.2013.05.019 ). First, three new polyester-polyurethane foams were prepared from mixtures of castor oil (CO), maleated castor oil (MACO), toluene diisocyanate (TDI), and water. Then, their degradation tests were carried out in an aqueous medium, and employing the two mentioned fungi, after their isolation from the environment. From the degradation tests, the following was observed: (a) the insoluble (and slightly collapsed) foams exhibited free hydroxyl, carboxyl, and amine moieties; and (b) the water soluble (and low molar mass) compounds contained amines, carboxylic acids, and glycerol. The most degraded foam contained the highest amount of MACO, and therefore the highest concentration of hydrolytic bonds. A basic biodegradation mechanism was proposed that involves hydrolysis and oxidation reactions.
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Aspergillus , Poliésteres , Poliuretanos , Poliuretanos/química , Poliuretanos/metabolismo , Poliésteres/metabolismo , Aspergillus niger/metabolismo , Óleo de Rícino/química , ÁguaRESUMO
Objective: The objective of the study was to determine the efficacy and safety of flexible ureteroscopy (F-URS) for the management of intrarenal or proximal ureteral lithiasis in aged patients. Materials and methods: In this retrospective, multicenter observational study, we collected the anonymized clinical data of patients who underwent F-URS at two institutions in Cali, Colombia between June 2015 and May 2018. The patients were divided into two groups based on age: Group A defined as aged patients (> 65 years) and Group B as patients of non-advanced age (< 65 years). Results: A total of 201 patients were included in this study. The average age for Group A was 75 years (± 4.5) and for Group B was 51 years (± 10). The anesthetic risk classification (American Society of Anesthesiology [ASA]) and comorbidities were significantly higher for Group A with an ASA II and III of 74% versus 50% in Group B. No significant differences were shown in the stone-free rates (SFRs) or significant ureteral injury (Grade III and IV). There was no difference in intraoperative or post-operative complications between both groups. Conclusions: Age > 65 years was not associated with a negative impact on the outcomes of F-URS for the management of intrarenal or proximal ureteral lithiasis in this cohort of patients. F-URS appears as a safe and effective procedure and should not be withheld from older patients
Objetivo: Determinar la efectividad y seguridad de la ureteroscopia flexible (F-URS) para el manejo de la litiasis ureteral intrarrenal o proximal en pacientes ancianos. Materiales y métodos: En este estudio observacional multicéntrico y retrospectivo, se recogieron los datos clínicos de los pacientes sometidos a F-URS en dos instituciones de Cali, Colombia, entre junio de 2015 y mayo de 2018. Los pacientes se dividieron en dos grupos según la edad. El grupo A se definió como pacientes de edad avanzada (> 65 años) y el grupo B como pacientes de edad no avanzada (< 65 años). Resultados: Un total de 201 pacientes fueron incluidos en este estudio. La edad media para el grupo A fue de 75 años (± 4,5) y para el grupo B fue de 51 años (± 10). La clasificación de riesgo anestésico (ASA) y las comorbilidades fueron significativamente mayores para el grupo A con un ASA II y III del 74% frente al 50% en el grupo B. No se observaron diferencias significativas en las tasas libres de cálculos ni en la lesión ureteral significativa (grado III y IV). No hubo diferencias en las complicaciones anestésicas, intraoperatorias o postoperatorias entre ambos grupos. Conclusiones: La edad > 65 años no se asoció con un impacto negativo en los resultados urológicos ni en la tasa de éxito de la F-URS para el manejo de la litiasis ureteral intrarrenal o proximal en esta cohorte de pacientes. La F-URS es un procedimiento seguro y eficaz, y no debe contraindicarse en los pacientes de edad avanzada
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Humanos , Segurança , Efetividade , Ureteroscopia , Litíase , Anestésicos , Organização Mundial da Saúde , Litotripsia , Idoso , Cálculos Urinários , LasersRESUMO
The electric stimulation (ES) of the cornea is a novel therapeutic approach to the treatment of degenerative visual diseases. Currently, ES is delivered by placing a mono-element electrode on the surface of the cornea that uniformly stimulates the eye along the electrode site. It has been reported that a certain degree of correlation exists between the location of the stimulated retinal area and the position of the electrode. Therefore, in this study, we present the development of a sectioned surface electrode for selective electric stimulation of the human cornea. The proposed device consists of 16 independent microelectrodes, a reference electrode, and 18 contact pads. The microelectrodes have a size of 200 µm × 200 µm, are arranged in a 4 × 4 matrix, and cover a total stimulation area of 16 mm2. The proposed fabrication process, based on surface micromachining technology and flexible electronics, uses only three materials: polyimide, aluminum, and titanium, which allow us to obtain a simplified, ergonomic, and reproducible fabrication process. The fabricated prototype was validated to laboratory level by electrical and electrochemical tests, showing a relatively high electrical conductivity and average impedance from 712 kΩ to 1.4 MΩ at the clinically relevant frequency range (from 11 Hz to 30 Hz). Additionally, the biocompatibility of the electrode prototype was demonstrated by performing in vivo tests and by analyzing the polyimide films using Fourier transform infrared spectroscopy (FTIR). The resulting electrode prototype is robust, mechanically flexible, and biocompatible, with a high potential to be used for selective ES of the cornea.
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Like other phthalates, diethyl phthalate (DEP) is considered as a contaminant of emerging concern (CEC) due to its ease in migrating from a package to water and food, and hence contaminate consumers, being metabolized and excreted in the urine. Its presence has a negative impact on aquatic ecosystems, especially with respect to disruption of the endocrine system and to reproductive disorders in humans. It mainly enters water bodies via sewage effluents from effluent treatment plants, due to its incomplete or inefficient removal. The objective of this work was to evaluate the toxicity of DEP at different trophic levels and to analyze data on the incidence and concentration of DEP according to its solubility. The concentrations ranged from 12.5 mg L-1 to 500 mg L-1 considering the response for toxicity at each trophic level and to determine the lethal concentration in 50% of the following organisms (LC50) (in mg L-1): Lactuca sativa seeds, Artemia salina Leach nauplii and Zebrafish embryo larval stage (Danio rerio), being 41,057.58 after 120 h; 401.77 after 48 h; and 470 after 96 h of exposure, respectively. As expected, higher organisms were more affected even at low concentrations, which shows the anthropological contribution of CECs to water bodies.
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INTRODUCCIÓN: Las opacidades pulmonares en receptores de trasplante de precursores hematopoyéticos (TPH) representan un desafío diagnóstico y son una causa de morbimortalidad. Existen grandes discrepancias con respecto a la sensibilidad diagnóstica del lavado broncoalveolar (LBA), sus complicaciones, y los factores asociados a la identificación microbiológica. OBJETIVO: Conocer la utilidad del estudio microbiológico del LBA en el diagnóstico, modificación de la conducta médica y estimar las complicaciones y mortalidad asociada al procedimiento, en receptores de TPH con opacidades pulmonares. PACIENTES Y MÉTODOS: Estudio de cohorte, retrospectivo, en adultos receptores de TPH a los que se les realizó una broncoscopía con LBA por presentar opacidades pulmonares, en el Hospital Italiano de Buenos Aires entre el 01/01/2011 y el 31/12/2020. RESULTADOS: De los 189 procedimientos analizados, en 79 se logró un hallazgo microbiológico (41,8%) y 122 permitieron modificar la conducta médica (64,6%). En 11 casos se observaron complicaciones graves dentro de las 12 horas (5,8%) de efectuado el LBA. La mortalidad intrahospitalaria fue de 16,8% (N = 21/125). El valor de neutrófilos en sangre previo al LBA (p = 0,037) y la presencia de nódulos pulmonares como lesión tomográfica predominante (p = 0,029) se asociaron independientemente al hallazgo microbiològico global. CONCLUSIONES: Nuestra investigación apoya la realización del LBA como herramienta diagnóstica en pacientes que reciben un TPH y presentan opacidades pulmonares.
BACKGROUND: Lung opacities are a cause of morbimortality in bone marrow transplant patients, and represent a diagnostic challenge. There are large discrepancies regarding the diagnostic sensitivity of bronchoalveolar lavage (BAL), its complications, and the factors associated with microbiological detection. AIM: To know the usefulness of the microbiological study of BAL in the diagnosis, in the modification in medical behavior and to estimate the complications and associated mortality of this diagnostic procedure in patients transplanted with hematopoietic progenitor cells with pulmonary opacities. METHODS: Retrospective cohort study in bone marrow transplant adult patients who underwent bronchoscopy with BAL due to lung opacities at Hospital Italiano de Buenos Aires between 01/01/2011 and 12/31/2020. RESULTS: Of the 189 BAL analyzed, 79 presented a microbiological detection (41.8%) and 122 allowed to modify the medical behavior (64.6%). Severe complications were observed within 12 hours after the procedure in11 cases (5.8%). In-hospital mortality was 16,8% (N = 21/125). The value of blood neutrophils prior to bronchoalveolar lavage (p = 0.037) and the presence of pulmonary nodules as the predominant tomographic lesion (p = 0.029) were independently associated with global microbiological detection. CONCLUSION: Our research supports the performance of BAL as a diagnostic tool in bone marrow transplant patients with lung opacities.
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Broncoscopia/métodos , Líquido da Lavagem Broncoalveolar/microbiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Lavagem Broncoalveolar/métodos , Neoplasias Hematológicas/terapia , Bactérias/isolamento & purificação , Vírus/isolamento & purificação , Análise Multivariada , Estudos de Coortes , Hospedeiro Imunocomprometido , Transplantados , Fungos/isolamento & purificação , Pulmão/microbiologiaRESUMO
Introduction: Assessing ileal conduit for double J stents removal after radical cystectomy is not always a straightforward task as navigation inside the ileal loop can be challenging to manage due to the difficulty to maintain a waterfilled environment and its long and tortuous aspect. Methods: We present a novel technique using a flexible ureteroscope that aims to ease this common demand with simple and readily available tools. Results: This technique has been successfully utilized in 2 patients now. No complications were documented. Conclusion: We propose a novel surgical technique to improve endoscopic navigation in incontinent ileal loop urinary diversion.
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Thermoelectric phenomena, such as the Anomalous Nernst and Longitudinal Spin Seebeck Effects, are promising for sensor applications in the area of renewable energy. In the case of flexible electronic materials, the request is even larger because they can be integrated into devices having complex shape surfaces. Here, we reveal that Pt promotes an enhancement of the thermoelectric response in Co-rich ribbon/Pt heterostructures due to the spin-to-charge conversion. Moreover, we demonstrated that the employment of the thermopiles configuration in this system increases the induced thermoelectric current, a fact related to the considerable decrease in the electric resistance of the system. By comparing present findings with the literature, we were able to design a flexible thermopile based on LSSE without the lithography process. Additionally, the thermoelectric voltage found in the studied flexible heterostructures is comparable to the ones verified for rigid systems.
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An arteriovenous fistula (AVF) is the access most recommended by several authors. However, its manufacture and use can cause several problems in the short, medium and long term. The study of fluid dynamics related to the structure of the AVF can provide information necessary for the reduction of these problems and a better quality of life for patients. The present study analyzed pressure variation in a rigid and flexible (thickness variation) model of AVFs manufactured based on patient data. A computed tomography was performed from which the geometry of the AVF was removed. This was treated and adapted to the pulsatile flow bench. Bench tests with simulation of systolic-diastolic pulse showed higher pressure peaks in the rigid AVF followed by the flexible model with 1 mm thickness. The inflection of the pressure values of the flexible AVF in relation to the rigid one was observed, being more expressive in the flexible AVF of 1 mm. The 1 mm flexible AVF presented an average pressure close to the physiological one and a smaller pressure drop, showing that this AVF model presents the best condition among the three to serve as a basis for the development of an AVF substitute.
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Elastomers based on block copolymers can self-organize into ordered nanoscale structures, making them attractive for use as flexible conductive nanocomposites. Understanding how ordered structures impact electrical properties is essential for practical applications. This study investigated the morphological evolution of flexible conductive elastomers based on polystyrene-b-poly(ethylene-co-butylene)-b-polystyrene (SEBS) block copolymers with aligned single- or multi-wall carbon nanotubes (SWCNTs or MWCNTs) and their electrical conductivity under large deformations. Oriented nanocomposites were obtained through injection molding and characterized using two different setups: tensile testing monitored by in situ small-angle X-ray scattering (SAXS) and tensile testing with simultaneous electrical conductivity measurements. Our findings demonstrate that structural orientation significantly influences electrical conductivity, with higher conductivity in the longitudinal direction due to the preferred orientation of carbon nanotubes. Tensile testing demonstrated that carbon nanotubes accelerate the process of realignment of the ordered structure. As a consequence, higher deformations reduced the conductivity of samples with longitudinal alignment due to the disruption of percolation contacts between nanotubes, while in samples with a transverse alignment the process promoted the formation of a new conductive network, increasing electrical conductivity.
RESUMO
La prótesis parcial removible (PPR) es una alternativa de tratamiento en pacientes que perdieron algunos elementos dentarios, debido al costo relativamente bajo y a la generación de una función masticatoria satisfactoria. Además, es una buena opción cuando hay pérdida de los tejidos óseos, dado que impide la instalación de implantes dentarios. La PPR convencional presenta una estructura metálica que ofrece retención y resistencia a la prótesis, convirtiéndola en poco agradable a los pacientes, por el hecho de dejar a la vista el metal en la cavidad oral. A partir de investigadores que decidieron ir más allá del simple estudio de la función y la estética de las PPR para adentrase en sus diversas formas de presentación, surgió la prótesis parcial flexible (PFlex). La PFlex es una prótesis parcial confeccionada con resina termoplástica, sin metal y con flexibilidad. Si bien, muchos profesionales la emplean como prótesis temporal, otros tantos la han usado como alternativa a la PPR convencional. Así, uno de los frecuentes interrogantes de los clínicos es si realmente es posible utilizar la PFlex como alternativa protética definitiva. Por tanto, el propósito de este trabajo fue realizar una revisión de la literatura para evaluar si el uso de prótesis parciales removibles con resina termoplástica puede ser una alternativa a las prótesis parciales convencionales, exponiendo las ventajas, desventajas, indicaciones, contraindicaciones y las propiedades del material protético.
Removable partial denture (RPP) is an alternative treatment when it comes to patients who have lost some dental elements, as they have the advantages of a relatively low cost and a satisfactory masticatory function. Furthermore, it is a good option when there is bone tissue loss, making dental implants placement unfeasible. Conventional PPR has a metallic frame that provides retention and resistance to the prosthesis, which makes it unpalatable to patients because it leaves the metal in the oral cavity evident. Many researchers, aiming to give back beyond function and aesthetics, are studying forms of presentation of PPR, thus emerging the flexible partial prosthesis (PFlex). PFlex is a partial denture made with thermoplastic, resin metal-free and with flexibility, however its use, for many professionals, is limited only as temporary prostheses, but there are some clinicians who use PFlex as an alternative to conventional PPR. Thus, one of the questions constantly asked by scientists is whether it is possible to use PFlex as a definitive prosthetic alternative. Therefore, the aim of this study was to conduct a literature review to assess whether the use of removable partial dentures with thermoplastic resin can be an alternative to conventional partial dentures, exposing the advantages, disadvantages, indications, contraindications, and the properties of the prosthetic material.
RESUMO
An analysis was carried out in relation to the adverse effects produced by the use of inadequately made footwear in patients with flexible flat feet in pediatric ages; we carried out an anatomical-functional reminder of the foot as a basic structure for standing and walking. The functional adaptability of the feet was valued in those populations with the habit of walking barefoot, also making a description of the basic characteristics that a properly made footwear must have. We address the different therapeutic approaches and their behavior over time. We highlight the widespread use in our society of inappropriate footwear, mainly of the flip-flop type, and its negative influence on the feet of those children with flexible flat feet and valgus of the ankle.
Se llevó a cabo un análisis en relación a los efectos adversos producidos por el uso de calzados de confección inadecuada en los pacientes portadores de pies planos flexibles en edades pediátricas. Se realizó un recordatorio anatomo-funcional del pie como estructura básica para la bipedestación y la marcha. Se valoró la adaptabilidad funcional de los pies en aquellas poblaciones con hábito de andar descalzos, haciéndose, además, una descripción de las características básica que debe reunir un calzado adecuadamente confeccionado. Se abordó los diferentes enfoques terapéuticos y su comportamiento en el tiempo, destacando el uso generalizado en la sociedad cubana de calzados inapropiados, principalmente del tipo chancletas, y su influencia negativa sobre los pies de aquellos niños con pies planos flexibles y tobillo valgo.