Occlusal Evaluation Using Modified Huddart and Bodenham Scoring System Following 2-Stage Palatoplasty With Hotz Plate: A Comparison Among 3 Different Surgical Protocols.

OBJECTIVE: This study aimed to determine if the change in technique of soft palate closure or timing of hard palatal repair induced occlusal changes in patients with complete unilateral cleft lip and palate (CUCLP). DESIGN: Retrospective study. SETTINGS: A medical and dental hospital in Japan. SUBJECTS: A total of 96 patients with CUCLP treated with 2-stage palatoplasty were included in the study and categorized into 3 groups (G1, G2, and G3) according to the protocol used. INTERVENTIONS: G1 underwent soft palate repair using Perko method at 1.5 years of age and hard palate repair using vomer flap procedure at 5.5 years of age. Furlow method was used for soft palate repair in G2 at 1.5 years of age and hard palate repair using vomer flap procedure at 5.5 years of age. The Furlow method was used to repair the soft palate in G3 at 1.5 years of age and vomer flap procedure was used to repair the hard palate at 4 years of age. MAIN OUTCOME MEASURES: Two evaluators assessed the dental arch relationship using the modified Huddart/Bodenham (mHB) index on 2 separate occasions. RESULTS: Intra- (intraclass correlation coefficient [ICC]: 0.962) and inter-examiner (ICC: 0.950) reliability showed very good agreement. The frequency of crossbite present in the major and minor segments gradually decreased with each change in protocol. Mean segmental scores showed no significant difference between 3 protocols (P > .05). Good inter-arch alignment occurred with all 3 surgical protocols (G1:82.6%, G2:89.8%, and G3:91.7%). CONCLUSIONS: There was no significant difference in the dental arch relationship outcomes between the 3 surgical protocols. The dentition status was comparable with all surgical protocols, even after the changes.

A Comparison of Deep Neural Networks for Monocular Depth Map Estimation in Natural Environments Flying at Low Altitude.

Currently, the use of Unmanned Aerial Vehicles (UAVs) in natural and complex environments has been increasing, because they are appropriate and affordable solutions to support different tasks such as rescue, forestry, and agriculture by collecting and analyzing high-resolution monocular images. Autonomous navigation at low altitudes is an important area of research, as it would allow monitoring parts of the crop that are occluded by their foliage or by other plants. This task is difficult due to the large number of obstacles that might be encountered in the drone's path. The generation of high-quality depth maps is an alternative for providing real-time obstacle detection and collision avoidance for autonomous UAVs. In this paper, we present a comparative analysis of four supervised learning deep neural networks and a combination of two for monocular depth map estimation considering images captured at low altitudes in simulated natural environments. Our results show that the Boosting Monocular network is the best performing in terms of depth map accuracy because of its capability to process the same image at different scales to avoid loss of fine details.

Microstructure and Electrical Conductivity of Cement Paste Reinforced with Different Types of Carbon Nanotubes.

Over the last few years, the addition of small amounts of carbon nanotubes (CNTs) to construction materials has become of great interest, since it enhances some of the mechanical, electrical and thermal properties of the cement. In this sense, single-walled and multi-walled carbon nanotubes (SWCNTs and MWCNTs, respectively) can be incorporated into cement to achieve the above-mentioned improved features. Thus, the current study presents the results of the addition of SWCNTs and MWCNTs on the microstructure and the physical properties of the cement paste. Density was measured through He pycnometry and the mass change was studied by thermogravimetric analysis (TGA). The microstructure and the phases were analyzed using scanning electron microscopy (SEM) and X-ray diffraction (XRD). Finally, the electrical conductivity for different CNT concentrations was measured, and an exponential increase of the conductivity with concentration was observed. This last result opens the possibility for these materials to be used in a high variety of fields, such as space intelligent systems with novel electrical and electronic applications.

Mechanical Properties of Cement Reinforced with Pristine and Functionalized Carbon Nanotubes: Simulation Studies.

Concrete is well known for its compression resistance, making it suitable for any kind of construction. Several research studies show that the addition of carbon nanostructures to concrete allows for construction materials with both a higher resistance and durability, while having less porosity. Among the mentioned nanostructures are carbon nanotubes (CNTs), which consist of long cylindrical molecules with a nanoscale diameter. In this work, molecular dynamics (MD) simulations have been carried out, to study the effect of pristine or carboxyl functionalized CNTs inserted into a tobermorite crystal on the mechanical properties (elastic modulus and interfacial shear strength) of the resulting composites. The results show that the addition of the nanostructure to the tobermorite crystal increases the elastic modulus and the interfacial shear strength, observing a positive relation between the mechanical properties and the atomic interactions established between the tobermorite crystal and the CNT surface. In addition, functionalized CNTs present enhanced mechanical properties.

Tectonic degassing drove global temperature trends since 20 Ma.

The Miocene Climatic Optimum (MCO) from ~17 to 14 million years ago (Ma) represents an enigmatic reversal in Cenozoic cooling. A synthesis of marine paleotemperature records shows that the MCO was a local maximum in global sea surface temperature superimposed on a period from at least 19 Ma to 10 Ma, during which global temperatures were on the order of 10°C warmer than at present. Our high-resolution global reconstruction of ocean crustal production, a proxy for tectonic degassing of carbon, suggests that crustal production rates were ~35% higher than modern rates until ~14 Ma, when production began to decline steeply along with global temperatures. The magnitude and timing of the inferred changes in tectonic degassing can account for the majority of long-term ice sheet and global temperature evolution since 20 Ma.

An elution independent collection device (EICD) for rapid collection of Anaplasma marginale DNA from blood samples.

Currently utilized molecular detection methods are based mainly on nucleic acid extraction, amplification, and detection procedures that may require costly equipment, numerous reagents, and highly trained personnel. These requirements make diagnostic tests expensive, time-consuming, and not suitable for point-of-care applications. There is an increasing demand for simple, low-cost portable technologies. To overcome these challenges, a paper-based elution independent collection device (EICD) was designed to collect microorganisms and recover nucleic acids for molecular biology applications with minimal steps. In this study, we demonstrate a simpler Anaplasma marginale detection that uses an EICD for nucleic acid collection combined with recombinase polymerase amplification (RPA), and a lateral flow dipstick for detection of the specified target. A pre-lysis blood treatment was optimized that uses Triton X-100 lysis buffer and bovine serum album in wash buffer. Blood samples were incubated for 5 min at room temperature and run through the EICD. Four 1-mm diameter discs excised from EICD were used as template in basic RPA and lateral flow (nfo) (endonuclease IV) RPA assays. Each disc of soluble central membrane (SCM) carried circa 0.249 pg/µl of Anaplasma DNA. The percentage of nucleic acid recoverable from the SCM ranged between 60% - 70%. Blood samples infected with A. marginale were treated with Triton X-100 pre-lysis protocol. All samples tested positive by PCR and RPA methods. EICD-driven collection of blood samples is a practical method successfully adapted to detect Anaplasma spp. or blood-borne pathogen DNA and has potential for point-of-care detection in resource-limited settings.

Robust and efficient software for reference-free genomic diversity analysis of genotyping-by-sequencing data on diploid and polyploid species.

Genotyping-by-sequencing (GBS) is a widely used and cost-effective technique for obtaining large numbers of genetic markers from populations by sequencing regions adjacent to restriction cut sites. Although a standard reference-based pipeline can be followed to analyse GBS reads, a reference genome is still not available for a large number of species. Hence, reference-free approaches are required to generate the genetic variability information that can be obtained from a GBS experiment. Unfortunately, available tools to perform de novo analysis of GBS reads face issues of usability, accuracy and performance. Furthermore, few available tools are suitable for analysing data sets from polyploid species. In this manuscript, we describe a novel algorithm to perform reference-free variant detection and genotyping from GBS reads. Nonexact searches on a dynamic hash table of consensus sequences allow for efficient read clustering and sorting. This algorithm was integrated in the Next Generation Sequencing Experience Platform (NGSEP) to integrate the state-of-the-art variant detector already implemented in this tool. We performed benchmark experiments with three different empirical data sets of plants and animals with different population structures and ploidies, and sequenced with different GBS protocols at different read depths. These experiments show that NGSEP has comparable and in some cases better accuracy and always better computational efficiency compared to existing solutions. We expect that this new development will be useful for many research groups conducting population genetic studies in a wide variety of species.

Probing Loop-Mediated Isothermal Amplification (LAMP) targeting two gene-fragments of rose rosette virus.

This study explores the development of Loop-mediated isothermal amplification (LAMP) for detection of rose rosette virus (RRV), a technique with the potential to be translated to rose nurseries. RRV is a negative-sense, single-stranded RNA virus which is a member of the genus Emaravirus (Family Fimoviridae) and the causal agent of the rose rosette disease (RRD). Although RRV symptoms are characteristics, early visual diagnosis of RRD can be misleading and confusing since it may appear like herbicide damage. Moreover, it may take incubation time for symptoms to appear after virus infection. Two sets of RRV gene sequences RNA3 and RNA4 were analyzed and two sets of four LAMP primers were designed. The direct antigen-capture method for direct trapping of RRV in plastic was used for RNA extraction followed by cDNA synthesis. RT-LAMP reactions were for 1 hour at 64°C (RRV-P3) and 66.5°C (RRV-P4) using either a thermocycler or a portable dry bath. RT-qLAMP was also optimized using DNA polymerase GspSSD LD using the same RRV sets of primers. RRV was detected in symptomatic and non-symptomatic RRD tissue from Oklahoma. The limit of detection (LoD) was 1pg/µL and 1 fg/µL using Bst 2.0 LAMP and GspSSD LD quantitative LAMP, respectively. In visual colorimetric pre- and post-reactions, the LoD was 10 pg/µL and 0.1 pg/µL using hydroxy naphthol blue (HNB, 120 µM) and SYBR green I (1:10 dilution), respectively. No cross-reactivity was detected in the RT-LAMP reaction testing cDNAs of eight commonly co-infecting rose viruses and one virus taxonomically related to RRV. Four different dyes were tested, and visible colorimetric reactions were obtained with RT-LAMP Bst 2.0 combined with SYBR I or HNB. RT-qLAMP with GspSSD2.0 offers LoD equal to RT-PCR and it is faster since it works with RNA directly.

Recombinase polymerase amplification (RPA) with lateral flow detection for three Anaplasma species of importance to livestock health.

Anaplasma marginale, A. ovis, and A. phagocytophilum are the causative agents of bovine anaplasmosis, ovine anaplasmosis, and granulocytic anaplasmosis, respectively. The gold standard for diagnosis of post-acute and long-term persistent infections is the serological cELISA, which does not discriminate between Anaplasma species and requires highly equipped laboratories and trained personnel. This study addresses the development of a rapid, isothermal, sensitive, species-specific RPA assays to detect three Anaplasma species in blood and cELISA A. marginale-positive serum samples. Three RPA primer and probe sets were designed targeting msp4 genes of each Anaplasma species and the internal control (GAPDH gene) for each assay. The limit of detection of gel-based or RPA-basic assays is 8.99 × 104 copies/µl = A. marginale, 5.04 × 106 copies/µl = A. ovis, and 4.58 × 103 copies/µl = A. phagocytophilum, and for each multiplex lateral flow or RPA-nfo assays is 8.99 × 103 copies/µl of A. marginale, 5.04 × 103 copies/µl of A. ovis, 4.58 × 103 copies/µl of A. phagocytophilum, and 5.51 × 103 copies/µl of internal control (GAPDH). Although none of the 80 blood samples collected from Oklahoma cattle were positive, the RPA-nfo assays detected all A. marginale cattle blood samples with varying prevalence rates of infection, 83% of the 24 cELISA A. marginale-positive serum samples, and all A. phagocytophilum cell culture samples. Overall, although early detection of three Anaplasma species was not specifically addressed, the described RPA technique represents an improvement for detection of three Anaplasma in regions where access to laboratory equipment is limited.

Comparison between the prophylactic effects of amoxicillin 24 and 48 hours pre-operatively on surgical site infections in Japanese patients with impacted mandibular third molars: A prospective cohort study.

INTRODUCTION: According to the guidelines, the dosage for mandibular wisdom tooth extraction (MWTE) varies within the administration period. There is a 24-fold difference between the minimum and maximum doses. If an appropriate antimicrobial can be administered without increasing incidence of surgical site infection (SSI), it may lead to a global action plan on antimicrobial resistance (AMR). Therefore, we prospectively surveyed incidence of SSI post-operatively and use of oral antibiotics (OA) for MWTE. METHODS: Subjects were patients who underwent MWTE in our dental outpatient clinic from May 2019 to April 2020. Two groups were formed depending on type of administration period they received: 24 h and 48 h after surgery. The following information was collected: (1) patient factors (age, gender, body mass index, presence/absence of preoperative medication, diagnosis, impacted wisdom tooth status; (2) surgical factors (operative time, presence/absence of closure, presence/absence of hemostat, doctor career, type and frequency of painkiller); (3) relationship between administration period of OA and SSI occurrence; and (4) details of SSI. RESULTS: Three hundred forty subjects were analyzed, all of which used amoxicillin. There were 106 cases in 24 h group and 234 cases in 48 h group. The total incidence of SSI was 1.1% (4/340 cases), with 0.9% (1/106 cases) in 24 h group and 1.3% (3/234 cases) in 48 h group; there was no difference between the two groups. CONCLUSION: Our study suggests that amoxicillin (250 mg/dose every 8 h x 3 doses beginning 1 h before surgery) might be sufficient in preventing SSI in Japanese dental patients without SSI risk factors.

Clinico-statistical survey of oral antimicrobial prophylaxis and surgical site infection regarding ordinary tooth extraction and mandibular wisdom tooth extraction in the dental outpatient clinic.

INTRODUCTION: We investigated the use of oral antibiotics (OA) and surgical site infection (SSI) related to extractions of ordinary teeth and mandibular wisdom teeth in a dental outpatient clinic from January 2015 to December 2019. METHODS: The following information were surveyed: (1) presence/absence of OA, (2) timing, (3) type, (4) administration period, and (5) SSI rates. RESULTS: The use of OA during ordinary tooth extraction decreased from 68.3% to 41.3%, but SSI rate did not change during this period of time. Total SSI rate was 0.8% (122/14,832) on average. For mandibular wisdom tooth extraction, preoperative administration of third-generation cephalosporins decreased from 70.4% to 0.3% while that of penicillin (AMPC) increased from 0% to 98%. SSI rate was not changed after these improvements. Total SSI rate was 3.5% (180/5106) on average. The duration of OA was slightly decreased to two days in 2018 and 2019, and it was found that there was no significant difference in SSI rates between 2- and 3-day durations. Preoperative administration had 0.37 odds ratio (OR) (95% confidence interval (95%CI): 0.22-0.63) of SSI compared with postoperative administration. AMPC had 0.76 OR (95% CI: 0.55-1.04) of SSI compared with Third-generation cephalosporins and others. Timing of OA was P < 0.01. CONCLUSIONS: SSI rates did not change over time, administration period of OA decreased and the use of AMPC increased. Therefore, it seems necessary to continue to investigate the effects of SSI risk factors proactively in the future and to make efforts in the advocacy of appropriate antimicrobial use.

Actualización general de inmunoterapia en cáncer / Cancer immunotherapy: an update

Cancer is one of the leading causes of death worldwide. The success rate of conventional anticancer therapeutic approaches such as chemotherapy is limited by the non-specific toxicity and low specificity towards specific tumors, which are highly dependent on the mutational burden present on each patient. Similarly, targeted therapies have proven to induce resistance in numerous malignancies. Therefore, immunotherapy has emerged as a better approach to discriminate between "the own" and "the non-own", which occurs through two types of mechanisms, innate and acquired immunity. Acquired immunity is one of the targets for new immunotherapeutic treatments, unleashing the power of antigen-specific T cells as a potential therapeutic weapon for cancer treatment. Thus, immunotherapy modifies the own immune system to increase the recognition and elimination of cancer cells by identifying these cancer antigens. One of the advantages of immunotherapy, when compared to conventional anticancer approaches, is the generation of long-term immunity (immunological memory). Currently, there are different potential types of immunotherapy in cancer to promote the modulation of the immune response. Among them, the use of cytokines, vaccines, viruses, monoclonal antibodies, and the generation of adaptive immune response cells have achieved successful results in some types of cancer.

Bacteriophage-Mediated Reduction of Bacterial Speck on Tomato Seedlings.

Background: One crucial first step in bacteriophage therapy is choosing a phage to apply, which involves screening for effectiveness in a meaningful way. Increasingly, research suggests that in vitro tests of phage-mediated bacterial lysis poorly translate to in planta effectiveness. Materials and Methods: We tested a seedling-based method for rapidly screening phage effectiveness in vivo. In three trials, phages were prophylactically applied to tomato seedlings in sterile conical tubes before flooding with the bacterial pathogen Pseudomonas syringae pv. tomato DC3000. We recorded seedling disease progression and quantified endpoint bacteria and phage densities. Results: Phages replicated in all trials, but reduction of disease symptoms and endpoint P. syringae density varied across trials with different application densities. Conclusions: This resource-efficient method rapidly identified an effective phage and application density to mitigate disease on seedlings. We propose that this method could be used to screen candidate phages before testing in agricultural conditions.

[Cancer immunotherapy: an update]. / Actualización general de inmunoterapia en cáncer.

Cancer is one of the leading causes of death worldwide. The success rate of conventional anticancer therapeutic approaches such as chemotherapy is limited by the non-specific toxicity and low specificity towards specific tumors, which are highly dependent on the mutational burden present on each patient. Similarly, targeted therapies have proven to induce resistance in numerous malignancies. Therefore, immunotherapy has emerged as a better approach to discriminate between "the own" and "the non-own", which occurs through two types of mechanisms, innate and acquired immunity. Acquired immunity is one of the targets for new immunotherapeutic treatments, unleashing the power of antigen-specific T cells as a potential therapeutic weapon for cancer treatment. Thus, immunotherapy modifies the own immune system to increase the recognition and elimination of cancer cells by identifying these cancer antigens. One of the advantages of immunotherapy, when compared to conventional anticancer approaches, is the generation of long-term immunity (immunological memory). Currently, there are different potential types of immunotherapy in cancer to promote the modulation of the immune response. Among them, the use of cytokines, vaccines, viruses, monoclonal antibodies, and the generation of adaptive immune response cells have achieved successful results in some types of cancer.

El enfoque de género y la Ley 1448 en Colombia / The gender perspective and the 1448 Colombian law

El conflicto armado colombiano se extiende por todos rincones del país; en esa guerra la violencia de género encontró un lugar fértil. Este artículo analiza el enfoque de género a partir de los lineamientos de la Ley 1448 de 2011, y entrevistas con funcionarios estatales, es un análisis de las narrativas propias de estos y de texto de la norma, así como otras normas concomitantes que no solo reconocen el conflicto armado sino que le otorgan importancia necesaria a las afectaciones particulares a la mujer, sumado a esto se explora la aparición de la presencia estatal y el avance que fue necesario en la política pública en Colombia para el reconocimiento de más de 8.000.000 de víctimas del conflicto armado. Se describe la situación vulnerable de las mujeres en el conflicto armado, que ve la luz en el reconocimiento normativo de las afectaciones particulares a este grupo poblacional. Para concluir se explora la importancia para la construcción de nación del reconocimiento del conflicto armado colombiano en el gobierno de Juan Manuel Santos, así como para la construcción de un camino hacia la paz mediante las políticas de reparación, perdón, verdad y reconciliación.(AU)

The Colombian armed conflict extends to all corners of the country; in that war, gender violence found a fertile place. This article analyzes the gender perspective based on the guidelines of Law 1448 of 2011, and interviews with state officials, it is an analysis of the narratives of these and the text of the norm, as well as other concomitant norms that not only they recognize the armed conflict but give necessary importance to the particular affectations on woman, added to this the novelty State presence and the advance that was necessary in the public policy in Colombia for the recognition of more than 8,000,000 victims of the armed conflict. It describes the vulnerable situation of women in the armed conflict, which sees the light in the normative recognition of their particular affectations. To conclude, the importance of recognizing the Colombian armed conflictin the construction of a nation is explored, as well as for the construction of a path towards peace through policies of reparation, forgiveness, truth and reconciliation, a context that was built on Juan Manuel Santos government.(AU)

O conflito armado colombiano se estende a todos os cantos do país; nessa guerra, a violência de gênero encontrou um lugar fértil. O texto analisa a abordagem de gênero, que faz parte da Lei de Vítimas e Restituição de Terras, no país que é traçado pela geografia da violência, enquadrado nas diferenças entre urbano-rural, masculino-feminino, centro - periferia… Depois, analisa a chegada da presença do Estado e o significativo avanço das políticas públicas na Colômbia para dar lugar ao reconhecimento de mais de 8.000.000 de vítimas do conflito armado. A situação particular das mulheres no conflito armado é descrita pelo reconhecimento normativo das afetações particulares nesse grupo populacional, incluindo sua saúde mental. As conclusões expressam a importância que tem para a construção de uma nação e que o governo de Juan Manuel Santos reconheceu a existência de um conflito armado, para a construção de um caminho em direção à paz por meio de políticas de perdão, verdade e reconciliação.(AU)

Influenza in Yucatan in 2018: Chronology, characteristics and outcomes of ambulatory and hospitalized patients.

INTRODUCTION: Influenza season is expected between October and February in the northern hemisphere, including Mexico. Previous studies suggested that transmission peak may occur earlier in Yucatan, a state in southeast Mexico. OBJECTIVES: (a) Describe the seasonality of 2018 influenza cases seen at O´Horan hospital, statewide, and nationwide; (b) analyze the characteristics, clinical manifestations and outcomes of ambulatory and hospitalized patients; (c) analyze fatal outcomes occurrence among vaccinated and unvaccinated individuals. METHODS: Retrospective analytic cohort of all confirmed influenza cases assisted at O´Horan hospital during 2018, along with a chronologic graphic description of the statewide epidemic curve from the epidemiological surveillance registries. RESULTS: A total of 264 influenza cases were analyzed; 145 (55%) were female; 26% were vaccinated. Health workers and unvaccinated individuals were more prone to develop severe cases. Dyspnea and tachypnea were strong predictors of hospitalization; headache, myalgias, arthralgias and rhinorrhea correlated inversely. 236 (89.47%) cases occurred in July and 22 of the 23 deaths occurred before October. No fatal outcomes were observed among vaccinated individuals. Influenza AH1N1 represented 83.6% of serotyped cases. DISCUSSION: Onset of influenza season in Yucatan may reflect a need for rethinking timing of vaccination and of preventive campaigns, as most cases occurred before vaccination period.

El oficio de cuidar a otro: "cuando mi cuerpo está aquí pero mi mente en otro lado" / Taking Care of Another Person: "When my Body is Here But my Mind is Somewhere Else" / O ofício de cuidar de outro: "quando meu corpo está aqui, mas minha mente em outro lado"

Resumen Introducción: se busca comprender el significado que tiene ser cuidador informal de un paciente en el Hospital Pablo Tobón Uribe de Medellín, durante un periodo de hospitalización, entre los años 2012 a 2015. Desarrollo: se parte de un enfoque cualitativo, y se desarrolla el método conocido como Teoría Fundamentada propuesto por Strauss y Corbin. Se entrevistaron 20 cuidadores. Las entrevistas fueron transcritas para luego ser analizadas por medio de codificación abierta y axial, de ahí se definieron, finalmente, tres categorías analíticas. Conclusiones: Cumplir con las tareas que exige ser el cuidador informal de un enfermo implica dividirse en dos ámbitos distintos: mantener el cuerpo al lado del enfermo hospitalizado, mientras que la mente sigue afuera, ocupándose de las otras esferas de la vida; y es que ser cuidador implica tiempo completo y estar hospitalizado con el paciente. El cuidador asume una sobrecarga de responsabilidades que tiene graves implicaciones en su estado de salud, lo que puede compensarse por el compromiso, el apoyo familiar y de la institución de salud. Urge ocuparse de las necesidades del cuidador desde la oferta y el acompañamiento de los sistemas de salud.

Abstract Introduction: To understand the meaning of being a patient's informal caregiver at Pablo Tobón Uribe Hospital in Medellin during a hospitalization period from 2012 to 2015. Development: This was a qualitative study that used the methodology known as grounded theory, which was proposed by Strauss and Corbin. A total of 20 caretakers were interviewed. The interviews were first transcribed and then analyzed via open axial coding. This ultimately led to the definition of three analytical categories. Conclusions: Fulfilling the tasks demanded by the role of the informal caregiver of a sick person implies separating own self into two distinct contexts: On the one hand, the caretaker's body should be next to the hospitalized patient, but, on the other hand, his/her mind is still outside, still taking care of some unrelated business. In fact, being a caregiver is a full-time job as it implies being hospitalized together with the patient. Caregivers have an excessive amount of responsibilities and this has a strong negative impact on their health. This can be compensated with their own commitment and the support of their relatives and the healthcare providing institution. It is urgent to address the needs of caregivers via the offers and support of healthcare systems.

Resumo Introdução: busca-se compreender o significado que tem ser o cuidador informal de um paciente no Hospital Pablo Tobón Uribe de Medellín, durante um período de hospitalização, entre os anos 2012 a 2015. Desenvolvimento: parte-se de um enfoque qualitativo, desenvolvendo o método conhecido como Teoria Fundamentada proposto por Strauss e Corbin. Entrevistaram-se 20 cuidadores. As entrevistas foram transcritas para posteriormente ser analisadas através de codificação aberta e axial, definindo finalmente três categorias analíticas. Conclusões: cumprir com as tarefas que exige ser o cuidador informal de um doente, implica dividir-se em dois âmbitos distintos: manter o corpo ao lado do doente hospitalizado, enquanto que a mente segue fora ocupando-se das outras esferas da vida; ser cuidador implica tempo completo e estar hospitalizado com o paciente. O cuidador assume uma sobrecarga de responsabilidades que tem graves implicações em seu estado de saúde, o que pode compensar-se pelo compromisso, o apoio familiar e da instituição de saúde. Urge ocupar-se das necessidades do cuidador desde a oferta e o acompanhamento dos sistemas de saúde.

A morphological database for 606 Colombian bird species.

Colombia is the country with the highest bird diversity in the world. Despite active research in ornithology, compelling morphological information of most bird species is still sparse. However, morphological information is the baseline to understand how species respond to environmental variation and how ecosystems respond to species loss. As part of a national initiative, the Instituto Alexander von Humboldt in collaboration with 12 Colombian institutions and seven biological collections, measured up to 15 morphological traits of 9,892 individuals corresponding to 606 species: 3,492 from individuals captured in field and 6,400 from museum specimens. Species measured are mainly distributed in high Andean forest, páramo, and wetland ecosystems. Seven ornithological collections in Colombia and 18 páramo complexes throughout Colombia were visited from 2013 to 2015. The morphological traits involved measurements from bill (total and exposed culmen, bill width and depth), wing (length, area, wingspan, and the distance between longest primary and longest secondary), tail (length and shape), tarsus (length), hallux (length and claw hallux), and mass. The number of measured specimens per species was variable, ranging from 1 to 321 individuals with a median of four individuals per species. Overall, this database gathered morphological information for >30% of Colombian bird diversity. No copyright, proprietary, or cost restrictions apply; the data should be cited appropriately when used.

Implante coclear en paciente con síndrome de Q-T prolongado / Cochlear implantation in a patient with elongated Q-T syndrome / Implante coclear em paciente com síndrome de Q-T alongado

El síndrome de Q-T prolongado es una afección que se caracteriza por interrupción del ritmo cardíaco normal. Esta enfermedad es causada por mutación en genes que codifican los canales de voltaje de potasio o sodio, interrumpiendo de esta forma el flujo de dichos iones en el músculo cardíaco. En algunos casos este flujo iónico también se encuentra alterado a nivel del oído interno, por lo cual puede encontrarse asociado a hipoacusia neurosensorial profunda. El diagnóstico se basa en la electrocardiografía y el cuadro clínico, caracterizado por ataques sincopales recurrentes, crisis convulsivas o muerte súbita como primera manifestación. En los casos asociados a hipoacusia neurosensorial profunda, el implante coclear como tratamiento de la sordera presenta riesgos adicionales debido a la posibilidad de arritmias cardíacas y muerte súbita; por lo cual existen consideraciones perioperatorias especiales.

Prolonged Q-T syndrome is a condition characterized by disruption of normal heart rhythm, presented as a prolonged QT interval. This disease is caused by mutation in genes encoding the potassium or sodium voltage channels, thus disrupting the flow of such ions into the cardiac muscle. In some cases this inonic flow is also altered at the level of the inner ear, which may be associated with deep neurosensorial hearing loss. The diagnosis is based on electrocardiography and the clinical picture, characterized by recurrent syncopal attacks, seizures or sudden death as the first manifestation. In cases associated with deep neurosensory hearing loss, the cochlear implant as a treatment for deafness presents additional risks due to the possibility of cardiac arrhythmias and sudden death; for which there are special peri-operative considerations.

Síndrome Q-T prolongada é uma condição caracterizada por uma ruptura do ritmo cardíaco normal, apresentado como um intervalo prolongado de QT. Esta doença é causada por mutação em genes que codificam os canais de tensão de potássio ou de sódio, interrompendo assim o fluxo de tais íons para o músculo cardíaco. Em alguns casos, este fluxo inônico também é alterado no nível da orelha interna, o que pode estar associado à perda auditiva neurosensorial profunda. O diagnóstico é baseado em eletrocardiografia e no quadro clínico, caracterizado por ataques de síncopes recorrentes, convulsões ou morte súbita como a primeira manifestação. Nos casos associados à perda auditiva neurosensorial profunda, o implante coclear como tratamento para surdez apresenta riscos adicionais devido à possibilidade de arritmias cardíacas e morte súbita; para o qual há considerações perioperatórias especiais