In vivo shear wave elasticity imaging for assessment of diaphragm function in muscular dystrophy.

Duchenne muscular dystrophy (DMD) causes patients to suffer from ambulatory disability and cardiorespiratory failure, the latter of which leads to premature death. Due to its role in respiration, the diaphragm is an important muscle for study. A common method for evaluating diaphragm function is ex vivo force testing, which only allows for an end point measurement. In contrast, ultrasound shear wave elastography imaging (US-SWEI) can assess diaphragm function over time; however, US-SWEI studies in dystrophic patients to date have focused on the limbs without preclinical studies. In this work, we used US-SWEI to estimate the shear wave speed (SWS) in diaphragm muscles of healthy (WT) mice, mdx mice, and mdx mice haploinsufficient for utrophin (mdx-utr) at 6 and 12 months of age. Diaphragms were then subjected to ex vivo force testing and histological analysis at 12 months of age. Between 6 and 12 months, a 23.8% increase in SWS was observed in WT mice and a 27.8% increase in mdx mice, although no significant difference was found in mdx-utr mice. Specific force generated by mdx-utr diaphragms was lower than that of WT diaphragms following twitch stimulus. A strong correlation between SWS and collagen deposition was observed, as well as between SWS and muscle fiber size. Together, these data demonstrate the ability of US-SWEI to evaluate dystrophic diaphragm functionality over time and predict the biochemical and morphological make-up of the diaphragm. Additionally, our results highlight the advantage of US-SWEI over ex vivo testing by obtaining longitudinal measurements in the same subject. STATEMENT OF SIGNIFICANCE: In DMD patients, muscles experience cycles of regeneration and degeneration that contribute to chronic inflammation and muscle weakness. This pathology only worsens with time and leads to muscle wasting, including in respiratory and cardiac muscles. Because respiratory failure is a major contributor to premature death in DMD patients, the diaphragm muscle is an important muscle to evaluate and treat over time. Currently, diaphragm function is assessed using ex vivo force testing, a technique that only allows measurement at sacrifice. In contrast, ultrasonography, particularly shear wave elasticity imaging (USSWEI), is a promising tool for longitudinal assessment; however, most US-SWEI in DMD patients aimed for limb muscles only with the absence of preclinical studies. This work broadens the applications of US-SWE imaging by demonstrating its ability to track properties and function of dystrophic diaphragm muscles longitudinally in multiple dystrophic mouse models.

A Low-Cost Luxometer Benchmark for Solar Illuminance Measurement System Based on the Internet of Things.

Natural illumination has an important place in home automation applications. Among other advantages, it contributes to better visual health, energy savings, and lower CO2 emissions. Therefore, it is important to measure illuminance in the most accurate and cost-effective way. This work compares several low-cost commercial sensors (VEML 7700, TSL2591, and OPT3001) with a professional one (ML-020S-O), all of them installed outdoors. In addition, a platform based on the Internet of Things technology was designed and deployed as a centralized point of data collection and processing. Summer months have been chosen for the comparison. This is the most adverse situation for low-cost sensors since they are designed for indoor use, and their operating range is lower than the maximum reached by sunlight. The solar illuminance was recorded every minute. As expected, the obtained bias depends on the solar height. This can reach 60% in the worst circumstances, although most of the time, its value stays below 40%. The positive side lies in the good precision of the recordings. This systematic deviation makes it susceptible to mathematical correction. Therefore, the incorporation of more sensors and data that can help the global improvement of the precision and accuracy of this low-cost system is left as a future line of improvement.

An Assessment on the Efficiency of Clothing with UV Protection among the Spanish Navy School Students.

Concern about the harmful effects that ultraviolet (UV) rays have on the skin of people who are routinely exposed to solar radiation has driven the industry of skin protection creams, sunglasses and clothing. Spanish Navy personnel are subject to different levels of exposure depending on their rank and function. The objective of this research is to analyze the behavioral variables associated to the effects on the skin caused by UV rays, denoted by the combined effects of perceived susceptibility and perceived severity, on their decision to purchase and wear uniforms with UV protection. A confirmatory analysis using a structural equation modeling (SEM) was performed on a sample of 100 respondents. The model results revealed a strong mediating characteristic of the intention to use, variable associated with the exogenous variables. Attitude towards the use of clothing and social influence, as well as the exogenous variable clothing action planning, on the sun protective clothing use during tactical maneuvers. These relationships were significant with p-values close to zero. However, exogenous variables related to perceived susceptibility and perceived severity in exposure to sunlight did not represent a significant influence when mediated by self-efficacy in use. The results revealed the consequence of awareness about the importance of protecting oneself and the influence that usage habits can have on the military with respect to the decision to purchase uniforms with UV protection.

Assessment of Factors Influencing Personal Exposure to Air Pollution on Main Roads in Bogota: A Mixed-Method Study.

Background and Objectives: Particulate Matter (PM), particles of variable but small diameter can penetrate the respiratory system via inhalation, causing respiratory and/or cardiovascular diseases. This study aims to evaluate the association of environmental particulate matter (PM2.5) and black carbon (BC) with respiratory health in users of different transport modes in four roads in Bogotá. Materials and Methods: this was a mixed-method study (including a cross sectional study and a qualitative description of the air quality perception), in 300 healthy participants, based on an exploratory sequential design. The respiratory effect was measured comparing the changes between pre- and post-spirometry. The PM2.5 and black carbon (BC) concentrations were measured using portable devices. Inhaled doses were also calculated for each participant according to the mode and route. Perception was approached through semi-structured interviews. The analysis included multivariate models and concurrent triangulation. Results: The concentration of matter and black carbon were greater in bus users (median 50.67 µg m-3; interquartile range (-IR): 306.7). We found greater inhaled dosages of air pollutants among bike users (16.41 µg m-3). We did not find changes in the spirometry parameter associated with air pollutants or transport modes. The participants reported a major sensory influence at the visual and olfactory level as perception of bad air quality. Conclusions: We observed greater inhaled doses among active transport users. Nevertheless, no pathological changes were identified in the spirometry parameters. People's perceptions are a preponderant element in the assessment of air quality.

A Versatile Open-Source Printhead for Low-Cost 3D Microextrusion-Based Bioprinting.

Three-dimensional (3D) bioprinting promises to be essential in tissue engineering for solving the rising demand for organs and tissues. Some bioprinters are commercially available, but their impact on the field of Tissue engineering (TE) is still limited due to their cost or difficulty to tune. Herein, we present a low-cost easy-to-build printhead for microextrusion-based bioprinting (MEBB) that can be installed in many desktop 3D printers to transform them into 3D bioprinters. We can extrude bioinks with precise control of print temperature between 2-60 °C. We validated the versatility of the printhead, by assembling it in three low-cost open-source desktop 3D printers. Multiple units of the printhead can also be easily put together in a single printer carriage for building a multi-material 3D bioprinter. Print resolution was evaluated by creating representative calibration models at different temperatures using natural hydrogels such as gelatin and alginate, and synthetic ones like poloxamer. Using one of the three modified low-cost 3D printers, we successfully printed cell-laden lattice constructs with cell viabilities higher than 90% after 24-h post printing. Controlling temperature and pressure according to the rheological properties of the bioinks was essential in achieving optimal printability and great cell viability. The cost per unit of our device, which can be used with syringes of different volume, is less expensive than any other commercially available product. These data demonstrate an affordable open-source printhead with the potential to become a reliable alternative to commercial bioprinters for any laboratory.

Data and calculation approach of the fuzzy AHP risk assessment of a large hydroelectric project.

This data article employs the Fuzzy Analytic Hierarchy Process (FAHP) to perform the project risk assessment in a phase of the construction of a large hydroelectric project. The list of service packs and risk events was extracted from in-depth interviews and content analysis with experts. Such qualitative data were used to identify the relevant service pack and risk event indicators for two groups - the owner's and the builder's representatives - required to specify the model. FAHP was used to calculate the relative importance of such indicators in two stages. First the relevance of the service packs was measured through paired comparisons and then weighted. Next, the relevance of the risk events associated with each service pack was assessed through the same method. A complete method of calculation for one of the respondents is presented. At the end, the average weights for the risk events of the two groups are calculated. For further information it is recommended to read the article entitled "Multi-criteria risk assessment: Case study of a large hydroelectric project" (Ribas et al., 2019).

Enabling mesenchymal stromal cell immunomodulatory analysis using scalable platforms.

Human mesenchymal stromal cells (hMSCs) are a promising cell source for numerous regenerative medicine and cell therapy-based applications. However, MSC-based therapies have faced challenges in translation to the clinic, in part due to the lack of sufficient technologies that accurately predict MSC potency and are viable in the context of cell manufacturing. Microfluidic platforms may provide an innovative opportunity to address these challenges by enabling multiparameter analyses of small sample sizes in a high throughput and cost-effective manner, and may provide a more predictive environment in which to analyze hMSC potency. To this end, we demonstrate the feasibility of incorporating 3D culture environments into microfluidic platforms for analysis of hMSC secretory response to inflammatory stimuli and multi-parameter testing using cost-effective and scalable approaches. We first find that the cytokine secretion profile for hMSCs cultured within synthetic poly(ethylene glycol)-based hydrogels is significantly different compared to those cultured on glass substrates, both in growth media and following stimulation with IFN-γ and TNF-α, for cells derived from two donors. For both donors, perfusion with IFN-γ and TNF-α leads to differences in secretion of interleukin 6 (IL-6), interleukin 8 (IL-8), monocyte chemoattractant protein 1 (MCP-1), macrophage colony-stimulating factor (M-CSF), and interleukin-1 receptor antagonist (IL-1ra) between hMSCs cultured in hydrogels and those cultured on glass substrates. We then demonstrate the feasibility of analyzing the response of hMSCs to a stable concentration gradient of soluble factors such as inflammatory stimuli for potential future use in potency analyses, minimizing the amount of sample required for dose-response testing.

GRADE-Based Recommendations for Surgical Repair of Nonruptured Abdominal Aortic Aneurysm.

The objective of this study was to provide evidence-based recommendations for endovascular aneurysm repair (EVAR) versus open surgical repair (OSR) for patients with a nonruptured abdominal aortic aneurysm (AAA). We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement and adhered to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Both low- and high surgical risk patients treated with EVAR showed decreased 30-day mortality, but the low-risk group had no differences in 4-year mortality. Compared with friendly anatomy, patients with hostile anatomy had an increased risk of type I endoleak. Young patients may prefer OSR. Endovascular aneurysm repair was not cost-effective in Europe. Four conditional recommendations were formulated: (1) OSR for low-risk patients up to 80 years old, (2) EVAR for low-risk patients older than 80 years, (3) EVAR for high-risk patients as long as is anatomically feasible, and (4) OSR in patients in whom it is not anatomically feasible to perform EVAR. Based on GRADE criteria, either OSR or EVAR can be suggested to patients with nonruptured AAA taking into account their surgical risk, hostile anatomy, and age. Given the weakness of the recommendations, personal preferences are determinant.

Assessment of ecosystem services of an urbanized tropical estuary with a focus on habitats and scenarios.

Tropical estuaries are one of the most valuable ecosystems on the planet because of the number of ecosystem services they provide. The increasing anthropogenic pressure to which these estuaries are subject has caused a reduction in their natural capital stock. Therefore, the application of a pragmatic and rational ecosystem-based management approach to sustainably manage the multiple ecosystem services provided by this ecosystem is necessary. The aim of our study is to present an approach that combines prospective scenarios with habitat-based perspective to assess the supply capacity of ecosystem services, plus determine the impact of protected areas in an urbanized tropical estuary. The current situation and two scenarios were generated to evaluate the capacity of habitats to supply ecosystem services. This type of assessment will allow the decision makers to visualize the effect of their choices or the occurrence of events which might produce significant changes in the estuary. Thus, over time, measures can be taken to sustain the supply of ecosystem services. We determined that the establishment of protected areas have a positive impact; however, the effect is not the same for all of them. Consequently, indicating that actions such as community participation, research, education, management planning and infrastructure development must accompany the development of a protected area.

Permutation entropy analysis of heart rate variability for the assessment of cardiovascular autonomic neuropathy in type 1 diabetes mellitus.

Heart rate variability (HRV) analysis is a relevant tool for the diagnosis of cardiovascular autonomic neuropathy (CAN). To our knowledge, no previous investigation on CAN has assessed the complexity of HRV from an ordinal perspective. Therefore, the aim of this work is to explore the potential of permutation entropy (PE) analysis of HRV complexity for the assessment of CAN. For this purpose, we performed a short-term PE analysis of HRV in healthy subjects and type 1 diabetes mellitus patients, including patients with CAN. Standard HRV indicators were also calculated in the control group. A discriminant analysis was used to select the variables combination with best discriminative power between control and CAN patients groups, as well as for classifying cases. We found that for some specific temporal scales, PE indicators were significantly lower in CAN patients than those calculated for controls. In such cases, there were ordinal patterns with high probabilities of occurrence, while others were hardly found. We posit this behavior occurs due to a decrease of HRV complexity in the diseased system. Discriminant functions based on PE measures or probabilities of occurrence of ordinal patterns provided an average of 75% and 96% classification accuracy. Correlations of PE and HRV measures showed to depend only on temporal scale, regardless of pattern length. PE analysis at some specific temporal scales, seem to provide additional information to that obtained with traditional HRV methods. We concluded that PE analysis of HRV is a promising method for the assessment of CAN.

[Construction of an Instrument of Risk Assessment and Injury Severity for the Diaper Area in Infants: RDIC-lac]. / Construcción de un instrumento de valoración del riesgo y gravedad de las lesiones del área del pañal en lactantes RDIC-lac*.

Objective: To design an instrument to measure impairment of skin integrity in the diaper area of infants and severity of injury for the prevention and management of irritative diaper dermatitis. Methodology: Design in 3 phases: 1) comprehensive review and critical appraisal of literature to design the preliminary content of the instrument; 2) critical evaluation of initial proposal by an expert group (nursing and pediatric medicine) with opinion survey and ad hoc questions; 3) content analysis using data tabulation for the modification and final design of the instrument. Setting: Primary Care Management of Tenerife. Results: In the 1st phase a proposed instrument is designed: two groups of risk factors (10 modulators risk and 9 high risk); and a severity scale with 5 aspects to assess including 4-5 items each (depth, location, extension, type of injury, signs of infection). The 2nd phase involved 19 professionals. A Tabulation of the data grouped into add or omit factors was used. The 3rd phase ends with a modified version of the instrument: 10 modulating factors, 5 of hig risk and 4 items for each aspect to assess severity. Discussion-Conclusions: The scarce bibliography found and absence of similar tools explain the design. The next phase will be the validation of RDIC-lac instrument. Clinical Relevance: Susceptibility to prevent skin lesions in the diaper area in the pediatric age.

Assessment of the Use of Natural Materials for the Remediation of Cadmium Soil Contamination.

Rice plants accumulate cadmium (Cd2+) within the grain, increasing the danger of human exposure. Natural materials have been used in soil remediation, but few studies have examined the risks (based on the bioavailability of these metals to plants) of using these materials, so the practice remains controversial. In the present study, we evaluated the effectiveness of biochar produced from sugarcane bagasse, vermicompost (VC), vermicompost solid residue (VCR) and humin for remediation of Cd2+-contaminated soils. We characterized the interactions between these materials and Cd2+ and evaluated their capacity to alter Cd2+ availability to rice plants. Our results show that under the conditions in this study, biochar and humin were not effective for soil remediation. Although biochar had high Cd2+ retention, it was associated with high Cd2+ bioavailability and increased Cd2+ accumulation in rice plants. VC and VCR had high Cd2+ retention capacity as well as low Cd2+ availability to plants. These characteristics were especially notable for VCR, which was most effective for soil remediation. The results of our study demonstrate that in the tested materials, the bioavailability of Cd2+ to plants is related to their structural characteristics, which in turn determine their retention of Cd2+.

Assessment of the zinc diffusion rate in estuarine zones.

Industrial pressures suffered by estuarine zones leave a pollution record in their sediment. Thus, high concentrations of many heavy metals and some organic compounds are often found in estuarine sediment. This work aims to contribute to the enhancement of water quality management strategies in these zones by studying in detail the diffusive processes that take place between the water and sediment using a two-pronged approach: experimental practice and numerical simulation. To provide an example of the practical application of the methodologies proposed in this paper, the Suances Estuary (northern Spain) was selected as the study zone. This estuary exhibits significant historical pollution and its sediment acts as a continuous internal source of zinc, mainly due to diffusive processes derived from the concentration gradient between the interstitial water at the solid particles of the sediment and the bottom of the water column. The experimentally obtained results, based on 6 case studies, demonstrated the buffering capacity of the system and allowed the determination of the required time for the mass transfer processes to reach an equilibrium state. Furthermore, the diffusion rate of zinc was approximately modeled taking into consideration the high concentration variability observed in sediment along the entire estuary. The convergence between the modeled and the experimental results indicated the required contact time to reach an equilibrium state in a real field situation.

Assessment of flower number per inflorescence in grapevine by image analysis under field conditions.

BACKGROUND: Flowers, flowering and fruit set are key determinants of grapevine yield. Currently, practical methods to assess the flower number per inflorescence, necessary for fruit set estimation, are time and labour demanding. This work aims at developing a simple, cheap, fast, accurate and robust machine vision methodology to be applied to RGB images taken under field conditions, to estimate the number of flowers per inflorescence automatically. RESULTS: Ninety images of individual inflorescences of Vitis vinifera L. cultivars Tempranillo, Graciano and Carignan were acquired in the vineyard with a pocket RGB camera prior to flowering, and used to develop and test the 'flower counting' algorithm. Strong and significant relationships, with R(2) above 80% for the three cultivars were observed between actual and automated estimation of inflorescence flower numbers, with a precision exceeding 90% for all cultivars. CONCLUSION: The developed algorithm proved that the analysis of digital images captured by pocket cameras under uncontrolled outdoors conditions was able to automatically provide a useful estimation of the number of flowers per inflorescence of grapevines at early stages of flowering.

Organizaciones inteligentes: evidenciaempírica de una organización queaprende en Colombia (Hospital Universitario San Ignacio) / Intelligent Organizations: Empirical Evidence of Learning Organization in Colombia (Hospital Universitario San Ignacio)

El artículo se centra en la relevancia de conectar tanto el aprendizaje organizativo como la gestión del conocimiento con la implantación de prácticas de dirección de recursoshumanos con un alto compromiso. A partir de estas ideas, se analiza el caso del Hospital Universitario San Ignacio y cómo pasaron de rojo a negro sus resultados financieros mediante una estrategia innovadora de intervención administrativa integral y medianteunas pautas empíricas basadas en dicha experiencia desde el direccionamiento del conocimiento y del talento humano. Se concluye que el Hospital Universitario San Ignacio se ha convertido en el ejemplo palpable de que una adecuada administracióny un sentido de trabajo basados en el talento humano y en su efectividad al momento de la resolución de conflictos es el camino para conseguir una organización inteligente en el área de salud, establecida en la generación de conocimiento y en la estrategia demejoramiento continuo...

This article focuses on the importance of connecting both organizational learning as knowledge management from the introduction of practices of management of human resources with a high commitment, so that the management of human resources translates into an improved organizational results. From these ideas seeks to look the Hospital Universitario San Ignacio and how stepof red to black with their financial processes, through an innovative comprehensive administrativeintervention strategy. An analysis is established through empirical guidelines based on the experience from the addressing of knowledgeand human talents. In conclusion the Hospital Universitario San Ignacio has become in a tangible example that a proper administration and a sense of work based on the human talent, and its effectiveness upon the resolution of conflicts, is the way towards a...

Effects of nutritional stress during lactation on immunity costs and indices of future reproduction in Iberian red deer (Cervus elaphus hispanicus).

Nutrition may affect the balance between immunity and traits such as reproduction or growth. This study examines the effect of low nutrient availability on immunity indices and lactation in captive Iberian red deer. Twelve hinds and their calves were allotted to a food-restricted (50-60% daily energy requirements) or a control group just after calving. Low calorie intake exerted a greater effect on the immunity of calves than on that of hinds. Whereas no difference was found for hinds, calves of the low intake group showed mean immunoglobulin (Ig) levels higher than those on a standard diet, which suggests that Ig level may indicate the level of fighting against pathogens. Serum indices of body condition in calves showed generally positive correlations with milk nutrient production. In contrast, Ig level within each group showed a pattern inverse to that of the other group for early lactation: in the standard diet group, the greater the milk nutrient produced and calf growth, the lower the Ig level; this relationship was inversed in the low-nutrition group. These results suggest that, on a standard diet, high Ig levels may indicate high levels of pathogen fighting paired to poorer body condition. Inversely, once the first barriers of innate immunity are surpassed, only those calves on the low-nutrition group with greater resources would be able to spend more resources to fight infection. Thus, low calorie intake might boost its slowing effect on growth by increasing the costs of infection fighting.