Retorno a actividades académicas universitarias presenciales: síntesis bibliográfica de las medidas de bioseguridad más eficaces / Return to face-to-face university academic activities: Bibliographical synthesis of the most effective biosecurity measures

Introducción:La pandemia provocada por la COVID-19 ha causado un gran impacto en la edu-cación. Actualmente se afrontan los retos del retorno progresivo a las actividades educativas.Objetivo: Determinar las medidas de mayor impacto en un contexto de retorno progresivo a las actividades presenciales en interiores. Material y métodos: Síntesis de información publicada, mediante la implementación de pa-labras claves en la búsqueda (return, biosecurity, vaccination, COVID-19, universities, mask, ventilation, fomites, body temperature, crowding, antibodies) en plataformas virtuales como: Pubmed, Google scholar, Elsevier que sustente la información de la aplicación de medidas de bioseguridad que permitan el retorno a clases.Resultados: El uso correcto de mascarillas, higiene frecuente, distanciamiento social, el respeto del aforo, y ventilación de ambientes cerrados son medidas indispensables que deben ser controladas por un comité para reducir la probabilidad de contagio. La medición de temperatura corporal como tamizaje de casos es cuestionable, son necesarias medidas regulatorias en el transporte de vehículos y terminales, los fómites en superficies juegan un papel mínimo en la transmisión de la COVID-19, las pruebas rápidas son una opción práctica y de confianza para el rastreo de casos activos y los vacunados deben seguir adoptando medidas de bioseguridad.Conclusiones: La factibilidad del retorno a clases presenciales depende de factores exter-nos: movilidad y transporte de estudiantes y su situación económica, e internos: implemen-tación y cumplimiento de las medidas ya mencionadas, lo cual se logrará con un adecuado manejo de los recursos económicos asignados a las universidades.

Introduction: The pandemic caused by the COVID-19 has had a great impact on education. Currently, the challenges of the progressive return to face-to-face educational activities are being faced.Objective: To determine the measures that have the greatest impact in a context of progres-sive return to classroom activities indoors.Material and methods: Synthesis of published information, through the implementation of keywords in the search (return, biosecurity, vaccination, COVID-19, universities, mask, ven-tilation, fomites, body temperature, crowding, antibodies) in virtual platforms such: Pubmed, google scholar, Elsevier that supports the information on the application of biosafety measu-res that allow the return to face-to-face classes.Results: The correct use of masks, frequent hygiene, social distancing, capacity respect, and the ventilation of closed environments are essential measures that must be controlled by a committee to reduce the probability of contagion, the measurement of body temperature as screening of cases is questionable, regulatory measures are necessary in the transport of vehicles and terminals, fomites on surfaces play a minimal role in the transmission of the COVID-19, rapid tests are a practical and reliable option for tracking active cases, and vacci-nated population should continue to adopt biosafety measures.Conclusions: The feasibility of returning to in-person classes depends on external factors: mobility and transportation of students and their economic situation, and internal factors: im-plementation and fulfillment with the afore mentioned measures, which will be achieved with an adequate management of the economic resources assigned to the universities.

Controlled Branching by Step-Growth Polymerization of Xylitol and Succinic Acid via Microwave Irradiation.

Copolymerization of xylitol usually yields cross-linked materials. In this work, microwave-assisted polyesterification of xylitol and succinic acid produced materials with diverse molecular weights and different branching degrees, and more importantly, no cross-linking was observed, as supported by the solubility behavior and spectroscopic data. Reactions were carried out for short times, less than 20 min, which is not common for production of industrial polyesters. Control over the branching degree was achieved by tuning the reaction conditions, such as temperature, time of exposure, and monomer ratio, during microwave irradiation. No solvent or catalyst was employed during the step-growth polymerization.

Pharmacoeconomic Analysis of Sitagliptin/Metformin for the Treatment of Type 2 Diabetes Mellitus: A Cost-Effectiveness Study.

OBJECTIVES: To assess the cost-effectiveness and cost utility of sitagliptin/metformin for the treatment of type 2 diabetes mellitus compared to those of glibenclamide/metformin in a semiprivate hospital and to compare the cost-effectiveness and cost utility of sitagliptin/metformin in a semiprivate hospital to those in the public health system (PHS) of Ecuador in 2019. METHODS: A cost-effectiveness study considering the probability of cardiovascular death as the outcome and quality-adjusted life-year as a measure of utility, estimating direct medical costs in US dollars by a model case from the perspective of the third payer. The results will be presented as an incremental cost-effectiveness ratio. One-way and 2-way sensitivity analyses with tornado diagrams were performed. RESULTS: Direct medical costs were lower at the hospital than from the PHS in Ecuador. Considering the drugs metformin/sitagliptin, the total cost was $35.69 less in the hospital ($880.38) than from the comparator ($916.07). The highest percentage of direct medical costs corresponded to drugs (between 63.94% and 84.65%). An ICER of -$19 131.61 was obtained at the Hospital Un Canto a la Vida and -$1621.85 at PHS. In addition, the cost per quality-adjusted life-year earned was $611.11. Sensitivity analysis showed that the probability of drug use and the relative risk of cardiovascular death associated with such prescription were parameters that most affected the model. CONCLUSIONS: The combination therapy metformin/sitagliptin compared to metformin/glibenclamide was shown not to be cost-effective in the Hospital Un Canto a la Vida, and highly cost-effective in the PHS.

Sugarcane Straw Recovery for Bioenergy Generation: A Case of an Organic Farm in Colombia.

In Latin America, the energy potential from sugarcane straw, such as tops, secondary stalk, and leaves, has been debated, but the literature associated with organic crops and its implementation for energy purposes is limited. Sugarcane straw is either left in the field for soil recovery or used for animal feed. This paper presents an analysis of using organic sugarcane straw for energy generation. We have characterized the physicochemical properties of this organic sugarcane straw, including caloric value, moisture, carbon, and ash content, and have explored the environmental benefits of using biomass to replace coal as an energy source. The study showed that it is possible to achieve the replacement of coal using 16% of the residual biomass, with the benefit of generating lower CO2 emissions compared to coal combustion. Additionally, emissions derived from transporting the biomass from the field to the farm are 68% lower than those involved in transporting coal. The residual biomass from the organic crop showed similar properties relative to bagasse. The use of organic sugarcane straw biomass will result in the reduction of energy costs and will generate green energy with lower emission of CO2.

Lipasas en síntesis de polímeros: avances y contribución a la química verde de polímeros / Lipases in polymer synthesis: advantages and its contribution to green polymer chemistry

RESUMEN Las lipasas han sido usadas en las últimas décadas como catalizadores eficientes en la síntesis enzimática de polímeros y gracias a características como alta selectividad, reciclabilidad, inocuidad y fácil separación/purificación se han convertido en una herramienta importante en el campo de los polímeros. En este trabajo se recopilan los desarrollos más importantes en el área y a su vez se muestra la tendencia actual de este campo de investigación.

ABSTRACT Lipases have been used in last decades as efficient catalysts in enzimatic polymer chemistry, thanks to its high selectivity, recyclabil-ity, safety and easy recovery/ separation, lipases have become in an important tool in polymer field. In this paper we compile the most important achievements in the enzimatic polymer chemistry and, at the same, time we show the current trend in this field of research.

Caracterización del uso inapropiado de antibióticos en faringoamigdalitis según los criterios de McIsaac / Characterization of inappropiate use of antibiotics on pharyngoamygdalitis according to McIsaac's criteria / Caracterização do uso indevido de antibióticos em faringotonsilite de acordo com os critérios do McIsaac

Objetivo: Describir el uso irracional de antibióticos en base a criterios de McIsaac (criterios de Centor modificados por McIsaac), en una unidad de salud de primer nivel de atención. Métodos: Se realizó un estudio descriptivo transversal con los registros de pacientes de 3 a 19 años atendidos en el servicio de emergencia (246), con los diagnósticos de faringitis aguda, amigdalitis aguda, e infecciones respiratorias superiores agudas de múltiples sitios y sin especificar. Se estableció como prescripción inadecuada si el facultativo indicó antibióticos con un puntaje menor o igual a 1 sobre 5 puntos o si no prescribió antibióticos con puntaje mayor o 4 sobre 5 puntos. Resultados: Se estimó 24,29% de uso inadecuado de antibióticos de los registros de emergencia. Se prescribió antibióticos en 160 pacientes, de los cuales se encontró que, amoxicilina fue el más utilizado (61,87%); seguido de benzilpenicilina benzatina (28,12%) y en tercer lugar macrólidos (8,12%). Conclusión: En la unidad de primer nivel analizada se encontró que el uso inadecuado de antibióticos es superior a la prevalecía estimada de faringoamigdalitis estreptocócica para el grupo de edad estudiado. Por esto, es imperativo que se tomen las medidas necesarias a nivel institucional y comunitario para lograr su reducción y evitar las complicaciones que se derivan de esta.

Objetivo: Descrever o uso irracional de antibióticos com base nos critérios de McIsaac (critérios de Centor modificados por McIsaac), em uma unidade de saúde de primeiro nível de atenção. Métodos: Foi realizado um estudo descritivo transversal com os prontuários de pacientes de 3 a 19 anos atendidos no serviço de emergência (246), com diagnóstico de faringite aguda, amigdalite aguda, e infecções respiratórias superiores agudas de múltiplos locais e sem especificação. Estabeleceu-se como uma prescrição inadequada se o médico indicou antibióticos com um escore menor ou igual a 1 de 5 pontos ou se ele não prescreveu antibióticos com um escore maior ou igual a 4 de 5 pontos. Resultados: O uso inadequado de antibióticos foi estimado em 24,29% dos prontuários de emergência. Antibióticos foram prescritos em 160 pacientes, dos quais constatou-se que a amoxicilina foi a mais utilizada (61,87%); em segundo, a penicilina benzatina (28,12%); e, em terceiro lugar, os macrolídeos (8,12%). Conclusão: Na unidade de primeiro nível analisada foi encontrado que o uso de antibióticos é superior à prevalência de faringite estreptocócica estimada para a faixa etária estudada. Então, é imperativo que a nível institucional e comunitário sejam tomadas as medidas necessárias para sua redução e evitar as complicações resultantes.

Objective: To describe the irrational use of antibiotics based on McIsaac criteria (Centor criteria modified by McIsaac), in a primary care facility. Methods: A cross-sectional descriptive study was conducted with the medical record of patients from 3 to 19 years old, treated in the emergency department (246), with the diagnoses of acute pharyngitis, acute tonsillitis, and acute upper respiratory infections from multiple sites and not specified. It was established as an inappropriate prescription if the physician indicated antibiotics with a score less than or equal to 1 out of 5 points or if he did not prescribe antibiotics with a score greater than or equal to 4 out of 5 points. Results: Inadequate use of antibiotics was found in 24.29% of emergency records. Antibiotics were prescribed in 160 patients, of which, amoxicillin was the most used (61.87%); followed by benzathine penicillin (28.12%) and in third place macrolides (8.12%). Conclusion: In the first level unit analyzed, it was found that the inappropriate use of antibiotics is superior to the estimated prevalence of streptococcal pharyngitis for the age group studied. Therefore, it is imperative that the necessary measures are taken at the institutional and community level to achieve its reduction and avoid the complications that result from it.

La Evaluación de Tecnologías Sanitarias y Evaluaciones Económicas, como herramientas para la toma de decisiones en la atención primaria y la salud pública / A Avaliação de Tecnologias em Saúde e Avaliações Econômicas, como ferramentas para tomada de decisões em atenção primária e saúde pública / The Evaluation of Health Technologies and Economic Evaluations, as tools for decision making in primary care and public health

Los sistemas de salud se enfrentan al reto de decidir cuáles de las nuevas tecnologías disponibles deben ser utilizadas y estar disponibles con carácter prioritario a través de la cobertura estatal. De esta manera la Organización Mundial de la Salud (OMS) ratifica la importancia de la Evaluación de la Tecnologías Sanitarias (ETS), con el objetivo de fortalecer los sistemas de información y la capacidad de investigación en salud. El proceso de la preparación de un informe de ETS, requiere una búsqueda exhaustiva de la evidencia disponible; para su posterior síntesis y presentación a los interesados. Este es un paso crucial para que una tecnología sea considerada para su introducción en un sistema de salud; convirtiéndose en la cuarta y última barrera (Calidad, Seguridad, Eficacia y Costo-Efectividad); para la implementación de nuevas intervenciones en salud. Sin embargo, para determinar mejor el impacto presupuestario de las intervenciones, la ETS se basa en las herramientas proporcionadas por las Evaluaciones Económicas en Salud (EES), que pueden analizar los costos y las consecuencias clínicas del uso de una determinada tecnología particular para un problema de salud particular en un contexto particular. Esta información resulta vital cuando se consideran principios como la equidad o el costo de oportunidad (lo que se gasta en una intervención no se puede utilizar en otra), y, en última instancia, el limitado presupuesto de salud de los sistemas de salud.

Health systems have the challenge of deciding which of the new available technologies should be used and be available as a priority through state coverage. In this way, the World Health Organization (WHO) ratifies the importance of the Health Technology Assessment (HTA), with the aim of strengthening information systems and health research capacity. The process of preparing an HTA report requires an exhaustive search of the available evidence; for its subsequent synthesis and presentation to those interested in it. This is a crucial step for a technology to be considered for its introduction into a health system; becoming the fourth and final barrier (Quality, Safety, Efficiency and Cost-Effectiveness); for the implementation of new health interventions. However, to better determine the budgetary impact of the interventions, the HTA relies on the tools provided by the Economic Health Assessments (EHA); which can analyze both the costs and the clinical consequences of the use of a certain technology for a particular health problem in a particular context. This information is vital, when we consider principles such as equity, or the opportunity cost (what is spent in one intervention, cannot be used in another), and ultimately the limited health budget of health systems.

Os sistemas de saúde enfrentam o desafio de decidir quais das novas tecnologias disponíveis devem ser usadas e estar disponíveis como prioridade através da cobertura do estado. Dessa forma, a Organização Mundial da Saúde (OMS) ratifica a importância da Avaliação de Tecnologias em Saúde (ATS), com o objetivo de fortalecer os sistemas de informação e a capacidade de pesquisa em saúde. O processo de preparação de um relatório de ATS requer uma pesquisa exaustiva das evidências disponíveis; para sua síntese e apresentação seguintes aos interessados. Este é um passo crucial para que uma tecnologia seja considerada para sua introdução em um sistema de saúde; tornando-se a quarta e última barreira (Qualidade, Segurança, Eficiência e Custo-Eficácia); para a implementação de novas intervenções de saúde. No entanto, para melhor determinar do impacto orçamentário das intervenções, a ATS conta com as ferramentas fornecidas pelas Avaliações Econômicas de Saúde (AES); que pode analisar os custos e as consequências clínicas do uso de uma determinada tecnologia para um problema de saúde particular em um contexto particular. Esta informação é vital, quando consideramos princípios como a equidade, ou o custo de oportunidade (o que é gasto em uma intervenção, não pode ser usado em outra) e em última instância, o orçamento limitado em saúde dos sistemas de saúde.

Freezing the graft is not necessary for autotransplants for plasma cell myeloma and lymphomas.

We studied rates of granulocyte and platelets recovery in 359 consecutive subjects receiving blood cell infusions in the context of autotransplants for plasma cell myeloma (N = 216) and lymphomas (N = 143). Blood cells were mobilised with filgrastim given for 4-5 days and collected after a median of 2 (range, 1-2) apheresis. Apheresis products were stored at 4° C for a median of 3 days (range, 2-6 days). Most subjects received carmustine, etoposide, cytarabine and melphalan (BEAM), cyclophosphamide, carmustine and etoposide (CBV) or high-dose melphalan. Filgrastim was given post transplant to 319 subjects. Median numbers of mononuclear cells collected was 31 × 10E + 6/kg (interquartile range (IQR) 37 × 10E + 6 cells/kg). Median numbers of CD34-positive cells collected was 3.6 × 10E + 6/kg (IQR 3.8 × 10E + 6/Kg). Median viability after collection was 90% (IQR 7%) after storage, 88% (IQR 12%). A total of 255 of 256 evaluable subjects recovered bone marrow function and there was no late bone marrow failure. Median interval to neutrophils >0.5 × E + 9/L was 13 days (range, 9-39 days) and to platelets >20 × 10E + 9/L, 16 days (range, 7-83 days). These rates and ranges seem comparable to those reported after autotransplants of frozen blood cells. There was no correlation between numbers of storage days at 4 °C and viability afte storage (r = -0.018, p = 0.14)) nor rates of recovery of neutrophils (r = -0.054, p = 0.52) or platelets (r = 0.116, p = 0.14). Blood cells collected for autotransplant can be stored at 4 °C for 6 d. This method is simple, inexpensive and widely applicable.

New Surgical Protocol to Create Interimplant Papilla: The Preliminary Results of a Case Series.

The aim of this study was to introduce a new surgical technique to regenerate the papilla adjacent to multiple or single implants using a novel instrument and a new incision design. A total of 10 consecutively treated patients with maxillary anterior implant-supported provisional restorations and missing interproximal papillae received a subepithelial connective tissue graft. The recipient site was prepared with a buccal incision apical to the mucogingival junction and to the defective papilla, and a palatal incision, followed by buccolingual tunneling performed with a translingual curette (EBINA). A total of 10 sites were treated and evaluated pre- and postoperatively with the papilla score based on the Jemt classification. The final prosthesis was delivered 3 months after the papilla regeneration surgical procedure. An average improvement in papilla index score from 0.8 to 2.4 was found after an average follow-up period of 16.3 months. This case series demonstrated that interimplant papilla regeneration can be successful over a period of 11 to 30 months postloading. Long-term prospective studies on tissue stability and esthetic outcomes are needed to corroborate the findings in this study.

Precision Long-Chain Branched Polyethylene via Acyclic Diene Metathesis Polymerization.

A series of polyethylenes containing 21-carbon alkyl branches have been synthesized by acyclic diene metathesis (ADMET) polymerization. These 21-carbon alkyl branches are precisely placed on every 15th, 19th, 21st, 23rd, and 39th carbon along the polymer backbone. Precision of primary structures of all polymers is verified by 1H and 13C NMR spectroscopy. All polymers present well-defined melting profiles, even at a high branch incorporation (13.3% mol). The melting temperature increases as the branch frequency decreases, similar to what we observed for short-chain branched polyethylenes. These observations together with a good linear relationship derived from Flory's theory suggest the exclusion of 21-carbon side chains from polyethylene crystal units.

Precision polyethylene: changes in morphology as a function of alkyl branch size.

Metathesis polycondensation chemistry has been employed to control the crystalline morphology of a series of 11 precision-branched polyethylene structures, the branch being placed on each 21st carbon and ranging in size from a methyl group to an adamantyl group. The crystalline unit cell is shifted from orthorhombic to triclinic, depending upon the nature of the precision branch. Further, the branch can be positioned either in the crystalline phase or in the amorphous phase of polyethylene, a morphology change dictated by the size of the precision branch. This level of morphology control is accomplished using step polymerization chemistry to produce polyethylene rather than conventional chain polymerization techniques. Doing so requires the synthesis of a series of unique symmetrical diene monomers incorporating the branch in question, followed by ADMET polymerization and hydrogenation to yield the precision-branched polyethylene under study. Exhaustive structure characterization of all reaction intermediates as well as the precision polymers themselves is presented. A clear change in morphology was observed for such polymers, where small branches (methyl and ethyl) are included in the unit cell, while branches equal to or greater in mass than propyl are excluded from the crystal. When the branch is excluded from the unit cell, all such polyethylene polymers possess essentially the same melting temperature, regardless of the size of the branch, even for the adamantyl branch.

Avoiding olefin isomerization during decyanation of alkylcyano alpha,omega-dienes: a deuterium labeling and structural study of mechanism.

A two-step synthetic pathway involving decyanation chemistry for the synthesis of pure alkyl alpha,omega-dienes in quantitative yields is presented. Prior methodologies for the preparation of such compounds required 6-9 steps, sometimes leading to product mixtures resulting from olefin isomerization chemistry. This isomerization chemistry has been eliminated. Deuteration labeling and structural mechanistic investigations were completed to decipher this chemistry. Deuterium labeling experiments reveal the precise nature of this radical decyanation chemistry, where an alcohol plays the role of hydrogen donor. The correct molecular design to avoid competing intramolecular cyclization, and the necessary reaction conditions to avoid olefin isomerization during the decyanation process are reported herein.