Barreras físicas percibidas por estudiantes de una institución universitaria de la ciudad de Cali-Colombia frente a la discapacidad / Physical barriers faced by disabled people perceived by university students in Cali-Colombia

Objetivo Identificar las barreras físicas percibidas por los estudiantes de Terapia Ocupacional y Nutrición de una institución universitaria de la ciudad de Cali-Colombia frente al tema de la discapacidad. Métodos Se realizó un estudio observacional analítico de corte transversal. La población estuvo constituida por 494 estudiantes. Inicialmente se realizó un análisis univariado en donde se estimaron prevalencias frente a las barreras físicas percibidas por los estudiantes frente a la discapacidad y sobre la participación de los mismos en la vida universitaria. Dado que la variable dependiente participación fue dicotomizada, se estableció un análisis bivariado logístico con el ánimo de explorar la relación existente entre las barreras físicas percibidas por los estudiantes y la participación en la vida universitaria, finalmente se elaboró un modelo de regresión logística obteniendo un modelo explicativo que dio respuesta a los objetivos planteados. Resultados En este estudio se encontró que alrededor del 58% de los estudiantes perciben la cafetería y los baños de la institución como espacios poco accesibles, dado que no cuentan con adecuada señalización, ventilación e iluminación. Finalmente, después de ajustar el modelo de regresión logística para todas las variables seleccionadas se encontró que la única barrera física relacionada con la participación de los estudiantes en la vida universitaria fue el transporte para llegar a la institución universitaria. Conclusiones Las universidades tienen el deber de realizar diagnósticos periódicamente, para identificar barreras físicas dentro de las universidades, dado que la accesibilidad es un punto fundamental en la construcción de una verdadera educación inclusiva (AU)

Objective To identify physical barriers faced by disabled people perceived by university occupational therapy and nutrition students in a single institution in Cali-Colombia. Methods We carried out an analytical observational cross-sectional study. The sample was composed of 494 students. A univariate analysis was carried out that estimated the prevalence of physical barriers faced by disabled people perceived by students and participation in university life. Given that the dependent variable, participation, was dichotomized, a bivariate logistic analysis was performed to explore the relationship between physical barriers perceived by students and participation in university life. Finally, a logistic regression model was conducted, obtaining an explanatory model to meet the objectives set. Results Around 58% of students perceived that the snack bar and toilets inside the institution had low accessibility, because of inadequate signalling, ventilation and lighting. After adjustment of the logistic regression model for all the selected variables, transportation to the university was the only physical barrier related to participation in university life. Conclusions Accessibility is a key point for a truly inclusive educational institution. Therefore, universities should periodically carry out a survey to identify physical barriers (AU)

Effective decellularization of human nerve matrix for regenerative medicine with a novel protocol.

Injuries to the peripheral nerves represent a frequent cause of permanent disability in adults. The repair of large nerve lesions involves the use of autografts, but they have several inherent limitations. Overcoming these limitations, the use of decellularized nerve matrix has emerged as a promising treatment in tissue regenerative medicine. Here, we generate longer human decellularized nerve segments with a novel decellularization method, using nonionic, zwitterionic, and enzymatic incubations. Efficiency of decellularization was measured by DNA quantification and cell remnant analysis (myelin, S100, neurofilament). The evaluation of the extracellular matrix (collagen, laminin, and glycosaminoglycans) preservation was carried out by enzyme-linked immunosorbent assay (ELISA) or biochemical methods, along with histological and immunofluorescence analysis. Moreover, biomechanical properties and cytocompatibility were tested. Results showed that the decellularized nerves generated with this protocol have a concentration of DNA below the threshold of 50 ng/mg of dry tissue. Furthermore, myelin, S100, and MHCII proteins were absent, although some neurofilament remnants could be observed. Moreover, extracellular matrix proteins were well maintained, as well as the biomechanical properties, and the decellularized nerve matrix did not generate cytotoxicity. These results show that our method is effective for the generation of decellularized human nerve grafts. The generation of longer decellularized nerve segments would allow the understanding of the regenerative neurobiology after nerve injuries in both clinical assays and bigger animal models. Effective decellularization of human nerve matrix for regenerative medicine with a novel protocol. Combination of zwitterionic, non-ionic detergents, hyperosmotic solution and nuclease enzyme treatment remove cell remnants, maintain collagen, laminin and biomechanics without generating cytotoxic leachables.

Pragmatic, open-label, single-center, randomized, phase II clinical trial to evaluate the efficacy and safety of methylprednisolone pulses and tacrolimus in patients with severe pneumonia secondary to COVID-19: The TACROVID trial protocol.

INTRODUCTION: Some COVID-19 patients evolve to severe lung injury and systemic hyperinflammatory syndrome triggered by both the coronavirus infection and the subsequent host-immune response. Accordingly, the use of immunomodulatory agents has been suggested but still remains controversial. Our working hypothesis is that methylprednisolone pulses and tacrolimus may be an effective and safety drug combination for treating severe COVID-19 patients. METHODS: and analysis: TACROVID is a randomized, open-label, single-center, phase II trial to evaluate the efficacy and safety of methylprednisolone pulses and tacrolimus plus standard of care (SoC) versus SoC alone, in patients at advanced stage of COVID-19 disease with lung injury and systemic hyperinflammatory response. Patients are randomly assigned (1:1) to one of two arms (42 patients in each group). The primary aim is to assess the time to clinical stability after initiating randomization. Clinical stability is defined as body temperature ≤37.5 °C, and PaO2/FiO2 > 400 and/or SatO2/FiO2 > 300, and respiratory rate ≤24 rpm; for 48 consecutive hours. DISCUSSION: Methylprednisolone and tacrolimus might be beneficial to treat those COVID-19 patients progressing into severe pulmonary failure and systemic hyperinflammatory syndrome. The rationale for its use is the fast effect of methylprednisolone pulses and the ability of tacrolimus to inhibit both the CoV-2 replication and the secondary cytokine storm. Interestingly, both drugs are low-cost and can be manufactured on a large scale; thus, if effective and safe, a large number of patients could be treated in developed and developing countries. TRIAL REGISTRATION NUMBER: NCT04341038 / EudraCT: 2020-001445-39.

In cardiac fibroblasts, interferon-beta attenuates differentiation, collagen synthesis, and TGF-ß1-induced collagen gel contraction.

Cardiac fibroblasts (CF) play a key role in the homeostasis of the extracellular matrix in cardiac tissue and are newly recognized as inflammatory supporter cells. Besides, CF-to-Cardiac myofibroblast differentiation is commanded by TGF-b, through SMAD signaling pathways, and these last cells are strongly implicated in cardiac fibrosis. In the heart IFN-ß is produced by CF; however, the role of IFN-ß, STAT proteins, and STAT-homo or heterodimers in the regulation of CF function with or without a fibrotic environment is unknown. CF were isolated from hearts of adult rats, and by western blot analysis we studied STAT1, STAT2, and STAT3 phosphorylation and through specific siRNA against these proteins we analyzed their role in CF functions such as differentiation (α-SMA expression); and pro-collagen type-I synthesis and secretion expression levels; collagen gels contraction and CF migration. In cultured adult rats CF, IFN-ß increases phosphorylation of STAT1, STAT2, and STAT3. Both STAT1 and STAT2 were involved in decreasing α-SMA and CF migration induced by TGF-ß1. Also, IFN-ß through STAT1 regulated pro-collagen type-I protein expression levels, and collagen gels contraction induced by TGF-ß1. STAT3 was not involved in any effects of IFN-ß studied. In conclusion, IFN-ß through STAT1 and STAT2 shows antifibrotic effects on CF TGF-ß1-treated, whereas STAT3 did not participate in such effect.

[Physical barriers faced by disabled people perceived by university students in Cali-Colombia]. / Barreras físicas percibidas por estudiantes de una institución universitaria de la ciudad de Cali-Colombia frente a la discapacidad.

OBJECTIVE: To identify physical barriers faced by disabled people perceived by university occupational therapy and nutrition students in a single institution in Cali-Colombia. METHODS: We carried out an analytical observational cross-sectional study. The sample was composed of 494 students. A univariate analysis was carried out that estimated the prevalence of physical barriers faced by disabled people perceived by students and participation in university life. Given that the dependent variable, participation, was dichotomized, a bivariate logistic analysis was performed to explore the relationship between physical barriers perceived by students and participation in university life. Finally, a logistic regression model was conducted, obtaining an explanatory model to meet the objectives set. RESULTS: Around 58% of students perceived that the snack bar and toilets inside the institution had low accessibility, because of inadequate signalling, ventilation and lighting. After adjustment of the logistic regression model for all the selected variables, transportation to the university was the only physical barrier related to participation in university life. CONCLUSIONS: Accessibility is a key point for a truly inclusive educational institution. Therefore, universities should periodically carry out a survey to identify physical barriers.

Design and fabrication of CuInS2/ZnS-based QLED for automotive lighting systems.

This work reports the design, manufacturing and numerical simulation approach of a 6-pixel (4.5 mm2/pixel) electroluminescent quantum dot light emitting device (QLED) based on CuInS2/ZnS quantum dots as an active layer. The QLED device was fabricated using a conventional multi-layer thin film deposition. In addition, the electrical I-V curves were measured for each pixel independently, observing how the fabrication process and layer thickness have an influence in the shape of the plot. This experimental device, enabled us to create a computational model for the QLED based on the Transfer Hamiltonian approach to calculate the current density J (mA cm-2), the band diagram of the system, and the accumulated charge distribution. Besides, it is worth highlighting that the simulator allows the possibility to study the influence of different parameters of the QLED structure like the junction capacitance between the distinct multilayer set. Specifically, we found that the Anode-HIL interface capacitance has a greater influence in the I-V curve. This junction capacitance plays an important role in the current density increase and the QLED turn-on value when a forward voltage is applied to the device. The simulation enabled that influence could be controlled by the selection of the optimal thickness and transport layers during the experimental fabrication process. This work is remarkable since it achieves to fit simulation and experiment results in an accurate way for electroluminescent QLED devices; particularly the simulation of the device current, which is critical when designing the automotive electronics to control these new nanotechnology lighting devices in the future.

A prospective study of lung disease in a cohort of early rheumatoid arthritis patients.

Lung disease is common in patients with rheumatoid arthritis (RA). The onset of lung involvement in RA is not well known. The objective is to describe the features and evolution of lung involvement in early RA, its relationship with disease activity parameters, smoking and treatments. Consecutive patients with early RA without respiratory symptoms were included and tracked for 5 years. Lung assessment included clinical, radiological and pulmonary function tests at diagnosis and during follow-up. Peripheral blood parameters (erythrocyte sedimentation rate, C reactive protein, rheumatoid factor and anti-citrullinated peptide autoantibodies) and scales of articular involvement, such as DAS28-CRP, were evaluated. 40 patients were included and 32 completed the 5-year follow up. 13 patients presented lung involvement in the initial 5 years after RA diagnosis, 3 of them interstitial lung disease. Significant decrease of diffusion lung transfer capacity of carbon monoxide over time was observed in six patients, 2 of them developed interstitial lung disease. DLCO decrease was correlated with higher values of CRP and ESR at diagnosis. Methotrexate was not associated with DLCO deterioration or lung disease development. Subclinical progressive lung disease correlates with RA activity parameters. Smoking status and methotrexate were not associated with development or progression of lung disease.

Genomic regions influencing intramuscular fat in divergently selected rabbit lines.

Intramuscular fat (IMF) is one of the main meat quality traits for breeding programmes in livestock species. The main objective of this study was to identify genomic regions associated with IMF content comparing two rabbit populations divergently selected for this trait, and to generate a list of putative candidate genes. Animals were genotyped using the Affymetrix Axiom OrcunSNP Array (200k). After quality control, the data involved 477 animals and 93 540 SNPs. Two methods were used in this research: single marker regressions with the data adjusted by genomic relatedness, and a Bayesian multiple marker regression. Associated genomic regions were located on the rabbit chromosomes (OCU) OCU1, OCU8 and OCU13. The highest value for the percentage of the genomic variance explained by a genomic region was found in two consecutive genomic windows on OCU8 (7.34%). Genes in the associated regions of OCU1 and OCU8 presented biological functions related to the control of adipose cell function, lipid binding, transportation and localisation (APOLD1, PLBD1, PDE6H, GPRC5D and GPRC5A) and lipid metabolic processes (MTMR2). The EWSR1 gene, underlying the OCU13 region, is linked to the development of brown adipocytes. The findings suggest that there is a large component of polygenic effect behind the differences in IMF content in these two lines, as the variance explained by most of the windows was low. The genomic regions of OCU1, OCU8 and OCU13 revealed novel candidate genes. Further studies would be needed to validate the associations and explore their possible application in selection programmes.

Band-like electron transport in 2D quantum dot periodic lattices: the effect of realistic size distributions.

Electron mobility in nanocrystal films has been a controversial topic in the last few years. Theoretical and experimental studies evidencing carrier transport by hopping or showing band-like features have been reported in the past. A relevant factor to analyze transport results is the progressive improvement in quantum dot superlattice fabrication, leading to better regimented structures for which band-like transport would be more relevant. This work presents an efficient model to compute temperature-dependent band-like electronic mobilities in 2D quantum dot arrays when a realistic quantum dot size distribution is considered. Comparisons with experimental results are used to estimate these size distributions, in good agreement with data of the samples.

Neoplasias quísticas mucinosas del páncreas: caso clínico y revisión de la literatura / Clinical case of pancreatic mucinous cystic neoplasms and literature review

Resumen Las neoplasias quísticas mucinosas del páncreas son lesiones relativamente frecuentes, afectan principalmente a mujeres perimenopáusicas; la mayoría son únicos, localizados en el cuerpo y la cola del páncreas, y no tienen comunicación con el sistema ductal pancreático. Menos del 20% de los casos se asocian con malignidad. La evaluación debe incluir la presentación clínica, las imágenes, la utilización de la ultrasonografía endoscópica y toma de biopsias por punción, la citología y el análisis químico del líquido para la medición de niveles de antígeno carcinoembrionario (ACE). La resección quirúrgica completa es el único tratamiento que mejora la supervivencia a largo plazo en pacientes con lesiones quísticas mucinosas malignas. Se realiza una revisión de la literatura a propósito de un caso diagnosticado por el grupo de gastroenterología clínico-quirúrgica de la Clínica la Presentación, Manizales, Colombia.

Abstract Mucinous cystic neoplasms of the pancreas occur relatively frequently and mainly affect women in the transition to menopause. Most of these neoplasms are unique but are located in the body and tail of the pancreas and have no communication with the pancreatic ductal system. Less than 20% are malignant. Evaluation should include clinical presentation, imaging, endoscopic ultrasonography, puncture biopsies, cytology and chemical analysis of the liquid to measure angiotensin converting enzyme (ACE) levels. Complete surgical resection is the only treatment that can improve long-term survival in patients with malignant mucinous cystic lesions. This article includes a review of the literature related to presentation of a case diagnosed by the surgical clinical gastroenterology group at Clínica la Presentación in Manizales, Colombia.

Hepatitis autoinmune y cáncer de colon: una asociación inusual. Caso clínico y revisión de la literatura / A case of an unusual association of autoimmune hepatitis and colon cancer: report and literature review

Resumen Introducción: la hepatitis autoinmune idiopática (HAI) es una enfermedad crónica que predomina en mujeres, con episodios de actividad y remisión, favoreciendo la fibrosis hepática. El 40% de los pacientes presenta historia familiar de enfermedades autoinmunes. Al parecer, es mediada por la interacción antígeno-anticuerpo; sin embargo, su causa es desconocida. Se conoce la asociación frecuente de HAI con cáncer hepatobiliar; menos frecuente con linfomas, cáncer de piel y cáncer de colon; y casi inexistente con síndromes hereditarios de cáncer de colon. Este caso debutó con HAI y sangrado rectal causado por poliposis adenomatosa familiar (PAF) y adenocarcinoma de colon sigmoide. Caso clínico: mujer de 51 años con HAI de 1 año de evolución manejada con prednisolona y azatioprina. Se realizó una colonoscopia total por anemia en la que se encontraron múltiples pólipos entre 5 y 10 mm y 1 de 30 mm sésil, ulcerado, en colon sigmoide. Se realizó una polipectomía endoscópica múltiple que reportó un adenoma tubulovelloso con displasia de alto y bajo grado en varios pólipos y un adenocarcinoma de bajo grado en el pólipo del sigmoide. Los estudios de extensión fueron negativos para metástasis. Se realizó una repleción nutricional prequirúrgica, luego una colectomía subtotal y una procto-ileoanastomosis con ileostomía de protección. La patología de pieza quirúrgica mostró un adenocarcinoma de colon de bajo grado y adenomas tubulares y tubulovellosos con displasias de alto y bajo grado. Discusión y conclusiones: La asociación de HAI con PAF y cáncer colorrectal (CC) es infrecuente. Es conocida la correlación de HAI con cáncer hepatobiliar (asociado con cirrosis), linfomas, cáncer de piel y otros desórdenes autoinmunes. El pronóstico es malo y no puede establecerse una correlación clara con moduladores inmunes.

Abstract Introduction: Idiopathic autoimmune hepatitis (IAH) is a chronic disease that occurs predominately in women, has episodic activity and remission, and favors hepatic fibrosis. Forty percent of patients have family histories of autoimmune diseases. It is apparently mediated by antigen-antibody interaction, but its causes are unknown. IAH is frequently associated with hepatobiliary cancer, less frequently with lymphomas, skin cancer and colon cancer and very rarely with hereditary colon cancer syndrome. This case debuted IAH and rectal bleeding caused by familial adenomatous polyposis (FAP) and adenocarcinoma of the sigmoid colon. Clinical case: The patient was a 51-year-old woman who had had IAH for one year which had been managed with prednisolone and azathioprine. A total colonoscopy, performed because of anemia, found multiple polyps that measured 5 and 10 mm and one ulcerated 30 mm sessile polyp in the sigmoid colon. A multiple endoscopic polypectomy revealed a tubulovillous adenoma with high and low grade dysplasia in several polyps and a low grade adenocarcinoma in the sigmoid polyp. Tests and examinations for metastasis were negative. Following presurgical nutritional repletion, a subtotal colectomy was performed and an ileal pouch-anal anastomosis with protective ileostomy was created. The pathology of the surgical specimen showed low grade adenocarcinoma of the colon and tubular and tubulovillous adenomas with high and low grade dysplasia. Discussion and conclusions: Association of IAH with familial adenomatous polyposis (FAP) and colorectal cancer (CC) occurs infrequently although associations of IAH with hepatobiliary cancer associated with cirrhosis, lymphomas, skin cancer and other autoimmune disorders are well-known. The prognosis is bad and no clear correlation with immune modulators can be established.

Hallazgos en endosonografía anorrectal en una cohorte prospectiva / Findings from anorectal endosonography in a prospective cohort

La endosonografía anorrectal permite diagnosticar múltiples patologías del canal anal y del recto. En Colombia se realiza en pocos sitios y es escaso el personal entrenado para ello. Un grupo de docentes de gastroenterología clínica quirúrgica de la Universidad de Caldas recibió entrenamiento en endosonografía anorrectal en Chile y España, después de lo cual inició su trayectoria, ya de 4 años. Con los datos del último año se realizó un estudio descriptivo en una cohorte prospectiva, tomando la información de los pacientes a quienes se les realizó endosonografía anorrectal entre octubre de 2014 y septiembre de 2015. Se obtuvieron datos de 136 pacientes, predominando el género femenino (72,05%); el 20,6% de los pacientes procedían de departamentos diferentes a Caldas. La principal indicación fue incontinencia fecal en 44 pacientes (32,35%), siendo 86% mujeres; otras indicaciones fueron neoplasia maligna rectal (23,5%), fístula perianal (12,5%), proctalgia (11,03%), endometriosis (7,35%) y absceso perianal (6,62%). El diagnóstico final más frecuente fue defecto de los esfínteres en 40 pacientes (29,41%), seguido por neoplasia maligna rectal (13,24%), fístula perianal (11,76%), absceso perianal (8,82%) y neoplasia benigna rectal (6,62%). Los resultados están en congruencia con la literatura mundial, donde la principal indicación es la incontinencia fecal en relación con el diagnóstico final, que es defectos de los esfínteres por alteraciones obstétricas. La endosonografía anorrectal es de gran importancia como método diagnóstico único o de apoyo para otros, con centros de referencia como el nuestro, donde se realiza en un volumen importante y siguiendo las pautas internacionales recomendadas.

Anorectal endosonography can diagnose many diseases of the anal canal and rectum. In Colombia, the procedure is performed in only a few medical centers because of the scarcity of trained personnel. Four years ago, a group of teachers from the gastroenterological surgery clinical at the University of Caldas received training in endoluminal ultrasonography in Chile and Spain and have been practicing these procedures ever since. This is a descriptive study of a prospective cohort using data from patients who underwent endoluminal ultrasonography between October 2014 and September 2015. Data were obtained from 136 patients, of whom 72.05% were women. 20.6% of the patients came from departments other than Caldas. Fecal incontinence was the reason for the procedure for 44 patients (32.35%, 86% of whom were women). Other indications were rectal malignancies (23.5%), perianal fistulas (12.5%), anal pain (11.03%), endometriosis (7.35%), and perianal abscesses (6.62%). The most common final diagnoses were defective sphincters in 40 patients (29.41%), rectal malignancy in 13.24% of the patients, perianal fistulas in 11.76% of the patients, perianal abscesses in 8.82% of the patients, and benign rectal neoplasms in 6.62% of the patients . The results are consistent with those found in the international literature where the most common final diagnoses reported for the reason for fecal incontinence are sphincter defects and obstetric disorders. Anorectal endosonography is of great importance when used alone or to support other diagnostic tools. It is recommended that this procedure be done in a referral center such as ours which performs a large volume of these procedures and which follows international guidelines.

Cardiac fibroblasts as sentinel cells in cardiac tissue: Receptors, signaling pathways and cellular functions.

Cardiac fibroblasts (CF) not only modulate extracellular matrix (ECM) proteins homeostasis, but also respond to chemical and mechanical signals. CF express a variety of receptors through which they modulate the proliferation/cell death, autophagy, adhesion, migration, turnover of ECM, expression of cytokines, chemokines, growth factors and differentiation into cardiac myofibroblasts (CMF). Differentiation of CF to CMF involves changes in the expression levels of various receptors, as well as, changes in cell phenotype and their associated functions. CF and CMF express the ß2-adrenergic receptor, and its stimulation activates PKA and EPAC proteins, which differentially modulate the CF and CMF functions mentioned above. CF and CMF also express different levels of Angiotensin II receptors, in particular, AT1R activation increases collagen synthesis and cell proliferation, but its overexpression activates apoptosis. CF and CMF express different levels of B1 and B2 kinin receptors, whose stimulation by their respective agonists activates common signaling transduction pathways that decrease the synthesis and secretion of collagen through nitric oxide and prostacyclin I2 secretion. Besides these classical functions, CF can also participate in the inflammatory response of cardiac repair, through the expression of receptors commonly associated to immune cells such as Toll like receptor 4, NLRP3 and interferon receptor. The activation by their respective agonists modulates the cellular functions already described and the release of cytokines and chemokines. Thus, CF and CMF act as sentinel cells responding to a plethora of stimulus, modifying their own behavior, and that of neighboring cells.

A comparison of the identification of group A streptococci and enterococci by two rapid pyrrolidonyl aminopeptidase methods.

Group A streptococci and enterococci can be differentiated from other streptococci by their ability to cleave L-pyrrolidonyl-beta-napthylamide (PYR). The authors evaluated two pyrrolidonyl aminopeptidase (PYRase) systems--Minitek (BBL Microbiology Systems, Cockeysville, MD) and Identicult-AE (Scott Laboratories, Inc., Fiskeville, RI)--for the presumptive identification of Group A streptococci and enterococci. Eighty-three Group A streptococci, 77 beta-hemolytic non-Group A streptococci, 74 enterococci, 56 nonenterococcal non-beta-hemolytic streptococci, 1 Streptococcus pneumoniae, and 1 Aerococcus were tested. Compared with results obtained with reference methods (bile esculin agar and 6.5% [w/v] sodium chloride for identification of enterococci, and latex agglutination tests by Streptex [Burroughs Wellcome, NC] for grouping of beta-hemolytic streptococci) both the Identicult-AE and MInitek systems were 100% sensitive and specific for identification of both enterococci and Group A beta-hemolytic streptococci. Advantages of the Identicult-AE system compared with Minitek were the use of a smaller inoculum for which subculture was not necessary, incubation at room temperature rather than at 37 degrees C, and lower cost. Both PYRase kits tested, and in particular the Identicult-AE system, were very easy to use and should be considered as rapid, reliable, and cost-effective alternative methods for the presumptive identification of Group A streptococci and enterococci in the clinical laboratory.