Efficacy of Continuous vs. Intermittent Administration of Cefepime in Adult ICU Patients with Gram-Negative Bacilli Bacteremia: A Randomized Double-Blind Clinical Study.

INTRODUCTION: The objective of this study was to compare the continuous infusion of cefepime with the intermittent infusion in patients with sepsis caused by Gram-negative bacilli (GNB). METHODS: Randomized 1:1 multicenter double-blinded placebo-controlled study with allocation concealment; multicenter study in the intensive care units of Colombia. Patients with sepsis, severe sepsis or septic shock, and GNB-suspected bacteremia. Cefepime was administered for 7 to 14 days over 30 m intermittently every 8 h over 24 h plus continuous saline solution (0.9%) (G1) or 3 g administered continuously plus saline solution every 8 h (0.9%) (G2). The percentage of clinical response at 3, 7, and 14 days, relapse at 28 days, and mortality at discharge were measured. RESULTS: The recruitment was stopped at the suggestion of the Institutional Review Board (IRB) following an FDA alert about cefepime. Thirty-two patients were randomized; 25 received the intervention, and GNB bacteremia was confirmed in 16 (9 G1 and 7 G2). Favorable clinical response in days 3, 7, and 14 was 88.8%, 88.8%, and 77.8% (G1) and was similar for G2 (85.7%). There were no relapses or deaths in G2, while in G1, one relapse and two deaths were observed. CONCLUSIONS: The results of this study support the use of cefepime for the treatment of Gram-negative infections in critically ill patients, but we could not demonstrate differences between continuous or intermittent administration because of the small sample size, given the early suspension of the study.

Disminución de la debilidad muscular adquirida en una unidad de cuidados intensivos con la implementación de un protocolo multicomponente: ensayo clínico cuasiexperimental

Introducción. La debilidad adquirida en las unidades de cuidados intensivos es una complicación frecuente de los pacientes con enfermedades críticas, que puede tener un impacto negativo en su pronóstico a corto y a largo plazo. Objetivos. Evaluar si la utilización de un protocolo multicomponente, que incluye movilidad activa temprana, manejo efectivo del dolor, reducción de la sedación, medidas no farmacológicas para prevenir el delirium, estimulación cognitiva y apoyo familiar, puede disminuir la incidencia de debilidad adquirida en las unidades de cuidados intensivos al momento del egreso del paciente. Materiales y métodos. Se trata de un ensayo clínico, no aleatorizado, en dos unidades de cuidados intensivos mixtas de un hospital de tercer nivel. Los participantes fueron pacientes mayores de 14 años con ventilación mecánica invasiva por más de 48 horas. Se aplicó como intervención un protocolo multicomponente y como control se utilizó el cuidado usual o estándar. Resultados. Ingresaron 188 pacientes al estudio, 82 al grupo de intervención y 106 al grupo control. La tasa de debilidad adquirida en las unidades de cuidados intensivos al egreso de la unidad fue significativamente menor en el grupo de intervención (41,3 % versus 78,9 %, p<0,00001). La mediana del puntaje de movilidad al momento del alta de la unidad de cuidados intensivos fue mayor en el grupo de intervención (3,5 versus 2, p<0,0138). No se encontraron diferencias estadísticamente significativas en las medianas de días libres de respiración mecánica asistida, ni de unidad de cuidados intensivos al día 28, tampoco en la tasa de mortalidad general al egreso del hospital (18 versus 15 días, p<0,49; 18,2 % versus 27,3 %, p<0,167). Conclusiones. Un protocolo multicomponente que incluía movilidad activa temprana tuvo un impacto significativo en la reducción de la debilidad adquirida en las unidades de cuidados intensivos al egreso en comparación con el cuidado estándar.

Introduction. Intensive care unit-acquired weakness is a frequent complication that affects the prognosis of critical illness during hospital stay and after hospital discharge. Objectives. To determine if a multicomponent protocol of early active mobility involving adequate pain control, non-sedation, non-pharmacologic delirium prevention, cognitive stimulation, and family support, reduces intensive care unit-acquired weakness at the moment of discharge. Materials and methods. We carried out a non-randomized clinical trial in two mixed intensive care units in a high-complexity hospital, including patients over 14 years old with invasive mechanical ventilation for more than 48 hours. We compared the intervention -the multicomponent protocol- during intensive care hospitalization versus the standard care. Results. We analyzed 82 patients in the intervention group and 106 in the control group. Muscle weakness acquired in the intensive care unit at the moment of discharge was less frequent in the intervention group (41.3% versus 78.9%, p<0.00001). The mobility score at intensive unit care discharge was better in the intervention group (median = 3.5 versus 2, p < 0.0138). There were no statistically significant differences in the invasive mechanical ventilation-free days at day 28 (18 versus 15 days, p<0.49), and neither in the mortality (18.2 versus 27.3%, p<0.167). Conclusion. A multi-component protocol of early active mobility significantly reduces intensive care unit-acquired muscle weakness at the moment of discharge.

Decrease in the intensive care unit-acquired weakness with a multicomponent protocol implementation: A quasi-experimental clinical trial / Disminución de la debilidad muscular adquirida en una unidad de cuidados intensivos con la implementación de un protocolo multicomponente: ensayo clínico cuasiexperimental

Introduction: Intensive care unit-acquired weakness is a frequent complication that affects the prognosis of critical illness during hospital stay and after hospital discharge. Objectives: To determine if a multicomponent protocol of early active mobility involving adequate pain control, non-sedation, non-pharmacologic delirium prevention, cognitive stimulation, and family support, reduces intensive care unit-acquired weakness at the moment of discharge. Materials and methods: We carried out a non-randomized clinical trial in two mixed intensive care units in a high-complexity hospital, including patients over 14 years old with invasive mechanical ventilation for more than 48 hours. We compared the intervention ­the multicomponent protocol­ during intensive care hospitalization versus the standard care. Results: We analyzed 82 patients in the intervention group and 106 in the control group. Muscle weakness acquired in the intensive care unit at the moment of discharge was less frequent in the intervention group (41.3% versus 78.9%, p<0.00001). The mobility score at intensive unit care discharge was better in the intervention group (median = 3.5 versus 2, p < 0.0138). There were no statistically significant differences in the invasive mechanical ventilation-free days at day 28 (18 versus 15 days, p<0.49), and neither in the mortality (18.2 versus 27.3%, p<0.167). Conclusion: A multi-component protocol of early active mobility significantly reduces intensive care unit-acquired muscle weakness at the moment of discharge.

Introducción: La debilidad adquirida en las unidades de cuidados intensivos es una complicación frecuente de los pacientes con enfermedades críticas, que puede tener un impacto negativo en su pronóstico a corto y a largo plazo. OBJETIVOS: Evaluar si la utilización de un protocolo multicomponente, que incluye movilidad activa temprana, manejo efectivo del dolor, reducción de la sedación, medidas no farmacológicas para prevenir el delirium, estimulación cognitiva y apoyo familiar, puede disminuir la incidencia de debilidad adquirida en las unidades de cuidados intensivos al momento del egreso del paciente. Materiales y métodos: Se trata de un ensayo clínico, no aleatorizado, en dos unidades de cuidados intensivos mixtas de un hospital de tercer nivel. Los participantes fueron pacientes mayores de 14 años con ventilación mecánica invasiva por más de 48 horas. Se aplicó como intervención un protocolo multicomponente y como control se utilizó el cuidado usual o estándar. RESULTADOS: Ingresaron 188 pacientes al estudio, 82 al grupo de intervención y 106 al grupo control. La tasa de debilidad adquirida en las unidades de cuidados intensivos al egreso de la unidad fue significativamente menor en el grupo de intervención (41,3 % versus 78,9 %, p<0,00001). La mediana del puntaje de movilidad al momento del alta de la unidad de cuidados intensivos fue mayor en el grupo de intervención (3,5 versus 2, p<0,0138). No se encontraron diferencias estadísticamente significativas en las medianas de días libres de respiración mecánica asistida, ni de unidad de cuidados intensivos al día 28, tampoco en la tasa de mortalidad general al egreso del hospital (18 versus 15 días, p<0,49; 18,2 % versus 27,3 %, p<0,167). CONCLUSIONES: Un protocolo multicomponente que incluía movilidad activa temprana tuvo un impacto significativo en la reducción de la debilidad adquirida en las unidades de cuidados intensivos al egreso en comparación con el cuidado estándar.

Mass mortality event in South American sea lions (Otaria flavescens) correlated to highly pathogenic avian influenza (HPAI) H5N1 outbreak in Chile.

In Chile, since January 2023, a sudden and pronounced increase in strandings and mortality has been observed among South American (SA) sea lions (Otaria flavescens), prompting significant concern. Simultaneously, an outbreak of highly pathogenic avian influenza H5N1 (HPAIV H5N1) in avian species has emerged since December 2022. To investigate the cause of this unexpected mortality, we conducted a comprehensive epidemiological and pathologic study. One hundred sixty-nine SA sea lions were sampled to ascertain their HPAIV H5N1 status, and long-term stranding trends from 2009 to 2023 were analyzed. In addition, two animals were necropsied. Remarkably, a significant surge in SA sea lion strandings was observed initiating in January 2023 and peaking in June 2023, with a count of 4,545 stranded and deceased animals. Notably, this surge in mortality correlates geographically with HPAIV outbreaks affecting wild birds. Among 168 sampled SA sea lions, 34 (20%) tested positive for Influenza A virus, and 21 confirmed for HPAIV H5N1 2.3.4.4b clade in tracheal/rectal swab pools. Clinical and pathological evaluations of the two necropsied stranded sea lions revealed prevalent neurological and respiratory signs, including disorientation, tremors, ataxia, and paralysis, as well as acute dyspnea, tachypnea, profuse nasal secretion, and abdominal breathing. The lesions identified in necropsied animals aligned with observed clinical signs. Detection of the virus via immunohistochemistry (IHC) and real-time PCR in the brain and lungs affirmed the findings. The findings provide evidence between the mass mortality occurrences in SA sea lions and HPAIV, strongly indicating a causal relationship. Further studies are needed to better understand the pathogenesis and transmission.

Design, Validation, and Reliability of an Observational Instrument for Technical and Tactical Actions in Singles Badminton.

Technical and tactical actions are decisive in terms of badminton player competitive performance. The main objective of this research was to design, validate, and estimate the reliability of an observational instrument for the analysis of the tactical and technical actions in individual badminton. The process was carried out in four different steps: first, there was a review of the scientific literature and a preliminary list of variables was made; second, a qualitative and quantitative assessment was completed by 10 badminton expert judges; in the third step, the content validity was estimated using Aiken's V coefficient; finally, intra-observer reliability and interobserver reliability were tested by two observers specialized in badminton using the Cohen's Kappa coefficient and the intraclass correlation coefficient. Strokes were used as the unit of measure by our observational instrument; every time badminton players hit the shuttlecock, 22 variables (eight contextual variables, seven variables related to the result of the match, and seven variables related to the game) are observed. The minimum Aiken's value was 0.58, and reliability was 0.63. In spite of these values, none of the variables had to be removed, but there were modifications in terms of drafting in some of them. The main findings confirmed the validity and the usefulness of this instrument.

Política pública transcultural y factores no adherentes al TARGA del VIH-sida etnia Perú-Amazónica Kusu Pagata / Cross-cultural public policy and factors not adherent to HIV-aids HAART-Peru-Amazon ethnic group Kusu Pagata

Introducción: Uno de los problemas que afecta los pueblos indígenas latinoamericanos es la falta de datos epidemiológicos respecto a la prevalencia del VIH-sida, debido a que los sistemas de información y vigilancia no registran la variable etnicidad. Objetivo: Proponer una política pública transcultural para prevenir factores asociados a la no adherencia a la terapia antirretroviral de gran actividad del VIH-Sida de la etnia Amazónica Kusu Pagata. Métodos: Estudio descriptivo, transversal, con 18 pobladores diagnosticados de VIH-sida en la comunidad Kusu Pagata, Perú. 2018-2019. Se aplicó cuestionario validado por expertos y confiabilidad alfa de Cronbach (0,71). La variable investigada fue factores asociados a la no adherencia a terapia antirretroviral, la propuesta fue una política pública basada en la Teoría de Madeleine Leininger. Se utilizaron estadísticas descriptivas (promedio, desviación estándar) e inferencial (prueba de comparación de promedios para varianzas homogéneas Shapiro-Wilk y prueba F para comparación de varianzas de 1 cola). Resultados: La edad promedio del paciente no adherente al tratamiento fue 21 años, significativamente mayor que la de los adherentes (18,2) años. El 80 por ciento de los que acudieron al curandero fueron no adherentes al tratamiento, el 50 por ciento fueron adherentes y acudieron al establecimiento sanitario. El 64 por ciento consumió tratamientos con productos elaborados con plantas, los que se consideraron no adherentes al tratamiento farmacológico, el 71 por ciento tomó otros tratamientos alternos. Conclusión: Se propuso una política pública transcultural según Teoría de Madeleine Leininger para prevenir factores asociados a la no adherencia a la terapia antirretroviral del VIH-sida de la etnia Amazónica Kusu Pagata(AU)

Introduction: One of the problems affecting Latin American indigenous peoples is the lack of epidemiological data regarding the prevalence of HIV-Aids, due to the fact that the information and surveillance systems do not register the ethnicity variable. Objective: To propose a cross-cultural public policy to prevent factors associated with non-adherence to highly active antiretroviral therapy for HIV-Aids of the Amazon Kusu Pagata ethnic group. Methods: Descriptive, cross-sectional study with 18 residents diagnosed with HIV-Aids in the Kusu Pagata community, Peru. 2018-2019. An expertly validated questionnaire and Cronbach's alpha reliability (0.71) were applied. The variable investigated was factors associated with non-adherence to antiretroviral therapy; the proposal was a public policy based on the Theory of Madeleine Leininger. Descriptive (mean, standard deviation) and inferential statistics (means comparison test for homogeneous Shapiro - Wilk variances and F-test for comparison of 1-tail variances) were used. Results: The average age of the patient not adherent to the treatment was 21 years, significantly higher than that of the adherents (18.2) years. 80.00 percent of those who went to the healer were non-adherent to the treatment, 50.00 percent were adherent and went to the health facility. 64.00 percent consumed treatments with products made with plants, those who were considered non-adherent to the pharmacological treatment, 71.00 percent took other alternative treatments. Conclusion: A cross-cultural public policy was proposed according to Madeleine Leininger's Theory to prevent factors associated with non-adherence to antiretroviral therapy for HIV-AIDS of the Amazon Kusu Pagata ethnic group(AU)

Effect of Scaling Task Constraints on the Learning Processes of Under-11 Badminton Players during Match-Play.

Scaling equipment and the playing space according to junior badminton players' characteristics and needs is a key aspect to design optimal learning environments. The purpose of the study is to analyze the incidence of reducing the court size (from 13.40 m × 5.18 m to 11.88 m × 5.18 m) and net height (from 1.55 m to 1.30 m) for under-11 badminton players on the following technical and tactical variables: (a) service area; (b) stroke effectiveness; (c) kinds of technical strokes; (d) players' hitting area; (e) shuttle landing area; (f) shuttle flight; and (g) rally length. Twenty-eight badminton players (mean age of players: 9.81 ± 0.93) were selected and played a badminton competition (B) with the current federative rules and a mini-badminton competition (MB) with the altered net height and court dimensions. The results showed that a lower net height and a shorter court would increase the frequency and variability of strokes and play patterns, introducing quantifiable changes considered beneficial for children in their first stages, both in training and competition.

A Low-Cost Visible Light Positioning System for Indoor Positioning.

Currently, a high percentage of the world's population lives in urban areas, and this proportion will increase in the coming decades. In this context, indoor positioning systems (IPSs) have been a topic of great interest for researchers. On the other hand, Visible Light Communication (VLC) systems have advantages over RF technologies; for instance, they do not need satellite signals or the absence of electromagnetic interference to achieve positioning. Nowadays, in the context of Indoor Positioning (IPS), Visible Light Positioning (VLP) systems have become a strong alternative to RF-based systems, allowing the reduction in costs and time to market. This paper shows a low cost VLP solution for indoor systems. This includes multiple programmable beacons and a receiver which can be plugged to a smartphone running a specific app. The position information will be quickly and securely available through the interchange between the receiver and any configurable LED-beacon which is strategically disposed in an area. The implementation is simple, inexpensive, and no direct communication with any data server is required.

Descompresión suboccipital percutánea como alternativa en el tratamiento del dolor secundario a la neuralgia del nervio occipital: serie de casos / Suboccipital decompression as an alternative in the treatment of pain secundary to occipital neuralgia: a case series

INTRODUCCIÓN: La neuralgia occipital es una entidad con componentes bien definidos, pero ocasionalmente subdiagnosticada, que tiende a mantener un comportamiento insidioso y generar cierta resistencia al tratamiento médico, manteniendo una buena respuesta al manejo intervencionista con un mínimo índice de complicaciones asociadas y un alivio del dolor satisfactorio y prolongado. DESCRIPCIÓN DEL CASO: Presentamos 5 casos de pacientes con criterios definidos para neuralgia occipital por la (IHS), los cuales fueron manejados mediante descompresión suboccipital percutánea, evaluados por la escala numérica análoga y escala verbal análoga durante un periodo de 90 días. Los procedimientos se realizaron sin complicaciones ni eventos adversos. El resultado fue un alivio satisfactorio para el paciente del dolor crónico, con una adecuada especificidad del sitio del padecimiento, así como mejoría en la calidad de vida, el estado de ánimo, el consumo de medicamentos y la satisfacción de la paciente. CONCLUSIONES: Consideramos que el uso de la descompresión percutánea del nervio occipital mayor vía suboccipital puede ser tomada como una alternativa en pacientes con neuralgia occipital, con una alta probabilidad de obtener un beneficio analgésico y una baja probabilidad de presentar algún efecto adverso o complicación

INTRODUCTION: Occipital neuralgia is an entity with welldefined components, but occasionally underdiagnosed that tends to maintain insidious behavior and generate some resistance to medical treatment, maintaining a good response to interventional management with a minimum rate of associated complications and pain relief. Satisfactory and prolonged. CASE DESCRIPTION: We present 5 cases of patients with defined criteria for occipital neuralgia by (IHS) which were managed by suboccipital decompression, evaluated by the analog numerical scale and analogous verbal scale over a period of 90 days. The procedures were performed without complications or adverse events. The result was a satisfactory relief for the patient of chronic pain, with adequate specificity of the site of the condition; as well as improvement in the quality of life, mood, medication consumption and patient satisfaction. CONCLUSIONS: We consider that the use of decompression of the major occipital nerve via suboccipital route can be taken as an alternative in patients with occipital neuralgia, with a high probability of obtaining an analgesic benefit and a low probability of presenting some adverse effect or complication

Statistical Differences in Set Analysis in Badminton at the RIO 2016 Olympic Games.

The aim of the present study was to determine statistical differences in a set of badminton competition matches in five different modalities with regard to competition level (Group Phase vs. Eliminatory Phase). Data from 453 sets (125 in men's singles; 108 sets in women's singles; 77 sets in men's doubles; 73 in women's doubles and 70 in mixed doubles) from the RIO 2016 Olympics Games were recorded and classified in two groups of variables to analyze variables related to match (5) and set (15). A descriptive analysis and univariate test (Mann-Whitney U) for non-parametric data were conducted. The results show in men's and women's singles all the variables related to match were higher in the Elimination Phase than in the Group Phase (p < 0.01). In Sets 1 and 3, the longest set duration, rally and average rally were found in the Elimination Phase than Group Stage (p < 0.05). In women's singles, these differences were also recorded in Set 2. For doubles, the results are more stable among groups. Men's doubles had a longer duration of the match and set (sets 1 and set 2) (p < 0.01), and also scored highest for average rally strokes (sets 1 3) (p < 0.05) and shuttles used in the Elimination Phase vs. the Group Phase along the match (p < 0.01). In women's doubles, more shuttles were used in a match in the Elimination than in the Group Phase. Moreover, the same results are established for Set 2, including for average rally. Mixed doubles saw no match going to three sets. However, the greatest differences showed a longer rally and average rally being registered in the Elimination than in the Group Phase. In conclusion, the timing factors of the badminton singles and doubles games were different in the Elimination and Group Phases. This information may help players and coaches prepare and administer different types of workouts or, more specifically, competition schedules adapted to the characteristics of modern badminton.

Health and Body Conditions of Riding School Horses Housed in Groups or Kept in Conventional Tie-Stall/Box Housing.

We compared welfare measures of horses among Swedish riding schools (RS) during winter where horses were kept either in group housing (n = 8) or in tie-stalls/boxes (n = 8), Health data for six previous months were obtained for all horses at each RS from their records. Ten horses per RS were examined, with the exception of one where only 8 horses were examined. Health conditions and body condition score (BCS) using the Henneke scale were recorded and management factors were quantified (health check routines, feeding, housing-related risk factors, time outside). RS-recorded health data (for 327 horses in total) revealed that lameness was the most common issue in both systems. Respiratory problems and colic were significantly more common in tie-stall/box horses. The percentage of horses with respiratory problems (mean ± SEM) was 5.8 ± 1.4 in tie-stall/box systems and 1.1 ± 0.8 in group housing (F = 8.65, p = 0.01). The percentage with colic was 2.38 ± 0.62 in tie-stall/box systems and 0.38 ± 0.26 in group housing (F = 8.62, p = 0.01). Clinical examination of 158 horses revealed 207 conditions in these horses, the most common being minor skin injuries in areas affected by tack (i.e., saddle and bridle, including bit). Such injuries tended to be more prevalent in horses housed in tie-stalls/boxes (1.8 ± 0.6) than in group housing (0.5 ± 0.3) (F=3.14, p = 0.01). BCS was similar between systems (tie-stall/box 6.2 ± 0.1, group 6.3 ± 0.1), but the average BCS exceeded the level that is considered optimal (BCS 4⁻6). In conclusion, we found that Swedish RS horses are generally in good health, particularly when group-housed. However, 25%⁻32% were overweight. Riding schools would thus benefit from having an independent feeding expert performing regular body condition scoring of all horses and advising on feeding regimens.

Non-Contact, Simple Neonatal Monitoring by Photoplethysmography.

This paper presents non-contact vital sign monitoring in neonates, based on image processing, where a standard color camera captures the plethysmographic signal and the heart and breathing rates are processed and estimated online. It is important that the measurements are taken in a non-invasive manner, which is imperceptible to the patient. Currently, many methods have been proposed for non-contact measurement. However, to the best of the authors' knowledge, it has not been possible to identify methods with low computational costs and a high tolerance to artifacts. With the aim of improving contactless measurement results, the proposed method based on the computer vision technique is enhanced to overcome the mentioned drawbacks. The camera is attached to an incubator in the Neonatal Intensive Care Unit and a single area in the neonate's diaphragm is monitored. Several factors are considered in the stages of image acquisition, as well as in the plethysmographic signal formation, pre-filtering and filtering. The pre-filter step uses numerical analysis techniques to reduce the signal offset. The proposed method decouples the breath rate from the frequency of sinus arrhythmia. This separation makes it possible to analyze independently any cardiac and respiratory dysrhythmias. Nine newborns were monitored with our proposed method. A Bland-Altman analysis of the data shows a close correlation of the heart rates measured with the two approaches (correlation coefficient of 0.94 for heart rate (HR) and 0.86 for breath rate (BR)) with an uncertainty of 4.2 bpm for HR and 4.9 for BR (k = 1). The comparison of our method and another non-contact method considered as a standard independent component analysis (ICA) showed lower central processing unit (CPU) usage for our method (75% less CPU usage).

Manejo actual de la endoftalmitis posterior a la cirugía de catarata / Current management of endophtalmitis after the cataract surgery

La endoftalmitis es una complicación grave de la cirugía de cataratas que todos los cirujanos oculares y pacientes se esfuerzan por evitar. La pérdida visual que se produce en una gran proporción de endoftalmitis posoperatorias puede ser de carácter grave e irreversible. Se debe sospechar endoftalmitis aguda ante una disminución brusca de la agudeza visual después de la cirugía de cataratas, normalmente asociada a dolor y signos de inflamación ocular difusa. La sospecha de endoftalmitis es una urgencia médica que se ha de tratar con antibióticos intravítreos y/o vitrectomía en el menor tiempo posible. Se realizó una búsqueda de los últimos 10 años sobre el tema, su incidencia, las recomendaciones y el manejo preoperatorio en la profilaxis de esta, los signos y síntomas clínicos, los gérmenes que con mayor frecuencia pueden ocasionarla, así como las opciones de tratamiento. Se utilizó la plataforma Infomed, específicamente la Biblioteca Virtual de Salud(AU)

Endophtalmitis is a severe complication of the cataract surgery which all the eye surgeons and patients try to avoid. The visual loss that occurs in a great proportion of postoperative endophthalmitis can be serious and irreversible. One may suspect the existence of acute endophthalmitis when there is sudden reduction of visual acuity after cataract surgery, normally associated to pain and signs of diffuse ocular inflammation. The suspicion of endophthalmitis is a medical urgency that must be treated with intravitreous antibiotics and/or vitrectomy as soon as possible. Information search about this topic in the last ten years, its incidence, recommendations and preoperative management in its prophylaxis, clinical signs and symptoms and the germs that may frequently cause it as well as the treatment options was made in Informed platform, particularly in the Virtual Library of Health(AU)

Manejo actual de la endoftalmitis posterior a la cirugía de catarata / Current management of endophtalmitis after the cataract surgery

La endoftalmitis es una complicación grave de la cirugía de cataratas que todos los cirujanos oculares y pacientes se esfuerzan por evitar. La pérdida visual que se produce en una gran proporción de endoftalmitis posoperatorias puede ser de carácter grave e irreversible. Se debe sospechar endoftalmitis aguda ante una disminución brusca de la agudeza visual después de la cirugía de cataratas, normalmente asociada a dolor y signos de inflamación ocular difusa. La sospecha de endoftalmitis es una urgencia médica que se ha de tratar con antibióticos intravítreos y/o vitrectomía en el menor tiempo posible. Se realizó una búsqueda de los últimos 10 años sobre el tema, su incidencia, las recomendaciones y el manejo preoperatorio en la profilaxis de esta, los signos y síntomas clínicos, los gérmenes que con mayor frecuencia pueden ocasionarla, así como las opciones de tratamiento. Se utilizó la plataforma Infomed, específicamente la Biblioteca Virtual de Salud(AU)

Endophtalmitis is a severe complication of the cataract surgery which all the eye surgeons and patients try to avoid. The visual loss that occurs in a great proportion of postoperative endophthalmitis can be serious and irreversible. One may suspect the existence of acute endophthalmitis when there is sudden reduction of visual acuity after cataract surgery, normally associated to pain and signs of diffuse ocular inflammation. The suspicion of endophthalmitis is a medical urgency that must be treated with intravitreous antibiotics and/or vitrectomy as soon as possible. Information search about this topic in the last ten years, its incidence, recommendations and preoperative management in its prophylaxis, clinical signs and symptoms and the germs that may frequently cause it as well as the treatment options was made in Informed platform, particularly in the Virtual Library of Health(AU)

Desempeño fonético-fonológico en niños con trastorno del espectro autista (TEA) de pre-kínder a tercero básico / Phonetic and phonological performance in children with autism spectrum disorder (ASD) from pre-primary school to third grade

Desde el punto de vista lingüístico, son conocidas las repercusiones del Trastorno del Espectro Autista (TEA) en la comunicación y el lenguaje, sin embargo, existen pocos estudios específicos para el nivel Fonético-Fonológico. El objetivo de este estudio fue analizar el desempeño Fonético-Fonológico de niños con TEA de los niveles pre-kínder, kínder, primero, segundo y tercero básico, mediante el uso de la Clasificación de Ajustes Fonético-Fonológicos del habla infantil (CLAFF). Para ello, se utilizó un enfoque descriptivo transversal y un diseño no probabilístico de tipo consecutivo. Los principales resultados mostraron que los niños con TEA realizan como Ajuste Fonético-Fonológico (AFF) a los rasgos del fonema el Ajuste de Modo y en los AFF a la sílaba, la Síncopa. Además, mediante la prueba de chi-cuadrado se determinó que existía una asociación entre las variables Nivel escolar y Categoría de ajuste. Para investigar más a fondo esta relación, se procedió a realizar un análisis de Regresión Logística Multinomial (RLM), el que reveló que Nivel escolar predice la probabilidad de aparición de AFF que afecten al Rasgo, en oposición a Sílaba, en los niveles estudiados.

From a linguistic standpoint, the consequences of Autism Spectrum Disorder (ASD) in both communication and linguistic skills are relatively well known. However, few studies have been conducted to observe the phonetic and phonemic domain. The aim of this study is to analyse the phonetic and phonemic performance of children with ASD from pre-primary school to third grade. This was accomplished by using the CLAFF, a guideline for classifying phonetic and phonemic adjustments. This study presents a cross-sectional approach and the sample was obtained via a consecutive non-probabilistic model. The main results showed that children with ASD prefer adjustments in manner of articulation and syncope. A Chi-squared analysis revealed a significant statistical association between School grade and Category of adjustment. To further observe this association, a multinomial logistic regression analysis was run, which showed that School grade predicted the probability of occurrence of adjustments that affect phonemic features rather the syllable.

Wireless Temperature Sensor Based on a Nematic Liquid Crystal Cell as Variable Capacitance.

Wireless communication is growing quickly and now allows technologies like the Internet of Things (IoT). It is included in many smart sensors helping to reduce the installation and system costs. These sensors increase flexibility, simplify deployment and address a new set of applications that was previously impossible with a wired approach. In this work, a wireless temperature sensor based on a nematic liquid crystal as variable capacitance is proposed as a proof of concept for potential wearable applications. Performance analysis of the wireless temperature sensor has been carried out and a simple equivalent circuit has been proposed. Sensor prototype has been successfully fabricated and demonstrated as the beginning of new biomedical sensors.

An All-Organic Flexible Visible Light Communication System.

Visible light communication systems can be used in a wide variety of applications, from driving to home automation. The use of wearables can increase the potential applications in indoor systems to send and receive specific and customized information. We have designed and developed a fully organic and flexible Visible Light Communication system using a flexible OLED, a flexible P3HT:PCBM-based organic photodiode (OPD) and flexible PCBs for the emitter and receiver conditioning circuits. We have fabricated and characterized the I-V curve, modulation response and impedance of the flexible OPD. As emitter we have used a commercial flexible organic luminaire with dimensions 99 × 99 × 0.88 mm, and we have characterized its modulation response. All the devices show frequency responses that allow operation over 40 kHz, thus enabling the transmission of high quality audio. Finally, we integrated the emitter and receiver components and its electronic drivers, to build an all-organic flexible VLC system capable of transmitting an audio file in real-time, as a proof of concept of the indoor capabilities of such a system.

Involving victim population in environmentally sustainable strategies: An analysis for post-conflict Colombia.

Environmental objectives tend to receive a push to the background in post-conflict scenarios. On the other hand, the processes displacement and refugee's relocation in post-conflict countries have been associated with different environmental impacts. Currently, Colombia faces a post-conflict scenario, which brings about relevant socio-environmental challenges: it is a mega-biodiverse country, it has millions of displaced people and is one of the most inequitable country in the world. Since there is a gap in post-conflict studies regarding the exploration of victims' involvement in environmental strategies, this paper aims to analyze victims' willingness to participate (WP) in Land Recovery Strategies (LRS) in post-conflict Colombia. This research (1) describes the socio-economic characteristics of forced-displacement victims from a Caribbean municipality of Colombia; (2) analyzes the victims' WP in hypothetical LRS and their preferred type of participation in the project, (3) identifies the way of grouping victims according their WP. Finally, (4) it analyzes the kind of benefits victims would prefer to receive in exchange for their participation in the LRS. Our results made evident that the majority of the consulted victims are willing to participate in LRS by giving up manual work time or in exchange of local ecological knowledge. We also found that the victims' participation in LRS associates to the age of the respondents, and whether they have benefited from government programs previously. Victims would prefer monetary retribution in exchange for their involvement in LRS, which may be explained by their vulnerable socioeconomic conditions. This research also demonstrates that victims with positive WP in LRS are a heterogeneous group. We highlight the need of actively involving women in LRS and other post-conflict projects in order to ensure their wellbeing. The results of this research are valuable, because they put forward the population of victims as an active performer within environmental sustainability.

Reduced schedules of 4CMenB vaccine in infants and catch-up series in children: Immunogenicity and safety results from a randomised open-label phase 3b trial.

BACKGROUND: This study evaluated the immunogenicity and safety of a licensed meningococcal serogroup B vaccine (4CMenB) administered alone according to reduced schedules in infants or catch-up series in children. METHODS: In this open-label, multicentre, phase 3b study (NCT01339923), infants randomised 1:1:1 received 4CMenB: 2+1 doses at 3½-5-11months or 6-8-11months of age, 3+1 doses at ages 2½-3½-5-11months. Children aged 2-10years received 2 catch-up doses administered 2months apart. Immune responses were measured by hSBA assays against 4 strains specific for vaccine components fHbp, NadA, PorA and NHBA. Sufficiency of immune responses was defined in groups with 2+1 doses schedules as a lower limit ≥70% for the 97.5% confidence interval of the percentage of infants with hSBA titres ≥4, 1month post-dose 2 for fHbp, NadA, PorA. Adverse events were collected for 7days post-vaccination; serious adverse events (SAEs) throughout the study. RESULTS: 754 infants and 404 children were enrolled. Post-primary vaccination, 98-100% of infants across all groups developed hSBA titres ≥4 for fHbp, NadA, PorA, and 48-77% for NHBA. Sufficiency of immune responses in infants receiving 2+1 schedules was demonstrated for fHbp, NadA, PorA after 2 doses of 4CMenB, as pre-specified criteria were met. Following receipt of 2 catch-up doses, 95-99% of children developed hSBA titres ≥4 for 4CMenB components. Similar safety profiles were observed across groups. A total of 45 SAEs were reported, 3 of which were related to vaccination. CONCLUSION: Reduced infant schedules and catch-up series in children were immunogenic and safe, having the potential to widen 4CMenB vaccine coverage. FUNDING: GlaxoSmithKline Biologicals SA.

Caracterización clínicoepidemiológica de los pacientes del municipio de Puerto Padre operados de catarata / Clinical and epidemiological characterization of patients of the municipality of Puerto Padre, who underwent cataract surgery

Fundamento: la catarata constituye la causa más frecuente de ceguera prevenible en el municipio de Puerto Padre y en el país, su tratamiento es quirúrgico.Objetivo: caracterizar variables clínico-epidemiológicas en los pacientes operados de catarata atendidos en el hospital Guillermo Domínguez del municipio de Puerto Padre, Las Tunas; de enero de 2005 a diciembre de 2015.Métodos: se realizó un estudio descriptivo, retrospectivo y transversal, de los pacientes atendidos en consulta de oftalmología del referido hospital, sometidos a cirugía de catarata con extracción extracapsular del cristalino (EECC) y colocación del lente intraocular (LIO). La muestra estuvo constituida por 2063 pacientes del municipio que recibieron tratamiento quirúrgico por esta técnica, en el periodo de tiempo ya señalado.Resultados: el grupo de edad más representado fue el de mayores de 60 años, sin un predominio evidente de alguno de los sexos. La enfermedad sistémica que se presentó con mayor frecuencia fue la diabetes mellitus. Las complicaciones fueron poco frecuentes y la que más se presentó fue la ruptura de la cápsulaposterior. Se logró una mejoría de la agudeza visual de más de cuatro líneas en la escala de Snellen. Conclusiones: se caracterizaron variables clínico-epidemiológicas en los pacientes operados de catarata incluidos en este estudio(AU)

Background: cataract is the most frequent cause of preventable blindness in the municipality of Puerto Padre and in the country. Its treatment is surgical.Objective: to characterize the clinical and epidemiological variables in patients operated on for cataract at Guillermo Domínguez Hospital of the municipality of Puerto Padre, Las Tunas, from January 2005 to December 2015.Methods: a descriptive, retrospective and cross-sectional study was carried out with the patients treated at the department of ophthalmology of the hospital herein mentioned, who underwent surgery, with extracapsular cataract extraction (ECCE) and intraocular lens (IOL) implantation. The sample was made up of 2063 patients of the municipality who had surgical treatment with this technique, in the period of time already indicated.Results: the 60 and over age group was the most represented one, without an evident predominance of sex. The most frequent systemic disease was diabetes mellitus. The complications were infrequent and the one mostly presented was the posterior capsule rupture. Improved visual acuity of more than 4 lines on theSnellen scale was achieved.Conclusions: the clinical and epidemiological variables were characterized in the patients operated on for cataract who were included in this study(AU)