Fixed-bed column adsorption modeling using Zr biocomposites for fluoride removal.

This research involved conducting continuous adsorption experiments to assess fluoride elimination from drinking water achieved by utilizing biocomposites created from the peels of oranges and apples, which were impregnated with zirconium (Zr), to form BOP-Zr and BAP-Zr, respectively. The findings from the experimental data indicate that BOP-Zr and BAP-Zr are effective biosorbents with a solid ability to remove fluoride selectively. Additionally, these biosorbents were found to be stable, as they do not release Zr into the treated water. Notably, these environmentally friendly biosorbents are derived from renewable sources and enhance the value of waste materials. The study employed various empirical models, including Bohart-Adamas, Thomas, Yoon-Nelson, BDST, Clark, Yan, and Woolborska, to elucidate the mechanisms and crucial parameters involved in fluoride adsorption within packed bed columns. The Yan model demonstrated the highest correlation among these models, indicating a chemical adsorption process with kinetics following a pseudo-second-order pattern. BOP-Zr and BAP-Zr exhibited a maximum adsorption capacity of 59.3 and 47.5 mg/g, respectively, under a flow rate of 4 mL/min and an inlet fluoride concentration of 25 mg/L. The analysis of mass transfer coefficients revealed that the primary step governing the adsorption procedure was diffusion through pores. Consequently, the study conclusively establishes that BOP-Zr and BAP-Zr biocomposites, originating from lignocellulosic biomass remains, present a practical and competitive choice for eliminating fluoride from water. These materials surpass waste materials in performance and rival more expensive options in efficiency and performance.

Workplace bullying and sexual harassment among general surgery residents in Colombia / Acoso laboral y sexual en residentes de cirugía general en Colombia

INTRODUCTION: Workplace bullying and sexual harassment are concerns among general surgery residents in Colombia. OBJETIVE: To explore the prevalence and impact of workplace bullying and sexual harassment incidents among general surgery residents in Colombia. MATERIALS AND METHODS: This nationwide study was conducted in 2020. Residents selfrated their exposure to workplace bullying and to sexual harassment in the forms of gender harassment, unwanted sexual attention, and sexual coercion. We analyzed demographic variables, perpetrator's characteristics, and differences between victims and non-victims. RESULTS: The study included 302 residents. It found that 49% of general surgery residents in Colombia suffered from workplace bullying and 14.9% experienced sexual harassment. The main forms of sexual harassment were gender harassment (47%) and unwanted sexual attention (47%). Women reported significantly higher rates of being sexually harassed. Surgeons were the main perpetrators of sexual harassment. CONCLUSIONS: Workplace bullying and sexual harassment are frequent events in general surgery residency in Colombia. These findings suggest the need for interventions to improve the educational culture of surgical departments and decrease the prevalence of these behaviors.

Introducción: El acoso laboral y el acoso sexual son preocupaciones en la formación quirúrgica. Objetivo: Exploramos la magnitud de estos problemas entre los residentes de cirugía general en Colombia. Materiales y métodos: se realizó un estudio nacional en junio de 2020. Los residentes autoevaluaron su exposición a la intimidación y el acoso sexual en forma de acoso de género, atención sexual no deseada y coerción sexual. Se analizaron variables demográficas y perpetradores entre víctimas y no víctimas. Resultados: Se incluyeron un total de 302 residentes. Las tasas de acoso laboral y sexual fueron del 49% y 14,9%, respectivamente. Las principales formas de acoso sexual correspondieron al acoso de género (47%) y la atención sexual no deseada (47%). El acoso sexual fue significativamente mayor entre las mujeres. Los cirujanos fueron los principales perpetradores. Conclusiones: El acoso laboral y el acoso sexual son frecuentes en la formación quirúrgica en Colombia. Estos hallazgos conducen a intervenciones para mejorar la cultura educativa de los departamentos quirúrgicos para disminuir la prevalencia de estos comportamientos.

Lignocellulosic Biomass as Sorbent for Fluoride Removal in Drinking Water.

Water supply to millions of people worldwide is of alarmingly poor quality. Supply sources are depleting, whereas demand is increasing. Health problems associated with water consumption exceeding 1.5 mg/L of fluoride are a severe concern for the World Health Organization (WHO). Therefore, it is urgent to research and develop new technologies and innovative materials to achieve partial fluoride reduction in water intended for human consumption. The new alternative technologies must be environmentally friendly and be able to remove fluoride at the lowest possible costs. So, the use of waste from lignocellulosic biomasses provides a promising alternative to commercially inorganic-based adsorbents-published studies present bioadsorbent materials competing with conventional inorganic-based adsorbents satisfactorily. However, it is still necessary to improve the modification methods to enhance the adsorption capacity and selectivity, as well as the reuse cycles of these bioadsorbents.

Síndrome de desgaste profesional en residentes de cirugía: estudio transversal colombiano en 2020 / Professional burnout syndrome in surgical residents: 2020 Colombian cross-sectional study

Introducción. El síndrome de desgaste profesional incluye un estado de agotamiento físico y mental relacionado con las actividades del trabajo. El personal en formación de residencias médicas puede experimentar una salud mental y un rendimiento laboral adverso, con una alta prevalencia del síndrome. El objetivo de este trabajo fue comparar los resultados publicados del desgaste profesional en residentes de cirugía con los obtenidos en el presente estudio. Métodos. Se hizo una encuesta anónima en línea a los residentes de los veinte programas de Cirugía general en Colombia, entre junio y julio del 2020. El desgaste profesional se evaluó con el cuestionario de Maslach Burnout Inventory - Human Services Survey (MBI). Se calcularon las puntuaciones para las subescalas de agotamiento emocional, despersonalización y realización personal, así como la frecuencia del síndrome según las variables demográficas. Resultados. Participaron 302 residentes en el estudio; el 20,2 % presentaron síndrome de desgaste profesional, 43,7 % agotamiento emocional, 23,2 % despersonalización y 45 % baja realización personal. Al comparar el grupo con desgaste frente al grupo sin desgaste, no se encontraron diferencias estadísticamente significativas en las variables demográficas. Conclusiones. Aunque el porcentaje de síndrome de desgaste profesional entre los residentes de Cirugía general en Colombia fue menor al encontrado en otros estudios, es preocupante. Dado su posible impacto en la práctica médica y los resultados en el paciente, es necesario continuar describiendo la aparición del síndrome en el personal en formación, comprender el desarrollo del mismo y, de esta forma, crear intervenciones específicas para controlarlo

Introduction. Burnout syndrome includes a state of physical and mental exhaustion related to work activities. Medical residency trainees, especially surgical specialties, may experience adverse mental health and job performance, with a high prevalence of the syndrome. This work aims to compare the published results of the national and international prevalence of professional burnout in surgical residents, with those obtained in the present study. Methods. A national survey about burnout was carried out in general surgery residents in the twenty active general surgery programs in Colombia, during the period from June to July 2020 through an anonymous online survey. Burnout was assessed with the Maslach Burnout Inventory-Human Services Survey (MBI) questionnaire. Total scores were calculated for the emotional exhaustion, depersonalization, and personal accomplishment subscales, as well as the frequency of the syndrome according to demographic variables. Results. 302 residents participated in the study; 20.2% presented BS, 43.7% presented emotional exhaustion, 23.2% depersonalization and 45% low personal fulfillment. When comparing the group with attrition versus the group without attrition, no statistically significant differences were found in any of the demographic variables. Conclusions. The percentage of burnout among general surgery residents, although lower than that found in other national or international studies, is worrisome. Given the possible impact of this on medical practice and patient outcomes, it is necessary to continue describing the appearance of the syndrome in trainees, understand its development and thus create specific interventions to control it

Zr-Based Biocomposite Materials as an Alternative for Fluoride Removal, Preparation and Characteristics.

The development of biocomposite materials used as adsorbents to remove ions in aqueous media has become an attractive option. The biomasses (base materials) are chemically treated and impregnated with metal cations, becoming competitive for fluoride-capture capacity. In this research, Valence orange (Citrus sinensis) and Red Delicious apple (Malus Domestica) peels were modified by alkaline treatment, carboxylation, and impregnation with zirconium (Zr). These materials were characterized morphologically and structurally to understand the modifications in the treated biomasses and the mechanism of fluoride adsorption. The results show changes in surface area and composition, most notably, an increment in roughness and Zr impregnation of the bioadsorbents. After batch experimentation, the maximum capacity of the materials was determined to be 4.854 and 5.627 mg/g for the orange and apple peel bioadsorbent, respectively, at pH 3.5. The experimental data fitted the Langmuir model, suggesting that chemisorption occurs in monolayers. Finally, the characterization of the bioadsorbents in contact with fluoride allowed the replacement of OH species by fluoride or the formation of hydrogen bonds between them as an adsorption mechanism. Therefore, these bioadsorbents are considered viable and can be studied in a continuous system.

Fundamentos para un currículo nacional en Cirugía General basado en competencia: Consenso Delphi de la División de Educación de la Asociación Colombiana de Cirugía / Foundations for a national competence-based curriculum in General Surgery: Delphi Consensus of the Division of Education of the Colombian Association of Surgery

Frente a los desafíos de la Educación Basada en Competencia, este consenso Delphi de la División de Educación de la Asociación Colombiana de Cirugía informa sobre las mínimas competencias profesionales esperadas del cirujano egresado de los veinte programas de Especialización en Cirugía General en Colombia. Un total de 105 profesores de los programas de especialización evaluaron tres áreas de competencia profesional: 1) atributos profesionales generales del residente durante su formación, 2) competencias prácticas (procedimientos quirúrgicos) que los residentes deben realizar al final de su entrenamiento y 3) Actividades Profesionales Confiables (APC) que los residentes deben ejecutar sin supervisión al final de su entrenamiento. Los resultados informan un alto nivel de consenso en el 100 % los atributos profesionales generales y APC, y del 75 % en diferentes procedimientos quirúrgicos. El consenso abre la puerta para el desarrollo de un currículo nacional de la especialidad y tiene implicaciones para la práctica educativa e investigación futura

Faced with the challenges of Competence-Based Education, this Delphi consensus from the Education Division of the Colombian Association of Surgery reports on the minimum professional competencies expected of the surgeon who graduated from the twenty residency programs in General Surgery in Colombia. A total of 105 professors from the training programs evaluated three areas of professional competence: 1) general professional attributes of the resident during their training, 2) practical skills (surgical procedures) that residents must perform at the end of their training, and 3) Activities Trusted Professionals (APC) that residents must run unsupervised at the end of their training. The results report a high level of consensus in 100% general professional attributes and APC, and 75% in different surgical procedures. The consensus opens the door for the development of a national specialty curriculum and has implications for educational practice and future research

Fundamentos para un currículo nacional en Cirugía General basado en competencia: Consenso Delphi de la División de Educación de la Asociación Colombiana de Cirugía / Foundations for a national competence-based curriculum in General Surgery: Delphi Consensus of the Division of Education of the Colombian Association of Surgery

Frente a los desafíos de la Educación Basada en Competencia, este consenso Delphi de la División de Educación de la Asociación Colombiana de Cirugía informa sobre las mínimas competencias profesionales esperadas del cirujano egresado de los veinte programas de Especialización en Cirugía General en Colombia. Un total de 105 profesores de los programas de especialización evaluaron tres áreas de competencia profesional: 1) atributos profesionales generales del residente durante su formación, 2) competencias prácticas (procedimientos quirúrgicos) que los residentes deben realizar al final de su entrenamiento y 3) Actividades Profesionales Confiables (APC) que los residentes deben ejecutar sin supervisión al final de su entrenamiento. Los resultados informan un alto nivel de consenso en el 100 % los atributos profesionales generales y APC, y del 75 % en diferentes procedimientos quirúrgicos. El consenso abre la puerta para el desarrollo de un currículo nacional de la especialidad y tiene implicaciones para la práctica educativa e investigación futura

Faced with the challenges of Competence-Based Education, this Delphi consensus from the Education Division of the Colombian Association of Surgery reports on the minimum professional competencies expected of the surgeon who graduated from the twenty residency programs in General Surgery in Colombia. A total of 105 professors from the training programs evaluated three areas of professional competence: 1) general professional attributes of the resident during their training, 2) practical skills (surgical procedures) that residents must perform at the end of their training, and 3) Activities Trusted Professionals (APC) that residents must run unsupervised at the end of their training. The results report a high level of consensus in 100% general professional attributes and APC, and 75% in different surgical procedures. The consensus opens the door for the development of a national specialty curriculum and has implications for educational practice and future research

Co-occurrence, possible origin, and health-risk assessment of arsenic and fluoride in drinking water sources in Mexico: Geographical data visualization.

Arsenic and fluoride in drinking water present a significant challenge to public health worldwide. In this study, we analyze the results of one of the largest surveys of drinking water quality in Mexico: 14,058 samples from 3951 sites, collected between January and December 2017. We use these data to identify the distribution and possible origin of arsenic and fluoride in drinking water throughout the country, and to estimate the associated health burden. The highest concentrations appear in alluvial aquifers in arid northern Mexico, where high-silica volcanic rock likely releases both arsenic and fluoride to the groundwater. We find fluoride contamination to be significantly correlated with aridity (Pearson correlation = -0.45, p = 0.0105), and also find a significant difference in fluoride concentrations between arid and humid states (Welch's t-test, p = 0.004). We estimate population exposure by assigning to each town in Mexico the average concentration of any sampling sites within 5 km. Our results show that 56% of the Mexican population lives within 5 km of a sampling site, 3.05 million people are exposed to fluoride above the reference dosage of 0.06 mg/(kg ∗ day), 8.81 million people are exposed to arsenic above the limit of 10 µg/L, and an additional 13,070 lifetime cases of cancer are expected from this arsenic exposure alone. This burden of disease is concentrated in the arid states of north-central Mexico.

Simultaneous removal of fluoride and arsenic from well water by electrocoagulation.

The co-occurrence of fluoride and arsenic in groundwater presents a problem in many, mostly arid, regions of Latin America and the world. These pollutants cause significant health problems and are difficult to remove simultaneously from drinking water. In this study, the electrocoagulation process for the simultaneous removal of fluoride and arsenic was evaluated in well from the state of Durango, Mexico, in order to both solve the local problem and determine how to apply the method generally. Tests were carried out with different times, concentrations, initial pH values, and electric current densities, with iron and aluminum as electrode materials. The removal efficiencies in simultaneous presence were 85.68% for fluoride and approximately 100% for arsenic. The final concentrations for both pollutants were below the drinking water limits established by the World Health Organization (WHO) and Mexican regulations. The optimum conditions of the electrocoagulation process found were a current density of 4.5 mA/cm2, an initial pH of 5, and a treatment time of 15 min, considering initial fluoride and arsenic concentrations of 5 mg/L and 80 µg/L, respectively.

Simultaneous extraction and determination of four different groups of pharmaceuticals in compost using optimized ultrasonic extraction and ultrahigh pressure liquid chromatography-mass spectrometry.

An analytical method for the simultaneous extraction and determination of four different groups of pharmaceuticals in compost from the biodegradation of biological infectious hazardous wastes (BIHW) was developed and successfully validated. Compost samples were spiked with known concentrations of the pharmaceuticals of interest. Ultrasonic extraction with an ethyl acetate and methanol solution (1:1) resulted to be effective for the extraction of eight target compounds. All the compounds were separated in a single gradient run by UHPLC using a Zorbax SB C18 Agilent (2.1×50mm, 1.8µm) column. Analytes were detected and quantified via multiple reaction monitoring (MRM) using an AB SCIEX API-5000TM triple quadrupole with electrospray ionization (ESI) in positive mode. The optimum mobile phase consisted of ammonium formate (2mM, pH 3): MeOH (50:50). Recovery values of the ultrasonic extraction for all compounds were on the order of 87% to 113% with absolute deviations lower than 11%. The limits of detection and quantification for the eight pharmaceuticals were on the order of 0.66ngg(-1) and 2ngg(-1) respectively for all the pharmaceuticals analyzed. These values are lower than those values reported in the literature. Suitable level of linearity, acceptable limits of detection and quantification, good repeatability and inter-day precision, non-ion interference, and low matrix effect resulted from the validation of the analytical method. Implementation of the analytical procedure proposed in this research will contribute in having shorter analysis time and lower costs when working with complex matrices such as compost.

Maternal mortality due to pandemic influenza A H1N1 2009 virus in Colombia.

AIMS: The 2009 H1N1 pandemic illustrated the higher morbidity and mortality from viral infections in peripartum women. We describe clinical features of women who recently died of H1N1 in Colombia. METHODS: This is a case series study that was gathered through a retrospective record review of all maternal H1N1 deaths in the country. The national mortality database of confirmed mortality from H1N1 in pregnancy and up to 42 days after delivery was reviewed during the H1N1 season in 2009. Women with H1N1 infections were confirmed by the laboratory of virology. Demographic, clinical, and laboratory data were reviewed. Statistical analyses were performed and median values of non-parametric data were reported with inter-quartile range (IQR). RESULTS: A total of 23 H1N1 maternal deaths were identified. Eighty-three percent occurred in the third trimester. None of the mothers who died had received influenza vaccination. The median time from symptom onset to the initiation of antiviral treatment was 8.8 days (IQR 5.8-9.8). Five fatalities did not receive any anti-viral therapy. Median PaO2/FiO2 on day 1 was 80 (IQR, 60-98.5). All patients required inotropic support and mechanical ventilation with barotrauma-related complications of mechanical ventilation occurring in 35% of patients. CONCLUSION: In Colombia, none of the women suffering H1N1-related maternal deaths had received vaccination against the disease and most had delayed or had no anti-viral therapy. Given the lack of evidence-based clinical predictors to identify women who are prone to die from H1N1 in pregnancy, following international guidelines for vaccination and initiation of antiviral therapy in suspected cases would likely improve outcomes in developing countries.