High Polymer Molecular Weight Yields Solar Cells with Simultaneously Improved Performance and Thermal Stability.

Simple synthetic routes, high active layer thickness tolerance as well as stable organic solar cells are relentlessly pursued as key enabling traits for the upscaling of organic photovoltaics. Here, the potential to address these issues by tuning donor polymer molecular weight is investigated. Specifically, the focus is on PTQ10, a polymer with low synthetic complexity, with number average molecular weights of 2.4, 6.2, 16.8, 52.9, and 54.4 kDa, in combination with three different non-fullerene acceptors, namely Y6, Y12, and IDIC. Molecular weight, indeed, unlocks a threefold increase in power conversion efficiency for these blends. Importantly, efficiencies above 10% for blade coated devices with thicknesses between 200 and 350 nm for blends incorporating high molecular weight donor are shown. Spectroscopic, GIWAXS and charge carrier mobility data suggest that the strong photocurrent improvement with molecular weight is related to both, improved electronic transport and polymer contribution to exciton generation. Moreover, it is demonstrated that solar cells based on high molecular weight PTQ10 are more thermally stable due to a higher glass transition temperature, thus also improving device stability.

Atypical Rasmussen's Encephalitis.

A three-year-old female patient was admitted to our institution due to subacute fever, intermittent vomiting, persistent bilateral mydriasis after cycloplegia, right central facial palsy, and mild right hemiparesis with hyperreflexia. Brain MRI shows encephalitis in frontal, parietal, insular, and left putamen course and loss of cortical volume and white matter of the entire left hemisphere which are features described in Rasmussen's encephalitis (RE). Therapy with intravenous methylprednisolone bolus was initiated, with adequate clinical response. We consider in this case the diagnosis of atypical RE by imaging criteria in the subacute stage. There are few reports of atypical RE without epilepsy or continuous partial epilepsy. Our purpose is to present a case of a patient with RE images without epilepsy seizures and review the diagnostic and therapeutic approach of RE.

Risk factors for cardiovascular diseases during medical academic training.

BACKGROUND: Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality in the world. Previous studies disagree about the prevalence of cardiovascular risk factors (CVRFs) among medical students. OBJECTIVES: Determine the CVRFs prevalence in medical students. Compare the FRCVs percentage from initial and advanced course stages. Evaluate whether the CVRFs percentage was similar to that from population in the same age group, as previously described in another studies. METHOD: This is a cross-sectional observational study that evaluated the CVRFs prevalence in medical students using a semi-structured questionnaire, in addition to physical examination and laboratory tests. For statistical analysis, statistical package for the social science software (SPSS, version 22.0) was used. RESULTS: 115 students were evaluated: 74.8%, female; mean age, 22.4±3.1 years. In the general sample was found altered dosages of total cholesterol (27.0%), high density lipoprotein cholesterol (HDL, 5.2%), triglycerides (12.2%), low density lipoprotein cholesterol (LDL, 8.7%), fasting glucose (4.3%), overweight (17.4%), obesity (5.2%), inadequate physical activity (45.2%), family history of cardiovascular disease (44.3%), stress (68.7%), anxiety (83.5%), insomnia (28.7%), sleep deprivation (60.0%), alcohol use (91.3%) and low cardiovascular risk (100.0%). The average score from PSS-14 questionnaire showed greater stress in the basic (27.0±6.7) and clinical cycle (28.3±7.1) and less stress in the internship (22.3±6.4). There was a statistical difference between the clinical cycle and internship (P < 0.05). During internship, there was a lower association between stress and graduation (33.3%), especially when compared to the clinical cycle (75.4%) (P < 0.01; ra=2.9). CONCLUSION: CVRFs exposure and the risk of negative cardiovascular outcomes are lower in medical students when compared to young adult population. Suggestive of medical training contributes to self-care, health promotion, stress reduction and disease prevention, reducing the cardiovascular diseases prevalence, especially in the internship.

Use of complementary and alternative medicine by cancer patients in Colombia.

BACKGROUND: The use of complementary and alternative medicines (CAM) among cancer patients varies greatly. The available data suggest an increasing use of CAM over time and a higher prevalence in low- and middle-income countries. However, no reliable data are available from Latin America. Accordingly, we examined the prevalence of CAM use among cancer patients from six Colombian regions. METHODS: We conducted a survey on cancer patients attending comprehensive cancer centres in six capital cities from different regions. The survey was designed based on a literature review and information gathered through focus groups on CAM terminology in Colombia. Independent random samples of patients from two comprehensive cancer centres in every city were obtained. Patients 18 years and older with a histopathological diagnosis of cancer undergoing active treatment were eligible. The prevalence of CAM use is reported as a percentage with the corresponding confidence interval. CAM types are reported by region. The sociodemographic and clinical characteristics of CAM users and non-users were compared using Chi square and t tests. RESULTS: In total, 3117 patients were recruited. The average age 59.6 years old, and 62.8% were female. The prevalence of CAM use was 51.7%, and compared to non-users, CAM users were younger, more frequently women, affiliated with the health insurance plan for low-income populations and non-Catholic. We found no differences regarding the clinical stage or treatment modality, but CAM users reported more treatment-related side effects. The most frequent types of CAM were herbal products, specific foods and vitamins, and individually, soursop was the most frequently used product. Relevant variability between regions was observed regarding the prevalence and type of CAM used (range: 36.6% to 66.7%). The most frequent reason for using CAM was symptom management (30.5%), followed by curative purposes (19.5%). CONCLUSIONS: The prevalence of CAM use among cancer patients in Colombia is high in general, and variations between regions might be related to differences in cultural backgrounds and access to comprehensive cancer care. The most frequently used CAM products and practices have little scientific support, suggesting the need to enhance integrative oncology research in the country.

Confirmed cases of COVID-19 after vaccination against COVID in health personnel in Bogotá, Colombia.

OBJECTIVE: The present study aims to estimate the frequency of COVID 19 infections in vaccinated health personnel at a Los CObos Medical Center in Bogotá, Colombia. The percentage of people positive to the PCR test and their clinical characteristics were analyzed. METHODS: We performed a cross-sectional study. The primary study variable was the COVID vaccination registry. We analyzed sex, age, signs, and symptoms. Multivariable logistic regression was applied to assess changes over time and to identify variables associated with vaccination in target groups. RESULTS: A cohort of 999 people working at Los Cobos Medical Center and followed from March to August 2021. The average age of this cohort was 37.0 years (devest = 10.5 years), 67.7 % were women. Two hundred eleven physicians, 287 nurses, 305 assistants, and 196 clerks follows. In addition, 8.4 % to be PCR positive after vaccination. The average age was 36.0 (devest = 23.4 years), 59 women and 25 men. Of these, 15 were administrative, 14 were doctors, 29 nurses, and 26 nursing assistants. The vaccination status found that 21.4 % do not vaccinates, 7.1 % were partially vaccinated, and 71.4 % with a complete schedule. When questioned about symptoms in these patients, 4.0 % were symptomatic, and 5.9 % were asymptomatic. CONCLUSIONS: A recent epidemiological study involving 12,364 health workers with a mean age of 38 years quantifies the protection in six months from the vaccine. The presence of antibodies was associated with 83 % protection against active SARS-CoV-2 infection (PCR positivity during the study period), which confirms the existence of protective Immunity at levels comparable to those obtained by the approved vaccines; our study found effectiveness of 92.6 %. Higher than that found in this study, possibly explained by the characteristics of the individuals included.

Enhanced Organic Electrochemical Transistor Performance of Donor-Acceptor Conjugated Polymers Modified with Hybrid Glycol/Ionic Side Chains by Postpolymerization Modification.

Emergent bioelectronic technologies are underpinned by the organic electrochemical transistor (OECT), which employs an electrolyte medium to modulate the conductivity of its organic semiconductor channel. Here we utilize postpolymerization modification (PPM) on a conjugated polymer backbone to directly introduce glycolated or anionic side chains via fluoride displacement. The resulting polymers demonstrated increased volumetric capacitances, with subdued swelling, compared to their parent polymer in p-type enhancement mode OECTs. This increase in capacitance was attributed to their modified side chain configurations enabling cationic charge compensation for thin film electrochemical oxidation, as deduced from electrochemical quartz crystal microbalance measurements. An overall improvement in OECT performance was recorded for the hybrid glycol/ionic polymer compared to the parent, owing to its low swelling and bimodal crystalline orientation as imaged by grazing-incidence wide-angle X-ray scattering, enabling its high charge mobility at 1.02 cm2·V-1·s-1. Compromised device performance was recorded for the fully glycolated derivative compared to the parent, which was linked to its limited face-on stacking, which hindered OECT charge mobility at 0.26 cm2·V-1·s-1, despite its high capacitance. These results highlight the effectiveness of anionic side chain attachment by PPM as a means of increasing the volumetric capacitance of p-type conjugated polymers for OECTs, while retaining solid-state macromolecular properties that facilitate hole transport.

Colombian Adaptation of the Self-Compassion Scale (SCS).

BACKGROUND: Self-Compassion is crucial for assessing how people relate to their suffering in moments of personal difficulty. The objective of this study was to check the psychometric properties of the Self-Compassion Scale (SCS) in a Colombian sample. METHOD: The Spanish version of the SCS was adapted to the Colombian context via a content validity technique. This version was administered to 751 Colombians from the general community. Psychometric analysis was performed using R studio packages. RESULTS: 7 models were tested, the best fit was found for the bifactor ESEM model (χ2/df = 0.86, CFI = 1, TLI= 1, RMSEA= 0.00, SRMR= 0.01). This model produced optimal reliability indices (ωh = 0.83, FD= 0.93, H= 0.96). CONCLUSIONS: The study produced initial psychometric evidence of the structure of the SCS in Colombia, with evidence of a general factor in the bifactor ESEM model. More research is needed to justify the complete usage of the SCS in the country.

Changes in the incidence of acute bacterial meningitis caused by Streptococcus pneumoniae and the implications of serotype replacement in children in Colombia after mass vaccination with PCV10.

Introduction: Acute bacterial meningitis (ABM) is a public health problem. The disease has reemerged after the introduction of pneumococcal conjugate vaccines (PCVs) due to an increase in serotypes that are not covered. The objective was to determine the changes in the disease incidence before and after the introduction of the 10-valent vaccine (PCV10) in Colombia. Methods: This multicenter study was conducted in 17 hospitals in Colombia. Data were collected from January 2008 to December 2019 in 10 hospitals in Bogotá and from January 2017 to December 2019 in seven hospitals in Cali, Medellín and Cartagena. The data were grouped into three periods: 2008-2011, 2012-2015, and 2016-2019. Results: Of the 706 cases of invasive pneumococcal disease, 81 (11.4%) corresponded to meningitis. The relative incidence in Bogotá in the first period was 0.6 per 100,000 patients ≤ 5 years, decreased to 0.4 per 100,000 patients ≤ 5 years in the second period and increased in the third period to 0.7 per 100,000 patients ≤ 5 years. Serotypes covered by PCV10 decreased from 75 to 9.1%, with Spn19A (31.8%) and Spn34 (13.6%) emerging in the third period. Increased resistance to penicillin (13 to 37%) and to ceftriaxone (5.9 to 16%) was due to the emergence of multidrug-resistant Spn19A. The total mortality rate was 23.5% and increased from 12 to 33%. Conclusions: ABM due to pneumococcus has high morbidity and mortality rates. Reemergence of the disease has been observed due to the inclusion of polymerase chain reaction (PCR) for diagnosis and replacement of circulating serotypes after the introduction of PCV10, with an increase in Spn19A, which causes death and exhibits antimicrobial resistance. Continued surveillance is needed.

Colombian Adaptation of the Self-Compassion Scale (SCS) / Adaptación Colombiana de la Escala de Autocompasión (EAC)

Background: Self-Compassion is crucial for assessing how people relate to their suffering in moments of personal difficulty. The objective of this study was to check the psychometric properties of the Self-Compassion Scale (SCS) in a Colombian sample. Method: The Spanish version of the SCS was adapted to the Colombian context via a content validity technique. This version was administered to 751 Colombians from the general community. Psychometric analysis was performed using R studio packages. Results: 7 models were tested, the best fit was found for the bifactor ESEM model (χ2/df = 0.86, CFI = 1, TLI= 1, RMSEA= 0.00, SRMR= 0.01). This model produced optimal reliability indices (ωh = 0.83, FD= 0.93, H= 0.96). Conclusions: The study produced initial psychometric evidence of the structure of the SCS in Colombia, with evidence of a general factor in the bifactor ESEM model. More research is needed to justify the complete usage of the SCS in the country.(AU)

Adaptación Colombiana de la Escala de Autocompasión (EAC). Antecedentes: La Autocompasión es un concepto clave para evaluar la forma en que las personas se relacionan con su sufrimiento en momentos de dificultad personal. El objetivo de este estudio fue verificar las propiedades psicométricas de la Escala de Autocompasión (EAC) en una muestra colombiana. Método: Se adaptó la versión en español de la SCS al contexto colombiano a través de una técnica de validez de contenido. Esta versión fue administrada a 751 colombianos de la comunidad en general. Los análisis psicométricos se realizaron usando diferentes paquetes de R Studio. Resultados: 7 modelos fueron probados, el que mejor ajustó fue el modelo bifactor ESEM (χ2/df = 0.86, CFI = 1, TLI= 1.00, RMSEA= 0.000, SRMR= 0.01). Este modelo obtuvo índices de confiabilidad adecuados (ωh = 0.83, FD= 0.93, H= 0.96). Conclusiones: Se logró obtener una evidencia psicométrica inicial de la estructura del EAC en Colombia, en la cual se obtuvieron pruebas de la existencia de un factor general en el modelo ESEM bifactorial. Es necesario hacer más investigación para justificar completamente el uso del SCS en el país.(AU)

Epidemiological characteristics and serotype distribution of culture-confirmed pediatric pneumococcal pneumonia before and after PCV 10 introduction, a multicenter study in Bogota, Colombia, 2008-2019.

BACKGROUND: Pneumococcal conjugate vaccines (PCVs) have decreased pneumonia in children. Colombia introduced mass vaccination with PCV10 in 2012. METHODS: Cases of pneumococcal pneumonia from 10 hospitals were included. Two periods were compared: pre-PCV10: 2008-2011 and post-PCV10: 2014-2019. The objective was to compare epidemiological and clinical characteristics before and after PCV10 vaccination. RESULTS: A total of 370 cases were included. Serotypes 1 (15, 11.2%) and 14 (33, 24.6%) were the most frequent in the pre-PCV10 period, with only 4 (3%) cases of serotype 19A and 1 case (0.7%) serotype 3. From the pre-PCV10 period to the post-PCV10 period, cases of serotypes 1 (6, 3.1%) and 14 (1, 7.8%) decreased, while cases of serotypes 19A (58, 30.2%), serotype 3 (32, 16.7%) and 6A (7, 3.6%) increased (p < 0.001); complicated pneumonia (CP) increased significantly (13.4% to 31.8%) (p < 0.001); hospitalizations increased from 8 (5.5-15) to 12 (7-22) days (p < 0.001); and the frequency of PICU admission increased from 32.8% to 51.6% (p = 0.001). The use of ampicillin-sulbactam (0.7% to 24%) and ceftriaxone/clindamycin (0.7% to 5.7%) increased in the post-PCV10 period. The duration of empirical antibiotic treatment was 7 (4-11) days in the pre-PCV10 period and increased to 10 (6-17) days (p < 0.001) in the post-PCV10 period. Lethality showed a slight nonsignificant increase (7.5% vs. 9.9%; p = 0.57) in the post-PCV10 period. CONCLUSIONS: PCV10 significantly decreased cases of serotypes 1 and 14, with an increase in cases of serotypes 19A, 3 and 6A, which were the predominant serotypes and had greater severity (e.g., admission to the PICU, CP and more resistance, with an increase in the use of broad-spectrum antibiotics and longer hospitalization) and subsequently included in PCV13. Current data support national and regional evidence on the importance of replacing PCV10 with a higher valence that includes 19A, such as PCV13, with the aim of reducing circulation, particularly of this serotype.

Semi-paracrystallinity in semi-conducting polymers.

Precise determination of structural organization of semi-conducting polymers is of paramount importance for the further development of these materials in organic electronic technologies. Yet, prior characterization of some of the best-performing materials for transistor and photovoltaic applications, which are based on polymers with rigid backbones, often resulted in conundrums in which X-ray scattering and microscopy yielded seemingly contradicting results. Here we solve the paradox by introducing a new structural model, i.e., semi-paracrystalline organization. The model establishes that the microstructure of these materials relies on a dense array of small paracrystalline domains embedded in a more disordered matrix. Thus, the overall structural order relies on two parameters: the novel concept of degree of paracrystallinity (i.e., paracrystalline volume/mass fraction, introduced here for the first time) and the lattice distortion parameter of paracrystalline domains (g-parameter from X-ray scattering). Structural parameters of the model are correlated with long-range charge carrier transport, revealing that charge transport in semi-paracrystalline materials is particularly sensitive to the interconnection of paracrystalline domains.

Emergence of Streptococcus pneumoniae serotype 19A (Spn19A) in the pediatric population in Bogotá, Colombia as the main cause of invasive pneumococcal disease after the introduction of PCV10.

Introduction: With the use of pneumococcal conjugate vaccines(PCV), the behavior of invasive pneumococcal disease(IPD) has changed relative to serotype distribution. The introduction of these vaccines in national immunization programs has reduced the incidence of IPD, with a marked decrease in the circulation of the serotypes included in the vaccine used in each country. However, the subsequent emergence of other serotypes not included in the vaccine, such 19A in case of PCV7 and PCV10, has been documented. Materials and methods: This was case series study (2008-2017) in pediatric patients admitted to 10 hospitals in Bogota who were diagnosed with IPD. It was conducted during the transitional period of implementing the PCV10 vaccine in Colombia in 2012. Cases of bacteremic pneumococcal pneumonia, meningitis, primary bacteremia and osteoarticular infection were included. A descriptive analysis of the demographic, clinical and laboratory variables of patients with IPD by Spn19A, its trend over time, profiles of antimicrobial susceptibility and clinical outcomes was performed. Results: There were 463 cases of IPD, 315(68%) with known serotypes. The prevalence of IPD by Spn19A was 17.7%(56 cases), tending to increase over time. During 2008-2011, the prevalence was 4.4%, and during 2014-2017, it was 32.4%, The most frequent diagnosis was pneumonia(80.4%). In nonmeningeal isolates, 39.6% were not susceptible to penicillin. An increase in the resistance was observed over time. Conclusion: Spn19A is a prevalent cause of IPD in the pediatric population of the analyzed cohort, with an increasing trend of this serotype during the surveillance period after the introduction of PCV10, being the most common serotype identified in recent years.

Risk factors for early childhood caries experience expressed by ICDAS criteria in Anapoima, Colombia: a cross-sectional study.

The aim of this study was to assess whether caries risk, nutritional status, access to dental care and socio-behavioral factors are associated to two caries experience outcome variables using the Epidemiologic International Caries Detection and Assessment System (ICDASepi), which includes initial enamel caries lesions: 1- The presence of ICDAS-epi caries experience (dmf-ICDASepi ≥ 1), and 2- Having an ICDAS-epi caries experience (dmft-ICDASepi) higher than national figures for the same age. The sample included 316 eight- to 71-month-old children from the municipality of Anapoima, Colombia. Assessments included: prevalence and mean of caries experience using the ICDASepi system without compressed air-drying of teeth surfaces (dmf-ICDASepi), caries risk and nutritional status. Caregivers completed an elevenitem questionnaire assessing oral health-related social determinants, practices and quality of life (OHRQoL), and children's access to dental care. Data were analysed using the Wilcoxon-rank-sum test, the test, the Fisher-exact test, and bivariate-linear and non-conditioned logistic-multivariate regression models. Prevalence and mean number of teeth with dmft-ICDASepi were 65. 2% and 3. 5±4. 13, respectively. Nutritional status outside the normal status, lower educational level of caregivers and age were significantly associated with dmf-ICDASepi≥ 1. OHRQoL, access barriers to miss and to attend dental care, operative-treatment or emergency being the reason to attend dental care, high caries risk, and age were significantly associated with a higher-than-national dmft-ICDASepi. The significant associations found between early childhood caries experience and other variables represent oral-health inequalities in early childhood in Anapoima, Colombia.

El objetivo de este estudio fue evaluar en la primera infancia la asociación entre el riesgo de caries, el estado nutricional, el acceso a la consulta odontológica y los factores socio-comportamentales y dos variables de desenlace de experiencia de caries usando el Sistema epidemiológico Internacional de Detección y Valoración de Caries (ICDASepi), que incluye lesiones de caries en el esmalte: 1-La presencia de experiencia de caries ICDAS-epi (ceod-ICDASepi ≥ 1) y, 2- Tener una experiencia de caries ICDASepi (ceod-ICDASepi) mayor que los datos nacionales correspondientes para la misma edad. La muestra fue de 316 niños del municipio de Anapoima, Colombia, de 8 a 71 meses de edad. Las valoraciones incluyeron: prevalencia y promedio de experiencia de caries usando el sistema ICDASepi sin secado de las superficies de los dientes con aire comprimido (dmf-ICDASepi); riesgo de caries y estado nutricional. Los cuidadores respondieron un cuestionario de once ítems que valoraba en relación con salud oral, determinantes sociales, prácticas y calidad de vida y, el acceso de los niños a la consulta odontológica. Los datos fueron analizados con la prueba de suma de rangos de Wilcoxon, la prueba de χ2, la prueba exacta de Fisher y, modelos de regresión logística multivariada tipos bivariantelineal y no condicionada. La prevalencia de experiencia de caries (ceod-ICDASepi) fue de 65. 18% y el promedio de dientes con ceod-ICDASepi de 3. 5 ± 4. 13. El estado nutricional por fuera de rangos de normalidad, el bajo nivel educativo de los cuidadores y la edad se asociaron significativamente con ceo-ICDASepi ≥ 1. Se encontró asociación estadísticamente significativa entre tener un ceod-ICDASepi mayor que el promedio nacional y, calidad de vida relacionada con salud oral, barreras de acceso para perder y asistir a consulta odontológica, tratamiento operatorio o urgencia como motivo de consulta odontológica, alto riesgo de caries y edad. Las asociaciones estadísticamente significativas encontradas en este estudio entre la experiencia de caries de infancia temprana y demás variables representan inequidades en salud oral en la primera infancia en Anapoima, Colombia.

Biofiltration of trimethylamine in biotrickling filter inoculated with Aminobacter aminovorans

Background: Trimethylamine (TMA) is the main responsible for the odor associated with rotting fish and other annoying odors generated in many industrial activities. Biofiltration has proved to be efficient for treating odorous gaseous emissions. The main objective of this work was to determine the removal capacity of TMA of a biotrickling filter inoculated with Aminobacter aminovorans and to evaluate the effect of H2S on its performance. Results: The maximumspecific growth rate ofA. aminovorans in a liquid culture was 0.15 h -1 , witha TMAto biomass yield of 0.10 (g g -1) and a specific consumption rate of 0.062 g·g-1·h-1 . The initial specific consumption rate of TMA was highly influenced by the presence of H2S in liquid culture at concentrations of 20 and 69 ppm in heading space oftheflasks.ABTF inoculatedwithA. aminovorans showedremoval efficiencieshigher than98%ina range ofloading rate of 0.2 to 8 g·m-3·h-1 at empty bed residence time (EBRT) of 85 and 180 s. No effect on the elimination capacity and efficiency was detected when H2S was added at 20 and 50 ppm to the inlet gaseous emission, though the fraction of A. aminovorans measured by qPCR in the biofilm decreased. Conclusions:Abiotrickling filter inoculated with A. aminovorans can remove efficiently the TMA in a gaseous stream. The elimination capacity of TMA can be negatively affected by H2S, but its effect is not notorious when it is forming part of a biofilm, due to its high specific consumption rate of TMA.

Mid-to-far infrared tunable perfect absorption by a sub - λ/100 nanofilm in a fractal phasor resonant cavity.

Integrating an absorbing thin film into a resonant cavity is the most practical way to achieve perfect absorption of light at a selected wavelength in the mid-to-far infrared, as required to target blackbody radiation or molecular fingerprints. The cavity is designed to resonate and enable perfect absorption in the film at the chosen wavelength λ. However, in current state-of-the-art designs, a still large absorbing film thickness (∼λ/50) is needed and tuning the perfect absorption wavelength over a broad range requires changing the cavity materials. Here, we introduce a new resonant cavity concept to achieve perfect absorption of infrared light in much thinner and thus, really nanoscale films, with a broad wavelength tenability by using a single set of cavity materials. It requires a nanofilm with giant refractive index and small extinction coefficient (found in emerging semi-metals, semi-conductors and topological insulators) backed by a transparent spacer and a metal mirror. The nanofilm acts both as absorber and multiple reflector for the internal cavity waves, which after escaping follow a fractal phasor trajectory. This enables a totally destructive optical interference for a nanofilm thickness more than 2 orders of magnitude smaller than λ. With this remarkable effect, we demonstrate angle-insensitive perfect absorption in sub - λ/100 bismuth nanofilms, at a wavelength tunable from 3 to 20 µm.

Risk factors for early childhood caries experience expressed by ICDAS criteria in Anapoima, Colombia: a cross-sectional study / Factores de riesgo de experiencia de caries temprana expresada con criterios ICDAS en niños de Anapoima, Colombia. Estudio de corte transversal

The aim of this study was to assess whether caries risk, nutritional status, access to dental care and sociobehavioral factors are associated to two caries experience outcome variables using the Epidemiologic International Caries Detection and Assessment System (ICDASepi), which includes initial enamel caries lesions: 1The presence of ICDASepi caries experience (dmfICDASepi ≥ 1), and 2Having an ICDASepi caries experience (dmftICDASepi) higher than national figures for the same age. The sample included 316 eightto 71monthold children from the municipality of Anapoima, Colombia. Assessments included: prevalence and mean of caries experience using the ICDASepi system without compressed airdrying of teeth surfaces (dmfICDASepi), caries risk and nutritional status. Caregivers completed an elevenitem questionnaire assessing oral healthrelated social determinants, practices and quality of life (OHRQoL), and children's access to dental care. Data were analysed using the Wilcoxonranksum test, the test, the Fisherexact test, and bivariatelinear and nonconditioned logisticmultivariate regression models. Prevalence and mean number of teeth with dmftICDASepi were 65.2% and 3.5±4.13, respectively. Nutritional status outside the normal status, lower educational level of caregivers and age were significantly associated with dmfICDASepi≥ 1. OHRQoL, access barriers to miss and to attend dental care, operativetreatment or emergency being the reason to attend dental care, high caries risk, and age were significantly associated with a higherthannational dmftICDASepi. The significant associations found between early childhood caries experience and other variables represent oralhealth inequalities in early childhood in Anapoima, Colombia (AU)

El objetivo de este estudio fue evaluar en la primera infancia la asociación entre el riesgo de caries, el estado nutricional, el acceso a la consulta odontológica y los factores sociocomporta mentales y dos variables de desenlace de experiencia de caries usando el Sistema epidemiológico Internacional de Detección y Valoración de Caries (ICDASepi), que incluye lesiones de caries en el esmalte: 1La presencia de experiencia de caries ICDASepi (ceodICDASepi ≥ 1) y, 2Tener una experiencia de caries ICDASepi (ceodICDASepi) mayor que los datos nacionales correspondientes para la misma edad.La muestra fue de 316 niños del municipio de Anapoima, Colombia, de 8 a 71 meses de edad. Las valoraciones incluyeron: prevalencia y promedio de experiencia de caries usando el sistema ICDASepi sin secado de las superficies de los dientes con aire comprimido (dmfICDASepi) ; riesgo de caries y estado nutricional. Los cuidadores respondieron un cuestionario de once ítems que valoraba en relación con salud oral, determinantes sociales, prácticas y calidad de vida y, el acceso de los niños a la consulta odontológica. Los datos fueron analizados con la prueba de suma de rangos de Wilcoxon, la prueba de χ2, la prueba exacta de Fisher y, modelos de regresión logística multivariada tipos bivariantelineal y no condicionada. La prevalencia de experiencia de caries (ceodICDASepi) fue de 65.18% y el promedio de dientes con ceodICDASepi de 3.5 ± 4.13. El estado nutricional por fuera de rangos de normalidad, el bajo nivel educativo de los cuidadores y la edad se asociaron significativamente con ceoICDASepi ≥ 1. Se encontró asociación estadísticamente significativa entre tener un ceodICDASepi mayor que el promedio nacional y, calidad de vida relacionada con salud oral, barreras de acceso para perder y asistir a consulta odontológica, tratamiento operatorio o urgencia como motivo de consulta odontológica, alto riesgo de caries y edad. Las asociaciones estadísticamente significativas encontradas en este estudio entre la experiencia de caries de infancia temprana y demás variables representan inequidades en salud oral en la primera infancia en Anapoima, Colombia (AU)

Caracterización de pacientes fallecidos por enfermedad neumocóccica invasiva en la poblacion infantil de Bogotá, Colombia / Characterization of patients who died of invasive pneumococcal disease in the child population of Bogota, Colombia

Introducción: El Streptococcus pneumoniae (S. pneumoniae), también denominado neumococo, es una de las principales bacterias asociadas a mortalidad en menores de 2 años, con una incidencia de morbimortalidad variable de acuerdo a la demografía y exposición a factores protectores o de riesgo. Objetivo: Caracterizar los pacientes fallecidos por enfermedad neumocóccica invasiva (ENI) entre el 2008-2014 en la población infantil de 8 instituciones de salud en Bogotá, Colombia. Pacientes y método: Estudio observacional descriptivo tipo serie de casos, en pacientes fallecidos por ENI, mayores de 28 días hasta los 18 años, en 8 instituciones de tercer nivel de atención en Bogotá, Colombia. Periodo del estudio del 1 de enero de 2008 al 15 de enero de 2014. Tamaño de la muestra: 239 pacientes. Resultados: Se revisaron 239 casos registrados de ENI, presentando una mortalidad del 7,5% (n = 18). La edad promedio de los pacientes que fallecieron fue de 43,7 meses, con un rango de edad entre 2 y 176 meses (14 años); el 66% de los casos era de sexo masculino. Se identificaron serotipos en 8 pacientes, encontrando: 6A, 6B, 10A, 14, 18C, 23B, 23F, 35B. La presentación clínica más frecuente de los casos de mortalidad fue meningitis con el 33% (6 casos), seguida por bacteriemia sin foco en el 28% (5 casos) y neumonía con el 27% (5 casos). Se presentaron situaciones clínicas combinadas como neumonía y meningitis en el 11% (2 casos). Dos de los pacientes tenían factores de riesgo para ENI claramente documentados (asplenia y enfermedad respiratoria crónica). Conclusiones: La mortalidad por ENI es especialmente alta en los menores de 2 años y en pacientes de sexo masculino, especialmente cuando presenta foco meníngeo (44%). La serotipificación no fue posible en todos los pacientes fallecidos, ya que no se envió la cepa aislada al Instituto Nacional de Salud. Se requiere una vigilancia continua y sistemática para evaluar el impacto de la vacunación y las posibles modificaciones en el patrón de presentación de la enfermedad.

Introduction: Streptococcus pneumoniae (S. pneumoniae), also known as pneumococcus, is one of the main bacteria associated with mortality in children under 2 years of age, with a morbidity and mortality incidence that varies according to demographics and exposure to risk, or protective factors. Objective: To describe the child mortality due to invasive pneumococcal disease (IPD) between 2008 -2014 (6 years), in 8 Medical Centres in Bogotá, Colombia. Patients and method: Descriptive observational case series of patients who died of IPD, aged 28 days to 18 years, in 8 tertiary care institutions in Bogota, Colombia. The study period was from 1 January 2008 to 15 January 2014. Sample size: 239 patients. Results: A total of 239 registered cases of IPD were reviewed, showing a mortality of 8% (n 18). The mean age of patients that died was 43.7 months, with an age range from 2 to 176 months (14 years), with 66% of the cases being male. Serotypes were identified in 8 patients, finding: 6A, 6B, 10A, 14, 18C, 23B, 23F, and 35B. The most common clinical presentation of the cases was meningitis with mortality of 33% (6 cases), followed by bacteraemia without focus in 28% (5 cases), and pneumonia with 27% (5 cases). Combined clinical situations were presented, such as pneumonia and meningitis in 11% (2 cases). Two of the patients had clearly documented risk factors for IPD (asplenia and chronic respiratory disease). Conclusions: IPD mortality is particularly high in children under 2 years in male patients, especially when presented with a meningeal focus (44%). Serotyping was not possible in all patients who died, since no strain isolated was sent to the National Institute of Health. Continuous and systematic vigilance is required to evaluate the impact of vaccination and possible changes in the pattern of presentation of disease.

[Characterization of patients who died of invasive pneumococcal disease in the child population of Bogota, Colombia]. / Caracterización de pacientes fallecidos por enfermedad neumocóccica invasiva en la poblacion infantil de Bogotá, Colombia.

INTRODUCTION: Streptococcus pneumoniae (S. pneumoniae), also known as pneumococcus, is one of the main bacteria associated with mortality in children under 2 years of age, with a morbidity and mortality incidence that varies according to demographics and exposure to risk, or protective factors. OBJECTIVE: To describe the child mortality due to invasive pneumococcal disease (IPD) between 2008 -2014 (6 years), in 8 Medical Centres in Bogotá, Colombia. PATIENTS AND METHOD: Descriptive observational case series of patients who died of IPD, aged 28 days to 18 years, in 8 tertiary care institutions in Bogota, Colombia. The study period was from 1 January 2008 to 15 January 2014. SAMPLE SIZE: 239 patients. RESULTS: A total of 239 registered cases of IPD were reviewed, showing a mortality of 8% (n 18). The mean age of patients that died was 43.7 months, with an age range from 2 to 176 months (14 years), with 66% of the cases being male. Serotypes were identified in 8 patients, finding: 6A, 6B, 10A, 14, 18C, 23B, 23F, and 35B. The most common clinical presentation of the cases was meningitis with mortality of 33% (6 cases), followed by bacteraemia without focus in 28% (5 cases), and pneumonia with 27% (5 cases). Combined clinical situations were presented, such as pneumonia and meningitis in 11% (2 cases). Two of the patients had clearly documented risk factors for IPD (asplenia and chronic respiratory disease). CONCLUSIONS: IPD mortality is particularly high in children under 2 years in male patients, especially when presented with a meningeal focus (44%). Serotyping was not possible in all patients who died, since no strain isolated was sent to the National Institute of Health. Continuous and systematic vigilance is required to evaluate the impact of vaccination and possible changes in the pattern of presentation of disease.

Enfermedades genéticas en una población rural colombiana con discapacidad / Genetic disease in a disabled population from a Colombian rural area

La enfermedad genética, como causa de discapacidad, es un problema de salud real pero subestimado. Aún son insuficientes las intervenciones oportunas y adecuadas en pacientes con discapacidad de origen genético. El objetivo de este estudio fue determinar la prevalencia de enfermedad genética en una población discapacitada del área rural de Anapoima, Colombia. Se evaluaron 35 pacientes con diferentes tipos de discapacidad y sus familias. Los diagnósticos etiológicos de los pacientes se clasificaron en cinco categorías de acuerdo con la carga genética: categoría I (enfermedades monogénicas), II (enfermedades cromosómicas), III (enfermedades multifactoriales), IV (enfermedades con origen desconocido) y V (enfermedades ambientales). Una vez practicados los estudios de genética, se volvieron a clasificar bajo las mismas categorías. Antes de practicar los estudios de genética, las enfermedades se ubicaban, principalmente, en la categoría IV seguida de la II. Al finalizar el estudio, la categoría IV disminuyó y la categoría I aumentó de manera importante. Estos hallazgos evidencian que la anamnesis adecuada, el examen físico, el genograma y los exámenes básicos de genética, contribuyen a la detección de enfermedades genéticas, incluso en niveles de atención de baja complejidad en salud. Se evaluó, además, el grado de cumplimiento de las guías de manejo para síndrome de Down en estos pacientes, siendo inadecuado por cada ítem. El abordaje del paciente en situación de discapacidad requiere, entre otras cosas, la valoración y los estudios genéticos. El conocer la etiología permitirá mejor entendimiento y aceptación del paciente y su familia de su condición, planear estrategias de prevención y tratamiento adecuadas, y mejorar el proceso de toma de decisiones sobre reproducción en la familia.

Genetic diseases are a common cause of disability, but this fact is underestimated. Properly and opportune medical interventions on patients with these diseases are not enough yet. The aim of this study was to determine the prevalence of genetic disease in a disabled population from a Colombian rural area. Thirty five patients and their families with different chronic disabling conditions were evaluated. Each patient was assigned to one of five groups on the basis of the presence or absence of an underlying chronic medical condition and whether that condition had a genetic basis or susceptibility as follows: I category (monogenic diseases), II (chromosomal disorders), III (multifactorial diseases), IV (unknown etiology diseases or acquired disorders without genetic determinant), V (no preexisting chronic medical condition, no genetic disease basis). Once genetic evaluation was performed, the etiologic diagnoses were reclassified according those categories. Before genetic evaluation, the patients were categorized in the IV and II categories. After the genetic evaluation and genetics tests were done, the patients of IV category dropped while patients in I category raised. This demonstrates that right anamnesis, physical exam, complete family history tree and some basic genetics tests are required for proper diagnosis of genetic diseases, even in centers of primary care. We also asses the medical guidelines compliance for the Down syndrome in this population and this was unsatisfactory. Finally, we conclude that establishment of the genetic disease contributes to patients and the families in the understanding of their condition and also promotes better strategies of medical attention, according to the medical needs of this patients, including reproductive assessment.