Characterization of Microstructure, Optical Properties, and Mechanical Behavior of a Temporary 3D Printing Resin: Impact of Post-Curing Time.

The present study aimed to characterize the microstructure of a temporary 3D printing polymer-based composite material (Resilab Temp), evaluating its optical properties and mechanical behavior according to different post-curing times. For the analysis of the surface microstructure and establishment of the best printing pattern, samples in bar format following ISO 4049 (25 × 10 × 3 mm) were designed in CAD software (Rhinoceros 6.0), printed on a W3D printer (Wilcos), and light-cured in Anycubic Photon for different lengths of time (no post-curing, 16 min, 32 min, and 60 min). For the structural characterization, analyses were carried out using Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscopy (SEM). The mechanical behavior of this polymer-based composite material was determined based on flexural strength tests and Knoop microhardness. Color and translucency analysis were performed using a spectrophotometer (VITA Easy Shade Advanced 4.0), which was then evaluated in CIELab, using gray, black, and white backgrounds. All analyses were performed immediately after making the samples and repeated after thermal aging over two thousand cycles (5-55 °C). The results obtained were statistically analyzed with a significance level of 5%. FT-IR analysis showed about a 46% degree of conversion on the surface and 37% in the center of the resin sample. The flexural strength was higher for the groups polymerized for 32 min and 1 h, while the Knoop microhardness did not show a statistical difference between the groups. Color and translucency analysis also did not show statistical differences between groups. According to all of the analyses carried out in this study, for the evaluated material, a post-polymerization time of 1 h should be suggested to improve the mechanical performance of 3D-printed devices.

Influencia del estrés oxidativo en la evolución de la aterosclerosis carotídea / Influence of oxidative stress on the progression of carotid atherosclerosis

Introducción y objetivo: el estrés oxidativo (EO) ha demostrado clara influencia en el desarrollo de las placas de ateroma por daños provocados en endotelio vascular. El objetivo de este trabajo es realizar un estudio de los principales marcadores de estrés oxidativo en pacientes con enfermedad aterosclerótica de la arteria carótida como signo de vulnerabilidad, analizar la implicación de la situación redox y el estado metabólico mitocondrial en patología aterosclerótica de la arteria carótida y su relación con clínica neurológica. Pacientes y métodos: se estudiaron las placas de ateroma obtenidas de pacientes intervenidos de endarectomía carotídea (asintomáticos y sintomáticos) en el Servicio de Angiología del Hospital Clínico Universitario de Valladolid en el año 2020. Se recogieron variables clínicas y demográficas y la existencia de sintomatología neurológica. Las características anatómicas y hemodinámicas se estudiaron mediante estudio eco Doppler y angiografía mediante tomografía computarizada en el preoperatorio. Se analizaron placas de ateroma como estimadores del grado de peroxidación lipídica que reflejaron el estado redox. Se ha estimado un tamaño muestral de 45 muestras en cada grupo, con una tasa de pérdidas de seguimiento del 5 %. Se estudiaron las diferencias entre los grupos mediante χ2 y la t de Student para determinar relación entre el potencial redox con las características morfológicas de placa de ateroma. Se utilizó el programa estadístico SPSS 27.0, aceptando como significativo un valor p < 0,05. Resultados: las placas de ateroma calcificadas mostraron mayor capacidad antioxidante con respecto a las placas de ateroma no calcificadas en el parámetro ABTS: 2,2-ácino-bis(ácido 3-etilbenzotiazolina-6-sulfónico) (2635,08 frente a 2803,28). La relación es estadísticamente significativa (p = 0,007)...(AU)

Introduction and objective: oxidative Stress (OS) has proven to have a clear impact on the development of atherosclerotic plaques due to the damage it causes to vascular endothelium. The aim of this study is to conduct a research on key oxidative stress markers in patients with carotid artery atherosclerotic disease as a sign of vulnerability, analyze the implications of the redox status and mitochondrial metabolic state in carotid artery atherosclerotic disease, and its relationship with neurological clinical presentation. Patients and methods: atherosclerotic plaques obtained from carotid endarterectomy patients (both asymptomatic and symptomatic) performed the Department of Angiology, Vascular and Endovascular Surgery of Hospital Clinico Universitario de Valladolid, Spain in 2020 will be examined. The clinical-demographic variables and the presence of neurological symptoms will be recorded. Anatomical and hemodynamic characteristics will be studied using Doppler ultrasound and coronary computed tomography angiography (CCTA) preoperatively. Atherosclerotic plaques will be analyzed as estimators of the degree of lipid peroxidation showing the redox state. A sample size of 45 speciments from each group has been estimated with a loss to follow-up rate of 5 %. Inter-group differences will be studied using the chi-square and Student’s t tests to establish the relationship between redox potential and morphological characteristics of the atheromatous plaque. SPSS 27.0 statistical software will be used, with a significance level set at p < 0.05. Results: calcified atherosclerotic plaques showed higher antioxidant capacity compared to non-calcified plaques in the ABTS parameter (2,2-azino-bis(3-ethylbenzthioziozline-6-sulfonic)) (2635.08 vs 2803.28), with statistically significant relationship (p = 0.007). They also exhibited greater antioxidant defense when analyzing catalase activity (160.73 vs 175.13) and SOD activity (1.11 vs 1.49) (p = 0.049)...(AU)

An approach for evaluating the bioavailability and risk assessment of potentially toxic elements using edible and inedible plants-the Remance (Panama) mining area as a model.

Mining affects the environment, particularly through the persistence of accumulation of tailings materials; this is aggravated under tropical climatic conditions, which favours the release of potentially toxic elements (PTEs) bioavailable to the local flora and fauna and supposing a risk to human health. The Remance gold mine (Panamá), exploited intermittently for more than 100 years, and has remained derelict for over 20 years. Within the area live farmers who carry out subsistence agriculture and livestock activities. The objective of this study has been to study the transference of PTEs in the local agricultural soil-plants system, with the goal of identifying their bioavailability to perform a human risk assessment. The results obtained of the Bioaccumulation coefficient in local plants show very weak to strong absorption of As (< 0.001-1.50), Hg (< 0.001-2.38), Sb (0.01-7.83), Cu (0.02-2.89), and Zn (0.06-5.32). In the case of Cu in grass (18.3 mg kg-1) and plants (16.9 mg kg-1) the concentrations exceed the maximum authorised value in animal nutrition for ruminants (10 mg kg-1). The risk to human health for edible plants exceeds the non-carcinogenic risk for rice, corn, cassava, and tea leaves for Sb (HQ 19.450, 18.304, 6.075, 1.830, respectively), the carcinogenic risk for Cu (CR = 2.3 × 10-3, 7.7 × 10 -4, 1.1 × 10-3, 1.0 × 10-3, respectively), and the carcinogenic risk for As in rice, corn and tea leaves (CR = 8 × 10-5, 3 × 10-5, 3 × 10-5, respectively). Urgent measures are needed to alleviate these effects.

Efeito de diferentes tratamentos de superfície na resistência ao cisalhamento entre uma resina nanohíbrida para impressão 3D e cimento resinoso / Effect of different surface treatments on the shear strength between a nanohybrid resin for 3D printing and resin cement

O objetivo deste trabalho foi avaliar a resistência de união entre uma resina nanohíbrida para impressão 3D com cimento resinoso após diferentes tratamentos de superfície e envelhecimento. Foram fabricados 120 blocos da resina nanohíbrida (Nanolab 3D, Wilcos do Brasil) em tamanhos de 10 x 8 x 2 mm, desenhados no software Rhinoceros 7 e depois impressos (W3D PRINT, Wilcos do Brasil) por método digital de processamento de luz (LCD). Foram produzidos também blocos de mesmo tamanho obtidos a partir de blocos de CAD/CAM de uma resina híbrida (Hybrid, Blue Dent), como grupo controle. Cinco tratamentos de superfície foram realizados nos blocos de resina: nenhum tratamento, condicionamento ácido com ácido fluorídrico, jateamento com Al3O2, imersão em monômero de metilmetacrilato (primer) e um grupo somando o jateamento com imersão em primer. Foram construídos cilindros (< 1 mm2) de cimento resinoso convencional dual sobre as superfícies tratadas com auxílio de matriz de silicone. A resistência de união foi medida usando uma máquina de ensaio universal e um teste de microcisalhamento com fio. Metade das amostras de cada grupo foram testadas sete dias após a cimentação, já a outra metade foi termociclada por 12.000 ciclos térmicos (5-55 ºC, 30 segundos cada) e ensaiadas a seguir. Os modos de falha foram analisados por um estereomicroscópio e imagens representativas foram realizadas com o auxílio do microscópio eletrônico de varredura. Após a análise inferencial com ANOVA 3-fatores foi possível observar que houve diferença estatisticamente significante tanto para os fatores material, tratamento de superfície e envelhecimento isoladamente, como para as interações entre eles. A resina híbrida de impressão mostrou maior resistência de união quando comparada com os blocos CAD/CAM. A ciclagem térmica aumentou a resistência de união das resinas impressas e diminuiu a mesma nos blocos de CAD/CAM. É possível concluir que a aplicação de silano é o melhor tratamento de superfície para as resinas de impressão 3D já que proporcionou bons valores de resistência de união e confiabilidade da interface adesiva. A resistência adesiva a longo prazo da resina híbrida de impressão 3D (Nanolab) é influenciada positivamente pelo envelhecimento (AU)

The objective of this work was to evaluate the bond strength between a nanohybrid resin for 3D printing with resin cement after different surface treatments and aging. 120 blocks of nanohybrid resin (Nanolab 3D, Wilcos do Brasil) were manufactured in sizes of 10 x 8 x 2 mm, designed in the Rhinoceros 7 software and then printed (W3D PRINT, Wilcos do Brasil) by digital light processing method (LCD ). Blocks of the same size obtained from CAD/CAM blocks of a hybrid resin (Hybrid, Blue Dent) were also produced as a control group. Five surface treatments were performed on the resin blocks: no treatment, acid etching with hydrofluoric acid, sandblasting with Al3O2, immersion in methylmethacrylate monomer (primer) and one group adding the sandblasting with immersion in primer. Cylinders (< 1 mm2) of conventional dual resin cement were built on the surfaces treated with the aid of a silicone matrix. Bond strength was measured using a universal testing machine and a wire microshear test. Half of the samples from each group were tested seven days after cementation, while the other half was thermocycled through 12,000 thermal cycles (5-55 ºC, 30 seconds each) and then tested. Failure modes were analyzed using a stereomicroscope and representative images were taken using a scanning electron microscope. After the inferential analysis with 3-way ANOVA, it was possible to observe that there was a statistically significant difference both for the material, surface treatment and aging factors alone, as well as for the interactions between them. The hybrid impression resin showed higher bond strength when compared to the CAD/CAM blocks. Thermal cycling increased the bond strength of printed resins and decreased it in CAD/CAM blocks. It is possible to conclude that silane application is the best surface treatment for 3D printing resins as it provided good bond strength values and reliability of the adhesive interface. The long-term adhesive strength of the 3D printing hybrid resin (Nanolab) is positively influenced by aging. (AU)

Impulsivity, Emotion Regulation, Cognitive Distortions and Attentional Bias in a Spanish Sample of Gambling Disorder Patients: Comparison between Online and Land-Based Gambling.

Several risk factors have been related to the onset and maintenance of gambling disorder (GD). The aim of this study was to explore the differences in emotion dysregulation, impulsivity, cognitive distortions, and attentional bias between online and land-based gamblers. The sample consisted of 88 treatment-seeking patients from the Behavioral Addictions Unit at the Hospital de la Santa Creu i Sant Pau, Barcelona (Spain). Patients were divided into two groups by considering their main type of gambling, i.e., online (n = 26) and land-based gambling (n = 62). Online gamblers were younger, more often employed, with a higher educational level than land-based gamblers. Regarding the rest of the variables, statistically significant differences were only found in Positive Urgency, one of the UPPS-P subscales, in which the land-based gambling group scored higher than the online gambling group. In this exploratory study, individuals with online and land-based GD phenotypes did not differ either in difficulties in emotion regulation or in attentional and cognitive biases. However, land-based GD patients showed a higher tendency to succumb to strong impulses under the influence of positive emotions. These preliminary findings warrant the need to continue investigating GD phenotypes in larger patient samples.

SARS-CoV-2 reinfection with a virus harboring mutation in the Spike and the Nucleocapsid proteins in Panama.

We report a case of reinfection by SARS-CoV-2 with the second virus harboring amino acid changes in the Spike protein (141-143del, D215A, ins215AGY, L452R, D614G), orf1a, helicase, orf3a, and Nucleocapside. The virus associated with the reinfection, from an endemic lineage containing the S:L452R immune escape mutation, was circulating in Panama at the time.

Neuromuscular blockade management and postoperative outcomes in enhanced recovery colorectal surgery: secondary analysis of POWER trial.

BACKGROUND: We evaluated the impact of neuromuscular blockade (NMB) management, monitoring and reversal on postoperative outcomes in colorectal surgical patients included in an enhanced recovery program. METHODS: We performed a predefined analysis in 2084 patients undergoing elective colorectal surgery who participated in POWER study. We analyzed them for complications, length of hospital stay and mortality. Two groups were defined: 1) monitoring + reversal of the neuromuscular blockade (M+R) group: all patients receiving neuromuscular blockade monitoring plus reversal of it with any drug (neostigmine or sugammadex) were included; and 2) no monitoring nor reversal (noM+noR) group. In this group all the patients who did not receive monitoring and reversal of the neuromuscular blockade were allocated. RESULTS: Multivariate analysis found no statistically significant differences in moderate-severe complications (174 [25.7%] vs. 124 [27.1%]; P=0.607), length of hospital stay (10.8±11.1 vs. 11.0 ±12.6 days; P=0.683) and mortality (6 [0.9%] vs. 5 [1.1%]; P=0.840) between the group receiving optimal neuromuscular management (M+R) and the one did not receive it (noM+noR). Univariate analysis showed patients reversed with neostigmine died more than those reversed with sugammadex (3 [2.7%] vs. 3 [0.5%]; P=0.048). CONCLUSIONS: Our data suggest optimal neuromuscular blockade management in colorectal surgery is not associated with less moderate-severe complications, length of hospital stay or death during postoperative period in an enhanced recovery program. Neostigmine reversal seems to be linked to higher rate of mortality than sugammadex.

Fluctuating neurological symptoms: should I call the neurologist or the hematologist?

Objectives: The objective of this study was to highlight the role of the clinical laboratory and the relevance of reporting the case immediately to the unit of hematology for the diagnosis and early administration of treatment in the presence of such an urgent hematologic disease as thrombotic thrombocytopenic purpura (TTP). Case presentation: An elderly patient was referred to the emergency department of our hospital by his general practitioner for speech difficulty, facial asymmetry and weakness in the upper limb. Stroke code was activated. However, laboratory findings (anemia, thrombocytopenia, elevated creatinine, total bilirubin and LDH, negative direct Coombs test) and presence of schistocytes in the peripheral blood smear test were consistent with a completely different diagnosis: TTP thrombotic microangiopathy. Conclusions: The first diagnostic approach of left hemispheric stroke was not confirmed in the laboratory, with findings of nonautoimmune hemolytic anemia, thrombocytopenia without apparent cause and presence of schistocytes. We should not forget that the clinical manifestations of this condition are widely variable and may include multiorganic dysfunction. Although confirmation of diagnosis is based on ADAMTS-13, its associated high mortalitiy requires immediate treatment on mere suspicion.

Clínica neurológica fluctuante: ¿Llamo al neurólogo o al hematólogo?

Objetivos: Resaltar el papel del laboratorio clínico y la pronta comunicación con el servicio de Hematología en el diagnóstico y la rapidez en la instauración del tratamiento de una patología hematológica tan urgente como la Púrpura Trombótica Trombocitopénica (PTT). Caso clínico: Varón de edad avanzada derivado a Urgencias hospitalarias por su médico de Atención Primaria por trastorno de emisión del lenguaje, asimetría facial y disminución de fuerza en extremidad superior, por lo que se activa el código ictus. Sin embargo, los hallazgos de laboratorio (anemia y trombocitopenia, creatinina, bilirrubina total y LDH elevadas, test de Coombs directo negativo) y presencia de esquistocitos en el frotis de sangre periférica, acaban derivando en un diagnóstico completamente diferente: microangiopatía trombótica tipo PTT. Conclusiones: La primera orientación diagnóstica de ictus hemisférico izquierdo fue rechazada ante los signos de anemia hemolítica no autoinmune, trombocitopenia sin causa aparente y presencia de esquistocitos. No debemos olvidar que esta patología puede cursar con afectación multiorgánica y características clínicas muy variables. Aunque su diagnóstico definitivo se basa en la determinación de actividad de ADAMTS-13, debido a la elevada mortalidad es necesario instaurar tratamiento de forma inmediata tras su sospecha.

Fotoféresis extracorpórea y trasplante renal / Extracorporeal photopheresis and renal transplantation

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Nódulo pulmonar solitario como forma de presentación de la criptococosis en el trasplantado renal / Solitary Pulmonary Nodule as a Form of Presentation of Cryptococcosis in a Renal Transplant Recipient

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Metformina y diuréticos / Metformin and diuretics

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Mindfulness-Based Interventions for the Treatment of Substance and Behavioral Addictions: A Systematic Review.

BACKGROUND: Emotion (dys)regulation as well as the interventions for improving these difficulties are receiving a growing attention in the literature. The aim of the present paper was to conduct a systematic review about the efficacy of mindfulness-based interventions (MBIs) in both substance and behavioral addictions (BAs). METHOD: A literature search was conducted using Cochrane, PubMed, and Web of Science. Fifty-four randomized controlled trials published in English since 2009 to April 2017 were included into a narrative synthesis. RESULTS: Mindfulness-based interventions were applied in a wide range of addictions, including substance use disorders (from smoking to alcohol, among others) and BAs (namely, gambling disorder). These treatments were successful for reducing dependence, craving, and other addiction-related symptoms by also improving mood state and emotion dysregulation. The most commonly used MBI approaches were as follows: Mindfulness-Based Relapse Prevention, Mindfulness Training for Smokers, or Mindfulness-Oriented Recovery Enhancement, and the most frequent control group in the included studies was Treatment as Usual (TAU). The most effective approach was the combination of MBIs with TAU or other active treatments. However, there is a lack of studies showing the maintenance of the effect over time. Therefore, studies with longer follow-ups are needed. CONCLUSION: The revised literature shows support for the effectiveness of the MBIs. Future research should focus on longer follow-up assessments as well as on adolescence and young population, as they are a vulnerable population for developing problems associated with alcohol, drugs, or other addictions.

Benefícios e Nível de Participação na Intervenção Precoce: Perspectivas de Mães de Crianças com Perturbação do Espetro do Autismo / Benefits and Level Of Participation in Early Intervention: Perspectives of Mothers of Children with Autism Spectrum Disorder

RESUMO a Intervenção Precoce (IP) na Perturbação do Espetro do Autismo (PEA) é eficaz quando os profissionais realizam o apoio com base nas práticas centradas na família. Assim, o profissional tem como responsabilidade facilitar e disponibilizar recursos que promovam a participação e o reconhecimento das competências das famílias, para que estas possam alcançar benefícios efetivos resultantes da IP. O presente artigo teve como finalidade analisar e compreender os benefícios do apoio da IP para seis mães de crianças com PEA, de 3 a 6 anos, assim como o tipo de participação que estas mães consideram ter no processo de apoio da IP. Neste sentido, foram definidos os seguintes objetivos de investigação: 1) analisar e compreender o nível de participação das mães nos diferentes momentos do processo de apoio (planificação e intervenção) e 2) analisar e compreender os benefícios do apoio da IP. A metodologia utilizada foi de natureza qualitativa, o instrumento de recolha de dados utilizado foi a entrevista semiestruturada e a técnica de análise de dados foi a análise de conteúdo. Os resultados globais deste estudo permitem-nos concluir que: todas as participantes consideraram obter benefícios da IP nas diversas áreas de desenvolvimento dos seus filhos. Grande parte das entrevistadas sente-se satisfeitas com os apoios, são informadas sobre seus direitos e possuem uma relação positiva com as profissionais. As famílias que participaram na elaboração do Plano Individual de Intervenção Precoce identificaram não só os seus objetivos e preocupações, como também participaram na implementação do Plano nos seus contextos naturais.

ABSTRACT Early Intervention (EI) in the Autism Spectrum Disorder (ASD) is effective when professionals perform it based on family-centered practices. Thus, the professional has the responsibility to facilitate and provide resources to promote the participation and recognition of the skills of families, so that they can achieve effective benefits of EI. The purpose of the present article was to analyze and understand the benefits of EI support for six mothers of children with ASD, aged 3 to 6 years, as well as the type of participation that these mothers consider having in the EI support process. In this sense, the following research objectives were defined: 1) To analyze and understand the level of participation of mothers in different phases of the support process (planning and intervention); 2) To analyze and understand the benefits of EI support. The methodology was qualitative, the data collection instrument was a semi-structured interview and data analysis technique was content analysis. The overall results of this study allow us to conclude that: all participants considered they obtained EI benefits in various areas of development of their children. Most of the women felt satisfied with the support, they are informed about their rights and have a positive relationship/interaction with the case-management professionals. Families who participated in the Individualized Family Service Plan identified not only their goals, concerns and priorities, but also participated in the implementation of the Plan in their natural contexts.

Peritonitis por Shewanella putrefaciens: a propósito de un caso / Peritonitis by Shewanella putrefaciens: Apropos of a case

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