New Arc Stability Index for Industrial AC Three-Phase Electric Arc Furnaces Based on Acoustic Signals.

This research proposes a new index to evaluate the stability of the melting process, in three-phase electric arc furnaces (EAFs), based on the acoustic signals generated during the different stages of the casting. The proposed stability index is obtained by characterizing the time and frequency domain of the acoustic signals. During EAF monitoring, acoustic signals were acquired using a microphone coupled to an NI USB-9234 acquisition system. To validate the results, the voltage and current signals were measured with the aid of a Circutor AR6 power analyzer for three-phase electrical networks. The results showed that the acoustic signal energy in the frequency range of 1 to 12 kHz can be used as an indicator of the process stability in the EAF. Finally, the validity of the proposed stability index is evaluated from the process characterization using the harmonic distortion analysis methods and the dynamic U-I characteristics of the arc voltage and current signals. The results obtained demonstrated the effectiveness of the proposal and constitute a starting point for advances in the automatic control of the process in the EAF, from the acoustic signals.

Liquid biopsy in clinical outcomes and detection of T790M mutation in metastatic non-small cell lung cancer after progression to EGFR-TKI.

BACKGROUND: Liquid biopsy (LB) is used to detect epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer (NSCLC) and has been demonstrated to have prognostic and predictive value. OBJECTIVE: To associate the rates of EGFR and T790M mutations detected by LB during disease progression after first- or second-generation EGFR-TKIs with clinical characteristics and survival outcomes. METHODS: From January 2018 to December 2021, 295 patients with advanced EGFR mutant (EGFRm) NSCLC treated with first- or second-generation EGFR-TKIs were retrospectively analyzed. LB was collected at the time of progression. The frequency of EGFRT790M mutations, overall survival (OS), and the clinical characteristics associated with LB positivity were determined. RESULTS: The prevalence of EGFRT790M mutation detected using LB was 44%. In patients with negative vs. positive LB, the median OS was 45.0 months vs. 25.0 months (p= 0.0001), respectively. Patients with a T790M mutation receiving osimertinib had a median OS of 44 months (95% CI [33.05-54.99]). Clinical characteristics associated with positive LB at progression extra-thoracic involvement, > 3 metastatic sites, and bone metastases. CONCLUSIONS: Our findings showed that LB positivity was associated with worse survival outcomes and specific clinical characteristics. This study also confirmed the feasibility and detection rate of T790M mutation in a Latin American population.

Prevalence of Mild Cognitive Impairment in Southern Regions of Colombia.

Background: Recent reports suggest that by 2050 there will be an increase of around 310% of cases affected by dementia in Latin American countries. A previous study in a Southern region reported one of the highest prevalences of dementia in Latin America. Objective: To investigate the prevalence of mild cognitive impairment associated with low education, rurality, and demographic characteristics. Methods: A cross-sectional study recruited a community-dwelling sample of 823 adults from rural and urban areas of two Southern provinces of Colombia from 2020-2022. Participants were assessed with a neuropsychological protocol validated in Colombia. To obtain general and region-specific prevalence rates, age, sex, schooling, and socioeconomic level were considered and controlled for. Results: Most of the participants reported low education and socioeconomic level, the participation of women was higher. It was determined that the prevalence of mild cognitive impairment (MCI) was 53.6%, with 56.6% in the province of Caquetá followed by 51.9% in the province of Huila. The amnestic MCI represented 42.6%, the amnestic multi-domain was 39%, the non-amnestic 16.55%, and the non-amnestic multi-domain 1.81%. Our participants reported comorbidities such as diabetes and hypertension. We also observed a relationship between exposure to pesticides and MCI. Conclusions: We observed one of the highest prevalences of MCI in Latin America reported to date. Variables such as age, gender, and education proved risk factors for MCI in the explored regions. Our findings are very much in line with recent studies that highlight the influence of non-canonical risk factors of dementia in underrepresented countries from Latin America.

Longitudinal analysis of cost and dental utilization patterns for older adults in outpatient and long-term care settings in Minnesota.

BACKGROUND: Dental utilization patterns and costs of providing comprehensive oral healthcare for older adults in different settings have not been examined. METHODS: Retrospective longitudinal cohort data from Apple Tree Dental (ATD) were analyzed (N = 1,159 total; 503 outpatients, 656 long-term care residents) to describe oral health status at presentation, service utilization patterns, and care costs. Generalized estimating equation (GEE) repeated measures analysis identified significant contributors to service cost over the three-year study period. RESULTS: Cohort mean age was 74 years (range = 55-104); the outpatient (OP) group was younger compared to the long-term care (LTC) group. Half (56%) had Medicaid, 22% had other insurance, and 22% self-paid. Most (72%) had functional dentitions (20+ teeth), 15% had impaired dentitions (9-19 teeth), 6% had severe tooth loss (1-8 teeth), and 7% were edentulous (OP = 2%, LTC = 11%). More in the OP group had functional dentition (83% vs. 63% LTC). The number of appointments declined from 5.0 in Year 1 (OP = 5.7, LTC = 4.4) to 3.3 in Year 3 (OP = 3.6, LTC = 3.0). The average cost to provide dental services was $1,375/year for three years (OP = $1,427, LTC = $1,336), and costs declined each year, from an average of $1,959 (OP = $2,068, LTC = $1,876) in Year 1 to $1,016 (OP = $989, LTC = $1,037) by Year 3. Those with functional dentition at presentation were significantly less costly than those with 1-19 teeth, while edentulous patients demonstrated the lowest cost and utilization. Year in treatment, insurance type, dentition type, and problem-focused first exam were significantly associated with year-over-year cost change in both OP and LTC patients. CONCLUSION: Costs for providing comprehensive dental care in OP and LTC settings were similar, modest, and declined over time. Dentate patients with functional dentition and edentulous patients were less costly to treat. LTC patients had lower utilization than OP patients. Care patterns shifted over time to increased preventive care and decreased restorative care visits.

Retention strategies for health disparities preventive trials: findings from the Early Childhood Caries Collaborating Centers.

OBJECTIVES: To identify successful strategies for retention of participants in multiyear, community-based randomized controlled trials (RCTs) aiming to reduce early childhood caries in health disparities populations from diverse racial/ethnic backgrounds and across diverse geographic settings. METHODS: Four RCTs conducted by the Early Childhood Caries Collaborating Centers (EC4), an initiative of the National Institute of Dental and Craniofacial Research, systematically collected information on the success of various strategies implemented to promote participant retention in each RCT. The observational findings from this case series of four RCTs were tabulated and the strategies rated by study staff. RESULTS: Participant retention at 12 months of follow-up ranged from 52.8 percent to 91.7 percent, and at 24 months ranged from 53.6 percent to 85.9, across the four RCTs. For the three RCTs that had a 36-month follow-up, retention ranged from 53.6 percent to 85.1 percent. Effectiveness of different participant retention strategies varied widely across the RCTs. CONCLUSIONS: Findings from this case series study may help to guide the design of future RCTs to maximize retention of study participants and yield needed data on effective interventions to reduce oral health disparities.

Infusión intravenosa de ketamina a bajas dosis durante cirugía de artrodesis de columna. Una estrategia en el manejo del dolor agudo posoperatorio / Intravenous ketamine infusión at low doses during spinal arthodesis surgery. A strategy in acute postoperative pain management

INTRODUCTION: Acute postoperative pain is a complex problem given the pathophysiological characteristics, increasing health costs and complications and hindering recovery[1],[2]. Spinal arthrodesis is one of the most painful surgical procedures, presenting intense and disabling pain[3],[4]. Multimodal analgesia has been the tool with the best results, based on opioids; however, the combined use of drugs and dependence on opiates are important consequences. Therefore, the analgesic behavior during the use of subanesthetic doses of ketamine is described in the patients undergoing this procedure. METHODOLOGY: A prospective case series study was conducted from January-December 2019, with patients undergoing spinal arthrodesis who met the inclusion criteria, at the Hernando Moncaleano Perdomo University Hospital, Neiva. A univariate statistical analysis of all the variables is performed, with a joint interpretation of the results. RESULTS: A total of 17 patients underwent surgery, one of whom was excluded due to complications related to the surgical material. 88% of the patients showed evaluations of mild or absent pain in at least 4 times, with a number of morphine rescues in 24 hours of 1-2 per patient and patient ambulation in 90% on the first day. CONCLUSIONS. Postoperative spinal arthrodesis patients receiving intravenous ketamine infusion-based analgesia at subanesthetic doses showed mild or absent pain scores at almost all times.

INTRODUCCIÓN: El dolor agudo postoperatorio es un problema complejo dada las características fisiopatológicas, aumentando los costos en salud y las complicaciones y dificultando la recuperación[1],[2]. La artrodesis de columna, es uno de los procedimientos quirúrgicos más dolorosos, presentando un dolor intenso e incapacitante[3],[4]. La analgesia multimodal ha sido la herramienta con mejores resultados, tomando como base los opioides; sin embargo, el uso combinado de fármacos y la dependencia a opiáceos son consecuencias importantes. Por lo anterior, se describe el comportamiento analgésico durante el uso de dosis subanestésicas de ketamina en los pacientes llevados a dicho procedimiento. METODOLOGÍA: Se realiza un estudio tipo serie de casos, prospectivo de enero-diciembre de 2019, con los pacientes llevados a artrodesis de columna que cumplieron con los criterios de inclusión en el Hospital Universitario Hernando Moncaleano Perdomo, Neiva. Se realiza un análisis estadístico univariado de la totalidad de las variables, con una interpretación conjunta de los resultados. RESULTADOS: Se intervinieron un total de 17 pacientes, uno de los cuales fue excluido por complicaciones relacionadas con el material quirúrgico. El 88% de los pacientes mostraron valoraciones de dolor leve o ausente en al menos 4 tiempos, con número de rescates de morfina en 24 h de 1-2 por paciente y deambulación de los pacientes en el 90% en el primer día. CONCLUSIONES: Los pacientes posoperatorios de artrodesis de columna que recibieron analgesia basada en infusión endovenosa de ketamina a dosis subanestésicas mostraron valoraciones de dolor leve o ausente, en casi todos los tiempos.

Embarazo y paternidad juvenil en el departamento del Cesar ¿Y dónde está el padre? / Teen pregnancy and paternity in cesar department: and where is the father?

En el departamento del Cesar, el embarazo juvenil se ha constituido en un fenómeno social que requiere del abordaje desde lo gubernamental y lo académico. Por cuanto se refiere al último aspecto, el presente artículo se convierte en un aporte reflexivo proponiendo que la emergencia de la paternidad juvenil trae consigo la necesidad de abordar las subjetividades y experiencias de estos jóvenes padres, así como los distintos roles, prácticas y actitudes dentro del marco de los significados y las consecuencias que acarrea para el individuo el reconocimiento, aceptación y ejercicio de la paternidad dentro de sus contextos personales, familiares y sociales. Para lo anterior, se propone, una visión ampliada del embarazo juvenil, no reducido únicamente a unas condiciones físicas o meramente biológicas, sino que se inserta dentro la dinámica de otras aristas como la psicológica, jurídica y cultural. Desde este último aspecto, se analiza la emergencia de la paternidad juvenil como un evento significativo, pues por un lado registra socialmente su masculinidad, y por otro lado, redirecciona su proyecto de vida. Así los cambios e implicaciones que el joven debe afrontar a partir de la noticia del embarazo y, posteriormente, con el nacimiento y crianza del hijo/hija, ponen a prueba su resistencia y formación como hombre desde las responsabilidades, la entrada al mundo del trabajo y los sacrificios que esto genera

In Cesar Department, the teenage pregnancy has become a social phenomenon which requires attention from the Government and the academic fieldsto tackle it. First, referring to the last aspect, the article becomes a reflexive contribution, proposing the emergence of teen parenthood that brings the need to address subjectivities and experiences of these young parents; as well as, the different roles, behaviors and, attitudes within the framework of the meaning and the consequences for recognition, acceptance and exercise of the subject, referring to paternity within their personal, family and, social contexts. Thus, it propose, a broad vision of teen pregnancy, which is not only reduced to a simply biological or physical conditions, but it is inserted into the dynamics of different aspects such as psychology, juridical, and cultural. From the last aspect, there is a proposal and analysis of the emergency and the importance of young parenthood, as meaningful event; on one hand, socially they register their masculinity, on the other hand, the assumption of his life project is given. So, the changes and the implications the teenager has to face when he realizes about the pregnancy; then, the birth, and, finally raising the son/daughter, to test the strength and the education as a man from the responsibilities, the entrance to the labor world and the necessary sacrifices that this generates.

Acerca de algunas vertientes ideológicas como andamiaje de la violencia / On some ideological strands as scaffolding for violence

Sobre la armazón de la ideología como poder material imbuido de certeza se sustenta la violencia. Este trabajo pretende reflexionar sobre diversas formas en las que la ideología se vuelve instancia de violencia, de una violencia que encuentra ahí su justificación, en un estancamiento de sentido, en la Überbesetzung de la interpretación. La cual se localiza en proclamas de propiedad, deber, derecho de excepcionalidad, poder y/o de lo que se considera de modo supremo justo o verdadero. Se encuentran modalidades de violencia resguardadas en la ideología en diversos pasajes de la historia, pero también aparecen incrustadas en discursos que pueden heroificar acciones criminales e impregnar de pretensión de honra y respeto su alarde asesino.

When certainty is located on the core of an ideology it can also be found the violence. This paper makes a reflection effort about some ways in which one ideology turns into violence –a violence that finds its justification on the standstill of the meaning, in an Überbesetzung. This violence can be found under the allegations of property, duty, an exceptional right, power and/or in the name of what is considered to be fair or true. These violence modalities which are sustained on an ideology arise in different passages of history, but they are also found in some speeches where the criminal acts are glorified.

La violence s’appuie sur l'idéologie en tant que pouvoir matériel empreint de certitude. Ce travail réfléchit aux diverses formes dans lesquelles l'idéologie devient instance de violence, d’une violence qui trouve ici sa justification, dans une impasse de sens, dans l’Überbesetzung de l'interprétation. Cette violence réside dans des proclamations de propriété, devoir, droit exceptionnel, pouvoir et/ou de ce qui est considéré de façon suprême comme étant juste ou véritable.On observe diverses modalités de violence protégées par l'idéologie dans plusieurs passages de l'histoire. Ces violences apparaissent également implantées dans des discours qui peuvent glorifier des actions criminelles et imprégner d'honneur et de respect leurs prétentions meurtrières.

Migraña con pleocitosis, un síndrome: presentación de dos casos / Migraine with pleocitosis

Se discuten dos casos de cefalea hemicránea pulsátil acompañada de náuseas sonofobia y fotofobia y alteraciones del liquido cefalorraquideo, que por su curso clínico corresponde a pseudomigraña con pleocitosis. Esta entidad es más común en hombres y se caracteriza por aura, hemicranea y manifestaciones disautonómicas, el LCR presenta aumento de células a expensas de los linfocitos. El estrés, el ejercicio físico y la menstruación suelen desencadenarla. También puede aparecer después de trauma craneocencefálico menor. En ocasiones cursa con fiebre pero no deben existir signos meningeos. Su curso es monofásico y su pronóstico benigno

Tuberculosis y sida: temible asociación

La tuberculosis (TBC) es una enfermedad infecciosa, crónica, causada por Mycobacterium tuberculosis y M. bovis. Reemerge como enfermedad epidémica en 1986, considerandose la epidemia concomitante de SIDA como factor contributivo importante. En la actualidad ha infectado a 1,7 millores de personas, con 8 millones de casos nuevos y 3 millones de muertes por año, siendo la principal causa de muerte en SIDA (más del 30 porciento). En Colombia, se notifican aproximadamente 10.000 casos nuevos/año, 8-30 porciento relacionados con VIH. El número de personas coinfectadas en toda el mundo se calcula en 5, 6 millones. EL VIH ataca directamente el mecanismo de defenza contra la TBC, lo que favorece la diseminación de la enfermedad. El riesgo de progresar la Tbc activa en los coinfectados es de 8 porciento por año, contra 0.2 porciento/año en los infectados solo por TBC. Este riesgo aumenta en pacientes PPD >5 mm, anérgicos o con CD4+ <200/ul. Las características clínicas de los pacientes coinfectados varía con el grado de inmunosupresión y tiempo de adquisición del M. tuberculosis. La PPD, radiografía de tórax y BK de esputo siguen siendo los pilares diagnosticos. Los pacientes coinfectados deben recibir el mejor tratamiento antituberculoso disponible. El esquema debe ser corto, supervisado estrictamente y basarse en: rinfanpicina, isoniazida, pirazinamida y estreptomicina o ethambutol. Se recomienda la profilaxis en áreas con alta prevalencia de TBC. La coinfección por VIH agrava la situación epidemiológica de la TBC, especialmente en paises en desarrollo. Existen pruebas de que la TBC agrava el curso de la infección por VIH