Abstract: The research aimed to determine the tensile bond strength (TBS) between polymerized intact and ground fiber-reinforced composite (FRC) surfaces. FRC prepregs (a reinforcing fiber pre-impregnated with a semi-interpenetrating polymer network (semi-IPN) resin system; everStick C&B) were divided into two groups: intact FRCs (with a highly PMMA-enriched surface) and ground FRCs (with a low PMMA gradient). Each FRC group was treated with: StickRESIN and G-Multi PRIMER. These groups were further divided into four subgroups based on the application time of the treatment agents: 0.5, 1, 2, and 5 min. Next, a resin luting cement was applied to the FRC substrates on the top of the photo polymerized treating agent. Thereafter, weight loss, surface microhardness, and TBS were evaluated. Three-factor analysis of variance (p ? 0.05) revealed significant differences in the TBS among the FRC groups. The highest TBS was recorded for the intact FRC surface treated with G-Multi PRIMER for 2 min (13.0 ± 1.2 MPa). The monomers and solvents of G-Multi PRIMER showed a time-dependent relationship between treatment time and TBS. They could diffuse into the FRC surface that has a higher PMMA gradient, further resulting in a high TBS between the FRC and resin luting cement. Resumen: La investigación tuvo como objetivo determinar la resistencia a la tracción (TBS) entre polimerizados Superficies compuestas reforzadas con fibra (FRC) intactas y rectificadas. Prepregs de FRC (una fibra de refuerzo preimpregnado con un sistema de resina de red polimérica semiinterpenetrante (semi-IPN); siempreStick C&B) se dividieron en dos grupos: FRC intactos (con una superficie altamente enriquecida en PMMA) y molidos. FRC (con un gradiente bajo de PMMA). Cada grupo de FRC fue tratado con: StickRESIN y G-Multi CEBADOR. Estos grupos se dividieron en cuatro subgrupos según el tiempo de aplicación del agentes de tratamiento: 0,5, 1, 2 y 5 min. A continuación, se aplicó un cemento de resina a los sustratos de FRC. en la parte superior del agente de tratamiento fotopolimerizado. Posteriormente, pérdida de peso, microdureza superficial, y TBS fueron evaluados. El análisis de varianza de tres factores (p ? 0,05) reveló diferencias significativas en el TBS entre los grupos del FRC. El TBS más alto se registró para la superficie intacta de FRC tratada con G-Multi PRIMER durante 2 min (13,0 ± 1,2 MPa). Los monómeros y disolventes de G-Multi PRIMER mostró una relación dependiente del tiempo entre el tiempo de tratamiento y TBS. Podrían difundirse hacia el Superficie de FRC que tiene un gradiente de PMMA más alto, lo que resulta además en un TBS alto entre el FRC y Cemento de fijación de resina.

Abstract: The purpose of this in vitro study was to evaluate the mechanical properties of 3 prepolymerized polymethyl methacrylate (PMMA) resins used in the fabrication of computer- aided design and computer-aided manufacturing (CAD-CAM) milled complete dentures (CDs), as well as 2 denture base polymers used for conventionally fabricated CDs. Material and methods. Three CAD-CAM materials were evaluated: Degos Dental L-Temp, IvoBase CAD, and Zirkonzahn Temp Basic Tissue. Two materials used for conventionally manufactured dentures were also included as controls (Palapress and Paladon 65). Each material type was sectioned into bars for flexural strength, nanohardness, elastic modulus, and surface microhardness evaluation (n=8/material). Half of the specimens were stored in water for 30 days, while the other half was dry-stored. A 2-way ANOVA was conducted to detect the effect of material and storage on the evaluated properties (a =.05). Linear contrasts were conducted to compare the differences among the 3 types of CAD-CAM material and the conventional ones. Results. Material type and storage had a significant influence on the flexural strength, nanohardness, elastic modulus, and surface hardness of the materials investigated (P<.001). The post hoc Scheffé test for flexural strength revealed a nonsignificant difference in the interaction between Degos L-Temp and Paladon (P=1.000). In terms of nanohardness, no difference was found when comparing Palapress with Paladon, as well as IvoBase CAD with Zirkonzahn Temp Basic (P=1.000). A nonsignificant interaction in terms of surface hardness was also found between IvoBase CAD and Palapress (P=.575). Resumen: El propósito de este estudio in vitro fue evaluar las propiedades mecánicas de 3 resinas prepolimerizadas de polimetilmetacrilato (PMMA) utilizadas en la fabricación de computadoras Diseño asistido y fabricación asistida por ordenador (CAD-CAM) de prótesis dentales completas fresadas (CD), así como así como 2 polímeros de base para dentaduras postizas utilizados para los CD fabricados de forma convencional. Material y métodos. Se evaluaron tres materiales CAD-CAM: Degos Dental L-Temp, IvoBase CAD y Zirkonzahn Temp Basic Tissue. Dos materiales utilizados de forma convencional. Las dentaduras postizas fabricadas también se incluyeron como controles (Palapress y Paladon 65). Cada El tipo de material se seccionó en barras para determinar la resistencia a la flexión, la nanodureza, el módulo elástico, y evaluación de microdureza superficial (n=8/material). La mitad de los especímenes fueron almacenados en agua durante 30 días, mientras que la otra mitad se almacenó en seco. Se realizó un ANOVA de 2 vías para detectar el efecto del material y el almacenamiento sobre las propiedades evaluadas (a =.05). Lineal Se realizaron contrastes para comparar las diferencias entre los 3 tipos de CAD-CAM. materiales y los convencionales. Resultados. El tipo de material y el almacenamiento tuvieron una influencia significativa en la resistencia a la flexión, nanodureza, módulo elástico y dureza superficial de los materiales investigados (P<0,001). El La prueba post hoc de Scheffé para la resistencia a la flexión reveló una diferencia no significativa en la interacción entre Degos L-Temp y Paladon (P=1.000). En términos de nanodureza, no se encontraron diferencias. Encontrado al comparar Palapress con Paladon, así como IvoBase CAD con Zirkonzahn Temp Básico (P=1.000). También se encontró una interacción no significativa en términos de dureza superficial. entre IvoBase CAD y Palapress (p=0,575).

Abstract: Objective: To evaluate the effect of post-curing method, printing layer thickness, and water storage on the me chanical properties and degree of conversion of a light-curing methacrylate based resin material (IMPRIMO® LC Splint), used for the fabrication of 3D printed occlusal splints and surgical guides. Methods: 96 bar-shaped specimens were 3D printed (Asiga MAX), half of them with a layer thickness of 100 ? m (Group A), and half with 50 ? m (Group B). Each group was divided in three subgroups based on the post-curing method used: post-curing with light emitting diode (LED) and nitrogen gas; post-curing with only LED; and non- post-curing. Half of the specimens from each subgroup were water-stored for 30 days while the other half was dry-stored (n = 8). Flexural strength and flexural modulus were evaluated. Additional specimens were prepared and divided in the same way for surface hardness (n = 96), fracture toughness, and work of fracture (n = 96). Five specimens were selected from each subgroup for evaluating the degree of conversion (DC). Data were collected and statistically analyzed with 1-way, 2-way ANOVA, and Tukey post-hoc analysis (? = 0.05). Results: The 2-way ANOVA showed that the post-curing method and water storage significantly affected the investigated mechanical properties (P < 0.001). The 1-way ANOVA revealed a statistically significant difference among the tested groups on the investigated properties (P < 0.001). After water storage, the 100 ? m subgroup post-cured with only LED showed higher flexural strength (51 ± 9) than the 50 ? m and 100 ? m subgroups that were post-cured with LED in addition to nitrogen gas atmosphere (38 ± 5, 30 ± 3) (p < 0.05). The 50 ? m subgroup post-cured with only LED showed the highest significant flexural modulus values (1.7 ± 0.08) (p < 0.05). However, the 50 ? m subgroup post-cured with LED plus nitrogen showed significantly higher surface hardness values (p < 0.05) among the investigated groups. The non-post-cured subgroups showed the lowest values, which were significantly different from the other subgroups (p < 0.05). Conclusion: The post-curing method, water storage, and printing layer thickness play a role in the mechanical properties of the investigated 3D Printed occlusal splints material. The combination of heat and light within the post-curing unit can enhance the mechanical properties and degree of conversion of 3D printed occlusal splints. Flexural strength and surface hardness can increase when decreasing printing layer thickness. Resumen: Objetivo: Evaluar el efecto del método de poscurado, el espesor de la capa de impresión y el almacenamiento de agua en el tiempo. Propiedades mecánicas y grado de conversión de un material de resina fotopolimerizable a base de metacrilato (IMPRIMO® LC Splint), utilizado para la fabricación de férulas oclusales y guías quirúrgicas impresas en 3D. Métodos: Se imprimieron en 3D (Asiga MAX) 96 muestras en forma de barra, la mitad de ellas con un espesor de capa de 100 ? m. (Grupo A), y la mitad con 50 ? m (Grupo B). Cada grupo se dividió en tres subgrupos según el poscurado. método utilizado: postcurado con diodo emisor de luz (LED) y gas nitrógeno; postcurado solo con LED; y no- después de curado. La mitad de los especímenes de cada subgrupo se almacenaron en agua durante 30 días mientras que la otra mitad se almacenó en agua. almacenado en seco (n = 8). Se evaluaron la resistencia a la flexión y el módulo de flexión. Se prepararon muestras adicionales. y dividido de la misma manera para dureza de la superficie (n = 96), tenacidad a la fractura y trabajo de fractura (n = 96). Se seleccionaron cinco ejemplares de cada subgrupo para evaluar el grado de conversión (DC). Los datos fueron recopilados y analizados estadísticamente con ANOVA de 1 vía, 2 vías y análisis posthoc de Tukey (? = 0,05).

Abstract: Transfer entropy (TE) has been used to identify and quantify interactions between physiological systems. Different methods exist to estimate TE, but there is no consensus about which one performs best in specific applications. In this study, five methods (linear, k-nearest neighbors, fixed-binning with ranking, kernel density estimation and adaptive partitioning) were compared. The comparison was made on three simulation models (linear, nonlinear and linear + nonlinear dynamics). From the simulations, it was found that the best method to quantify the different interactions was adaptive partitioning. This method was then applied on data from a polysomnography study, specifically on the ECG and the respiratory signals (nasal airflow and respiratory effort around the thorax). The hypothesis that the linear and nonlinear components of cardio-respiratory interactions during light and deep sleep change with the sleep stage, was tested. Significant differences, after performing surrogate analysis, indicate an increased TE during deep sleep. However, these differences were found to be dependent on the type of respiratory signal and sampling frequency. These results highlight the importance of selecting the appropriate signals, estimation method and surrogate analysis for the study of linear and nonlinear cardio-respiratory interactions. Resumen: La entropía de transferencia (TE) se ha utilizado para identificar y cuantificar las interacciones entre sistemas fisiológicos. Existen diferentes métodos para estimar la TE, pero no hay consenso sobre cuál funciona mejor en aplicaciones específicas. En este estudio, se compararon cinco métodos (lineal, k-nearest neighbors, fixed binning with ranking, kernel density estimation, and adaptive partitioning). La comparación se realizó en tres modelos de simulación (lineal, no lineal y dinámicas lineales + no lineales). A partir de las simulaciones, se encontró que el mejor método para cuantificar las diferentes interacciones fue el adaptive partitioning. Este método se aplicó luego a datos de un estudio de polisomnografía, específicamente a las señales de ECG y respiratorias (flujo nasal y esfuerzo respiratorio alrededor del tórax). Se probó la hipótesis de que los componentes lineales y no lineales de las interacciones cardiorespiratorias durante el sueño ligero y profundo cambian con la etapa del sueño. Diferencias significativas, después de realizar un análisis de subrogados, indican un aumento en la TE durante el sueño profundo. Sin embargo, se encontró que estas diferencias dependían del tipo de señal respiratoria y la frecuencia de muestreo. Estos resultados resaltan la importancia de seleccionar las señales apropiadas, el método de estimación y el análisis de subrogados adecuados para el estudio de las interacciones cardiorespiratorias lineales y no lineales.

Abstract: Acute brain injuries are associated with high mortality rates and poor long-term functional outcomes. Measurement of cerebrospinal fluid (CSF) biomarkers in patients with acute brain injuries may help elucidate some ofthe pathophysiological pathways involved in the prognosis of these patients. We performed a systematic search and descriptive review using the MEDLINE database and the PubMed interface from inception up to June 29, 2021. Of the 39 studies that met our criteria, 30 reported that the biomarker concentration was associated with neurological outcome and 9 reported no association. In traumatic brain injury patients, increased extracellular concentrations of biomarkers related to neuronal cytoskeletal disruption, apoptosis and inflammation were associated with the severity of acute brain injury, early mortality and worse long-term functional outcome. Reduced concentrations of protein biomarkers related to impaired redox function were associated with increased risk of neurological deficit. In non-traumatic acute brain injury, concentrations of CSF protein biomarkers related to dysregulated inflammation and apoptosis were associated with a greater risk of vasospasm and a larger volume of brain ischemia. Resumen: Las lesiones cerebrales agudas se asocian con altas tasas de mortalidad y malos resultados funcionales a largo plazo. La medición de biomarcadores en el líquido cefalorraquídeo (LCR) en pacientes con lesiones cerebrales agudas puede ayudar a dilucidar algunas de las vías fisiopatológicas implicadas en el pronóstico de estos pacientes. Realizamos una búsqueda sistemática y revisión descriptiva utilizando la base de datos MEDLINE y la interfaz PubMed desde su inicio hasta el 29 de junio de 2021.De los 39 estudios que cumplieron con nuestros criterios de inclusión, 30 informaron que la concentración del biomarcador se asoció con el resultado neurológico y 9 no informaron ninguna asociación. En lesiones cerebrales traumáticas, el aumento de las concentraciones extracelulares de biomarcadores relacionados con la alteración del citoesqueleto neuronal, la apoptosis y la inflamación se asociaron con la gravedad de la lesión cerebral aguda, la mortalidad temprana y un peor resultado funcional a largo plazo. Las concentraciones reducidas de biomarcadores proteicos relacionados con la función redox deteriorada se asociaron con un mayor riesgo de déficit neurológico. En la lesión cerebral aguda no traumática, las concentraciones de biomarcadores proteicos del LCR relacionados con la inflamación desregulada y la apoptosis se asociaron con un mayor riesgo de vasoespasmo y un mayor volumen de isquemia cerebral.

Abstract: Latin American countries are experiencing a significant increase in the reports of mistreatment that women experience while using the maternity healthcare services, a phenomenon acknowledged as “Obstetric Violence” (OV). The Latin American region is crucial for the recognition of OV, not only because the term OV was originated there, but also because of its particular response to the matter. The present Scoping Review aimed to identify and review the available evidence about the response of Latin American countries to OV. As a result, it was found, firstly, that the emergence of the concept of OV in Latin America demonstrated to be a transformative tool useful to raise awareness about the mistreatment women face when giving birth. This OV concept also positions this problematic as subset of gendered violence and as a type of structural violence, through which the need to address it systemically is highlighted. Secondly, the used categorization of OV appears to be the broadest and more inclusive typology, emphasizing that OV might stem from both intentional and unintentional actions of healthcare professionals, as well as from conditions within healthcare organizations. Moreover, the identified variables that influence the response to OV in Latin America were synthetized into a theoretical framework, which offers insight into how the problem has been addressed until now and subsequently, provides useful lessons for other countries seeking approaches to combat mistreatment of women during childbirth. Lastly, it was determined that, in order to address OV and allow the progression of public policies to become regionally available, a broadened view encompassing a human rights-based approach is necessary. This research allowed to conclude that OV is a multi-faceted and complex phenomenon whose solution requires a multidimensional and multidisciplinary approach. Furthermore, OV should be understood as more than a simple act of mistreatment, but rather be viewed as a set of socially constructed symbolic, and violent, meanings allowing different stakeholders to reframe the abuse and violence that women undergoing childbirth experience as natural, expected, and accepted, reinforcing specific gender dynamics not merely in maternity care but in society overall. Finally, the framework to tackle OV within the human rights approach developed by the author is expected to be advantageous for the development of further research, programs, and policies to prevent OV in Latin America and beyond.

Abstract: Mixed microbial cultures have become a preferred choice of biocatalyst for chain elongation systems due to their ability to convert complex substrates into medium chain carboxylates. However, the complexity of the effects of process parameters on the microbial metabolic networks is a drawback that makes the task of optimizing product selectivity challenging. Here, we studied the effects of small air contaminations on the microbial community dynamics and the product formation in anaerobic bioreactors fed with lactate, acetate and H2/CO2. Two stirred tank reactors and two bubble column reactors were operated with H2/CO2 gas recirculation for 139 and 116 days, respectively, at pH 6.0 and 32°C with a hydraulic retention time of 14 days. One reactor of each type had periods with air contamination (between 97 ± 28 and 474 ± 33 mL O2 L−1 d−1, lasting from 4 to 32 days), while the control reactors were kept anoxic. During air contamination, production of n-caproate and CH4 was strongly inhibited, whereas no clear effect on nbutyrate production was observed. In a period with detectable O2 concentrations that went up to 18%, facultative anaerobes of the genus Rummeliibacillus became predominant and only n-butyrate was produced. However, at low air contamination rates and with O2 below the detection level, Coriobacteriia and Actinobacteria gained a competitive advantage over Clostridia and Methanobacteria, and propionate production rates increased to 0.8–1.8 mmol L−1 d−1 depending on the reactor (control reactors 0.1–0.8 mmol L−1 d−1). Moreover, i-butyrate production was observed, but only when Methanobacteria abundances were low and, consequently, H2 availability was high. After air contamination stopped completely, production of n-caproate and CH4 recovered, with n-caproate production rates of 1.4–1.8 mmol L−1 d−1 (control 0.7–2.1 mmol L−1 d−1). The results underline the importance of keeping strictly anaerobic conditions in fermenters when consistent n-caproate production is the goal. Beyond that, micro-aeration should be further tested as a controllable process parameter to shape the reactor microbiome. When odd-chain carboxylates are desired, further studies can develop strategies for their targeted production by applying micro-aerobic conditions.

Abstract: Botulism is caused by a potent neurotoxin that blocks neuromuscular transmission, resulting in death by asphyxiation. Currently, the therapeutic options are limited and there is no antidote. Here, we harness the structural and trafficking properties of an atoxic derivative of botulinum neurotoxin (BoNT) to transport a function-blocking single-domain antibody into the neuronal cytosol where it can inhibit BoNT serotype A (BoNT/A1) molecular toxicity. Post-symptomatic treatment relieved toxic signs of botulism and rescued mice, guinea pigs, and nonhuman primates after lethal BoNT/A1 challenge. This platform might enable delivery of antibodies and other protein-based therapeutics to previously inaccessible intraneuronal targets. Resumen: El botulismo es causado por una potente neurotoxina que bloquea la transmisión neuromuscular, provocando la muerte por asfixiamiento. Actualmente, las opciones de tratamiento son limitadas y no existe un antídoto. En este artículo aprovechamos las propiedades estructurales y de tráfico neuronal de un derivado atóxico de la neurotoxina botulínica (BoNT) para transportar un anticuerpo que bloquea la función al citosol neuronal, donde puede inhibir la toxicidad molecular del serotipo A de la BoNT (BoNT /A1). El tratamiento post-sintomático alivió los signos tóxicos del botulismo y rescató de la muerte a ratones, conejillos de indias y primates no humanos después de la exposición letal a BoNT / A1. Esta plataforma podría permitir la administración de anticuerpos y otros terapéuticos basados en proteínas a blancos intraneuronales que previamente eran inaccesibles.

Abstract: Objective: To investigate opportunities for task shifting to decongest an outpatient neurology clinic in Zambia by describing current patient flow through the clinic and potential nodes for intervention using process mapping. Background: Zambia has a population of approximately 18 million people with 4 full-time adult neurologists, as of 2018, who all practice at the University Teaching Hospital (UTH), the main tertiary care center in the country. As a result of this provider-to-patient ratio, the outpatient neurology clinic is overcrowded and overbooked. Task-shifting programs have shown to improve efficiency, access and quality of care through the use of less specialized healthcare workers in low- and middle-income countries (LMIC). Methods: We evaluated patient flow in the UTH neurology outpatient clinic through the development and analysis of a process map. The characteristics of the clinic population between 2014 and 2018 were retrospectively reviewed from the clinic register. Between July and August 2018, we prospectively collected appointment lag times and time each patient spent waiting at various points in the clinic process. We conducted interviews with clinic staff and neurologists to generate a detailed process map of current pathways to care within the clinic. We then devised task- shifting strategies to help reduce patient wait times based on the overview of clinic process mapping and patient demographics. Results: From 2014 to 2018, there were 4701 outpatients seen in the neurology clinic. The most common neurologi- cal diagnoses were epilepsy (39.2%), headache (21.5%) and cerebrovascular disease (16.7%). During prospective data collection, patients waited an average of 57.8 (SD 73.4) days to be seen by a neurologist. The average wait time from arrival in the clinic to departure was 4.0 (SD 2.5) h. The process map and interviews with clinic staff revealed long waiting times due to a paucity of providers. Nurses and clerks represent an influential stakeholder group, but are not actively involved in any activity to reduce wait times. A large proportion of follow-up patients were stable and seen solely to obtain medication refills. Conclusions: Epilepsy, headache, and stroke make up the largest percentage of outpatient neurological illness in Zambia. Targeting stable patients in these diagnostic categories for a task-shifting intervention may lead to substan- tially decreased patient wait times. Potential interventions include shifting clinical follow-ups and medication refills to less specialized healthcare workers.

Abstract: Objective: To investigate opportunities for task shifting to decongest an outpatient neurology clinic in Zambia by describing current patient flow through the clinic and potential nodes for intervention using process mapping. Background: Zambia has a population of approximately 18 million people with 4 full-time adult neurologists, as of 2018, who all practice at the University Teaching Hospital (UTH), the main tertiary care center in the country. As a result of this provider-to-patient ratio, the outpatient neurology clinic is overcrowded and overbooked. Task-shifting programs have shown to improve efficiency, access and quality of care through the use of less specialized healthcare workers in low- and middle-income countries (LMIC). Methods: We evaluated patient flow in the UTH neurology outpatient clinic through the development and analysis of a process map. The characteristics of the clinic population between 2014 and 2018 were retrospectively reviewed from the clinic register. Between July and August 2018, we prospectively collected appointment lag times and time each patient spent waiting at various points in the clinic process. We conducted interviews with clinic staff and neurologists to generate a detailed process map of current pathways to care within the clinic. We then devised task- shifting strategies to help reduce patient wait times based on the overview of clinic process mapping and patient demographics. Results: From 2014 to 2018, there were 4701 outpatients seen in the neurology clinic. The most common neurologi- cal diagnoses were epilepsy (39.2%), headache (21.5%) and cerebrovascular disease (16.7%). During prospective data collection, patients waited an average of 57.8 (SD 73.4) days to be seen by a neurologist. The average wait time from arrival in the clinic to departure was 4.0 (SD 2.5) h. The process map and interviews with clinic staff revealed long waiting times due to a paucity of providers. Nurses and clerks represent an influential stakeholder group, but are not actively involved in any activity to reduce wait times. A large proportion of follow-up patients were stable and seen solely to obtain medication refills. Conclusions: Epilepsy, headache, and stroke make up the largest percentage of outpatient neurological illness in Zambia. Targeting stable patients in these diagnostic categories for a task-shifting intervention may lead to substan- tially decreased patient wait times. Potential interventions include shifting clinical follow-ups and medication refills to less specialized healthcare workers.