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: SEPSIS-3 IN PREGNANT WOMEN IN LABOUR Abstract Introduction: Maternal sepsis represents 10.7% of maternal deaths worldwide, ranking as the third cause of mortality after haemorrhage and hypertensive disorders. Despite its high incidence, it still lacks a gold standard diagnosis. The latest update that proposed new sepsis criteria and scores, Sepsis-3, did not mention pregnancy as part of the study population. This study aims to evaluate the inclusion or exclusion of Sepsis- 3 pregnancy. Methods: This is a literature review of the Sepsis-3 database looking for the inclusion or exclusion of pregnancy from the latest update in sepsis and the basis of current definitions and guidelines. In addition, I reported the retrospective measurement of qSOFA and SOFA scores in 100 pregnant patients in labour from the EPIFEVER-2 cohort at the Royal London Hospital compared to their infection status. Results: Sepsis-3 investigators evaluated the predictive validity of the SOFA and qSOFA score for mortality in sepsis among nearly 1 million patients, however, pregnant women were not included. The SOFA and qSOFA score overlap with the normal physiological changes of pregnancy and labour, in the EPIFEVER-2 cohort 16% of uninfected pregnant patients during labour scored 1 point on qSOFA and 17% 1 point on SOFA score. The highest SOFA score of 3 points was obtained in a patient with bleeding rather than infection. Conclusion: Pregnant patients were not included in the Sepsis-3 databases. Therefore, qSOFA and SOFA score have not been validated for use in this population. Furthermore, as they are not modified for the normal physiological changes of pregnancy, detection of patients without infection has been reported. Further validation of qSOFA or modified SOFA scores as sepsis-specific maternal warning scores is expected in future research.

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.

Manifestación pública que hace Sebastián Barriga en contra del quienes lo acusaban de no ser neogranadino sino ecuatoriano, razón por la cual fue expulsado del país. El documento está acompañado por una serie de testimonios que legitiman la ciudadanía de Barriga.

Abstract: Antibiotic resistance is driven by selection, but the degree to which a bacterial strain’s evolutionary history shapes the mechanism and strength of resistance remains an open question. Here, we reconstruct the genetic and evolutionary mechanisms of carbapenem resistance in a clinical isolate of Klebsiella quasipneumoniae. A combination of short- and long-read sequencing, machine learning, and genetic and enzymatic analyses established that this carbapenem-resistant strain carries no carbapenemase-encoding genes. Genetic reconstruction of the resistance phenotype confirmed that two distinct genetic loci are necessary in order for the strain to acquire carbapenem resistance. Experimental evolution of the carbapenem-resistant strains in growth conditions without the antibiotic revealed that both loci confer a significant cost and are readily lost by de novo mutations resulting in the rapid evolution of a carbapenem-sensitive phenotype. To explain how carbapenem resistance evolves via multiple, low-fitness single-locus intermediates, we hypothesised that one of these loci had previously conferred adaptation to another antibiotic. Fitness assays in a range of drug concentrations show how selection in the antibiotic ceftazidime can select for one gene (blaDHA-1) potentiating the evolution of carbapenem resistance by a single mutation in a second gene (ompK36). These results show how a patient’s treatment history might shape the evolution of antibiotic resistance and could explain the genetic basis of carbapenem-resistance found in many enteric-pathogens.

Abstract: 3D printing technologies enable medicine customization adapted to patients' needs. There are several 3D printing techniques available, but majority of dosage forms and medical devices are printed using nozzle-based extrusion, laser-writing systems, and powder binder jetting. 3D printing has been demonstrated for a broad range of applications in development and targeting solid, semi-solid and locally applied or implanted medicines. 3D printed solid dosage forms allow the combination of one or more drugs within the same solid dosage form to improve patient compliance, facilitate deglutition, tailor the release profile, or fabricate new medicines for which no dosage form is available. Sustained release 3D-printed implants, stents and medical devices have been used mainly for joint replacement therapies, medical prostheses, and cardiovascular applications. Locally applied medicines such as wound dressing, microneedles, and medicated contact lenses have also been manufactured using 3D printing techniques. The challenge is to select the 3D printing tech-nique most suitable for each application and the type of pharmaceutical ink that should be devel-oped that possesses the required physicochemical and biological performance. The integration of biopharmaceuticals and nanotechnology-based drugs along with 3D printing (""Nanoprinting"") brings printed personalized nanomedicines within the most innovative perspectives for the coming years. Continuous manufacturing through the use of 3D-printed microfluidic chips facilitates their translation into clinical practice.

Abstract: Las lesiones cerebrales agudas (LCA) se asocian con altas tasas de mortalidad y malos resultados funcionales a largo plazo. La medición de biomarcadores del líquido cefalorraquídeo ventricular (vLCR) en pacientes con LCA puede ayudar a dilucidar algunas de las vías fisiopatológicas implicadas en el pronóstico de estos pacientes. Primero realizamos una búsqueda sistemática y una revisión descriptiva (Crit Care. 5 de agosto de 2021; 25 (1): 278; DOI: 10.1186/s13054-021-03698-z) donde concluimos que en pacientes con LCA, las concentraciones alteradas de biomarcadores proteicos en el vLCR relacionados con el daño citoesquelético, la inflamación, la apoptosis y el estrés oxidativo pueden predecir peores resultados neurológicos. Debido a estos resultados, realizamos un estudio de observación prospectivo (Neurocrit Care. 2022 Oct;37(2):463-470.doi:10.1007/s12028-022-01507-1.) donde concluimos que la expresión desregulada de la proteína en el vLCR diferenciaba entre LCA y no LCA. Luego realizamos otro estudio (J Neurosurg Anesthesiol. 27 de abril de 2023. doi:10.1097/ANA.0000000000000916.) donde concluimos que la expresión de patrones moleculares asociados al peligro (DAMP) específicos del vLCR se asociaba con un aumento de episodios de hipertensión intracraneal severa y muerte. Por último, en otro estudio observacional (Crit Care. 2023 Jun 24;27(1):249. doi: 10.1186/s13054-023-04538-y.), concluimos que las concentraciones de proteínas del vLCR después de una LCA eran un factor de riesgo para el desarrollo de enfermedades neurodegenerativas crónicas después de una LCA no traumática. Los hallazgos más importantes de esta tesis fueron que la respuesta proteómica después de una LCA es homogénea entre la LCA traumática y no traumática, involucra múltiples proteínas (DAMP) y puede estar asociada con enfermedades neurodegenerativas a largo plazo también en la LCA no traumática.

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.

Documento en el que se reproduce el informe que redactaron los comisionados del Concejo de Bogotá Diodoro Sánchez y Liborio Orejuela, acerca de la inspección que realizaron a los trabajos realizados en el río San Cristóbal para el abastecimiento de agua de la ciudad. A lo largo del documento se incluyen la exposición que los comisionados hicieron al alcalde de la ciudad, el reporte de la inspección realizada, los datos técnicos utilizados durante el estudio, el análisis de los datos y planos del proyecto, entre otros.