Desarrollo de un procedimiento para la observación y caracterización mecánica de células sobre sustratos opacos mediante microscopía de fuerzas atómicas : aplicación al estudio de linfocitos

Las células en los tejidos biológicos están continuamente sometidas a estímulos físicos tales como la presión hidrostática y esfuerzos de tracción, compresión o cortante, entre otros. La importancia de los estímulos mecánicos en el comportamiento de las células se ha reconocido recientemente al comprobarse cómo la naturaleza de estas fuerzas puede cambiar en patologías tales como las enfermedades vasculares o el cáncer. En respuesta a estos cambios, las células reaccionan modificando desde su forma o aspecto hasta su ciclo celular. Consecuentemente, el interés por el comportamiento mecánico de las células ha experimentado un auge creciente que ha requerido el desarrollo de varias técnicas de caracterización. En este contexto, se puede afirmar que una de las técnicas que ha irrumpido con más fuerza en esta nueva área, situada entre el mundo biológico y el físico, es la microscopía de fuerza atómica. En esta Tesis se ha abordado el estudio mediante microscopía de fuerza atómica de linfocitos de ratón que constituyen un linaje celular especialmente difícil de caracterizar mediante esta técnica por su tamaño y naturaleza no adherente. Los linfocitos, como actores fundamentales del sistema inmune, tienen gran importancia en la determinación de la respuesta que un organismo desencadena ante la presencia de un biomaterial. Bajo esta premisa, y como condición previa a la caracterización de los linfocitos, ha sido necesario el desarrollo de una metodología robusta y de amplia aplicabilidad que permita el estudio de células sobre biomateriales. Finalmente y con el objetivo de correlacionar el comportamiento mecánico de los linfocitos con alguna característica fisiológica relevante, se ha analizado la hipótesis de que el comportamiento mecánico pueda ser utilizado como marcador de la edad biológica. Consecuentemente se ha abordado el estudio del comportamiento mecánico de los linfocitos clasificados por grupos de edad, de manera que se han obtenido los primeros resultados que indican cómo puede manifestarse el proceso de inmunosenescencia -depresión del sistema inmune relacionada con el envejecimiento- en el comportamiento mecánico de las células del sistema inmune. Cells within tissues are continuously exposed to physical forces including hydrostatic pressure, shear stress, and compression and tension forces. The relevance of these mechanical stimuli has recently been recognised by different works in which significant changes were observed in these forces when they were measued in individuals affected by cardiovasvular diseases or cancer. Cells may alter their orientation, shape, internal constitution, contract, migrate, adhere, modify the synthesis and degradation of extracellular constituents, or even their life cycle in response to perturbations in their mechanical environment. As a consequence of this, the attention in cell mechanical behavior has undergone a significant thrust and novel techniques have been developed. In this context, atomic force microscopy has become a basic tool for the progress of this field. In this Thesis, the mechanical behavior of living murine T-lymphocytes was assessed by atomic force microscopy. Lymphocytes play a main role in the immune system of the individual and, consequently, in the immune response triggered by the presence of a biomaterial. The observation and characterization of the lymphocytes required the development of a robust experimental procedure that allowed overcoming the difficulties related to the analysis of this cell lineage, in particular their relatively large size and non-adherent character. These procedures could be easily transferred to other non-adherent cell lineages. Finally, to check the viability of developed method, we study the lymphocyte mechanical behavior as a function of the murine ageing. The obtained data represent a first step in the knowledge about how mechanical stimuli can affect the age-dependent decrease in immunological competence, i.e., the immunosenescence

Active microrheology of colloidal suspensions of hard cuboids

By performing dynamic Monte Carlo simulations, we investigate the microrheology of isotropic suspensions of hard-core colloidal cuboids. In particular, we infer the local viscoelastic behaviour of these fluids by studying the dynamics of a probe spherical particle that is incorporated in the host phase and is dragged by an external force. This technique, known as active microrheology, allows one to characterise the microscopic response of soft materials upon application of a constant force, whose intensity spans here three orders of magnitude. By tuning the geometry of cuboids from oblate to prolate as well as the system density, we observe different responses that are quantified by measuring the effective friction perceived by the probe particle. The resulting friction coefficient exhibits a linear regime at forces that are much weaker and larger than the thermal forces, whereas a non-linear, force-thinning regime is observed at intermediate force intensities.Malaysian Government Agency Majlis Amanah RakyatLeverhulme Trust Research (Project Grant No. RPG-2018-415)NextGenerationEU progra

Reproducibility of the Masmali scale in the assessment of the lagrimal film

Objective: To determine the inter-rater reproducibility of the Masmali scale based on the Ferning Test for the evaluation of tear film. Materials and methods: An analytical observational study was carried out to evaluate diagnostic tests. The sample consisted of 50 students from the optometry program of the Universidad Santo Tomás, Bucaramanga. The osmolarity of the tear film of the individuals was evaluated through the Ferning test. Two observers classified the fern patterns obtained, using the Masmali scale to determine their reproducibility. Results: the Masmali scale was shown to be a valid tear osmolarity measurement tool; its results are reliable and reproducible. The inter-rater agreement was moderate with a Weighted Kappa of 0.5658 with 88% agreement and a standard error of kappa of 0.0995 and a P value of <0.0001.Conclusions: The Masmali scale based on the Ferning Test proved to be reproducible and reliable considering the results obtained.  Objetivo: determinar la reproducibilidad inter evaluador de la escala de Masmali en función del Test de Ferning para la evaluación de la película lagrimal. Materiales y Métodos: se realizó un estudio observacional analítico de evaluación de pruebas diagnósticas. La muestra estuvo integrada por 50 estudiantes del programa de optometría de la Universidad Santo Tomás, Bucaramanga.  Se evaluó la osmolaridad de la película lagrimal de los individuos a través del test de Ferning.  Dos observadores clasificaron los patrones en helecho obtenidos, empleando la escala de Masmali para determinar su reproducibilidad. Resultados: se demostró que la escala de Masmali es una herramienta de medición de la osmolaridad lagrimal válida; sus resultados son confiables y reproducibles. La concordancia inter evaluador fue moderada con un Kappa Ponderado de 0,5658 con un 88% de acuerdo y un error estándar de kappa de 0,0995 y un valor P de <0,0001. Conclusiones: se recomienda el uso de la escala de Masmali como un método de evaluación del fluido lagrimal, por arrojar resultados confiables. No obstante, estos deben ser correlacionados con otras pruebas de superficie ocular para la emisión de diagnósticos en la evaluación de las disfunciones lagrimales

Daños a la salud auditiva por exposición a ruido en operadores de maquinaria pesada en minas de carbón a cielo abierto año 2017

La importancia del presente trabajo de investigación de tipo descriptivo, estuvo direccionado a interpretar las características inherentes en relación a la exposición laboral a ruido de los operadores de una mina de cielo abierto en la región norte del país, específicamente en la Jagua de Ibirico (Cesar), en donde para obtener sus resultados se utilizó un instrumento inspirado bajo el esquema de la “guía de Atención Integral basada en evidencia para la hipoacusia neurosensorial inducida por ruido en un lugar de trabajo (GAT-HNIR); la expansión de sus operaciones, las edades, el tiempo de trabajo y sobre todo las patologías relacionadas con la hipoacusia; el desconocimiento de su influencia podría subestimar la evaluación del riesgo a ruido de los trabajadores y por consiguiente la efectividad de direccionar elementos que sean considerados de manera preventiva. Se realiza un análisis distribucional de los resultados en 72 operadores, seleccionados de manera aleatoria simple, con mediciones de ruido de tipo audiometría, se tomó en consideración el tipo de actividad que realizan los operadores (manual o automatizado), conduciendo a mostrar las diferencias entre los resultados en torno a la exposición del ruido, se encontró un nivel del 31% tienen problemas auditivos. Además, se analiza la influencia del entorno de trabajo, a cielo abierto, en las mediciones de ruidoUniversidad Libre Seccional Barranquilla -- Ciencias de la Salud -- Especialización en Seguridad y Salud en el TrabajoThe importance of this descriptive research work was aimed at interpreting the inherent characteristics in relation to the occupational exposure to noise of the operators of an open pit mine in the northern region of the country, specifically in Jagua de Ibirico (Cesar ), where an inspired instrument was used to obtain the results under the "Evidence-based Comprehensive Care Guide for Noise-induced Noise-Sensitive Hypoacusis in a Workplace (GAT-HNIR); the expansion of its operations, ages, work time and, above all, pathologies related to hearing loss; ignorance of their influence could underestimate the evaluation of the risk to noise of workers and therefore the effectiveness of addressing elements that are considered preventively. A distributional analysis of the results was carried out in 72 operators, selected in a simple random manner, with noise measurements of the audiometry type, taking into consideration the type of activity carried out by the operators (manual or automated), leading to show the differences between the results around noise exposure, found a level of 31% have hearing problems. In addition, the influence of the work environment, in the open sky, on noise measurements is analyze

Automatic evaluation of the adherence to recommendations for managing heart failure from the electronic health records : The EXEMED tool

Objetivo La implementación de las guías de práctica clínica está limitada por la falta de herramientas que faciliten los procesos de auditoría y retroalimentación a los profesionales de salud. Este estudio evalúa la herramienta automatizada (EXEMED), diseñada para valorar la adherencia a las guías de práctica clínica a partir de la información consignada en las historias clínicas electrónicas. Métodos En un grupo de 35 pacientes hospitalizados entre enero y marzo de 2016 se evaluó la adherencia a cinco recomendaciones contenidas en las guías de práctica clínica de falla cardiaca del Hospital Universitario San Ignacio. Se utilizó la herramienta automatizada EXEMED y se evaluó la validez de la misma comparando los resultados con la valoración realizada por una junta médica independiente. Se determinó concordancia entre los dos métodos usando el coeficiente kappa. Resultados La adherencia a las diferentes recomendaciones osciló entre 0% para la determinación del perímetro abdominal al ingreso, hasta 97% para el uso de betabloqueadores al egreso. La proporción de acuerdo entre los dos métodos de evaluación estuvo por encima del 90% para todas las recomendaciones. El kappa para las diferentes recomendaciones fue de 0,78 (IC 95% 0,62-0,95) y 0,64 (0,48-0,80). El tiempo de evaluación se redujo de veinte a dos minutos por paciente con el uso de la herramienta EXEMED. Conclusiones EXEMED es una herramienta válida y eficiente en la evaluación de la adherencia a las guías de práctica clínica. Se requieren nuevos estudios para evaluar el impacto de su uso asociado a retroalimentación a los clínicos, en la evolución a largo plazo de los pacientes con falla cardiaca.Q4Artículo original321-326Objective The implementation of clinical practice guidelines is limited due to the lack of tools to carry out audits and provide feedback to the health professionals. In this study, an evaluation is performed using the automated (EXEMED) tool in order to assess the adherence to clinical practice guidelines from the information entered in the electronic health records. Methods The adherence to 5 recommendations contained in the heart failure clinical practice guidelines was evaluated in a group of 35 patients admitted to the Hospital Universitario San Ignacio between January 2016 and March 2016. The automated EXEMED tool was used to assess this, by comparing the results obtained with the evaluation carried out by an independent medical committee. The kappa coefficient was used to determine the agreement between the two methods. Results The adherence to the different recommendations varied between 0%, for the determination of the abdominal circumference, up to 97%, for the use of beta-blockers at discharge. Percentage agreement between the two evaluation methods was above 90% for all the recommendations. The kappa for the different recommendations was 0.78 (95% CI; 0.62-0.95) and 0.64 (0.48-0.80). The evaluation time was reduced from 20minutes to 2minutes with the use of the EXEMED tool. Conclusions EXEMED is a valid and effective tool in the evaluation of adherence to clinical practice guidelines. Further studies are required to assess the impact of its used associated with feedback to the clinicians, in the long-term outcomes of patients with heart failure

UDEC

Todo proyecto de infraestructura cuenta con diferentes procesos tales como: estudios, diseños, actividades preliminares, actividades propias de la obra que se va a ejecutar, entre otras; estas actividades deben ser congruentes para que aporten a obtener el producto o servicio que se desea entregar, sin embargo, para realizarlas se debe tener una dirección que conozca a tal punto el proyecto que tenga la capacidad de desarrollar las estrategias necesarias para cumplir con los tiempos, costos y calidad, allí es hacia donde apunta la gerencia de proyectos. Durante un tiempo se han buscado estrategias para desarrollar la dirección del proyecto denominado “PRIMERA FASE DE LA NUEVA SEDE DE LA EXTENSIÓN DE ZIPAQUIRÁ” para lo cual se determinó que el valor aproximado para realizar la obra es de $19.718.000.000, con un origen de fondos mixtos por lo que se interactuara con entidades privadas y públicas esto permite desarrollar competencias de liderazgo referente a diferentes formas de contratación y de seguimiento. Entendiendo que es diferente licitar con una entidad privada y con una entidad pública. El alcance del proyecto es poner en marcha a finales del año 2022 la alternativa escogida para la construcción de la infraestructura de educación superior, para la ampliación del portafolio de programas que ofrece actualmente la universidad a la población de Zipaquirá y municipios aledaños, favoreciendo 200.000 habitantes teniendo en cuenta que el crecimiento anual es de 1,65analizaron y determinaron los aspectos fundamentales desde la perspectiva de la gerencia de proyecto, es decir desde la dirección.Each infrastructure project has different processes such as: studies, designs, preliminary activities, activities specific to the work to be executed, among others; these activities must be consistent in order for them to contribute to obtaining the product or service to be delivered, However, to carry them out, you must have a management that knows the project to such an extent that it has the capacity to develop the necessary strategies to comply with the times, costs and quality, that is where the project management aims. For a time have been sought strategies to develop the direction of the project called "FIRST PHASE OF THE NEW HEADQUARTERS OF THE EXTENSION OF ZIPAQUIRA" for which it was determined that the approximate value to carry out the work is$19,718,000,000, with an origin of mixed funds so that they will interact with private and public entities this allows to develop leadership skills regarding different forms of recruitment and monitoring. Understanding that it is different to tender with a private entity and with a public entity. The scope of the project is to implement by the end of 2021 the chosen alternative for the construction of the higher education infrastructure, for the expansion of the portfolio of programs currently offered by the university to the population of Siqueira and surrounding municipalities, favoring 200,000 inhabitants taking into account that the annual growth is 1.65% per year. There are different factors that lead to obtain the total scope of the project, and through this work were analyzed and determined the fundamentals from the perspective of project management, that is from the management

Topographical and mechanical characterization of living eukaryotic cells on opaque substrates: development of a general procedure and its application to the study of non-adherent lymphocytes

The mechanical behavior of living murine T-lymphocytes was assessed by atomic force microscopy (AFM). A robust experimental procedure was developed to overcome some features of lymphocytes, in particular their spherical shape and non-adherent character. The procedure included the immobilization of the lymphocytes on amine-functionalized substrates, the use of hydrodynamic effects on the deflection of the AFM cantilever to monitor the approaching, and the use of the jumping mode for obtaining the images. Indentation curves were analyzed according to Hertz's model for contact mechanics. The calculated values of the elastic modulus are consistent both when considering the results obtained from a single lymphocyte and when comparing the curves recorded from cells of different specimen

Cysteamine (Cystagon®) adherence in patients with cystinosis in Spain: successful in children and a challenge in adolescents and adults.

Journal Article; Research Support, Non-U.S. Gov't;BACKGROUND Cysteamine has improved survival and prognosis in cystinosis. Increasing numbers of patients reach adulthood and face new challenges such as compliance that wanes over time. The aim of this study was to evaluate adherence to cysteamine treatment in a group of cystinotic patients in Spain in an attempt to identify potential therapy pitfalls and improve the overall care of affected individuals. Despite the impact of cysteamine on prognosis, there is a paucity of data regarding adherence. METHOD Thirty-four cystinotic patients (21 male) 38% ≥18 years were enrolled in a voluntary, anonymous survey. Replies were obtained from patients (15/34), mothers (11/34), fathers (4/34) and both parents (4/34). RESULTS Patient age (median and interquartile range) at diagnosis was 1 year (0.57-1), and patient age at Cystagon® initiation was also 1 year (0.8-1.8). Sixteen (47%) were kidney transplant (KTx) recipients; six were retransplanted. Age at first KTx 10 years (8.7-13.7). Patient understanding of multiorgan involvement in cystinosis: 4.1 organs reported; eye 97% and kidney 91%. Cysteamine was given by mother (100%) and father (83%) in <11 year olds, or self-administered (94%) in ≥11 year olds. Four daily doses in 89% versus 56% in <11 year olds or ≥11 year olds, with fixed schedule in 94% versus 50% in <11 or ≥11 year olds and progressive loss of reminders over time. Furthermore, 44% complained of unpleasant smell. Motivation for treatment compliance was 100% versus 40% in <11 versus ≥11 year olds, respectively. Disease impact in patients <18 years is as follows: school (29%), social (14%), 'feeling different' (10%); in patients ≥18 years: 'feeling different' (62%), professional (39%) and job absenteeism (31%). Referring physician: paediatric nephrologist (94%) and nephrologist (63%) in <11 versus ≥11 year olds. Ophthalmological follow-up: 83% versus 38% in <11 versus ≥11 year olds. Patient opinion of physician expertise: paediatric nephrologist (94%) and nephrologist (44%). New treatment options (65%) and better information (42%) were demanded to improve adherence. CONCLUSION Treatment with Cystagon is effective in young patients. However, adherence diminishes over time in adolescents and adults despite disease impact. Strategies such as better information on the disease, patient self-care promotion and facilitated transition to adult healthcare services are required to improve compliance and the clinical management of cystinosis.This study has been supported by A.C. Nielsen Company S.L.and Orphan Europe S.L.UYe

Safety and preliminary efficacy on cognitive performance and adaptive functionality of epigallocatechin gallate (EGCG) in children with Down syndrome. A randomized phase Ib clinical trial (PERSEUS study)

Purpose: Although some caregivers are using epigallocatechin gallate (EGCG) off label in hopes of improving cognition in young adults with Down syndrome (DS), nothing is known about its safety, tolerability, and efficacy in the DS pediatric population. We aimed to evaluate safety and tolerability of a dietary supplement containing EGCG and if EGCG improves cognitive and functional performance. Methods: A total of 73 children with DS (aged 6-12 years) were randomized. Participants received 0.5% EGCG (10 mg/kg daily dose) or placebo for 6 months with 3 months follow up after treatment discontinuation. Results: In total, 72 children were treated and 66 completed the study. A total of 38 participants were included in the EGCG group and 35 in the placebo group. Of 72 treated participants, 62 (86%) had 229 treatment-emergent adverse events (AEs). Of 37 participants in the EGCG group, 13 (35%) had 18 drug-related treatment-emergent AEs and 12 of 35 (34%) from the placebo group had 22 events. In the EGCG group, neither severe AEs nor increase in the incidence of AEs related to safety biomarkers were observed. Cognition and functionality were not improved compared with placebo. Secondary efficacy outcomes in girls point to a need for future work. Conclusion: The use of EGCG is safe and well-tolerated in children with DS, but efficacy results do not support its use in this population. (C) 2022 The Authors. Published by Elsevier Inc. on behalf of American College of Medical Genetics and Genomics

Actividad física y salud Tomo 2

En la actualidad, las actividades deportivas han alcanzado un alto nivel de importancia desde las estancias gubernamentales, en las cuales continuamente se desarrollan programas que promueven la práctica de una variedad de deportes y en donde se plantea el desarrollo de innumerables escenarios que permitan estas prácticas en las diferentes etapas de la vida. En la comunidad, también se identifica un importante aumento en el número de personas que incluyen rutinas deportivas en su diario vivir, basando su motivación en las implicaciones positivas que, a nivel social, emocional y en términos del mejoramiento de la calidad de vida, plantea la práctica deportiva. Teniendo en cuenta la relevancia de la temática expuesta anteriormente, a continuación, se describe el impacto que tiene la actividad física desde el ámbito médico.Cirugía en ortopedia deportiva y artroscopia. -- El ejercicio como intervención terapéutica en el paciente con enfermedad pulmonar obstructiva crónica. -- Actividad física y cáncer. -- Imágenes diagnósticas, compañía del deportista durante una lesión. -- Esports: retos de la actividad física