DesignABILITY: Framework for the Design of Accessible Interactive Tools to Support Teaching to Children with Disabilities

Developing educational tools aimed at children with disabilities is a challenging process for designers and developers because existing methodologies or frameworks do not provide any pedagogical information and/or do not take into account the particular needs of users with some type of impairment. In this study, we propose a framework for the design of tools to support teaching to children with disabilities. The framework provides the necessary stages for the development of tools (hardware-based or software-based) and must be adapted for a specific disability and educational goal. For this study, the framework was adapted to support literacy teaching and contributes to the design of educational/interactive technology for deaf people while making them part of the design process and taking into account their particular needs. The experts' evaluation of the framework shows that it is well structured and may be adapted for other types of disabilities

Protein network prediction and topological analysis in Leishmania major as a tool for drug target selection

<p>Abstract</p> <p>Background</p> <p>Leishmaniasis is a virulent parasitic infection that causes a worldwide disease burden. Most treatments have toxic side-effects and efficacy has decreased due to the emergence of resistant strains. The outlook is worsened by the absence of promising drug targets for this disease. We have taken a computational approach to the detection of new drug targets, which may become an effective strategy for the discovery of new drugs for this tropical disease.</p> <p>Results</p> <p>We have predicted the protein interaction network of <it>Leishmania major </it>by using three validated methods: PSIMAP, PEIMAP, and iPfam. Combining the results from these methods, we calculated a high confidence network (confidence score > 0.70) with 1,366 nodes and 33,861 interactions. We were able to predict the biological process for 263 interacting proteins by doing enrichment analysis of the clusters detected. Analyzing the topology of the network with metrics such as connectivity and betweenness centrality, we detected 142 potential drug targets after homology filtering with the human proteome. Further experiments can be done to validate these targets.</p> <p>Conclusion</p> <p>We have constructed the first protein interaction network of the <it>Leishmania major </it>parasite by using a computational approach. The topological analysis of the protein network enabled us to identify a set of candidate proteins that may be both (1) essential for parasite survival and (2) without human orthologs. These potential targets are promising for further experimental validation. This strategy, if validated, may augment established drug discovery methodologies, for this and possibly other tropical diseases, with a relatively low additional investment of time and resources.</p

Point‑of‑care ultrasound in cardiorespiratory arrest (POCUS‑CA): narrative review article.

The POCUS-CA (Point-of-care ultrasound in cardiac arrest) is a diagnostic tool in the Intensive Care Unit and Emergency Department setting. The literature indicates that in the patient in a cardiorespiratory arrest it can provide information of the etiology of the arrest in patients with non-defibrillable rhythms, assess the quality of compressions during cardiopulmonary resuscitation (CPR), and define prognosis of survival according to specific findings and, thus, assist the clinician in decision-making during resuscitation. This narrative review of the literature aims to expose the usefulness of ultrasound in the setting of cardiorespiratory arrest as a tool that allows making a rapid diagnosis and making decisions about reversible causes of this entity. More studies are needed to support the evidence to make ultrasound part of the resuscitation algorithms. Teamwork during cardiopulmonary resuscitation and the inclusion of ultrasound in a multidisciplinary approach is important to achieve a favorable clinical outcomepost-print2391 K

Rattus norvegicus como indicador de la circulación de Capillaria hepatica y Taenia taeniaeformis en la Plaza Minorista de Medellín, Colombia

Introduction. Rattus norvegicus, the Norway rat, plays a pivotal role in the maintenance and spread of several zoonotic bacterial, viral and parasitic pathogens of public health interest. The presence of helminthic infections near susceptible human populations can, under appropriate environmental conditions, become a risk factor for their transmission.Objective. Frequencies of infection were reported for Capillaria hepatica and larval forms of Taenia taeniaeformis in wild rats (R. norvegicus) captured in an urban area.Materials and methods. Two hundred and fifty-four adult specimens of R. norvegicus were collected in an urban zone of Medellín, Colombia. The livers of 54 specimens that showed macroscopic hepatic lesions during necropsy were examined by conventional histopathology.Results. The frequency of infestation with C. hepatica was 20.1% (51/254). Six livers (2.4%) were also positive for larvae of T. taeniaeformis. Livers infested with C. hepatica exhibited adult or juvenile parasites and oval eggs with bipolar opercula, and were associated with mild to moderate multifocal granulomatous hepatitis with leucocyte infiltrate. Granulomatous lesions and calcified residual fibroses were found with eggs but without adult parasites. Those animals with cysticerci of T. taeniaeformis showed a high frequency of hepatic cysts containing larvae as well as inflammed and fibrotic lesions.Conclusion. Zoonotic helminths circulate at high frequency in R. norvegicus that occur in urban environments. Further research about the distribution of these parasites will determine the level of health threat they present for susceptible human and domestic animal populations. doi: http://dx.doi.org/10.7705/biomedica.v32i4.442Introducción. Rattus norvegicus cumple un papel epidemiológico en el mantenimiento y dispersión de agentes zoonóticos bacterianos, virales y parasitarios de interés en salud pública. La presencia de infección por helmintos en especies Rattus cercanas a poblaciones expuestas en condiciones ambientales propicias, puede convertirse en un factor de riesgo de transmisión.Objetivo. Reportar la frecuencia de infección con Capillaria hepatica y formas larvarias de Taenia taeniaeformis en ratas silvestres (R. norvegicus) capturadas en una zona urbana de Medellín.Materiales y métodos. Se capturaron 254 ejemplares de R. norvegicus. Los hígados de 54 ejemplares que presentaron lesión hepática macroscópica durante la necropsia, fueron examinados por histopatología convencional.Resultados. La frecuencia de infección por C. hepatica fue de 20,1 % (51/254). Seis hígados fueron también positivos para larvas de T. taeniaeformis con una frecuencia de 2,4 % (6/254). Los hígados infestados con C. hepatica exhibían parásitos en el estadio adulto o juvenil y huevos ovalados conopérculos bipolares, asociados con hepatitis granulomatosa leve a moderada multifocal y acompañada por infiltrado leucocitario. Se observaron lesiones granulomatosas en resolución y fibrosis residual o calcificada que contenía huevos. Donde se encontraron cisticercos de T. taeniaeformis, el hallazgo más frecuente fueron quistes hepáticos que contenían larvas, y lesiones inflamatorias y fibróticas.Conclusión. Estos resultados indican que helmintos de potencial zoonótico circulan en R. norvegicus de ambientes urbanos. Debe investigarse la verdadera distribución de estos parásitos, para determinar el riesgo potencial que corren las poblaciones animales y humanas expuestas a adquirir este tipo de infecciones. doi: http://dx.doi.org/10.7705/biomedica.v32i4.442

Research Trends on Pillared Interlayered Clays (PILCs) Used as Catalysts in Environmental and Chemical Processes: Bibliometric Analysis

Over the last four decades, a large number of studies have been published on pillared interlayered clays (PILCs) used as adsorbent materials and catalysts or supports for transition metals in heterogeneous catalysis. Particularly, PILCs have been used for water treatment through advanced oxidation processes (AOPs) to remove organic pollutants. They have also been studied in various chemical and environmental processes. Because of the growing interest in PILCs, this article is focused on analyzing scientific publications such as research/review articles and book chapters from the last four decades (from 1980 to 2019) through a bibliometric analysis (BA) to visualize and describe research trends on PILCs. By narrowing the bibliographic search to titles, keywords, and abstracts of publications related to PILCs, using Scopus and Web of Science (WoS) (the two scientific databases), a total of 3425 documents have been retrieved. The bibliometric dataset was analyzed by VantagePoint®. The main research trends identified in the last four decades were the use of PILCs in environmental processes (34.4% of total publications) along with chemical processes (petrochemical reactions 17.5%, SCR NOx 10.8%, and decomposition 8.2%). In environmental processes, PILCs have been used in photo-oxidation (32%), CWPO (21.1%), and heterogeneous catalysis (19.4%). Phenols, dyes, and VOCs have been the main pollutants studied using PILCs as catalysts. Fe, Ti, Zr, Cu, and Co are the most supported active phases in PILCs. Other research trends grouped by characterization techniques, countries, research areas, institutes, scientific journals that have published the most on this topic, number of publications per 5-year period, and most frequently used keywords through the last four decades have been identified. It was determined that the number of publications on PILCs has increased since 1980 and the countries with the highest number of publications are China, Spain, and The United States of America.Centro de Investigación y Desarrollo en Ciencias Aplicada

MYCN mediates cysteine addiction and sensitizes neuroblastoma to ferroptosis

Aberrant expression of MYC transcription factor family members predicts poor clinical outcome in many human cancers. Oncogenic MYC profoundly alters metabolism and mediates an antioxidant response to maintain redox balance. Here we show that MYCN induces massive lipid peroxidation on depletion of cysteine, the rate-limiting amino acid for glutathione (GSH) biosynthesis, and sensitizes cells to ferroptosis, an oxidative, non-apoptotic and iron-dependent type of cell death. The high cysteine demand of MYCN-amplified childhood neuroblastoma is met by uptake and transsulfuration. When uptake is limited, cysteine usage for protein synthesis is maintained at the expense of GSH triggering ferroptosis and potentially contributing to spontaneous tumor regression in low-risk neuroblastomas. Pharmacological inhibition of both cystine uptake and transsulfuration combined with GPX4 inactivation resulted in tumor remission in an orthotopic MYCN-amplified neuroblastoma model. These findings provide a proof of concept of combining multiple ferroptosis targets as a promising therapeutic strategy for aggressive MYCN-amplified tumors

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P &lt; 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P &lt; 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries