Recomendaciones de consenso en ventilación protectora intraoperatoria

During last few years it has been several guidelines about lung-protective ventilation on patients suffering from ARDS on intensive care units but this review is the first one related to the surgical patient. A group of experts have tried to define and determinate the risk factors envolving postoperatory lung complications and the characteristics of the protective ventilation.   En los últimos años, son varias las guías publicadas sobre ventilación protectora (VP) en pacientes con síndrome de distrés respiratorio agudo (SDRA) en unidades de cuidados críticos (UCI), pero las presentes son las primeras guías de consenso de VP en el paciente quirúrgico. Un grupo de expertos ha intentado definir los factores de riesgo para desarrollar complicaciones pulmonares postoperatorias (CPPs) y las características de la VP intraoperatoria.    

Influence of cavity type and size of composite restorations on cuspal flexure

Objectives: The present study examines the influence of cavity type, and size of composite restorations on cuspal flexure due to polymerization shrinkage. Methods: Thirty healthy premolars were selected and divided into two experimental groups. Group 1: Mesial, mesiodistal, and MOD cavities were successively prepared in each tooth by means of the SONICSYS approx system (KaVo ®) using a nº 2 (small) diamond tip. Group 2: The same cavity preparation sequence was followed but a nº 3 (medium) tip was used. Cavity preparations were performed and afterwards restored using the same adhesive system and resin composite. Cuspal displacement was measured 15 min after completion of each type of restoration. Results: Under the experimental conditions used, polymerization shrinkage of composite restorations resulted in an inward deflection of the cusps in all the situations evaluated. The Friedman global test found significant differences according to the cavity type and size (p0.05). Conclusions: The present study demonstrates that significantly higher cuspal deflection is observed in MOD restorations, showing that the degree of dental removal influences the cuspal flexure from polymerization shrinkage of composite restorations

Physicochemical properties of 3D-printed polylactic acid/hydroxyapatite scaffolds

The reconstruction or regeneration of damaged bone tissue is one of the challenges of orthopedic surgery and tissue engineering. Among all strategies investigated, additive manufacturing by fused deposition modeling (3D-FDM printing) opens the possibility to obtain patient-specific scaffolds with controlled architectures. The present work evaluates in depth 3D direct printing, avoiding the need for a pre-fabricated filament, to obtain bone-related scaffolds from direct mixtures of polylactic acid (PLA) and hydroxyapatite (HA). For it, a systematic physicochemical characterization (SEM-EDS, FT-Raman, XRD, micro-CT and nanoindentation) was performed, using different PLA/HA ratios and percentages of infill. Results prove the versatility of this methodology with an efficient HA incorporation in the 3D-printed scaffolds up to 13 wt.% of the total mass and a uniform distribution of the HA particles in the scaffold at the macro level, both longitudinal and cross sections. Moreover, an exponential distribution of the HA particles from the surface toward the interior of the biocomposite cord (micro level), within the first 80 µm (10% of the entire cord diameter), is also confirmed, providing the scaffold with surface roughness and higher bioavailability. In relation to the pores, they can range in size from 250 to 850 µm and can represent a percentage, in relation to the total volume of the scaffold, from 24% up to 76%. The mechanical properties indicate an increase in Young’s modulus with the HA content of up to ~50%, compared to the scaffolds without HA. Finally, the in vitro evaluation confirms MG63 cell proliferation on the 3D-printed PLA/HA scaffolds after up to 21 days of incubation

Design and Implementation of a Stereo Vision System on an Innovative 6DOF Single-Edge Machining Device for Tool Tip Localization and Path Correction

[EN] In the current meso cutting technology industry, the demand for more advanced, accurate and cheaper devices capable of creating a wide range surfaces and geometries is rising. To fulfill this demand, an alternative single point cutting device with 6 degrees of freedom (6DOF) was developed. Its main advantage compared to milling has been the need for simpler cutting tools that require an easier development. To obtain accurate and precise geometries, the tool tip must be monitored to compensate its position and make the proper corrections on the computer numerical control (CNC). For this, a stereo vision system was carried out as a different approach to the modern available technologies in the industry. In this paper, the artificial intelligence technologies required for implementing such vision system are explored and discussed. The vision system was compared with commercial measurement software Dino Capture, and a dedicated metrological microscope system TESA V-200GL. Experimental analysis were carried out and results were measured in terms of accuracy. The proposed vision system yielded an error equal to ±3 µm in the measurement.SIMinisterio de Economía y Competitividad (DPI2016-79960-C3-1-P)Ministerio de Economía y Competitividad (DPI2016-79960-C3-2-P)National Council on Science and Technology (CONACyT) ( CVU-482229 (México))SENESCYT ( No 223-2012 (Ecuador)

How young people’s perceptions of their physical education lessons and social skills varied in terms of sociodemographic features. The case of a rural area of China

The aim of this study was to examine whether motivation, support, basic-needs satisfaction, and social skills in physical education lessons differed among Chinese secondary students from rural areas depending on their sociodemographic profiles. Two hundred and seven students enrolled in a camp organized by a non-profit organization in Chengdu province (15.8 ± 0.8 years, 74% female and 26% male) completed validated Chinese versions of the pertinent questionnaires. Appropriate social skills were perceived higher by women that by men (z = 2.2; p = 0.014; r = 0.16). Inappropriate social skills (z = 2.9; p = 0.021; r = 0.22) were perceived higher among those students with lower annual home income (50,000 yuan or less). Perceived autonomy support (z = 2.9; p = 0.002; r = 0.20), basic-needs satisfaction (z = 2.9; p = 0.002; r = 0.20), and physical-education motivation (z = 4.2; p < 0.001; r = 0.30) were higher among students who practiced physical activity or sport outside school. Students who practiced during their physical-education team-sports lessons reported higher motivation for physical education (z = 2.9; p = 0.002; r = 0.20) than those who practiced individual sports. The findings from this study are relevant to practitioners who work with students from these underprivileged rural areas

Derivation and validation of a clinical prediction rule for sleep apnoea syndrome for use in primary care

Background: Several clinical prediction rules (CPRs) are available for sleep apnoea-hypopnoea syndrome (OSAH), but they are difficult to apply in primary care (PC). Aim: Derivation and validation of a CPR using simple measurements available in PC. Design & setting: A prospective study conducted in health centres from the area of influence of three Spanish hospitals. Method: Patients (aged 18-70 years) who attended for any reason; who presented with at least one of the three key symptoms for OSAH (snoring, breathing pauses while sleeping, and daytime sleepiness); and who were not undergoing non-invasive ventilation or prior treatment with continuous positive airway pressure (CPAP) were included. Anthropometric data, smoking habit, comorbidities, and Epworth test were collected. Patients were subsequently referred to the sleep unit (SU), where the decision was taken whether or not to instigate treatment. A multivariate logistic model was constructed using a sub-sample and scores assigned based on the regression coefficients; the CPR was validated with the remaining sample. Both receiver operating characteristic (ROC) curves were plotted and the sensitivity, specificity, and predictive values calculated. Results: The derivation sample comprised 352 patients, with 260 in the validation sample. The final factors (arterial hypertension [AHT], age, body mass index [BMI], and sex) were used to develop a rule with scores ranging from 0.00-5.50. The cut-off point that optimises the area under the curve (AUC) is ?2.50 points (AUC = 0.78; sensitivity = 86%; specificity = 54%; positive predictive value [PPV] = 45%; negative predictive value [NPV] = 90%; likelihood ratio [LR] = 0.26). The properties for the validation sample with this cut-off point are as follows: AUC = 0.68; sensitivity = 81%; specificity = 43%; PPV = 61%; NPV = 68%; LR = 0.44. Conclusion: As in similar cases, the specificity is low, meaning that healthy people are referred to a specialist. A negative result rules out the disease in most cases

Investigating the Contribution of Decision-Making, Cognitive Insight, and Theory of Mind in Insight in Schizophrenia: A Cross-Sectional Study

INTRODUCTION: Insight in schizophrenia spectrum disorders (SSD) is associated with outcomes. Although the neurocognitive basis of insight is widely accepted, the specific contribution of decision-making (Jumping to Conclusions [JTC]), Cognitive Insight (CI), and Theory of Mind (ToM) to insight remains unclear. METHODS: The sample included N = 77 SSD outpatients aged 18–64 years from a randomized controlled trial of metacognitive training. Assessments included JTC-Beads Task, CI-Beck Cognitive Insight Scale, ToM-Hinting Task, and the Emotions Recognition Test Faces. STATISTICS: hierarchical multivariable linear regression models tested their contribution to total insight (TI) and three insight dimensions – illness recognition (IR), symptom relabelling (SR), and treatment compliance (TC) – measured with the Schedule for the Assessment of Insight – Expanded version, whilst adjusting for potential confounders. RESULTS: Bivariate analyses showed that CI was associated with TI (R2 change = 0.214; p < 0.001), IR (R2 change = 0.154; p = 0.003), and SR (R2 change = 0.168; p = 0.003), while JTC predicted IR (R2 change = 0.790; p = 0.020). Multivariable regression models showed that CI predicted TI (R2 change = 0.116; p = 0.036) and SR (R2 change = 0.166, p = 0.011), whereas JTC was linked with IR (R2 change = 0.710; p = 0.026). ToM was not linked with any insight score. No cognitive variable was associated with treatment compliance. DISCUSSION: Results supported the (meta)cognitive model of insight in SSD. JTC and CI emerged as the main (meta)cognitive processes underlying insight. Metacognitive interventions may therefore improve insight in SSD, although these therapies alone may fail to address treatment compliance

Strength plus Endurance Training and Individualized Diet Reduce Fat Mass in Overweight Subjects:A Randomized Clinical Trial

Studies with overweight people are a priority in order to observe the effect of the timing of intervention on pre-obesity people. The aim was to compare different physical activity programs plus an individualized hypocaloric diet on body composition in overweight subjects. A randomized controlled clinical trial was carried out in overweight adults with no history of relevant illness. Primary outcome was total fat mass (TFM). Participants were allocated into four activity programs with equal intensity and volume of exercise for 22 weeks: strength training (S), endurance training (E), strength + endurance training (SE), and 'adhering to physical activity recommendations' (C). Participants followed a diet with 25% less energy (50%-55% carbohydrates, 30%-35% fat) measured by accelerometer. Variables were assessed at baseline and at the end of the intervention. Body composition was measured by dual-energy X-ray absorptiometry. One hundred nineteen from 205 subjects were randomized in the four exercise groups (S = 30/E = 30/SE = 30/C = 29) and 84 participants (36 men/48 women) ended the intervention (S = 19/E = 25/SE = 22/C = 18). At the end of the experiment, all groups except C increased their total physical activity (S = 1159 ± 1740; E = 1625 ± 1790; SE = 1699 ± 2516; C = 724 ± 1979 MET-min/week). Using an ANOVA-test, improvements were observed in body weight (S = -4.6 ± 4.5; E = -6.6 ± 4.6; SE = -8.5 ± 2.8; C = -6.1 ± 5.6 kg, p = 0.059) and TFM (S = -4.24 ± 2.02; E = -4.74 ± 2.96; SE = -6.74 ± 3.27; C = -3.94 ± 4.18%; p < 0.05). The main conclusion was that there were no adverse events. Strength and endurance training with a balanced, individualized hypocaloric diet was the most effective at reducing weight loss and fat mass in overweight subjects. Trial registration: NCT01116856

SINGLE-CELL sequencing workflow to study cellular composition and cell type specific expression profiles of human Cerebral Organoids

IBRO 11th World Congress of Neuroscience. Granada (Spain). 9-13 September 2023.Human cerebral organoid culture is a technology with immense potential in the areas of developmental neurobiology and neurodegeneration for example to study cell types, mechanisms involved, to discover of new biomarkers, to propose specific therapeutic strategies or to study the effects of compound-induced toxicity. Single-cell RNA sequencing (scRNA-seq) is a promising technology that will help to define the identity of the cerebral organoids and to understand cellular composition and cell type specific expression profiles. Standardization of workflows to do the scRNA-seq analysis is an important means to improve the use of this technology. We present the workflow and results of the scRNA-seq performed for cerebral organoids generated from the AND-2 cell line of human embryonic stem cells (hESCs). Dissociated cerebral organoid samples were loaded on the 10X Chromium and single cell libraries were prepared according to 10X Genomics standard procedures and sequenced on the Novaseq sequencer (Illumina).The data were checked and aligned to the GRCh38 human reference genome with CellRanger v6.0.2 and analyzed with Seurat v4.0. After quality filtering and data normalization with the SCTransform function, we performed Principal component analysis (PCA) using the highly variable genes, built a Shared Nearest Neighbor (SNN) graph using the Louvain method. To visualize data, Uniform Manifold Approximation and Projection (UMAP) dimensional reduction was performed. The identities of the cell clusters were assigned using the expression of genes specific of each cell type. We annotate in the AND2 cerebral organoids clusters for intermediate progenitor cells, astrocytes, oligodendrocyte precursor cells, excitatory neurons, inhibitory neurons, and mesodermal cells. We find also some cells in these organoids with expression of endothelial and microglial gene markers. Enrichment analysis of the highly variable differentially expressed genes (DEGs) was utilized to characterize the assigned cell types with Gene Ontology (GO), PanglaoDB and Cellmarker databases.S

Effects of Hyperoxia on Oxygen-Related Inflammation with a Focus on Obesity

Several studies have shown a pathological oxygenation (hypoxia/hyperoxia) on the adipose tissue in obese subjects. Additionally, the excess of body weight is often accompanied by a state of chronic low-degree inflammation. The inflammation phenomenon is a complex biological response mounted by tissues to combat injurious stimuli in order to maintain cell homeostasis. Furthermore, it is believed that the abnormal oxygen partial pressure occurring in adipose tissue is involved in triggering inflammatory processes. In this context, oxygen is used in modern medicine as a treatment for several diseases with inflammatory components. Thus, hyperbaric oxygenation has demonstrated beneficial effects, apart from improving local tissue oxygenation, on promoting angiogenesis, wound healing, providing neuroprotection, facilitating glucose uptake, appetite, and others. Nevertheless, an excessive hyperoxia exposure can lead to deleterious effects such as oxidative stress, pulmonary edema, and maybe inflammation. Interestingly, some of these favorable outcomes occur under high and low oxygen concentrations. Hereby, we review a potential therapeutic approach to the management of obesity as well as the oxygen-related inflammation accompanying expanded adipose tissue, based on elevated oxygen concentrations. To conclude, we highlight at the end of this review some areas that need further clarification