Estimación del coeficiente de compresibilidad de combustibles diésel

Conocer las propiedades de los combustibles diésel resulta de gran importancia para el análisis y la comprensión de fenómenos relacionados con los procesos de inyección, formación de la mezcla, combustión y emisión de compuestos contaminantes. Este trabajo describe un método de estimación del coeficiente isoentrópico de compresibilidad de combustibles diésel. Empleando una instalación para obtener tasas de inyección, se ha ensayado un diésel comercial (con 5.8% de biodiesel), un aceite vegetal hidrotratado (hydrotreated vegetal oil, HVO) y un combustible obtenido a partir de gas natural (gas to liquid, GTL) mediante un proceso Fischer Tropsch de baja temperatura. Variando la presión de inyección, regulando la temperatura del combustible, manteniendo constante la contrapresión en el interior del tasímetro y utilizando dos tipos de inyectores (de bobina electromagnética y piezoeléctrico), se han estimado experimentalmente los valores del coeficiente isoentrópico de compresibilidad para dichos combustibles. Adicionalmente, se ha determinado que el desfase inicial entre el pulso eléctrico de alimentación del inyector y la curva de tasa solo depende del tipo de inyector. Sin embargo, el desfase final entre el pulso eléctrico del inyector y la tasa depende sólo del inyector en el caso del inyector controlado con bobina electromagnética mientras que en el caso del inyector piezoeléctrico depende además de la presión de inyección a la que se trabaje.Los autores quieren agradecer a la Junta de Comunidades de Castilla La Mancha la financiación al proyecto COMBALT2. Asimismo, agradecen la cesión de los combustibles GTL y HVO a las empresas SASOL y NESTE OIL respectivamente, así como el apoyo logístico ofrecido por la empresa Turbo-inyección Alonso. Finalmente, los autores agradecen a la Universidad Autónoma de Nuevo León, Monterrey, México y a la financiación del proyecto PAICYT IT 647-11 por la estancia del Prof. Simón Martínez Martínez durante la realización de los ensayos

Quantification of endothelin-1 level in placentae and human fetal membranes

A endotelina é um peptídeo vasoconstrictor potente que possui funções angiogênicas, mitogênicas e neurotróficas. Neste estudo procurou-se quantificar os níveis de Endotelina -1 (ET-1) em vilos coriônicos placentários e no âmnio de placentas de fetos gemelares, cujas mães submeteram-se à reprodução assistida e fecundação espontânea. Foram colhidas oito amostras de placentas, que após o delivramento placentário, foram colocadas em nitrogênio líquido e, posteriormente, congeladas e mantidas à -80ºC até o processamento por ensaio imunoenzimático (ELISA). Os níveis de concentração de ET-1 em amostras de vilos coriônicos de placentas de fetos gemelares variaram de 0,52 a 0,70fmol/ml, enquanto que de fetos únicos variou de 0,47 a 0,86fmol/ml. A mesma determinação em amostras de âmnio de placentas de gemelares variou de 0,61 a 1,16 fmol/ml, enquanto que de fetos únicos variou de 0,65 a 1,04fmol/ml. Estes achados indicam que em vilos coriônicos, os níveis de concentração de ET-1 não variaram entre gemelares e fetos únicos. No âmnio, os níveis de ET-1 são mais elevados em gemelares que em fetos únicos, dados que sugerem que o âmnio é a principal fonte de ET-1 presente no líquido amniótico.The endothelin is a potent vasoconstricor that possess angiogenic, mitogenic and neurotrophical functions. In this study we aimed to quantify the Endothelin-1 (ET-1) levels in chorionic placental villi and amnion of placentae of twins childbirths whose women were submitted to an assisted pregnancy and spontaneal fecundation. Were collected 08 placental samples. After the placental delivery the samples had been placed in liquid nitrogen and later in a -80ºC until the Enzyme-Linked Immunosorbent Assay (ELISA) technique. The concentration levels of ET-1 in samples of chorionic villi in twins placentae varied from 0,52 to 0,70 fmol/ml, while in chorionic villi single gestation varied from 0,47 to 0,86 fmol/ml. The same determination in samples of amnion of twins placentae varied from 0,65 to 1,16 fmol/ml, while in single gestation varied from 0,65 to 1,04 fmol/ml. These findings suggests that in the chorionic villi the levels of ET-1 didn't vary between twins and single gestation. In the amnion the levels of ET-1 are higher in twins than in single gestation, suggesting that the amnion is the source of ET-1 in the amniotic fluid

Quantification of endothelin-1 level in placentae and human fetal membranes

The endothelin is a potent vasoconstricor that possess angiogenic, mitogenic and neurotrophical functions. In this study we aimed to quantify the Endothelin-1 (ET-1) levels in chorionic placental villi and amnion of placentae of twins childbirths whose women were submitted to an assisted pregnancy and spontaneal fecundation. Were collected 08 placental samples. After the placental delivery the samples had been placed in liquid nitrogen and later in a -80ºC until the Enzyme-Linked Immunosorbent Assay (ELISA) technique. The concentration levels of ET-1 in samples of chorionic villi in twins placentae varied from 0,52 to 0,70 fmol/ml, while in chorionic villi single gestation varied from 0,47 to 0,86 fmol/ml. The same determination in samples of amnion of twins placentae varied from 0,65 to 1,16 fmol/ml, while in single gestation varied from 0,65 to 1,04 fmol/ml. These findings suggests that in the chorionic villi the levels of ET-1 didn't vary between twins and single gestation. In the amnion the levels of ET-1 are higher in twins than in single gestation, suggesting that the amnion is the source of ET-1 in the amniotic fluid.A endotelina é um peptídeo vasoconstrictor potente que possui funções angiogênicas, mitogênicas e neurotróficas. Neste estudo procurou-se quantificar os níveis de Endotelina -1 (ET-1) em vilos coriônicos placentários e no âmnio de placentas de fetos gemelares, cujas mães submeteram-se à reprodução assistida e fecundação espontânea. Foram colhidas oito amostras de placentas, que após o delivramento placentário, foram colocadas em nitrogênio líquido e, posteriormente, congeladas e mantidas à -80ºC até o processamento por ensaio imunoenzimático (ELISA). Os níveis de concentração de ET-1 em amostras de vilos coriônicos de placentas de fetos gemelares variaram de 0,52 a 0,70fmol/ml, enquanto que de fetos únicos variou de 0,47 a 0,86fmol/ml. A mesma determinação em amostras de âmnio de placentas de gemelares variou de 0,61 a 1,16 fmol/ml, enquanto que de fetos únicos variou de 0,65 a 1,04fmol/ml. Estes achados indicam que em vilos coriônicos, os níveis de concentração de ET-1 não variaram entre gemelares e fetos únicos. No âmnio, os níveis de ET-1 são mais elevados em gemelares que em fetos únicos, dados que sugerem que o âmnio é a principal fonte de ET-1 presente no líquido amniótico

Delphi Project on the trends in Implant Dentistry in the COVID-19 era: Perspectives from Latin America

This article is made available for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.Aim To establish trends in Implant Dentistry in Latin America in the COVID‐19 pandemic. Material and methods A steering committee and an advisory group of experts in Implant Dentistry were selected among eighteen countries. An open‐ended questionnaire by Delphi methodology was validated including 64 questions, divided in 7 topics, concerning the various trends in dental implantology. The survey was conducted in two rounds, which provided the participants in the second round with the results of the first. The questionnaires were completed on August 2020, and the online meeting conference was held on September 2020. The final prediction was developed through consensus by a selected group of experts. Results A total of 197 experts from Latin America answered the first and second questionnaire. In the first round, the established threshold for consensus (65%) was achieved in 30 questions (46.87%). In the second round, performed on average 45 days later, this level was achieved in 47 questions (73.43%). Consensus was completely reached on the item “Diagnostic” (100%), the field with the lowest consensus was “Demand for treatment with dental implants” (37.5%). Conclusions The present study in Latin America has provided relevant and useful information on the predictions in the education and practice of Implant Dentistry in the COVID‐19 era. The consensus points toward a great confidence of clinicians in the biosecurity protocols used to minimize the risk of SARS‐CoV‐2 transmission. It is foreseen as an important change in education, with introduction of virtual reality and other simulation technologies in implant training

Acceptability and feasibility of a virtual community of practice to primary care professionals regarding patient empowerment: A qualitative pilot study

Background: Virtual communities of practice (vCoPs) facilitate online learning via the exchange of experiences and knowledge between interested participants. Compared to other communities, vCoPs need to overcome technological structures and specific barriers. Our objective was to pilot the acceptability and feasibility of a vCoP aimed at improving the attitudes of primary care professionals to the empowerment of patients with chronic conditions. Methods: We used a qualitative approach based on 2 focus groups: one composed of 6 general practitioners and the other of 6 practice nurses. Discussion guidelines on the topics to be investigated were provided to the moderator. Sessions were audio-recorded and transcribed verbatim. Thematic analysis was performed using the ATLAS-ti software. Results: The available operating systems and browsers and the lack of suitable spaces and time were reported as the main difficulties with the vCoP. The vCoP was perceived to be a flexible learning mode that provided up-to-date resources applicable to routine practice and offered a space for the exchange of experiences and approaches. Conclusions: The results from this pilot study show that the vCoP was considered useful for learning how to empower patients. However, while vCoPs have the potential to facilitate learning and as shown create professional awareness regarding patient empowerment, attention needs to be paid to technological and access issues and the time demands on professionals. We collected relevant inputs to improve the features, content and educational methods to be included in further vCoP implementation. Trial registration: ClinicalTrials.gov, NCT02757781. Registered on 25 April 2016.This study was financed by Instituto de Salud Carlos III and Cofinanced by Fondo Europeo de Desarrollo Regional (FEDER). Ministerio de Economía y Competitividad. Gobierno de España. (PI15/00164, PI15/00586, PI15/00566

Desenvolvimento neuropsicomotor na infância e eventos obstétricos

Objective: Investigate and analyze the relationship between obstetric events and neuropsychomotor development in children aged 0 to 12 years. The research aims to contribute to understanding the impacts of these events on child development, providing insights that can guide obstetric practices, early interventions, and strategies for promoting health in childhood.Introduction: Contextualization and relevance of the study, addressing the importance of understanding the influence of obstetric events on neuropsychomotor child development. The need to explore this relationship is emphasized to inform obstetric practices and intervention strategies that promote healthy development in childhood. Methodology: Searches were conducted in the PubMed, Scielo, and Latindex databases using terms related to neuropsychomotor development and obstetric events. The DeCS terms used included "Neurology," "Growth and Development," "Child Development," "Obstetric Delivery," "Child Psychiatry," and "Adverse Birth Outcomes," combined with boolean operators AND and OR. Conclusion: The conclusion highlights the relationship between obstetric events and neuropsychomotor development. Understanding risk factors guides prevention and personalized interventions, addressing neonatal vulnerability. Evaluation and diagnosis are vital for adapted support, and therapeutic interventions drive progress. Emphasis on prevention, family support, research, and advocacy is crucial for inclusive environments and healthy development.Objetivo: Investigar e analisar a relação entre eventos obstétricos e o desenvolvimento neuropsicomotor em crianças de 0 a 12 anos. A pesquisa visa contribuir para a compreensão dos impactos desses eventos no desenvolvimento infantil, fornecendo insights que possam orientar práticas obstétricas, intervenções precoces e estratégias de promoção da saúde na infância. Introdução: Contextualização e relevância do estudo, abordando a importância de compreender a influência dos eventos obstétricos no desenvolvimento neuropsicomotor infantil. Destaca-se a necessidade de explorar essa relação para informar práticas obstétricas e estratégias de intervenção que promovam um desenvolvimento saudável na infância. Metodologia: Foram conduzidas buscas nas bases de dados PubMed, Scielo e Latindex usando termos relacionados ao desenvolvimento neuropsicomotor e eventos obstétricos. Os DeCs utilizados incluíram "Neurologia", "Crescimento e Desenvolvimento", "Desenvolvimento Infantil", "Parto Obstétrico", "Psiquiatria Infantil" e "Desfechos Adversos do Nascimento", combinados por operadores booleanos AND e OR. Conclusão: A conclusão destaca a relação entre eventos obstétricos e desenvolvimento neuropsicomotor. Entender fatores de risco guia prevenção e intervenções personalizadas, atendendo à vulnerabilidade neonatal. Avaliação e diagnóstico são vitais para suporte adaptado, e intervenções terapêuticas impulsionam o progresso. A ênfase em prevenção, suporte familiar, pesquisa e advocacia é crucial para ambientes inclusivos e o desenvolvimento saudável

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years