Desarrollo y construcción de un curador cúltiple de riboflavina

La queratitis infecciosa es una enfermedad ocular asociada con la pérdida permanente de la visión y causada por microorganismos; en ocasiones se presentan casos resistentes al tratamiento quimioterapéutico. La utilización del enlace cruzado o reticulación (CRUVR) para esos casos resulta interesante en el área oftalmológica. Actualmente el CRUVR terapéutico se utiliza para el tratamiento de la enfermedad queratocono, y consiste en una reacción química que produce enlaces entre cadenas de polímeros, donde se incluye la aplicación de riboflavina sobre el ojo hasta que penetre en su interior, y la posterior irradiación del ojo con con luz ultravioleta (UV). La realización de ensayos in vitro para el testeo de la eficacia del CRUVR en el tratamiento de la queratitis infecciosa presenta dificultades al no existir un dispositivo emisor de luz UV adaptado a las condiciones de laboratorio; por lo cual los ensayos actualmente se realizan con el dispositivo médico utilizado para el tratamiento del queratocono. En el presente trabajo se diseñó y construyó un dispositivo que permite la irradiación simultánea de múltiples muestras a 0.112 mW/cm², lo que constituye un avance hacia la optimización de la realización de ensayos in vitroFil: Troche Rotela, Abdon. Universidad Nacional de Asunción (Paraguay)Fil: Álvarez Dagogliano, Rolando. Universidad Nacional de Asunción (Paraguay)Fil: Benítez Candia, Nidia. Universidad Nacional de Asunción (Paraguay)Fil: Riveros Maidana, Rocío. Universidad Nacional de Asunción (Paraguay)Fil: Sánchez Di Martino, Daniel. Universidad Nacional de Asunción (Paraguay)Fil: Fernández Ríos, Danilo. Universidad Nacional de Asunción (Paraguay

Paciente con artropatía progresiva. Una historia diferente. Formas atenuadas de la mucopolisacaridosis tipo I. caso clínico y revisión de la literatura

Mucopolysaccharidosis type I are lisosomal storage diseases that are caused by a mutation on the gene that encodes the lisosomal enzyme α-L-iduronidase necessary for the glycosaminoglycan heparan sulfate and dermatan sulfate catabolism. The inheritance is autosomal recessive, with a prevalence of 1 to 1,9 per 100.000 live births. It is of progressive and multisystemic nature. Three phenotypes of the diseases has been described, Hurler syndrome, Hurler-Scheie syndrome and Scheie syndrome, depending of the severity of the symptoms and the neurological impairment. There are not clinical parameters that differentiate one phenotype from the others. Therefore, currently it is accepted the difference between accentuated phenotypes and attenuated phenotypes taking into account the therapeutical options for each type. The coarse features onset in the attenuated phenotypes presents a heterogeneous display, this is the reason why it often goes unnoticed, contributing to its underdiagnoses. The arthropathy presented in most patients, is bilateral, symmetrical and universal, affecting to a greater or lesser extent to all joints, causing joint mobility restriction. These patients also present upper airway compromise, cardiac and ophthalmological involvement and risk of myelopathy, all these could lead to increased morbidity and mortality. Early diagnosis is very important, since enzyme replacement therapy with laronidase improves the non-neurological clinical manifestation and stabilizes the disease progression. We present a clinical case of a patient with a story of progressive joint mobility restriction, accompanied of decrease visual acuity due to corneal clouding, otorhinolaryngologic recurrent infections, developmental delay (short stature) and umbilical hernia surgery. Patient was diagnosed MPS I at 21 and started treatment with laronidase at 23 years old.Las mucopolisacaridosis son enfermedades de depósito lisosomal que se producen por una mutación en el gen que codifica la enzima lisosomal α-L-iduronidasa, necesaria para el catabolismo de los glicosaminoglicanos heparan sulfato y dermatan sulfato. La herencia es autosómica recesiva, con una prevalencia de 1-1,9/100.000 nacidos vivos. Es de carácter progresivo y multisistémico. Se han descripto tres fenotipos de la enfermedad, síndrome de Hurler, síndrome de Hurler-Scheie y síndrome de Scheie, según el grado de severidad de los síntomas y el compromiso neurológico que presenten. No existen parámetros clínicos claros que diferencien un fenotipo de otro, por lo que actualmente se acepta la diferenciación en fenotipo severo y fenotipo atenuado, teniendo en cuenta las opciones terapéuticas para cada forma de presentación. Los fenotipos atenuados tienen una presentación heterogénea en cuanto a la aparición de los rasgos toscos característicos, por lo que muchas veces pasan desapercibidas y esto contribuye al subdiagnóstico de las mismas. La artropatía está presente en la mayoría de los pacientes, es bilateral, simétrica y universal, afectando en mayor o menor medida a todas las articulaciones, causando restricción en la movilidad articular. Estos pacientes también presentan compromiso de vías aéreas altas, afectación cardiaca, oftalmológica y riesgo de mielopatía, que pueden ser causa de mayor morbilidad y mortalidad. El diagnóstico precoz es muy importante ya que la terapia de reemplazo enzimático con laronidasa mejora las manifestaciones clínicas no neurológicas y estabiliza la progresión de la enfermedad. Presentamos el caso clínico de una paciente con historia clínica de rigidez articular progresiva acompañado de disminución de la agudeza visual por opacidad de la córnea, infecciones otorrinolaringológicas de repetición, retraso en desarrollo (talla baja) y cirugía por hernia umbilical. Fue diagnosticada de Mucopolisacaridosis tipo I, fenotipo Scheie a los 21 años de edad, inició tratamiento con Laronidasa a los 23 años

Mucopolysaccharidosis type I (MPS I). Multidiciplinary aspects and clinical guidelines

The existence of a specific enzyme replacement therapy for the treatment of Mucopolysaccharidosis type I has modified the natural course of the disease. Given the progressive nature and multisystem commitment, it is very important to coordinate interdisciplinary work, so as to provide comprehensive coverage and optimize results of all interventions made in patients. The content of this guide deals with current knowledge of Mucopolysaccharidosis (MPS) in general, and then more specifically in the subject matter of MPS I, with the contribution of specialists from each area, and from different institutions in the country. We will also find recommendations based on scientific evidence published in literatura.La existencia de una terapia de reemplazo enzimático específica para el tratamiento de la Mucopolisacaridosis tipo I ha modificado el curso natural de la enfermedad. Dada la naturaleza progresiva y el compromiso multisistémico, es muy importante el trabajo coordinado interdisciplinario, de manera a dar cobertura integral y optimizar resultados de todas las intervenciones hechas en los pacientes. El contenido de esta guía trata sobre conocimientos actuales de las Mucopolisacaridosis (MPS) en general, para luego adentrarse más específicamente en la temática propia de la MPS I, con la contribución de los estudiosos de cada área, y procedentes de diferentes Instituciones del país.Se encontrarán además recomendaciones basadas en evidencias científicas publicadas en la literatura

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis

Differential cross section measurements for the production of a W boson in association with jets in proton–proton collisions at √s = 7 TeV

Measurements are reported of differential cross sections for the production of a W boson, which decays into a muon and a neutrino, in association with jets, as a function of several variables, including the transverse momenta (pT) and pseudorapidities of the four leading jets, the scalar sum of jet transverse momenta (HT), and the difference in azimuthal angle between the directions of each jet and the muon. The data sample of pp collisions at a centre-of-mass energy of 7 TeV was collected with the CMS detector at the LHC and corresponds to an integrated luminosity of 5.0 fb[superscript −1]. The measured cross sections are compared to predictions from Monte Carlo generators, MadGraph + pythia and sherpa, and to next-to-leading-order calculations from BlackHat + sherpa. The differential cross sections are found to be in agreement with the predictions, apart from the pT distributions of the leading jets at high pT values, the distributions of the HT at high-HT and low jet multiplicity, and the distribution of the difference in azimuthal angle between the leading jet and the muon at low values.United States. Dept. of EnergyNational Science Foundation (U.S.)Alfred P. Sloan Foundatio

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good

Juxtaposing BTE and ATE – on the role of the European insurance industry in funding civil litigation

One of the ways in which legal services are financed, and indeed shaped, is through private insurance arrangement. Two contrasting types of legal expenses insurance contracts (LEI) seem to dominate in Europe: before the event (BTE) and after the event (ATE) legal expenses insurance. Notwithstanding institutional differences between different legal systems, BTE and ATE insurance arrangements may be instrumental if government policy is geared towards strengthening a market-oriented system of financing access to justice for individuals and business. At the same time, emphasizing the role of a private industry as a keeper of the gates to justice raises issues of accountability and transparency, not readily reconcilable with demands of competition. Moreover, multiple actors (clients, lawyers, courts, insurers) are involved, causing behavioural dynamics which are not easily predicted or influenced. Against this background, this paper looks into BTE and ATE arrangements by analysing the particularities of BTE and ATE arrangements currently available in some European jurisdictions and by painting a picture of their respective markets and legal contexts. This allows for some reflection on the performance of BTE and ATE providers as both financiers and keepers. Two issues emerge from the analysis that are worthy of some further reflection. Firstly, there is the problematic long-term sustainability of some ATE products. Secondly, the challenges faced by policymakers that would like to nudge consumers into voluntarily taking out BTE LEI

An embedding technique to determine ττ backgrounds in proton-proton collision data

An embedding technique is presented to estimate standard model tau tau backgrounds from data with minimal simulation input. In the data, the muons are removed from reconstructed mu mu events and replaced with simulated tau leptons with the same kinematic properties. In this way, a set of hybrid events is obtained that does not rely on simulation except for the decay of the tau leptons. The challenges in describing the underlying event or the production of associated jets in the simulation are avoided. The technique described in this paper was developed for CMS. Its validation and the inherent uncertainties are also discussed. The demonstration of the performance of the technique is based on a sample of proton-proton collisions collected by CMS in 2017 at root s = 13 TeV corresponding to an integrated luminosity of 41.5 fb(-1).Peer reviewe

Impacts of the Tropical Pacific/Indian Oceans on the Seasonal Cycle of the West African Monsoon

The current consensus is that drought has developed in the Sahel during the second half of the twentieth century as a result of remote effects of oceanic anomalies amplified by local land–atmosphere interactions. This paper focuses on the impacts of oceanic anomalies upon West African climate and specifically aims to identify those from SST anomalies in the Pacific/Indian Oceans during spring and summer seasons, when they were significant. Idealized sensitivity experiments are performed with four atmospheric general circulation models (AGCMs). The prescribed SST patterns used in the AGCMs are based on the leading mode of covariability between SST anomalies over the Pacific/Indian Oceans and summer rainfall over West Africa. The results show that such oceanic anomalies in the Pacific/Indian Ocean lead to a northward shift of an anomalous dry belt from the Gulf of Guinea to the Sahel as the season advances. In the Sahel, the magnitude of rainfall anomalies is comparable to that obtained by other authors using SST anomalies confined to the proximity of the Atlantic Ocean. The mechanism connecting the Pacific/Indian SST anomalies with West African rainfall has a strong seasonal cycle. In spring (May and June), anomalous subsidence develops over both the Maritime Continent and the equatorial Atlantic in response to the enhanced equatorial heating. Precipitation increases over continental West Africa in association with stronger zonal convergence of moisture. In addition, precipitation decreases over the Gulf of Guinea. During the monsoon peak (July and August), the SST anomalies move westward over the equatorial Pacific and the two regions where subsidence occurred earlier in the seasons merge over West Africa. The monsoon weakens and rainfall decreases over the Sahel, especially in August.Peer reviewe