Soluciones hipertónicas en trauma craneoencefálico: revisión sistemática de la literatura

El traumatismo craneoencefálico, es la epidemia silenciosa de nuestra época, que genera gastos en salud, en países como Estados Unidos, cercanos a los 60 billones de dólares anuales, y cerca de 400 billones en rehabilitación de los discapacitados. El pilar del manejo médico del trauma craneoencefálico moderado o severo, es la osmoterapia, principalmente con sustancias como el manitol y las soluciones hipertónicas. Se realizó la revisión de 14 bases de datos, encontrando 4657754 artículos, quedando al final 40 artículos después de un análisis exhaustivo, que se relacionaban con el manejo de la hipertensión endocraneana y terapia osmótica. Resultados: Se compararon diferentes estudios, encontrando gran variabilidad estos, sin homogenización en los análisis estadísticos, y la poca rigurosidad no permitieron, la recolección de datos y la comparación entre los diferentes estudios, no permitió realizar el meta-análisis y por esto se decidió la realización de una revisión sistemática de la literatura. Se evidenció principalmente tres cosas: la primera es la poca rigurosidad con la que se realizan los estudios clínicos; la segunda, es que aún falta mucha más investigación principalmente, la presencia de estudios clínicos aleatorizados multicéntricos, que logren dar una sólida evidencia y que genere validez científica que se requiere, a pesar de la evidencia clara en la práctica clínica; la tercera es la seguridad para su uso, con poca presencia de complicaciones para las soluciones salinas hipertónicas.

Hallazgos radiológicos de la enfermedad pulmonar en pacientes Colombianos con esclerodermia

La esclerosis sistémica (ES) es una enfermedad autoinmune multisistémica que afecta principalmente la piel, los pulmones, el tracto gastrointestinal, el corazón y los riñones. La enfermedad pulmonar, presente en casi el 100% de los casos, es el factor con mayor influencia en la mortalidad. El propósito de este estudio es realizar un análisis detallado de la enfermedad pulmonar por tomografía computarizada de alta resolución(TCAR) en pacientes Colombianos con ES, para lo cual se realizó un estudio de prevalencia analítica en 44 pacientes con ES valorados en el Hospital Universitario Mayor Méderi en los últimos 7 años. Los resultados mostraron características demográficas y clínicas similares a las previamente descritas. La prevalencia de enfermedad pulmonar intersticial fue alta, y los hallazgos de fibrosis pulmonar como vidrio esmerilado y panal de abejas se asociaron con la presencia del autoanticuerpo antiSCL70. La medida del diámetro esofágico por TCAR fue mayor en los pacientes con disfagia, antiSCL 70 y linfopenia, los cuales son marcadores de mal pronóstico.

Toxina botulínica en manejo de síntomas del tracto urinario bajo en pacientes con hiperplasia prostática benigna - revisión sistemática de la literatura

Revisión sistemática de la literatura tomando ensayos clínicos aleatorizados sobre el uso de la inyección intraprostática de la toxina botulínica en los pacientes con hiperplasia prostática benigna evaluando una escala validada de síntomas del tracto urinario bajo como desenlace primario

Prevalencia de patologías osteomusculares del miembro superior y su relación con factores ocupacionales en trabajadores de una empresa de flores. Bogotá 2015

Antecedentes: Las patologías osteomusculares del miembro superior son una importante causa de morbilidad laboral a nivel mundial y en nuestro país, particularmente en el sector de la floricultura. Del desarrollo de estos desórdenes se derivan importantes costos derivados del ausentismo laboral, incapacidades y secuelas. Objetivo: determinar la prevalencia de patología osteomuscular de miembro superior con calificación de origen de enfermedad laboral, en los trabajadores con diagnóstico de patología musculo esquelética de miembro superior y su relación con algunos factores ocupacionales y demográficos. Metodología: Estudio de corte transversal en el que se revisaron datos secundarios procedentes de una base de datos del servicio de salud ocupacional entre enero y mayo de 2015, correspondiente a 465 operarios (no administrativos) a término indefinido de una empresa floricultora de Bogotá, incluyendo únicamente aquellos trabajadores con patologías osteomusculares de miembro superior, que contaban con la clasificación en el diagnóstico ya sea como enfermedad laboral o enfermedad común y mayores de edad. Se excluyeron 19 trabajadores, quienes habían sido reubicados en nuevos sitios de trabajo y no se contó con la información para determinar su actividad antes de realizar el cambio. Se evaluaron las siguientes variables: sexo, edad, antigüedad y el cargo desempeñados por los operarios. La relación entre variables se realizó con la prueba de chi2 de Pearson. Se midió la magnitud de la asociación por medio de OR con sus respectivos intervalos de confianza del 95%. Resultados: Se incluyó a 373 operarios a término fijo, con una media de edad de 39 años (DE=5.55) y una media de antigüedad en el cargo de 6 años (DE=1.15). El 82.84% correspondió al sexo femenino. La prevalencia de enfermedad laboral osteomuscular de miembro superior fue del 54,4%. En el análisis de relación entre la calificación de la enfermedad, y demás variables (sexo, antigüedad en el cargo, edad, actividad desempeñada, localización de la lesión); se encontró que: estar entre los 40 a 49 años (OR= 1,7; IC-95%:1,12 – 2,79), diagnóstico de síndrome de manguito (OR= 4.45; IC-95%: 2.48 – 8.23) y el síndrome de túnel de carpo (OR= 4.22; IC-95%: 2.45 – 7.41) se asociaron a enfermedad laboral. Conclusiones: La prevalencia de enfermedad laboral de patología osteomuscular de miembro superior en los operarios de un cultivo de flores de la Sabana de Bogotá es del (54,4%). Se encontró una mayor asociación con el síndrome del manguito rotador y enfermedad laboral. No se encontró asociación entre la enfermedad laboral y la actividad desempeñada, el tiempo de exposición, ni con el sexo del trabajador.

A new all-round density functional based on spin states and SN2 barriers

We report here a new empirical density functional that is constructed based on the performance of OPBE and PBE for spin states and SN 2 reaction barriers and how these are affected by different regions of the reduced gradient expansion. In a previous study [Swart, Sol̀, and Bickelhaupt, J. Comput. Methods Sci. Eng. 9, 69 (2009)] we already reported how, by switching between OPBE and PBE, one could obtain both the good performance of OPBE for spin states and reaction barriers and that of PBE for weak interactions within one and the same (SSB-sw) functional. Here we fine tuned this functional and include a portion of the KT functional and Grimme's dispersion correction to account for π- π stacking. Our new SSB-D functional is found to be a clear improvement and functions very well for biological applications (hydrogen bonding, π -π stacking, spin-state splittings, accuracy of geometries, reaction barriers)

Oxygen precipitation in Czochralski grown silicon heat treated at 525 degrees C

The diffusion of interstitial oxygen In silicon at 525 degrees C is studied using time-of-flight small-angle neutron scattering (SANS) to separate the elastic scattering from oxygen-containing aggregates from the inelastic scattering from neutron-phonon interactions. The growth of oxygen-containing aggregates as a function of time gives a diffusion coefficient, D, calculated from Ham's theory, that is I factor of similar to 3.8 +/- 1.4 times higher than that expected by extrapolation of higher and lower temperature data (D = 0.13 exp(-2.53 eV kT(-1)) cm(2) s(-1)). This result confirms previous observations of enhanced diffusion at intermediate temperatures (400 degrees C-650 degrees C) although the magnitude of the enhancement we find is Much smaller than that reported by some others.

Knowledge communication and translation- A knowledge transfer model

Purpose – The purpose of this paper is to propose a process model for knowledge transfer in using theories relating knowledge communication and knowledge translation. Design/methodology/approach – Most of what is put forward in this paper is based on a research project titled “Procurement for innovation and knowledge transfer (ProFIK)”. The project is funded by a UK government research council – The Engineering and Physical Sciences Research Council (EPSRC). The discussions are mainly grounded on a thorough review of literature accomplished as part of the research project. Findings – The process model developed in this paper has built upon the theory of knowledge transfer and the theory of communication. Knowledge transfer, per se, is not a mere transfer of knowledge. It involves different stages of knowledge transformation. Depending on the context of knowledge transfer, it can also be influenced by many factors; some positive and some negative. The developed model of knowledge transfer attempts to encapsulate all these issues in order to create a holistic framework. Originality/value of paper – An attempt has been made in the paper to combine some of the significant theories or findings relating to knowledge transfer together, making the paper an original and valuable one.

Establishing a connection between knowledge transfer and innovation diffusion

Successful innovation diffusion process may well take the form of knowledge transfer process. Therefore, the primary objectives of this paper include: first, to evaluate the interrelations between transfer of knowledge and diffusion of innovation; and second to develop a model to establish a connection between the two. This has been achieved using a four-step approach. The first step of the approach is to assess and discuss the theories relating to knowledge transfer (KT) and innovation diffusion (ID). The second step focuses on developing basic models for KT and ID, based on the key theories surrounding these areas. A considerable amount of literature has been written on the association between knowledge management and innovation, the respective fields of KT and ID. The next step, therefore, explores the relationship between innovation and knowledge management in order to identify the connections between the latter, i.e. KT and ID. Finally, step four proposes and develops an integrated model for KT and ID. As the developed model suggests the sub-processes of knowledge transfer can be connected to the innovation diffusion process in several instances as discussed and illustrated in the paper.

K-T transition in Deccan traps of central India marks major marine seaway across India.

Deccan intertrappean sediments in central India are generally considered as terrestrial deposits of Maastrichtian age, but the Cretaceous–Tertiary (K–T) position is still unknown. Here we report the discovery of the K–T transition, a marine incursion and environmental changes preserved within the intertrappean sediments at Jhilmili, Chhindwara District, Madhya Pradesh. Integrative biostratigraphic, sedimentologic, mineralogic and chemostratigraphic analyses reveal the basal Danian in the intertrappean sediments between lower and upper trap basalts that regionally correspond to C29r and the C29R/C29N transition, respectively. Intertrappean deposition occurred in predominantly terrestrial semi-humid to arid environments. But a short aquatic interval of fresh water ponds and lakes followed by shallow coastal marine conditions with brackish marine ostracods and early Danian zone P1a planktic foraminifera mark this interval very close to the K–T boundary. This marine incursion marks the existence of a nearby seaway, probably extending inland from the west through the Narmada and Tapti rift valleys. The Jhilmili results thus identify the K–T boundary near the end of the main phase of Deccan eruptions and indicate that a major seaway extended at least 800 km across India.

Balitskiǐ-Fadin-Kuraev-Lipatov equation versus data from DESY HERA

The BFKL equation and the kT-factorization theorem are used to obtain predictions for F2 in the small Bjo/rken-x region over a wide range of Q2. The dependence on the parameters, especially on those concerning the infrared region, is discussed. After a background fit to recent experimental data obtained at DESY HERA and at Fermilab (E665 experiment) we find that the predicted, almost Q2 independent BFKL slope λ≳0.5 appears to be too steep at lower Q2 values. Thus there seems to be a chance that future HERA data can distinguish between pure BFKL and conventional field theoretic renormalization group approaches. © 1995 The American Physical Society.

Cesium toxicity in Arabidopsis

Cesium (Cs) is chemically similar to potassium (K). However, although K is an essential element, Cs is toxic to plants. Two contrasting hypotheses to explain Cs toxicity have been proposed: (1) extracellular Cs+ prevents K+ uptake and, thereby, induces K starvation; and (2) intracellular Cs+ interacts with vital K+-binding sites in proteins, either competitively or noncompetitively, impairing their activities. We tested these hypotheses with Arabidopsis (Arabidopsis thaliana). Increasing the Cs concentration in the agar (Cs(agar)) on which Arabidopsis were grown reduced shoot growth. Increasing the K concentration in the agar (K(agad)) increased the Cs(agar) at which Cs toxicity was observed. However, although increasing Cs(agar) reduced shoot K concentration (K(shoot)), the decrease in shoot growth appeared unrelated to K(shoot) per se. Furthermore, the changes in gene expression in Cs-intoxicated plants differed from those of K-starved plants, suggesting that Cs intoxication was not perceived genetically solely as K starvation. In addition to reducing K(shoot) increasing Cs(agar) also increased shoot Cs concentration (Cs(shoot)), but shoot growth appeared unrelated to Cs(shoot) per se. The relationship between shoot growth and Cs(shoot)/Kt(shoot) suggested that, at a nontoxic Cs(shoot) growth was determined by K(shoot) but that the growth of Cs-intoxicated plants was related to the Cs(shoot)/K(shoot) quotient. This is consistent with Cs intoxication resulting from competition between K+ and Cs+ for K+-binding sites on essential proteins.

The sources of phosphorus in the waters of Great Britain

Total phosphorus (TP) and soluble reactive phosphorus (SRP) loads to watercourses of the River Basin Districts (RBDs) of Great Britain (GB) were estimated using inventories of industrial P loads and estimates of P loads from sewage treatment works and diffuse P loads calculated using region-specific export coefficients for particular land cover classes combined with census data for agricultural stocking densities and human populations. The TP load to GB waters was estimated to be 60 kt yr(-1), of which households contributed 73, agriculture contributed 20, industry contributed 3, and 4 came from background sources. The SRP load to GB waters was estimated to be 47 kt yr(-1), of which households contributed 78, agriculture contributed 13, industry contributed 4, and 6 came from background Sources. The 'average' area-normalized TP and SRP loads to GB waters approximated 2.4 kg ha(-1) yr(-1) and 1.8 kg ha(-1) yr(-1), respectively. A consideration of uncertainties in the data contributing to these estimates suggested that the TP load to GB waters might lie between 33 and 68 kt yr(-1), with agriculture contributing between 10 and 28 of the TP load. These estimates are consistent with recent appraisals of annual TP and SRP loads to GB coastal waters and area-normalized TP loads from their catchments. Estimates of the contributions of RBDs to these P loads were consistent with the geographical distribution of P concentrations in GB rivers and recent assessments of surface waters at risk from P Pollution.

Self-assembly of palmitoyl lipopeptides used in skin care products

The self-assembly of three cosmetically active peptide amphiphiles C16-GHK, C16-KT, and C16-KTTKS (C16 denotes a hexadecyl, palmitoyl chain) used in commercial skin care products is examined. A range of spectroscopic, microscopic, and X-ray scattering methods is used to probe the secondary structure, aggregate morphology, and the nanostructure. Peptide amphiphile (PA) C16-KTTKS forms flat tapes and extended fibrillar structures with high β-sheet content. In contrast, C16-KT and C16-GHK exhibit crystal-like aggregates with, in the case of the latter PA, lower β-sheet content. All three PA samples show spacings from bilayer structures in small-angle X-ray scattering profiles, and all three have similar critical aggregation concentrations, this being governed by the lipid chain length. However, only C16-KTTKS is stained by Congo red, a diagnostic dye used to detect amyloid formation, and this PA also shows a highly aligned cross-β X-ray diffraction pattern consistent with the high β-sheet content in the self-assembled aggregates. These findings may provide important insights relevant to the role of self-assembled aggregates on the reported collagen-stimulating properties of these PAs.

Gross direct and embodied carbon sinks for urban inventories

Cities and urban regions are undertaking efforts to quantify greenhouse (GHG) emissions from their jurisdictional boundaries. Although inventorying methodologies are beginning to standardize for GHG sources, carbon sequestration is generally not quantified. This article describes the methodology and quantification of gross urban carbon sinks. Sinks are categorized into direct and embodied sinks. Direct sinks generally incorporate natural process, such as humification in soils and photosynthetic biomass growth (in urban trees, perennial crops, and regional forests). Embodied sinks include activities associated with consumptive behavior that result in the import and/or storage of carbon, such as landfilling of waste, concrete construction, and utilization of durable wood products. Using methodologies based on the Intergovernmental Panel on Climate Change 2006 guidelines (for direct sinks) and peer-reviewed literature (for embodied sinks), carbon sequestration for 2005 is calculated for the Greater Toronto Area. Direct sinks are found to be 317 kilotons of carbon (kt C), and are dominated by regional forest biomass. Embodied sinks are calculated to be 234 kt C based on one year's consumption, though a complete life cycle accounting of emissions would likely transform this sum from a carbon sink to a source. There is considerable uncertainty associated with the methodologies used, which could be addressed with city-specific stock-change measurements. Further options for enhancing carbon sink capacity within urban environments are explored, such as urban biomass growth and carbon capture and storage.