Herramientas de Accesibilidad
Eastern Venezuela Basin is one of the world\'s most prolific hydrocarbon basins and an ecosystem where water management poses a significant challenge for energy production in Venezuela. Several studies have explored the management and utilization of water from this basin, particularly for improved/ enhanced oil recovery. However, the efficient use of produced water for geothermal energy extraction has not been thoroughly investigated. This article aims to evaluate the feasibility of applying geothermal energy extraction technologies in mature hydrocarbon reservoirs and high-water production wells through numerical simulation. Numerical simulations using 3D sector models were conducted for a high-temperature/high-pressure reservoir in North of Monagas state (140 °C) and in a cluster of wells in the Orinoco Oil Belt (50 °C), where high-water production wells were adapted to assess heat transfer and estimate the energy output from these reservoirs. Furthermore, this article presents a detailed analysis of the sources and composition of waters in Eastern Venezuela Basin hydrocarbon reservoirs, geologic context, geothermal gradients, and key factors influencing geothermal energy applications. It also examines selected geothermal techniques suitable for deep reservoirs in North of Monagas State and shallow reservoirs in the Orinoco Oil Belt, particularly in areas with high water cuts and wells with low commercial value, for geothermal energy generation. The findings of this study suggest that medium-shallow and deep high-temperature geothermal energy techniques, together with the use of water for alternative IOR/EOR processes and exploring hydrogen production and mineral extraction are potential scenarios for water management in the Eastern Venezuela Basin. Sensitivities of key parameters such as borehole depth, reservoir temperature, and circulating flow rate were taken into account during the simulation of geothermal scenarios. Current results emphasize the need for robust studies on geological and geophysical assessments to update geothermal gradients in Eastern Venezuela Basin, as well as physical and geochemical characterization of geothermal water sources. Additionally, for the generation of geothermal energy in this basin from high water production zones, it is crucial to account for physical and geochemical reactions, such as solid precipitation, scaling, acid gases management, and designing efficient underground-to surface heat transfer. These factors directly influence the efficiency, safety, and cost-effectiveness of geothermal applications This article explores the potential use of geothermal energy as an alternative approach for water management and energy generation in complex deep compositional reservoirs and shallow reservoirs with highly viscous crude oils. This study will serve as a reference for technical and economic feasibility assessments in other field applications. The outcomes of this work will help in determining suitable geothermal energy conversion technologies and conducting feasibility analysis for future geothermal energy production in Venezuela.
SPE Annual Technical Conference Proceedings
Background: The factors driving Coronavirus disease 2019 (COVID-19) severity and its long-term respiratory sequelae remain poorly understood. This study evaluates whether baseline lung function (LF) influences COVID-related clinical outcomes, mortality, and post-infection LF decline. Methods: Data from 602 participants in the Prospective Urban Rural Epidemiology (PURE)-Colombia study were analyzed. Among these, 200 with confirmed SARS-CoV-2 infection and 402 controls (65% women; 68% aged ≥60 years). All underwent baseline spirometry prior to 2010 and follow-up testing 1–40 months post-recovery. Among infected individuals, 51 (26%) died. Spirometric parameters Forced Expiratory Volume in 1 Second (FEV
Journal of Clinical Medicine
University Social Responsibility (USR) is a management tool that recognizes the relevance of universities in the transformation of the territories that are part of their area of influence and is aimed at strengthening the social, ethical and political commitment of higher education. Its implementation promotes an active connection with the community, based on principles of equity, sustainability and social justice. In this framework, the objective is to analyze the impact of the pedagogical practice of Social Work in the consolidation of university social responsibility as a strategy for peace building in the department of Córdoba. The methodological design was mixed with exploratory sequential order (qualitative / quantitative). The techniques used to collect information in the qualitative phase were interviews with social leaders of the communities of the department of Córdoba in the municipalities of Montería, Valencia, Tierralta and San Andrés de Sotavento, semi-structured participant observation and documentary review. Regarding the quantitative phase, surveys were conducted with teachers who accompany the pedagogical practice subject of Social Work and community students who attended the eighth (8) semester. The results show that social work practice focuses on immediate needs and endogenous processes, promoting empathy, conflict resolution, and social empowerment. Students believe their theoretical and practical training prepares them to address social problems. The study\'s conclusions highlight the importance of interdisciplinary collaboration and the participation of all stakeholders in building an inclusive, equitable, and resilient community environment in which University Social Responsibility plays a key role.
Aibi Revista De Investigacion Administracion E Ingenierias
Primary thrombocytosis is associated with increased risk of thromboembolism and bleeding. Therapeutic plateletpheresis (TPP), capable of rapid, transient platelet (Plt) count reduction, is employed as an emergency intervention for symptomatic thrombocytosis while awaiting the therapeutic effect of medical cytoreductive therapy. Nonetheless, the effect of TPP on outcomes and optimal role for TPP remain poorly understood. Critical analytic review of highest-pertinence and -quality articles was performed with the goal of establishing current knowledge gaps to direct original case data collection. Retrospective review of TPP procedures at six United States sites over ten years was performed. Pre-TPP symptoms, medical cytoreduction, adverse events (AEs), and 30-day post-TPP outcomes were analyzed. Critical analytic review revealed no randomized controlled trial (RCT) or controlled trials (CT) of TPP versus first-line medical therapies, and insufficient information on symptoms, goals, criteria-based determination of course, and post-TPP outcomes. New data presented here details 45 adult patients receiving TPP for thrombocytosis. TPP was performed rarely (of n = 6 sites, median 4.5 TPP/10 years, range 4-20). The most frequent diagnosis was myeloproliferative neoplasm (MPN) (34, 75.6%). The most frequent symptoms were any neurologic symptoms (present pre-64.4% of TPPs). TPP goals were commonly Plt-related (n = 85, 94.4% total TPP) and were met in 72.9% of TPP with stated Plt-related goals. Often, (n = 11/50 single TPP or series) TPP was begun or continued despite resolution of the stated indication for TPP. AE occurred during 20% of TPP and were predominantly hypocalcemia related (17/18, 94.4%). Four patients died within 30 days post TPP, three of stroke, one of a non-stroke neurologic complication. All deaths were deemed unrelated to TPP. Critical analytic reviews revealed no RCTs or CTs, a paucity of data on TPP goals and prescribed courses, and significant variability in AE reporting. Little information on long-term outcomes is available. Without controlled evidence supporting clinical outcome benefit of TPP for symptomatic thrombocytosis, utilization is expected to be rare and guideline-informed, following careful consideration of known risk in the setting of unclear benefit.
Transfusion Medicine Reviews
Introduction. The feminization and familiarization of caregiving have become a global concern and is prioritized as a public health issue, not only because of the potential health consequences for those who perform this role, but also because of the increasing population that will require a caregiver. This article aims to offer a reflection on the feminization and familiarization of caregiving for people with disabilities, based on the experience of designing a public health management project using the Objectives-Oriented Project Planning (ZOPP) approach. Qualitative data collection methods were employed, including focus groups and semi-structured interviews. Topics of reflection. The feminization and familiarization of caregiving for people with disabilities, its effects on the health, personal and economic development of women caregivers, and the experience of designing a program to promote well-being. Conclusions. It is of great importance to recognize the feminization and increasing prevalence of care work as a public health issue, taking into account the protection and promotion of health and well-being, as well as the participation of caregivers in social, educational, work, and political life. This also implies that the role of caregivers should be recognized within the context of paid employment.
Medunab
Introduction. Warfarin, an oral anticoagulant with a narrow therapeutic margin, exposes patients to risks associated with its therapy, underscoring the need for constant monitoring. In this context, this study evaluated the therapeutic follow-up of warfarin in anticoagulated patients at an ambulatory healthcare institution in eastern Colombia. Methodology. An observational analytical longitudinal study with prospective follow-up was conducted, including 244 patients, in which sociodemographic and clinical variables obtained from medical records were analyzed over a one-year period. Results. Within the participant cohort, 53.7% were female, and the prevailing diagnosis was atrial fibrillation and atrial flutter (46.3%). Generic warfarin was administered to 60.7% of participants, while 52.9% were concurrently prescribed an average of 5 medications. Alterations in weekly therapeutic dose showed significant correlation with time within therapeutic range (p = 0.000) and occurrence of adverse drug events (p = 0.001). Drug non-adherence (13.1%) emerged as the most frequent event. Assessment of 3,032 International Normalized Ratio results revealed a mean time in therapeutic range of 149 days, with an average of 6 tests falling within this range. Discussion. Suboptimal anticoagulation control was primarily associated with dose adjustments and patient non-adherence rather than manufacturer changes or comorbidities. These findings underscore the critical role of patient education in warfarin therapy management, particularly among elderly populations with polypharmacy. Conclusion. Anticoagulation programs should implement rigorous monitoring of weekly therapeutic dose administration, complemented by continuous education regarding timing of intake, posology, and factors influencing the International Normalized Ratio. This recommendation has particular significance given the advanced age of most patients.
Medunab
Introduction: Necrotizing enterocolitis (NEC) is one of the most severe complications in neonates and infants. However, term infants with congenital heart disease (CHD) represent a scenario of multiple complications due to pathophysiological mechanisms that differ from the classic pathogenesis. The objective of the study was to determine factors associated with complications of NEC in term infants hospitalized for CHD in a pediatric intensive care unit of a referral hospital in Colombia between 2010 and 2023. Materials and Methods: A retrospective cohort study was conducted, including 148 term infants with CHD who developed NEC during their hospitalization. Demographic and clinical characteristics were analyzed. Descriptive and bivariate analyses were performed using the Chi-square and Mann–Whitney U-tests. A multivariate analysis was conducted using robust Poisson regression with Stata 18.0® software. Results: The most frequent CHD were hypoplastic left heart syndrome (HLHS), pulmonary atresia, and persistent ductus arteriosus. The most common NEC stages were IIa (38.5%) and IIb (23.7%), which were associated with complications such as short bowel syndrome (18.8%) and post-surgical sepsis (37.5%). Among factors related to complications from NEC, medical-surgical management increased the risk (adjusted relative risk: 10.14 and 95% confidence interval: 1.95–48.72), while cardiac surgery reduced the likelihood of complications. Conclusions: NEC in infants with CHD is associated with multiple factors currently under investigation, which may explain a pathophysiological mechanism distinct from that of classic NEC.
Annals of Pediatric Cardiology
Lupus
Background There are limited data to inform dietary recommendations in persons with heart failure (HF). Objectives The aim of this study was to examine associations between consumption levels of 11 common foods, and a healthy diet pattern, with clinical outcomes in a HF population. Methods This analysis was a substudy of 3,798 participants from 25 countries enrolled in the multinational G-CHF (Global Congestive Heart Failure) registry with dietary data collected through food frequency questionnaires. Associations were examined between consumption levels of 6 plant-based foods (fruits, vegetables, legumes, nuts, whole grains, and refined grains) and 5 animal-based foods (fish, poultry, unprocessed red meat, eggs, and dairy) with the primary composite outcome of death or HF hospitalization and its components. Also examined was the association between an overall healthy diet pattern (measured by using a mAHEI [modified Alternative Heathy Eating Index]) and these outcomes. Results A total of 1,236 participants had a primary outcome event, 890 participants died, and 593 were hospitalized for HF. Higher legume intake (HR: 0.85 [95% CI: 0.73-0.99] for 0.1 to <0.5 serving per day and HR: 0.80 [95% CI: 0.65-0.98] for ≥0.5 serving per day vs <0.1 serving per day) was associated with a lower risk of the primary outcome. Moderate vegetable intake (1 to <3 servings per day) was associated with a lower risk of HF hospitalization (HR: 0.77 [95% CI: 0.61-0.97]) compared with <1 serving per day. Higher refined grain intake was associated with a higher risk of hospitalization for HF (HR: 1.56 [95% CI: 1.19-2.05] for 1-3 servings per day and HR: 1.76 [95% CI: 1.30-2.39) for >3 servings per day vs <1 serving per day). Associations with other foods, as well as with the mAHEI, were neutral. Conclusions In persons with HF, higher legume and vegetable intake were each associated with a lower risk of adverse clinical outcomes, whereas higher refined grain intake was associated with a higher risk of adverse clinical outcomes.
Jacc Heart Failure
Objective: To evaluate the clinical and biological effects of vitamin D supplementation in patients with chronic obstructive pulmonary disease, based on evidence from randomized controlled trials. Materials and Methods: A systematic review was conducted in accordance with the PRISMA guidelines. Three databases (PubMed/MEDLINE, Scopus, and Web of Science) were searched for randomized controlled trials published until June 2025. Studies were included if they assessed the effects of vitamin D supplementation in patients with chronic obstructive pulmonary disease and reported clinical or biological outcomes. Results: Twelve randomized controlled trials involving 6626 participants from diverse regions, with wide variability in sample sizes (36 to 5 110 participants). Most studies targeted patients with baseline vitamin D deficiency and evaluated varied dosing strategies (daily, weekly, monthly, or single high-dose regimens). Supplementation significantly increased serum 25(OH) D levels in all trials. Symptom burden and exacerbation frequency were reduced in most studies, particularly among patients with vitamin D deficiency. Consistent reductions in inflammatory markers, including IL-6, IL-8, and CRP, were observed. However, findings on pulmonary function (e.g., FEV
Gaceta Medica De Caracas
Background: Disorders of the gut–brain interaction (DGBIs) constitute a group of functional conditions widely described in adults; however, some of these have not been included in pediatric Rome criteria, despite the fact that they may manifest during childhood. Early identification of these conditions is relevant due to their clinical/psychosocial impact as well as their effect on quality of life. The aim was to determine the prevalence and associated factors of some DGBIs described in adults according to the Rome IV criteria in pediatric population. Methods: An observational/prospective/cross-sectional study was conducted in toddlers, school-aged children, and adolescents from three Colombian cities. The adapted Questionnaire for Pediatric Gastrointestinal Symptoms Rome IV (QPGS-IV) using adult criteria was applied, along with quality-of-life scales and PROMIS for anxiety/depression. Descriptive uni/bivariate analyses were performed as well as a multivariate logistic regression model. Results: A total of 704 participants were included (13.7 ± 2.8 years old). The prevalence of DGBIs described in adults according to QPGS-IV was 5.8%, with proctalgia fugax being the most frequent. In the bivariate analysis, race, school/social absenteeism, depressive traits, and impaired quality of life were significantly associated. In the multivariate model depressive traits (OR = 4.08; 95%CI = 1.82–9.12; p = 0.001), school (OR = 2.51; 95%CI = 1.06–5.98; p = 0.036), and social absenteeism (OR = 4.04; 95%CI = 1.70–9.62; p = 0.002) were the factors independently associated. Conclusions: These adult DGBIs, according to the QPGS-IV, can occur in pediatric populations and are closely related to psycho-emotional and functional factors. These are mainly associated with depression and school/social absenteeism, supporting the need for a biopsychosocial approach and a revision of the pediatric diagnostic criteria.
Children
SummaryBackgroundChagas disease (ChD) remains a public health concern in Latin America. Despite a decline in overall prevalence, the chronic symptomatic forms still impose a substantial epidemiological and economic burden. This study undertakes a comprehensive, population-based cost analysis of chronic Chagas disease (CCD) from a societal perspective in seven endemic Latin American countries for 2010 and 2023.MethodsA Markov model with one-year cycles and six states was employed. Direct medical and indirect costs, converted to 2024 purchasing power parity US dollars, were estimated using prevalence data from the Global Burden of Disease Study 2023. Based on a previous Brazilian Markov model, parameters were adjusted using healthcare coverage and per capita health expenditure ratios for each country, further validated by national experts.FindingsIn 2010, Brazil (US$252 billion) and Argentina (US$164 billion) had the highest lifetime burdens. As a percentage of annual Gross Domestic Product, Bolivia (0·9%) and Argentina (0·8%) were most affected. CCD accounted for 6% of total health expenditures in both countries. Between 2010 and 2023, most countries experienced a decline in economic burden due to decreased CCD prevalence, despite an increased proportion of patients with cardiac conditions, reflecting population aging and disease progression.InterpretationCCD imposes substantial economic burden across Latin American countries. Epidemiological shift to older populations with severe cardiac forms signals increased healthcare demands. Findings inform policymakers for resource allocation and tailored interventions.FundingFunding was provided by Novartis Pharma AG as part of a research collaboration with the World Heart Federation (project number CLCZ696D2010R).
Lancet Regional Health Americas
Background Cervical foraminal stenosis is a common cause of radiculopathy, and its assessment by magnetic resonance imaging is typically performed using orthogonal planes, which may limit evaluation of the neural foramen due to its oblique orientation. Oblique sagittal sequences provide visualisation more closely aligned with the foraminal axis. Objective To assess agreement in the grading of foraminal stenosis between oblique sagittal and axial magnetic resonance imaging sequences of the lower cervical spine in patients with a history of cervicalgia. Materials and methods A prospective observational analytical study was conducted in 50 adult patients (400 neural foramina). The degree of foraminal stenosis from C4/C5 to C7/T1 was assessed using the Park classification for oblique sagittal sequences and the Kim classification, adapted by institutional consensus, for axial sequences. Intraobserver agreement between the two sequences was evaluated using Cohen\'s weighted kappa coefficient, interpreted according to Landis and Koch criteria. Additionally, the Stuart–Maxwell test was applied to identify systematic differences in the classification of stenosis severity between the two sequences. Results The mean age was 58.8 ± 12 years (range: 28–88), and 31 patients (62.0%) were women. The highest degree of stenosis was observed at C4/C5 and C5/C6. A higher grade of foraminal stenosis was identified on oblique sagittal sequences compared with axial sequences. Overall agreement was substantial to almost perfect at left C4/C5, right C6/C7, and left C7/T1 levels, with kappa values ranging from 0.81 to 0.92. The Stuart–Maxwell test showed a statistically significant difference (p < 0.001), with a tendency for the axial plane to classify a lower degree of severity. Conclusions Oblique sagittal and axial sequences show high agreement in the evaluation of cervical foraminal stenosis. However, a systematic difference in severity categorisation was identified, with axial sequences tending to assign lower stenosis grades. The inclusion of oblique sagittal sequences may be useful as a complementary technique in patients with a clinical suspicion of radiculopathy.
Radiologia
Ceftriaxone-associated pseudocholelithiasis is common but underdiagnosed in children, occurring in up to half of those receiving ceftriaxone. Although self-limiting, it is frequently accompanied by symptoms. OBJECTIVE: To report the incidence, course, risk factors, and clinical behavior of pseudocholelithiasis in children receiving ceftriaxone. PATIENTS AND METHOD: Prospective, descriptive, observational case series study. Patients aged 1 month to 18 years who received ceftriaxone were included. Clinical follow-up and hepatobiliary ultrasound were performed at the start of treatment and every 5 days until complete resolution. Association with risk factors was explored. Statistics used included Pearson\'s chi-square test and Fisher\'s exact test. RESULTS: Eighty patients were included, 51.2% were male, median age 4.5 years (range 5 months to 17 years). The prevalence of pseudocholelithiasis was 35% (28 patients), documented in 6 and 27 patients during the first and second ultrasound (21.4% and 96.4%). Pseudocholelithiasis was significantly more frequent in the age group older than 5 years, those with lower fluid intake, obese, overweight, and very rare in malnourished patients (all p < 0.05). Twelve patients presented abdominal pain as a cardinal symptom (42.9%). The mean duration of the stones was 19.1 (5-44) days. CONCLUSION: Ceftriaxone-associated pseudocholelithiasis is common, occurring in 1 out of 3 children who receive it. Its main risk factors were age over 5 years, lower fluid intake, overweight, and obesity. Abdominal pain is frequent, and the progression was self-limited.
Andes Pediatrica Revista Chilena De Pediatria
With technological advances in different areas, we have seen how education has been significantly transformed, improving teaching methods, facilitating different processes, and extending knowledge to people who previously would not have had access to it. This study conducts a systematic review of the impact and effects of emerging technologies on education over the last decade. To carry out this review, relevant studies are selected that address emerging technologies in education and their impact on learning, the challenges faced in implementing emerging technologies in education, and the evaluation of educational institutions\' experience in using information systems.
Congreso Internacional De Innovacion Y Tendencias En Ingenieria Coniiti
In the present study the surface qualities of the orthodontic stainless austenitic steel brackets, modified through techniques commonly used in its recycling, specifically, the techniques of sandblasting and direct flamed were compared with a new technique of surface modification known as electropolishing with passivation. Through electrochemical tests such as Electrochemical Impedance Spectroscopy (EIS), Tafel extrapolation and cyclic potentiodynamic polarization all the corrosion processes for the material were evaluated in simulated physical medium, it means the mouth cavity. This one was simulated through an electrolytic assembly with three electrodes and one experimental physiological medium composed by artificial saliva Afnor at 37 °C. The results gathered evidenced that sandblasting produced the best protection qualities towards corrosion in the simulated mouth environment. The electropolishing technique and passivation showed good characteristics regards to the direct flaming brackets. However, sandblasting technique showed the best results in the specimen tested. Based on the facts previously mentioned, the recycling of metallic brackets at the surface level is an issue of great importance in the current orthodoncy field due to the fact that recycling presents important variables which influence the strength of adhesion to the teeth and the liberation of ions into the body.
Journal of Bio and Tribo Corrosion
This study assesses the technical, operational, environmental, and economic feasibility of integrating alkaline water electrolysis (AEL) using on-site measured surplus electricity from two 20 MW natural-gas turbogenerators installed at a Central Processing Facility (CPF) in a Colombian oilfield. Unlike approaches based on modeled profiles, the analysis relies on more than 31,000 experimental records of gas consumption and active power, enabling an accurate characterization of the structural availability of energy surpluses under real operating conditions. A specialized industrial water treatment and purification company was consulted and provided with the physicochemical characterization results obtained from process water samples analyzed by an accredited laboratory. Based on these parameters, the technical supplier confirmed the feasibility of designing a multistage treatment train, including equalization, filtration, clarification, activated carbon, ultrafiltration, and reverse osmosis, capable of achieving final conductivities at or below 5 µS/cm. This water quality level is compatible with typical industrial alkaline electrolysis requirements and in line with technical specifications commonly aligned with ASTM and ISO standards for pressurized AEL systems. A strategic comparison between PEM and AEL technologies, supported by IFE/EFE matrices and sensitivity analyses, identified alkaline electrolysis as the optimal alternative under a stable electrical profile and capital expenditure constraints. Energy sizing for scenarios between 1.5 and 10 MW, assuming continuous 24 h operation and an average specific consumption of 50 kWh/kg H
Sci
Viral infection is a critical early event in Epstein–Barr virus (EBV)-positive B-cell lymphomas. While latent EBV proteins are known to promote cancer development, the role of EBV-encoded microRNAs (miRNAs) is not yet clear. These miRNAs are reported to regulate viral persistence, immune evasion, B-cell survival, and growth. This review compiles evidence on the role of EBV miRNAs in B cells and B-cell lymphomas, including their known target genes, and their effects on cancer-related pathways. By combining profiling studies and results from laboratory models, we highlight how EBV miRNAs might contribute to lymphoma development. Overall, this review provides a comprehensive overview of the biology of EBV-positive B-cell lymphoma, and current knowledge supports a critical role for EBV miRNAs in B cell transformation.
Cancers
The authors regret that following publication of the article, two of the originally listed co-authors, Anneke van Heteren and Gertrud Rößner, have requested that their names be removed from the author list, as they did not have an opportunity to approve the final, revised version. The corresponding author confirms that the revisions were conducted in good faith and accepts full responsibility for the final published content. With this corrigendum, the author list is updated to: María Fernanda Martínez-Polanco, Thomas Ingicco, Iván Rey-Rodríguez, Sergio Andrés Castro Méndez, Máximo Jiménez-Acosta, Juan Guillermo Martín. The corresponding author would like to apologise for any inconvenience caused. The authors would like to apologise for any inconvenience caused.
Journal of Archaeological Science
The scalable production of green hydrogen from biomass gasification is hindered by unpredictable yields arising from complex, non-linear interactions among multiple feedstock and process parameters, compounded by sparse data in pilot-scale operations. Existing machine learning models demand large datasets, while traditional grey system models lack adaptability to recent information and multivariate dependencies. This study introduces a novel recency-weighted grey multivariate model incorporating a data preference accumulation operation with exponential weighting controlled by memory factor to dynamically prioritize recent observations. Integrated into a multivariable grey framework, it captures interdependencies while maintaining robustness with small samples. Theoretical stability analysis shows enhanced noise resistance in limited-data regimes. Validated on real-world biomass gasification data with 23 data points, the novel model achieves high accuracy with 0.096% mean absolute percentage error, 0.046 root mean square error and coefficient of determination of 0.9907. The prediction robustness is confirmed by Diebold-Mariano and superior prediction ability tests over some grey models, statistical models, and machine learning benchmarks. This first application of recency-weighted grey multivariate forecasting to biomass hydrogen production provides a data-efficient, interpretable tool for optimizing reactor operation and feedstock selection, accelerating the transition to a sustainable hydrogen economy.
Renewable Energy
AbstractBackgroundChagas disease, caused by Trypanosoma cruzi parasites, is a common cause of heart failure (HF) in Latin America and has recently been declared endemic in the United States. The authors compared outcomes in Chagasic HF vs ischemic and other nonischemic etiologies of HF with reduced ejection fraction (HFrEF).ObjectivesThe aim of this study was to compare clinical outcomes of Chagasic HFrEF vs ischemic and other nonischemic etiologies.MethodsInvestigator-reported etiology of HFrEF in the ATMOSPHERE, PARADIGM-HF, and GALACTIC-HF trials was categorized as ischemic, valvular, alcoholic, hypertensive, idiopathic, viral, Chagasic, or “other.” Time to the composite of first HF hospitalization or cardiovascular death, its components, all-cause death, and stroke was analyzed using Cox models adjusted for baseline characteristics, patient setting, trial, and other potential confounders.ResultsAmong 23,647 patients (13,381 ischemic, 4,344 idiopathic, 2,559 hypertensive, 1,923 others, 423 alcoholic, 412 valvular, 297 viral, and 308 Chagasic), Chagasic HF had the highest incidence rates of all clinical outcomes compared with other etiologies. Compared with patients with ischemic etiology, the adjusted HRs in Chagasic HF were significantly higher for the composite outcome (HR: 1.65; 95% CI: 1.36-2.02), HF hospitalization (HR: 1.75; 95% CI: 1.36-2.25), cardiovascular death (HR: 1.86; 95% CI: 1.47-2.35), all-cause death (HR: 1.82; 95% CI: 1.47-2.25), and stroke (HR: 2.16; 95% CI: 1.20-3.88).ConclusionsPatients with Chagasic HFrEF have a distinct clinical course associated not only with excess mortality but also with an increased risk for stroke compared with other etiologies except for valvular and “other” etiologies. (Aliskiren Trial to Minimize Outcomes in Patients with Heart Failure [ATMOSPHERE], NCT00853658; Prospective Comparison of ARNI [Angiotensin Receptor-Neprilysin Inhibitor] with ACEI [Angiotensin-Converting-Enzyme Inhibitor] to Determine Impact on Global Mortality and Morbidity in Heart Failure Trial [PARADIGM-HF], NCT01035255; Global Approach to Lowering Adverse Cardiac Outcomes Through Improving Contractility in Heart Failure [GALACTIC-HF], NCT02929329)
Journal of the American College of Cardiology
Introduction. Burrow and tunnel systems preserved in sandy and muddy marine substrates are commonly associated with the behavioral activities of polychaete worms and other benthic invertebrates, providing relevant ethological information in sedimentary records. Objectives. This study aims to i) describe the morphological and ethological characteristics of a radial ichnofossil, ii) evaluate its possible correspondence with previously established radial ichnogenera, and iii) propose paleoecological interpretations of the trace-making organism and its depositional environment. Materials and Methods. A detached sandstone block from the Aguardiente Formation (Albian–Cenomanian, Lower Cretaceous) was examined along the banks of the Hisgaura River, San Andrés municipality (Santander, Colombia). The trace architecture was documented through high-resolution photography, digital image processing, and artificial intelligence–assisted three-dimensional reconstruction to enhance visualization of its morphology and internal organization. UPGMA–Jaccard similarity and parsimony analyses were applied to assess relationships with other radial and rosette ichnogenera. Results. The specimen is preserved in full relief and consists of a central ellipsoidal chamber from which slightly sinuous tubular galleries radiate, locally arranged in superposed tiers. Similarity analysis groups the structure with Arenituba, Guanshanichnus, and Hartsellea. Parsimony analysis recovered a single most-parsimonious tree (length = 32 steps; CI = 0.34; RI = 0.7) in which the specimen forms part of a clade characterized primarily by branched galleries and shallow-marine occurrence. Conclusions. The structure records ethological evidence of a benthic organism inhabiting sandy shallow-marine environments. Diagnostic differences preclude confident assignment to any previously established radial ichnogenus.
Innovaciencia
Background: Refractory dominant cardioinhibitory vasovagal syncope (VVS) remains a therapeutic challenge in patients older than 40 years. Dual-chamber pacemakers with closed-loop stimulation (CLS-PM) are guideline-supported, while cardioneuroablation (CNA), targeting ganglionated plexus, has emerged as a device-free alternative. Direct comparative data between these strategies are limited. Methods: We conducted a retrospective, comparative cohort study including patients > 40 years with refractory cardioinhibitory VVS treated between 2018 and 2024. Patients underwent either CNA with extracardiac vagal stimulation validation (CNA-ECVS) or CLS-PM implantation. The primary outcome was recurrence of the first syncope episode. Secondary outcomes included syncope-free survival, syncope burden (≥ 50% reduction), and safety. Kaplan–Meier analysis and Cox proportional hazards models were applied. Results: Eighty patients were included (37 CNA-ECVS, 43 CLS-PM; mean age 58.0 ± 14.6 years). Patients in the CNA group were younger than those in the CLS-PM group (49.9 ± 10.3 vs. 65.0 ± 14.1 years; p < 0.001). During a mean follow-up of 3.8 years, syncope-free rates were 89.2% in the CNA group and 79.1% in the CLS-PM group (p = 0.363). Syncope-free survival did not differ significantly (log-rank p = 0.168), and recurrence risk was similar between strategies (HR 0.45; 95% CI 0.14–1.46; p = 0.182). Post-procedural syncope burden was numerically lower after CNA (10.8% vs. 20.9%) but without statistical significance. No major adverse events were observed in either group. Conclusions: In patients older than 40 years with refractory cardioinhibitory NCS, CNA with physiological validation and CLS-PM therapy demonstrated comparable efficacy and safety. Both strategies represent viable therapeutic options, warranting confirmation in randomized clinical trials.
Journal of Interventional Cardiac Electrophysiology
The Staphylococcus spp. they can cause a wide range of infections systemic and located in community and hospital patients. Its high pathogenicity and growing resistance to multiple antimicrobials including methicillin, causes high morbiditymortality rates, causing a high epidemiological impact. Objective: to determine the phenotypic profile of resistance to different antimicrobials in strains of the genus Staphylococcus spp. Materials and methods: collected 75 strains and determined them susceptibility to different antibiotics by the Kirby-Bauer method. The production of betalactamase check using the nitrocefin test. (Resistance to Methicillin in S. aureus was conducted using Mueller Hinton with 4% NaCl and oxacillin 6 μg/mL). Inducible clindamycin resistance tamizo by D-Test test. Results: they were isolated by 38% of staphylococcus coagulase negative (SNA) and 62% of S. aureus. 53% were penicillin resistant staphylococci: S. aureus with 58% and 42% SNA. 47% of the strains showed resistance to methicillin: S. aureus with 61% and SNA with 39%. A strain of S. aureus showed inducible resistance to clindamycin (1.33%). Coagulase negative staphylococci were isolated mostly from blood samples (31%), blood (29%), tip of catheter (5%) and came mostly from neonatal ICU (25%), medical (21%) and surgery (16%). Conclusions: S. aureus and SNA were isolated with greater frequency in blood and wounds from surgery and neonatal ICU. The predominant resistance phenotypes were penicillin and oxacillin.
Revista Ciencias de la Salud
Colombia Medica
Universidad de Santander UDES. Vigilada Mineducación.
Resolución otorgada por el Ministerio de Educación Nacional: No. 6216 del 22 de diciembre de 2005 / Personería Jurídica 810 de 12/03/96.
Institución sujeta a inspección y vigilancia por el Ministerio de Educación Nacional. Resolución 12220 de 2016.
Notificaciones administrativas y judiciales:
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