The ILux^(®) compared to the mechanical meibomian gland expression for the treatment of moderate and severe meibomian gland dysfunction

AIM:To compare the safety and effectiveness of eyelid treatment with the ILux®-MGD Treatment System in one session versus five sessions of mechanical meibomian gland expression(MMGE)in patients with moderate to severe meibomian gland dysfunction(MGD).METHODS:A prospective,randomized,open-label,and controlled clinical trial that compared one session of the ILux®MGD Treatment System versus five sessions of MMGE in both eyes of 130 patients aged≥18y with Ocular Surface Disease Index(OSDI)scores≥13,total meibomian gland scores(MGS)of<15 in the lower eyelid of each eye,and non-invasive tear break-up time(NI-TBUT)<10s,who were randomized 1:1 to ILux®or MMGE.RESULTS:The mean age was 58±17.49y.Baseline total MGS scores in both treatment groups were comparable.During follow-up,there were significant differences in total MGS and per sector with P<0.001.Multivariate analysis was performed using generalized estimating equations corresponding to the generalized linear model for repeated means to determine the treatment relationship with total MGS,NIBUT,and OSDI.There was a significant difference between ILux®and MMGE(P<0.001)at follow-up from the first to the twelfth month in MGS,NI-BUT,and OSDI scores.No adverse events were reported.CONCLUSION:ILux®treatment compared to MMGE significantly improves symptoms and signs in patients with moderate to severe MGD for one year without adverse events.

State Variable Model for Considering the Parasitic Inductor Resistance on the Open Loop Performance of DC to DC Converters

This paper shows DC and small-signal circuit models for the PWM DC to DC buck, boost and back/ boost converters with the equivalent series resistance of the inductor. The DC voltage transfer function and the efficiency of the converter are derived from the DC model. Small-signal open-loop characteristics are derived from the small-signal model based on a state variable model. A design example proves the performance of the circuit and verification of the model.

Minimally Invasive Surgical Approach for Spinal Canal Tumors—Technique Description and Experience from a Reference Center

Background: Spinal canal tumors are difficult to diagnose and treat. The traditional surgical approaches for attempting a complete excision of these lesions frequently involve big incisions and tissue dissection with high risk of postop instability and cerebrospinal fluid leakage. Also, there is a risk of neurological worsening, sometimes irreversible. Methods: We present our experience in a patient series with spinal canal tumors and describe the surgical approach with minimally invasive techniques (MIS). All of them were performed by the Neurosurgery team of the Hospital Universitario San Ignacio during the period of 2011-2016. Results: We reviewed forty patients with spinal canal tumors surgically treated with MIS techniques. 15 patients (37.5%) had Meningioma diagnosis (complete resection in 11 (73.3%), subtotal in 3 (20%) and biopsy in one patient), 10 patients (25%) with Schwannomas reached complete resection in 70% and subtotal in 30%. 5 patients had spinal cord metastasis, with complete resection in 4 patients (80%) and subtotal in 1 (20%). Other included ependymoma, astrocytoma, and miscellaneous. No patient has had cerebrospinal fluid leakage and no postoperative fusion has been required. Conclusions: The minimally invasive approach allowed complete tumors removal in a high number of patients and good postoperative results. These findings are similar and in some cases, better than the reported with traditional techniques. This MIS technique provides encouraging results. It requires a wide learning curve and a high degree of surgical experience.

Abatement of Helminth Eggs and Bacterial and Viral Indicators in Soil after Land Application of Treated Sludges

The reduction of helminth eggs, fecal coliforms and somatic coliphages present in sewage sludge after treatments and abatement by application to soil was determined. Traditional stabilization processes produced small changes in the concentrations of the parameters studied. In contrast, thermal treatments and liming produced dramatic reductions. Fecal coliforms were the most affected by both types of treatments;somatic coliphages showed some persistence after 30 minutes at 60°C;and both somatic coliphages and helminth eggs showed some persistence to storage in quick lime. However, both treatments supplied biosolid suitable for unrestricted application in agriculture. Abatement in soils in the climatic conditions tested (mild to cold temperatures and high relative humidity) was slow and took several months to reach the background levels. These results suggest that environmental conditions (temperature and humidity) play the main role in inactivating the microorganisms, since abatement was similar in different soil types. The extended permanence of pathogens and microbial indicators in soil after the application of treated sludges indicates that, in the normal weather conditions of the areas where the study was performed and the amounts of sludges applied, contaminant microbes are not easily mobilized from the complex matrixes that constitute the treated sludges and that consequently in normal conditions their release as diffuse pollution is of lesser importance.

Minimally invasive nephrectomy for inflammatory renal disease

Objective:Once chronic inflammatory renal disease(IRD)develops,it creates a severe peri-fibrotic process,which makes it a relative contraindication for minimally invasive surgery(MIS).Our objective is to show that laparoscopic nephrectomy(LN)is a surgical option in IRD with fewer complications and better outcomes.Methods:Retrospective review of patients who underwent a modified-surgical laparoscopic transperitoneal nephrectomy was performed.Data search included all operated patients between May 2013 and May 2018 that had a pathology result with any renal inflammatory condition(xanthogranulomatous pyelonephritis,chronic nephritis,and renal tuberculosis).We describe intra-operative variables such as operative time,blood loss,conversion rate,postoperative complications and length of hospital stay.Results:There were 51 patients who underwent laparoscopic nephrectomy with a confirmatory pathology report for IRD.We identified four(8%)major complications;three of them required transfusion and one conversion to open surgery.The mean operative time was 233108 min.Mean estimated blood loss was 206242 mL excluding the conversion cases and 281423 mL including them.The mean length of hospital stay was 3.02.0 days.Conclusion:Laparoscopic nephrectomy for IRD can safely be done.It is a reproducible technique with low risks and complication rates.Our experience supports that releasing the kidney first and leaving the hilum for the end is a safe approach when vascular structures are embedded into a single block of inflammatory and scar tissue.

Tuberculous pericarditis-a silent and challenging disease:A case report

BACKGROUND Tuberculous pericarditis(TP)remains a challenge for endemic countries.In developing countries,one to two percent of patients with pulmonary tuberculosis develops TP.CASE SUMMARY A 49-year-old woman presented with dyspnea,chest pain and dry cough.On physical examination,veiled heart sounds were found.The electrocardiogram showed low-voltage complexes and the transthoracic echocardiography revealed a large and free-looking pericardial effusion.The patient was taken for an open pericardiotomy.The pericardial fluid revealed high levels of adenosine deaminase and Ziehl-Neelsen stain showed acid-fast bacilli.Polymerase chain reaction study for Mycobacterium tuberculosis in pericardial fluid was positive.The patient received tetra conjugate management with adequate clinical response after the first week of treatment and resolution of fever and chest pain.CONCLUSION In cases of TP,obtaining pericardial fluid and/or pericardial biopsy is the most efficient strategy to confirm the diagnosis.Early diagnosis of this entity will allow physicians to initiate timely treatment,avoid complications and improve the patient's clinical outcome,so we consider the description of this case pertinent and its review in the literature.

Wearable monitors criterion validity for energy expenditure in sedentary and light activities

Background: Wearable monitors(WMs) are used to estimate the time spent in sedentary behaviors(SBs) and light-intensity physical activities(LPAs) and their associated energy cost; however, the accuracy of WMs in measuring behaviors on the lower end of the intensity spectrum is unclear. The aim of this study was to assess the validity of 3 WMs(Acti Graph GT3X+; activ PAL, and Sense Wear 2) in estimating the intensity of SB and LPA in adults as compared with the criterion measure of oxygen uptake(VO_2) measured by indirect calorimetry.Methods: Sixteen participants(age: 25.38 ± 8.58 years) wore the ActiG raph GT3X+, activP AL, and SenseW ear 2 devices during 7 sedentary-to-light activities. VO_2(mL/kg/min) was estimated by means of a portable gas analyzer, Oxycon Mobile(Carefusion, Yorba Linda, CA, USA). All data were transformed into metabolic equivalents and analyzed using mean percentage error, equivalence plots, Bland-Altman plots, kappa statistics, and sensitivity/specificity.Results: Mean percentage error was lowest for the activ PAL for SB(14.9%) and LPA(9.3%) compared with other WMs, which were >21.2%.None of the WMs fell within the equivalency range of ±10% of the criterion mean value. Bland-Altman plots revealed narrower levels of agreement with all WMs for SB than for LPA. Kappa statistics were low for all WMs, and sensitivity and specificity varied by WM type.Conclusion: None of the WMs tested in this study were equivalent with the criterion measure(VO_2) in estimating sedentary-to-light activities;however, the activ PAL had greater overall accuracy in measuring SB and LPA than did the Acti Graph and Sense Wear 2 monitors.

Effect of Domestic Wastewater as Co-Substrate on Biological Stain Wastewater Treatment Using Fungal/Bacterial Consortia in Pilot Plant and Greenhouse Reuse

In this study, a pilot wastewater treatment plant was used to evaluate the co-treatment of biological-staining residues and domestic wastewater under non-sterile conditions. A novel microbial consortia formed by Trametes versicolor, Trametes sp, Pleurotus ostreatus, Pseudomonas fluorescens, Pseudomonas azotoformans, Pseudomonas sp, Enterobacter xianfangensis and Bacillus subtillis was inoculated in an extended aeration type bio-reactor. The treatment units were operated during three consecutive cycles during a period of 147 h. After the last operating cycle, the concentrations of Chemical Oxygen Demand, Biochemical Oxygen Demand, Color Units, Total suspended solids, and the pH value were 1695 mg/L, 105 mg/L, 106 CU, 5), 1367 (CU), 566 mg/L (TSS) and 7.0 (pH) respectively. The reduction of pollutants load was related with the ratio of the two types of wastewater (3.5:0.5) combined to increase biodegradability, the concentration of fungi and bacteria used in the consortia (30 × 103 - 55 × 106 CUF/mL Total Fungi and 70 × 107 - 83 × 108 CFU/mL of Total Bacteria) and ligninolytic enzymes production, Laccase (13 - 96 U/L), MnP (9.8 - 39 U/L) and LiP (0.3 - 5.3 U/L). The post-treated effluent was used as irrigation water. Lolium perenne plants were watered during 60 days with post-treated effluent. The results of root weight showed that there are significant differences between the initial water and the effluent obtained after the operational cycles (p = 0.00470). The highest root weights (1 - 1.12 g) were found in plants irrigated with water obtained from the last treatment cycle.

Morbidity Due to Obesity, Hypertension and Diabetes II Attributable to Non-Breastfeeding and Low Birth Weight during the 1000 Days of Life: Estimation of the Population Attributable Fraction

Introduction: There is evidence that malnutrition during the first 1000 days of life contributes to the development of chronic diseases in adulthood and therefore may produce a lasting impact on the health of the population. Colombia, like other middle-income countries suffers the double burden of malnutrition in pregnant women and children under 5 years. Also, chronic diseases have positioned within the leading causes of morbidity and mortality. Objective: The aim is to estimate the burden of disease of noncommunicable chronic diseases-NCD’s (hypertension, obesity, diabetes mellitus II) in adults attributable to nutritional risk factors (no-breastfeeding and low birthweight) in the period of 1000 days in Colombia. Methods: The population attributable fraction and the number of NCD’s (hypertension, diabetes mellitus II and obesity) cases due to the risk factors (low birthweight and no-breastfeeding) were estimated. Prevalences of NCD’s and risk factors of interest were taken from national health surveys. Effect measures (odds ratios/relative risks) of the associations 1—low birthweight and hypertension, diabetes mellitus II and 2—no-breastfeeding and obesity were obtained after a systematic literature search. Results: It was estimated that not receiving breastfeeding in the 1000 days could contribute up to 29.9% of all cases of obesity, equivalent to about 4,009,779 cases across the country. Low birth weight could contribute up to 2.1% of cases of hypertension in men and to 4.0% of cases in women, equivalent to 103.769 cases across the country. In addition, low birth weight could contribute to 6.3% of diabetes mellitus II cases, which is equivalent to 23.857 cases in the country. Conclusion: In Colombia, risk factors during the first 1000 days like not receiving breastfeeding and having low birth weight could contribute up to 4,113,549 cases of obesity, hypertension and diabetes mellitus II, with important implications for the health of the population and the Colombian health system.

Neuroendocrine Tumor of Small Intestine, a Diagnostic Challenge

Incidence of neuroendocrine tumors (NET) has significantly increased in the past three decades. In the small intestine, NET are the most frequent tumors, even more frequent than adenocarcinomas. Due to atypical presentations and late symptoms, NET in the small intestine frequently represent a diagnostic challenge. It is important to take these tumors into consideration in differential diagnosis of gastrointestinal neoplasms. Surgeons, oncologists, endocrinologists, and gastroenterologists should understand the disease characteristics and management alternatives. This document aims to review the key points of NET and main diagnostic tools. We present the case of a 50-year-old male who presented lower gastrointestinal bleeding. Imaging and endoscopic studies showed no conclusive findings. A capsule endoscopy showed multiple ulcered lesions with neoplastic aspect in the distal jejune. Due to the multifocal nature of the lesions, clinicians suspected NET-associated digestive bleeding. The patient underwent exploratory laparoscopy with ileectomy and radical abdominal lymphadenectomy. Histopathologic examination confirmed the suspected diagnosis of NET. This case reflects the complexity of diagnostic approach and differential diagnoses for these tumors.

Comparative mitogenome phylogeography of two anteater genera (Tamandua and Myrmecophaga;Myrmecophagidae, Xenarthra): Evidence of discrepant evolutionary traits

The species within Xenarthra(sloths,anteaters,and armadillos)are quintessential South American mammals.Of the three groups,Vermilingua(anteaters)contains the fewest extant and paleontological species.Here,we sampled and sequenced the entire mitochondrial genomes(mitogenomes)of two Tamandua species(Tamandua tetradactyla and T.mexicana)(n=74)from Central and South America,as well as Myrmecophaga tridactyla(n=41)from South America.Within Tamandua,we detected three different haplogroups.The oldest(THI)contained many specimens with the T.tetradactyla morphotype(but also several with the T.mexicana morphotype)and originated in southeastern South America(currently Uruguay)before moving towards northern South America,where the THII haplogroup originated.THII primarily contained specimens with the T.mexicana morphotype(but also several with the T.tetradactyla morphotype)and was distributed in Central America,Colombia,and Ecuador.THI and THII yielded a genetic distance of 4%.THII originated in either northern South America or“in situ”in Central America with haplogroup THIII,which consisted of~50%T.mexicana and 50%T.tetradactyla phenotypes.THIII was mostly located in the same areas as THII,i.e.,Central America,Ecuador,and Colombia,though mainly in the latter.The three haplogroups overlapped in Colombia and Ecuador.Thus,T.tetradactyla and T.mexicana were not reciprocally monophyletic.For this reason,we considered that a unique species of Tamandua likely exists,i.e.,T.tetradactyla.In contrast to Tamandua,M.tridactyla did not show different morphotypes throughout its geographical range in the Neotropics.However,two very divergent genetic haplogroups(MHI and MHII),with a genetic distance of~10%,were detected.The basal haplogroup,MHI,originated in northwestern South America,whereas the more geographically derived haplogroup,MHII,overlapped with MHI,but also expanded into central and southern South America.Thus,Tamandua migrated from south to north whereas Myrmecophaga migrated from north to south.Our results also showed that temporal mitochondrial diversification for Tamandua began during the Late Pliocene and Upper Pleistocene,but for Myrmecophaga began during the Late Miocene.Furthermore,both taxa showed elevated levels of mitochondrial genetic diversity.Tamandua showed more evidence of female population expansion than Myrmecophaga.Tamandua experienced population expansion~0.6–0.17 million years ago(Mya),whereas Myrmecophaga showed possible population expansion~0.3–0.2 Mya.However,both taxa experienced a conspicuous female decline in the last 10000–20000 years.Our results also showed little spatial genetic structure for both taxa.However,several analyses revealed higher spatial structure in Tamandua than in Myrmecophaga.Therefore,Tamandua and Myrmecophaga were not subjected to the same biogeographical,geological,or climatological events in shaping their genetic structures.

Bovine Leukemia Virus Gene Segment Detected in Human Breast Tissue

Background: Bovine Leukemia Virus (BLV) is known by infections in bovine cattle and produce, in 30% of infected animals, persistent lymphocytosis significantly impacts the beef industry. It has been proposed that this virus could be transmitted to humans and be present in cases of breast cancer. Aim: to determine the presence of 380 bp of gag gene segment of BLV in paraffin-embedded breast tissue. Study Design: Control-case study. Methodology: 106 tissue samples were collected. 53 were cancer positive samples and 53 were negative samples for this pathology. After dewaxing tissues, DNA was extracted, amplified and sequenced. Phylogenetic analysis was done in order to verify BLV gene segment, presence and origin. Results: 43 samples were positive (40.5%) for BLV segment. In the case group this segment was found in 35.8% of the samples and in the control group, BLV presented in 45.2% of the samples. Phylogenetic analysis confirmed BLV presence and had shown a high homology between amplified gene sequences obtained from human breast tissues and those coming from bovine cattle with leukosis reported by GenBank. Conclusion: The presence of BLV genes in humans and its location in breast tissue can be confirmed, however, it should be clarified as a possible promoter of malignancy processes on this tissue.

Reading and Writing Practices： Case Studies at the Sergio Arboleda University of Colombia

This research project analyzes the reading and writing practices used in five first and second year undergraduate courses of different disciplines at a Colombian university. During one semester, we conducted polls, class observations, and interviews with teachers. The data collected contain information about the strategies that teachers use to guide, clarify, and evaluate the readings they assigned. It also informs about the ways in which teachers classify texts and participate in the process of composing, editing, and evaluating the students＇ writing. Finally, the data inform about the role that teachers assign to the practices of reading and writing in their courses. The results of the study prove that there is a misconception based on the idea that there is a unique way of understanding and practicing reading and writing in the academia, and that there is a set of unique strategies that are transferable to any discipline or field of study. The cases analyzed in this study suggest that it would be much more effective to incorporate intensive reading and writing strategies in disciplinary courses, than to concentrate on first year writing courses.

The effect of nitrification inhibitor 3,4-dimethylpyrazole phosphate (DMPP) on nitrifying organism populations under <i>in vitro</i>conditions

The application of nitrification inhibitors is a technique to reduce the nitrate concentration on leachates that delay ammonium oxidation by reducing the activity of ammonium oxidizing bacteria in soils. Two experiments were carried out in order to estimate the influence of DMPP on the population of ammonium oxidization bacteria under in vitro conditions. In both experiments, three treatments were established. The treatments were the following: a) ammonium oxidization bacteria established in a growing media without fertilizers, b) ammonium oxidization bacteria established in a growing media with Urea, and c) ammonium oxidization bacteria established in a growing media with DMPP. Results obtained showed that the population of the ammonia oxidizing bacteria diminished in the DMPP treatment as compared with the urea and control treatments. In conclusion, DMMP influences on ammonium oxidization bacteria activity being a useful tool in fertilizers strategies to reduce the contamination by nitrates in groundwater.

Feasibility of using pedometers in a state-based surveillance system：2014 Arizona Behavioral Risk Factor Surveillance System

Background: Despite their utility in accessing ambulatory movement, pedometers have not been used consistently to monitor physical activity in U.S. surveillance systems. This study was designed to determine the feasibility of using pedometers to assess daily steps taken in a sub-sample of adults from Maricopa County who completed the 2014 Arizona Behavioral Risk Factor Surveillance System Survey.Methods: Respondents were sent an Omron HJ324 U pedometer, a logbook to record steps taken, and a walking questionnaire. The pedometer was worn for 7 days. Feasibility was assessed for acceptability(interest in study), demand(procedures followed correctly), implementation(time to complete study), and practicality(cost).Results: Acceptability was modest with 23.9%(830/3476) agreeing to participate. Among those participating(92.9%; 771/830), 50.1%(386/771)returned the logbook. Demand was modest with 39.3%(303/771) of logbooks returned with valid data. Implementation represented 5 months to recruit participants. The cost to obtain valid step-count data was USD61.60 per person. An average of 6363 ± 3049 steps/day were taken with most participants classified as sedentary(36.0%) or low active(35.6%).Conclusion: The feasibility of using pedometers in a state-based surveillance system is modest at best. Feasibility may potentially be improved with easy-to-use pedometers where data can be electronically downloaded.

Morpho-Molecular Characterization of Ditylenchus dipsaci and Alternatives for Its Management in Green Onion Allium fistulosum Crops from Colombia

Green onion is one of the most consumed vegetables in Colombia. However, its production is negatively affected by the nematode Ditylenchus. To determine the species of the nematode, as well as to propose management strategies for its control, in the present study the morphological, morphometric, and molecular characterization of the phytonematode was carried out and was used to evaluate the effect of immersion of the propagation material in water hot, application of a commercial strain of Purpureocillium lilacinum and the application of an agrochemical with insecticidal-nematicidal action to control the phytosanitary problem under field conditions. The morphological and morphometric characteristics of the nematode were similar to those reported for the type and reference populations of D. dipsaci. Based on sequences of the D2-D3 segment and Internal Transcribed Spacer-ITS of the rRNA, the presence of D. dipsaci in green onion crops in Colombia was confirmed. The application of P. lilacinum statistically showed an efficient control of D. dipsaci, at the same time that presented the highest yield, in relation to the other evaluated treatments (P ≤ 0.05).

Nightlife in the city: drivers of the occurrence and vocal activity of a tropical owl

Background:Cities differ from non-urban environments by the intensity,scale,and extent of anthropogenic pres-sures,which can drive the occurrence,physiology,and behavior of the organisms thriving in these settings.Traits as green cover often predict the occurrence patterns of bird species in urban areas.Yet,anthropogenic noise and artificial light at night(ALAN)could also limit the presence and disrupt the behavior of birds.However,there is still a dearth of knowledge about the influence of urbanization through noise and light pollution on nocturnal bird species ecology.In this study,we assessed the role of green cover,noise,and light pollution on the occurrence and vocal activity of the Mottled Owl(Ciccaba virgata)in the city of Xalapa(Mexico).Methods:We obtained soundscape recordings in 61 independent sites scattered across the city of Xalapa using autonomous recording units.We performed a semi-automated acoustic analysis of the recordings,corroborating all Mottled Owl vocalizations.We calculated two measures of anthropogenic noise at each study site:daily noise(during 24 h)and masking noise(mean noise amplitude at night per site that could mask the owl’s vocalizations).We further performed generalized linear models to relate green cover,ALAN,daily noise,and masking noise in relation to the owl’s occurrence(i.e.,detected,undetected).We also ran linear models to assess relationships among the beginning and ending of vocal activity with ALAN,and with the anthropogenic and masking noise levels at the moment of which vocalizations were emitted.Finally,we explored variations of the vocal activity of the Mottled Owl measured as vocalization rate across time.Results:The presence of Mottled Owls increased with the size of green cover and decreased with increases in both artificial light at night and noise levels.At the temporal scale,green cover was positively related with the ending of the owl’s vocal activity,while daily noise and ALAN levels were not related to the timing and vocal output(i.e.,number of vocalizations).Furthermore,the Mottled Owl showed a marked peak of vocal activity before dawn than after dusk.Although anthropogenic noise levels varied significantly across the assessed time,we did not find an association between high vocal output during time periods with lower noise levels.Conclusions:Spatially,green cover area was positively related with the presence of the Mottled Owl in Xalapa,while high noise and light pollution were related to its absence.At a temporal scale,daily noise and ALAN levels were not related with the timing and vocal output.This suggests that instead of environmental factors,behavioral contexts such as territoriality and mate interactions could drive the vocal activity of the Mottled Owl.Further studies need to incorporate a wider seasonal scale in order to explore the variation of different vocalizations of this species in relation to environmental and biological factors.

Use of recycled concrete aggregates in asphalt mixtures for pavements:A review

Large quantities of natural aggregates(NA)are required in the manufacturing of asphalt mixtures for pavements.The extraction of NA generates high environmental impacts that negatively affect environmental preservation and conservation.Diverse alternative materials obtained in construction and demolition processes in civil construction worked have been studies as possible replacements for NA,with the purpose of reducing these environmental impacts.The foregoing study presents a state of knowledge review referring to the use of recycled concrete aggregates(RCA)when these are used in the manufacturing of asphalt mixtures(mainly hot-mix asphalt HMA type).Environmental aspects are presented,as well as possible benefits and limitations of using RCA as replacements for NA in asphalt mixtures.However,it is not possible to establish a behavior pattern,since the characteristics of the RCA are very heterogeneous and vary from the original source of the concrete.It is highlighted from the literature that RCA has a wide potential for use in the manufacture of asphalt mixtures,since in most studies,the mixtures with these materials comply the quality requirements contemplated by the construction specifications,mainly in low-volume roads.Additionally,based on the literature review,some recommendations and suggestions are presented for future research.