Universidad del Caribe

In vehicle systems, the suspension is fundamental in achieving acceptable levels of ride comfort, while ensuring ride safety. Semi-active suspensions allow changing the suspension damping to prioritize different performance metrics. Multiple control techniques have been developed to find a suitable trade-off between comfort and road holding. This manuscript proposes the use of standard (proportional-integral-derivative) controllers tuned in real time by an artificial neural network. The formulation of the controller considers a magnetorheological damper represented through the Bouc-Wen model. A stochastic gradient descent algorithm with backward propagation is used to train the artificial neural network that then selects the controller gains in real time. This technique is tested numerically through quarter and full car models, with the latter one running on the automotive simulation software CarSim. The obtained results highlight significant improvements of the proposed approach in comparison to state-of-the-art controllers. Furthermore, the study proves the viability of running four controllers on a real-time embedded hardware platform through processor-in-the-loop tests.

Being an extremely high mortality rate condition, cardiac arrest cases have rightfully been evaluated via various studies and scoring factors for effective resuscitative practices and neurological outcomes post resuscitation. This narrative review aims to explore the role of Artificial Intelligence (AI) in predicting neurological outcomes post cardiac resuscitation. Methodology involved detailed review of all relevant recent studies of AI, different machine learning algorithms, prediction tools and assessing their benefit in predicting neurological outcomes in post cardiac resuscitation cases as compared to more traditional prognostic scoring systems and tools. Previously, outcome determining clinical, blood and radiological factors were prone to other influencing factors like limited accuracy and time constraints. Studies conducted also emphasized that to predict poor neurological outcomes, a more multimodal approach helped adjust for confounding factors, interpret diverse datasets and provide a reliable prognosis which only demonstrates need for AI to help overcome challenges faced. Advanced machine learning algorithms like Artificial Neural Networks (ANN) using supervised learning by AI have improved accuracy of prognostic models outperforming conventional models. Several real-world cases of effective AI powered algorithm models have been cited here. Studies comparing machine learning tools like XGBoost, AI Watson, hyperspectral imaging, ChatGPT-4 and AI based gradient boosting have noted their beneficial uses. AI could help reduce workload, healthcare costs and help personalize care, process vast genetic and lifestyle data and help reduce side effects from treatments. Limitations of AI have been covered extensively in this article including data quality, bias, privacy issues and transparency. Our objectives should be to use more diverse data sources, use interpretable data output giving process explanation, validation method and implement policies to safeguard patient data. Despite the limitations, the advancements already made by AI and its potential in predicting neurological outcomes in post cardiac resuscitation cases has been quite promising and boosts a continually improving system, albeit requiring close human supervision with training and improving models, with plans to educate clinicians, the public and sharing collected data.

This study analyzes the current state and challenges of electric mobility and energy generation in Colombia and the Dominican Republic, as well as the cases of Germany and Sweden, in the context of the transition towards a more sustainable future. Electric mobility aims to reduce dependence on fossil fuels and greenhouse gas (GHG) emissions, supported by the increase in charging infrastructure and favorable government policies. However, the objective of this work emphasizes that the mere use of electric vehicles does not automatically guarantee a reduction in GHG emissions, as observed in the Dominican Republic, where electricity generation mainly depends on thermoelectric sources. This reliance prevents the adoption of electric vehicles from achieving a significant reduction in carbon dioxide (CO2) emissions due to the high emission levels in electricity production. In contrast, in Colombia, where the energy matrix is dominated by hydroelectric power, electric mobility significantly contributes to the reduction of GHG emissions. In Germany, despite its significant share of renewable energy, many challenges remain due to its dependence on lignite and coal. On the other hand, Sweden presents a much more positive outlook and is a global example in the field of energy transition. The results underscore the importance of diversifying energy sources to maximize the positive impact of electric mobility on emission reductions and highlight the need for comprehensive strategies that consider both the transportation and energy sectors to achieve a sustainable transition.

This study analyzes the dynamic relationship between tourism and human development in a sample of 123 countries between 1995–2019 using a symbolic time series methodological analysis, with the number of international tourist arrivals per capita as the tourism measurement variable and the Human Development Index as the development measurement variable. The objective was to determine if a higher level of tourism specialization is related to a higher level of economic development. The definition of economic regime is used and the concept of the distance between the dynamic trajectories of the different countries analyzed is introduced to create a minimum spanning tree. In this way, groups of countries are identified that display similar behavior in terms of tourism specialization and levels of human development. The results suggest that countries with a high level of tourism specialization have a higher level of development as compared to those in which tourism has a lower specific weight. However, the largest group of countries identified is characterized by low levels of tourism specialization and economic development, which appears to translate into a poverty trap. Therefore, policies related to tourism activity expansion should be created since higher tourism levels have been linked to higher levels of human development. In the case of less developed countries, however, these projects should be financed by international organizations so that these countries can escape the poverty trap in which they are currently found.

Purpose: We report the 5-year study closeout results for the ROBUST I trial evaluating the safety and efficacy of the Optilume drug-coated balloon (DCB) for men with short, recurrent bulbar urethral strictures. Materials and methods: Adult men with recurrent bulbar urethral strictures ≤ 2 cm long and lumen < 12F were included in the study and treated with the Optilume DCB. Outcome measures included symptom questionnaires, maximum urinary flow rate, postvoid residual, and freedom from repeat intervention. Functional success was defined as improvement in International Prostate Symptom Score ≥ 50% without re-treatment. Results: Fifty-three men were enrolled and treated, and 31 subjects completed all follow-up. Functional success was achieved in 58% (25/43) patients at 5 years. Average International Prostate Symptom Score improved from a mean of 25.2 at baseline to 7.2 at 5 years (P < .001). Freedom from repeat intervention was maintained through 5 years at 71.7% estimated by Kaplan-Meier. Maximum urinary flow rate improved from 5.0 mL/s at baseline to 19.9 (P < .01), and average postvoid residual was reduced from 141.4 mL to 59.5 mL (P < .01) at 5 years of follow-up. Erectile function remained unaffected. There were no serious treatment-related adverse events. Conclusions: In this challenging cohort of men with failed prior endoscopic treatment, the Optilume DCB shows sustained improvement in subjective and objective voiding parameters at 5 years. Optilume is a safe and effective treatment option for appropriately selected men with recurrent bulbar urethral stricture who wish to avoid urethroplasty. Results are in line with the ROBUST III randomized controlled trial that will continue follow-up through 5 years. Clinical trial no.: : NCT03014726.

We deposited bare TiO2 and TiO2/ZnO thin filmsto study their antimicrobial capacity against Fusarium oxysporum f.sp. dianthi. The deposit of TiO2 was performed by spin coating andthe ZnO thin films were deposited onto the TiO2 surface byplasma-assisted reactive evaporation technique. The character-ization of the compounds was carried out by scanning electronmicroscopy (SEM) and powder X-ray diffraction techniques.Furthermore, density functional theory (DFT) and time-dependentDFT (TDDFT) calculations were performed to support theobserved experimental results. Thus, the removal of methylene blue(MB) by adsorption and posterior photocatalytic degradation wasstudied. Adsorption kinetic results showed that TiO2/ZnO thinfilms were more efficient in MB removal than bare TiO2 thin films,and the pseudo-second-order model was suitable to describe the experimental results for TiO2/ZnO (qe = 12.9 mg/g; k2 = 0.14 g/mg/min) and TiO2 thin films (qe = 12.0 mg/g; k2 = 0.13 g/mg/min). Photocatalytic results under UV irradiation showed that TiO2thin films reached 10.9% of MB photodegradation (k = 1.0 × 10−3 min−1), whereas TiO2/ZnO thin films reached 20.6% of MBphotodegradation (k = 3.9 × 10−3 min−1). Both thin films reduced the photocatalytic efficiency by less than 3% after 4 photocatalytictests. DFT study showed that the highest occupied molecular orbital−lowest unoccupied molecular orbital (HOMO−LUMO)energy gap decreases for the mixed nanoparticle system, showing its increased reactivity. Furthermore, the chemical hardness showsa lower value for the mixed system, whereas the electrophilicity index shows the biggest value, supporting the larger reactivity for themixed nanoparticle system. Finally, the antimicrobial activity against F. oxysporum f. sp. dianthi showed that bare TiO2 reached agrowth reduction of 68% while TiO2/ZnO reached a growth reduction of 90% after 250 min of UV irradiation

Background Gender inequality permeates the rheumatology landscape in Latin America, affecting female practitioners at multiple levels. Objectives A mixed-methods survey study was conducted to assess gender inequalities, identify barriers in the medical practices of female rheumatologists in the Pan-American region, and propose potential solutions. The aim was to pinpoint contributing factors and capture the narratives of these experiences. Methods A cross-sectional study was undertaken using a mixed-methods design through an online survey administered to PANLAR member countries. Closed-ended questions were employed for the quantitative phase, while open-ended questions were used for the qualitative phase. Descriptive and analytical methods were applied for the quantitative approach, and a phenomenological method was employed for the qualitative aspect. The research adhered to the Helsinki Declaration and the International Ethical Guidelines of the World Health Organization (WHO). Results The survey was completed by 246 participants (239 rheumatologists and 9 rheumatology trainees) from 17 PANLAR countries. The mean age of respondents was 44 years, with the majority residing in Argentina (31.30%), Mexico, and Colombia (Figure 1). Eleven percent were pediatric rheumatologists, 60% were involved in teaching, and 49% in research. About 50% were married, and 63% were mothers.Perceived barriers related to gender included misogyny and harassment in the work environment, a preference for men in workplaces, academic roles, leadership positions, and residencies. This perception was consistent among female rheumatologists, both with and without children. Mother rheumatologists perceived more barriers related to difficulties in balancing work/family time, less time for patient care and academic work due to family issues, disadvantages in the workplace due to maternity and breastfeeding, and fewer opportunities to attend academic events because of childcare responsibilities. For some participants, no gender barriers were identified. Proposed solutions included improving the work environment, promoting gender equity policies, education, and increased effort (Figure 2). Conclusion This marks the first Pan-American study evaluating the gender-related challenges female rheumatologists face in the region. Various barriers were discovered, primarily affecting female rheumatologists who are mothers in their medical practices. However, no significant associations were identified between individual characteristics and gender-related experiences. Further research is needed to investigate underlying factors and devise targeted interventions to promote gender equity in rheumatology. REFERENCES NIL • Download figure • Open in new tab • Download powerpoint Figure 1. Distribution by country of residence • Download figure • Open in new tab • Download powerpoint Figure 2. Barriers in rheumatology practice and proposed solutions by female rheumatologists Acknowledgements NIL Disclosure of Interests None declared

A bending test was selected by modern codes as a reference test for fibre-reinforced concrete (FRC) mechanical characterization. However, specimen dimensions, lack of laboratories adequately equipped, and its complexity hinder its use. This study aims to evaluate the so-called Montevideo (MVD) test as an alternative to the results of EN14651 bending tests, simplifying FRC mechanical evaluation. A strong correlation was obtained using the results of experimental campaigns carried out in three countries. Using two linear transformations, MVD loads can be converted to the EN14651 ones, both for the limit of proportionality and for the residual loads, which are valid for all the CMOD reported in EN14651. These general rules seem valid for different types of concretes (conventional, Self-Compacting, Ultra High-Performance, Micro and Sprayed concrete), blended with different fibre types (plastic and steel) and a wide range of contents, which show both softening and hardening behaviour.

PURPOSE The study aims to investigate the influence of the ferrule effect and types of posts on the stress distribution in three morphological types of the maxillary central incisor. MATERIALS AND METHODS Nine models were created for 3 maxillary central incisor morphology types: “Fat” type - crown 12.5 mm, root 13 mm, and buccolingual cervical diameter 7.5 mm, “Medium” type - crown 11 mm, root 14 mm, and buccolingual cervical diameter 6.5 mm, and “Slim” type - crown 9.5 mm, root 15 mm, and buccolingual cervical diameter 5.5 mm. Each model received an anatomical castable post-and-core or glass-fiber post with resin composite core and three ferrule heights (nonexistent, 1 mm, and 2 mm). Then, a load of 14 N was applied at the cingulum with a 45° slope to the long axis of the tooth. The Maximum Principal Stress and the Minimum Principal Stress were calculated in the root dentin, crown, and core. RESULTS Higher tensile and compression stress values were observed in root dentin using the metallic post compared to the fiber post, being higher in the slim type maxillary central incisor than in the medium and fat types. Concerning the three anatomical types of maxillary central incisors, the slim type without ferrule height in mm presented the highest tensile stress in the dentin, for both types of metal and fiber posts. CONCLUSION Post system and tooth morphology were able to modify the biomechanical response of restored endodontically-treated incisors, showing the importance of personalized dental treatment for each case.

“Disorders of Gut-Brain Interaction (DGBIs),” formerly referred to as “Functional Gastrointestinal Disorders (FGIDs),” encompass a prevalent array of chronic or recurring gastrointestinal symptoms that notably impact the quality of life for affected children and their families. Recent studies have elucidated the intricate pathophysiology of DGBIs, underscoring their correlation with gut microbiota. This review seeks to explore the present comprehension of the gut microbiota's role in DGBI development. While other factors can contribute to DGBIs, the gut microbiota prominently influences the onset and progression of these conditions. According to the Rome IV diagnostic criteria, DGBI prevalence is approximately 40% worldwide. The Rome Foundation has diligently worked for nearly three decades to refine our comprehension of DGBIs. By centering on the gut microbiota, this review sheds light on potential therapeutic interventions for DGBIs, potentially enhancing the quality of life for pediatric patients and their families.

Introduction: The leptomeningeal collaterals (LMCs) undergo outward remodeling after stroke to increase rescue flow toward the occluded region. We previously showed increased VWF in remodeled LMCs and others have shown that VWF can act as a smooth muscle cell (SMC) mitogen. Here we test the hypothesis that VWF modulates vascular remodeling of LMCs in the post-stroke brain. Methods: Permanent distal middle cerebral artery occlusion (pdMCAO) was performed in C57BL6 WT mice (cohort 1; 4 mos), aged (cohort 2; 24 mos) or VWF KO and WT male mice (cohort 3; 4 mos). At 3, 7, and 14 days after pdMCAO, the pial vessels were processed for VWF/Ki67/SMA immunofluorescence and morphometric analysis. Lastly, distribution of VWF was evaluated in LMCs from human and pig brains. Results: During the 3-14 days post-stroke, WT mice of cohort 1 demonstrated significantly increased VWF in ipsilateral LMCs as well as increased Ki67 positive cells. In ECs, Ki67-positive cells were 10.68 ± 1.48 and 10.73 ± 1.26 per mm of vessel at 3 and 7 days, respectively. In SMCs, Ki67-positive cells were 0.049 ± 0.22 and 4.546 ± 0.95 per mm vessel at 3 and 7 days, respectively. By 14 days, LMC no longer showed Ki67-positive ECs or SMCs. In aged cohort 2, along with attenuated VWF expression and remodeling, the Ki67-positive ECs and SMCs were significantly decreased in the aged mice compared to young mice (Ki67-positive ECs were reduced by 40% and 50% at 3 and 7 days, respectively; Ki67-positive SMCs were reduced by 75% at 7 days). In cohort 3, Ki67-positive SMCs were absent in the VWF-KOs at 3 days post-stroke. However, by 7 days, Ki67-positive SMCs were equivalent between WT and VWF-KOs (4.8-5.0 per mm vessel). Lastly, the presence of VWF was detected in the smooth muscle layer of LMCs of human and pig brains. Conclusions: Our study revealed increased VWF in the mural layer of remodeled LMCs and both EC and SMC proliferation. The remodeling response, VWF expression, and number of proliferative cells were attenuated in LMCs from aged brains. Knockout of VWF resulted in reduced LMC remodeling and delayed SMC proliferation. Our findings also provide evidence for VWF within the smooth muscle layer of pig and human brain arterioles, supporting the broader potential role of VWF as a molecular player in vascular remodeling.

Extremophile organisms are known that can metabolize at temperatures down to -25°C (psychrophiles) and up to 122°C (hyperthermophiles). Understanding viability under extreme conditions is relevant for human health, biotechnological applications, and our search for life elsewhere in the universe. Information about the stability and dynamics of proteins under environmental extremes is an important factor in this regard. Here we compare the dynamics of small Fe-S proteins – rubredoxins – from psychrophilic and hyperthermophilic microorganisms, using three different nuclear techniques as well as molecular dynamics calculations to quantify motion at the Fe site. The theory of ‘corresponding states’ posits that homologous proteins from different extremophiles have comparable flexibilities at the optimum growth temperatures of their respective organisms. Although ‘corresponding states’ would predict greater flexibility for rubredoxins that operate at low temperatures, we find that from 4K to 300K, the dynamics of the Fe sites in these homologous proteins are essentially equivalent.

Cyanobacterial blooms pose potential health and economic risks when they reach drinking water intakes. In basins with intensive agricultural production, there are numerous small and medium-sized (0.25-60 ha) productive freshwater reservoirs. These reservoirs create favorable conditions for the excessive growth of phytoplankton, which can be transported downstream after heavy rainfall events. These environments have been identified as potential sources of cyanobacterial inoculum in Uruguay's main drinking water intake, located in the Santa Lucía River Basin. To pinpoint areas with the highest risk of cyanobacterial biomass export, this study integrated chlorophyll-a concentration monitoring in 325 reservoirs using Sentinel-2 satellite images, along with meteorological and structural information from the reservoirs. An Export Index (EI) for biomass was developed, and spatial distribution patterns were explored through geostatistical and multivariate analyses. According to the EI, the western and southern zones, characterized by intensive agricultural land uses such as dairy farming and horticulture, were the most at risk for biomass export. Conversely, the northeastern zone exhibited the lowest risk, aligning with extensive cattle ranching practices associated with low nutrient export to aquatic systems. This study marks the initial effort to assess the risk of transporting cyanobacterial inoculum from numerous reservoirs to Uruguay's primary drinking water intake, providing valuable input for the development of early warning systems for the occurrences of cyanobacterial blooms.

Clinical capacity for sustainability, or the clinical resources needed to sustain an evidence-based practice, represent proximal determinants that contribute to intervention sustainment. We examine the relationship between clinical capacity for sustainability and sustainment of PEWS, an evidence-based intervention to improve outcomes for pediatric oncology patients in resource-variable hospitals. We conducted a cross-sectional survey among Latin American pediatric oncology centers participating in Proyecto Escala de Valoración de Alerta Temprana (EVAT), an improvement collaborative to implement Pediatric Early Warning Systems (PEWS). Hospitals were eligible if they had completed PEWS implementation. Clinicians were eligible to participate if they were involved in PEWS implementation or used PEWS in clinical work. The Spanish-language survey consisted of 56 close and open-ended questions about the respondent, hospital, participants’ assessment of clinical capacity to sustain PEWS using the clinical sustainability assessment tool (CSAT), and perceptions about PEWS and its use as an intervention. Results were analyzed using a multi-level modeling approach to examine the relationship between individual, hospital, intervention, and clinical capacity determinants to PEWS sustainment. A total of 797 responses from 37 centers in 13 countries were included in the analysis. Eighty-seven percent of participants reported PEWS sustainment. After controlling for individual, hospital, and intervention factors, clinical capacity was significantly associated with PEWS sustainment (OR 3.27, p < .01). Marginal effects from the final model indicate that an increasing capacity score has a positive influence (11% for every additional CSAT point) of predicting PEWS sustainment. PEWS is a sustainable intervention and clinical capacity to sustain PEWS contributes meaningfully to PEWS sustainment.

In this work we propose a one-class self-supervised method for anomaly segmentation in images, that benefits both from a modern machine learning approach and a more classic statistical detection theory. The method consists of three phases. First, features are extracted using a multi-scale image Transformer architecture. Then, these features are fed into a U-shaped Normalizing Flow that lays the theoretical foundations for the last phase, which computes a pixel-level anomaly map and performs a segmentation based on the a contrario framework. This multiple-hypothesis testing strategy permits the derivation of robust automatic detection thresholds, which are crucial in real-world applications where an operational point is needed. The segmentation results are evaluated using the Intersection over Union (IoU) metric, and for assessing the generated anomaly maps we report the area under the Receiver Operating Characteristic curve (AUROC), and the area under the per-region-overlap curve (AUPRO). Extensive experimentation in various datasets shows that the proposed approach produces state-of-the-art results for all metrics and all datasets, ranking first in most MvTec-AD categories, with a mean pixel-level AUROC of 98.74%. Code and trained models are available at https://github.com/mtailanian/uflow.

Galactomannans are polysaccharides commonly extracted from the endosperm of various leguminous seeds, exhibiting variations in their man/gal ratio based on their botanical origin. These gums are highly valued for their biodegradability and excellent stability. However, their applications have been limited due to their high viscosity and molecular weight. In this study, we explore the enzymatic and ultrasound depolymerization of galactomannans, resulting in the production of freeze-dried hydrolysates that are subsequently characterized. The hydrolysis process leads to a decrease in viscosity and molecular weight, accompanied by a noticeable increase in polydispersity through enzymatic treatment. Thin-layer chromatography (TLC) analysis indicates the generation of subunits consisting of nine or eight members. Fourier-transform infrared (FTIR) spectroscopy analysis demonstrates no significant changes in functional groups following ultrasound hydrolysis. Furthermore, consistent with the TLC results, the hydrolysates display reactivity towards non-enzymatic browning (NEB), yielding intermediate products with limited browning development.This study expands, diversifies, and enhances the potential applications of these galactomannans in the pharmaceutical, cosmetic, and food industries.

For decades, the risks of catching infectious diseases in recreational beaches has been addressed by measuring abundance of fecal indicator bacteria from water samples through culture methods. Recently, analyses of sand samples for beach quality assessments have been developed as a complement for monitoring recreational waters. In parallel, the growing use of molecular techniques for environmental monitoring has led to obtaining rapid results on the exposure to fecal contamination and the detection of pathogenic genes directly. The aim of this work was to analyze the fecal contamination of sand from touristic beaches by qPCR, together with abundance of thermotolerant coliforms in sand and water. The results revealed the presence of pathogenic genes. Pathogenic genes (mainly stx1 ) were confirmed in 8 out of 20 samples, associated with the lack of sanitation network. The recreational use of sandy beaches may imply a risk to the health of its users, especially near streams and creek outflows, demonstrating the importance of monitoring sand bacteriological quality, and the usefulness of directly monitoring pathogens by means of molecular tools.

Teenage fertility is a social problem because of its private and public costs in countries of different development levels. Reductions in adolescent birth rates do not necessarily follow drops in overall fertility due to the demographic transition model. This paper analyses the impact of a subdermal contraceptive program on repeat teenage motherhood. Using a regression discontinuity design, we find that the intervention reduced mothers' likelihood of having another child in the next 48 months by 10 percentage points. This reduction is not random, and we also identify small positive selection in subsequent births.