Universidad del Rosario

This work delves into the bonding nature of the pentagonal-pyramidal benzene and hexamethylbenzene dications, C6R62+ (R = H and CH3), which contain a hexacoordinate carbon. The study employs a range...

Background Clarithromycin is a macrolide used to treat microorganisms that cause atypical pneumonia or whooping cough in pediatrics. Studies have shown that its use in typical pneumonia does not change clinical outcomes. The implementation of an Antimicrobial Stewardship (ASP) strategy directed at this antibiotic and its rational use allows for reductions in its unnecessary consumption. The aim of this work is to show the impact of an antibiotic control intervention on the use of clarithromycin in a pediatric hospital. Methods A before-and-after study was carried out in between 2018 and 2022. In 2020 begins the intervention period during which several educational measures aimed at the clarithromycin formulation were implemented, including a virtual training space, a graphic piece for knowledge of the tools, and the implementation of an audit and feedback system for all clarithromycin formulations. Special emphasis was placed on the differential diagnosis of atypical pneumonia caused by viruses and the promotion of the oral route for this antibiotic. Antibiotic consumption was measured using Days of Therapy (DOT) and adherence to local prescription guidelines. R (version 4.2.2) was used for statistical analysis. Results Two years prior to the intervention (2018 and 2019) were analyzed, 2020 was taken as the washout year, and two years after the intervention (2021 and 2022) were analyzed. The average DOT in the pre-intervention period was 10 DOT x 1,000 hospital discharges, compared to the post-intervention period where it was 0.8 DOT x 1,000 hospital discharges (p value < 0.001). In the pre-intervention years, a peak in formulation related to the respiratory peak was observed (between March and May) (Figure 1). Adherence to local prescription guidelines increased from 60% to 95% in the post-intervention period (p value < 0.05). Days of Therapy (DOT) x 1.000 hospital beds between 2018 and 2022. A decrease in the consumption of antibiotics is shown after the implementation of ASP strategy in February 2020 Conclusion The use of the tools of an antibiotic control program aimed at the use of clarithromycin showed a decrease in the consumption of this antibiotic and increased adherence to the prescription guidelines. It is possible that, on many occasions, the formulation of this was unnecessary. Disclosures All Authors: No reported disclosures

Background The cleaning and disinfection process (CDP) of hospital surfaces has proven to be an effective tool in preventing healthcare-associated infections. ATP bioluminescence meters have been established as the standard for CDP evaluation. The use of fluorescent markers has also been established as an alternative to this. The aim of this study was to assess the concordance between luminometry measurements and fluorescent marker use in the CDP of a pediatric hospital. Methods A diagnostic test study was conducted in which luminometry (Clean-Trace™ LX25 - 3M™) was compared with the use of a fluorescent marker (West Scan - West Química). Joint relative light units (RLU) were taken, and a subjective scale was used to define the erasure of the fluorescent marker after the cleaning and disinfection process (completely erased, partially erased, and intact). The process was established as adequate when less than 65 ATP units were obtained in critical sites and less than 175 in general hospitalization sites. The R program v 4.2.2 was used for data analysis. Results We performed 292 paired measurements: 222 (76%) in critical areas and 70 (24%) in non-critical areas. Measurements were taken from different high-contact surfaces such as crash carts, monitor screens, worktables, dressing carts, and defibrillators, among others. The luminometries carried out in 244 (83.5%) were adequate, and the measurements with fluorescent marker showed that 187 (64%) presented total erasure, 37 (12.6%) showed partial erasure, and 66 (22%) were intact. The Kappa index between both tests for total erasure was calculated as adequate, being 0.155 (p-value 0.002). When the tests with the criteria of partial or total erasure were compared as adequate, the Kappa index was 0.007 (p-value 0.6). When they were sub-analyzed according to the areas (critical and non-critical), a kappa value of 0.141 (p-value 0.02) was found for critical areas and 0.194 (p-value 0.03) for non-critical areas. Conclusion The correlation between the evaluation of the cleaning and disinfection process using a luminometer and a fluorescent marker showed slight agreement for total erasure. More studies are required to understand the reasons for this low correlation. Disclosures All Authors: No reported disclosures

Instantons, which emerged in particle physics, have been intensely studied since the 1970’s and had an enormous impact on mathematics since then. In this paper, we focus on one particular way in which ideas originating in mathematical physics have guided the development of algebraic geometry in the past 40+ years. To be precise, we examine how the notion of (mathematical) instanton bundles in algebraic geometry has evolved from a class of vector bundles over \({{\mathbb {C}}{\mathbb {P}}^{3}}\) both to a class of torsion free sheaves on projective varieties of arbitrary dimension, and to a class of objects in the derived category of Fano threefolds. The original results contained in this survey focus precisely on the latter direction; in particular, we prove that the classical rank 2 instanton bundles over the projective space are indeed instanton objects for any suitable chamber in the space of Bridgeland stability conditions .

Even in the genomics era, the phylogeny of Neotropical small felids comprised in the genus Leopardus remains contentious. We used whole-genome resequencing data to construct a time-calibrated consensus phylogeny of this group, quantify phylogenomic discordance, test for inter-species introgression, and assess patterns of genetic diversity and demographic history. We infer that the Leopardus radiation started in the Early Pliocene as an initial speciation burst, followed by another in its subgenus Oncifelis during the Early Pleistocene. Our findings challenge the long-held notion that ocelot (Leopardus pardalis) and margay (L. wiedii) are sister species, and instead indicate that margay is most closely related to the enigmatic Andean cat (L. jacobita), whose whole-genome data are reported here for the first time. In addition, we found that the newly sampled Andean tiger cat (L. tigrinus pardinoides) population from Colombia associates closely with Central American tiger cats (L. tigrinus oncilla). Genealogical discordance was largely attributable to incomplete lineage sorting, yet was augmented by strong gene flow between ocelot and the ancestral branch of Oncifelis, as well as between Geoffroy’s cat (L. geoffroyi) and southern tiger cat (L. guttulus). Contrasting demographic trajectories have led to disparate levels of current genomic diversity, with a nearly tenfold difference in heterozygosity between Andean cat and ocelot, spanning the entire range of variability found in extant felids. Our analyses improved our understanding of the speciation history and diversity patterns in this felid radiation, and highlight the benefits for phylogenomic inference of embracing the many heterogeneous signals scattered across the genome.

This forum reconsiders the standing of ‘the international’ in relation to ‘critique’. Is this relation best understood in ways reminiscent of the ‘Fourth Great Debate’, where the international, associated with political realism, was targeted for deconstruction by critical approaches drawn from outside International Relations? Or is the international, on the contrary, itself a source of potential critique needing to be excavated and utilized, as recent debates on ‘societal multiplicity’ and Uneven and Combined Development have suggested? In this forum, seven international theorists debate the latter question from a range of intellectual perspectives.

One of the most commonly used methods to prevent overfitting and select relevant variables in regression models with many predictors is the penalized regression technique. Under such approaches, variable selection is performed in a non-probabilistic way, using some optimization criterion. A Bayesian approach to penalized regression has been proposed by assuming a prior distribution for the regression coefficients that plays a similar role as the penalty term in classical statistics: to shrink non-significant coefficients toward zero and assign a significant probability mass to non-negligible coefficients. These prior distributions, called shrinkage priors, usually assume independence among the covariates, which may not be an appropriate assumption in many cases. We propose two shrinkage priors to model the uncertainty about coefficients that are spatially correlated. The proposed priors are considered as an alternative approach to model the uncertainty about the coefficients of categorical variables with many levels. To illustrate their use, we consider the linear regression model. We evaluate the proposed method through several simulation studies.

Brain-Computer Interfaces (BCIs) have gained significant attention in recent years for their role in connecting individuals with external devices using neural signals. Electroencephalography (EEG)-based BCIs, in combination with Motorized Mini Exercise Bikes (MMEBs), have emerged as promising tools for post-stroke patient rehabilitation. Nevertheless, the EEG signal-to-noise ratio (SNR) remains a challenge, susceptible to interference from physical and mental artifacts, thereby compromising the accuracy of motor task recognition, such as pedaling. This limitation hampers the effectiveness of lower-limb rehabilitation devices. In this study, we propose a comparative study which uses Multilayer Perceptron (MLP) and Extreme Learning Machine (ELM) to accurately identify from EEG signals when a subject is engaged in pedaling tasks. The results outperform those reported in the literature, achieving a remarkable Accuracy of 0.97 and a negligible False Positive Rate close to zero, resulting in an overall performance of 0.77 and 0.24, respectively. Additionally, we conducted an evaluation of four distinct frequency bands during the filtering process, with the most promising outcomes achieved within the 3 to 7 Hz frequency band. These findings support the conclusion that our proposed methodology is well-suited for the real-time detection of lower-limb tasks using EEG signals, thus offering potential applications in the control of robotic BCIs for rehabilitation purposes.

Tuberculosis is a contagious disease considered as world emergency by the World Health Organization. One of the common prevalent problems are associated to drug-resistant TB, because of unsuccessful treatments of using antibiotics. The use of artificial intelligence algorithms, mainly machine learning (ML) models have allowed to provided more tools for the drug discovery field. For this study, the methodology used was driven to identify new components that may contribute to the inhibition of the inhA protein. Leveraging ML models that learn from data, six regression models were implemented. Best model obtained R2 value of 0.99 and a MSE value of 1.8 e-5.

Background This study aims to identify which risk factors are associated with the appearance of an incisional hernia in a stoma site after its closure. This in the sake of identifying which patients would benefit from a preventative intervention and thus start implementing a cost-effective protocol for prophylactic mesh placement in high-risk patients. Methods A systematic review of PubMed, Cochrane library, and ScienceDirect was performed according to PRISMA guidelines. Studies reporting incidence, risk factors, and follow-up time for appearance of incisional hernia after stoma site closure were included. A fixed-effects and random effects models were used to calculate odds ratios’ estimates and standardized mean values with their respective grouped 95% confidence interval. This to evaluate the association between possible risk factors and the appearance of incisional hernia after stoma site closure. Results Seventeen studies totaling 2899 patients were included. Incidence proportion between included studies was of 16.76% (CI95% 12.82; 21.62). Out of the evaluated factors higher BMI (p = 0.0001), presence of parastomal hernia (p = 0.0023), colostomy (p = 0,001), and end stoma (p = 0.0405) were associated with the appearance of incisional hernia in stoma site after stoma closure, while malignant disease (p = 0.0084) and rectum anterior resection (p = 0.0011) were found to be protective factors. Conclusions Prophylactic mesh placement should be considered as an effective preventative intervention in high-risk patients (obese patients, patients with parastomal hernia, colostomy, and end stoma patients) with the goal of reducing incisional hernia rates in stoma site after closure while remaining cost-effective.

Background The relevance of training medical students in surgical specialty services has been a matter of debate in contexts where the health care system focuses on primary health care. Some educators argue that medical students should be trained in primary care settings. Other educators assert that rotating in highly complex hospitals strengthens the competencies of future general practitioners. Nonetheless, little attention has been paid to the added value that rotations in surgical specialties have brought to newly graduated doctors' lives. In this study, we explored the perceptions of a group of graduates by focusing on the relevant experiences they had during their surgical specialty rotations in undergraduate medical training and how this training influenced their personal and professional life. Methods We conducted a qualitative study using a convenience sampling strategy to recruit a total of seven junior doctors. Data were collected through semi-structured interviews in 2022. Thematic analysis was used to analyse the data until code saturation was reached. Results The recurring themes were (1) perception of rotations, (2) valuable learning for medical practice and (3) defining their professional future. Participants felt that their experiences in surgical specialty rotations were beneficial, as they gained confidence to perform professionally and decide on future employment and strengthened their research and primary healthcare competencies. Conclusion Although training in primary healthcare centres is crucial in undergraduate medical education, these results suggest that including rotations in surgical specialties may be valuable in enhancing the future careers of junior doctors.

Path to a Sustainable Country (in Spanish “Ruta País Sostenible”) is an institutional commitment that seeks to reinforce the importance of natural resources in the university community and promote learning based on experience. We make field trips around the country that connect nature and communities. The areas selected are the National Natural Parks (NNP) and the protected areas of Colombia (12% of the country's territory). This project has the intention to be closer to the territory´s realities. At the same time, we have an experiential analysis to develop academic projects that promote the conservation of ecosystem services, and the improvement of the quality of life of the surrounding communities. Since 2022, we have made three field trips to the NNP: Chingaza (paramo), Bahía Málaga (mangrove), Desierto de la Tatacoa (tropical dry forest), El Zoque (andean forest), El Cocuy (Glacier). On those trips, we have had 150 participants among students, professors, staff, and alumni. We tested the most appropriate and effective sustainable learning process. The result indicated that 50% of people memorize the concepts when they directly observe nature and communities. Meanwhile, the second most successful tool was applied research (20%), followed by classes (16%), and finally, laboratory practices (14%).

Chagas disease (CD) is a parasitic infection caused by the parasite Trypanosoma cruzi . Reports of CD cases associated with oral transmission have increased, particularly in Colombia, Brazil, and Venezuela. In this investigation, parasitological, serological, and molecular tests were conducted on samples obtained from humans, mammal reservoirs, and hosts involved in the assessment of a suspected oral transmission outbreak in Cubara, Boyaca, Colombia. Seropositivity was observed in 60% (3 of 5) of index patients and 6.4% (5 of 78) of close contacts. Trypanosoma cruzi DNA was detected by quantitative polymerase chain reaction in 100% of index cases, 6.4% (5 of 78) of close contacts, 60% (6 of 10) of canines, and 100% (5 of 5) of opossums. In all index cases, the TcI lineage was identified, along with two cases of mixed infection (TcI/TcII–TcVI). Hemoculture revealed a flagellate presence in 80% of opossums, whereas all triatomine bugs tested negative. Our findings suggest a potential oral transmission route through contamination with opossum secretions.

ARTICLE Ongoing harlequin toad declines suggest the amphibian extinction crisis is still an emergency Biodiversity loss is extreme in amphibians. Despite ongoing conservation action, it is difficult to determine where we stand in overcoming their extinction crisis. Among the most threatened amphibians are the 131 Neotropical harlequin toads. Many of them declined since the 1980s with several considered possibly extinct. Recently, more than 30 species have been rediscovered, raising hope for a reversing trend in the amphibian extinction crisis. We use past and present data available for harlequin toads (Atelopus), to examine whether the amphibian extinction crisis is still in an emergency state. Since 2004 no species has improved its population status, suggesting that recovery efforts have not been successful. Threats include habitat change, pathogen spread and climate change. More mitigation strategies need implementation, especially habitat protection and disease management, combined with captive conservation breeding. With harlequin toads serving as a model, it is clear that the amphibian extinction crisis is still underway.

CITATION González LdM, Romero-Orjuela SP, Rabeya FJ, del Castillo V and Echeverri D (2023) Age and vascular aging: an unexplored frontier. Vascular age is an emerging field in cardiovascular risk assessment. This concept includes multifactorial changes in the arterial wall, with arterial stiffness as its most relevant manifestation, leading to increased arterial pressure and pulsatile flow in the organs. Today, the approved test for measuring vascular age is pulse wave velocity, which has been proven to predict cardiovascular events. Furthermore, vascular phenotypes, such as early vascular aging and "SUPERNOVA," representing phenotypic extremes of vascular aging, have been found. The identification of these phenotypes opens a new field of study in cardiovascular physiology. Lifestyle interventions and pharmacological therapy have positively affected vascular health, reducing arterial stiffness. This review aims to define the concepts related to vascular age, pathophysiology, measurement methods, clinical signs and symptoms, and treatment.

Obsessive‐compulsive disorder (OCD) is a debilitating psychiatric disorder. Worldwide, its prevalence is ~2% and its etiology is mostly unknown. Identifying biological factors contributing to OCD will elucidate underlying mechanisms and might contribute to improved treatment outcomes. Genomic studies of OCD are beginning to reveal long‐sought risk loci, but >95% of the cases currently in analysis are of homogenous European ancestry. If not addressed, this Eurocentric bias will result in OCD genomic findings being more accurate for individuals of European ancestry than other ancestries, thereby contributing to health disparities in potential future applications of genomics. In this study protocol paper, we describe the Latin American Trans‐ancestry INitiative for OCD genomics (LATINO, https://www.latinostudy.org ). LATINO is a new network of investigators from across Latin America, the United States, and Canada who have begun to collect DNA and clinical data from 5000 richly phenotyped OCD cases of Latin American ancestry in a culturally sensitive and ethical manner. In this project, we will utilize trans‐ancestry genomic analyses to accelerate the identification of OCD risk loci, fine‐map putative causal variants, and improve the performance of polygenic risk scores in diverse populations. We will also capitalize on rich clinical data to examine the genetics of treatment response, biologically plausible OCD subtypes, and symptom dimensions. Additionally, LATINO will help elucidate the diversity of the clinical presentations of OCD across cultures through various trainings developed and offered in collaboration with Latin American investigators. We believe this study will advance the important goal of global mental health discovery and equity.

Purpose Visual function is a complex process in which external visual stimuli are interpreted. Patients with retinal diseases and prolonged follow-up times may experience changes in their visual function that are not detected by the standard visual acuity measure, as they are a result of other alterations in visual function. With the advancement of different methods to evaluate visual function, additional measurements have become available, and further standardization suggests that some methods may be promising for use in clinical trials or routine clinical practice. The objectives of this article are to review these additional measurements and to provide guidance on their application. Methods The Vision Academy’s membership of international retinal disease experts reviewed the literature and developed consensus recommendations for the application of additional measures of visual function in routine clinical practice or clinical trials. Results Measures such as low-luminance visual acuity, contrast sensitivity, retinal fixation and microperimetry, and reading performance are measures which can complement visual acuity measurements to provide an assessment of overall visual function, including impact on patients’ quality of life. Measures such as dark adaptation, color vision testing, binocular vision testing, visual recognition testing, and shape discrimination require further optimization and validation before they can be implemented in everyday clinical practice. Conclusion Additional measurements of visual function may help identify patients who could benefit from earlier diagnosis, detection of disease progression, and therapeutic intervention. New and additional functional clinical trial endpoints are required to fully understand the early stages of macular disease, its progression, and the response to treatment.