Universidad Libre de Colombia

Diverticular disease of the small bowel is a rare, generally asymptomatic condition with a challenging diagnostic approach and the potential for life-threatening complications. While diverticular disease can manifest in any part of the gastrointestinal tract, its occurrence in the jejunum is exceptionally uncommon, with an incidence of up to 1%. Although rare, complications from diverticular disease of the small bowel can arise in up to 10% of cases, usually manifesting as signs and symptoms mimicking other etiologies or an acute abdomen. In this case report, we present the management of an elderly male patient with multiple comorbidities who developed an acute abdomen during his intensive care unit stay. The patient required surgical intervention, which revealed numerous complicated diverticula of the small bowel, affecting the jejunum, as the underlying cause of his symptoms.

Microalgal production has gained importance as various bioproducts can be derived from biomass processing. Large-scale production growth impacts on the rise of innovations. Microalgae biomass is the main and final product in the market. Techniques for algae production still are followed by extraction of pigments, proteins, carbohydrates, and lipids. Considering the microalgae diversity, non-conventional techniques could be critical for efficient cultivation, biomass processing, and product purification. Therefore, the patent survey includes many focused on industrial cultivation processes applied to microalgae. In this chapter, an overview of the patent survey is presented, from types of reactors, cultivation modes, strategies to increase productivity, reduced cost, biomass harvesting and processing, and final product refinement. It is known that the first patent was registered in 1982 and described the use of microalgae Chlorella extract as a plant growth promoter. After that, no patent was registered for 15 years. This scenario changed in 2015. Currently, microalgae-based patents are being registered in various innovative areas. Those technologies are primarily concentrated on “cultivation area” (C12), including “media culture” (C12N), development of “apparatus for culturing” (C12M), and culturing strategies for “bioproduct synthesis” from microalgae (C12P). This group accounts for more than 89% of microalgae patents. Other representative groups are related to “greenhouse gas mitigation” (Y02) and “effluents treatment” (C02) involving nearly 32% of patents. Following, 15% of registered patents are related to bioproducts derived from microalgae, namely: “ingredient for food or feed” (A23), “oil or lipid” (C11), and “protein and amino acid” (C07). Other minor groups, such as fuel-related technologies (C10L), pharmaceuticals purposes (A61K), and unitary process development (B01D) will also be presented. In this chapter, a brief discussion about each group classification (IPCs and CPCs codes) is included.

The survivable variant of the Ring Star Problem aims at building a network such that when a hub fails, the Ring Star structure is preserved thanks to backup arcs and edges. In this article, we propose a resilient variant of the Ring Star Problem named 1‐R‐RSP in which the failure of a node in a given subset of so‐called uncertain nodes triggers two corrective operations to repair a ring star structure. The first operation repairs the ring, and the second operation reconnects the star. For a given real positive input parameter , which represents the total duration of breakdowns during the considered time horizon, the objective is to minimize the classical costs of the Ring Star Problem plus the costs incurred by the corrective operations when the hub associated with the largest fixing cost fails during units of time. We model this problem as an integer linear program (ILP), which is also addressed with a Branch‐and‐bins‐cut algorithm. We then perform a sensitivity analysis to help the decision maker understand the impact of the parameter .

Cardiac fibrosis (CF) is characterized by the excessive deposition of collagen types I (COI I) and III (COI III), primarily mediated by cardiac fibroblasts (CFB). Recent advances in epigenetic research have enhanced our understanding of the molecular mechanisms underlying CF and have facilitated the identification of novel therapeutic strategies targeting key proteins and signaling pathways involved in its progression. Epigenetic modifications, including DNA methylation, histone modifications, and non-coding RNAs (ncRNAs), are structural and chemical alterations that regulate gene expression and cellular responses without changing the DNA sequence. Investigating the role of epigenetic enzymes in CF may reveal promising pharmacological targets. This review summarizes current evidence on epigenetic modifications implicated in CF and discusses their potential as therapeutic targets for modulating this pathological process.

Post-chikungunya viral arthritis may persist for months to years after infection and is characterized by relapsing and remitting symptoms. This study investigates the relationship between autoantibodies and chikungunya arthritis severity, providing insights into arthritis pathogenesis. We assessed arthritis measures in a cohort of serologically confirmed chikungunya cases from Colombia between 2019 and 2021 (n = 144). We measured arthritis disease severity, flare intensity, pain, and disability, then plasma antibody levels of rheumatoid factor IgM, anti-cyclic citrullinated peptide (CCP), anti-citrullinated α-enolase peptide 1 (CEP-1), anti-nuclear antibody (ANA), anti-citrullinated vimentin (Sa), and immunoglobulins produced in response to chikungunya, Zika and Mayaro. Finally, we examined the correlation between the arthritis measures with the titers of antibodies hypothesized to play a potential role in arthritis pathogenesis. Cases were characterized by moderate disease severity (Disease Activity Score-28 mean, 3.66 ± 1.23) in current arthritis flare with moderate intensity (Flare Score, 25.42 ± 12.38), moderate pain (61.47 ± 27.23 on visual analog scale 0–100), and some disability (Health Assessment Questionnaire 0.77 ± 0.58). After Bonferroni adjustment, there were no statistically significant correlations between the levels of antibodies and arthritis measures. Weak correlations between rheumatoid factor IgM with arthritis severity and pain (P < 0.01) and anti-CEP1 with disability (P < 0.05) were observed when unadjusted for multiple comparisons. The data suggest that autoantibodies, such as RF, anti-CCP, and anti-CEP-1, do not correlate with post-chikungunya arthritis disease severity, thus unlikely to significantly contribute to pathogenesis. Exposure to other arboviral infections was not related to worse post-chikungunya arthritis. This suggests that other pathways for arthritis disease pathogenesis should be examined. IMPORTANCE This cohort study describes the correlation between levels of autoantibodies, viral antibodies, and arthritis outcomes, suggesting that autoantibodies known to play an important role in other autoimmune diseases do not correlate with chikungunya arthritis relapse disease severity and are unlikely to contribute significantly to arthritis pathogenesis. This suggests that other pathways for arthritis disease pathogenesis should be examined to identify diagnostic and prognostic markers of alphaviral arthritis.

Background Respiratory syncytial virus (RSV) is a common cause of bronchiolitis in children under the age of five. RSV infection proceeds by fusion of the viral envelope with the target cell membrane, but it is unclear whether fusion occurs with plasma or endosomal membranes. Methods Entry and/or infection was studied in undifferentiated primary cultures of human bronchial epithelial cells. Synchronization of viral entry or infection was achieved by attaching the virus to the plasma membrane at temperatures of 4°C or 22°C. Cells in which entry events had occurred were identified by the enzymatic action of beta-lactamase M (BlaM) fused to the RSV P protein (BlaM-P) carried by rgRSV virions. BlaM cleaves the beta-lactam ring of CCF2 loaded into the cells, disrupting FRET and allowing blue light to be emitted. Green fluorescent protein (GFP) expression, encoded by the rgRSV genome, was used to identify infected cells. Results We found that adsorption of RSV at 4°C favors entry via endocytosis, whereas binding of the virus to the membrane at 22°C favors RSV entry via the plasma membrane. The induction of endocytosis by synchronization at 4°C is, therefore, an artifact. In addition, we found that all drugs that interfered with RSV infection reduced cell membrane deformations such as filopodia and lamellipodia, suggesting a mechanism by which they may interfere with RSV fusion with the cell membrane. Discussion In conclusion, RSV enters the cell by direct fusion of its envelope with the plasma membrane.

Case description A 23-year-old male patient, with no relevant medical history, who received direct contusion to the lower limbs at the level of the thighs due to a fall from a sheet bending machine. Clinical findings Clinical and radiographic findings compatible with bilateral comminuted sub-trochanteric fractures, with extension towards the diaphysis in both, with a Trauma Severity Index of 16. Treatment and outcome Favorable clinical and radiological outcome after early definitive surgical stabilization of both extremities with cephalomedullary nails, rehabilitation with physical therapy and clinical follow-up. Clinical relevance High energy trauma, due to different causes, constitutes a challenge for all health personnel, due to the patient's own conditions, the individual inflammatory response, the associated musculoskeletal injuries, some not detected at the beginning, and additionally in other systems. Patients with bilateral femur fractures may present the conditions listed above, which requires early identification of the risks of respiratory and multi-organ failure, knowledge of their metabolic status and definition of their clinical situation, considered potentially or truly critical, which even with timely treatment Mortality figures of 6.9% to 27% are found. According to defined parameters, early and definitive osteosynthesis of fractures can be performed, but its characteristics may represent difficulties for surgical planning.

La gestión ambiental portuaria es un tema de gran prioridad para las naciones, no sólo porque lo amerita los Objetivos de Desarrollo Sostenible, también las empresas y multinacionales están al tanto de eso, pues nos les interesa que sus flujos de mercancías pasen por puertos no certificados, unido a los inconvenientes que podría traer al usar ese servicio por los puertos marítimos, el propósito de este artículo es revisar cómo se lleva a cabo la gestión ambiental de los puertos marítimos de América, teniendo en cuenta algunos lineamientos de Europa y de organismos multilaterales. Se hizo mediante el racionalismo crítico y por ende positivista, extrayendo una muestra de varios textos e indagando en fuentes reconocidas, en él se concluye que los puertos no sólo deben tener un manejo ambiental o un Sistema de Gestión Ambiental y certificarse, sino ir a la vanguardia incluyendo más indicadores en materia ambiental que minimizarán su potencial efecto nocivo sobre las comunidades portuarias.

Expanded polystyrene (EPS) is a widely used material in multiple industries, especially in the construction and packaging of appliances and equipment, owing to its properties of lightweight, sound insulation, thermal insulation, and strength. However, in the final stage of the EPS life cycle, multiple environmental issues arise related to the management of this material’s waste due to the large volume occupied and greenhouse gas emissions. This issue has generated growing interest among researchers worldwide, seeking sustainable alternatives to mitigate these negative impacts. In this study, an alternative for utilizing EPS waste was explored, using it in a diluted form with gasoline to manufacture mortar, where EPS acts as a binder. The properties of the material were evaluated, including compressive strength (CS), density (D), and ultrasonic pulse velocity (UPV), using nonparametric statistical tests and multiple linear regression. Variables such as the weight ratio of EPS, the curing method and temperature, and the pressing load were considered in manufacturing 175 cylindrical samples. The results revealed notable strengths of up to 25 MPa, and correlations were established with nondestructive test data, such as UPV. This research opens new perspectives in the search for sustainable solutions for using EPS waste.

El sector turístico en la actualidad está marcado por las concepciones de gestión, los espacios y la visión económica de las regiones, territorios y ciudades. Además, se aprecia que, como industria y como campo, debe contribuir al desarrollo social y comunitario sostenible en función de elevar la calidad de vida de los habitantes. El objetivo de la investigación estuvo encaminado al análisis de las nuevas tendencias del turismo sostenible tras la Covid-19. Para ello se implementó un diseño mixto en dos etapas, con un estudio bibliométrico como principal y una revisión hermenéutica de la literatura adaptada a los intereses cognoscitivos y metas de la investigación. Los resultados de la primera etapa evidenciaron un ligero incremento de la producción del año 2022 al año 2023, siendo las áreas más representativas las ciencias sociales y las ciencias ambientales. En la segunda etapa se examinó la relación entre sostenibilidad y turismo en el marco de los objetivos del desarrollo sostenible, así como las principales tendencias y retos.

Introduction: The Polymerase Chain Reaction (PCR) has been applied to detect challenging-to-isolate pathogenic microorganisms from food or clinical samples. However, inhibitors or inherent elements of the samples can impact its efficiency. The quantity and quality of extracted DNA are crucial. Objective: To compare two extraction methods for obtaining PCR-amplifiable DNA in real-time PCR (qPCR). Methodology: DNA was extracted using the Phenol-Chloroform-Isoamyl Alcohol (PC) and Chelex® 100 (Chlx) methods from stool samples inoculated with Salmonella spp. previously cultured in selective Selenite Cystine (SC) and Tetrationate (T) broths. Results: DNA was quantified by spectrophotometry and amplified by qPCR to detect Salmonella spp. The average DNA purity value using the PC method from SC culture was 1.61 ± 0.21, while from T culture it was 1.56 ± 0.21. The Chlx method from SC culture resulted in a purity of 1.57 ± 0.24, while from T culture it was 1.79 ± 0.20. However, better amplification was achieved using the PC extraction method from SC culture. Conclusions: It was determined that the PC extraction method from SC culture provides PCR-amplifiable DNA in Real-Time PCR, and pre-PCR culturing is advantageous as it enhances the bacterial target and dilutes inhibitors.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) primarily affects the adult population and is closely related to obesity. The most severe form of MASLD, metabolic dysfunction-associated steatohepatitis (MASH), can progress to liver fibrosis. While lipoprotein(a) (Lp(a)) is known to be associated with cardiovascular disease, its relationship with MASLD remains unclear. This study aims to determine the prevalence of MASLD in ambulatory patients and to explore the association between Lp(a) levels and advanced liver damage. Methods: This retrospective cross-sectional study included 130 patients older than 18 years seen in a healthcare center in Medellin, Colombia, between April 2023 and May 2024. Sociodemographic, clinical, and specific biomarker data were collected. Patients with cirrhosis, previous liver disease, frequent alcohol consumption, cancer, and other severe conditions were excluded. Continuous variables were analyzed using Student's t-tests or Mann-Whitney tests according to their distribution, and categorical variables were analyzed using contingency tables and chi-square tests. Results: Of the 130 patients, 57.9% (n=73) had MASLD, with a higher prevalence in patients with obesity (80%, n=32). Lp(a) levels were abnormally high in 43.1% (n=31) of patients; however, a weak but significant inverse correlation was found between Lp(a) levels and the Fibrosis-4 (FIB-4) score, which is used to assess the severity of liver fibrosis. Patients with MASLD had significantly lower high-density lipoprotein (HDL) and vitamin D levels, and higher levels of gamma-glutamyl transferase (GGT). Conclusions: This study highlights the significant prevalence of MASLD in outpatients and its relationship with various biomarkers, including Lp(a), HDL, vitamin D, and GGT. Although the findings suggest a possible utility of Lp(a) as a biomarker in MASLD, longitudinal studies are needed to confirm these associations and clarify their role in liver disease progression. The study's limitations include its cross-sectional nature and potential selection bias, indicating the need for further research to validate these results.

El propósito de esta investigación es proponer un modelo para el diseño de ambientes laborales en las Pymes Bogotá Área – Metropolitana tomando como guía la metodología de la Ingeniería Kansei, con el apoyo de instrumentos como la encuesta y la prueba de diferencial semántico, las redes neuronales (perceptrón multicapa) para su validación. Se elabora un cuestionario con cuestionario con el apoyo de expertos, al que se le realiza una prueba piloto para mejorar y evaluar la pertinencia de las preguntas. Haciendo uso del Software SPSS se realizó el análisis estadístico, aplicando las pruebas de normalidad, realizando correlaciones de Spearman, análisis de componentes principales, regresión lineal a las ecuaciones resultantes para entender las relaciones entre las percepciones estudiadas y el ambiente laboral en general. Posteriormente, hizo uso del perceptrón multicapa como modelo de redes neuronales para validar las relaciones entre las variables y percepciones propuestas permitiendo a su vez determinar la importancia de las dimensiones emocionales en el diseño de ambientes laborales, a partir de lo cual se pudo concluir que es posible la aplicación de la Ingeniería Kansei para el diseño de ambientes laborales.

Tomando como punto de referencia, en términos de la temporalidad, el desarrollo de la última década del siglo actual, este estudio aborda la imperiosa tarea de comprender y promover una implementación efectiva del DIH en el contexto del conflicto armado en la región Caribe colombiana. Ahora bien, en virtud de este análisis, se identifica la necesidad de un enfoque armónico fundamentado en premisas participativas, tomando en cuenta a los residentes locales como a los actores directamente involucrados en el conflicto. Cabe resaltar que este análisis destaca como ejemplo el caso del Clan del Golfo. Con una metodología primordialmente cualitativa, consecuente con su naturaleza, este estudio busca ofrecer una perspectiva renovada y contextual que pueda orientar futuras investigaciones y políticas públicas en los ámbitos del DIH. En consonancia con sus objetivos, se enfatiza la importancia de afinar las metodologías ante la naturaleza cambiante de los conflictos en la región.

Background Dengue vascular permeability syndrome is the primary cause of death in severe dengue infections. The protective versus potentially pathogenic role of dengue nonstructural protein-1 (NS1) antibodies are not well understood. The main goal of this analysis was to characterize the relationship between free NS1 concentration and NS1 antibody titers in primary and secondary dengue infection to better understand the presence and duration of NS1 antibody complexes in clinical dengue infections. Methods Hospitalized participants with acute dengue infection were recruited from Northern Colombia between 2018 and 2020. Symptom assessment, including dengue signs and symptoms, chart review, and blood collection, was performed. Primary versus secondary dengue was assessed serologically. NS1 titers and anti-NS1 antibodies were measured daily. Results Patients with secondary infection had higher antibody titers than those in primary infection, and there was a negative correlation between anti-NS1 antibody titer and NS1 protein. We demonstrate that in a subset of secondary infection, there were indeed NS1 antigen-antibody complexes on the admission day during the febrile phase that were not detectable by the recovery phase. Furthermore, dengue infection status was associated with higher circulating sialidases. Discussion The negative correlation between antibody and protein suggests that antibodies may play a role in clearing this viral protein.

Este artículo ilustra la intersección crítica entre la diversidad cultural, los conflictos armados, y los esfuerzos de justicia transicional en el Norte del Cauca. Las comunidades étnicas, a pesar de enfrentar desafíos persistentes derivados del conflicto armado y la explotación de recursos, han mostrado una resiliencia notable, adaptando estrategias legales y organizativas para abogar por sus derechos y preservar su rica herencia cultural, este estudio no solo contribuye al entendimiento académico de estos fenómenos complejos, sino que también subraya la necesidad de enfoques más integrados y culturalmente sensibles en la formulación de políticas y prácticas de paz y justicia. Metolodgicamente se revisaron publicaciones de antropólogos jurídicos, sociólogos y abogados, complementadas con experiencias de campo y un análisis crítico de los datos. Se destaca la perspectiva histórica-crítica en una región de rica biodiversidad, examinando las posibles transformaciones del conflicto y la justicia transicional.

Objective To identify, through a systematic review, the prevalence and/or risk of peri- and postnatal complications in children of mothers with gestational diabetes mellitus Design and method To answer the PICO question: What is the prevalence/risk of peri- and postnatal complications in children of mothers with gestational diabetes mellitus? An exhaustive review of scientific articles was carried out based on the PRISMA methodology, between June 16 and July 26, 2022, in the Pubmed, Scopus, Cochrane, Google Scholar, ScienceDirect and Lilacs databases. The Mesh terms, gestational diabetes, hyperglycemia, infant complications, diabetes mellitus, newborn, observational study, systematic review and overweight. They were combined with Boolean operators AND and OR and entered into the database search engines. The established limits were type of study, type of document, language, date of publication. Articles referring to children of mothers with pre-existing diseases were excluded. After passing the established filters, the methodological quality was assessed with Strengthening the Reporting of Observational Studies in Epidemiology STROBE and PRISMA. Those preselected underwent an assessment of the level of evidence with Sackett's proposal; those that obtained a high level and degree of recommendation were included in the present review, a total of 6 studies. Results The main findings were: Probability of death of 56.8%; jaundice 8.7 vs. 2.1%; p < 0.000; RR: 3.1; 95% CI: 1.9-5.9; respiratory distress 4.9 vs. 1.3%; p < 0.009; RR: 2.9; 95% CI: 1.4-6.7 and asphyxiation 2.9 vs. 0.4%; p < 0.005; RR: 4.3; 95% CI: 1.8-11.1); relative risk of macrosomia OR 1.32 1.02–1.72; Macrosomia 2.9% 0.024; Hypoglycemia 5.1%0.013 Conclusions Diabetes Mellitus associated with pregnancy continues to be an important event, causing morbidity and mortality in the mother and perinatal and postnatal effects if it is not adequately treated. The success of the treatment is based on the control of patients with GDM, from a metabolic point of view, from before conception and continuing throughout the course of pregnancy.

La depresión es la entidad psiquiátrica más frecuente en oncología, el diagnóstico o posible diagnóstico de cáncer impacta en la salud mental del paciente y los familiares, por el significado que atribuye la enfermedad al nuevo estado de salud. El objetivo del presente artículo es actualizar los conocimientos recientes sobre la epidemiología, la etiología, la patogenia, las herramientas diagnósticas y el tratamiento, en cuanto a la relación del trastorno depresivo con el cáncer. Con este fin se realizó una búsqueda bibliográfica utilizando los términos depresión, cáncer y el comando and para el término depresión y cáncer en las bases de datos PubMed, Scopus, SciELO y Google Académico, en español, inglés y francés, en el periodo del 2016 hasta el 2022. Fueron elegidos un total de 50 artículos factibles para el objetivo del artículo, en donde se evidenció asociación del cáncer con el desarrollo del trastorno depresivo mayor con una alta prevalencia de al menos el 40 %. Esto se origina por una combinación de factores genéticos, epigenéticos y ambientales. Para evaluar la depresión en pacientes se encuentran validadas la escala hospitalaria de ansiedad y depresión (hads), la escala de depresión de Beck y la escala de evaluación de la depresión Montgomery-Åsberg (madrs). Finalmente, la farmacoterapia y/o psicoterapia se debe considerar una vez confirmado el diagnóstico de trastorno depresivo en la población oncológica para mejorar la calidad de vida, prevenir el incumplimiento del tratamiento y aumentar las tasas de supervivencia.

This paper introduces CYCLOPS, an acquisition system developed to capture images and inertial measurement data of moving cyclists from a vehicle. The development of CYCLOPS addresses the need to acquire useful data for training machine learning models capable of predicting the motion intentions of cyclists on urban roads. Considering its application, it is a completely original development. The system consists of two devices. The first device is installed on the bicycle and is based on an electronic acquisition board comprising an inertial measurement unit (IMU), a microcontroller, and a transceiver for sending the cyclist’s acceleration and orientation data to a vehicle. The second device is installed on the vehicle and uses the same board architecture to acquire the vehicle’s accelerations and orientations, along with an RGB monocular camera. The data is stored in real-time in a laptop’s drive for subsequent analysis and manipulation. The hardware architecture is presented in detail, including the designs to install the devices, for IMUs configuration, and software installation on the laptop. All design and software files required to develop the proposed system are available for download at: doi.org/10.17632/3yx5y8b7tm.1, licensed under the Open-source license CC BY 4.0.

Objective To define the relationship between chronic chikungunya post-viral arthritis disease severity, cytokine response and T cell subsets in order to identify potential targets for therapy. Methods Participants with chikungunya arthritis were recruited from Colombia from 2019–2021. Arthritis disease severity was quantified using the Disease Activity Score-28 and an Arthritis-Flare Questionnaire adapted for chikungunya arthritis. Plasma cytokine concentrations (interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, interferon-γ and tumor necrosis factor (TNF)) were measured using a Meso Scale Diagnostics assay. Peripheral blood T cell subsets were measured using flow cytometry. Results Among participants with chikungunya arthritis (N = 158), IL-2 levels and frequency of regulatory T cells (Tregs) were low. Increased arthritis disease activity was associated with higher levels of inflammatory cytokines (IL-6, TNF and CRP) and immunoregulatory cytokine IL-10 (p<0.05). Increased arthritis flare activity was associated with higher Treg frequencies (p<0.05) without affecting T effector (Teff) frequencies, Treg/Teff ratios and Treg subsets. Finally, elevated levels of IL-2 were correlated with increased Treg frequency, percent Tregs out of CD4⁺ T cells, and Treg subsets expressing immunosuppressive markers, while also correlating with an increased percent Teff out of live lymphocytes (p<0.05). Conclusion Chikungunya arthritis is characterized by increased inflammatory cytokines and deficient IL-2 and Treg responses. Greater levels of IL-2 were associated with improved Treg numbers and immunosuppressive markers. Future research may consider targeting these pathways for therapy.