Universidad Pontificia Bolivariana

Disorders of the brain can exhibit considerable epidemiological comorbidity and often share symptoms, provoking debate about their etiologic overlap. We quantified the genetic sharing of 25 brain disorders from genome-wide association studies of 265,218 patients and 784,643 control participants and assessed their relationship to 17 phenotypes from 1,191,588 individuals. Psychiatric disorders share common variant risk, whereas neurological disorders appear more distinct from one another and from the psychiatric disorders. We also identified significant sharing between disorders and a number of brain phenotypes, including cognitive measures. Further, we conducted simulations to explore how statistical power, diagnostic misclassification, and phenotypic heterogeneity affect genetic correlations. These results highlight the importance of common genetic variation as a risk factor for brain disorders and the value of heritability-based methods in understanding their etiology.

A method to construct a family of strict Lyapunov functions, i.e., with negative definite derivative, for the super-twisting algorithm, without or with perturbations, is provided. This second order sliding modes algorithm is widely used to design controllers, observers and exact differentiators. The proposed Lyapunov functions ascertain finite time convergence, provide an estimate of the convergence time, and ensure the robustness of the finite-time or ultimate boundedness for a class of perturbations wider than the classical ones for this algorithm. Since the Lyapunov functions and their derivatives are quadratic forms, the operation with them is as simple as for linear time invariant systems.

In this paper a strong Lyapunov function is obtained, for the first time, for the super twisting algorithm, an important class of second order sliding modes (SOSM). This algorithm is widely used in the sliding modes literature to design controllers, observers and exact differentiators. The introduction of a Lyapunov function allows not only to study more deeply the known properties of finite time convergence and robustness to strong perturbations, but also to improve the performance by adding linear correction terms to the algorithm. These modification allows the system to deal with linearly growing perturbations, that are not endured by the basic super twisting algorithm. Moreover, the introduction of Lyapunov functions opens many new analysis and design tools to the higher order sliding modes research area.

RATIONALE: Recent literature in mechanical ventilation includes strong evidence from randomized trials. Little information is available regarding the influence of these trials on usual clinical practice. OBJECTIVES: To describe current mechanical ventilation practices and to assess the influence of interval randomized trials when compared with findings from a 1998 cohort. METHODS: A prospective international observational cohort study, with a nested comparative study performed in 349 intensive care units in 23 countries. We enrolled 4,968 consecutive patients receiving mechanical ventilation over a 1-month period. We recorded demographics and daily data related to mechanical ventilation for the duration of ventilation. We systematically reviewed the literature and developed 11 practice-change hypotheses for the comparative cohort study before seeing these results. In assessing practice changes, we only compared data from the 107 intensive care units (1,675 patients) that also participated in the 1998 cohort (1,383 patients). MEASUREMENTS AND MAIN RESULTS: In 2004 compared with 1998, the use of noninvasive ventilation increased (11.1 vs. 4.4%, P < 0.001). Among patients with acute respiratory distress syndrome, tidal volumes decreased (7.4 vs. 9.1 ml/kg, P < 0.001) and positive end-expiratory pressure levels increased slightly (8.7 vs. 7.7 cm H(2)O, P = 0.02). More patients were successfully extubated after their first attempt of spontaneous breathing (77 vs. 62%, P < 0.001). Use of synchronized intermittent mandatory ventilation fell dramatically (1.6 vs. 11%, P < 0.001). Observations confirmed 10 of our 11 practice-change hypotheses. CONCLUSIONS: The strong concordance of predicted and observed practice changes suggests that randomized trial results have advanced mechanical ventilation practices internationally.

RATIONALE: Baseline characteristics and management have changed over time in patients requiring mechanical ventilation; however, the impact of these changes on patient outcomes is unclear. OBJECTIVES: To estimate whether mortality in mechanically ventilated patients has changed over time. METHODS: Prospective cohort studies conducted in 1998, 2004, and 2010, including patients receiving mechanical ventilation for more than 12 hours in a 1-month period, from 927 units in 40 countries. To examine effects over time on mortality in intensive care units, we performed generalized estimating equation models. MEASUREMENTS AND MAIN RESULTS: We included 18,302 patients. The reasons for initiating mechanical ventilation varied significantly among cohorts. Ventilatory management changed over time (P < 0.001), with increased use of noninvasive positive-pressure ventilation (5% in 1998 to 14% in 2010), a decrease in tidal volume (mean 8.8 ml/kg actual body weight [SD = 2.1] in 1998 to 6.9 ml/kg [SD = 1.9] in 2010), and an increase in applied positive end-expiratory pressure (mean 4.2 cm H2O [SD = 3.8] in 1998 to 7.0 cm of H2O [SD = 3.0] in 2010). Crude mortality in the intensive care unit decreased in 2010 compared with 1998 (28 versus 31%; odds ratio, 0.87; 95% confidence interval, 0.80-0.94), despite a similar complication rate. Hospital mortality decreased similarly. After adjusting for baseline and management variables, this difference remained significant (odds ratio, 0.78; 95% confidence interval, 0.67-0.92). CONCLUSIONS: Patient characteristics and ventilation practices have changed over time, and outcomes of mechanically ventilated patients have improved. Clinical trials registered with www.clinicaltrials.gov (NCT01093482).

In this paper, the transmission planning state-of-the-art, which was obtained from the review of the most interesting models found in the international technical literature, is presented. The classification of publications was made, keeping in mind the solution methods, the treatment of the planning horizon, and the consideration of the new competitive schemes in the power sector. A discussion about the available tools for development of transmission planning models is also included.

“Advanced Materials Research” is a peer-reviewed journal which covers all aspects of theoretical and practical research of materials science: synthesis, analysis of properties, technologies of materials processing and their use in modern manufacturing. “Advanced Materials Research” is one of the largest periodicals in the field of materials engineering. “Advanced Materials Research” specializes in the publication of thematically complete volumes from international conference proceedings and complete special topic volumes as well as stand-alone papers by individual authors. Authors retain the right to publish an extended and significantly updated version in another periodical. All published materials are archived with PORTICO and CLOCKSS. Presented, Distributed and Abstracted/Indexed in: Inspec (IET, Institution of Engineering Technology) www.theiet.org. Chemical Abstracts Service (CAS) www.cas.org. Google Scholar scholar.google.com. GeoRef www.americangeosciences.org/georef. Cambridge Scientific Abstracts (CSA) www.csa.com. ProQuest www.proquest.com. Ulrichsweb www.proquest.com/products-services/Ulrichsweb.html. EBSCO Discovery Service https://www.ebscohost.com/discovery. Zetoc zetoc.jisc.ac.uk. EVISA http://www.speciation.net/Public/Linklists/EVISA.html. Index Copernicus Journals Master List www.indexcopernicus.com. WorldCat (OCLC) www.worldcat.org. UGC-CARE ugccare.unipune.ac.in

The Laplace–Young equation is solved for axisymmetric menisci, analytically in terms of elliptic integrals for all possible types of pendular rings and liquid bridges when the effect of gravity is negligible, numerically for selected other cases in order to assess gravity's effect. Meniscus shapes, mean curvatures, areas and enclosed volumes are reported, as are capillary forces. It is shown that capillary attraction may become capillary repulsion when wetting is imperfect. The special configurations of vanishing capillary force and of zero mean curvature are treated. The range of utility of the convenient ‘circle approximation’ is evaluated.

Abstract Risk management has reduced vulnerability to floods and droughts globally 1,2 , yet their impacts are still increasing 3 . An improved understanding of the causes of changing impacts is therefore needed, but has been hampered by a lack of empirical data 4,5 . On the basis of a global dataset of 45 pairs of events that occurred within the same area, we show that risk management generally reduces the impacts of floods and droughts but faces difficulties in reducing the impacts of unprecedented events of a magnitude not previously experienced. If the second event was much more hazardous than the first, its impact was almost always higher. This is because management was not designed to deal with such extreme events: for example, they exceeded the design levels of levees and reservoirs. In two success stories, the impact of the second, more hazardous, event was lower, as a result of improved risk management governance and high investment in integrated management. The observed difficulty of managing unprecedented events is alarming, given that more extreme hydrological events are projected owing to climate change 3 .

To characterize the genetic determinants of resistance to antituberculosis drugs, we performed a genome-wide association study (GWAS) of 6,465 Mycobacterium tuberculosis clinical isolates from more than 30 countries. A GWAS approach within a mixed-regression framework was followed by a phylogenetics-based test for independent mutations. In addition to mutations in established and recently described resistance-associated genes, novel mutations were discovered for resistance to cycloserine, ethionamide and para-aminosalicylic acid. The capacity to detect mutations associated with resistance to ethionamide, pyrazinamide, capreomycin, cycloserine and para-aminosalicylic acid was enhanced by inclusion of insertions and deletions. Odds ratios for mutations within candidate genes were found to reflect levels of resistance. New epistatic relationships between candidate drug-resistance-associated genes were identified. Findings also suggest the involvement of efflux pumps (drrA and Rv2688c) in the emergence of resistance. This study will inform the design of new diagnostic tests and expedite the investigation of resistance and compensatory epistatic mechanisms. A GWAS of multi- and extensively drug-resistant tuberculosis using 6,465 Mycobacterium tuberculosis clinical isolates from more than 30 countries identifies novel mutations associated with resistance. The capacity to detect resistance in particular to ethionamide, pyrazinamide, capreomycin, cycloserine and paraaminosalicylic acid was enhanced by inclusion of insertions and deletions.

RATIONALE: A new classification of patients based on the duration of liberation of mechanical ventilation has been proposed. OBJECTIVES: To analyze outcomes based on the new weaning classification in a cohort of mechanically ventilated patients. METHODS: Secondary analysis included 2,714 patients who were weaned and underwent scheduled extubation from a cohort of 4,968 adult patients mechanically ventilated for more than 12 hours. MEASUREMENTS AND MAIN RESULTS: Patients were classified according to a new weaning classification: 1,502 patients (55%) as simple weaning,1,058 patients (39%) as difficult weaning, and 154 (6%) as prolonged weaning.Variables associated with prolonged weaning(.7d)were: severity at admission (odds ratio [OR] per unit of Simplified Acute Physiology Score II, 1.01; 95% confidence interval [CI], 1.001–1.02), duration of mechanical ventilation before first attempt of weaning (OR per day, 1.10; 95% CI, 1.06–1.13), chronic pulmonary disease other than chronic obstructive pulmonary disease (OR,13.23; 95% CI, 3.44–51.05), pneumonia as the reason to start mechanical ventilation (OR, 1.82; 95% CI, 1.07–3.08), and level of positive end-expiratory pressure applied before weaning (OR per unit,1.09; 95% CI, 1.04–1.14). The prolonged weaning group had a nonsignificant trend toward a higher rate of reintubation (P ¼ 0.08),tracheostomy (P ¼ 0.15), and significantly longer length of stay and higher mortality in the intensive care unit (OR for death, 1.97;95%CI, 1.17–3.31). The adjusted probability of death remained constant until Day 7, at which point it increased to 12.1%.

The direct estimation of heritability from genome-wide common variant data as implemented in the program Genome-wide Complex Trait Analysis (GCTA) has provided a means to quantify heritability attributable to all interrogated variants. We have quantified the variance in liability to disease explained by all SNPs for two phenotypically-related neurobehavioral disorders, obsessive-compulsive disorder (OCD) and Tourette Syndrome (TS), using GCTA. Our analysis yielded a heritability point estimate of 0.58 (se = 0.09, p = 5.64e-12) for TS, and 0.37 (se = 0.07, p = 1.5e-07) for OCD. In addition, we conducted multiple genomic partitioning analyses to identify genomic elements that concentrate this heritability. We examined genomic architectures of TS and OCD by chromosome, MAF bin, and functional annotations. In addition, we assessed heritability for early onset and adult onset OCD. Among other notable results, we found that SNPs with a minor allele frequency of less than 5% accounted for 21% of the TS heritability and 0% of the OCD heritability. Additionally, we identified a significant contribution to TS and OCD heritability by variants significantly associated with gene expression in two regions of the brain (parietal cortex and cerebellum) for which we had available expression quantitative trait loci (eQTLs). Finally we analyzed the genetic correlation between TS and OCD, revealing a genetic correlation of 0.41 (se = 0.15, p = 0.002). These results are very close to previous heritability estimates for TS and OCD based on twin and family studies, suggesting that very little, if any, heritability is truly missing (i.e., unassayed) from TS and OCD GWAS studies of common variation. The results also indicate that there is some genetic overlap between these two phenotypically-related neuropsychiatric disorders, but suggest that the two disorders have distinct genetic architectures.

INTRODUCTION: Critically ill patients can develop hyperglycaemia even if they do not have diabetes. Intensive insulin therapy decreases morbidity and mortality rates in patients in a surgical intensive care unit (ICU) and decreases morbidity in patients in a medical ICU. The effect of this therapy on patients in a mixed medical/surgical ICU is unknown. Our goal was to assess whether the effect of intensive insulin therapy, compared with standard therapy, decreases morbidity and mortality in patients hospitalised in a mixed ICU. METHODS: This is a prospective, randomised, non-blinded, single-centre clinical trial in a medical/surgical ICU. Patients were randomly assigned to receive either intensive insulin therapy to maintain glucose levels between 80 and 110 mg/dl (4.4 to 6.1 mmol/l) or standard insulin therapy to maintain glucose levels between 180 and 200 mg/dl (10 and 11.1 mmol/l). The primary end point was mortality at 28 days. RESULTS: Over a period of 30 months, 504 patients were enrolled. The 28-day mortality rate was 32.4% (81 of 250) in the standard insulin therapy group and 36.6% (93 of 254) in the intensive insulin therapy group (Relative Risk [RR]: 1.1; 95% confidence interval [CI]: 0.85 to 1.42). The ICU mortality in the standard insulin therapy group was 31.2% (78 of 250) and 33.1% (84 of 254) in the intensive insulin therapy group (RR: 1.06; 95%CI: 0.82 to 1.36). There was no statistically significant reduction in the rate of ICU-acquired infections: 33.2% in the standard insulin therapy group compared with 27.17% in the intensive insulin therapy group (RR: 0.82; 95%CI: 0.63 to 1.07). The rate of hypoglycaemia (< or = 40 mg/dl) was 1.7% in the standard insulin therapy group and 8.5% in the intensive insulin therapy group (RR: 5.04; 95% CI: 1.20 to 21.12). CONCLUSIONS: IIT used to maintain glucose levels within normal limits did not reduce morbidity or mortality of patients admitted to a mixed medical/surgical ICU. Furthermore, this therapy increased the risk of hypoglycaemia. TRIAL REGISTRATION: clinicaltrials.gov Identifiers: 4374-04-13031; 094-2 in 000966421.

Abstract The objective of this article is to analyze the barriers faced by small and medium enterprises (SMEs) when implementing initiatives for sustainable development. For this purpose, a search equation was designed, and the 50 highest cited articles from the search results in Scopus between years 2013 and 2017 were reviewed. The selected criteria for the article analysis were article name, article year, country, continent, journal, Scimago Journal Rank, Scimago Quartiles, Affiliated Universities, abstract, and keywords. Among the main results, 175 barriers to sustainability for SMEs were identified. The barriers that appeared most frequently were lack of resources, the high initial capital cost of implementing sustainability measures, and lack of expertise. At the end of the article, a proposal is included which shows the 175 identified barriers, classified by “sector,” “sustainability tool,” and “internal/external” which can aid in new qualitative and quantitative studies of barriers to sustainability in SMEs.

Condition-based maintenance refers to the installation of permanent sensors on a structure/system. By means of early fault detection, severe damage can be avoided, allowing efficient timing of maintenance works and avoiding unnecessary inspections at the same time. These are the goals for structural health monitoring (SHM). The changes caused by incipient damage on raw data collected by sensors are quite small, and are usually contaminated by noise and varying environmental factors, so the algorithms used to extract information from sensor data need to focus on sensitive damage features. The developments of SHM techniques over the last 20 years have been more related to algorithm improvements than to sensor progress, which essentially have been maintained without major conceptual changes (with regards to accelerometers, piezoelectric wafers, and fiber optic sensors). The main different SHM systems (vibration methods, strain-based fiber optics methods, guided waves, acoustic emission, and nanoparticle-doped resins) are reviewed, and the main issues to be solved are identified. Reliability is the key question, and can only be demonstrated through a probability of detection (POD) analysis. Attention has only been paid to this issue over the last ten years, but now it is a growing trend. Simulation of the SHM system is needed in order to reduce the number of experiments.

BACKGROUND: Resilience is a multidimensional construct that explains why people facing the consequences of adversity and stress can have a positive outcome, emphasizing adjustment to experiences that are perceived as threatening. OBJECTIVE: The aim of this study is to review the construct of resilience and associated variables in caregivers of patients with chronic, advanced illness and at the end of life. METHODS: The review included studies published between January 2009 and January 2019, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide reporting. The Medline, ScienceDirect, HINARI, PsychINFO, and SciELO databases were used for bibliographic exploration to identify research studies that examined the impact of resilience on adaptation and overall well-being in caregivers of patients with chronic and advanced illness. RESULTS: A total of 23 quantitative and qualitative studies were identified whose aim was to describe the role of resilience in adaptation and coping in caregivers. In these studies, resilience was associated with a positive impact on the quality of life and emotional distress. Communication and social support increase resilient coping strategies. In most selected articles, the sampling strategy used was convenience sampling. Data collection used evaluation scales related to resilience and associated variables for quantitative studies, and semistructured interviews were used for qualitative studies. CONCLUSION: Promoting a resilient coping style in caregivers reduces the distress that normally results from illness-related changes in the biopsychosocial and spiritual dimensions. A resilient coping style can diminish the risk of stress and burden, and promote adaptation in the caregiver.

The search to improve the characteristics of biomaterials obtained from natural biopolymers such as starch has led to the use of mixtures of various polymers with plasticizing agents such as glycerol and sorbitol. In this research, the effect of concentration (10, 20, 30, 40 and 50% starch basis) and type of plasticizer (glycerol and sorbitol) on water solubility (WS), total color difference (ΔE), mechanical properties and water vapor permeability (WVP) of films based on sweet potato starch was evaluated. The mechanical properties were determined by the Puncture Strength method, WVP and WS were performed using gravimetric methods, ΔE was determined by a colorimeter. The results showed an inverse relationship between the puncture resistance and ΔE of the films with the concentration of the plasticizers. However, an increase in plasticizer concentration led to an increase in the percentage of elongation, WS, and WVP of sweet potato starch films. The highest values for percentage elongation and WVP were found in films plasticized with glycerol. Sweet potato starch can be used for the development of film for edible candy wrappers and edible coatings fresh fruit and vegetables.

Abstract Background Chemical reduction has become an accessible and useful alternative to obtain silver nanoparticles (AgNPs). However, its toxicity capacity depends on multiple variables that generate differences in the ability to inhibit the growth of microorganisms. Thus, optimazing parameters for the synthesis of AgNPs can increase its antimicrobial capacity by improving its physical-chemical properties. Methods In this study a Face Centered Central Composite Design (FCCCD) was carried out with four parameters: A g N O 3 concentration, sodium citrate (TSC) concentration, N a B H 4 concentration and the pH of the reaction with the objective of inhibit the growth of microorganisms. The response variables were the average size of AgNPs, the peak with the greatest intensity in the size distribution, the polydispersity of the nanoparticle size and the yield of the process. AgNPs obtained from the optimization were characterized physically and chemically. The antimicrobial activity of optimized AgNPs was evaluated against Staphylococcus aureus , Escherichia coli , Escherichia coli AmpC resistant, and Candida albicans and compared with AgNPs before optimization. In addition, the cytotoxicity of the optimized AgNPs was evaluated by the colorimetric assay MTT (3- (4,5- Dimethylthiazol- 2- yl)- 2, 5 - Diphenyltetrazolium Bromide). Results It was found that the four factors studied were significant for the response variables, and a significant model (p &lt; 0.05) was obtained for each variable. The optimal conditions were 8 for pH and 0.01 M, 0.0 6M, 0.01 M for the concentration of TSC, A g N O 3 , and N a B H 4 , respectively. Optimized AgNPs spherical and hemispherical were obtained, and 67.66% of it had a diameter less than 10.30 nm. A minimum bactericidal concentration (MBC) and minimum fungicidal Concentration (MFC) of optimized AgNPs was found against Staphylococcus aureus , Escherichia coli , Escherichia coli AmpC resistant, and Candida albicans at 19.89, 9.94, 9.94, 2.08 μ g/mL, respectively. Furthermore, the lethal concentration 50 ( L C 50 ) of optimized AgNPs was found on 19.11 μ g/mL and 19.60 μ g/mL to Vero and NiH3T3 cells, respectively. Conclusions It was found that the factors studied were significant for the variable responses and the optimization process used was effective to improve the antimicrobial activity of the AgNPs.

The group contribution method proposed by Valderrama and Robles in 2007 and extended by Valderrama and Rojas in 2009 to estimate the critical properties of ionic liquids is revised and an additional test for determining the consistency of the estimated properties is proposed. The new testing method includes the calculation of the saturation pressure at the normal boiling temperature using an equation of state and an accurate model to represent the temperature function of the attractive term in the equation of state. In determining the vapor pressure, the critical temperature, the critical pressure, the critical volume, and the acentric factor determined by group contribution are included. The proposed method complements the previous density test of the authors that tested the critical temperature, the critical volume, and the normal boiling temperature only. A total of 1130 ionic liquids are considered in this work, and double checking, using the density and the normal vapor pressure, is applied. Also, a spreadsheet file that allows any reader to calculate and check the critical properties of other ionic liquids containing any of the 44 groups defined by the method is provided.

Abstract Geoscientists now live in a world rich with digital data and methods, and their computational research cannot be fully captured in traditional publications. The Geoscience Paper of the Future (GPF) presents an approach to fully document, share, and cite all their research products including data, software, and computational provenance. This article proposes best practices for GPF authors to make data, software, and methods openly accessible, citable, and well documented. The publication of digital objects empowers scientists to manage their research products as valuable scientific assets in an open and transparent way that enables broader access by other scientists, students, decision makers, and the public. Improving documentation and dissemination of research will accelerate the pace of scientific discovery by improving the ability of others to build upon published work.