Título del artículo:

Leukocytoclastic vasculitis secondary to COVID-19 infection

We present the case of a 36-year-old female patient with a history of recent infection by COVID 19 with mild symptoms who started with bullous dermal lesions that evolved into ulcers with necrotic background without improvement with antihistamines and topical corticosteroids, a skin biopsy was taken which reported leukocytoclastic vasculitis, it is considered secondary to recent infection by COVID 19, for which medical management is given with subsequent improvement.

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Atencion Primaria Practica

Título del artículo:

Pellegrini stieda syndrome in an amateur cyclist

An average adult male with a history of trauma to the left knee with chronic pain that did not improve with conservative management underwent magnetic resonance imaging of the right knee with evidence of a grade II partial lesion of the medial collateral ligament with calcification of the femoral insertion.

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Atencion Primaria Practica

Título del artículo:

Laugier-Hunziker Syndrome, in older adults

Laugier-Hunziker syndrome (LHS) is a rare benign disorder, often acquired in adulthood, characterized by lentiginous hyperpigmentation of the oral mucosa and lips, associated with longitudinal melanonychia. Its importance is based on the early recognition and differential diagnosis of various oral and cutaneous hyperpigmentation pathologies. The case of a 74-year-old man with probable SLH is presented below and important differential diagnoses are discussed.

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Atencion Primaria Practica

Título del artículo:

Coinfection of tuberculosis and COVID 19 associated with pulmonary thromboembolism: Case report

Context: Currently, infection by the SARS-CoV-2 virus predominantly generates a respiratory infection, which can lead to acute and late complications, as well as mild or severe sequelae. A complication that has been evidenced is the state of hypercoagulability, such as pulmonary thromboembolism (PE) or deep vein thrombosis (DVT). Clinical case: We present the case of a patient with a recent history of COVID-19 infection who consulted for dyspnea and pain in the left hemithorax, complementary images were taken showing a large cavern at the right pulmonary base and an electrocardiogram suggestive of pulmonary thromboembolism, a CT scan was taken with protocol for PET that confirms it and smear microscopies that report positive for pulmonary tuberculosis coinfection. Discussion and conclusions: The formation of prothrombotic phenomena by COVID-19 has become a frequent complication, however, the coinfection of tuberculosis and COVID-19 is rare, this is due to a process of amplification of the deregulated immune response called «cytokine storm», which activates latent and hidden infections, in addition the use of immunosuppressive drugs in COVID-19 can lead to an expression of tuberculosis. Tuberculosis infection should be suspected in an endemic environment together with persistence of symptoms after the resolution of the viral infection, symptomatic cases before the acute viral process or in cases of atypical radiographic findings; in these cases, HIV infection or infection should be ruled out. another bacterial coinfection.

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Atencion Primaria Practica

Título del artículo:

Darier-white disease in a young adult patient

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Atencion Primaria Practica

Título del artículo:

Cerebral neurotoxoplasmosis in immunosuppressed patient. Diagnostic approach on imaging

Cerebral toxoplasmosis is an infection produced by an opportunistic organism, which in the case of immunocompetent people can be asymptomatic or produce mild symptoms, however in the immunocompromised population can generate severe symptoms and even death as a final outcome, it is necessary to have a diagnostic suspicion and provide appropriate management to avoid complications, sequelae and/or death. This case report seeks to promote the importance of clinical suspicion, diagnosis and timely treatment.

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Atencion Primaria Practica

Título del artículo:

Mycotic aneurysm: A case report

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Atencion Primaria Practica

Título del artículo:

Dulaglutide and incident atrial fibrillation or flutter in patients with type 2 diabetes: A post hoc analysis from the REWIND randomized trial

Aim: To assess the occurrence of atrial fibrillation or atrial flutter (atrial arrhythmias [AA]) in patients with type 2 diabetes treated with once-weekly subcutaneous dulaglutide versus placebo. Materials and Methods: Patients without electrocardiographic (ECG)-confirmed AA at baseline and randomized in the REWIND trial were assessed for the development of AA based on an annual ECG. Additional analyses included whether dulaglutide compared with placebo reduced the composite outcome of AA or death, AA or cardiovascular death, AA or stroke and AA or heart failure. Results: Among 9543 participants (mean age 66 ± 7 years, with cardiovascular risk factors and 31% with previous cardiovascular disease) without AA at entry in the trial, 524 patients (5.5%) had at least one episode of AA during the median 5.4 years of follow-up. Incident AA occurred in 269 of the 4769 participants allocated to dulaglutide (5.6%), at a rate of 10.7 per 1000 person-years, versus 255 of the 4774 allocated to placebo (5.3%), at a rate of 10.5 per 1000 person-years (P =.59). There was also no effect of dulaglutide on the composite outcome of AA and death or AA and heart failure. Conclusion: This post hoc analysis of data from the REWIND trial showed that treatment with dulaglutide was not associated with a reduced incidence of AA in this at-risk group of patients with type 2 diabetes.

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Diabetes, Obesity and Metabolism

Título del artículo:

Erratum: ‘Corrigendum to “Association of bedtime with mortality and major cardiovascular events: an analysis of 112,198 individuals from 21 countries in the PURE study” [Sleep Medicine 80 (2021) 265–272]’ (Sleep Medicine (2021) 80 (265–272), (S1389945721000745), (10.1016/j.sleep.2021.01.057))

The authors regret < Co-author Sadi Gulec (Ankara University School of Medicine, Ankara, Turkey) was inadvertently omitted and has been added after co-author Shrikant I. Bangdiwala. The conflict of interest section remains unchanged >. The authors would like to apologise for any inconvenience caused.

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Sleep Medicine

Título del artículo:

Functional Profile of CD8⁺ T-Cells in Response to HLA-A*02:01-Restricted Mutated Epitopes Derived from the Gag Protein of Circulating HIV-1 Strains from Medellín, Colombia

CD8+ T-cells play a crucial role in the control of HIV replication. HIV-specific CD8+ T-cell responses rapidly expand since the acute phase of the infection, and it has been observed that HIV controllers harbor CD8+ T-cells with potent anti-HIV capacity. The development of CD8+ T-cell-based vaccine against HIV-1 has focused on searching for immunodominant epitopes. However, the strong immune pressure of CD8+ T-cells causes the selection of viral variants with mutations in immunodominant epitopes. Since HIV-1 mutations are selected under the context of a specific HLA-I, the circulation of viral variants with these mutations is highly predictable based on the most prevalent HLA-I within a population. We previously demonstrated the adaptation of circulating strains of HIV-1 to the HLA-A*02 molecule by identifying mutations under positive selection located in GC9 and SL9 epitopes derived from the Gag protein. Also, we used an in silico prediction approach and evaluated whether the mutations found had a higher or lower affinity to the HLA-A*02. Although this strategy allowed predicting the interaction between mutated peptides and HLA-I, the functional response of CD8+ T-cells that these peptides induce is unknown. In the present work, peripheral blood mononuclear cells from 12 HIV-1+ HLA-A*02:01+ individuals were stimulated with the mutated and wild-type peptides derived from the GC9 and SL9 epitopes. The functional profile of CD8+ T-cells was evaluated using flow cytometry, and the frequency of subpopulations was determined according to their number of functions and the polyfunctionality index. The results suggest that the quality of the response (polyfunctionality) could be associated with the binding affinity of the peptide to the HLA molecule, and the functional profile of specific CD8+ T-cells to mutated epitopes in individuals under cART is maintained.

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Frontiers in Immunology

Título del artículo:

Effect of adding ZrM (M=Fe, Ni) intermetallic compounds on the hydrogen absorption/desorption properties of TiCr1.1V0.9 alloy

In this paper, the effect of intermetallic compounds Zr2Fe and Zr7Ni10 on the microstructure and first hydrogenation kinetic of TiCr1.1V0.9 alloy is reported. Samples were synthesized by arc melting separately and then 5% of each intermetallic was co-melt with TiCr1.1V0.9 alloy. First hydrogenation of all alloys was performed at room temperature under 2.0 MPa of hydrogen. Kinetics and absorption capacities were measured at room temperature, by using apparatus type sieverts. Results indicate that the addition of the intermetallic has an enhancing effect on the kinetic reaction without further modification of hydrogen storage capacities, going from 3.6 wt.% for as-cast alloy, to 3.61 wt.% for alloys +5 wt.% intermetallic. On the other hand, the structure and microstructural analysis were carried out by X-ray diffraction and scanning electron microscopy, respectively. These results show conservation of the structure in the body-centered cubic, and two additional minor phase formations: C14 laves phase for both alloys, and an additional Ti2Ni phase for the TiCr1.1V0.9 + 5% Zr7Ni10 alloy. Finally, the thermal stabilization of the sample was determined by using differential scanning calorimetry. The results show two types of hydrides that form trapped in different clamping sites with different energies.

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Heliyon

Título del artículo:

Sustainable use of spilled turbinable energy in Ecuador: Three different energy storage systems

The incorporation of Energy Storage Systems (ESS) in an electrical power system is studied for the application of Energy Time Shift (ETS) or energy arbitrage, taking advantage of the turbinable energy discharged in hydroelectric plants. For this, three storage systems were selected: Lithium-Ion Batteries (LIB), Vanadium Redox Flow Battery (VRFB), and Hydrogen Storage Systems (H2SS). The spilled turbinable energy available at the Paute Integral hydropower complex in the Republic of Ecuador is taken as the case study. Based on real data from the operation of these plants, a distinctive element of the study, the performance of the selected energy storage systems was analyzed applying the Analytic Hierarchy of Process for decision-making, where technical, economic, and environmental criteria were considered. Electrical energy stored during the early morning seeks to displace the thermal generation during peak hours, close to the demand centers. The results show that all the storage systems analyzed satisfy the required demand, although VRFB is recommended for the ETS. From an economic point of view, LIB represents the best alternative. From a technical point of view, H2SS is slightly superior, while prioritizing environmental aspects, VRFB technology prevails. However, the selection of the best ESS alternative must be continually evaluated, due to permanent technological changes. It is concluded that ESS represent a viable alternative to improve the operational performance of hydroelectric plants, meet the variability of demand, improve the quality of the electrical energy delivered, and displace the pollution-generation plants.

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Renewable and Sustainable Energy Reviews

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Factors Associated with Cyberbullying Victimisation among Colombian High-School Adolescents

The study’s purpose was to examine the prevalence and explore some factors associated with cyberbullying in high-school adolescents at ​​Santa Marta, Colombia. A cross-sectional study was designed, which participated in students between 13 and 17 years. Participants completed the item for being a victim of cyberbullying of the Youth Risk Behavior Survey for high school students designed by the Center for Disease Control of the United States. A total of 1462 students answered the questionnaire (M = 14.4 years, SD = 0.8). 19.6% (n = 287) reported lifetime cyberbullying victimisation. Cyberbullying victimisation was associated with post-traumatic stress disorder risk (OR = 2.05, 95%CI 1.51–2.79), lifetime cigarette smoking (OR = 1.91, 95%CI 1.42–2.57), female gender (OR = 1.68, 95%CI 1.25–2.26), family dysfunction (OR = 1.68, 95%CI 1.18–2.41), and poor-fair health condition (OR = 1.45, 95%CI 1.08–1.95). Being a victim of cyberbullying is frequent among Colombian high-school adolescents. It is associated with post-traumatic stress disorder risk, cigarette smoking, female gender, family dysfunction, and poor-fair general health condition. Longitudinal investigations are needed to measure better the dynamics of cyberbullying and the nature of such associations.

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Journal of Child and Adolescent Trauma

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Examining Facilitators and Barriers to Cardiac Rehabilitation Adherence in a Low-Resource Setting in Latin America from Multiple Perspectives

Cardiac rehabilitation (CR) is under-used, particularly in low-resource settings. There are few studies of barriers and facilitators to CR adherence in these settings, particularly considering multiple perspectives. In this multiple-method study, a cross-sectional survey including the Cardiac Rehabilitation Barriers Scale (each item scored on a five-point Likert scale) was administered to patients treated between February and July, 2019, in three CR centers in Colombia. A random subsample of 50 participants was invited to a focus group, along with an accompanying relative. Physiotherapists from the programs were invited to an interview, with a similar interview guide. Audio-recordings were transcribed and analyzed using interpretive description. A total of 210 patients completed the survey, and 9 patients, together with 3 of their relatives and 3 physiotherapists, were interviewed. The greatest barriers identified were costs (mean = 2.8 ± 1.6), distance (2.6 ± 1.6) and transportation (2.5 ± 1.6); the logistical subscale was highest. Six themes were identified, pertaining to well-being, life roles, weather, financial factors, healthcare professionals and health system factors. The main facilitators were encouragement from physiotherapists, relatives and other patients. The development of hybrid programs where patients transition from supervised to unsupervised sessions when appropriate should be considered, if health insurers were to reimburse them. Programs should consider the implications regarding policies of family inclusion.

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International Journal of Environmental Research and Public Health

Título del artículo:

Letter: Spectrum of hospitalized NeuroCOVID diagnoses from a tertiary care neurology centre in Eastern India

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Journal of Clinical Neuroscience

Título del artículo:

Undergraduate research in medicine: A summary of the evidence on problems, solutions and outcomes

Scientific research plays a fundamental role in current medical practice and it is of great importance that medical students relate to it from the beginning of their professional career, since it generates multiple benefits that will be reflected during the course of their careers as university students and future professionals. However, getting involved in research during the undergraduate years is not always easy, as there are different obstacles and challenges that result in a reduced number of research students. Because of this, it is necessary to adopt appropriate strategies and measures to help facilitate this process, in order to foster the early development of essential skills that will facilitate responsible clinical practice. Knowing the evidence on this issue is fundamental to propose educational solutions depending on each context.

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Annals of Medicine and Surgery

Título del artículo:

Variations in the financial impact of the COVID-19 pandemic across 5 continents: A cross-sectional, individual level analysis

Background: COVID-19 has caused profound socio-economic changes worldwide. However, internationally comparative data regarding the financial impact on individuals is sparse. Therefore, we conducted a survey of the financial impact of the pandemic on individuals, using an international cohort that has been well-characterized prior to the pandemic. Methods: Between August 2020 and September 2021, we surveyed 24,506 community-dwelling participants from the Prospective Urban-Rural Epidemiology (PURE) study across high (HIC), upper middle (UMIC)-and lower middle (LMIC)-income countries. We collected information regarding the impact of the pandemic on their self-reported personal finances and sources of income. Findings: Overall, 32.4% of participants had suffered an adverse financial impact, defined as job loss, inability to meet financial obligations or essential needs, or using savings to meet financial obligations. 8.4% of participants had lost a job (temporarily or permanently); 14.6% of participants were unable to meet financial obligations or essential needs at the time of the survey and 16.3% were using their savings to meet financial obligations. Participants with a post-secondary education were least likely to be adversely impacted (19.6%), compared with 33.4% of those with secondary education and 33.5% of those with pre-secondary education. Similarly, those in the highest wealth tertile were least likely to be financially impacted (26.7%), compared with 32.5% in the middle tertile and 30.4% in the bottom tertile participants. Compared with HICs, financial impact was greater in UMIC [odds ratio of 2.09 (1.88–2.33)] and greatest in LMIC [odds ratio of 16.88 (14.69–19.39)]. HIC participants with the lowest educational attainment suffered less financial impact (15.1% of participants affected) than those with the highest education in UMIC (22.0% of participants affected). Similarly, participants with the lowest education in UMIC experienced less financial impact (28.3%) than those with the highest education in LMIC (45.9%). A similar gradient was seen across country income categories when compared by pre-pandemic wealth status. Interpretation: The financial impact of the pandemic differs more between HIC, UMIC, and LMIC than between socio-economic categories within a country income level. The most disadvantaged socio-economic subgroups in HIC had a lower financial impact from the pandemic than the most advantaged subgroup in UMIC, with a similar disparity seen between UMIC and LMIC. Continued high levels of infection will exacerbate financial inequity between countries and hinder progress towards the sustainable development goals, emphasising the importance of effective measures to control COVID-19 and, especially, ensuring high vaccine coverage in all countries. Funding: Funding for this study was provided by the Canadian Institutes of Health Research and the International Development Research Centre.

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eClinicalMedicine

Título del artículo:

Variations in risks from smoking between high-income, middle-income, and low-income countries: an analysis of data from 179 000 participants from 63 countries

Background: Separate studies suggest that the risks from smoking might vary between high-income (HICs), middle-income (MICs), and low-income (LICs) countries, but this has not yet been systematically examined within a single study using standardised approaches. We examined the variations in risks from smoking across different country income groups and some of their potential reasons. Methods: We analysed data from 134 909 participants from 21 countries followed up for a median of 11·3 years in the Prospective Urban Rural Epidemiology (PURE) cohort study; 9711 participants with myocardial infarction and 11 362 controls from 52 countries in the INTERHEART case-control study; and 11 580 participants with stroke and 11 331 controls from 32 countries in the INTERSTROKE case-control study. In PURE, all-cause mortality, major cardiovascular disease, cancers, respiratory diseases, and their composite were the primary outcomes for this analysis. Biochemical verification of urinary total nicotine equivalent was done in a substudy of 1000 participants in PURE. Findings: In PURE, the adjusted hazard ratio (HR) for the composite outcome in current smokers (vs never smokers) was higher in HICs (HR 1·87, 95% CI 1·65–2·12) than in MICs (1·41, 1·34–1·49) and LICs (1·35, 1·25–1·46; interaction p<0·0001). Similar patterns were observed for each component of the composite outcome in PURE, myocardial infarction in INTERHEART, and stroke in INTERSTROKE. The median levels of tar, nicotine, and carbon monoxide displayed on the cigarette packs from PURE HICs were higher than those on the packs from MICs. In PURE, the proportion of never smokers reporting high second-hand smoke exposure (≥1 times/day) was 6·3% in HICs, 23·2% in MICs, and 14·0% in LICs. The adjusted geometric mean total nicotine equivalent was higher among current smokers in HICs (47·2 μM) than in MICs (31·1 μM) and LICs (25·2 μM; ANCOVA p<0·0001). By contrast, it was higher among never smokers in LICs (18·8 μM) and MICs (11·3 μM) than in HICs (5·0 μM; ANCOVA p=0·0001). Interpretation: The variations in risks from smoking between country income groups are probably related to the higher exposure of tobacco-derived toxicants among smokers in HICs and higher rates of high second-hand smoke exposure among never smokers in MICs and LICs. Funding: Full funding sources are listed at the end of the paper (see Acknowledgments).

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The Lancet Global Health

Título del artículo:

Actinobacteria-enhanced plant growth, nutrient acquisition, and crop protection: Advances in soil, plant, and microbial multifactorial interactions

Agricultural areas of land are deteriorating every day owing to population increase, rapid urbanization, and industrialization. To feed today\'s huge populations, increased crop production is required from smaller areas, which warrants the continuous application of high doses of inorganic fertilizers to agricultural land. These cause damage to soil health and, therefore, nutrient imbalance conditions in arable soils. Under these conditions, the benefits of microbial inoculants (such as Actinobacteria) as replacements for harmful chemicals and promoting ecofriendly sustainable farming practices have been made clear through recent technological advances. There are multifunctional traits involved in the production of different types of bioactive compounds responsible for plant growth promotion, and the biocontrol of phytopathogens has reduced the use of chemical fertilizers and pesticides. There are some well-known groups of nitrogen-fixing Actinobacteria, such as Frankia, which undergo mutualism with plants and offer enhanced symbiotic trade-offs. In addition to nitrogen fixation, increasing availability of major plant nutrients in soil due to the solubilization of immobilized forms of phosphorus and potassium compounds, production of phytohormones, such as indole-3-acetic acid, indole-3-pyruvic acid, gibberellins, and cytokinins, improving organic matter decomposition by releasing cellulases, xylanase, glucanases, lipases, and proteases, and suppression of soil-borne pathogens by the production of siderophores, ammonia, hydrogen cyanide, and chitinase are important features of Actinobacteria useful for combating biotic and abiotic stresses in plants. The positive influence of Actinobacteria on soil fertility and plant health has motivated us to compile this review of important findings associated with sustaining plant productivity in the long run.

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Pedosphere

Título del artículo:

Seroprevalence and risk factors for Leptospira spp. in small ruminants of semi-arid zone in northeastern Colombia

Leptospirosis in small ruminants is an economically important disease that causes important losses by pathologies of the reproductive tract. The present study aimed to estimate the seroprevalence and risk factors associated with Leptospira spp. in small ruminants under traditional husbandry systems. A cross-sectional epidemiological study was carried out in a sample of 1039 animals which included 793 sheep and 245 goats from 49 farms of 10 municipalities of northeastern areas of Colombia. The MAT test using a panel of 13 laboratory serovars was performed to diagnose the Leptospira spp. antibodies in the serum samples of animals. A structured questionnaire was filled in each farm to obtain information on putative risk factors, and its association with Leptospira spp. infection was detected by univariate and multivariate logistic regression. The general seroprevalence showed a rate of 13.9%, the 79.6% of farms showed at least one positive animal, the 14.2% and 0.4% of positive animals showed titers ≥ 1:100 and 1:200, respectively. The seroprevalence in sheep and goats showed a rate of 13.1% and 16.2%, respectively. The most common serovars in positive animals were Autumnalis (3.6%), Tarassovi (3.4%), Bratislava (2.9%), Mini (2.9%), Bataviae (1.4%), Canicola (0.3%), and Grippotyphosa (0.3%). The univariate and multivariate analysis showed as risk factors the absence of housing system (OR = 3.412 CI: 1.347–8.152), the absence of quarantine measures to new animals (OR = 1.371 CI: 0.943–1.978), and the protective factor identified was the use of Toggenburg breed (OR = 0.571 CI: 0.249–1.074). This exploratory study showed the Leptospira spp. positive small ruminants located in the northeastern areas of Colombia with titer associated with chronic and subclinical infection.

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Tropical Animal Health and Production

Título del artículo:

Multinational prediction of household and personal exposure to fine particulate matter (PM2.5) in the PURE cohort study

Introduction: Use of polluting cooking fuels generates household air pollution (HAP) containing health-damaging levels of fine particulate matter (PM2.5). Many global epidemiological studies rely on categorical HAP exposure indicators, which are poor surrogates of measured PM2.5 levels. To quantitatively characterize HAP levels on a large scale, a multinational measurement campaign was leveraged to develop household and personal PM2.5 exposure models. Methods: The Prospective Urban and Rural Epidemiology (PURE)-AIR study included 48-hour monitoring of PM2.5 kitchen concentrations (n = 2,365) and male and/or female PM2.5 exposure monitoring (n = 910) in a subset of households in Bangladesh, Chile, China, Colombia, India, Pakistan, Tanzania and Zimbabwe. PURE-AIR measurements were combined with survey data on cooking environment characteristics in hierarchical Bayesian log-linear regression models. Model performance was evaluated using leave-one-out cross validation. Predictive models were applied to survey data from the larger PURE cohort (22,480 households; 33,554 individuals) to quantitatively estimate PM2.5 exposures. Results: The final models explained half (R2 = 54%) of the variation in kitchen PM2.5 measurements (root mean square error (RMSE) (log scale):2.22) and personal measurements (R2 = 48%; RMSE (log scale):2.08). Primary cooking fuel type, heating fuel type, country and season were highly predictive of PM2.5 kitchen concentrations. Average national PM2.5 kitchen concentrations varied nearly 3-fold among households primarily cooking with gas (20 μg/m3 (Chile); 55 μg/m3 (China)) and 12-fold among households primarily cooking with wood (36 μg/m3 (Chile)); 427 μg/m3 (Pakistan)). Average PM2.5 kitchen concentration, heating fuel type, season and secondhand smoke exposure were significant predictors of personal exposures. Modeled average PM2.5 female exposures were lower than male exposures in upper-middle/high-income countries (India, China, Colombia, Chile). Conclusion: Using survey data to estimate PM2.5 exposures on a multinational scale can cost-effectively scale up quantitative HAP measurements for disease burden assessments. The modeled PM2.5 exposures can be used in future epidemiological studies and inform policies targeting HAP reduction.

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Environment International

Título del artículo:

Anger or emotional upset and heavy physical exertion as triggers of stroke: The INTERSTROKE study

Aims: In INTERSTROKE, we explored the association of anger or emotional upset and heavy physical exertion with acute stroke, to determine the importance of triggers in a large, international population. Methods and results: INTERSTROKE was a case-control study of first stroke in 32 countries. Using 13 462 cases of acute stroke we adopted a case-crossover approach to determine whether a trigger within 1 hour of symptom onset (case period), vs. the same time on the previous day (control period), was associated with acute stroke. A total of 9.2% (n = 1233) were angry or emotional upset and 5.3% (n = 708) engaged in heavy physical exertion during the case period. Anger or emotional upset in the case period was associated with increased odds of all stroke [odds ratio (OR) 1.37, 99% confidence interval (CI), 1.15-1.64], ischaemic stroke (OR 1.22, 99% CI, 1.00-1.49), and intracerebral haemorrhage (ICH) (OR 2.05, 99% CI 1.40-2.99). Heavy physical exertion in the case period was associated with increased odds of ICH (OR 1.62, 99% CI 1.03-2.55) but not with all stroke or ischaemic stroke. There was no modifying effect by region, prior cardiovascular disease, risk factors, cardiovascular medications, time, or day of symptom onset. Compared with exposure to neither trigger during the control period, the odds of stroke associated with exposure to both triggers were not additive. Conclusion: Acute anger or emotional upset was associated with the onset of all stroke, ischaemic stroke, and ICH, while acute heavy physical exertion was associated with ICH only.

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European Heart Journal

Título del artículo:

Knowledge sharing among academics: why organizational narcissism in higher education matters?

Purpose: This paper aims to analyse the effects of organizational narcissism on four knowledge-sharing aspects among academics: publications, personal interactions, organizational communication and network interaction. Design/methodology/approach: This research uses a sample of 288 research groups from public and private universities in Colombia. The study used structural equations by the partial least squares method (PLS). Findings: The results indicate that organizational narcissism has a positive and significant influence on the four knowledge-sharing aspects analysed. The greatest effect of organizational narcissism is generated in organizational communication, followed by personal interactions, network interaction and publications. Originality/value: This work contributes to developing the emerging theoretical perspective which gives greater attention to the analysis of organizational behaviours considered strategic given their potential to dynamize knowledge sharing as opposed to focusing on how publications are affected by fragments or specific aspects of organizational culture. The findings show organizational narcissism is one of such strategic behaviours. Moreover, the study sheds light on the controversy between positions for and against organizational narcissism, and the results contradict previous studies that highlight the negative repercussions of this organizational behaviour on publications. In addition, our work provides a perspective that allows for a broader view in evaluating the actual extent of the impact of organizational narcissism, which is not exclusively limited to the publication dimension. In this way, the research horizons of organizational narcissism are also expanded, as regrettably it was long seen as a phenomenon that occurred almost exclusively in the business context.

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VINE Journal of Information and Knowledge Management Systems

Título del artículo:

Thermodynamics performance optimization of a hybrid solar gas turbine power plant in Colombia

A thermodynamic model is presented for evaluation of a solar hybrid gas-turbine power plant. The model uses variable ambient temperature and estimates direct solar radiation at different day times. The plant is evaluated in Barranquilla, Colombia, with a solar concentration system and a combustion chamber that burns natural gas. The hybrid system enables to maintain almost constant the power output throughout day. The model allows optimizing the different plant parameters and evaluating maximum performance point. This work presents pressure ratio ranges where the maximum values of overall efficiency, power output, thermal engine efficiency and fuel conversion rate are found. The study is based on the environmental conditions of Barranquilla, Colombia. The results obtained shows that optimum pressure ratio range for power output and overall efficiency is between 6.4 and 8.3, when direct solar radiation its maximum at noon. This thermodynamic analysis is necessary to design new generations of solar thermal power plants.

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Journal of Physics: Conference Series

Título del artículo:

Biomechanical analysis of grip strength in upper limb rehabilitation

This research is based on biomechanics as a science that involves concepts of engineering, mechanics, physic, anatomy, physiology, and many others, to study the human body with the desire to solve certain problems that may affect the performance of an individual in their work or personal level. This work is an investigative process in these areas of scientific and applied disciplines, in which the attention is focused on the hand as a valuable tool for the occupational performance of the human being, since through it is possible to touch, move, grasp, or manipulate objects. Injuries to this limb may be due to various causes, which require complex surgeries and long periods of rehabilitation to be reversed. This research highlights the importance of certain physical concepts that must be understood by the rehabilitation expert in order not to affect the surgery and thus guarantee the maximum functionality of the patient at the end of the recovery cycle.

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Journal of Physics: Conference Series