Search

Objectives This study aims to determine how workplace experiences of National Health Service (NHS) staff varied by ethnicity during the COVID-19 pandemic and how these experiences are associated with mental and physical health at the time of the study. Methods An online Inequalities Survey was conducted by the Tackling Inequalities and Discrimination Experiences in Health Services study in collaboration with NHS CHECK. This Inequalities Survey collected measures relating to workplace experiences (such as personal protective equipment (PPE), risk assessments, redeployments and discrimination) as well as mental health (Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder 7 (GAD-7)), and physical health (PHQ-15) from NHS staff working in the 18 trusts participating with the NHS CHECK study between February and October 2021 (N=4622). Results Regression analysis of this cross-sectional data revealed that staff from black and mixed/other ethnic groups had greater odds of experiencing workplace harassment (adjusted OR (AOR) 2.43 (95% CI 1.56 to 3.78) and 2.38 (95% CI 1.12 to 5.07), respectively) and discrimination (AOR 4.36 (95% CI 2.73 to 6.96) and 3.94 (95% CI 1.67 to 9.33), respectively) compared with white British staff. Staff from black ethnic groups also had greater odds than white British staff of reporting PPE unavailability (AOR 2.16 (95% CI 1.16 to 4.00)). Such workplace experiences were associated with negative physical and mental health outcomes, though this association varied by ethnicity. Conversely, understanding employment rights around redeployment, being informed about and having the ability to inform redeployment decisions were associated with lower odds of poor physical and mental health. Conclusions Structural changes to the way staff from ethnically minoritised groups are supported, and how their complaints are addressed by leaders within the NHS are urgently required.

Objective: To determine the profile of medical and health sciences researchers belonging to the Carlos Monge Medrano group, qualified by Consejo Nacional de Ciencia, Tecnología e Innovación Tecnológica (CONCYTEC - National Council of Science, Technology and Technological Innovation) and registered in Registro Nacional Científico, Tecnológico y de Innovación Tecnológica (RENACYT - National Scientific, Technological and Technological Innovation Registry) in 2022. Materials and methods: A quantitative, descriptive and cross-sectional study. The CTI Vitae - Hojas de vida afines a la Ciencia y Tecnología (CTI Vitae - Résumés related to Science and Technology) data sheets of 706 researchers registered in Renacyt were reviewed during September 2022. Demographic characteristics, academic background, career and scientific output were collected in a data collection sheet, which was used to create a database. Results: Out of all researchers, 65.3 % were males, 80.0 % came from Peru, and 66.7 % were fluent in two or three languages, the most frequent being Spanish, English, Portuguese, French, Italian, German and Quechua. As for their academic background, the highest degree was a doctorate (71.2 %), the first reported program was not always strictly a health sciences program, 80.3 % pursued master’s studies and 71.2 % pursued doctoral studies. In addition, 75.5 % indicated a university as their primary affiliation. Regarding their career, 38.2 % had more than 20 years of work experience, 84 % served as educator, 51.7 % had experience as research project evaluator or developer and 74.8 % received an award or distinction during their career. Moreover, 133 researchers had an h-index between 4 and 6. Furthermore, 94.5 % (667 researchers) drafted scientific papers, out of whom 41.4 % were the lead author in one to five articles and 65.9 % served as undergraduate and graduate thesis advisor. Conclusions: Medical and health sciences researchers are mostly males, are fluent in at least, Objetivo: Determinar el perfil de los investigadores en ciencias médicas y de la salud de la categoría Monge Medrano, calificados por el Consejo Nacional de Ciencia, Tecnología e Innovación Tecnológica (CONCYTEC) y registrados en el Registro Nacional Científico, Tecnológico y de Innovación Tecnológica (RENACYT) en el año 2022. Materiales y métodos: Estudio de enfoque cuantitativo, tipo descriptivo y de corte transversal. Se revisaron las Hojas de vida afines a la Ciencia y Tecnología (CTI Vitae) de 706 investigadores registrados en Renacyt durante el mes de setiembre del 2022. Se recopilaron las características demográficas, de formación académica, de actividad profesional y de producción científica mediante una ficha de recolección de datos y, a partir de esto, se elaboró una base de datos. Resultados: El 65,3 % de investigadores fueron de sexo masculino, un 80,0 % procedía de Perú y un 66, 7 % dominaba dos o tres idiomas; los más frecuentes eran español, inglés, portugués, francés, italiano, alemán y quechua. A nivel académico, el máximo grado académico obtenido fue el de doctor (71,2 %), la primera carrera profesional no siempre fue una carrera estrictamente de la salud, el 80,3 % reportó estudios de maestría y el 71,2 %, estudios de doctorado; además, el 75,5 % indicó una universidad como institución de primera filiación. A nivel profesional, el 38,2 % registró más de 20 años de experiencia laboral, el 84 % como docente y el 51,7 % tenían experiencia como evaluador o formulador de proyectos de investigación; el 74,8 % reportó haber recibido un premio o distinción en su carrera, asimismo, 133 investigadores contaban con un índice h entre 4 y 6. Adicionalmente, el 94,5 % (667 investigadores) tenía artículos de producción científica, y de estos, el 41,4 % había redactado entre uno y cinco artículos donde era primer autor; además, el 65,9 % de los investigadores reportó haber realizado asesoría de tesis en pregrado y posgrado. Conclusiones: El investigador en cienci

Penyelenggaraan reformasi birokrasi mencakup program yang bertujuan untuk meningkatkan akuntabilitas kinerja. Akuntabilitas kinerja berperan penting dalam mencapai tata kelola yang baik (good governance). Aspek kunci untuk mendorong tata pemerintahan yang baik adalah pembentukan sistem pengukuran kinerja yang efektif dalam pemerintahan. Pemerintah menciptakan suatu sistem pengukuran kinerja yang disebut dengan Sistem Akuntabilitas Kinerja Instansi Pemerintah (SAKIP). Badan Pengawasan Keuangan dan Pembangunan (BPKP) sebagai aparat pengawasan intern pemerintah yang berkedudukan di bawah dan bertanggung jawab kepada Presiden mempunyai tugas menyelenggarakan urusan pemerintahan di bidang pengawasan keuangan negara/daerah dan pembangunan nasional. Sebagai wujud transparansi dan akuntabilitas kepada stakeholders, Perwakilan BPKP Provinsi Sumatera Barat sebagai unit kerja BPKP di daerah wajib mempertanggungjawabkan pelaksanaan program dan kegiatan yang dilakukan melalui impelementasi SAKIP. Penelitian ini bertujuan untuk (1) mengetahui capaian dan keselarasan komponen SAKIP Perwakilan BPKP Provinsi Sumatera Barat, (2) mengetahui efektivitas pelaksanan SAKIP termasuk pemanfaatan teknologi informasi dalam pengukuran SAKIP, dan (3) mengetahui faktor yang mempengaruhi penerapan SAKIP di Perwakilan BPKP Provinsi Sumatera Barat. Metodologi penelitian yang digunakan yaitu penelitian kualitatif dengan pendekatan deskriptif. Pengumpulan data melalui wawancara, observasi, dokumentasi dan studi kepustakaan. Wawancara dilakukan kepada pimpinan dan beberapa pegawai yang terlibat pelaksanaan SAKIP. Hasil penelitian menujukkan bahwa capaian SAKIP Perwakilan BPKP Provinsi Sumatera Barat selama tahun 2021-2023 mengalami fluktuasi nilai. SAKIP di Perwakilan BPKP Provinsi Sumatera Barat berjalan efektif, jika dilihat dari 3 (tiga) perspektif efektivitas menurut teori Duncan. Namun demikian, masih terdapat hambatan yang mempengaruhi penerapan SAKIP yaitu sistem rewarding dan punishment belum

Background: During the COVID-19 pandemic, antigen diagnostic tests were frequently used for screening, triage, and diagnosis. Novel instrument-based antigen tests (iAg tests) hold the promise of outperforming their instrument-free, visually-read counterparts. Here, we provide a systematic review and meta-analysis of the SARS-CoV-2 iAg tests’ clinical accuracy. Methods: We systematically searched MEDLINE (via PubMed), Web of Science, medRxiv, and bioRxiv for articles published before November 7th, 2022, evaluating the accuracy of iAg tests for SARS-CoV-2 detection. We performed a random effects meta-analysis to estimate sensitivity and specificity and used the QUADAS-2 tool to assess study quality and risk of bias. Sub-group analysis was conducted based on Ct value range, IFU-conformity, age, symptom presence and duration, and the variant of concern. Results: We screened the titles and abstracts of 20,431 articles and included 114 publications that fulfilled the inclusion criteria. Additionally, we incorporated three articles sourced from the FIND website, totaling 117 studies encompassing 95,181 individuals, which evaluated the clinical accuracy of 24 commercial COVID-19 iAg tests. The studies varied in risk of bias but showed high applicability. Of 24 iAg tests from 99 studies assessed in the meta-analysis, the pooled sensitivity and specificity compared to molecular testing of a paired NP swab sample were 76.7% (95% CI 73.5 to 79.7) and 98.4% (95% CI 98.0 to 98.7), respectively. Higher sensitivity was noted in individuals with high viral load (99.6% [95% CI 96.8 to 100] at Ct-level ≤ 20) and within the first week of symptom onset (84.6% [95% CI 78.2 to 89.3]), but did not differ between tests conducted as per manufacturer’s instructions and those conducted differently, or between point-of-care and lab-based testing. Conclusion: Overall, iAg tests have a high pooled specificity but a mo

It is still not fully understood how genetic haploinsufficiency in del(5q) myelodysplastic syndrome (MDS) contributes to malignant transformation of hematopoietic stem cells. We asked how compound haploinsufficiency for Csnk1a1 and Egr1 in the common deleted region on chromosome 5 affects hematopoietic stem cells. Additionally, Trp53 was disrupted as the most frequently comutated gene in del(5q) MDS using CRISPR/Cas9 editing in hematopoietic progenitors of wild-type (WT), Csnk1a1–/+, Egr1–/+, Csnk1a1/Egr1–/+ mice. A transplantable acute leukemia only developed in the Csnk1a1–/+ Trp53–edited recipient. Isolated blasts were indefinitely cultured ex vivo and gave rise to leukemia after transplantation, providing a tool to study disease mechanisms or perform drug screenings. In a small-scale drug screening, the collaborative effect of Csnk1a1 haploinsufficiency and Trp53 sensitized blasts to the CSNK1 inhibitor A51 relative to WT or Csnk1a1 haploinsufficient cells. In vivo, A51 treatment significantly reduced blast counts in Csnk1a1 haploinsufficient/Trp53 acute leukemias and restored hematopoiesis in the bone marrow. Transcriptomics on blasts and their normal counterparts showed that the derived leukemia was driven by MAPK and Myc upregulation downstream of Csnk1a1 haploinsufficiency cooperating with a downregulated p53 axis. A collaborative effect of Csnk1a1 haploinsufficiency and p53 loss on MAPK and Myc upregulation was confirmed on the protein level. Downregulation of Myc protein expression correlated with efficient elimination of blasts in A51 treatment. The “Myc signature” closely resembled the transcriptional profile of patients with del(5q) MDS with TP53 mutation.

In this study, we explore the explainability of neural networks in agriculture and forestry, specifically in fertilizer treatment classification and wood identification. The opaque nature of these models, often considered 'black boxes', is addressed through an extensive evaluation of state-of-the-art Attribution Maps (AMs), also known as class activation maps (CAMs) or saliency maps. Our comprehensive qualitative and quantitative analysis of these AMs uncovers critical practical limitations. Findings reveal that AMs frequently fail to consistently highlight crucial features and often misalign with the features considered important by domain experts. These discrepancies raise substantial questions about the utility of AMs in understanding the decision-making process of neural networks. Our study provides critical insights into the trustworthiness and practicality of AMs within the agriculture and forestry sectors, thus facilitating a better understanding of neural networks in these application areas.

Since the advent of Deepfakes in digital media, the development of robust and reliable detection mechanism is urgently called for. In this study, we explore a novel approach to Deepfake detection by utilizing electroencephalography (EEG) measured from the neural processing of a human participant who viewed and categorized Deepfake stimuli from the FaceForensics++ datset. These measurements serve as input features to a binary support vector classifier, trained to discriminate between real and manipulated facial images. We examine whether EEG data can inform Deepfake detection and also if it can provide a generalized representation capable of identifying Deepfakes beyond the training domain. Our preliminary results indicate that human neural processing signals can be successfully integrated into Deepfake detection frameworks and hint at the potential for a generalized neural representation of artifacts in computer generated faces. Moreover, our study provides next steps towards the understanding of how digital realism is embedded in the human cognitive system, possibly enabling the development of more realistic digital avatars in the future.

Objectives The progression of long-term conditions (LTCs) from zero-to-one (initiation), and from one-to-many (progression)are common trajectories that impact a person’s quality of life including their ability to work. This study aimed to explore the demographic, socioeconomic, psychosocial, and health-related determinants of LTC initiation and progression, with a focus on work participation. Methods Data from 622 working-age adults who had completed two waves (baseline and follow-up) of the South-East London Community Health survey were analysed. Chi square tests and multinomial logistic regression were used to describe the associations between self-reported demographic, socioeconomic, psychosocial, and health-related variables, and the progression of LTCs. Results Small social networks, an increased number of stressful life events, low self-rated health, functional impairment, and increased somatic symptom severity were all associated with both the progression from zero-to-one LTC and from one LTC to multimorbidity (two or more LTCs). Renting accommodation (RRR 1.73 [95% CI 1.03–2.90]), smoking (RRR 1.91 [95% CI 1.16–3.14]) and being overweight (RRR 1.88 [95% CL 1.12–3.16]) were unique risk factors of developing initial LTCs, whereas low income (RRR 2.53 [95% CI 1.11–5.80]), working part-time (RRR 2.82 ([95% CL 1.12–7.10]), being unemployed (RRR 4.83 [95% CI 1.69–13.84]), and making an early work exit (RRR 16.86 [95% CI 3.99–71.30]) all increased the risk of progressing from one LTC to multimorbidity compared to being employed full-time. At follow-up, depression was the most prevalent LTC in the unemployed group whereas musculoskeletal conditions were the most prevalent in those working. Conclusions The journey to multimorbidity is complex, with both common and unique risk factors. Non-full-time employment was associated with an increased risk of progression to multimorbidity. Future research should explore the risk and benefit pathways between employment and prog

Epilepsy is a highly heritable disorder affecting over 50 million people worldwide, of which about one-third are resistant to current treatments. Here we report a multi-ancestry genome-wide association study including 29,944 cases, stratified into three broad categories and seven subtypes of epilepsy, and 52,538 controls. We identify 26 genome-wide significant loci, 19 of which are specific to genetic generalized epilepsy (GGE). We implicate 29 likely causal genes underlying these 26 loci. SNP-based heritability analyses show that common variants explain between 39.6% and 90% of genetic risk for GGE and its subtypes. Subtype analysis revealed markedly different genetic architectures between focal and generalized epilepsies. Gene-set analyses of GGE signals implicate synaptic processes in both excitatory and inhibitory neurons in the brain. Prioritized candidate genes overlap with monogenic epilepsy genes and with targets of current antiseizure medications. Finally, we leverage our results to identify alternate drugs with predicted efficacy if repurposed for epilepsy treatment.

Chronic pain affects more than 50 million Americans. Treatments remain inadequate, in large part, because the pathophysiological mechanisms underlying the development of chronic pain remain poorly understood. Pain biomarkers could potentially identify and measure biological pathways and phenotypical expressions that are altered by pain, provide insight into biological treatment targets, and help identify at-risk patients who might benefit from early intervention. Biomarkers are used to diagnose, track, and treat other diseases, but no validated clinical biomarkers exist yet for chronic pain. To address this problem, the National Institutes of Health Common Fund launched the Acute to Chronic Pain Signatures (A2CPS) program to evaluate candidate biomarkers, develop them into biosignatures, and discover novel biomarkers for chronification of pain after surgery. This article discusses candidate biomarkers identified by A2CPS for evaluation, including genomic, proteomic, metabolomic, lipidomic, neuroimaging, psychophysical, psychological, and behavioral measures. Acute to Chronic Pain Signatures will provide the most comprehensive investigation of biomarkers for the transition to chronic postsurgical pain undertaken to date. Data and analytic resources generatedby A2CPS will be shared with the scientific community in hopes that other investigators will extract valuable insights beyond A2CPSs initial findings. This article will review the identified biomarkers and rationale for including them, the current state of the science on biomarkers of the transition from acute to chronic pain, gaps in the literature, and how A2CPS will address these gaps.

The research articulates the experience lived in the Institutional Program of Scholarships for Initiation to Teaching, at Realengo Educational Reference Center in Childhood Education, with studies that reinforce the essentiality of an anti-racist education, since childhood. The methodological approach used was research-education and conversation, in order to share possible paths for the construction of pedagogical practices that value diversity. It is understood that Brazil is marked by a history of colonization and violence against black populations. Education, which is not separated from society, has an essential role in the deconstruction of stereotypes and prejudices. In this way, we believe that educational and training processes that dialogue with the anti-racist struggle make it possible to strengthen a more just society., A pesquisa articula a experiência vivida no Programa Institucional de Bolsas de Iniciação à docência, no Centro de Referência em Educação Infantil Realengo, com os estudos que reforçam a essencialidade de uma educação antirracista, desde a infância. A abordagem metodológica utilizada foi a pesquisa-formação e a conversa, a fim de compartilhar caminhos possíveis para a construção de práticas pedagógicas que valorizem a diversidade. Compreende-se que o Brasil é marcado por uma história de colonização e violência contra as populações negras. A educação, que não é apartada da sociedade, possui um papel essencial na desconstrução de estereótipos e preconceitos. Dessa forma, acreditamos que os processos educativos e de formação que dialoguem com a luta antirracista possibilitam o fortalecimento de uma sociedade mais justa.

Penelitian ini dilakukan untuk mengetahui persepsi atas kualitas sistem dan informasi dalam mendorong kepuasan pengguna pada sistem BJB Greens di PT Bank Pembangunan Daerah Jawa Barat Dan Banten Tbk (BJB). Pada penelitian ini menggunakan model kesuksesan DeLone dan McLean untuk menilai keberhasilan sistem informasi dengan menggunakan tiga elemen yaitu kualitas sistem, kualitas informasi, dan kepuasan pengguna. Interaksi diantara ketiga elemen tersebut yang dipertimbangkan sebagai dasar dalam menilai kesuksesan sistem informasi BJB Greens di organisasi perbankan seperti BJB. Dengan pendekatan kuantitatif dan teknik analisis regresi linier berganda serta penyebaran kuesioner selama kurun waktu satu bulan kepada 67 responden yaitu pegawai Bank BJB kantor cabang Jatinangor dan Sukajadi yang menggunakan sistem BJB Greens. Hasil penelitian menghasilkan beberapa temuan, diantaranya kualitas sistem dan kualitas informasi berpengaruh positif dan signifikan terhadap kepuasan pengguna, selain itu kualitas sistem mempunyai pengaruh yang lebih besar dibandingkan kualitas informasi. Penggunaan sistem BJB Greens telah terbukti bermanfaat dari sudut pandang pengguna dalam mengefisiensikan pekerjaan berdasarkan tiga elemen dalam Delone & McLean Information Success Model yang mendapatkan nilai sebesar 79.70% dan masuk dalam kategori sukses. Selain itu, elemen kualitas sistem memerlukan perbaikan, dengan fokus khusus sistem yang dapat dikembangkan sesuai dengan apa yang dibutuhkan pengguna dan diharapkan untuk meningkatkan pelaksanaan sosialisasi sistem BJB Greens kepada karyawan.

Penelitian ini membahas pemanfaatan marketplace Tokopedia oleh PT. XYZ, perusahaan tekstil industri di Cimahi. Metode yang digunakan adalah deskriptif kualitatif dengan wawancara dan observasi. Tujuan penelitian ini adalah untuk mengevaluasi dampak pemanfaatan Tokopedia dalam meningkatkan penjualan produk kain interior PT. XYZ kota Cimahi. Hasil wawancara menunjukan beberapa masalah yang mempengaruhi penjualan, seperti penurunan kunjungan ke halaman toko, ketidakpastian mengenai produk, dan lain sebagainya. Untuk mengatasi masalah tersebut, PT. XYZ, menggunakan strategi promosi melalui Instagram dan iklan di Tokopedia. Selain itu, PT. XYZ juga menyediakan deskripsi produk yang jelas, foto berkualitas, dan video penggunaan produk untuk memberikan informasi yang lengkap kepada pembeli, memberikan jaminan pengembalian barang, voucher discount, dan harga grosir sebagai strategi persaingan. Dengan strategi tersebut, PT. XYZ berhasil meningkatkan penjualan produk kain interior melalui Tokopedia dan mendapat pelanggan dengan wilayah yang lebih luas.

Penelitian ini dilakukan untuk mengetahui persepsi atas kualitas sistem dan informasi dalam mendorong kepuasan pengguna pada sistem BJB Greens di PT Bank Pembangunan Daerah Jawa Barat Dan Banten Tbk (BJB). Pada penelitian ini menggunakan model kesuksesan DeLone dan McLean untuk menilai keberhasilan sistem informasi dengan menggunakan tiga elemen yaitu kualitas sistem, kualitas informasi, dan kepuasan pengguna. Interaksi diantara ketiga elemen tersebut yang dipertimbangkan sebagai dasar dalam menilai kesuksesan sistem informasi BJB Greens di organisasi perbankan seperti BJB. Dengan pendekatan kuantitatif dan teknik analisis regresi linier berganda serta penyebaran kuesioner selama kurun waktu satu bulan kepada 67 responden yaitu pegawai Bank BJB kantor cabang Jatinangor dan Sukajadi yang menggunakan sistem BJB Greens. Hasil penelitian menghasilkan beberapa temuan, diantaranya kualitas sistem dan kualitas informasi berpengaruh positif dan signifikan terhadap kepuasan pengguna, selain itu kualitas sistem mempunyai pengaruh yang lebih besar dibandingkan kualitas informasi. Penggunaan sistem BJB Greens telah terbukti bermanfaat dari sudut pandang pengguna dalam mengefisiensikan pekerjaan berdasarkan tiga elemen dalam Delone & McLean Information Success Model yang mendapatkan nilai sebesar 79.70% dan masuk dalam kategori sukses. Selain itu, elemen kualitas sistem memerlukan perbaikan, dengan fokus khusus sistem yang dapat dikembangkan sesuai dengan apa yang dibutuhkan pengguna dan diharapkan untuk meningkatkan pelaksanaan sosialisasi sistem BJB Greens kepada karyawan.

Penelitian ini membahas pemanfaatan marketplace Tokopedia oleh PT. XYZ, perusahaan tekstil industri di Cimahi. Metode yang digunakan adalah deskriptif kualitatif dengan wawancara dan observasi. Tujuan penelitian ini adalah untuk mengevaluasi dampak pemanfaatan Tokopedia dalam meningkatkan penjualan produk kain interior PT. XYZ kota Cimahi. Hasil wawancara menunjukan beberapa masalah yang mempengaruhi penjualan, seperti penurunan kunjungan ke halaman toko, ketidakpastian mengenai produk, dan lain sebagainya. Untuk mengatasi masalah tersebut, PT. XYZ, menggunakan strategi promosi melalui Instagram dan iklan di Tokopedia. Selain itu, PT. XYZ juga menyediakan deskripsi produk yang jelas, foto berkualitas, dan video penggunaan produk untuk memberikan informasi yang lengkap kepada pembeli, memberikan jaminan pengembalian barang, voucher discount, dan harga grosir sebagai strategi persaingan. Dengan strategi tersebut, PT. XYZ berhasil meningkatkan penjualan produk kain interior melalui Tokopedia dan mendapat pelanggan dengan wilayah yang lebih luas.

Ahmad A Elshafei,1,2 Stephani A Flores,2 Ramandeep Kaur,3 Ellen A Becker3 1Department of Quality Operations & Population Health, Advocate Health, Green Bay, WI, USA; 2Department of Respiratory Care, Rush University Medical Center Chicago, IL, USA; 3Department of Cardiopulmonary Sciences, Rush University, Chicago, IL, USACorrespondence: Ahmad A Elshafei, Department of Quality Operations & Population Health, Advocate Health, Green Bay, WI, USA, Email Ahmad.elshafei@aah.orgPurpose: Coronavirus disease 2019 (COVID-19) impacted outcomes of persons with chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD). This study investigated the differences in respiratory interventions, hospital utilization, smoking status, and 30-day readmission in those with COPD and COVID-19 based on hospital survival status.Methods: A retrospective cross-sectional study was conducted from February 2020 to October 2020 and included persons with COPD and COVID-19 infection. We examined respiratory interventions, hospital utilization and outcomes, and 30-day hospital readmission. Chi-square test analysis was used to assess categorical variables, and t-test or Mann–Whitney was used to analyze continuous data based on normality.Results: Ninety persons were included in the study, 78 (87%) were survivors. The most common comorbidity was hypertension 71 (78.9%) (p = 0.003). Twenty-two (24%) persons were intubated, from whom 12 (15%) survived (p < 0.001). There were 25 (32.1%) and 12 (100%), (p < 0.001) persons who required an ICU admission from the survivor and non-survivor groups, respectively. Among the survivor group, fifteen (19%) persons required 30-day hospital readmission.Conclusion: Persons with COPD and COVID-19 had a lower mortality rate (13%) compared to other studies in the early pandemic phase. Non-survivors had increased ICU utilization, endotracheal intubation, and more frequent application of volume control mode. Discharging survivors to long-t

Self-testing is an effective tool to bridge the testing gap for several infectious diseases; however, its performance in detecting SARS-CoV-2 using antigen-detection rapid diagnostic tests (Ag-RDTs) has not been systematically reviewed. This study aimed to inform WHO guidelines by evaluating the accuracy of COVID-19 self-testing and self-sampling coupled with professional Ag-RDT conduct and interpretation. Articles on this topic were searched until November 7th, 2022. Concordance between self-testing/self-sampling and fully professional-use Ag-RDTs was assessed using Cohen’s kappa. Bivariate meta-analysis yielded pooled performance estimates. Quality and certainty of evidence were evaluated using QUADAS-2 and GRADE tools. Among 43 studies included, twelve reported on self-testing, and 31 assessed self-sampling only. Around 49.6% showed low risk of bias. Overall concordance with professional-use Ag-RDTs was high (kappa 0.91 [95% confidence interval (CI) 0.88–0.94]). Comparing self-testing/self-sampling to molecular testing, the pooled sensitivity and specificity were 70.5% (95% CI 64.3–76.0) and 99.4% (95% CI 99.1–99.6), respectively. Higher sensitivity (i.e., 93.6% [95% CI 90.4–96.8] for Ct < 25) was estimated in subgroups with higher viral loads using Ct values as a proxy. Despite high heterogeneity among studies, COVID-19 self-testing/self-sampling exhibits high concordance with professional-use Ag-RDTs. This suggests that self-testing/self-sampling can be offered as part of COVID-19 testing strategies. Trial registration: PROSPERO: CRD42021250706.

The consumption of edible insects can be anadvantageous alternative to the conventional food supply chain, which involves global water waste, land deficit, undernutrition, and starvation. Besides the nutritional aspects, insect proteins have demonstrated a wide range of functional properties such as foamability, emulsifying and gelling abilities. The protein content and amino acid profile of some insects have revealed a good nutritional value and interesting functional properties. However, it is crucial to comprehend how the protein quality is affected by insect feeding, drying, and defatting. There is a knowledge gap about the impact of industrial treatment, such as pH, ionic strength, and heat treatment, on insect proteins' functional properties. In this review, we have aimed to highlight the potential application of insect proteins as a nutritional source and their promising technological applications. The study reported the principal insect protein characterization methodologies that have been investigated in the literature aiming to correlate the physicochemical parameters to possible protein functionalities. The research on the functional properties of insect proteins is at the exploratory level. Further detailed studies are needed to clarify the structure-function relation of insect proteins and how these functionalities and insect processing can increase consumer acceptance.

Erworben im Rahmen der Schweizer Nationallizenzen (http://www.nationallizenzen.ch), Context: Wildlife–vehicle collisions (WVCs) are a significant threat for many species, cause financial loss and pose a serious risk to motorist safety. Objectives: We used spatial data science on regional collision data from Switzerland with the objectives of identifying the key environmental collision risk factors and modelling WVC risk on a nationwide scale. Methods: We used 43,000 collision records with roe deer, red deer, wild boar, and chamois from 2010 to 2015 for both midlands and mountainous landscape types. We compared a fixed-length road segmentation approach with segments based on Kernel Density Estimation, a data-driven segmentation method. The segments’ environmental properties were derived from land-cover geodata using novel neighbourhood operations. Multivariate logistic regression and random forest classifiers were used to identify and rank the relevant environmental factors and to predict collision risk in areas without collision data. Results: The key factors for WVC hotspots are road sinuosity, and two composite factors for browsing/forage availability and traffic noise—a proxy for traffic flow. Our best models achieved sensitivities of 82.5% to 88.6%, with misclassifications of 20.14% and 27.03%, respectively. Our predictions were better in forested areas and revealed limitations in open landscape due to lack of up-to-date data on annual crop changes. Conclusions: We illustrate the added value of using fine-grained land-cover data for WVC modelling, and show how such detailed information can be annotated to road segments using spatial neighbourhood functions. Finally, we recommend the inclusion of annual crop data for improving WVC modelling.

Through this article the authors seek to analyze the sexual violence in the context of the Russian-Ukrainian conflict between 2014 and 2022, through the review of the reports of the Office of the United Nations High Commissioner for Human Rights, the United Nations General Secretariat and, the Independent International Commission of Inquiry on Ukraine, making a comparison with the Statute of the International Criminal Court and relevant decisions of the international jurisprudence. Based on this, a prospective analysis of accountability and access to justice for victims is made, identifying the existence of de jure and de facto limitations at the national and international levels that hinder the punishment of crimes of sexual violence committed in the Russian-Ukrainian conflict. Received: 22.03.2023Accepted: 13.06.2023, Este artículo busca analizar el delito de violencia sexual como crimen internacional en el contexto del conflicto ruso-ucraniano entre el 2014 y el 2022, a través de la revisión de los informes de la Oficina del Alto Comisionado de Naciones Unidas para los Derechos Humanos, la Secretaría General de Naciones Unidas y, la Comisión Internacional Independiente de Investigación sobre Ucrania, haciendo una comparación con las tipificaciones establecidas en el Estatuto de la Corte Penal Internacional y los precedentes establecidos en la jurisprudencia internacional. En base a lo expuesto, se realiza un análisis prospectivo de la rendición de cuentas y el acceso a la justicia por parte de las víctimas, donde se identifica la existencia de limitaciones de iure y de facto a nivel nacional e internacional que obstaculizan la punibilidad de los crímenes de violencia sexual cometidos en el conflicto ruso-ucraniano. Recibido: 22.03.2023Aceptado: 13.06.2023

Compensation and emotional salary in companies in the commerce sector in Villavicencio-Meta, Colombia, have been little influenced by situations and dynamics such as staff turnover and the limited growth of people due to having extended organizational structures, with remunerations affected by reason for migration to other sectors of the economy, it seeks to analyze compensation and emotional salary in order to provide elements that improve human management practices. A quantitative investigation with an inferential approach was carried out, with a non-probabilistic sampling, based on the database collected in the year 2020, by the GYDO research group with the Mp05c instrument, compensation section, which was applied accordingly. virtual form to the collaborators of the companies of the city; It was found that there is a negative correlation between the average salary and the emotional salary, in addition to the fact that they tend to have a very low frequency of application of extra-legal social benefits, and it is concluded that the sector offers employees job and salary stability; however, salaries are not significant compared to other sectors, this is due to the fact that most of the companies that make up the sector are micro and small companies., A remuneração e o salário emocional nas empresas do setor de comércio em Villavicencio-Meta, Colômbia, foram pouco influenciados por situações e dinâmicas como a rotatividade de pessoal e o crescimento limitado de pessoas devido a estruturas organizacionais estendidas, com remunerações afetadas por motivo de migração para outros setores da economia, busca analisar a remuneração e o salário emocional a fim de fornecer elementos que aprimorem as práticas de gestão humana. Foi realizada uma investigação quantitativa com abordagem inferencial, com amostragem não probabilística, com base no banco de dados coletado no ano de 2020, pelo grupo de pesquisa GYDO com o instrumento de seção de compensação Mp05c, que foi aplicado de forma virtual aos colaboradores da as empresas da cidade; Constatou-se que existe correlação negativa entre o salário médio e o salário emocional, além do fato de que tendem a ter uma frequência muito baixa de aplicação de benefícios sociais extralegais, e conclui-se que o setor oferece aos empregados estabilidade de emprego e salário; no entanto, os salários não são significativos em comparação com outros setores, isso se deve ao fato de que a maioria das empresas que compõem o setor são micro e pequenas empresas., Las compensaciones y el salario emocional en las empresas del sector comercio en Villavicencio-Meta, Colombia, han sido poco influidas por situaciones y dinámicas como la rotación del personal y el limitado crecimiento de las personas por tener estructuras organizacionales ampliadas, siendo las remuneraciones afectadas a razón de la migración hacia otros sectores de la economía, se busca analizar las compensaciones y el salario emocional con el fin de brindar elementos que mejoren las prácticas de gestión humana. Se realizó una investigación de tipo cuantitativa con enfoque inferencial, con un muestreo no probabilístico, a partir de la base de datos recolectada en el año 2020, por parte del grupo de investigación GYDO con el instrumento Mp05c, sección compensaciones, el cual se aplicó de forma virtual a los colaboradores de las empresas de la ciudad; se encontró que existe una correlación negativa entre el promedio salarial y el salario emocional, además que se tienden a contar con una frecuencia de aplicación de beneficios sociales extralegales muy baja, y se concluye que el sector les ofrece a los colaboradores estabilidad laboral y salarial; sin embargo, los salarios no son significativos en comparación con otros sectores, esto debido a que la mayoría de empresas que conforman el sector son micro y pequeñas empresas.

Through this article the authors seek to analyze the sexual violence in the context of the Russian-Ukrainian conflict between 2014 and 2022, through the review of the reports of the Office of the United Nations High Commissioner for Human Rights, the United Nations General Secretariat and, the Independent International Commission of Inquiry on Ukraine, making a comparison with the Statute of the International Criminal Court and relevant decisions of the international jurisprudence. Based on this, a prospective analysis of accountability and access to justice for victims is made, identifying the existence of de jure and de facto limitations at the national and international levels that hinder the punishment of crimes of sexual violence committed in the Russian-Ukrainian conflict. Received: 22.03.2023Accepted: 13.06.2023, Este artículo busca analizar el delito de violencia sexual como crimen internacional en el contexto del conflicto ruso-ucraniano entre el 2014 y el 2022, a través de la revisión de los informes de la Oficina del Alto Comisionado de Naciones Unidas para los Derechos Humanos, la Secretaría General de Naciones Unidas y, la Comisión Internacional Independiente de Investigación sobre Ucrania, haciendo una comparación con las tipificaciones establecidas en el Estatuto de la Corte Penal Internacional y los precedentes establecidos en la jurisprudencia internacional. En base a lo expuesto, se realiza un análisis prospectivo de la rendición de cuentas y el acceso a la justicia por parte de las víctimas, donde se identifica la existencia de limitaciones de iure y de facto a nivel nacional e internacional que obstaculizan la punibilidad de los crímenes de violencia sexual cometidos en el conflicto ruso-ucraniano. Recibido: 22.03.2023Aceptado: 13.06.2023

En Colombia la industria avícola ha mostrado un crecimiento constante en los últimos años, sin embargo, conforme con este aumento el uso de antibióticos para mantener la salud animal también ha ido en incremento ocasionando la aparición de cepas resistentes tales como Escherichia coli, Salmonella y Campylobacter generando un problema de salud pública. Múltiples estudios han demostrado que el uso de bacterias ácido lácticas (BAL) con capacidad antimicrobiana puede ser empleadas en alimentación animal, disminuyendo el uso de antibióticos. Para el uso industrial de BAL es necesario encontrar medios de cultivos económicos y adecuados para la recuperación y crecimiento de las cepas. Por lo cual, durante el presente estudio se buscará la concentración adecuada de los sustratos leche de soya, suero de leche, azúcar y salvado de trigo que permitan el crecimiento de BAL aisladas de intestino de gallinas para su posterior uso en alimentación animal. Para esto, se realizaron cinéticas de fermentación a 24 h, tomando la viabilidad de las BAL cada 6 h durante 24 h. Se encontró que la mejor concentración de los sustratos donde se alcanzó una viabilidad similar al medio de cultivo comercial fue 15,76 g/L azúcar, 14,24 g/L suero de leche y 10,00 g/L de leche de soya, lo cual muestra que el uso de sustratos alternativos para la elaboración de medios de cultivo puede ser factible en la producción de BAL., In Colombia, the poultry industry has shown a constant growth in recent years, however, in line with this increase, the use of antibiotics to maintain animal health has also been increasing, causing the appearance of resistant strains such as Escherichia coli, Salmonella and Campylobacter, generating a public health problem. Multiple studies have shown that the use of probiotic bacteria (LAB) with antimicrobial capacity can be used in animal feed, reducing the use of antibiotics. For the industrial use of LAB, it is necessary to find economical and adequate culture media for the recovery and growth of the strains. For this reason, during the present study, the adequate concentration of the substrate soy milk, whey, sugar, and wheat bran will be sought to allow the growth of LAB isolated from chicken intestine for their subsequent use in animal feed. For this purpose, 24 h fermentation kinetics were performed, taking the viability of LAB every 6 h during 24 h. It was found that the best substrate concentration where viability like the commercial culture medium was achieved was 15.76 g/L sugar, 14.24 g/L whey and 10.00 g/L soy milk, which shows that the use of alternative substrates for the elaboration of culture media can be feasible in the production of LAB.

Pediatric brain and spinal cancers remain the leading cause of cancer-related death in children. Advancements in clinical decision-support in pediatric neuro-oncology utilizing the wealth of radiology imaging data collected through standard care, however, has significantly lagged other domains. Such data is ripe for use with predictive analytics such as artificial intelligence (AI) methods, which require large datasets. To address this unmet need, we provide a multi-institutional, large-scale pediatric dataset of 23,101 multi-parametric MRI exams acquired through routine care for 1,526 brain tumor patients, as part of the Children's Brain Tumor Network. This includes longitudinal MRIs across various cancer diagnoses, with associated patient-level clinical information, digital pathology slides, as well as tissue genotype and omics data. To facilitate downstream analysis, treatment-na\"ive images for 370 subjects were processed and released through the NCI Childhood Cancer Data Initiative via the Cancer Data Service. Through ongoing efforts to continuously build these imaging repositories, our aim is to accelerate discovery and translational AI models with real-world data, to ultimately empower precision medicine for children.

We have developed a methodology for the systematic generation of a large image dataset of macerated wood references, which we used to generate image data for nine hardwood genera. This is the basis for a substantial approach to automate, for the first time, the identification of hardwood species in microscopic images of fibrous materials by deep learning. Our methodology includes a flexible pipeline for easy annotation of vessel elements. We compare the performance of different neural network architectures and hyperparameters. Our proposed method performs similarly well to human experts. In the future, this will improve controls on global wood fiber product flows to protect forests.

VCP associated inclusion body myopathy, Paget's disease of bone, and Frontotemporal Dementia (IBMPFD, VCP disease, or multisystem proteinopathy type 1 (MSP1)) is an autosomal dominant disease caused by missense mutations in the VCP gene, which plays a crucial role in ubiquitin-proteasome dependent degradation of cytosolic proteins. Those diagnosed with the disorder often suffer from cardiovascular complications in the advanced stages. We conducted an observational cross-section study to investigate echocardiographic features of asymptomatic carriers and those affected by the disease to determine the differences and potential early features of the VCP-associated cardiomyopathy. The study cohort constituted of 32 patients with VCP mutations including 23 affected individuals diagnosed with myopathy +/- Paget disease of bone, and 9 asymptomatic carriers. Among the affected individuals, 95.7% had myopathy, 43.5% had Paget's disease of bone, and none had frontotemporal dementia, and the carriers were asymptomatic. Not surprisingly the carriers were younger (mean age 38.4 ± 3.8 years), than the affected cohort (mean age 50.6 ± 9.1 years; p < 0.001). There was a 43.5% prevalence of diastolic dysfunction on echocardiogram among patients who were symptomatic from VCP disease, whereas none of the two asymptomatic carriers manifested diastolic dysfunction (p = 0.017). Among the 5 affected individuals who had consequential echocardiograms 2-3 years apart, three affected individuals developed diastolic dysfunction, and two already had diastolic dysfunction on the initial study. The two carriers did not develop diastolic function changes. This present study represents the largest series of echocardiograms performed in patients and asymptomatic carriers with VCP myopathy, and will pave the way for future, large-scale studies that may include other imaging modalities such as cardiac MRI and strain evaluation in patients at all stages of the disease.

BackgroundCardiovascular disease is the most common cause of death among Fabry disease patients, who carry significantly increased risk for heart failure and sudden cardiac death. Echocardiographic strain imaging and cardiac MRI are important clinical tools for early detection of cardiomyopathy before onset of systolic or diastolic dysfunction. However, studies on these imaging modalities are limited among Fabry patients.Aim and objectiveTo evaluate echocardiographic strain pattern and correlation with cardiac MRI in Fabry disease.Materials and methodsWe performed a detailed analysis of global longitudinal strain and correlation with cardiac MRI finding in 9 patients diagnosed with Fabry disease.ResultsDespite normal left ventricular ejection fraction, basal and mid inferior segments are more likely to demonstrate strain abnormalities compared to other regions. Additionally, increased interventricular septal and left ventricular posterior wall thickness are correlated with greater strain abnormalities. Finally, MRI evidence of fibrosis and infiltration are detected among most patients with strain abnormalities, but in some cases, strain imaging were able to detect early evidence of cardiomyopathy even before MRI was fully able to detect the change. Basal and mid inferoseptal segment strain abnormalities are early signs of developing cardiomyopathy among patients with Fabry disease.ConclusionThough cardiac MRIs are critical tools for detection of myocardial infiltration and scarring, these findings may not always be detectable in early phases of the disease. Multiple imaging modalities maybe considered in monitoring and evaluation of cardiomyopathy in Fabry disease.

BackgroundCardiovascular disease is the most common cause of death among Fabry disease patients, who carry significantly increased risk for heart failure and sudden cardiac death. Echocardiographic strain imaging and cardiac MRI are important clinical tools for early detection of cardiomyopathy before onset of systolic or diastolic dysfunction. However, studies on these imaging modalities are limited among Fabry patients.Aim and objectiveTo evaluate echocardiographic strain pattern and correlation with cardiac MRI in Fabry disease.Materials and methodsWe performed a detailed analysis of global longitudinal strain and correlation with cardiac MRI finding in 9 patients diagnosed with Fabry disease.ResultsDespite normal left ventricular ejection fraction, basal and mid inferior segments are more likely to demonstrate strain abnormalities compared to other regions. Additionally, increased interventricular septal and left ventricular posterior wall thickness are correlated with greater strain abnormalities. Finally, MRI evidence of fibrosis and infiltration are detected among most patients with strain abnormalities, but in some cases, strain imaging were able to detect early evidence of cardiomyopathy even before MRI was fully able to detect the change. Basal and mid inferoseptal segment strain abnormalities are early signs of developing cardiomyopathy among patients with Fabry disease.ConclusionThough cardiac MRIs are critical tools for detection of myocardial infiltration and scarring, these findings may not always be detectable in early phases of the disease. Multiple imaging modalities maybe considered in monitoring and evaluation of cardiomyopathy in Fabry disease.

VCP associated inclusion body myopathy, Paget's disease of bone, and Frontotemporal Dementia (IBMPFD, VCP disease, or multisystem proteinopathy type 1 (MSP1)) is an autosomal dominant disease caused by missense mutations in the VCP gene, which plays a crucial role in ubiquitin-proteasome dependent degradation of cytosolic proteins. Those diagnosed with the disorder often suffer from cardiovascular complications in the advanced stages. We conducted an observational cross-section study to investigate echocardiographic features of asymptomatic carriers and those affected by the disease to determine the differences and potential early features of the VCP-associated cardiomyopathy. The study cohort constituted of 32 patients with VCP mutations including 23 affected individuals diagnosed with myopathy +/- Paget disease of bone, and 9 asymptomatic carriers. Among the affected individuals, 95.7% had myopathy, 43.5% had Paget's disease of bone, and none had frontotemporal dementia, and the carriers were asymptomatic. Not surprisingly the carriers were younger (mean age 38.4 ± 3.8 years), than the affected cohort (mean age 50.6 ± 9.1 years; p < 0.001). There was a 43.5% prevalence of diastolic dysfunction on echocardiogram among patients who were symptomatic from VCP disease, whereas none of the two asymptomatic carriers manifested diastolic dysfunction (p = 0.017). Among the 5 affected individuals who had consequential echocardiograms 2-3 years apart, three affected individuals developed diastolic dysfunction, and two already had diastolic dysfunction on the initial study. The two carriers did not develop diastolic function changes. This present study represents the largest series of echocardiograms performed in patients and asymptomatic carriers with VCP myopathy, and will pave the way for future, large-scale studies that may include other imaging modalities such as cardiac MRI and strain evaluation in patients at all stages of the disease.

Objective: in this work, the level of knowledge about toxoplasmosis and its risk factors in pregnant women who attend prenatal care was investigated because the low level of knowledge of this infection can be directly related to the increase in its incidence due to poor perception of the population regarding the risk and consequences in the future.Methodology: a random sample of 93 pregnant women who were taking their prenatal check-ups at a Clinic in Barranquilla, during the second trimester of 2021, was adminis-tered a survey with binary questions related to the understanding about toxoplasmosis and risk factors for contracting the infection. The survey was divided into two part: one part before and the other, after an informative talk about Toxoplasmosis, risk factors, health consequence and prevention methods. The clinical history, prenatal controls and socioeconomic level of the participant were taken into account.Results: it was found that 64.5 % of pregnant women did not know what Toxoplasmosis is and 66.6 % the risk factors and prevention methods.Conclusions: the level of knowledge about Toxoplasma gondii infection found in the pregnant women who attend prenatal control at the San Diego General Clinic, during the study period, is low.infección por Toxoplasma gondii; zoonosis; toxoplasmosis congénita, Objetivo: en este estudio, se investigó el nivel de conocimiento acerca de la toxoplasmosis y sus factores de riesgo en mujeres gestantes que asisten a control prenatal. Esto se debió a que el bajo nivel de conocimiento sobre esta infección podría relacionarse directamente con un aumento en su incidencia, debido a la pobre percepción de la población respecto a los riesgos y consecuencias a futuro. Metodología: se aplicó una encuesta aleatoria a 93 mujeres embarazadas que estaban realizando sus controles prenatales en una Clínica de Barranquilla, durante el segundo trimestre de 2021. La encuesta consistió en preguntas de tipo binario relacionadas con el entendimiento sobre la toxoplasmosis y los factores de riesgo para contraer la infección. La encuesta se dividió en dos partes: una antes y otra después de una charla informativa sobre la toxoplasmosis, sus factores de riesgo, las consecuencias para la salud y los métodos de prevención. Además, se tuvieron en cuenta los antecedentes clínicos, los controles prenatales y el nivel socioeconómico de las participantes. Resultados: se encontró que el 64,5 % de las embarazadas desconocía qué es la toxoplasmosis, y el 66,6 % desconocía los factores de riesgo y los métodos de prevención. Conclusiones: el nivel de conocimiento sobre la infección causada por el Toxoplasma gondii que se encontró en las gestantes que asistieron a control prenatal en la Clínica General San Diego durante el período de estudio es bajo.

Society expects women always to maintain their physical appearance throughout the ages. We can see this condition from the public's view of senior female celebrities, an example of successful ageing or ageing well. This study explores the visual discourse of femininity over the age of 50, which emerges from the Instagram accounts of senior female celebrities. Multimodal critical discourse analysis was conducted on images and texts to reveal dominant themes and rhetorical elements inherent in the femininity of senior female celebrities. The concepts of representation, body and femininity, ageism, and social media analyse alternative discourse related to ageing femininity. This study denotes that the ageing discourse of senior female celebrities reflects the dialectic of realising or revising sexist and ageist ideas about how women look after they reach old age.

Inclusion Body Myopathy, Paget's Disease of Bone, with Frontotemporal Dementia is a progressive autosomal dominant disease that affects the ubiquitin-proteasome complex, that is caused by variants in the Valosin Containing Protein (VCP) gene. We report the first case of concurrent pathogenic variants in both MYBPC3 and VCP that led to earlier onset of congestive heart failure with features of dilated cardiomyopathy. Cardiomyopathy has previously been associated with VCP inclusion body myopathy mostly at an advanced stage of the disease. Due to acute onset of cardiomyopathy in a previous asymptomatic individual, a cardiomyopathy gene panel was obtained which revealed an additional c.177_187del variant of the MYBPC3 gene. We report a first case of concurrent pathogenic variants in both c.177_187del gene of MYBPC3 and p.R155C VCP that led to earlier onset and a more severe form of the cardiomyopathy.

Hepatocellular carcinoma (HCC) is the most common primary liver tumor and develops in most cases in patients with underlying chronic liver disease, usually cirrhosis. In recent years, there has been a progressive increase in its incidence in industrialized countries and it is currently the sixth most frequent neoplasm, with more than half a million new cases per year, the third cause of death from cancer and the main cause of death in cirrhotic patients. The methodology used for this research work focuses on a methodology oriented towards the need to investigate a situation precisely and coherently. Framed within a bibliographic review of documentary type, since we are going to deal with issues raised at a theoretical level such as hepatocellular carcinoma. differential diagnosis. The technique for data collection is made up of printed, audiovisual and electronic materials, the latter such as Google Scholar, PubMed, among others. The information obtained here will be reviewed for further analysis. As has been observed, the diagnostic criteria are generally associated with "what can be seen", that is, through ultrasound, magnetic resonance imaging, ultrasound screening tests and even pathology. In this context, the differential diagnosis is associated with "what is not seen" and that can trigger hepatocellular carcinomas such as nodules with benign lesions: angiomas, hematomas, regeneration nodules and low-grade dysplasia and focal lesions in the liver, among others. which may include: hepatic adenoma, metastatic tumors, carcinoma of the intrahepatic bile ducts, focal nodular hyperplasia, indicating that there are more risk factors than are generally known, El carcinoma hepatocelular (CHC) es el tumor hepático primario más frecuente y se desarrolla en la mayoría de los casos en pacientes con una enfermedad hepática crónica subyacente, generalmente cirrosis. En los últimos años se ha constatado un aumento progresivo de su incidencia en países industrializados y actualmente constituye la sexta neoplasia más frecuente, con más de medio millón de nue - vos casos al año, la tercera causa de muerte por cáncer y la principal causa de muerte en pacientes cirróticos. La metodología utilizada para el presente trabajo de investigación, se enfoca hacia una metodología orientada hacia la necesidad de indagar en forma precisa y coherente una situación. Enmarcada dentro de una revisión bibliográfica de tipo documental, ya que nos vamos a ocupar de temas plan - teados a nivel teórico como es Carcinoma hepatocelular. Diagnostico diferencial. La técnica para la recolección de datos está constituida por materiales impresos, audiovisuales y electrónicos, estos últimos como Google Académico, PubMed, entre otros. La información aquí obtenida será revisada para su posterior análisis. Como se ha podido observar generalmente los criterios diagnósticos están asociados a “lo que se puede ver” es decir, mediante ecografías, resonancias magnéticas, pruebas de cribado mediante ultrasonido y hasta anato - mopatológicas. En este contexto el diagnóstico diferencial está asociado “a lo que no se ve” y que puede desencadenar en carcinomas hepatocelulares como nódulos con lesiones benignas: angiomas, hematomas, nódulos de regeneración y displasia de bajo grado y de lesiones focales en el hígado, entre las cuales pueden figurar: adenoma hepático, tumores metastásicos, carcinoma de las vías biliares intrahepáticas, hiperplasia nodular focal, lo que indica que hay más factores de riesgo de los que generalmente se conocen

The Colombian Orinoquía and the Altillanura subregion show comparative and competitive advantages for soybean production (edaphoclimatic conditions, cost-benefit ratio, potential area, and location), essential food with a high protein content (~37%) and used mostly for poultry and pig nutrition. However, this immense region has scarce varietal alternatives of high grain yield and quality that are adapted to its climatic and edaphic conditions. The current research is based on the selection of superior lines or potential varieties with high genetic merit using the restricted maximum likelihood/standardized best linear unbiased predictor (REML/BLUPe) procedure. Sixty advanced lines and four commercial varieties were tested in an 8x8 alpha lattice design. Grain yield (GY) oscillated between 1,117 and 4,431 kg ha-1, the population average yield was 2,682 kg ha-1, and BLUPe predictors ranged between 5.37 and -3.71. With a t-test at a significance of 5% (1.67) and a predictor comparator of (t1-t2)≥1.67 (√2), six outstanding lines were identified with superior BLUPe values compared to the mean (P<0.05) and GY>3,500 kg ha-1. In descending order (kg ha-1), the GY was: L-041 (4,431), L-019 (4,326), L-104 (3,923), L-149 (3,832), L-202 (3,536), and L-201 (3,519 kg ha-1). The BLUPe standardized predictor allowed an effective selection (92%) of lines., La Orinoquía colombiana y en particular, la subregión de la Altillanura presenta ventajas comparativas y competitivas para la producción de soya (condiciones edafoclimáticas, relación costo-beneficio, área potencial y ubicación), alimento esencial por su contenido proteico (~37%), especialmente para aves y cerdos. Sin embargo, las alternativas varietales adaptadas y de alto rendimiento de grano son escasas para esta vasta región. Por ello, la presente investigación fue orientada hacia la selección de líneas mejoradas o variedades potenciales con alto mérito genético mediante la aplicación del mejor predictor lineal insesgado estandarizado (REML/BLUPe). Se evaluaron 60 líneas avanzadas y cuatro variedades comerciales en un diseño Alfa látice 8x8. El rendimiento de grano (RG) osciló entre 1117 y 4431 kg ha-1, el promedio poblacional fue de 2682 kg ha-1 y los predictores BLUPe oscilaron entre 5.37 y -3.71. Con una significancia t del 5% (1.67) y un comparador de predictores (t1-t2)≥1.67 (√2), se identificaron 6 líneas sobresalientes con BLUPe superiores a la media (P<0.05) y RG>3500 kg ha-1. En orden descendente el RG fue: L-041 (4431), L-019 (4326), L-104 (3923), L-149 (3832), L-202 (3536) y L-201 (3519 kg ha-1). El predictor estandarizado BLUPe permitió una selección efectiva (92%) de líneas.

Comorbidities are associated with adverse patient outcomes. The authors conducted a systematic review according to a pre-determined protocol, established PRISMA guidelines and reporting standards to estimate the prevalence of common comorbidities in people with epilepsy, and to explore whether the burden is greater in more deprived populations. In total, 107 studies were included and reviewed. The results indicate that the most common comorbidities in people with epilepsy are anxiety (19.2%) and major depressive disorder (17.4%). Among adults with epilepsy, common comorbidities include hypertension (18.2%), stroke (14.5%), heart disease (11%), diabetes (10.2%) and arthritis (9.2%). There was no evidence that the income status of a country was a moderating factor for the prevalence of anxiety and depression in people with epilepsy. However, prevalence rates for hypertension and stroke were lower for lower-income countries where epilepsy is a more common symptom of brain infection or injury. The analyses were affected by the heterogeneity of the included studies and should therefore be interpreted cautiously.

Comorbidities are associated with adverse patient outcomes. The authors conducted a systematic review according to a pre-determined protocol, established PRISMA guidelines and reporting standards to estimate the prevalence of common comorbidities in people with epilepsy, and to explore whether the burden is greater in more deprived populations. In total, 107 studies were included and reviewed. The results indicate that the most common comorbidities in people with epilepsy are anxiety (19.2%) and major depressive disorder (17.4%). Among adults with epilepsy, common comorbidities include hypertension (18.2%), stroke (14.5%), heart disease (11%), diabetes (10.2%) and arthritis (9.2%). There was no evidence that the income status of a country was a moderating factor for the prevalence of anxiety and depression in people with epilepsy. However, prevalence rates for hypertension and stroke were lower for lower-income countries where epilepsy is a more common symptom of brain infection or injury. The analyses were affected by the heterogeneity of the included studies and should therefore be interpreted cautiously.

Hepatocellular carcinoma (HCC) is the most common primary liver tumor and develops in most cases in patients with underlying chronic liver disease, usually cirrhosis. In recent years, there has been a progressive increase in its incidence in industrialized countries and it is currently the sixth most frequent neoplasm, with more than half a million new cases per year, the third cause of death from cancer and the main cause of death in cirrhotic patients. The methodology used for this research work focuses on a methodology oriented towards the need to investigate a situation precisely and coherently. Framed within a bibliographic review of documentary type, since we are going to deal with issues raised at a theoretical level such as hepatocellular carcinoma. differential diagnosis. The technique for data collection is made up of printed, audiovisual and electronic materials, the latter such as Google Scholar, PubMed, among others. The information obtained here will be reviewed for further analysis. As has been observed, the diagnostic criteria are generally associated with "what can be seen", that is, through ultrasound, magnetic resonance imaging, ultrasound screening tests and even pathology. In this context, the differential diagnosis is associated with "what is not seen" and that can trigger hepatocellular carcinomas such as nodules with benign lesions: angiomas, hematomas, regeneration nodules and low-grade dysplasia and focal lesions in the liver, among others. which may include: hepatic adenoma, metastatic tumors, carcinoma of the intrahepatic bile ducts, focal nodular hyperplasia, indicating that there are more risk factors than are generally known, El carcinoma hepatocelular (CHC) es el tumor hepático primario más frecuente y se desarrolla en la mayoría de los casos en pacientes con una enfermedad hepática crónica subyacente, generalmente cirrosis. En los últimos años se ha constatado un aumento progresivo de su incidencia en países industrializados y actualmente constituye la sexta neoplasia más frecuente, con más de medio millón de nue - vos casos al año, la tercera causa de muerte por cáncer y la principal causa de muerte en pacientes cirróticos. La metodología utilizada para el presente trabajo de investigación, se enfoca hacia una metodología orientada hacia la necesidad de indagar en forma precisa y coherente una situación. Enmarcada dentro de una revisión bibliográfica de tipo documental, ya que nos vamos a ocupar de temas plan - teados a nivel teórico como es Carcinoma hepatocelular. Diagnostico diferencial. La técnica para la recolección de datos está constituida por materiales impresos, audiovisuales y electrónicos, estos últimos como Google Académico, PubMed, entre otros. La información aquí obtenida será revisada para su posterior análisis. Como se ha podido observar generalmente los criterios diagnósticos están asociados a “lo que se puede ver” es decir, mediante ecografías, resonancias magnéticas, pruebas de cribado mediante ultrasonido y hasta anato - mopatológicas. En este contexto el diagnóstico diferencial está asociado “a lo que no se ve” y que puede desencadenar en carcinomas hepatocelulares como nódulos con lesiones benignas: angiomas, hematomas, nódulos de regeneración y displasia de bajo grado y de lesiones focales en el hígado, entre las cuales pueden figurar: adenoma hepático, tumores metastásicos, carcinoma de las vías biliares intrahepáticas, hiperplasia nodular focal, lo que indica que hay más factores de riesgo de los que generalmente se conocen

Hepatocellular carcinoma (HCC) is the most common primary liver tumor and develops in most cases in patients with underlying chronic liver disease, usually cirrhosis. In recent years, there has been a progressive increase in its incidence in industrialized countries and it is currently the sixth most frequent neoplasm, with more than half a million new cases per year, the third cause of death from cancer and the main cause of death in cirrhotic patients. The methodology used for this research work focuses on a methodology oriented towards the need to investigate a situation precisely and coherently. Framed within a bibliographic review of documentary type, since we are going to deal with issues raised at a theoretical level such as hepatocellular carcinoma. differential diagnosis. The technique for data collection is made up of printed, audiovisual and electronic materials, the latter such as Google Scholar, PubMed, among others. The information obtained here will be reviewed for further analysis. As has been observed, the diagnostic criteria are generally associated with "what can be seen", that is, through ultrasound, magnetic resonance imaging, ultrasound screening tests and even pathology. In this context, the differential diagnosis is associated with "what is not seen" and that can trigger hepatocellular carcinomas such as nodules with benign lesions: angiomas, hematomas, regeneration nodules and low-grade dysplasia and focal lesions in the liver, among others. which may include: hepatic adenoma, metastatic tumors, carcinoma of the intrahepatic bile ducts, focal nodular hyperplasia, indicating that there are more risk factors than are generally known, El carcinoma hepatocelular (CHC) es el tumor hepático primario más frecuente y se desarrolla en la mayoría de los casos en pacientes con una enfermedad hepática crónica subyacente, generalmente cirrosis. En los últimos años se ha constatado un aumento progresivo de su incidencia en países industrializados y actualmente constituye la sexta neoplasia más frecuente, con más de medio millón de nue - vos casos al año, la tercera causa de muerte por cáncer y la principal causa de muerte en pacientes cirróticos. La metodología utilizada para el presente trabajo de investigación, se enfoca hacia una metodología orientada hacia la necesidad de indagar en forma precisa y coherente una situación. Enmarcada dentro de una revisión bibliográfica de tipo documental, ya que nos vamos a ocupar de temas plan - teados a nivel teórico como es Carcinoma hepatocelular. Diagnostico diferencial. La técnica para la recolección de datos está constituida por materiales impresos, audiovisuales y electrónicos, estos últimos como Google Académico, PubMed, entre otros. La información aquí obtenida será revisada para su posterior análisis. Como se ha podido observar generalmente los criterios diagnósticos están asociados a “lo que se puede ver” es decir, mediante ecografías, resonancias magnéticas, pruebas de cribado mediante ultrasonido y hasta anato - mopatológicas. En este contexto el diagnóstico diferencial está asociado “a lo que no se ve” y que puede desencadenar en carcinomas hepatocelulares como nódulos con lesiones benignas: angiomas, hematomas, nódulos de regeneración y displasia de bajo grado y de lesiones focales en el hígado, entre las cuales pueden figurar: adenoma hepático, tumores metastásicos, carcinoma de las vías biliares intrahepáticas, hiperplasia nodular focal, lo que indica que hay más factores de riesgo de los que generalmente se conocen

Hepatocellular carcinoma (HCC) is the most common primary liver tumor and develops in most cases in patients with underlying chronic liver disease, usually cirrhosis. In recent years, there has been a progressive increase in its incidence in industrialized countries and it is currently the sixth most frequent neoplasm, with more than half a million new cases per year, the third cause of death from cancer and the main cause of death in cirrhotic patients. The methodology used for this research work focuses on a methodology oriented towards the need to investigate a situation precisely and coherently. Framed within a bibliographic review of documentary type, since we are going to deal with issues raised at a theoretical level such as hepatocellular carcinoma. differential diagnosis. The technique for data collection is made up of printed, audiovisual and electronic materials, the latter such as Google Scholar, PubMed, among others. The information obtained here will be reviewed for further analysis. As has been observed, the diagnostic criteria are generally associated with "what can be seen", that is, through ultrasound, magnetic resonance imaging, ultrasound screening tests and even pathology. In this context, the differential diagnosis is associated with "what is not seen" and that can trigger hepatocellular carcinomas such as nodules with benign lesions: angiomas, hematomas, regeneration nodules and low-grade dysplasia and focal lesions in the liver, among others. which may include: hepatic adenoma, metastatic tumors, carcinoma of the intrahepatic bile ducts, focal nodular hyperplasia, indicating that there are more risk factors than are generally known, El carcinoma hepatocelular (CHC) es el tumor hepático primario más frecuente y se desarrolla en la mayoría de los casos en pacientes con una enfermedad hepática crónica subyacente, generalmente cirrosis. En los últimos años se ha constatado un aumento progresivo de su incidencia en países industrializados y actualmente constituye la sexta neoplasia más frecuente, con más de medio millón de nue - vos casos al año, la tercera causa de muerte por cáncer y la principal causa de muerte en pacientes cirróticos. La metodología utilizada para el presente trabajo de investigación, se enfoca hacia una metodología orientada hacia la necesidad de indagar en forma precisa y coherente una situación. Enmarcada dentro de una revisión bibliográfica de tipo documental, ya que nos vamos a ocupar de temas plan - teados a nivel teórico como es Carcinoma hepatocelular. Diagnostico diferencial. La técnica para la recolección de datos está constituida por materiales impresos, audiovisuales y electrónicos, estos últimos como Google Académico, PubMed, entre otros. La información aquí obtenida será revisada para su posterior análisis. Como se ha podido observar generalmente los criterios diagnósticos están asociados a “lo que se puede ver” es decir, mediante ecografías, resonancias magnéticas, pruebas de cribado mediante ultrasonido y hasta anato - mopatológicas. En este contexto el diagnóstico diferencial está asociado “a lo que no se ve” y que puede desencadenar en carcinomas hepatocelulares como nódulos con lesiones benignas: angiomas, hematomas, nódulos de regeneración y displasia de bajo grado y de lesiones focales en el hígado, entre las cuales pueden figurar: adenoma hepático, tumores metastásicos, carcinoma de las vías biliares intrahepáticas, hiperplasia nodular focal, lo que indica que hay más factores de riesgo de los que generalmente se conocen

Hepatocellular carcinoma (HCC) is the most common primary liver tumor and develops in most cases in patients with underlying chronic liver disease, usually cirrhosis. In recent years, there has been a progressive increase in its incidence in industrialized countries and it is currently the sixth most frequent neoplasm, with more than half a million new cases per year, the third cause of death from cancer and the main cause of death in cirrhotic patients. The methodology used for this research work focuses on a methodology oriented towards the need to investigate a situation precisely and coherently. Framed within a bibliographic review of documentary type, since we are going to deal with issues raised at a theoretical level such as hepatocellular carcinoma. differential diagnosis. The technique for data collection is made up of printed, audiovisual and electronic materials, the latter such as Google Scholar, PubMed, among others. The information obtained here will be reviewed for further analysis. As has been observed, the diagnostic criteria are generally associated with "what can be seen", that is, through ultrasound, magnetic resonance imaging, ultrasound screening tests and even pathology. In this context, the differential diagnosis is associated with "what is not seen" and that can trigger hepatocellular carcinomas such as nodules with benign lesions: angiomas, hematomas, regeneration nodules and low-grade dysplasia and focal lesions in the liver, among others. which may include: hepatic adenoma, metastatic tumors, carcinoma of the intrahepatic bile ducts, focal nodular hyperplasia, indicating that there are more risk factors than are generally known, El carcinoma hepatocelular (CHC) es el tumor hepático primario más frecuente y se desarrolla en la mayoría de los casos en pacientes con una enfermedad hepática crónica subyacente, generalmente cirrosis. En los últimos años se ha constatado un aumento progresivo de su incidencia en países industrializados y actualmente constituye la sexta neoplasia más frecuente, con más de medio millón de nue - vos casos al año, la tercera causa de muerte por cáncer y la principal causa de muerte en pacientes cirróticos. La metodología utilizada para el presente trabajo de investigación, se enfoca hacia una metodología orientada hacia la necesidad de indagar en forma precisa y coherente una situación. Enmarcada dentro de una revisión bibliográfica de tipo documental, ya que nos vamos a ocupar de temas plan - teados a nivel teórico como es Carcinoma hepatocelular. Diagnostico diferencial. La técnica para la recolección de datos está constituida por materiales impresos, audiovisuales y electrónicos, estos últimos como Google Académico, PubMed, entre otros. La información aquí obtenida será revisada para su posterior análisis. Como se ha podido observar generalmente los criterios diagnósticos están asociados a “lo que se puede ver” es decir, mediante ecografías, resonancias magnéticas, pruebas de cribado mediante ultrasonido y hasta anato - mopatológicas. En este contexto el diagnóstico diferencial está asociado “a lo que no se ve” y que puede desencadenar en carcinomas hepatocelulares como nódulos con lesiones benignas: angiomas, hematomas, nódulos de regeneración y displasia de bajo grado y de lesiones focales en el hígado, entre las cuales pueden figurar: adenoma hepático, tumores metastásicos, carcinoma de las vías biliares intrahepáticas, hiperplasia nodular focal, lo que indica que hay más factores de riesgo de los que generalmente se conocen

Inclusion Body Myopathy, Paget's Disease of Bone, with Frontotemporal Dementia is a progressive autosomal dominant disease that affects the ubiquitin-proteasome complex, that is caused by variants in the Valosin Containing Protein (VCP) gene. We report the first case of concurrent pathogenic variants in both MYBPC3 and VCP that led to earlier onset of congestive heart failure with features of dilated cardiomyopathy. Cardiomyopathy has previously been associated with VCP inclusion body myopathy mostly at an advanced stage of the disease. Due to acute onset of cardiomyopathy in a previous asymptomatic individual, a cardiomyopathy gene panel was obtained which revealed an additional c.177_187del variant of the MYBPC3 gene. We report a first case of concurrent pathogenic variants in both c.177_187del gene of MYBPC3 and p.R155C VCP that led to earlier onset and a more severe form of the cardiomyopathy.

Hepatocellular carcinoma (HCC) is the most common primary liver tumor and develops in most cases in patients with underlying chronic liver disease, usually cirrhosis. In recent years, there has been a progressive increase in its incidence in industrialized countries and it is currently the sixth most frequent neoplasm, with more than half a million new cases per year, the third cause of death from cancer and the main cause of death in cirrhotic patients. The methodology used for this research work focuses on a methodology oriented towards the need to investigate a situation precisely and coherently. Framed within a bibliographic review of documentary type, since we are going to deal with issues raised at a theoretical level such as hepatocellular carcinoma. differential diagnosis. The technique for data collection is made up of printed, audiovisual and electronic materials, the latter such as Google Scholar, PubMed, among others. The information obtained here will be reviewed for further analysis. As has been observed, the diagnostic criteria are generally associated with "what can be seen", that is, through ultrasound, magnetic resonance imaging, ultrasound screening tests and even pathology. In this context, the differential diagnosis is associated with "what is not seen" and that can trigger hepatocellular carcinomas such as nodules with benign lesions: angiomas, hematomas, regeneration nodules and low-grade dysplasia and focal lesions in the liver, among others. which may include: hepatic adenoma, metastatic tumors, carcinoma of the intrahepatic bile ducts, focal nodular hyperplasia, indicating that there are more risk factors than are generally known, El carcinoma hepatocelular (CHC) es el tumor hepático primario más frecuente y se desarrolla en la mayoría de los casos en pacientes con una enfermedad hepática crónica subyacente, generalmente cirrosis. En los últimos años se ha constatado un aumento progresivo de su incidencia en países industrializados y actualmente constituye la sexta neoplasia más frecuente, con más de medio millón de nue - vos casos al año, la tercera causa de muerte por cáncer y la principal causa de muerte en pacientes cirróticos. La metodología utilizada para el presente trabajo de investigación, se enfoca hacia una metodología orientada hacia la necesidad de indagar en forma precisa y coherente una situación. Enmarcada dentro de una revisión bibliográfica de tipo documental, ya que nos vamos a ocupar de temas plan - teados a nivel teórico como es Carcinoma hepatocelular. Diagnostico diferencial. La técnica para la recolección de datos está constituida por materiales impresos, audiovisuales y electrónicos, estos últimos como Google Académico, PubMed, entre otros. La información aquí obtenida será revisada para su posterior análisis. Como se ha podido observar generalmente los criterios diagnósticos están asociados a “lo que se puede ver” es decir, mediante ecografías, resonancias magnéticas, pruebas de cribado mediante ultrasonido y hasta anato - mopatológicas. En este contexto el diagnóstico diferencial está asociado “a lo que no se ve” y que puede desencadenar en carcinomas hepatocelulares como nódulos con lesiones benignas: angiomas, hematomas, nódulos de regeneración y displasia de bajo grado y de lesiones focales en el hígado, entre las cuales pueden figurar: adenoma hepático, tumores metastásicos, carcinoma de las vías biliares intrahepáticas, hiperplasia nodular focal, lo que indica que hay más factores de riesgo de los que generalmente se conocen

Hepatocellular carcinoma (HCC) is the most common primary liver tumor and develops in most cases in patients with underlying chronic liver disease, usually cirrhosis. In recent years, there has been a progressive increase in its incidence in industrialized countries and it is currently the sixth most frequent neoplasm, with more than half a million new cases per year, the third cause of death from cancer and the main cause of death in cirrhotic patients. The methodology used for this research work focuses on a methodology oriented towards the need to investigate a situation precisely and coherently. Framed within a bibliographic review of documentary type, since we are going to deal with issues raised at a theoretical level such as hepatocellular carcinoma. differential diagnosis. The technique for data collection is made up of printed, audiovisual and electronic materials, the latter such as Google Scholar, PubMed, among others. The information obtained here will be reviewed for further analysis. As has been observed, the diagnostic criteria are generally associated with "what can be seen", that is, through ultrasound, magnetic resonance imaging, ultrasound screening tests and even pathology. In this context, the differential diagnosis is associated with "what is not seen" and that can trigger hepatocellular carcinomas such as nodules with benign lesions: angiomas, hematomas, regeneration nodules and low-grade dysplasia and focal lesions in the liver, among others. which may include: hepatic adenoma, metastatic tumors, carcinoma of the intrahepatic bile ducts, focal nodular hyperplasia, indicating that there are more risk factors than are generally known, El carcinoma hepatocelular (CHC) es el tumor hepático primario más frecuente y se desarrolla en la mayoría de los casos en pacientes con una enfermedad hepática crónica subyacente, generalmente cirrosis. En los últimos años se ha constatado un aumento progresivo de su incidencia en países industrializados y actualmente constituye la sexta neoplasia más frecuente, con más de medio millón de nue - vos casos al año, la tercera causa de muerte por cáncer y la principal causa de muerte en pacientes cirróticos. La metodología utilizada para el presente trabajo de investigación, se enfoca hacia una metodología orientada hacia la necesidad de indagar en forma precisa y coherente una situación. Enmarcada dentro de una revisión bibliográfica de tipo documental, ya que nos vamos a ocupar de temas plan - teados a nivel teórico como es Carcinoma hepatocelular. Diagnostico diferencial. La técnica para la recolección de datos está constituida por materiales impresos, audiovisuales y electrónicos, estos últimos como Google Académico, PubMed, entre otros. La información aquí obtenida será revisada para su posterior análisis. Como se ha podido observar generalmente los criterios diagnósticos están asociados a “lo que se puede ver” es decir, mediante ecografías, resonancias magnéticas, pruebas de cribado mediante ultrasonido y hasta anato - mopatológicas. En este contexto el diagnóstico diferencial está asociado “a lo que no se ve” y que puede desencadenar en carcinomas hepatocelulares como nódulos con lesiones benignas: angiomas, hematomas, nódulos de regeneración y displasia de bajo grado y de lesiones focales en el hígado, entre las cuales pueden figurar: adenoma hepático, tumores metastásicos, carcinoma de las vías biliares intrahepáticas, hiperplasia nodular focal, lo que indica que hay más factores de riesgo de los que generalmente se conocen

Chronic pain has become a global health problem contributing to years lived with disability and reduced quality of life. Advances in the clinical management of chronic pain have been limited due to incomplete understanding of the multiple risk factors and molecular mechanisms that contribute to the development of chronic pain. The Acute to Chronic Pain Signatures (A2CPS) Program aims to characterize the predictive nature of biomarkers (brain imaging, high-throughput molecular screening techniques, or "omics," quantitative sensory testing, patient-reported outcome assessments and functional assessments) to identify individuals who will develop chronic pain following surgical intervention. The A2CPS is a multisite observational study investigating biomarkers and collective biosignatures (a combination of several individual biomarkers) that predict susceptibility or resilience to the development of chronic pain following knee arthroplasty and thoracic surgery. This manuscript provides an overview of data collection methods and procedures designed to standardize data collection across multiple clinical sites and institutions. Pain-related biomarkers are evaluated before surgery and up to 3 months after surgery for use as predictors of patient reported outcomes 6 months after surgery. The dataset from this prospective observational study will be available for researchers internal and external to the A2CPS Consortium to advance understanding of the transition from acute to chronic postsurgical pain.

BackgroundWith recent improvements in survival of cancer patients and common use of high-value care at end of life, the management of cardiovascular disease (CVD) in patients with cancer is increasingly important. To our knowledge, there are no current U.S. data examining how the presence and extent of cancer influence cardiologists' decision making for common cardiovascular conditions.MethodsAn anonymous online vignette-based survey of cardiologists was conducted at five U.S. institutions investigating how the extent of gastrointestinal and thoracic malignancies (prior/localized, metastatic) would influence treatment recommendations for atrial fibrillation (AF), aortic stenosis, unstable angina (UA), and obstructive coronary artery disease (CAD).ResultsThirty-three percent (86/259) of cardiologists completed the survey between September and November 2019. Participants were 67% male, 51% below age 40, and 58% had five or more years of clinical experience. Majority of cardiologists practiced at teaching hospitals (72%) and were noninterventional (63%). Cardiologists were more likely to recommend procedural interventions for patients with localized cancer than for those with metastatic disease: AF (left atrial appendage occlusion: 20% vs. 8%), atrial stenosis (aortic valve repair: 83% vs. 11%), UA (left heart catheter: 70% vs. 27%), and obstructive CAD (percutaneous coronary intervention: 81% vs. 38%). In patients with metastatic cancer, most cardiologists sought an oncology (82%) or a palliative care (69%) consultation. However, a persistent trend of undertreatment in patients with localized cancers and overtreatment in patients with end-of-life disease was apparent.ConclusionsCardiologists were less likely to recommend invasive cardiovascular therapies to patients with metastatic cancer. This preference pattern likely reflects the influence of comorbidities and quality of life expectation on cardiologists' treatment recommendations but may also be related to the sti

Hepatocellular carcinoma (HCC) is the most common primary liver tumor and develops in most cases in patients with underlying chronic liver disease, usually cirrhosis. In recent years, there has been a progressive increase in its incidence in industrialized countries and it is currently the sixth most frequent neoplasm, with more than half a million new cases per year, the third cause of death from cancer and the main cause of death in cirrhotic patients. The methodology used for this research work focuses on a methodology oriented towards the need to investigate a situation precisely and coherently. Framed within a bibliographic review of documentary type, since we are going to deal with issues raised at a theoretical level such as hepatocellular carcinoma. differential diagnosis. The technique for data collection is made up of printed, audiovisual and electronic materials, the latter such as Google Scholar, PubMed, among others. The information obtained here will be reviewed for further analysis. As has been observed, the diagnostic criteria are generally associated with "what can be seen", that is, through ultrasound, magnetic resonance imaging, ultrasound screening tests and even pathology. In this context, the differential diagnosis is associated with "what is not seen" and that can trigger hepatocellular carcinomas such as nodules with benign lesions: angiomas, hematomas, regeneration nodules and low-grade dysplasia and focal lesions in the liver, among others. which may include: hepatic adenoma, metastatic tumors, carcinoma of the intrahepatic bile ducts, focal nodular hyperplasia, indicating that there are more risk factors than are generally known, El carcinoma hepatocelular (CHC) es el tumor hepático primario más frecuente y se desarrolla en la mayoría de los casos en pacientes con una enfermedad hepática crónica subyacente, generalmente cirrosis. En los últimos años se ha constatado un aumento progresivo de su incidencia en países industrializados y actualmente constituye la sexta neoplasia más frecuente, con más de medio millón de nue - vos casos al año, la tercera causa de muerte por cáncer y la principal causa de muerte en pacientes cirróticos. La metodología utilizada para el presente trabajo de investigación, se enfoca hacia una metodología orientada hacia la necesidad de indagar en forma precisa y coherente una situación. Enmarcada dentro de una revisión bibliográfica de tipo documental, ya que nos vamos a ocupar de temas plan - teados a nivel teórico como es Carcinoma hepatocelular. Diagnostico diferencial. La técnica para la recolección de datos está constituida por materiales impresos, audiovisuales y electrónicos, estos últimos como Google Académico, PubMed, entre otros. La información aquí obtenida será revisada para su posterior análisis. Como se ha podido observar generalmente los criterios diagnósticos están asociados a “lo que se puede ver” es decir, mediante ecografías, resonancias magnéticas, pruebas de cribado mediante ultrasonido y hasta anato - mopatológicas. En este contexto el diagnóstico diferencial está asociado “a lo que no se ve” y que puede desencadenar en carcinomas hepatocelulares como nódulos con lesiones benignas: angiomas, hematomas, nódulos de regeneración y displasia de bajo grado y de lesiones focales en el hígado, entre las cuales pueden figurar: adenoma hepático, tumores metastásicos, carcinoma de las vías biliares intrahepáticas, hiperplasia nodular focal, lo que indica que hay más factores de riesgo de los que generalmente se conocen

Hepatocellular carcinoma (HCC) is the most common primary liver tumor and develops in most cases in patients with underlying chronic liver disease, usually cirrhosis. In recent years, there has been a progressive increase in its incidence in industrialized countries and it is currently the sixth most frequent neoplasm, with more than half a million new cases per year, the third cause of death from cancer and the main cause of death in cirrhotic patients. The methodology used for this research work focuses on a methodology oriented towards the need to investigate a situation precisely and coherently. Framed within a bibliographic review of documentary type, since we are going to deal with issues raised at a theoretical level such as hepatocellular carcinoma. differential diagnosis. The technique for data collection is made up of printed, audiovisual and electronic materials, the latter such as Google Scholar, PubMed, among others. The information obtained here will be reviewed for further analysis. As has been observed, the diagnostic criteria are generally associated with "what can be seen", that is, through ultrasound, magnetic resonance imaging, ultrasound screening tests and even pathology. In this context, the differential diagnosis is associated with "what is not seen" and that can trigger hepatocellular carcinomas such as nodules with benign lesions: angiomas, hematomas, regeneration nodules and low-grade dysplasia and focal lesions in the liver, among others. which may include: hepatic adenoma, metastatic tumors, carcinoma of the intrahepatic bile ducts, focal nodular hyperplasia, indicating that there are more risk factors than are generally known, El carcinoma hepatocelular (CHC) es el tumor hepático primario más frecuente y se desarrolla en la mayoría de los casos en pacientes con una enfermedad hepática crónica subyacente, generalmente cirrosis. En los últimos años se ha constatado un aumento progresivo de su incidencia en países industrializados y actualmente constituye la sexta neoplasia más frecuente, con más de medio millón de nue - vos casos al año, la tercera causa de muerte por cáncer y la principal causa de muerte en pacientes cirróticos. La metodología utilizada para el presente trabajo de investigación, se enfoca hacia una metodología orientada hacia la necesidad de indagar en forma precisa y coherente una situación. Enmarcada dentro de una revisión bibliográfica de tipo documental, ya que nos vamos a ocupar de temas plan - teados a nivel teórico como es Carcinoma hepatocelular. Diagnostico diferencial. La técnica para la recolección de datos está constituida por materiales impresos, audiovisuales y electrónicos, estos últimos como Google Académico, PubMed, entre otros. La información aquí obtenida será revisada para su posterior análisis. Como se ha podido observar generalmente los criterios diagnósticos están asociados a “lo que se puede ver” es decir, mediante ecografías, resonancias magnéticas, pruebas de cribado mediante ultrasonido y hasta anato - mopatológicas. En este contexto el diagnóstico diferencial está asociado “a lo que no se ve” y que puede desencadenar en carcinomas hepatocelulares como nódulos con lesiones benignas: angiomas, hematomas, nódulos de regeneración y displasia de bajo grado y de lesiones focales en el hígado, entre las cuales pueden figurar: adenoma hepático, tumores metastásicos, carcinoma de las vías biliares intrahepáticas, hiperplasia nodular focal, lo que indica que hay más factores de riesgo de los que generalmente se conocen

Hepatocellular carcinoma (HCC) is the most common primary liver tumor and develops in most cases in patients with underlying chronic liver disease, usually cirrhosis. In recent years, there has been a progressive increase in its incidence in industrialized countries and it is currently the sixth most frequent neoplasm, with more than half a million new cases per year, the third cause of death from cancer and the main cause of death in cirrhotic patients. The methodology used for this research work focuses on a methodology oriented towards the need to investigate a situation precisely and coherently. Framed within a bibliographic review of documentary type, since we are going to deal with issues raised at a theoretical level such as hepatocellular carcinoma. differential diagnosis. The technique for data collection is made up of printed, audiovisual and electronic materials, the latter such as Google Scholar, PubMed, among others. The information obtained here will be reviewed for further analysis. As has been observed, the diagnostic criteria are generally associated with "what can be seen", that is, through ultrasound, magnetic resonance imaging, ultrasound screening tests and even pathology. In this context, the differential diagnosis is associated with "what is not seen" and that can trigger hepatocellular carcinomas such as nodules with benign lesions: angiomas, hematomas, regeneration nodules and low-grade dysplasia and focal lesions in the liver, among others. which may include: hepatic adenoma, metastatic tumors, carcinoma of the intrahepatic bile ducts, focal nodular hyperplasia, indicating that there are more risk factors than are generally known, El carcinoma hepatocelular (CHC) es el tumor hepático primario más frecuente y se desarrolla en la mayoría de los casos en pacientes con una enfermedad hepática crónica subyacente, generalmente cirrosis. En los últimos años se ha constatado un aumento progresivo de su incidencia en países industrializados y actualmente constituye la sexta neoplasia más frecuente, con más de medio millón de nue - vos casos al año, la tercera causa de muerte por cáncer y la principal causa de muerte en pacientes cirróticos. La metodología utilizada para el presente trabajo de investigación, se enfoca hacia una metodología orientada hacia la necesidad de indagar en forma precisa y coherente una situación. Enmarcada dentro de una revisión bibliográfica de tipo documental, ya que nos vamos a ocupar de temas plan - teados a nivel teórico como es Carcinoma hepatocelular. Diagnostico diferencial. La técnica para la recolección de datos está constituida por materiales impresos, audiovisuales y electrónicos, estos últimos como Google Académico, PubMed, entre otros. La información aquí obtenida será revisada para su posterior análisis. Como se ha podido observar generalmente los criterios diagnósticos están asociados a “lo que se puede ver” es decir, mediante ecografías, resonancias magnéticas, pruebas de cribado mediante ultrasonido y hasta anato - mopatológicas. En este contexto el diagnóstico diferencial está asociado “a lo que no se ve” y que puede desencadenar en carcinomas hepatocelulares como nódulos con lesiones benignas: angiomas, hematomas, nódulos de regeneración y displasia de bajo grado y de lesiones focales en el hígado, entre las cuales pueden figurar: adenoma hepático, tumores metastásicos, carcinoma de las vías biliares intrahepáticas, hiperplasia nodular focal, lo que indica que hay más factores de riesgo de los que generalmente se conocen

Hepatocellular carcinoma (HCC) is the most common primary liver tumor and develops in most cases in patients with underlying chronic liver disease, usually cirrhosis. In recent years, there has been a progressive increase in its incidence in industrialized countries and it is currently the sixth most frequent neoplasm, with more than half a million new cases per year, the third cause of death from cancer and the main cause of death in cirrhotic patients. The methodology used for this research work focuses on a methodology oriented towards the need to investigate a situation precisely and coherently. Framed within a bibliographic review of documentary type, since we are going to deal with issues raised at a theoretical level such as hepatocellular carcinoma. differential diagnosis. The technique for data collection is made up of printed, audiovisual and electronic materials, the latter such as Google Scholar, PubMed, among others. The information obtained here will be reviewed for further analysis. As has been observed, the diagnostic criteria are generally associated with "what can be seen", that is, through ultrasound, magnetic resonance imaging, ultrasound screening tests and even pathology. In this context, the differential diagnosis is associated with "what is not seen" and that can trigger hepatocellular carcinomas such as nodules with benign lesions: angiomas, hematomas, regeneration nodules and low-grade dysplasia and focal lesions in the liver, among others. which may include: hepatic adenoma, metastatic tumors, carcinoma of the intrahepatic bile ducts, focal nodular hyperplasia, indicating that there are more risk factors than are generally known, El carcinoma hepatocelular (CHC) es el tumor hepático primario más frecuente y se desarrolla en la mayoría de los casos en pacientes con una enfermedad hepática crónica subyacente, generalmente cirrosis. En los últimos años se ha constatado un aumento progresivo de su incidencia en países industrializados y actualmente constituye la sexta neoplasia más frecuente, con más de medio millón de nue - vos casos al año, la tercera causa de muerte por cáncer y la principal causa de muerte en pacientes cirróticos. La metodología utilizada para el presente trabajo de investigación, se enfoca hacia una metodología orientada hacia la necesidad de indagar en forma precisa y coherente una situación. Enmarcada dentro de una revisión bibliográfica de tipo documental, ya que nos vamos a ocupar de temas plan - teados a nivel teórico como es Carcinoma hepatocelular. Diagnostico diferencial. La técnica para la recolección de datos está constituida por materiales impresos, audiovisuales y electrónicos, estos últimos como Google Académico, PubMed, entre otros. La información aquí obtenida será revisada para su posterior análisis. Como se ha podido observar generalmente los criterios diagnósticos están asociados a “lo que se puede ver” es decir, mediante ecografías, resonancias magnéticas, pruebas de cribado mediante ultrasonido y hasta anato - mopatológicas. En este contexto el diagnóstico diferencial está asociado “a lo que no se ve” y que puede desencadenar en carcinomas hepatocelulares como nódulos con lesiones benignas: angiomas, hematomas, nódulos de regeneración y displasia de bajo grado y de lesiones focales en el hígado, entre las cuales pueden figurar: adenoma hepático, tumores metastásicos, carcinoma de las vías biliares intrahepáticas, hiperplasia nodular focal, lo que indica que hay más factores de riesgo de los que generalmente se conocen