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Harmaline (1) and harmalol (2) represent two 3,4-dihydro-β-carboline (DHβCs) most frequently reported in a vast number of living systems. Fundamental aspects including the photosensitizing properties, cellular uptake, as well as the cyto- and phototoxicity of 1 and 2 were investigated herein. The molecular basis underlying the investigated processes are elucidated. Data reveal that both alkaloids show a distinctive pattern of extracellular DNA photodamage. Compound 1 induces a DNA photodamage profile dominated by oxidised purines and sites of base loss (AP sites), whereas 2 mostly induces single-strand breaks (SSBs) in addition to a small extent of purine oxidative damage. In both cases, DNA oxidative damage would occur through type I mechanism. In addition, a concerted hydrolytic attack is suggested as an extra mechanism accounting for the SSBs formation photoinduced by 2. Subcellular internalisation, cyto- and phototoxicity of 1 and 2 and the corresponding full-aromatic derivatives harmine (3) and harmol (4) also showed quite distinctive patterns in a structure-dependent manner. These results are discussed in the framework of the potential biological, biomedical and/or pharmacological roles reported for these alkaloids. Graphical abstract The subtle structural difference (i.e., the exchange of a methoxy group for a hydroxyl substituent at C(7)) between harmaline and harmalol, gives rise to distinctive photosensitizing and subcellular localisation patterns.

Purpose This study aims to review processes of accreditation for Chilean Universities. Along with cataloguing evolutionary milestones, the study analyses effects at the institutional and program levels. Design/methodology/approach The study adopts a meta-evaluative approach and is based on secondary information sources, including both specialised publications and national databases, regarding the expansion of institutions, programs and enrolment, as well as the results of accreditation processes. Findings University quality assurance reflects developments in economic policies, and supply and demand. Progressive consolidation of the national system has had positive effects on the management and development of universities, but the implementation of quality assurance has brought some problems. A traditional classification of universities into customary categories is predictive of the results of accreditation. The variable of administrative compliance is more important than a culture of quality in explaining the results of institutional and program accreditation. Originality/value This review identifies advances, limitations and challenges in the improvement and assurance of quality of Chilean Universities and their programs. This is an unprecedented metanalysis of studies concerning the evolution of accreditation processes and will inform future practice.

OBJECTIVE: To explore the pattern of fetal cortical development in pregnancies complicated by pre-eclampsia (PE), with and without a small-for-gestational-age (SGA) fetus, compared to uncomplicated pregnancies. METHODS: This was a prospective observational study including singleton pregnancies complicated by normotensive SGA (birth weight < 10(th) centile) (n = 77), PE with an appropriate-for-gestational-age (AGA) fetus (n = 76) or PE with a SGA fetus (n = 67), and 128 uncomplicated pregnancies (normotensive AGA) matched by gestational age at ultrasound. All pregnancies underwent detailed neurosonography, using a transabdominal and transvaginal approach, at 31-35 weeks' gestation to assess the depth of the insula, Sylvian fissure, parieto-occipital sulcus, cingulate sulcus and calcarine sulcus. All measurements were adjusted for biparietal diameter (BPD). In addition, a grading score of cortical development was assigned to each brain structure, ranging from Grade 0 (no development) to Grade 5 (maximum development). Univariate and multiple regression analyses were conducted. RESULTS: Similar to findings in previous studies, normotensive pregnancies with a SGA fetus showed significant differences in cortical development compared with controls, with reduced Sylvian fissure depth adjusted for BPD (14.5 ± 2.4 vs 16.6 ± 2.3; P < 0.001) and increased insula depth adjusted for BPD (33.2 ± 2.0 vs 31.8 ± 2.0; P < 0.001). Interestingly, a similar cortical development pattern was observed in PE pregnancies with a SGA fetus and in PE pregnancies with an AGA fetus, manifested by reduced Sylvian fissure depth adjusted for BPD (14.2 ± 2.3 and 14.3 ± 2.3 vs 16.6 ± 2.3; P < 0.001 for both) and greater insula depth adjusted for BPD (33.2 ± 2.1 and 32.8 ± 1.7 vs 31.8 ± 2.0; P < 0.001 for both) compared with controls. No significant differences were observed in parieto-occipital, cingulate sulcus or calcarine sulcus depth across the study groups. The Sylvian fissure was scored as Grade 4 in significantly more (93.2% vs 59.5%) and as Grade 5 in significantly fewer (2.7% vs 37.3%) PE pregnancies with an AGA fetus compared with controls (P < 0.05 for both). These differences remained significant even after statistical adjustment for potential confounders, including ethnicity, low socioeconomic status, nulliparity, chronic hypertension, pregestational diabetes, assisted reproductive technologies, smoking and fetal gender, with the application of Benjamini-Hochberg procedure for multiple comparisons. CONCLUSIONS: PE with or without SGA is associated with a differential fetal cortical development pattern which is similar to that described previously in small fetuses. Future research is warranted to elucidate better the mechanism(s) underlying these changes. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

Nous présentons le cas clinique d’une femme de 42 ans pour laquelle une mort fœtale in utero (MFIU) a été découverte 11 semaines après le décès du fœtus. Au moment du constat du décès, la patiente s’engageait dans un protocole d’interruption médicale de grossesse (IMG) suite à la découverte d’une cardiopathie congénitale liée à une trisomie 21. L’ambivalence quant aux choix de procéder à une IMG s’est traduite par une grande discontinuité dans la prise en charge avec des conséquences potentiellement grave pour la santé physique de la mère. Pour mieux comprendre les enjeux psychopathologiques de cette patiente nous avons utilisé une méthode qualitative sur la base d’entretiens semi-dirigés auprès de professionnels. La patiente présentait de nombreux antécédents obstétricaux qui sont apparus déterminants pour comprendre certaines réactions d’angoisses qui se traduisaient finalement par une rupture de lien. Ce cas clinique illustre les spécificités du deuil périnatal dont les manifestations psychotraumatiques peuvent se réactiver lors de futures grossesses. Cette situation exceptionnelle illustre le rôle, mais aussi les limites, d’une équipe de périnatalité qui vise à mobiliser les capacités de liaison psychique et de contenance de la patiente mais aussi de l’équipe de soin.

Sixteen selected small-scale dairy farms were investigated in Kiambu County (Kenya) during the short rains seasonto develop a snapshot of the types of rations fed, milk yields obtained and sources of fodder. On average farmers had1 ha of land and 2.2 lactating cows yielding 8.93 kg milk/cow/d with feed intake of 10.5 kg DM/d. Only 35% of feedconsumed was produced on farm. Boma Rhodes grass hay and green Napier grass were the main forage components(37.9 and 28.3% of total DM). Protein forages used were the herbaceous legumes lucerne and desmodium (19.9 and15.9% CP, respectively) and leguminous shrubs (Leucaena, Calliandra and Sesbania with 21.1% CP and 43.4%aNDFom, on average). Grasses had higher aNDFom digestibility (47.1%) than legumes (39.7%). Napier grass, BomaRhodes grass, lucerne and desmodium had fiber digestibility of 51.9, 48.6, 46.8 and 32.6%, respectively. The energyand protein balances (actual vs. requirements) of the cows were on average -19.3 and -16.4%, respectively, indicatingthat cows utilized body tissues to produce the levels of milk obtained. Mutiple correspondence analysis showed that amilk yield higher than 9.1 kg/d was associated with a level of Boma Rhodes grass 22.0% (DM basis), concentrate level >2.63 kg/cow/d and CP% in the ration >9.1%. To improve milk yields during this season farmers should harvest grass forage at a younger age, include leguminous forage in the diets and increase the level of concentrates fed. These strategies should be demonstrated on farms to show possible benefits.

High-throughput synthesis and characterization methods were used to investigate ZnGeP2 thin films.

Si bien el arbitraje es un mecanismo de solución de controversias que reposa en el consentimiento, hay quienes afirman que, en ciertas circunstancias, laincorporación de una parte no signataria se explica por consideraciones de buena fe o equidad, y no propiamente por el consentimiento. Este artículo busca dilucidar si dichas teorías “no consensuales” realmente merecen una categoría independiente a la luz del derecho peruano.

The optoelectronic properties of the world's oldest photovoltaic material, selenium, are revisited using modern characterization techniques in state-of-the-art selenium solar cells with record open-circuit voltages.

Aims Being born small for gestational age (SGA, 10% of all births) is associated with increased risk of cardiovascular mortality in adulthood together with lower exercise tolerance, but mechanistic pathways are unclear. Central obesity is known to worsen cardiovascular outcomes, but it is uncertain how it affects the heart in adults born SGA. We aimed to assess whether central obesity makes young adults born SGA more susceptible to cardiac remodelling and dysfunction. Methods and results A perinatal cohort from a tertiary university hospital in Spain of young adults (30–40 years) randomly selected, 80 born SGA (birth weight below 10th centile) and 75 with normal birth weight (controls) was recruited. We studied the associations between SGA and central obesity (measured via the hip-to-waist ratio and used as a continuous variable) and cardiac regional structure and function, assessed by cardiac magnetic resonance using statistical shape analysis. Both SGA and waist-to-hip were highly associated to cardiac shape (F = 3.94, P < 0.001; F = 5.18, P < 0.001 respectively) with a statistically significant interaction (F = 2.29, P = 0.02). While controls tend to increase left ventricular end-diastolic volumes, mass and stroke volume with increasing waist-to-hip ratio, young adults born SGA showed a unique response with inability to increase cardiac dimensions or mass resulting in reduced stroke volume and exercise capacity. Conclusion SGA young adults show a unique cardiac adaptation to central obesity. These results support considering SGA as a risk factor that may benefit from preventive strategies to reduce cardiometabolic risk.

Desde la ecología política, en este artículo se analizará la magnitud y el significado de las transformaciones ocurridas en el valle del Chira y a nivel nacional, para la promoción y siembra de los cultivos energéticos como la caña de azúcar. Para ello se describirán los cambios alternos ocurridos en términos ecológicos, político-económicos y sociales que se articulan en una lógica neoliberal. Se sostiene que estos procesos de cambio son producto de un régimen de gubernamentalidad transnacional (transnational governmentality), es decir, «formas de gobierno emergentes que acompañan la extracción de recursos en diferentes partes del mundo» (Sawyer y Gómez, 2012: 7),4 que adquieren una especificidad en el caso que aquí se analizará.

IntroductionDespite a growing body of research on the risks of SARS-CoV-2 infection during pregnancy, there is continued controversy given heterogeneity in the quality and design of published studies.MethodsWe screened ongoing studies in our sequential, prospective meta-analysis. We pooled individual participant data to estimate the absolute and relative risk (RR) of adverse outcomes among pregnant women with SARS-CoV-2 infection, compared with confirmed negative pregnancies. We evaluated the risk of bias using a modified Newcastle-Ottawa Scale.ResultsWe screened 137 studies and included 12 studies in 12 countries involving 13 136 pregnant women.Pregnant women with SARS-CoV-2 infection-as compared with uninfected pregnant women-were at significantly increased risk of maternal mortality (10 studies; n=1490; RR 7.68, 95% CI 1.70 to 34.61); admission to intensive care unit (8 studies; n=6660; RR 3.81, 95% CI 2.03 to 7.17); receiving mechanical ventilation (7 studies; n=4887; RR 15.23, 95% CI 4.32 to 53.71); receiving any critical care (7 studies; n=4735; RR 5.48, 95% CI 2.57 to 11.72); and being diagnosed with pneumonia (6 studies; n=4573; RR 23.46, 95% CI 3.03 to 181.39) and thromboembolic disease (8 studies; n=5146; RR 5.50, 95% CI 1.12 to 27.12).Neonates born to women with SARS-CoV-2 infection were more likely to be admitted to a neonatal care unit after birth (7 studies; n=7637; RR 1.86, 95% CI 1.12 to 3.08); be born preterm (7 studies; n=6233; RR 1.71, 95% CI 1.28 to 2.29) or moderately preterm (7 studies; n=6071; RR 2.92, 95% CI 1.88 to 4.54); and to be born low birth weight (12 studies; n=11 930; RR 1.19, 95% CI 1.02 to 1.40). Infection was not linked to stillbirth. Studies were generally at low or moderate risk of bias.ConclusionsThis analysis indicates that SARS-CoV-2 infection at any time during pregnancy increases the risk of maternal death, severe maternal morbidities and neonatal morbidity, but not stillbirth or intrauterine growth restriction. As more data become available, we will update these findings per the published protocol.

Selenium is experiencing renewed interest as a promising candidate for the wide bandgap photoabsorber in tandem solar cells. However, despite the potential of selenium-based tandems to surpass the theoretical efficiency limit of single junction devices, such a device has never been demonstrated. In this study, we present the first monolithically integrated selenium/silicon tandem solar cell. Guided by device simulations, we investigate various carrier-selective contact materials and achieve encouraging results, including an open-circuit voltage of V$_\text{oc}$=1.68 V from suns-V$_\text{oc}$ measurements. The high open-circuit voltage positions selenium/silicon tandem solar cells as serious contenders to the industrially dominant single junction technologies. Furthermore, we quantify a pseudo fill factor of more than 80% using injection-level-dependent open-circuit voltage measurements, indicating that a significant fraction of the photovoltaic losses can be attributed to parasitic series resistance. This work provides valuable insights into the key challenges that need to be addressed for realizing higher efficiency selenium/silicon tandem solar cells.

Accurate segmentation of fetal brain magnetic resonance images is crucial for analyzing fetal brain development and detecting potential neurodevelopmental abnormalities. Traditional deep learning-based automatic segmentation, although effective, requires extensive training data with ground-truth labels, typically produced by clinicians through a time-consuming annotation process. To overcome this challenge, we propose a novel unsupervised segmentation method based on multi-atlas segmentation, that accurately segments multiple tissues without relying on labeled data for training. Our method employs a cascaded deep learning network for 3D image registration, which computes small, incremental deformations to the moving image to align it precisely with the fixed image. This cascaded network can then be used to register multiple annotated images with the image to be segmented, and combine the propagated labels to form a refined segmentation. Our experiments demonstrate that the proposed cascaded architecture outperforms the state-of-the-art registration methods that were tested. Furthermore, the derived segmentation method achieves similar performance and inference time to nnU-Net while only using a small subset of annotated data for the multi-atlas segmentation task and none for training the network. Our pipeline for registration and multi-atlas segmentation is publicly available at https://github.com/ValBcn/CasReg., Comment: 17 pages, 8 figures, 5 tables, paper submitted to IEEE transaction on medical imaging

OBJECTIVES/GOALS: To understand the implications of minimal HIV generic drug availability on long-term HIV disease management, including anti-competitive agreements and patent strategies that hinder (ART) competition and ART medication safety and efficacy improvement. METHODS/STUDY POPULATION: Individuals living with Human Immunodeficiency Virus (HIV) require sustained ART treatment. Despite excessive ART costs, the treatments use active ingredients known to be toxic, causing bone and renal impairments. A review of pharmaceutical legal cases examined the role of strategic patenting–product hopping–and anti-competitive agreements, which prevent generic competition and contribute to minimal ART improvement. A literature review explored the long-term safety effects of ART medications on HIV patients and disease management. A cost analysis of HIV disease management assessed the implications of using treatments with known toxins and their contribution to comorbidities and their effect on the cost of overall HIV disease management. RESULTS/ANTICIPATED RESULTS: Ongoing lawsuits of major ART medication manufacturers demonstrate the intentional agreements made to hinder generic competition, which is an inherently anti-competitive strategy. Thus, prices for ART medications remained high, causing treatment costs to be a significant barrier to treatment access. Further, the entry of a new ART, Tenofovir Alafenamide Fumarate (TAF), was delayed despite knowing the key active ingredient in Tenofovir Disoproxil Fumarate (TDF) was toxic to patients long-term. As a result, patients were more likely to experience comorbidities, significantly increasing the cost of HIV care. The average cost of HIV care without comorbidities is $30,312. However, HIV care is $46,000 for two comorbidities and about $219,000 for people with 11 or more. DISCUSSION/SIGNIFICANCE: Abuse of patent rights prevents more effective HIV medication and generic option development. Thus, HIV disease management is inhibited. The only method of HIV disease management is patient adherence to ARTs. Patients taking less effective medications increase the development of comorbidities from toxic treatments, magnifying the cost of HIV care.

This study aims to determine the rates of clinically-significant anxiety and depressive symptoms during the immediate postpartum in a sample of women referred to a university maternity department, as well as the associated risk factors and the relations with the level of maternal bonding.During the third national lockdown for the COVID-19 pandemic (February-April 2021), on days 2-3 after delivery 127 mothers were administrated the Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory (STAI-YA), the Mother-to-Infant Bonding Scale (MIBS) and questions issued from the CoRonavIruS Health Impact Survey Questionnaire (CRISIS).The rate of perinatal clinically-significant symptoms were 17% for depression (EPDS cut-off ≥ 12) and 15% for anxiety (STAI-YA cut-off ≥ 40). In the multivariate analysis, being a single mother, risk of being infected by the SARS-CoV2, risk that a close relative might be infected by the SARS-CoV2 and the length of stay in maternity were associated with an increased EPDS total score, while breastfeeding was associated with a lower EPDS total score. Six variables remained positively associated with the STAI-YA total score in the multivariate model: the maternal level of academic achievement, a hospitalization during the pregnancy, peripartum medical complications, risk of being infected by the SARS-CoV2, risk of a close relative being infected by the SARS-CoV2, and physical fatigue. Low but statistically significant correlations were found between the MIBS total score and the EPDS total score (The observed rates of anxiety and depressive symptoms were in the same range as those reported in observational studies conducted in high-resource countries during the COVID-19 pandemic. Risk of being infected by the SARS-CoV2 was both an independent risk factor for anxiety and depressive symptoms. The relations between the measure of maternal bonding and the severity of maternal emotional symptoms call for a better consideration of the long-term consequences of the pandemic on children's socio-emotional development.Cette étude a pour objectif de déterminer la fréquence des symptômes dépressif et anxieux maternels lors de la période du post-partum immédiat dans un groupe de femmes venant d’accoucher sur un service universitaire, ainsi que les facteurs de risques associés et les conséquences sur les interactions mère-enfant.Au tout début de la pandémie de COVID-19 (entre les mois de Février et Avril 2021), 127 femmes venant d’accoucher ont complété dans les 2 à 3 jours qui suivent l’accouchement l’Edinburgh Postnatal Depression Scale (EPDS), le State-Trait Anxiety Inventory (STAI-YA), le Mother-to-Infant Bonding Scale (MIBS) et le CoRonavIruS Health Impact Survey Questionnaire (CRISIS).La fréquence des symptômes dépressif cliniquement significatifs était de 17% et de 15% pour les symptômes anxieux. Le risque d’infection par le SARS-CoV2 était associés à la sévérité de ces symptômes dans les analyses multivariés. Des corrélations statistiquement significatives ont été mis en évidence entre le score MIBS et le score EPDS (rs=0.26) et avec le score STAI-YA (rs=0.26).La fréquence des symptômes anxieux et dépressifs du péripartum étaient comparable avec d’autres études conduites dans les pays à haut niveau de ressource au cours de la pandémie de COVID-19. Le risque d’infection par le SARS-CoV2 est associés à des niveaux plus élevés de symptômes anxieux et dépressifs, à côté des autres facteurs connus de symptômes émotionnels. Les liens retrouvés entre ces symptômes et le niveau d’interaction mère-enfant invitent à être attentif aux conséquences à long-terme de la pandémie sur le développement socio-émotionnel du nourrisson.Des études complémentaires sont nécessaires pour confirmer ces résultats et déterminer les conséquences potentiellement délétères sur le développement des interactions mère-enfant et du nourrisson.

Maternal sensitivity (MS), the ability to perceive and synchronously respond to the social signals (SSs), is affected by prematurity. The development of early supportive psychotherapy to foster MS, before discharge of the infant from the neonatal intensive care unit (NICU) is a major challenge in the prevention of subsequent developmental and mental disorders in the child. There are currently no reliable methods for evaluating MS to social interactions with very to moderate preterm infants. We investigated the reliability of a newly developed procedure for assessing MS in interactions between the mother and her 34- to 36-week postmenstrual age (PMA) preterm infant: the Preterm Infant Coding System for Maternal Sensitivity (PRICOSMAS).MethodThis study encompassed three steps: testing of the capacity to videorecord SSs in very to moderate preterm infants, selection, by an expert committee, of the recordable and relevant SSs, and investigation of the internal consistency and interrater reliability. The synchronicity between infant and mother's SSs was determined on a 1 s period basis, using ELAN software. Preterm infants born after 25-weeks gestational age (GA) were included while being between 34- and 36-weeks PMA. A perinatal risk inventory score > 10 for the infant precluded from inclusion. Interrater reliabilities were assessed independently by two raters blind to the clinical situation of the mother and infant.ResultsThe resulting PRICOSMAS encompassed two four-item SS sections, one covering the preterm infant's SSs and the other, the mother's SSs. Reliability was assessed on a sample of 26 videorecorded observations for 13 mother-preterm infant dyads. Infants' mean age at birth was 30.4 ± 3.1-weeks GA (range: 26.4–35) and PMA at the time of the test was 34.7-weeks (±0.8). Internal consistency ranged from 0.81 to 0.89. Interrater reliability ranged from substantial to almost perfect (0.73–0.88).ConclusionThis study shows that the infants' SSs and MS can be reliably scored in preterm infants as young as 34- to 36-weeks PMA. Our findings suggest that the PRICOSMAS is sufficiently reliable for use, including in NICU, by healthcare professionals or researchers for coding early parent-infant interactions with 34- to 36-week PMA preterm infants.

El presente libro es el resultado de investigación de distintos proyectos en América Latina que se enlazan desde el Programa-Red Estudios del Rururbano en América Latina (ELER). Por este motivo, es necesario, antes de continuar con los antecedentes que llevan al ELER a pensar en una segunda publicación luego de su fundación en 2019, explicar qué entendemos por rururbano. Lo rururbano es una configuración territorial que puede ubicarse básicamente en tres órdenes: en los márgenes del campo y de la ciudad, en lo rural excentrado con modos de vida urbanos-urbanizados en el campo o, también, en los modos de vida rurales de la ciudad.

Background Being born small-for-gestational age (SGA, 10 percent of all births) is associated with increased risk of cardiovascular mortality (1,2) in adulthood together with lower exercise tolerance (3), but mechanistic pathways are unclear. Central obesity is known to worsen cardiovascular outcomes, but it is uncertain how it affects the heart in adults born SGA. Purpose We aimed to assess whether central obesity makes young adults born SGA more susceptible to cardiac remodelling and dysfunction. Methods A perinatal cohort study including 80 young adults born SGA (birth weight below 10th centile) and 75 adults with normal birth weight (controls). Current waist-to-hip ratio was used as a surrogate of central obesity. Cardiac structure and function were assessed by cardiac magnetic resonance. Statistical shape analysis was used to study the regional geometric variability of the biventricular surfaces produced by central obesity and SGA, and synthetic surfaces representative of obese and non obese were generated for both SGA and controls. Results Figure 1 shows the superimposed representative surfaces of obese and non-obese according to our model, for controls (right column) and SGA (left column). Both SGA and waist-to-hip were highly associated to cardiac shape (F=3.94 p Conclusions SGA young adults show unique cardiac adaptation to central obesity, which is associated with a decrease in stroke volume. Preventive strategies aiming to reduce cardiometabolic risk in SGA population may be warranted. Funding Acknowledgement Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Union Horizon 2020 Programme

Phosphides are interesting candidates for hole transport materials and p type transparent conducting applications, capable of achieving greater valence band dispersion than their oxide counterparts due to the higher lying energy and increased size of the P 3p orbital. After computational identification of the indirect gap semiconductor CaCuP as a promising candidate, we now report reactive sputter deposition of phase pure p type CaCuP thin films. Their intrinsic hole concentration and hole mobility exceed 1 1020 cm amp; 8722;3 and 35 cm2 V amp; 8722;1 s amp; 8722;1 at room temperature, respectively. Transport calculations indicate potential for even higher mobilities. Copper vacancies are identified as the main source of conductivity, displaying markedly different behaviour compared to typical p type transparent conductors, leading to improved electronic properties. The optical transparency of CaCuP films is lower than expected from first principles calculations of phonon mediated indirect transitions. This discrepancy could be partly attributed to crystalline imperfections within the films, increasing the strength of indirect transitions. We determine the transparent conductor figure of merit of CaCuP films as a function of composition, revealing links between stoichiometry, crystalline quality, and opto electronic properties. These findings provide a promising initial assessment of the viability of CaCuP as a p type transparent contact

OBJECTIVE To evaluate left myocardial performance index (MPI) and its time intervals in monochorionic diamniotic (MCDA) twin pairs complicated by selective fetal growth restriction (sFGR) with abnormal (persistent -type II- or intermittent -type III- absent or reversed end-diastolic flow) umbilical artery Doppler. METHODS Retrospective study including 16 MCDA twin pairs with sFGR type II, 26 MCDA twin pairs with sFGR type III and 42 gestational age-matched uncomplicated MCDA twin pairs in a single tertiary center. Left isovolumetric contraction time (ICT), ejection time (ET), and isovolumetric relaxation time (IRT) were measured and MPI calculated by conventional Doppler at diagnosis of sFGR. RESULTS In sFGR type II, the smaller twin had shorter ET and prolonged IRT and MPI, while the larger twin showed prolonged ICT and MPI as compared to uncomplicated MCDA twins. In sFGR type III, the smaller twin had shorter ICT and ET, while the larger twin showed prolonged ICT, IRT, and MPI in comparison to controls. CONCLUSION A differential pattern of MPI time intervals could be observed in MCDA twins with sFGR type II and III. All twins had echocardiographic signs of pressure/volume overload, except the smaller twin type III with shorter systolic times probably reflecting reduced volume load.

Con más frecuencia permitimos que las máquinas elijan por nosotros, a través de innumerables algoritmos dejamos que las máquinas conozcan nuestros gustos y deseos y los proyecten ante nosotros para que, en medio de un aura de espejismo de control, elijamos lo que ya está predeterminado, pero, ¿en el fondo estos algoritmos nos conocen? ¿pueden reconocer en qué consiste nuestra humanidad? Este artículo en particular tiene el propósito de explorar la razón del por qué dejamos que las máquinas puedan tomar el control de nosotros, hasta llegar al punto que ellas puedan elegir nuestra existencia y la manera de vivir, como se plantea en la película “I am mother”.

To explore the associations between the consumption of three categories of ultra-processed food (sugary beverages, sweet, and salty snacks) and body mass index (BMI) among Chilean university studen...

Editorial

Editorial

Este artículo presenta, por un lado, el proceso histórico de construcción social del riesgo en una “Zona de Sacrificio”, discutiendo acerca de distintas vulnerabilidades que afectan al territorio, sus habitantes y trabajadores; y, por otro lado, centra su discusión en el proceso de reconocimiento y alteración de la percepción social del riesgo de trabajadores afectados y organizados en torno al asbesto. Para esto último, el trabajo sitúa la trayectoria de la agrupación Trabajadores Unidos Contra el Asbesto (TUCA), organización que reúne a gran parte de los trabajadores que se vieron afectados y expuestos a una contaminación por inhalación de asbesto en un trabajo de remoción de éste desde una central termoeléctrica. La investigación se fundamenta en un proceso de inmersión etnográfica, que contempló la partición en eventos y entrevistas etnográficas para dar cuenta del proceso de reconocimiento en torno al “asbesto” como una amenaza para la salud por parte de los trabajadores afectados. Asimismo, se revisaron antecedentes generales, historiográficos, estadísticos, de literatura especializada y de material de prensa, para presentar tanto antecedentes de este proceso de reconocimiento del riesgo como para describir la construcción social del riesgo de una “Zona de Sacrificio”. This article presents, on the one hand, the historical process of social construction of risk in a "Sacrifice Zone", discussing about various vulnerabilities that affect the territory, its inhabitants and workers; and, on the other hand, focuses its discussion on process of recognition and alteration of the social perception of the risk of affected and organized workers around asbestos. For this last, the work locates the trajectory of the group United Workers Against Asbestos (TUCA), organization that brings together a large part of the workers who were affected and exposed to contamination by inhalation of asbestos as they were removing it from a thermoelectric plant. The research is based on an ethnographic immersion process, which included ethnographic interviews to account the recognition process around “asbestos” as a threat to health by the affected workers. Likewise, general, historiographic, statistical, specialized literature and press materials, were reviewed to present both antecedents of this risk recognition process as well as to describe the social construction of the risk of a “Sacrifice Zone”. Cet article présente, d'une part, le processus historique de la construction sociale du risque dans une « Zone de sacrifice », en discutant les différentes vulnérabilités qui affectent le territoire, ses habitants et ses travailleurs ; et, d'autre part, la réflexion se centre sur le processus de reconnaissance et d'altération de la perception sociale du risque des travailleurs concernés et organisés sur la question de l'amiante. Pour cela, le travail s'intéresse à la trajectoire du groupe Travailleurs unis contre l'amiante (TUCA), une organisation qui regroupe une grande partie des travailleurs qui ont été touchés et exposés à la contamination par inhalation d'amiante dans un travail de désamiantage d'une centrale thermoélectrique. La recherche est basée sur un processus d'immersion ethnographique, qui comprend la participation à des événements et des entretiens ethnographiques pour rendre compte du processus de reconnaissance autour de « l'amiante » comme une menace pour la santé par les travailleurs concernés. De même, les antécédents de la littérature générale, historiographique, statistique, spécialisée et du matériel de presse ont été passés en revue pour présenter à la fois les antécédents de ce processus de reconnaissance du risque et pour décrire la construction sociale du risque dans une « zone de sacrifice ». Fil: Lincura Matamala, Oliver. Universidad Católica de Temuco. Licenciado en Antropología. Temuco; Chile. Fil: Díaz Crovetto, Gonzalo. Universidad Católica de Temuco. Departamento de Antropología. Investigador del Núcleo de Investigaciones Interculturales e Interétnicas. Temuco; Chile.

OBJECTIVE To explore whether neurosonography can detect differences in cortical development and corpus callosal length in late-onset small fetuses subclassified into small-for-gestational age (SGA) or growth restricted (FGR). METHODS This was a prospective cohort study in singleton pregnancies, including normally grown fetuses (birth weight between the 10th and 90th centiles) and late-onset small fetuses (estimated fetal weight

In 2018 the European Working Group on Sarcopenia in Older People (EWGSOP2) updated the definition of sarcopenia, with loss of muscle strength being the primary feature. The objective is to describe and associate sarcopenia and nutritional status in a group of Chilean older adults aged 65 years and older. Methods: Descriptive, associative and comparative study, with a cross-sectional design and a quanti-qualitative approach. A number of 155 institutionalized and community-dwelling Chilean older people aged 65 years and older participated in the study (year 2018). Sarcopenia was diagnosed using the algorithm proposed by the EWGSOP2. Muscle strength, muscle quantity and physical performance were assessed; Body Mass Index (BMI) and Mini Nutritional Assessment (MNA) were used. Variables were described according to sex and age groups (65–69; 70–79; and ≥80 years). The association between sarcopenia and nutritional status was studied by the application of multivariate logistic regression analysis with adjustments for age and sex. Results: 49.7% and 5.2% of older adults had probable sarcopenia and severe sarcopenia, respectively; 52.9% and 7% had malnutrition by excess and by deficit, respectively, according to their BMI; and 33.5% had malnutrition according to the MNA. Participants with obesity had 3.2 times more risk of presenting sarcopenia, versus subjects with normal nutritional status (OR: 3.2; 95% CI; 1.24; 8.26). Conclusion: Sarcopenia, as defined by the criteria of the EWGSOP2, depends on the nutritional status according to BMI in older people, with obese individuals being at greater risk of suffering from sarcopenia. Nearly 50% had probable sarcopenia, a condition that could be detected early with the purpose of taking preventive measures, such a nutritional approach.

Numerous phosphorus-rich metal phosphides containing both P-P bonds and metal-P bonds are known from the solid-state chemistry literature. A method to grow these materials in thin-film form would be desirable, as thin films are required in many applications and they are an ideal platform for high-throughput studies. In addition, the high density and smooth surfaces achievable in thin films are a significant advantage for characterization of transport and optical properties. Despite these benefits, there is hardly any published work on even the simplest binary phosphorus-rich phosphide films. Here, we demonstrate growth of single-phase CuP

espanolLa paradoja denominada «maldicion de los recursos naturales» ha demostrado que las economias basadas en actividades extractivas no contribuyen positivamente a la erradicacion de la pobreza, la discriminacion y las desigualdades. Por el contrario, estos problemas parecen empeorar, incrementando los niveles de corrupcion, desigualdad y violencia. Mientras que los defensores de estas actividades enfatizan la necesidad de desarrollar las industrias extractivas, sus criticos senalan las consecuencias ambientales, politicas y sociales de esta industria. No obstante, es innegable que la principal causa de los conflictos socioambientales en el mundo, que incluye la violacion de los derechos humanos fundamentales, los derechos culturales y los derechos ambientales, tiene como corolario la mercantilizacion y explotacion de la naturaleza. El caracter global de las industrias extractivas requiere una teoria de la justicia mas comprensiva, que tenga en consideracion el desafio global y la soberania estatal, ademas de la complejidad que caracteriza a este tipo de problemas en terminos de espacio, tiempo, sujetos y materias. Filosofos politicos, en su mayoria angloamericanos, han desarrollado diversas aproximaciones teoricas a la justicia global que hacen referencia al desarrollo, la redistribucion, la proteccion ambiental, la solidaridad, la responsabilidad, la proteccion de los derechos humanos y la equidad. Este articulo busca analizar en que medida el concepto de justicia global puede contribuir a comprender mejor y resolver los conflictos socioambientales relativos a las industrias extractivas. EnglishThe paradox of «the natural resources curse» has shown that extractive economies do not contribute positively to the eradication of poverty, discrimination and inequality. On the contrary, these problems seem to worsen in such economies, increasing the levels of corruption, inequality and violence. While advocates of these activities emphasize the advantages of developing extractive industries, their critics underline the environmental, political and social consequences of this industry. It is undeniable, however, that the main cause of social and environmental conflicts in the world, including the violation of fundamental, cultural and environmental rights, is the commodification and exploitation of nature. The global character of extractive industries demands a more comprehensive theory of justice that considers the global challenge and state sovereignty, as well as the complexity that characterizes this type of problem in terms of space, time, agents and subjects. Political philosophers, mostly Anglo-American, have developed various theoretical approaches to global justice that refer to development, redistribution, environmental protection, solidarity, responsibility, the protection of human rights and equity. This article seeks to analyze the extent to which the concept of global justice can contribute to a better understanding and resolution of socio-environmental conflicts related to extractive industries.

RESUMEN Introducción. El objetivo de este estudio es establecer patrones positivos y negativos de los resultados de los procesos de acreditación de las carreras. Asimismo, identificar desde una perspectiva cualitativa, variables relevantes y relaciones entre los criterios usados en su evaluación. Materiales y métodos. El estudio es transversal, descriptivo y cualitativo. Se analizaron veinte resoluciones de acreditación de las carreras de Nutrición y Dietética en Chile, emitidas entre los años 2004 y 2016 por la Comisión Nacional de Acreditación mediante el software ATLAS ti. Se consideraron las tres dimensiones; Propósitos e Institucionalidad; Condiciones de Operación y Resultados; y Capacidad de Autorregulación para establecer una matriz de relaciones con la identificación de patrones positivos y negativos entre criterios. Resultados. Se evidencian fuertes diferencias entre las carreras. Las relaciones positivas y negativas entre los códigos de los criterios perfil de egreso y plan de estudio indican que solo algunas de ellas proveen una formación adecuada. Del mismo modo, las relaciones entre la calificación del cuerpo docente y la investigación revelan casos de docentes sin niveles suficientes. Otros aspectos deficitarios son el nivel con que ingresan los estudiantes y el uso efectivo de diagnósticos y autoevaluaciones. Conclusiones. El estudio provee información relevante para la toma de decisiones y procesos de retroalimentación orientados al urgente mejoramiento y aseguramiento de la calidad de carreras, en particular de sus planes de estudio, calificación de docentes y efectividad de los procesos de aseguramiento de la calidad, dada la creciente importancia de estos profesionales en la salud pública.

Stress and anxiety are frequent occurrences among pregnant women. We aimed to evaluate the effects of a Mediterranean diet intervention during pregnancy on maternal stress, well-being, and sleep quality throughout gestation. In a randomized clinical trial, 1221 high-risk pregnant women were randomly allocated into three groups at 19–23 weeks’ gestation: a Mediterranean diet intervention, a Mindfulness-Based Stress Reduction program, or usual care. All women who provided self-reported life-style questionnaires to measure their anxiety (State Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS)), well-being (WHO Five Well Being Index (WHO-5)), and sleep quality (Pittsburgh sleep quality index (PSQI)) at enrollment and at the end of the intervention (34–36 weeks) were included. In a random subgroup of 106 women, the levels of cortisol and related metabolites were also measured. At the end of the intervention (34–36 weeks), participants in the Mediterranean diet group had significantly lower perceived stress and anxiety scores (PSS mean (SE) 15.9 (0.4) vs. 17.0 (0.4), p = 0.035; STAI-anxiety mean (SE) 13.6 (0.4) vs. 15.8 (0.5), p = 0.004) and better sleep quality (PSQI mean 7.0 ± 0.2 SE vs. 7.9 ± 0.2 SE, p = 0.001) compared to usual care. As compared to usual care, women in the Mediterranean diet group also had a more significant increase in their 24 h urinary cortisone/cortisol ratio during gestation (mean 1.7 ± SE 0.1 vs. 1.3 ± SE 0.1, p < 0.001). A Mediterranean diet intervention during pregnancy is associated with a significant reduction in maternal anxiety and stress, and improvements in sleep quality throughout gestation.

Study question Do spontaneously conceived (SC) fetuses from subfertile couples present signs of cardiac remodeling as those observed after in vitro fertilization (IVF) treatments? Summary answer SC fetuses from subfertile couples do not associate cardiac remodeling, and their cardiac structure and function are similar to those of SC from fertile couples. What is known already Fetuses and children from IVF associate cardiac remodeling and suboptimal function, including dilated atria, more globular and thicker ventricles, reduced longitudinal motion and impaired relaxationin uteroand after birth. Fetal cardiac changes have been demonstrated both after fresh and frozen embryo transfer. The SC fetuses used as ‘controls’ in our previous publications were conceived by fertile couples thus making it difficult to separate the contribution of infertilityper sefrom the IVF procedures on cardiac programming. There are no previous cardiovascular studies investigating the independent effects of infertility in SC fetuses from subfertile couples (time-to-pregnancy (TTP) over 12 months). Study design, size, duration Prospective cohort study of 289 singleton pregnancies recruited from 2017 to 2021, including 96 SC pregnancies from fertile couples (TTP less than 12 months), 97 SC from subfertile couples (TTP over 12 months) and 96 from IVF after fresh ET. Fetal echocardiography was performed in all pregnancies. Epidemiological data and perinatal outcomes were collected in all pregnancies. Participants/materials, setting, methods IVF pregnancies from our centre were identified as eligible at pregnancy diagnosis. Eligible SC pregnancies from fertile and subfertile couples who attended our Maternal-Fetal Unit were invited to participate at third trimester, being matched to the IVF pregnancies by maternal age. Fetal echocardiography was performed at 29-34 weeks of pregnancy to assess cardiac structure and function. Echocardiographic comparisons were adjusted by nulliparity, birthweight centile, gestational age and estimated fetal weight at scan. Main results and the role of chance Parental age, ethnicity, body mass index and smoking exposure, median gestational age and estimated fetal weight were similar in all study groups. There were no significant differences in infertility duration or aetiology between the subfertile and the IVF populations (TTP: subfertile median 30 months [IQR 20-54] versus IVF: 47 [25-61]; p-value=0.052). While both fertile and subfertile SC groups presented similar fetal cardiac results, IVF fetuses showed larger atria (right atria-to-heart ratio: IVF mean 18.9% [SD 3.4] versus subfertile 17.8% [3.5] versus fertile 17.6% [3.3]; adjusted P-value Limitations, reasons for caution The fetal cardiac changes reported here are subclinical, with most cardiovascular parameters lying within normal ranges. Although echocardiographic changes are recognized as potential cardiovascular risk factors, their association with long-term cardiovascular disease remains to be proven. Wider implications of the findings Subfertility per se does not seem to be associated to fetal cardiac remodeling, which have been previously described in IVF fetuses. Future studies are warranted to further investigate the factors related to fetal cardiac changes associated to ART. Trial registration number Not a trial

Vancomycin is commonly used to treat methicillin-resistant Staphylococcus aureus infections and is known to cause nephrotoxicity. Previous Vancomycin Consensus Guidelines recommended targeting trough concentrations but the 2020 Guidelines suggest monitoring vancomycin area under the curve (AUC) given the reduced risk of acute kidney injury (AKI) at similar levels of efficacy. This meta-analysis compares vancomycin-induced AKI incidence using AUC-guided dosing strategies versus trough-based monitoring. Literature was queried from Medline (Ovid), Web of Science, and Google Scholar from database inception through November 5, 2021. Interventional or observational studies reporting the incidence of vancomycin-induced AKI between AUC- and trough-guided dosing strategies were included. In the primary analysis, the Vancomycin Consensus Guidelines definition for AKI was used if reported; otherwise, the Risk, Injury, and Failure; and Loss, and End-stage kidney disease (RIFLE) or Kidney Disease Improving Global Outcomes (KDIGO) definitions were used. The incidence of nephrotoxicity was evaluated between the two strategies using a Mantel-Haenszel random-effects model, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Subgroup analyses for adjusted ORs and AKI definitions were performed. Heterogeneity was identified using Cochrane's Q test and I

Harmaline (1) and harmalol (2) represent two 3,4-dihydro-β-carboline (DHβCs) most frequently reported in a vast number of living systems. Fundamental aspects including the photosensitizing properties, cellular uptake, as well as the cyto- and phototoxicity of 1 and 2 were investigated herein. The molecular basis underlying the investigated processes are elucidated. Data reveal that both alkaloids show a distinctive pattern of extracellular DNA photodamage. Compound 1 induces a DNA photodamage profile dominated by oxidised purines and sites of base loss (AP sites), whereas 2 mostly induces single-strand breaks (SSBs) in addition to a small extent of purine oxidative damage. In both cases, DNA oxidative damage would occur through type I mechanism. In addition, a concerted hydrolytic attack is suggested as an extra mechanism accounting for the SSBs formation photoinduced by 2. Subcellular internalisation, cyto- and phototoxicity of 1 and 2 and the corresponding full-aromatic derivatives harmine (3) and harmol (4) also showed quite distinctive patterns in a structure-dependent manner. These results are discussed in the framework of the potential biological, biomedical and/or pharmacological roles reported for these alkaloids. The subtle structural difference (i.e., the exchange of a methoxy group for a hydroxyl substituent at C(7)) between harmaline and harmalol, gives rise to distinctive photosensitizing and subcellular localisation patterns.

Numerous phosphorus-rich metal phosphides containing both P-P bonds and metal-P bonds are known from the solid-state chemistry literature. A method to grow these materials in thin-film form would be desirable, since thin films are required in many applications and they are an ideal platform for high-throughput studies. In addition, the high density and smooth surfaces achievable in thin films are a significant advantage for characterization of transport and optical properties. Despite these benefits, there is hardly any published work on even the simplest binary phosphorus-rich phosphides. Here, we demonstrate growth of single-phase CuP2 films by a two-step process involving reactive sputtering of amorphous CuP{2+x} and rapid annealing in an inert atmosphere. At the temperature required for crystallization, CuP2 tends to decompose into Cu3P and gaseous phosphorus. However, CuP2 can still be synthesized if the amorphous precursors are mixed on the atomic scale and are sufficiently close to the desired composition (neither too P poor nor too P rich). Fast formation of polycrystalline CuP2, combined with a short annealing time, makes it possible to bypass the diffusion processes responsible for decomposition. We find that thin-film CuP2 is a 1.5 eV band gap semiconductor with interesting properties, such as a high optical absorption coefficient (above 1e5 cm-1), low thermal conductivity (1.1 W/Km), and composition-insensitive electrical conductivity (around 1 S/cm). We anticipate that our processing route can be extended to other phosphorus-rich phosphides that are still awaiting thin-film synthesis, and will lead to more complete understanding of these materials and of their potential applications.

Homogeneous development of temporal bone structures is explained by their ontogenic origin; tegmen tympani (TT) and superior semicircular canal (SSC) are related with the glenoid fossa at the temporomandibular joint (TMJ). Therefore, our objective was to determine a possible relationship between TT status (dehiscence or integrity) and the roof of the glenoid fossa (RGF) thickness; SSC status has also been considered. This cross-sectional descriptive study was conducted in two tertiary hospitals on 95 patients (109 ears) presenting hypoacusia, facial palsy, vertigo, tinnitus, and other single or combined symptoms, and submitted to a thin-section multidetector-row computed axial tomography (CT) scan. A significant interaction effect of TT × SSC statuses on RGF thickness was found (p = 0.049). A significant difference in RGF thickness was found only for SSC integrity status between TT integrity and TT dehiscence (p = 0.004). The TT dehiscence increased the risk for RGF dehiscence 12.047 times (p = 0.002). There is an interaction effect of the statuses of both TT and SSC on the thickness of the RGF, instead of an independent effect of the TT status. When RGF dehiscence is found, TT and SSC statuses should be assessed, to discard associated dehiscences.

Introducción: El objetivo de este trabajo fue determinar si entre los factores que más influyen en la calidad de las carreras en Nutrición y Dietética, representada por el tiempo de acreditación, está la calidad de la universidad. Material y métodos: El estudio fue transversal, descriptivo y asociativo. Se usaron fuentes oficiales del Ministerio de Educación de las universidades que ofertan la carrera de Nutrición y Dietética en Chile y que se presentaron a acreditación entre los años 2004-2016. Se usó una muestra intencionada de 20 carreras acreditadas. Se usaron análisis estadísticos multivariados: regresión lineal, múltiple y análisis de conglomerados; la regresión lineal múltiple para estimar cuales variables explican el tiempo de acreditación de las carreras de Nutrición y Dietética y el análisis de conglomerado para evidenciar la afinidad de carreras de Nutrición y Dietética dictadas por distintos tipos de universidades. Se aplicó el software estadístico SPSS 24.0 Resultados: Los años de acreditación de las carreras y de las universidades se asociaron positivamente, sin que variables económicas y de selectividad de las carreras sean estadísticamente significativas. Las carreras mostraron un patrón de afinidad según el tipo de universidad que las imparte y ello estuvo también relacionado con la calidad.Conclusiones: La acreditación de la universidad es un factor crítico para el aseguramiento de la calidad de las carreras de Nutrición y Dietética.

Eight lactating Italian Friesian cows were housed in individual respiration chambers in a repeated Latin square design to determine their dry matter intake (DMI) and their milk and methane production, as well as to collect the total feces and urine to determine the N and energy balances. Four diets, based on the following forages (% of dry matter, DM), were tested: corn silage (CS, 49.3), alfalfa silage (AS, 26.8), wheat silage (WS, 20.0), and a typical hay-based Parmigiano Reggiano cheese production diet (PR, 25.3 of both alfalfa and Italian ryegrass hay). The greatest DMI was observed for cows fed PR (23.4 vs. 20.7 kg/d, the average of the other 3 diets). The DM digestibility was lower for PR (64.5 vs. 71.7%, the average of the other diets). The highest ash-free neutral detergent fiber digestibility values were obtained for CS (50.7%) and AS (47.4%). In the present study, no differences in milk production were observed between diets, although PR showed a higher milk yield trend. The highest milk urea N concentration (mg/dL) was found for the cows fed the WS diet (13.8), and the lowest was observed for the cows fed AS (9.24). The highest milk urea N concentration for the cows fed WS was also correlated with the highest urinary N excretion (g/d), which was found for the cows fed that same diet (189 vs. 147 on average for the other diets). The protein digestibility was higher for the cows fed the CS and WS diets (on average 68.5%) than for the cows fed AS and PR (on average 57.0%); dietary soybean inclusion was higher for CS and WS than for AS and PR. The rumen fermentation pattern was affected by the diet; the cows fed the PR diet showed a higher rumen pH and decreased propionate production than those fed CS, due to the lower nonfiber carbohydrate content and higher ash-free neutral detergent fiber content of the PR diet than the CS diet. Feeding cows with PR diet increased the acetate:propionate ratio in comparison with the CS diet (3.30 vs. 2.44 for PR and CS, respectively). Cows fed the PR diet produced a greater daily amount of methane and had a greater methane energy loss (% of digestible energy intake) than those fed the CS diet (413 vs. 378 g/d and 8.67 vs. 7.70%), but no differences were observed when methane was expressed as grams per kilogram of DMI or grams per kilogram of milk. The PR diet resulted in a smaller net energy for lactation content than the CS diet (1.36 vs. 1.70 Mcal/kg of DM for the PR and CS diets, respectively). Overall, our research suggests that a satisfactory milk production can be attained by including different high-quality forages in balanced diets without any negative effect on milk production or on the methane emissions per kilogram of milk.

RESUMEN El propósito de este artículo es analizar la evolución de las carreras y programas de Nutrición y Dietética en Chile. Se verifica un incremento sostenido de la oferta formativa, particularmente en los últimos veinte años, asociado a procesos de mercantilización de la Educación Superior. El aseguramiento de la calidad ha operado a través de la acreditación voluntaria y sus resultados son congruentes con el contexto nacional. La creciente importancia de la alimentación y nutrición en la salud pública del país exige formular cambios en la formación en Nutrición y Dietética, para lo cual se plantean diversas recomendaciones para lograr mayores niveles de pertinencia y el mejoramiento continuo de la calidad.