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Introducción. El síndrome hemofagocítico es una condición poco reconocida, pero con gran mortalidad en la población pediátrica. Se caracteriza por la activación excesiva de células inmunitarias y la liberación de citocinas, lo cual causa inflamación persistente. Puede ser primario o secundario, asociado con diversos factores. Objetivo. Describir 12 casos clínicos de niños menores de cinco años con síndrome hemofagocítico en una institución de alta complejidad del suroccidente de Colombia. Materiales y métodos. Se presenta una serie retrospectiva de 12 casos de síndrome hemofagocítico en menores de cinco años en una institución de alta complejidad de Colombia entre el 2019 y el 2022. Resultados. La mediana de la edad de los pacientes fue de un año, 7 eran de sexo masculino. La fiebre y la esplenomegalia fueron las manifestaciones clínicas más comunes en 11 pacientes. Los hallazgos de laboratorio predominantes fueron: hiperferritinemia en 11 casos, hipertrigliceridemia en 10, bicitopenia en 6 y pancitopenia en 2. Se observó aumento de la lactato-deshidrogenasa en 11 casos. Siete pacientes se sometieron a estudios genéticos. En cuanto al tratamiento, el protocolo HLH-2004 completo se cumplió en 5 pacientes. Tres casos reportados en este trabajo recibieron trasplante de progenitores hematopoyéticos. Tres pacientes fallecieron. Conclusión. Se resalta la complejidad del síndrome hemofagocítico y, más aún, en niños menores de cinco años, ya que la baja prevalencia de la enfermedad y su presentación clínica inespecífica contribuyen al subdiagnóstico. Se destaca la importancia de considerar los factores desencadenantes, la evaluación genética para un diagnóstico preciso y temprano, la necesidad de un enfoque multidisciplinario y la consideración oportuna del trasplante de progenitores hematopoyéticos para mejorar la morbimortalidad.

Introduction. Immunodeficiencies are disturbances in the immune system that can affect cell function, quantity, or both. They can be either primary, associated with genetic defects, or secondary, linked to external factors such as hemato-oncological conditions. Secondary immunodeficiencies can lead to the initiation, reactivation, or acceleration of latent, residual, or active infections, which are the leading cause of mortality. Objective. To elucidate the occurrence and clinical characteristics of hypogammaglobulinemia in pediatric oncology patients in a high-complexity hospital in Colombia between January 2020 and December 2022. Materials and methods. We conducted an observational study with patients under 18 years old with a cancer diagnosis, serum immunoglobulins measurements at the time of the diagnosis, and later follow-up during treatment. Results. We included 133 patients with a median age of eight years. Based on local guidelines of immunoglobulin levels for age, all patients had normal values at the time of cancer diagnosis. In the follow-up, the most significant reduction among all ages was for IgA and was related to infections and death. Conclusions. Our findings highlight the importance of measuring immunoglobulin levels at the time of the cancer diagnosis, as hypogammaglobulinemia may be linked to a poorer prognosis. Early detection could potentially improve patient outcomes.

Introducción. Los errores innatos de la inmunidad se asocian frecuentemente con bronquiectasias. Actualmente, el diagnóstico de los errores innatos de la inmunidad ha mejorado porque se conoce con certeza la asociación de estas entidades con el daño progresivo de las vías respiratorias. Esto ha permitido el reconocimiento y la intervención adecuada, lo cual reduce el deterioro de la función pulmonar y mejora la calidad de vida. Objetivo. Describir un grupo de pacientes con bronquiectasias no relacionadas con la fibrosis quística y con diagnóstico de errores innatos de la inmunidad, estudiados en un centro de referencia de inmunología en Cali, Colombia. Materiales y métodos. Se desarrolló un estudio observacional, descriptivo y retrospectivo de pacientes menores de 18 años con diagnóstico de errores innatos de la inmunidad y bronquiectasias no relacionadas con fibrosis quística, entre diciembre de 2013 y diciembre de 2023 en la Fundación Valle del Lili, en Cali (Colombia). Resultados. Se incluyeron 17 pacientes con diagnóstico de bronquiectasias no relacionadas con fibrosis quística y errores innatos de la inmunidad, cuya edad media fue de nueve años. El inferior fue el lóbulo pulmonar más frecuentemente afectado y su compromiso fue unilateral en la mayoría de los casos. La inmunodeficiencia con predominio de defectos de los anticuerpos fue la más común, seguida de las inmunodeficiencias combinadas asociadas con síndromes. Trece pacientes presentaron compromiso de la inmunidad humoral y 4 pacientes, alteraciones en la inmunidad humoral y celular. En 12 pacientes se identificaron modificaciones genéticas relacionadas con su fenotipo. Trece pacientes recibieron suplemento de inmunoglobulina intravenosa y 3 fallecieron. Conclusión. La inmunodeficiencia con predominio de defectos de los anticuerpos, seguida de las inmunodeficiencias combinadas asociadas con características sindrómicas, fueron los errores innatos de la inmunidad que con mayor frecuencia se acompañaron de bronquiectasias no relacionadas con la fibrosis quística.

Accurate solar radiation prediction leverages various machine learning techniques, with artificial neural networks (ANN) being the most common and precise due to their ability to detect and learn relationships between meteorological variables and solar radiation. Traditionally, training and deploying these models require high-capacity computers. However, the proliferation of low-power smart devices, such as embedded systems and mobile devices, necessitates exploring methodologies for implementing ANN on systems with limited computational resources. This paper proposes a quantized neural network model for solar radiation prediction, considering the hardware limitations of low-power devices like the Raspberry Pi RP2040 microcontroller. The methodology involves five stages: hardware and software selection, neural network development and quantization, microcontroller implementation, model validation, and result analysis. Experimental design allows detailed performance evaluation of quantized neural networks, demonstrating that the TensorFlow Lite Quantized Aware model is suitable for solar radiation prediction. Metrics such as root mean square error (RMSE) of 44.24 and R² of 0.96 indicate that the selected quantized model differs from the original non-quantized model by less than 0.5% in RMSE and 0.04% in R². The study concludes that implementing quantized ANN models on microcontrollers is a technically and economically viable solution for solar radiation prediction. Quantization enables complex predictive models to run on low-cost, energy-efficient devices, thereby democratizing advanced prediction technologies for critical applications like solar energy generation.

Background and objectives Polycystic ovary syndrome (PCOS) is a prevalent female reproductive and metabolic disorder. Among patients with chronic conditions, an increasing number have approached complementary and alternative medicine (CAM) to cope with their disease. This study aimed to assess the use of CAM among females with PCOS in Jordan.Design, settings and participants A cross-sectional study was conducted at one of the largest tertiary centres in Jordan. Adult females with PCOS were interviewed using a data collection tool.Outcome measures CAM use and the factors associated with its use.Results A total of 402 women participated in the study, the median-IQR age was 25 (31–21) years. Common PCOS signs/symptoms included menses irregularity (81.8%), fatigue (71.6%) and hyperandrogenism (77.6%). Among all participants, 63.2% used CAM with the most common being herbs (60.4%). The primary sources of information were family and friends (46.1%).Longer duration since diagnosis, having more PCOS signs/symptoms and a higher level of education were factors significantly associated with CAM use (β=1.257, 95% CI=1.018 to 2.552, p=0.034; β=1.146, 95% CI=1.052 to 1.250, p=0.002 and β=1.584, 95% CI=1.054 to 2.379, p=0.027, respectively). Of all the CAM users, 57.5% reported an amelioration in PCOS symptoms; this was significantly associated with the long-term use of CAM (β=12.759, 95% CI=6.789 to 23.976, p

Suicidal ideation and attempts are more prevalent during adolescence than at any other stage of life. Suicidal thoughts are the best predictors of a subsequent suicide attempt in children and adolescents. The purpose of this study was to identify latent classes or groups of youth with similar patterns of suicidal ideation using their responses to the five items of the Columbia-Suicide Severity Rating Scale, that measures suicidal ideation, plus a sixth item measuring intent to carry out suicide. This study included 388 adolescents admitted to primary and secondary mental health care programs in the Maule Region, Chile. Person-centered latent class analysis was utilized. Five classes were detected: ‘planners with intent’, ‘unintentional planners’, ‘non-planners with specific ideation’, ‘non-planners with nonspecific ideation’, and ‘non-ideators’. The class of ‘planners with intent’ was the most frequent (29.0%) and severe in all the indicators evaluated, comprising adolescents who reported self-injury, suicidal ideation, planning and at least one suicide attempt in their lifetime. The highest percentage of this class is represented by females (76.3%), middle adolescents (69.3%), living with both parents (43%) and presenting depressive disorder (57.9%). To enhance preventive strategies within healthcare services, it is recommended to include an assessment of the severity of suicidal ideation. This approach aims to mitigate risk factors that could potentially escalate to active suicidal ideation and suicide.

Introduction. Diabetes mellitus is one of the most common diseases worldwide, with a high morbidity and mortality rate. Its prevalence has been increasing, as well as its acute complications, such as hyperglycemic crises. Hyperglycemic crises can present with combined features of diabetic ketoacidosis and hyperosmolar state. However, their implications are not fully understood. Objective. To describe the characteristics, outcomes, and complications of the diabetic population with hyperglycemic crises and to value the combined state in the Latin American population. Materials and methods. Retrospective observational study of all hyperglycemic crises treated in the intensive care unit of the Fundación Valle del Lili between January 1, 2015, and December 31, 2020. Descriptive analysis and prevalence ratio estimation for deaths were performed using the robust Poisson regression method. Results. There were 317 patients with confirmed hyperglycemic crises, 43 (13.56%) with diabetic ketoacidosis, 9 (2.83%) in hyperosmolar state, and 265 (83.59%) with combined diabetic ketoacidosis and hyperosmolar state. Infection was the most frequent triggering cause (52.52%). Fatalities due to ketoacidosis occurred in four patients (9.30%) and combined diabetic ketoacidosis/hyperosmolar state in 22 patients (8.30%); no patient had a hyperosmolar state. Mechanical ventilation was associated with death occurrence (adjusted PR = 1.15; 95 % CI 95 = 1.06 - 1.24). Conclusions. The combined state was the most prevalent presentation of the hyperglycemic crisis, with a mortality rate similar to diabetic ketoacidosis. Invasive mechanical ventilation was associated with a higher occurrence of death.

Objetivo: Describir las características clínicas, complicaciones intraquirúrgicas y posquirúrgicas y los desenlaces oncológicos de los pacientes sometidos a prostatectomía radical por laparoscopia en un centro de alta complejidad en la ciudad de Cali, Colombia. Método: Estudio observacional de cohorte retrospectiva entre el 2011 y el 2021. Se incluyeron pacientes llevados a prostatectomía laparoscópica por diagnóstico de cáncer de próstata. Se clasificaron en bajo, mediano y alto riesgo según antígeno específico de próstata (PSA) y estadios clínicos TNM. Se agruparon según la escala de la International Society of Urological Pathology (ISUP). La clasificación D’Amico determinó el riesgo de recurrencia bioquímica. Se realizó un análisis de supervivencia a 60 meses según el método de Kaplan-Meier. Se estimaron los factores relacionados con la recaída y la probabilidad de tiempo libre de enfermedad con la regresión de Cox univariante y multivariante. Resultados: Se incluyeron 379 pacientes. La mediana de PSA inicial fue de 8,3. El 25,34% fue clasificado como patología localmente avanzada. La supervivencia global a cinco años fue del 97%. Los pacientes con persistencia bioquímica con enfermedad localmente avanzada tuvieron un 44% de probabilidad de recaer. La probabilidad de recaída a cinco años en pacientes con riesgo alto era de del 35%. Conclusiones: El factor de riesgo con mayor impacto en la recaída oncológica a los 60 meses es la persistencia bioquímica a los seis meses del procedimiento. Los pacientes con alto riesgo según la clasificación D’Amico presentaron una mayor recaída.

Introducción: A la fecha no existe consenso sobre la dosis óptima de verde de indocianina a administrar que permita el mayor realce de la vía biliar extrahepática con menor realce del parénquima hepático. El objetivo principal de este proyecto es analizar las diferencias entre una dosis de verde indocianina ajustada al peso de 0.0119mg/kg y una dosis de 2.5mg, una hora antes de la cirugía en pacientes operados de colecistectomía laparoscópica en el CMDLT en el tiempo comprendido entre abril – noviembre 2023. Métodos: ensayo clínico aleatorizado. Se evaluaron 30 pacientes y se dividieron en dos grupos según dosis administrada. Se obtuvieron datos generales y demográficos; del procedimiento quirúrgico se evaluó la intensidad de fluorescencia de la vía biliar. Luego de la cirugía se llenó la instrumento de recolección de datos, y se copiaron en una base de datos para ser analizado a posteriori. Resultados: No hubo reacciones adversas a la administración del fármaco, ni complicaciones trans o postoperatorias. Con la micro dosis el conducto cístico fue identificado en 42% y 82% antes y después de la disección del triángulo de Calot, mientras que con la dosis estándar un 30% y 93%, estas diferencias no fueron significativas, sin embargo, se aprecia una tendencia general de superioridad de la micro dosis. En pacientes con obesidad el porcentaje de identificación del conducto cístico con micro dosis y estándar fue de 0% y 33% p

IntroductionFood allergy affects 2-10% of the general population; it is more frequent among children than among adults, and it is one of the leading causes of anaphylaxis. Diagnosis of food allergy requires a detailed medical history, skin tests, specific immunoglobulin E (IgE) tests for the food involved, and an oral challenge as final confirmation.ObjectivesThis study aimed to describe the clinical and epidemiological characteristics of patients who underwent oral food challenges for suspected food allergies in a reference center in Colombia.MethodologyAn observational, descriptive, cross-sectional and retrospective study was conducted. Data were retrospectively collected from patients who were evaluated in the allergology service and suspected of food allergy from 2011 to 2018. Quantitative variables are presented as means or medians depending on the normality of the distribution (assessed by the Shapiro-Wilk test), and categorical variables are presented as frequencies and percentages.ResultsA total of 215 controlled open challenges were performed on 176 patients, most of whom were children (69%). Thirty-one patients (17%) required another oral challenge with a second food, and 11 (6.25%) required another oral challenge with three foods. Twelve oral challenges (5.58%) were positive. Of these, five challenges were positive for cow’s milk, 5 were positive for shrimp, and 2 were positive for legumes (peanuts and lentils).ConclusionThe frequency of confirmed food allergies and the profile of food allergies in our population differs from that reported in other parts of the world.

BackgroundThe epidemiology, morbidity, and burden of disease related to airway sequelae associated with invasive mechanical ventilation in the context of the COVID-19 pandemic remain unclear. ObjectiveThis scoping review aims to summarize the current knowledge regarding airway sequelae after severe SARS-CoV-2 infection. This knowledge will help guide research endeavors and decision-making in clinical practice. MethodsThis scoping review will include participants of all genders, and no particular age group who developed post–COVID-19 airway-related complication will be excluded. No exclusion criteria will be applied from country, language, or document type. The information source will include analytical observational studies. Unpublished data will not be completely covered as gray literature will be covered. A total of 2 independent reviewers will participate in the process of screening, selection, and data extraction, and the whole process will be performed blindly. Conflict between the reviewers will be solved through discussion and an additional reviewer. The results will be reported by using descriptive statistics, and information will be displayed on RedCap (Research Electronic Data Capture). ResultsThe literature search was conducted in May 2022 in the following databases: PubMed, Embase, SCOPUS, Cochrane Library, as well as LILACS and gray literature to identify observational studies; a total of 738 results were retrieved. The scoping review will be finished by March 2023. ConclusionsThis scoping review will describe current knowledge on the most frequently encountered laryngeal or tracheal sequelae in patients exposed to mechanical ventilation due to SARS-CoV-2 infection. This scoping review will find the incidence of airway sequelae post COVID-19 and the most common sequelae such as airway granuloma, vocal fold paralysis, and airway stenoses. Future studies should evaluate the incidence of these disorders. International Registered Report Identifier (IRRID)DERR1-10.2196/41811

Abstract Fish in the upper Madeira River basin (Bolivian Amazon) are an important source of livelihoods and protein for both rural and urban human populations. We characterised fisheries in the area of the port city of Riberalta, which possesses some of the most important fisheries landing sites bordering the Moxos lowlands, and evaluated the contribution of an invasive species (Arapaima gigas) to the landings. We compared the regional economic contribution of urban‐based and rural indigenous fisheries. Both fisheries contribute significantly to local food security and livelihoods and take advantage in a different but complementary way of the abundance of the invasive species, avoiding conflicts by partitioning the fish catch and supplying different urban markets. Both fisher groups are involved in a debt peonage system making them dependent on middlemen. A. gigas represented 57.6% of the overall economic value of fish in the region. The socioeconomic impact of the invasive species might increase considerably if it would invade and colonise the available habitats in the nuclear area of the Moxos lowlands.

Introduction: Insulin pumps serve as alternative insulin delivery methods with physiological similarity to the normal pancreas. The MiniMed 780G device is an advanced closed-loop hybrid system. Recent real-life studies have allowed reaching a higher percentage of time in range (TIR) (70 to 180 mg/dL). Being an emerging technology, it is of the utmost value to report on the early experience of use of this device. Methods: This was an observational, descriptive, cross-sectional study that included patients older than 18 years with types 1 diabetes mellitus and other types switched to a Medtronic 780G insulin pump. Baseline clinical and glycemic control variables and those after 4 weeks of using the SmartGuard mode were evaluated. Results: Thirty-nine patients (mean age, 33 years) were analyzed, 95 % of whom had type 1 diabetes with an average disease duration of 17 years. The values for time below range (TBR) 180 mg/dL, and TAR >250 mg/dL were 0 %, 3 %, 72 %, 21 %, and 3 %, respectively, at baseline and 1 %, 2 %, 79 %, 14 %, and 2 %, respectively, after the intervention. The changes in TIR varied based on prior therapy: multiple daily injections of insulin, 13 % improvement; MiniMed Paradigm Veo/MiniMed 640G, 6 % improvement; and MiniMed 670G, −4 % improvement. Conclusion: In conclusion, the application of a hybrid closed-loop system allowed for better glycemic control based on international standards. The average percentage improvement in TIR was lower than that in other studies and was dependent on the previous method of insulin administration, achieving lower performance with the migration from recent technologies such as the Minimed 670G.

Abstract Consuming wildmeat may protect against iron-deficiency anemia, a serious public health problem globally. Contributing to debates on the linkages between wildmeat and the health of forest-proximate people, we investigate whether wildmeat consumption is associated with hemoglobin concentration in rural and urban children (

El objetivo de la investigación fue determinar el efecto de la exposición prenatal al paraquat (PQ) sobre la formación craneofacial y corporal en ratas BIOU: Wistar. Metodología: estudio experimental, con cincuenta ratas gestantes, distribuidas en cinco grupos: PQ1 y PQ2, recibieron respectivamente 2 y 3 mg/kg de PQ vía subcutánea (SC); vitamina A (control positivo): tratado con 100.000 U.I. de vitamina A vía intragástrica (IG) y grupos controles (agua destilada, vía SC y vía IG). Los tratamientos fueron administrados desde el 6º al 15º día de gestación. Se comparó el peso materno los días 6, 14 y 21. Este último día se practicó laparotomía y determinó el número de implantaciones, reabsorciones, fetos vivos, muertos, peso y talla fetal, y la presencia de alteraciones craneofaciales y corporales. Resultados: no hubo diferencia significativa en la ganancia de peso materno entre los grupos. En los grupos PQ 2mg/Kg y vitamina A se registró, respectivamente, el mayor número de fetos muertos y reabsorciones. El peso y talla de los fetos del grupo vitamina A fue inferior (p

BackgroundIncorrect use of inhalers is a problem associated with poor patient outcomes. Despite improvement in the technique after verbal educations, this deteriorates over-time requiring re-enforcement through different educative strategies. This study aimed to assess the impact of a novel video-based teach-to-goal (TTG) educational intervention on: mastery of inhaler technique, disease control, medication adherence and disease-related quality of life (QoL) over-time among asthma and COPD patients.MethodsThis prospective, open-label, randomized controlled trial was registered in ClinicalTrials.gov: Identifier NCT05664347. After baseline assessment participants received either a verbal (control group) or a video-based (intervention group) TTG strategy. After 3-month the intervention was assessed for impact on the intended outcomes. Inhaler technique was assessed using standardized checklists, disease control using the Asthma control test and COPD assessment test respectively for asthma and COPD patients while adherence using the Morisky Green Levine scale. For QoL, the mini asthma quality of life questionnaire and the St. George respiratory questionnaire were used for asthmatic and COPD patients, respectively. Differences in outcomes between intervention-control groups were analyzed using either Chi-Square (X2)/Fisher Exact or Mann Whitney test. The impact of intervention on outcomes over-time was examined using either McNemar or Wilcoxon test.ResultsAt baseline, intervention (n = 51) and control (n = 52) groups had comparable demographic/clinical characteristics. At follow-up, inhaler technique improved among intervention group compared to control group (93.4% vs 67%) and to baseline (93.4% to 49.5%), (PConclusionVideo-based (TTG) was effective in enhancing inhaler technique over time as well as improving disease control, medication adherence, and QoL.Trial registrationClinicalTrials.gov: NCT05664347. https://clinicaltrials.gov/ct2/show/NCT05664347.

En el presente estudio se inventarió la riqueza de taxones endémicos que habitan en el Área Tropical Importante para Plantas (TIPA) Concepción, así como el efecto de la pérdida de la cobertura natural sobre estos atributos florísticos. El inventario fue realizado mediante fuentes de datos primarios (prospecciones de campo) y secundarios (bases de datos y especímenes de herbarios). La pérdida de la cobertura vegetal fue determinada mediante el análisis multitemporal de imágenes satelitales de tres periodos de tiempo (1990-2000, 2001-2010, 2011-2020). Basados en los registros históricos e inventarios de campo, un total de 28 taxones endémicos fueron inventariados (dos son nuevas especies para la ciencia). El endemismo que resguardan los hábitats que conforman el paisaje del área de estudio resultó distinto cuando comparados unos con otros (

Measuring muscle fatigue and resistance to fatigue is a topical theme in many clinical research studies. Multi-domain approaches, including electromyography (EMG), are employed to measure fatigue in rehabilitation contexts. In particular, spectral features, such as the reduction in the median frequency, are accepted biomarkers to detect muscle fatigue conditions. However, applications of fatigue detection in clinical scenarios are still limited and with margin for improvement. One of the potential applications of such methodology in clinics concerns the evaluation of the rehabilitation after hip fracture. In this work, 20 inpatients, in the acute phase after hip fracture surgery and with lower limb weakness, performed isometric contractions with their healthy lower limb (quadriceps muscle) and their resistance to fatigue before and after 2 weeks of rehabilitation program was measured. Multi-channel EMG and Maximum Voluntary Contractions (MVC, force) were recorded on five muscle heads. We found that, after performing the same number of repetitions (repetitions pre-treatment: 19.7 ± 1.34; repetitions post-treatment: 19.9 ± 0.36; p = 0.223), MVC improved (MVC pre-treatment: 278 ± 112 N; MVC post-treatment: 322 ± 88 N; p = 0.015) after rehabilitation for most of the patients and fatigue did not change. These results suggest that higher force exertion was performed after rehabilitation, with the same level of fatigue (fatigued muscles pre-treatment: 1.40 ± 1.70; fatigued muscles post-treatment: 1.15 ± 1.59; p = 0.175) after. Results are discussed addressing the potential of multifactorial instrumental assessments for describing patients’ status and provide data for clinical decision making.

Baccharis is one of the largest genera of Asteraceae and its species are used in folk medicine for several medicinal purposes due to the presence of bioactive compounds. We investigated the phytochemical composition of polar extracts of B. sphenophylla. Using chromatographic procedures, diterpenoids (ent-kaurenoic acid), flavonoids (hispidulin, eupafolin, isoquercitrin, quercitrin, biorobin, rutin, and vicenin-2), caffeic acid, and chlorogenic acid derivatives (5-O-caffeoylquinic acid and its methyl ester, 3,4-di-O-caffeoylquinic acid, 4,5-di-O-caffeoylquinic acid, and 3,5-di-O-caffeoylquinic acid and its methyl ester) were isolated from polar fractions and are described. The extract, polar fractions, and fifteen isolated compounds were evaluated in relation to radical scavenging activity using two assays. Chlorogenic acid derivatives and flavonols exhibited higher antioxidant effects, confirming that B. sphenophylla is an important source of phenolic compounds with antiradical properties.

Non-adherence to antibiotics is a well-known, core player to antibiotic resistance. The current adherence behavior toward short-term antibiotic regimens has never been investigated before in Jordan. This study assessed the prevalence and predictors of non-adherence to short-term antibiotics among Jordanians and investigated participants' views about different reasons related to antibiotics non-adherence. A cross-sectional face-to-face survey-based interview was conducted in three hospital pharmacies in Jordan. Adults and mother of children (≤12 years old) who completed their short course treatment (

The Morisky Green Levine (MGL) adherence scale is a 4-item tool used for the detection of medication nonadherence among patients with chronic health conditions. Despite being widely used in Arabic-speaking research contexts, it has never been validated in Arabic language. The aim of this study was to translate and validate the MGL tool into Arabic. A standard forward-backward process was used to translate the questionnaire. Cronbach's alpha coefficient was measured to assess internal consistency of the scale. The test-retest reliability measured the consistency of participants' responses over time. Construct validity was evaluated by Explanatory factor analysis (EFA); Kaiser-Meyer-Olkin value and Bartlett's test of sphericity were determined. Convergent validity was assessed using a preexisting medications Arabic Adherence Assessment Tool (AAAT). The model fit was evaluated using confirmatory factor analysis (CFA). Associations between the MGL scale scores and the patient demographic/clinical characteristics were tested by linear regressions. A total of 201 participants were included into the study. The MGL scale categorization revealed that 20.9%, 59.2% and 19.9% of the participants had high, moderate and low levels of adherence respectively. Adequate internal consistency (alpha = 0.593) was observed. A significant strong ICC and Pearson's correlations were generated between responses at time 1 and time 2. EFA results elucidated the suitability of the data for factor analysis. Pearson's coefficient (r) revealed a significant strong correlation between MGL scale and AAAT. CFA results confirmed a good fit for the suggested model. Linear regression revealed higher number of medications, more frequent outpatient clinic visits and not experiencing medication adverse effect factors significantly associated with better adherence. The Arabic version of MLG scale is a reliable valid tool to assess adherence among Arabic-speaking communities. Implementing interventions targeting patients not compliant to regular clinic visits and those at higher risk of experiencing medication side effects can greatly enhance medication adherence.

Background: Respiratory recurrent papillomatosis (RRP) is a fatal disease with no known cure. In severe RRP cases, systemic bevacizumab (SB) could be used as adjuvant therapy. Objective: This study aims to determine the extent and type of evidence in relation to the clinical outcomes of RRP after SB treatment. Methods: Participants with RRP of all genders are included in this scoping review. There were no exclusion criteria (country, language, or document type). The information sources included experimental, quasi-experimental, and analytical observational studies. Unpublished data will not be covered, but gray literature was covered. Screening, paper selection, and data extraction were all done by two independent reviewers. This procedure was performed blindly. Results: Of the 175 unique records found, 15 were eligible for inclusion. Fourteen studies were included after applying inclusion and exclusion criteria. Thirty-four patients in these studies came from the United States, India, Germany, Colombia, Argentina, Chile, and Spain. In total, 17 and 34 patients were below 18 years old and were adults respectively. The most commonly reported dose was 10 mg/kg, which was received by 25 (73.5%) patients. According to reports, 58.8% of patients completed the questionnaire. Twelve (35%) patients did not require a repeat surgery. The time interval between surgical procedures has increased for patients who require them. Conclusion: SB may be a promissory treatment and control option for RRP. More research is needed to evaluate the efficiency and adverse effects in various populations.

Los roles en el aula de clase hablan de las funciones que los actores desempeñan en el proceso educativo; por ello, puede parecer equivocado pensar que el dinámico escenario pedagógico en las instituciones se reduce a concebir al docente y al estudiante como objetos inanimados cuya única función es transmitir y recibir información, reflejando la inexistente identificación y reconocimiento de los diversos comportamientos que toman lugar en el proceso de enseñanza – aprendizaje. Lo anterior, hace necesario caracterizar al estudiante y docente con indicadores que permitan el descubrimiento y la exploración de su quehacer académico y que, a su vez, provoque una adecuada ret- roalimentación e innovación asertiva. Para tal efecto, se elaboran y aplican dos instrumentos para analizar a los actores en los momentos de planificación, dinámica de la clase y evaluación, basado en la teoría del aprendizaje experimen- tal. Como resultado se identifica una baja cor- respondencia en la forma en que los docentes enseñan y en la que los estudiantes aprenden, evidenciando la necesidad de transformación de los actores en como planificar, dinamizar y evaluar sus clases.

En este trabajo se presenta el diseño y construcción de un sistema integrado de monitoreo inalámbrico para la generación de mapas de intensidad enfocado en la agricultura de precisión empleando una metodología de cuatro etapas: análisis general, construcción, desarrollo del software y, validación y gestión de cambios. El sistema cuenta con la instrumentación para medir dióxido de carbono, temperatura, radiación ultravioleta y humedad del aire y suelo; además, implementa un sistema de posicionamiento global que permite la creación de los mapas. Los datos se envían a través del protocolo LoRaWAN a una interfaz gráfica para visualizar el comportamiento de cada variable y generar los mapas; la cual se construye bajo las necesidades particulares de un cultivo de tomate. Finalmente, se obtiene un sistema adaptable para analizar a detalle las condiciones agroambientales, facilitando la toma de decisiones del agricultor.

Biochar soil amendment can improve growing medium water and nutrient status and crop productivity. A pot experiment was conducted using Solanum lycopersicum var. cerasiforme plants to investigate the effects of biochar amendment (20% application rate) on a soilless substrate, as well as on plant growth, fruit yield, and quality. During the experiment, substrate characteristics, plant morphological traits, and root and leaf C/N content were analyzed at three sampling points defined as early stage (36 days after germination), vegetative stage (84 days a. g.), and fruit stage (140 days a. g.). Fruit morphological traits, titratable acidity, lycopene, and solid soluble content were measured at the end of the experiment. Biochar ameliorated substrate characteristics (Nav increase of 17% and Ctot increase of 13% at the beginning of the study), resulting in a promotion effect on plant root, shoot, and leaf morphology mainly at the vegetative and fruit stages. Indeed, at these two sampling points, the biochar-treated plants had a greater number of leaves (38 and 68 at the vegetative and fruit stages, respectively) than the untreated plants (32 and 49, respectively). The biochar also increased leaf area with a rise of 26% and 36% compared with the values measured in the untreated plants. Moreover, the amendment increased twofold root length, root surface area, and root, stem, and leaf biomasses in comparison with untreated plants. Regarding plant productivity, although fruit morphology remained unchanged, biochar increased flower and fruit numbers (six times and two times, respectively), acidity (75%), lycopene (28%), and solid soluble content (16%). By unveiling promoting changes in morphological traits, fruit number, and antioxidant content occurring in cherry tomato plants growing in a biochar-treated soilless substrate, it could be possible to highlight the importance of biochar for future applications in the field for enhancing plant production and fruit quality in a sustainable agriculture framework.

Objective To evaluate the attitudes of undergraduate pharmacy students towards patient safety in six developing countries.Design A cross-sectional study.Setting Participants were enrolled from the participating universities in six countries.Participants Undergraduate pharmacy students from the participating universities in six developing countries (Jordan, Saudi Arabia, Kuwait, Qatar, India and Indonesia) were invited to participate in the study between October 2018 and September 2019.Primary outcome Attitudes towards patient safety was measured using 14-item questionnaire that contained five subscales: being quality-improvement focused, internalising errors regardless of harm, value of contextual learning, acceptability of questioning more senior healthcare professionals’ behaviour and attitude towards open disclosure. Multiple-linear regression analysis was used to identify predictors of positive attitudes towards patient safety.Results A total of 2595 students participated in this study (1044 from Jordan, 514 from Saudi Arabia, 134 from Kuwait, 61 from Qatar, 416 from India and 429 from Indonesia). Overall, the pharmacy students reported a positive attitude towards patient safety with a mean score of 37.4 (SD=7.0) out of 56 (66.8%). The ‘being quality-improvement focused’ subscale had the highest score, 75.6%. The subscale with the lowest score was ‘internalising errors regardless of harm’, 49.2%. Female students had significantly better attitudes towards patient safety scores compared with male students (p=0.001). Being at a higher level of study and involvement in or witnessing harm to patients while practising were important predictors of negative attitudes towards patient safety (p

El cambiante escenario pedagógico y didáctico del aula de clase genera una permanente inquietud en todos los ámbitos educativos, en donde la enseñanza de las ciencias ha sido un área de creciente interés. Investigaciones recientes priorizan la búsqueda de estrategias que cierren la brecha existente entre la enseñanza el aprendizaje, la cual se profundiza en una diversa comunidad estudiantil que acompaña sus procesos con el desconocimiento pedagógico de la planta docente, cuyas alternativas didácticas para lograr una formación competente están sustentadas en un pensamiento transmisionista – conductista. Este artículo presenta una alternativa pedagógica de aprendizaje basada en la teoría experiencial de Kolb, tomando como caso de estudio el concepto de onda armónica en la propagación de ondas electromagnéticas. La metodología comprende la formulación de la hipótesis de trabajo desde la teoría del aprendizaje experimental, la definición del contexto sustentado en el enfoque cuantitativo y basado en los estilos de aprendizaje de Kolb, la generación de la estrategia pedagógica siguiendo el modelo CUVIMA, la aplicación de esta en un solo grupo con pretest y postest para conocer las ideas previas y el cambio conceptual y, el análisis de resultados utilizando estadísticos gráficos y la media. Como resultado se identificó que los estudiantes tienen un estilo de aprendizaje Convergente – Asimilador según los estilos de aprendizaje de Kolb, lo cual implica que tienen preferencias hacia las prácticas de laboratorio y de simulación en donde pueden poner a prueba los conceptos teóricos aprendidos. De acuerdo con el análisis de los datos se concluye que la experimentación mejora la comprensión del fenómeno físico estudiado, lo cual está acorde con el estilo de aprendizaje identificado en los estudiantes.

Introducción: frente a la actual pandemia causada por el virus SARS CoV-2 se deben tomar acciones proactivas encaminadas a desarrollar estrategias que preparen a las unidades renales para atender un número inusual de pacientes. Objetivos: revisar de forma narrativa los estudios que reporten experiencias en unidades renales para el manejo de pacientes con COVID-19 y proporcionar evidencia de los planes de acción a desarrollar por cada equipo de una unidad de diálisis. Materiales y métodos: se realizó una revisión de literatura en MEDLINE, Scopus y LILACS con los términos “chronic kidney disease AND Covid”, “dialysis AND Covid”, “renal unit AND Covid”. La búsqueda no se limitó por fecha de publicación, por idioma, ni por diseño del estudio. Resultados: se encontraron 27 publicaciones, de las cuales se incluyeron 7 que contenían recomendaciones para el manejo de pacientes con COVID-19 en las unidades renales. Conclusión: las estrategias de mitigación en las unidades renales deben estar encaminadas hacia la detección temprana de los pacientes con COVID-19, el control de la transmisión y la protección del personal de salud. Se recomienda conformar un equipo de trabajo que lidere las actividades; diseñar un programa de educación para personal de salud, pacientes y familiares; gestionar una adecuada planeación del recurso humano ante el riesgo que se vea afectado por COVID-19; proveer suficientes insumos y equipos de protección personal, y delimitar áreas específicas para pacientes con COVID-19 y sin la enfermedad.

In order to toughen Poly(lactic) acid and binary blends with low PBAT content while maintaining a high biodegradability of the final material, poly(lactic) acid (PLA)/poly(butylene-adipate-co-terephthalate) (PBAT)/ polyolefin elastomer grafted with glycidyl methacrylate (POE-g-GMA) extruded ternary blends have been investigated in this work from a thermal, mechanical, and rheological point of view. The two elastomers have been added in different amounts as dispersed phases into the PLA matrix, paying attention to the final objective: the design of a 90% biodegradable formulation according to EN 13432. These ternary blends exhibited improved impact properties but still low elongation at break. Consequently, to the ternary composition with the best compromise of PLA quantity, biodegradability and thermo-mechanical properties (81 wt.% PLA, 9 wt.% PBAT, and 10 wt.% POE-g-GMA) a small quantity (10 wt.%) of a biobased plasticizer was added in order to further increase the impact properties in parallel with the tensile flexibility. Two types of plasticizers were investigated, one not reactive [Acetyl Tributyl Citrate (ATBC)], and one reactive [Glycidyl ether (EJ-400)]. A micromechanical study, in order to investigate the toughening mechanism of these systems, was carried out on the final formulations. They were also examined by dilatometric tests and elasto-plastic fracture mechanics correlating the data obtained to the morphology and to the rheological properties. In conclusion, the best compromise between impact, tensile properties and biodegradability content was achieved using the reactive plasticizer (EJ-400) whose interaction with the matrix is confirmed by the FT-IR analysis.

Sourcing and intertextual integration skills are critical to the development of young students' digital literacy skills. Sourcing skills include identifying source parameters (e.g., recognizing the author, publication date, publisher) and analyzing the author's expertise. The objective of this study is to investigate which sourcing skills used by students in document selection are most associated with intertextual integration skills. A total of 165 students attending lower secondary school participated in the research. Students completed a sourcing inventory, an intertextual integration task (after reading multiple texts), and control variables measures (prior knowledge, prior beliefs, and text comprehension). The results of exploratory factor analysis showed three dimensions for sourcing, namely source identification, author's competence, and judgment on website choice. Furthermore, hierarchical regressions showed that author competence was the only sourcing factor associated with intertextual integration skills, after controlling for the effect of control variables. These results suggest that even younger students pay attention to author expertise when choosing texts to use for their assignments, and doing so enhances their competence in integrating information across sources.

La incorporación cada vez más masiva de las mujeres al mercado de trabajo e importantes cambios en las configuraciones familiares han puesto en tela de juicio la organización tradicional de las familias sobre la base de hombres proveedores/mujeres cuidadoras. Sin embargo, la evidencia disponible indica que ello no ha cambiado la distribución tradicional de tareas por sexo. Este trabajo busca aportar a la comprensión de las razones que ayudarían a explicar la persistencia de estos patrones tradicionales, y cómo parejas jóvenes con y sin hijos enfrentan el reto de conciliar familia y trabajo en la ciudad de Talca (Chile). Ello, con foco en las representaciones sociales sobre el trabajo doméstico y de cuidado y en los procesos de negociación – si los hay – que explicarían sus arreglos domésticos actuales. Nuestros resultados sugieren que se declaran patrones de organización familiar basados en la igualdad, habilidades o preferencias personales, pero las prácticas revelan la persistencia de modos de organización apegados a los patrones tradiciones según género

Summary: Plasmacytoid dendritic cells (pDCs) are sensor cells with diverse immune functions, from type I interferon (IFN-I) production to antigen presentation, T cell activation, and tolerance. Regulation of these functions remains poorly understood but could be mediated by functionally specialized pDC subpopulations. We address pDC diversity using a high-dimensional single-cell approach: mass cytometry (CyTOF). Our analysis uncovers a murine pDC-like population that specializes in antigen presentation with limited capacity for IFN-I production. Using a multifaceted cross-species comparison, we show that this pDC-like population is the definitive murine equivalent of the recently described human AXL+ DCs, which we unify under the name transitional DCs (tDCs) given their continuum of pDC and cDC2 characteristics. tDCs share developmental traits with pDCs, as well as recruitment dynamics during viral infection. Altogether, we provide a framework for deciphering the function of pDCs and tDCs during diseases, which has the potential to open new avenues for therapeutic design. : Dendritic cells (DCs) are unique therapeutic targets given their capacity to modulate immune responses. Yet complete alignment of the DC network between species is lacking. Using a multi-dimensional approach, Leylek et al. identify the mouse homolog of human AXL+ DCs, named transitional DCs (tDCs), and reveal their similarities with pDCs. Keywords: plasmacytoid dendritic cells, transitional dendritic cells, AXL+ dendritic cells, noncanonical dendritic cells, viral infection, mouse, human, CyTOF, ASDC, pre-DCs

A exclusão social ocorre também nas pequenas cidades; contudo, ante seu menor impacto territorial e menor visibilização, tem-se a errônea sensação de que todos vivem adequadamente. A mobilização social em torno da luta por moradia e seus impactos na produção do espaço urbano deve considerar especificidades, a exemplo da questão da identidade e dimensões políticas locais (dentre outros fatores) como condicionadores da inércia aparente ou do questionamento emergente nas pequenas cidades. Esse texto identifica e discute a presença (ou ausência) de movimentos sociais de luta por habitação popular ou de mobilizações sociais relacionadas à moradia nas pequenas cidades da Bahia, nos vinte municípios do território de identidade do sisal. Há conflitos relacionados à moradia em nove dos vinte municípios do território do sisal, mas não foram encontrados movimentos sociais de luta por habitação no território do sisal e sim importantes mobilizações sociais em Itiúba, São Domingos, Valente, Retirolândia, Conceição do Coité, Quijingue e Barrocas, bem como ocupações diretas em Santaluz e Araci, que estão relacionadas ao questionamento da propriedade privada e da busca pelo valor de uso do solo urbano e do atendimento ao direito à moradia, o que demonstra que a população das pequenas cidades do semiárido baiano não é inerte, que outras forças estão sendo engendradas, há insurgências importantes, há articulações espontâneas e muito corajosas que podem gestar outros imaginários e novas ordens socioespaciais.