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AIM: To analyze if a relationship between levels of inflammatory serum biomarkers and severity of primary proliferative vitreoretinopathy (PVR) exists. METHODS: A retrospective case-control study. The healthy adult patients with rhegmatogenous retinal detachment and primary PVR were included in the PVR group. For the control group, healthy adults who underwent cataract surgery were included. The grade of PVR was classified according to the Retinal Society Terminology Committee. Blood samples were obtained before surgery, and processed in MYTHIC 18. Measures of interest were neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR), the time between the decrease in visual acuity and surgery, PVR grade, type of surgery, final best corrected visual acuity, and rate of re-detachment. RESULTS: Totally 240 patients were included, 120 in each group, 79 (65.8%) and 56 (46.7%) were male in the PVR and control group, respectively. PVR A had greater levels of monocytes (0.28±0.18 vs 0.12±0.32, P=0.002), neutrophils (4.59±1.51 vs 3.92±1.27, P=0.006), and LMR (9.32±4.42 vs 7.43±3.90, P=0.01). PVR B had a greater monocyte count (0.30±0.13 vs 0.12±0.32, P=0.001), and PVR C demonstrated higher levels in monocytes (0.27±0.12 vs 0.12±0.32, P=0.004), neutrophils (4.39±1.13 vs 3.92±1.27, P=0.004), and LMR (9.63±3.24 vs 7.43±3.90, P=0.002) compared to control, respectively. An LMR cut-off value of 9.38 predicted PVR with a sensibility of 54.2% and specificity of 77.5% and NLR cut-off of 1.70 predicted PVR with a sensibility of 62% and specificity of 54.2%. CONCLUSION: Patients with primary PVR demonstrate greater neutrophil, monocyte, and LMR levels than the control group. Cut-off values obtained from ratios could be useful in a clinical setting when no posterior view of the fundus is possible due to media opacity.

Este trabajo evalúa la efectividad de diferentes tipos de argumentos de impugnación planteados con la intención de invalidar resoluciones emitidas por la Administración Tributaria Boliviana. Se analizaron todos los recursos de alzada interpuestos ante la Autoridad de Impugnación Tributaria de Cochabamba en el año 2020. Los seiscientos cuarenta y seis argumentos identificados fueron organizados en treinta tipos de argumentos mutuamente excluyentes. Se registró la frecuencia y efectividad de cada uno de los tipos de argumentos. Se encontró una importante inclinación favorable a los recurrentes en los fallos observados que fue causada, principalmente, por altos índices de eficacia en algunos tipos de argumentos. A la luz de los resultados, se concluye que el recurso de alzada es un medio de impugnación conveniente para los recurrentes, sobre todo si tienen bases para plantear alguno de los argumentos altamente efectivos.

En lo medular, el libro de Pablo Aravena -La inactualidad de Bolívar. Anacronismo, mito y conciencia histórica- desarrolla una reflexión sobre el estatuto de la historia en el presente a partir de la idea de conciencia histórica, tomando como motivo la cuestión de la construcción política de Simón Bolívar. El concepto de anacronismo es aquí una clave de ingreso al tratamiento del problema de la conciencia histórica en el presente. Algo anacrónico -una idea, un personaje, una interpretación, etc.- es aquello cuyo uso -y abuso- lo pone fuera del tiempo que le es propio; “fuera de contexto” o “fuera de época”, son las expresiones coloquiales con que suele referirse esa condición. También es anacrónico atribuirle a determinado personaje ideas y convicciones que pertenecen al presente. En este caso, el personaje histórico resulta anacronizado. Esto es lo que, según Aravena, ha sucedido con la figura de Simón Bolívar.

Abstract The production of green hydrogen in water electrolyzers is limited by the oxygen evolution reaction (OER). State-of-the-art electrocatalysts are based on Ir. Ru electrocatalysts are a suitable alternative provided their performance is improved. Here we show that low-Ru-content pyrochlores (R2MnRuO7, R = Y, Tb and Dy) display high activity and durability for the OER in acidic media. Y2MnRuO7 is the most stable catalyst, displaying 1.5 V at 10 mA cm−2 for 40 h, or 5000 cycles up to 1.7 V. Computational and experimental results show that the high performance is owed to Ru sites embedded in RuMnOx surface layers. A water electrolyser with Y2MnRuO7 (with only 0.2 mgRu cm−2) reaches 1 A cm−2 at 1.75 V, remaining stable at 200 mA cm−2 for more than 24 h. These results encourage further investigation on Ru catalysts in which a partial replacement of Ru by inexpensive cations can enhance the OER performance.

The demand of green hydrogen, that is, the hydrogen produced from water electrolysis, is expected to increase dramatically in the coming years. State‐of‐the‐art proton exchange membrane water electrolysis (PEMWE) uses high loadings of platinum group metals, such as Pt in the electrode where hydrogen is produced. Alternative electrodes based on phosphides, sulfides, nitrides, and other low‐cost alternatives are under investigation. Herein, a simple process for the preparation of RuP electrodes with high activity for the hydrogen evolution reaction (HER) in acidic electrolyte is described. A straightforward one‐pot synthesis that yields RuP nanoparticles with fine‐tuned composition and stoichiometry is presented, as determined by multiple characterization techniques, including lab‐ and synchrotron‐based experiments and theoretical modeling. The RuP nanoparticles exhibit a high activity of 10 mA cm−2 at 36 mV overpotential and a Tafel slope of 30 mV dec−1, which is comparable to Pt/C. Moreover, a RuP catalyst‐coated membrane (CCM) with a low Ru loading of 0.6 mgRu cm−2 is produced and tested in a PEMWE cell configuration, yielding 1.7 A cm−2 at 2 V.

Malaria is a common and serious disease that primarily affects developing countries and its spread is influenced by a variety of environmental and human behavioral factors; therefore, accurate prevalence prediction has been identified as a critical component of the Global Technical Strategy for Malaria from 2016 to 2030. While traditional differential equation models can perform basic forecasting, supervised machine learning algorithms provide more accurate predictions, as demonstrated by a recent study using an elastic net model (REMPS). Nevertheless, current short-term prediction systems do not achieve the required accuracy levels for routine clinical practice. To improve in this direction, stacked hybrid models have been proposed, in which the outputs of several machine learning models are aggregated by using a meta-learner predictive model. In this paper, we propose an alternative specialist hybrid approach that combines a linear predictive model that specializes in the linear component of the malaria prevalence signal and a recurrent neural network predictive model that specializes in the non-linear residuals of the linear prediction, trained with a novel asymmetric loss. Our findings show that the specialist hybrid approach outperforms the current state-of-the-art stacked models on an open-source dataset containing 22 years of malaria prevalence data from the city of Ibadan in southwest Nigeria. The specialist hybrid approach is a promising alternative to current prediction methods, as well as a tool to improve decision-making and resource allocation for malaria control in high-risk countries.

Objectives: Patients with urolithiasis receive a significant amount of radiation during diagnosis, treatment, and follow-up of their pathology, with nearly 20% receiving more than the annual recommended, creating a growing concern regarding radiation exposure faced by patients and health personnel. The objectives of the study were to describe a standardized fluoroscopy-free (FF) semirigid (SR) ureteroscopy (URS) technique for ureteral stone treatment and to determine the feasibility, efficacy, and safety of this technique for the treatment of ureteral stones comparing it to a historical cohort of fluoroscopy-guided (FG) SR-URS. Materials and Methods: A prospective single-arm study of patients submitted to FF SR-URS was conducted. Visual and tactile cues were employed to avoid the use of ionizing radiation. The success (feasibility), stone-free (efficacy), and complication (safety) rates of each procedure were registered. The results were compared to a historical cohort of patients that underwent FG SR-URS at our center. Results: One hundred and five patients subjected to FF SR-URS were included in the study and compared to a historical cohort of 87 patients subjected to FG SR-URS. The main characteristics were comparable among groups. Ninety-seven patients (92.38%) were completed without any use of ionizing radiation. The stone-free rate was 92.45%, similar to the historical cohort. Only Clavien I and II complications were found without statistical difference between the study groups. The average dose of radiation exposure for the historical cohort was approximately 0.5 mSv. Conclusions: FF SR-URS is a feasible, efficacious, and safe technique for treating the ureteral stones for urologists with good practice of the traditional technique. Implementing this procedure allows a decrease in radiation exposure to both patients and health personnel.

While water splitting offers a renewable means to produce H2 fuel, most electrolyzers rely on scarce elements to function. Here, authors study low-content Iridium catalysts derived from mixed oxides for proton exchange membrane water electrolysis anodes without compromising activity and durability.

La superposición de vulneraciones es un rasgo característico de la población infantil y adolescente, especialmente de las clases sociales desfavorecidas. En ese sentido, los riesgos identificados se centran en el aumento de la pobreza, producto de la suspensión de las actividades económicas y la reducción de los ingresos durante el periodo más estricto del confinamiento. Esto sumió a las familias de las clases sociales desfavorecidas en un terreno de incertidumbre y dificultad para asegurar el sustento alimentario. El riesgo de la fragmentación social, por su parte, fue otro aspecto crucial del análisis, compuesto de dos rasgos: el apoyo institucional del Estado focaliza la asistencia de manera segregada y, muchas veces, bajo criterios clientelistas; en grupos específicos, esto termina desarticulando todo tipo de organización y acción colectiva, restando fuerza a las iniciativas de cooperación local. Por otra parte, la afrenta contra la integridad es un factor gravitante de vulnerabilidad, en el que las niñas y las adolescentes son víctimas estructuralmente, debido a las desigualdades de género. Los tres riesgos sintetizan condiciones de vida asociadas a vulnerabilidades concretas, erigidas sobre el terreno frágil de la pobreza, la precariedad y la exclusión.

We present emission maps ( $1\buildrel{\,\prime}\over{.} 5\,\times \,1\buildrel{\,\prime}\over{.} 5$ scale, corresponding to 0.18 pc) of the DCN ( J = 2 − 1) and DCO ^+ ( J = 2 − 1) lines in the 2 mm band toward the Orion KL region obtained with the 2 mm receiver system named B4R installed on the Large Millimeter Telescope. The DCN emission shows a peak at the Orion KL hot core position, whereas no DCO ^+ emission has been detected there. The DCO ^+ emission shows enhancement at the west side of the hot core, which is well shielded from the UV radiation from OB massive stars in the Trapezium cluster. We have derived the abundance ratio of DCN/DCO ^+ at three representative positions where both species have been detected. The gas components with V _LSR ≈ 7.5–8.7 km s ^−1 are associated with low abundance ratios of ∼4–6, whereas much higher abundance ratios (∼22–30) are derived for the gas components with V _LSR ≈ 9.2–11.6 km s ^−1 . We have compared the observed abundance ratio to our chemical models and found that the observed differences in the DCN/DCO ^+ abundance ratios are explained by different densities.

El artículo presenta, desde una perspectiva de políticas públicas, una revisión de las medidas implementadas por el Estado paraguayo y las instancias descentralizadas a partir de la pandemia por COVID-19. La metodología implicó la sistematización de fuentes secundarias de información estadística y la aplicación de entrevistas semiestructuradas en las localidades de estudio. Seplanteaun análisis de la actuación del poder público en materia de políticas sociales durante la pandemia, con el fin de examinar la evolución de los esfuerzos financieros en el área de las intervenciones sociales, tanto durante elperiodoanterioralacrisissanitariacomoduranteelañodedesenvolvimientode lapandemia (años 2018, 2019 y 2020).Se observa la inversión social en cuatrodepartamentos:Boquerón, Caazapá, San PedroyCentral. Estos conciernen respectivamente a los distritos de Mariscal Estigarribia, San Juan Nepomuceno, Santa Rosa del Aguaray y Villeta. Se analiza, por último,la situación de la capital del país,Asunción.Estas cinco localidadesconstituyeron los casos de estudio de la investigación.La crisis causada por la pandemia muestra que la inversión social en sectores estratégicos como salud, educación y protección social representa un eje fundamental para el fortalecimiento de sistemas sociales de protección que garanticen el sostenimiento de procesos de seguridad alimentaria, subsidios y seguros de desempleos para controlar los efectos negativos del confinamiento y de las pérdidas de empleo

The purpose of the present case is to describe a patient with tractional retinal detachment (RD) associated with contractile morning glory: a 17-year-old female, with a history of failed surgery for RD when she was 2 years old in her right eye (OD), nystagmus, and a limited visual acuity in the left eye (OS). The slit lamp examination showed phthisis bulbi in OD and the anterior segment was unremarkable in OS. Dilated fundus examination revealed a tractional RD in the posterior pole and peripapillary and preretinal fibrosis without evidence of intravitreal dispersion of retinal pigment epithelial cells. After surgery treatment, the RD resolved and the posterior segment showed a staphylomatous excavation around the optic disc anomaly with irregular contractions that folded the macular area. This were unrelated to light, breathing, or eye movements. Although morning glory disc anomaly is associated with RD, the early diagnosis can reverse structural changes. In this case, the rare association with contractile movements was found posterior to the pars plana vitrectomy after all the fibroglial epiretinal tissue was removed.

Las intervenciones no farmacéuticas (NPI) son actualmente el único mecanismo que los gobiernos pueden usar para mitigar el impacto de la epidemia de COVID-19. De manera similar a la propagación real de la enfermedad, la dinámica de los patrones de contención que surgen de la aplicación de los NPI es compleja y depende de las interacciones entre las personas dentro de una región específica, así como de otros factores estocásticos asociados a condiciones demográficas, geográficas, políticas y económicas. Los modelos basados en agentes simulan reglas microscópicas de interacciones simultáneas de múltiples individuos dentro de una población en un intento de reproducir la dinámica compleja del efecto de las medidas de contención. De esta manera, es posible diseñar comportamientos individuales junto con escenarios de NPI, midiendo cómo se ve afectada la dinámica de la simulación y, por lo tanto, brindando información útil para realizar una evaluación rápida del potencial de las intervenciones combinadas, en las diferentes etapas de la epidemia. En este artículo describimos un modelo y una herramienta para experimentar con este tipo de análisis, considerando una serie de NPI ampliamente utilizadas, tales como distanciamiento físico, aislamiento de casos, cuarentena domiciliaria, encierro total, pruebas centinela, uso de tapabocas y una novedosa aplicación “zonal”, que permite aplicar estas intervenciones gradualmente a localidades o zonas separadas. La elección de las intervenciones o combinaciones más adecuadas para un territorio particular, dependerá en última instancia de las condiciones socioeconómicas y de salubridad, así como de una validación a gran escala de la viabilidad de los escenarios identificados preliminarmente mediante la herramienta.

Objetivo: Describir un caso clínico de maculopatía intermedia paracentral aguda asociada a asas vasculares prepapilares de origen venoso. Caso clínico: Mujer de 42 años que acude por presentar un escotoma paracentral inferior del ojo derecho con agudeza visual de 20/25. En la exploración física se observan asas venosas prepapilares. Tanto en los estudios de imagen multimodal como en la tomografía de coherencia óptica se identifica el sitio del área afectada de la mácula, con atrofia focal de la retina a expensas de la capa nuclear interna. Conclusión: La maculopatía intermedia paracentral aguda puede ser secundaria a diversas alteraciones de la vasculatura retiniana. Hasta el conocimiento de los autores, no existen reportes previos que describan la asociación entre una maculopatía intermedia paracentral aguda y asas vasculares prepapilares.

The search for the right person for the right job, or in other words the selection of the candidate who best reflects the skills demanded by employers to perform a specific set of duties in a job appointment, is a key premise of the personnel selection pipeline of recruitment departments. This task is usually performed by human experts who examine the résumé or curriculum vitae of candidates in search of the right skills necessary to fit the vacant position. Recent advances in AI, specifically in the fields of text analytics and natural language processing, have sparked the interest of research on the application of these technologies to help recruiters accomplish this task or part of it automatically, applying algorithms for information extraction, parsing, representation, and matching of résumés and job descriptions, or sections within. In this study, we aim to better understand how the research landscape in this field has evolved. To do this, we follow a multifaceted bibliometric approach aimed at identifying trends, dynamics, structures, and visual mapping of the most relevant topics, highly cited or influential papers, authors, and universities working on these topics, based on a publication record retrieved from Scopus and Google Scholar bibliographic databases. We conclude that, unlike a traditional literature review, the bibliometric-guided approach allowed us to discover a more comprehensive picture of the evolution of research in this subject and to clearly identify paradigm shifts from the earliest stages to the most recent efforts proposed to address this problem.

The development of Ce-based materials is directly dependent on the catalyst surface defects, which is caused by the calcination steps required to increase structural stability. At the same time, the evaluation of cerium’s redox properties under reaction conditions is of increasing relevant importance. The synthesis of Ce-UiO-66 and CeZr-UiO-66 and their subsequent calcination are presented here as a simple and inexpensive approach for achieving homogeneous and stable CeO2 and CeZrOx nanocrystals. The resulting materials constitute an ideal case study to thoroughly understand cerium redox properties. The Ce3+/Ce4+ redox properties are investigated by H2-TPR experiments exploited by in situ FT-IR and Ce M5-edge AP-NEXAFS spectroscopy. In the latter case, Ce3+ formation is quantified using the MCR-ALS protocol. FT-IR is then presented as a high potential/easily accessible technique for extracting valuable information about the cerium oxidation state under operating conditions. The dependence of the OH stretching vibration frequency on temperature and Ce reduction is described, providing a novel tool for qualitative monitoring of surface oxygen vacancy formation. Based on the reported results, the molecular absorption coefficient of the Ce3+ characteristic IR transition is tentatively evaluated, thus providing a basis for future Ce3+ quantification through FT-IR spectroscopy. Finally, the FT-IR limitations for Ce3+ quantification are discussed.

Se presentó el caso de una paciente femenina de 20 años de edadqueacudió al servicio de Neurocirugíapor presentar dolor en la región lumbar. Al interrogatorio la paciente refirió tener constipación, retención urinaria y dolor lumbar. En los exámenes complementarios lo más significativo fue la resonancia magnética nuclear que mostró una imagen hiperdensa a nivel de D12-L5. Se realizó laminectomía de D12-L5, durotomía y extracción tumoral, fijación transpedicular con tornillos ubicados en T12-L1-L3-L4 con barras de titanio, se obtuvo un diagnóstico de astrocitoma grado II-III.Al analizar los diferentes aspectos del caso en cuestión, los investigadores concluyen que con la conducta terapéutica tomada con este caso se sientan las bases para un correcto manejo de posteriores pacientes.

While water splitting may afford a renewable means to store energy in chemical bonds, water oxidation catalysts suffer from poor stabilities in acidic media. Here, authors show sodium doping of strontium ruthenate to improve the catalytic durability while maintaining a high O2 evolution activity.

Introducción:la búsqueda de alternativas terapéuticas para la atención al paciente con patología de la columna vertebral es una exigencia social, para lo cual se promueve el uso de la ozonoterapia.Objetivo: caracterizar la respuesta clínica de los pacientes con patología de la columna vertebral tratados con ozonoterapia paravertebral en el Hospital General Docente “Dr. Agostinho Neto” de Guantánamo durante el período comprendido entre los meses de septiembre de 2017 y agosto de 2018.Método: se realizó un estudio observacional, prospectivo y transversal en el servicio de Neurocirugía en 78 pacientes con enfermedades de la columna vertebral, seleccionados intencionalmente y que participaron conscientemente en un preexperimento que consistió en la aplicación de un ciclo de diez sesiones de ozonoterapia por vía paravertebral durante un periodo de dos semanas. Se controlaron las siguientes variables: intensidad del dolor lumbar medida mediante la escala de evaluación analógica; incapacidad funcional evaluada mediante la escala de Oswestry. Resultados. la mayoría de los pacientes transitó a una categoría de dolor inferior y el 80,7 % se evaluó en la categoría leve–moderado después de la ozonoterapia. Esta posibilitó que en el mayor porcentaje disminuyera el grado de incapacidad funcional y la proporción con un grado mínimo de incapacidad función se incrementara en un 46,0 %.Conclusiones: la ozonoterapia paravertebral constituye una alternativa que puede ayudar en el tratamiento conservador del paciente con patología vertebral.

El fin es un motivo que cruza prácticamente toda la obra de Samuel Beckett. En este artículo propongo, con especial atención a su novela Cómo es, que el agotamiento de la significación en la escritura de Beckett no constituye propiamente una tesis o una posición acerca de la “condición humana” (no sirve como ilustración de perspectivas filosóficas de tipo existencialistas), sino que es una exploración de los límites del lenguaje, paradójicamente inagotables.

BackgroundWe aimed to compare the performance of the recent CASTLE score to J-CTO, CL and PROGRESS CTO scores in a comprehensive database of percutaneous coronary intervention of chronic total occlusion procedures.MethodsScores were calculated using raw data from 1,342 chronic total occlusion procedures included in REBECO Registry that includes learning and expert operators. Calibration, discrimination and reclassification were evaluated and compared.ResultsMean score values were: CASTLE 1.60±1.10, J-CTO 2.15±1.24, PROGRESS 1.68±0.94 and CL 2.52±1.52 points. The overall percutaneous coronary intervention success rate was 77.8%. Calibration was good for CASTLE and CL, but not for J-CTO or PROGRESS scores. Discrimination: the area under the curve (AUC) of CASTLE (0.633) was significantly higher than PROGRESS (0.557) and similar to J-CTO (0.628) and CL (0.652). Reclassification: CASTLE, as assessed by integrated discrimination improvement, was superior to PROGRESS (integrated discrimination improvement +0.036, pConclusionProcedural percutaneous coronary intervention difficulty is not consistently depicted by available chronic total occlusion scores and is influenced by the characteristics of each chronic total occlusion cohort. In our study population, including expert and learning operators, the CASTLE score had slightly better overall performance along with CL score. However, we found only intermediate performance in the c-statistic predicting chronic total occlusion success among all scores.

Background. After several waves of spread of the COVID-19 pandemic, countries around the world are struggling to regain their economies by slowly lifting mobility restrictions and social distance measures applied during the crisis. Meanwhile, recent studies provide compelling evidence on how contact distancing, the use of face masks, and handwashing habits can reduce the risk of SARS-CoV-2 transmission. In this context, we investigated the effect that these personal protection habits can have in preventing new waves of contagion. Methods. We extended an agent-based COVID-19 epidemic model in a simulated community to incorporate the mechanisms of these aforementioned personal care habits and measure their incidence in person-to-person transmission. A full factorial experiment design was performed to illustrate the extent to which the interplay between these personal habits is effective in mitigating the spread of disease. A global sensitivity analysis was performed on the parameters that control these habits to further validate the results. Results. We found that observing physical distance is the dominant habit in reducing disease transmission, although adopting either or both of the other two habits is necessary to some extent to suppress a new outbreak entirely. When physical distance is not observed, adherence to the use of masks or handwashing has a significant decrease in infections and mortality, but the epidemic still unfolds. We also found that in all scenarios, the combined effect of adhering to the three habits is more powerful than adopting them separately. Conclusions. Our findings suggest that a broad adherence of the population to voluntary self-care habits would help contain unfold of new outbreaks. The purpose of our model is illustrative and contributes to ratify the importance of urging citizens to adopt the amalgam of personal care habits as a primary collective protection measure to prevent communities from returning to confinements, while immunisation is carried out in late stages of the pandemic.

In this work, we study the direct synthesis of DME using CO2-rich syngas, with a CO2/CO ratio similar to that obtained from the gasification of biomass, i.e., 1.9. We used catalytic beds consisting of physical mixtures of the benchmark catalysts used for the synthesis of methanol from syngas and for methanol dehydration to DME, namely Cu/ZnO/Al2O3 and γ-Al2O3, respectively. Our results show that the ratio between each catalytic phase determines the productivity and selectivity to DME, as well CO and CO2 conversions. Thus, higher total carbon conversions were obtained with the catalytic bed with the highest content of the Cu/Zn/Al2O3 phase. The presence of γ-Al2O3 allows to exceed the equilibrium conversion of CO for the syngas to methanol synthesis. The highest DME productivity is obtained with the catalytic bed containing equal amounts of both catalytic phases. In addition, we also show that other reaction variables such as temperature, pressure, and contact time also play an important role in terms of DME productivity. The presence of a high fraction of CO2 in the syngas results in a high production of H2O, which after long times on stream result in the deactivation of the Cu/ZnO/Al2O3 catalytic phase due to the sintering of the copper particles. The in situ removal of H2O via the addition of an H2O sorbent, zeolite 3A, into the catalytic bed, results in a significant enhancement of both carbon conversion and DME productivity.

Pergunto-me, neste artigo, sobre a possibilidade da arte de enfrentar a violência hoje, quando já é claro que ela não funciona como uma interrupção excepcional do cotidiano, mas nele se concretiza. O que procuro refletir não é sobre o modo como as artes fazem da violência um "tema", mas sobre a possibilidade de que seja pensada, que o destinatário das obras seja alterado não pelo espetáculo da violência, viabilizada por feitos de sangue, mas pelo quão esmagador pode ser, efetivamente, pensar a ordem da violência. Que não esteja, em primeiro plano, uma carnificina humana que emudece, fazendo faltar as palavras, mas o pensamento que a violência provoca no espectador a partir de uma circunstância artística. A hipótese principal é que, em relação à violência, os próprios limites instituídos da arte podem se tornar um recurso tão ambíguo quanto essencial para dar origem a esse pensamento.

Introduction: The purpose was to assess the level of agreement and reproducibility between fluorescein angiography (FA) and optical coherence tomography angiography (OCTA), throughout the evaluation of the foveal avascular zone (FAZ) to diagnose diabetic macular ischemia (DMI). Methods: In this ambispective, observational, cross-sectional research, 41 patients underwent traditional FA and OCTA to obtain the level of agreement and reproducibility between them, using an intraclass correlation coefficient (ICC) in mixed models. Two raters independently graded the area of the FAZ using the ImageJ software and the Early Treatment Diabetic Retinopathy Study protocols. Spearman and rank-biserial correlational analysis were used to calculate the strength of linear relationship between the area of the retinal vessels, the thickness of subfoveal retinal and choroid layers, the presence of neovascularization, and the visual acuity. A classification, based on the radius of the FAZ, was proposed and used to categorize the severity of DMI into five different grades. Result: From 52 evaluated eyes, the level of agreement between the OCTA and FA among the raters had an ICC of 0.99 and 0.907 (p

Introduction: There are inconclusive data about the potential delay of procedure time in emergent percutaneous coronary intervention (PCI) by radial compared with femoral approach in patients with ST-segment elevation myocardial infarction (STEMI). Aims: The purpose of the current study is to conduct a comprehensive meta-analysis of controlled randomized trials (CRTs) comparing the procedure time in STEMI patients undergoing emergent PCI with radial versus femoral access. Methods: Formal search of CRTs through electronic databases (Medline and PubMed) was performed from January 1990 to October 2014 without language restrictions. Mean difference (MD) of procedure time was evaluated as overall effect. Results: Twelve studies were included with 2052 and 2121 patients in radial and femoral group, respectively. Variability in the definition of procedure time was found with unavailability of a precise definition in 41.6% of studies. When all studies were included, no significant longer procedure time in radial approach was detected (MD [95% confidence interval [CI] = 1.6 min [−0.10, 3.3], P = 0.07, P het = 0.56). After deleting RIVAL trial, procedure time was significantly longer in radial group (MD [95% CI] = 1.5 min [0.71, 2.3], P < 0.001, P het = 0.20). Meta-analysis of three studies with similar definition of procedure time showed (MD [95% CI] = 1.26 min [−0.43, 2.95], P = 0.14, P het = 0.85). Conclusions: Although the procedure time in STEMI patients undergoing emergent PCI by radial access is generally comparable with femoral approach, there is an absence of uniformity in its definition, which leads to divergent results. A standardized definition of procedure time is required to elucidate this relevant matter.

Abstract Background Age-related macular degeneration (AMD) is the leading cause of blindness in the western world. As a consequence of AMD, patients develop structural damage that comprises the fovea and subsequently present loss of central vision, low visual acuity and unstable fixation. Contrary to what happens with anti-angiogenic treatment in neovascular AMD, there is currently no definitive treatment to reverse geographic atrophy progression. The aim of this study was to determine the effectiveness of the visual rehabilitation treatment via microperimetry in patients with geographic atrophy. Methods Longitudinal and prospective study, 18 patients with areas of geographic atrophy in their eye of better visual acuity were included. Macular integrity assessment (Maia) microperimeter (CentreVue, Padova, Italy) was used to diagnose retinal fixation and sensitivity in these patients. Based on these data and using the training module available in the equipment, the patients underwent visual rehabilitation sessions intended to allow the patient to establish the best possible fixation in the best area of retinal sensitivity. To determine the training effectiveness, the following variables were compared before and after: visual acuity in LogMAR scale with ETDRS charts, reading speed with Minnesota Low-Vision Reading Test (MN Read), average sensitivity threshold in microperimetry; P1 and 95% Bivariate Contour Ellipse Area (BCEA) values were used for fixation stability measurement. Results Mean age was 77 years old (65–92). Visual acuity of the trained eye was on average 0.7 versus 0.6 LogMAR (p = 0.006) before and one week after training. Reading speed, using both eyes, was 47 words per minute (wpm) before training and 69 wpm after training (p = 0.04). Average retinal sensitivity was 14.1 versus 14.6 db (p = 0.4). Fixation stability improved with P1 values of 45% versus 51% (p = 0.05) and 95% BCEA values of 43 versus 25 (p = 0.02) before and after training, respectively. Conclusions Visual training via microperimetry in patients with age-related macular degeneration is effective in improving fixation stability, reading speed, and visual acuity, measured one week after training is completed.

We describe a case of septal branch perforation during percutaneous coronary intervention of a right coronary artery chronic total occlusion. The septal branch perforation was treated with administration of autologous fat into the septal branch with significant reduction of extravasation. This treatment was followed by prolonged balloon inflation at the exit point of the septal branch in the donor artery which definitively sealed the perforation.

Objectives Guidelines recommending 12-month dual antiplatelet therapy (DAPT) in patients with ST-elevation acute coronary syndrome (STEACS) undergoing percutaneous coronary intervention (PCI) were published in year 2012. We aimed to describe the influence of guideline implementation on the trend in 12-month persistence with DAPT between 2010 and 2015 and to evaluate its relationship with DAPT duration regimens recommended at discharge from PCI hospitals.Design Observational study based on region-wide registry data linked to pharmacy billing data for DAPT follow-up.Setting All PCI hospitals (10) belonging to the acute myocardial infarction (AMI) code network in Catalonia (Spain).Participants 10 711 STEACS patients undergoing PCI between 2010 and 2015 were followed up.Primary and secondary outcome measures Primary outcome was 12-month persistence with DAPT. Calendar year quarter, publication of guidelines, DAPT duration regimen recommended in the hospital discharge report, baseline patient characteristics and significant interactions were included in mixed-effects logistic regression based interrupted time-series models.Results The proportion of patients on-DAPT at 12 months increased from 58% (56–60) in 2010 to 73% (71–75) in 2015. The rate of 12-month persistence with DAPT significantly increased after the publication of clinical guidelines with a time lag of 1 year (OR=1.20; 95% CI 1.11 to 1.30). A higher risk profile, more extensive and complex coronary disease, use of drug-eluting stents (OR=1.90; 95% CI 1.50 to 2.40) and a 12-month DAPT regimen recommendation at discharge from the PCI hospital (OR=5.76; 95% CI 3.26 to 10.2) were associated with 12-month persistence.Conclusion Persistence with 12-month DAPT has increased since publication of clinical guidelines. Even though most patients were discharged on DAPT, only 73% with potential indication were on-DAPT 12 months after PCI. A guideline-based recommendation at PCI hospital discharge was highly associated with full persistence with DAPT. Establishing evidence-based, common prescribing criteria across hospitals in the AMI-network would favour adherence and reduce variability.

Contexto: Ingeniería es una revista científica editada en Colombia por la Universidad Distrital Francisco José de Caldas, que publica investigación multidisciplinaria en todos los campos de la ingeniería. El objetivo de este trabajo es realizar un análisis bibliométrico de su producción científica durante el período 2010-2017. Método: Se examinó un corpus de 144 artículos publicados, se recopilaron sus metadatos bibliográficos y se realizaron varios análisis bibliométricos, incluidos productividad, autoría, citas, cobertura geográfica y temática, redes de colaboración, mapas conceptuales temáticos y métricas de impacto. Resultados: Entre los resultados se encuentran: promedio de citas por artículo de 2.1, índice de colaboración de 2.22, tasa de crecimiento de publicación es 19 %, h-index de h = 10, g-index de g = 13, hi5-index de hi5 = 9, el total de citas es de 298, hay diez grupos de autores muy conectados y cuatro grupos temáticos obtenidos a partir del análisis de coincidencia de las palabras clave y los resúmenes. Conclusiones: El perfil de la revista con respecto a citaciones e impacto es prometedor, aunque requiere mejorar su visibilidad y reconocimiento, ya que las métricas de cobertura, autoría y áreas temáticas, parecen incipientes. También es deseable ampliar las redes de colaboración de su base de autores.

BACKGROUND: Balloon advancement and dilation through chronic total occlusion segment could be challenging in some cases after successful wire crossing. The purpose of this study was to evaluate efficacy and safety of Tornus catheter in percutaneous coronary intervention of chronic total occlusion in hard or balloon-uncrossable chronic total occlusion. METHODS: The present study is a retrospective and descriptive analysis of 14 hard or balloon-uncrossable chronic total occlusions treated percutaneously in our cath. Tornus catheter was used to penetrate and eventually cross the chronic total occlusion segment. Procedure success was defined when Tornus penetrated at least partly into chronic total occlusion segment making possible the subsequent balloon dilatation and stent implantation achieving a final TIMI III angiographic result with residual stenosis less than 30%. Switch to other microcatheter was considered as an unsuccessful procedure. Complications associated with the Tornus use were analyzed in order to evaluate device safety. RESULTS: The average age of patients was 65.2 ± 9.6 and 11 out of 14 (78.6%) were male. In 7 (50%) cases, Tornus was used after an unsuccessful balloon passage through occluded segment. In 11 (78.6%) out of 14 cases the procedure was successful and in 3 (21.4%) cases, the operator switched to another microcatheter to continue with the procedure. No complication occurred during all procedures. CONCLUSION: Tornus catheter can be effectively and safely used in a subgroup of patients undergoing percutaneous coronary intervention of chronic total occlusion with hard or balloon-uncrossable lesions and could facilitate the treatment of this type of lesions.

The complexities presented by the exercise of interpretation on Beckett’s work are not due only to questions of philosophical content (i.e. The horizon of Postwar Existentialism), but to his formal approach to language reflection. Namely, words go through a progressive devastation at the core of their significance and connotative reach. This article further explores that process, and the exhaustion of the self as subject in the narrative trilogy Molloy, Malone Dies and The Unnamable

We present a case of an accidentally crushed stent due to an unnoticed passage of a guidewire through a lateral stent strut with subsequent stent compression after balloon dilatation, during a planned percutaneous coronary intervention on the left main. The crushed stent segment was reconstructed with step-by-step balloon dilation, guided by intravascular ultrasound. Resumo: Apresenta-se um caso em que durante uma angioplastia eletiva do tronco comum, devido à passagem inadvertida do fio-guia através da malha do stent, ocorreu um esmagamento do stent após a dilatação com balão. O segmento de stent danificado foi reparado através de sucessivas dilatações com balão, tendo o procedimento sido guiado por ecografia intravascular (IVUS). Keywords: Left main, Percutaneous coronary intervention, Crushed stent, Palavras-chave: Tronco comum, Intervenção coronária percutânea, Stent danificado

El presente artículo propone la hipótesis de que es posible reconocer en la obra narrativa de Samuel Beckett la figura del cogito cartesiano, especialmente en relación al problema de la separación entre mente y cuerpo, y a las paradojas que resultan de una autorreflexividad filosófica cuyas operaciones parecen describir acontecimientos biográficos. El sujeto que medita se retira del mundo, hablando y escribiendo, acompañado solo por su propia voz.

Wetlands are considered strategic ecosystems in Colombia. They play an essential role in water regulation, especially in extreme rainfall events or drought as El Nino and La Nina. Despite that, Colombia did not have a national wetland map. The Humboldt Institute, with the Adaptation Fund support and in partnership with Ideam, built the Identification Wetlands Map of Colombia Inland Territory using official information available at 1:100.000 of soils, geomorphology and associated wetland vegetation coverage. Additionally, a flood frequency map obtained from radar satellite images was integrated; it provided information of the spatial and temporal ecosystem dynamics. We identified 30.781.149 hectares of wetlands (26.99% of the national inland area) distributed in the following categories: open or under canopy permanent wetlands, temporary wetlands, and medium and low potential wetlands. The largest category is temporary wetlands with 17.861.536 ha. The thematic map accuracy was performed through 19 windows and 3176 points with a score of 75.79% total accuracy. To deal such magnitude of national wetlands area, it is necessary to develop policies and actions that enable differentiated management and recognize the identity of each wetland category.

Objetivo: Evaluar la sobrevida global y libre de enfermedad en pacientes con tratamiento concomitante de radioquimioterapia más histerectomía extrafascial en cáncer de cuello uterino IB2. Método: 31 pacientes con cáncer cérvico-uterino en etapa IB2 fueron tratadas con radioquimioterapia concomitante más histerectomía extrafascial programada en 4 a 6 semanas. Se efectuó radioterapia pelviana externa e implante de braquiterapia útero-vaginal con dosis preoperatoria entre 70-75 Gy a punto A y quimioterapia con cisplatino. Resultados: La edad promedio de las pacientes fue de 41 ± 8 años. El 81% de los casos fue carcinoma escamocelular. La histerectomía extrafascial se realizó 4 a 6 semanas post-radiación en el 85% de los casos. El 79% y el 13% de las pacientes recibieron 5 y 4 ciclos de quimioterapia respectivamente. La mediana de seguimiento fue de 38 meses. La sobrevida global y libre de enfermedad estimada a 5 años fue de 86% y 79% respectivamente. Hubo diferencia significativa en la sobrevida global en los subgrupos sin o con enfermedad residual macroscópica en la pieza operatoria (pAim: To evaluate overall and disease free survival in cervical cáncer IB2 patients with concomitant chemo-radiotherapy and posterior extrafascial hysterectomy treatment. Methods: Between July 2005 to December 2009, a total of 31 eligible patients with IB2 cervical cancer were treated with chemoradiotherapy and posterior hysterectomy in the Carlos Van Buren Hospital Oncology Unit. Radiotherapy consisted in external pelvic radiation and a utero-vaginal brachitherapy with low rate doses to get preoperatory doses between 70 and 75 Gy to the A point and a concomitant Cisplatin based chemotherapy. After this treatment, the patients received extrafascial hysterectomy 4 to 6 weeks completed chemoradiotherapy. Results: The mean age was 41 ± 8 years. 81% of the patients had an spinocelular carcinoma. The extrafascial hysterectomy was made between 4 to 6 weeks post-radiation in 85% of the patients. 79% and 13% of the patients received 5 and 4 chemotherapy cycles respectively. The median follow up was 38 months. The 5 years overall survival and disease free survival estimates were 86% and 79% respectively. There was a significant difference between subgroups of patients with and without macroscopic residual disease in the operatory specimen (p

Objetivo: Evaluar la experiencia con videotoracoscopía en pacientes con sospecha de cáncer de ovario avanzado con probable compromiso del tórax. Método: Se analiza las pacientes con sospecha clínica e imagenológica de cáncer de ovario avanzado que presentan derrames pleurales moderado y severo, así como procesos tumorales torácicos para evaluar la posibilidad de citorreducción óptima o completa. Todos los casos sometidos a este procedimiento entre enero de 2009 a Agosto de 2011, son analizados con énfasis en el diagnóstico y en los hallazgos a la videotoracoscopía, así como sus resultados. Resultados: 11 pacientes con clínica y tomografía axial computarizada de tórax sospechoso de compromiso pleural o pulmonar, son sometidas al procedimiento previo al intento de citorreducción abdominopélvica. La edad promedio fue de 62 años y Ca 125 promedio de 1030 U/ml. En 6 pacientes se encontró enfermedad macroscópica pleural, la biopsia fue positiva para adenocarcinoma en 5. Dos de ellas se consideraron no citorreducible en abdomen y se indicó neoadyuvancia. La tercera se citorredujo en forma óptima. En 2 pacientes se indicó neoadyudancia por tener residuo tumoral torácico mayor a 1 cm, consideradas citorreducibles en abdomen. De las 6 pacientes sin enfermedad torácica, 4 se citorredujeron óptimamente, una falleció previo a la cirugía abdominal y otra resultó un tumor ovárico benigno. Conclusión: La videotoracoscopía es útil para evaluar enfermedad torácica y tomar decisiones en relación a la citorreducción abdominal o neoadyuvancia en cáncer avanzado de ovario.Objective: To describe the experience with video-assisted thoracic evaluation in patients with suspected advanced ovarian cancer with a probable thoracic involvement. Method: Patients with clinical and imaging suspicion of advanced ovarian cancer who have pleural effusions, and thoracic tumor processes are examined to evaluate the possibility of optimal debulking. All cases that underwent this procedure between January 2009 to August 2011, were studied with emphasis on diagnosis, results and findings at videotho-racoscopy. Results: 11 patients with a suspected thoracic commitment, with clinical and computerized axial tomography scan, undergo the procedure previous to an abdominopelvic cytoreductive surgery attempt. The average age was 62 years and CA 125 of 1030 U/ml average. Macroscopic pleural disease was found in 6 patients, but in 5 of them the biopsy gave positive for adenocarcinoma. Two of them were not considered for a cytoreductive surgery in the abdomen and neoadjuvant therapy was indicated. The third patient of the 5 previously mentioned, underwent an optimal cytoreduction. In 2 patients, neoadjuvant therapy was indicated for having residual tumor in the thorax greater than 1 cm, although they were considered for a cytoreductive surgery in the abdomen. Of the 6 patients without chest involvement, 4 underwent an optimal cytoreductive surgery, and one died before the abdominal surgery and the other had a benign ovarian tumor. Conclusion: Videothoracoscopy is useful for diagnosing thoracic metastasis and making decisions regarding cytoreduction and neoadjuvant therapy in advanced ovarian cancer.

Objetivo: Comunicar una técnica mínimamente invasiva para el manejo quirúrgico del cáncer cérvicouterino en estadio precoz y sus resultados. Método: 40 pacientes con cáncer cérvicouterino en estadios IA2 y IB1 operadas en un período de 2,5 años. Se les efectúa linfadenectomía pelviana sistemática laparoscópica seguidas de histerectomía vaginal radical, excepto aquellas pacientes que tienen compromiso ganglionar detectado en biopsia contemporánea. Resultados: 40 pacientes son sometidas a esta técnica. Cuatro pacientes son abortadas de su cirugía, 3 por presentar ganglios positivos para carcinoma en biopsia contemporánea y 1 por tener un extenso compromiso cervical al momento de efectuar la histerectomía vaginal radical. Los 36 casos restantes tienen una edad promedio de 43,9 años, ninguna nulípara y 8 tienen el antecedente de cesárea. El IMC promedio fue de 30,49 y 14 conizadas previas. El tiempo operatorio promedio fue de 238 minutos. La estadía postoperatoria promedio fue de 2,9 días. El sangrado estimado fue de 139 cc y ninguna paciente requirió transfusión. Se conservan los anexos en 13 pacientes y en todas se suspenden por vía laparoscópica. El promedio de ganglios obtenidos fue de 30. Cuatro pacientes sufren lesión vesical, 1 fístula vesicovaginal y 3 disfunciones vesicales. Conclusión: El cáncer cérvicouterino en estadio precoz es factible de ser tratado con esta técnica y brinda las ventajas de la cirugía laparoscópica y vaginal con mínimas complicaciones.Objective: To communicate a minimally invasive technique for surgical handling of early stage cervical cancer and its results. Methods: 40 patients with cervical cancer in stages IA2 and IB1, all of them operated in a period of 2.5 years, are presented. Laparoscopic systemic pelvic lymphadenectomy with posterior radical vaginal hysterectomy was performed, with the exception of those patients who had compromised nodes detected in contemporary biopsy. Results: 40 patients were submitted to this technique. 4 patients had their surgery aborted: 3 presented positive nodes for carcinoma in contemporary biopsy and 1 had extensive cervical compromise when performing radical vaginal hysterectomy. Analysis of the remaining 36 cases shows an average age of 43.9 years, all of them had given birth before, 8 of them through Cs-section. BMI averaged 30.49 and 14 had had cone surgery performed previously. Average duration of surgery was of 238 minutes. Postoperative hospitalization averaged 2.9 days. Bleeding volume was estimated at 139 cc and no patient required blood transfusion. 13 uterine annexes were kept and all of them were suspended by means of laparoscopy. On average, 30 nodes were obtained. 4 patients suffered bladder injury, one had vesicovaginal fistula and there were 3 bladder dysfunctions. Conclusion: The early stage cervical cancer is likely to be treated with this technique and provides de benefits of laparoscopic and vaginal surgery with minimal complications.

In some geological formations, borehole resistivity measurements can be simulated using a sequence of 1D models. By considering a 1D layered media, we can reduce the dimensionality of the problem from 3D to 1.5D via a Hankel transform. The resulting formulation is often solved via a semi-analytic method, mainly due to its high performance. However, semi-analytic methods have important limitations such as, for example, their inability to model piecewise linear variations on the resistivity. Herein, we develop a multi-scale finite element method (FEM) to solve the secondary field formulation. This numerical scheme overcomes the limitations of semi-analytic methods while still delivering high performance. We illustrate the performance of the method with numerical synthetic examples based on two symmetric logging-while-drilling (LWD) induction devices operating at 2 MHz and 500 KHz, respectively.

El historiador del arte Ernst Gombrich ha sido un crítico de los supuestos filosóficos de la iconología de Erwin Panofsky, debido a que en ésta, tanto la obra de arte como su creador, se diseminan en la generalidad de la «cultura». Sin embargo, proyectadas sobre el arte contemporáneo, ambas teorías historiográficas deben reflexionar sus límites. Basándose en la filosofía de Karl Popper, Gombrich expresa su distancia respecto al historicismo del arte moderno en general, señalando el «hegelianismo» dominante en la producción y reflexión estética del siglo XX. Sostenemos en este artículo que en esta crítica Gombrich elabora una lúcida caracterización del arte contemporáneo.The Art-Historian Ernst Gombrich has been a critic of the philosophical assumptions of the iconology of Erwin Panofsky because in this theory, both work of art and its creator scatter in the generality of «culture». Nevertheless, projected on contemporary art, both historiographic theories must reflect their limits. Basing on the philosophy of Karl Popper, Gombrich expresses distance in relation to the historicism of the Modern Art in general, indicating the dominant «hegelianism» in the production and aesthetical reflection of the XX Century. We maintain in this article that in this critic Gombrich elaborates a perceptive characterization of Contemporary Art.

En el presente siglo, ha surgido en Chile un conjunto de escritores que, sin corresponder técnicamente al concepto de “generación”, comparten en sus narrativas importantes elementos tanto en estilo como en contenido. Pertenecientes al contexto de la transición política en el país, los personajes rememoran su propio pasado en relatos e imágenes de infancia y juventud, buscando un remedo de historia. En lugar de grandes acontecimientos, encuentran el tiempo de una densa cotidianeidad nunca interrumpida. Esta literatura nos permite reflexionar la emergencia de las memorias de lo cotidiano en el Chile de hoy, cuando la matriz narrativa de la gran historia parece agotada en el imaginario social y un pasado múltiple e insubordinado retorna como la cifra del presente. In this century, has emerged in Chile a group of writers who, without correspond technically to the concept of “generation”, have in their narratives important elements common, both in stylistic such as in contents. Belonging to the context of the political transition in the country, the characters remember their past in stories and images of childhood and youth, seeking a semblance of history. Instead of large events, they find a time of density everyday never interrupted. This literature allows us to reflect the emergence of memories of everyday life in Chile today, when the matrix narrative of the great story seems exhausted in the social imaginary and a past multiple and insubordinate returns as the figure of the present.

BACKGROUND:The analysis of complex proteomic and genomic profiles involves the identification of significant markers within a set of hundreds or even thousands of variables that represent a high-dimensional problem space. The occurrence of noise, redundancy or combinatorial interactions in the profile makes the selection of relevant variables harder. METHODOLOGY/PRINCIPAL FINDINGS:Here we propose a method to select variables based on estimated relevance to hidden patterns. Our method combines a weighted-kernel discriminant with an iterative stochastic probability estimation algorithm to discover the relevance distribution over the set of variables. We verified the ability of our method to select predefined relevant variables in synthetic proteome-like data and then assessed its performance on biological high-dimensional problems. Experiments were run on serum proteomic datasets of infectious diseases. The resulting variable subsets achieved classification accuracies of 99% on Human African Trypanosomiasis, 91% on Tuberculosis, and 91% on Malaria serum proteomic profiles with fewer than 20% of variables selected. Our method scaled-up to dimensionalities of much higher orders of magnitude as shown with gene expression microarray datasets in which we obtained classification accuracies close to 90% with fewer than 1% of the total number of variables. CONCLUSIONS:Our method consistently found relevant variables attaining high classification accuracies across synthetic and biological datasets. Notably, it yielded very compact subsets compared to the original number of variables, which should simplify downstream biological experimentation.