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We present the case of a 23-year-old man who was admitted to the emergency department due to thoracic trauma with a gunshot wound in the right fifth intercostal space with the anterior axillary line, with an outflow tract in the third intercostal space on the left parasternal line. The patient exhibited signs of cardiac tamponade and grade IV hemorrhagic shock. Bilateral tube thoracostomy was performed, yielding a substantial left hemothorax (1500 mL). As the patient presented deterioration of hemodynamic instability despite adequate resuscitation maneuvers, prompted immediate transportation to the operating room to perform a sternotomy. A posterior brachiocephalic trunk injury was identified, consisting of a laceration of 60% of total circumference, with an extension of over 2 cm. The distal portion of the injury was resected and reconstructed using a 6 mm polytetrafluoroethylene graft, with a proximal graft anastomosis employing a lateral anchor technique and a distal graft anastomosis using a parachute technique, secured with 4-0 polypropylene vascular sutures. The patient's postoperative recovery progressed favorably, he remained in the intensive care unit for 5 days and in general hospitalization for an additional 4 days. Further interventions were not required. A control CT angiography was performed 3 months postoperatively, demonstrating complete graft patency. Resumen: Presentamos el caso de un varón de 23 años que ingresó al servicio de urgencias por traumatismo torácico con herida de bala en el quinto espacio intercostal derecho con la línea axilar anterior, y un tracto de salida en el tercer espacio intercostal en la línea paraesternal izquierda. El paciente presentaba signos de taponamiento cardiaco y shock hemorrágico grado IV. Se realizó toracostomía con inserción de tubo de tórax bilateral, identificado un hemotórax izquierdo sustancial (1.500 mL). Como el paciente presentó deterioro de la inestabilidad hemodinámica a pesar de las adecuadas maniobras de reanimación, se motivó su traslado inmediato al quirófano para realizarle una esternotomía. Se identificó una lesión del tronco braquiocefálico posterior, consistente en una laceración del 60% de la circunferencia total, con una extensión superior a 2 cm. La porción distal de la lesión se resecó y reconstruyó mediante un injerto de politetrafluoroetileno de 6 mm, con una anastomosis del injerto proximal mediante técnica de anclaje lateral y una anastomosis del injerto distal mediante técnica de paracaídas, asegurada con suturas vasculares de polipropileno 4-0. La recuperación postoperatoria del paciente evolucionó favorablemente, permaneció cinco días en unidad de cuidado intensivo y en hospitalización general por cuatro días adicionales. No fueron necesarias más intervenciones. Se realizó una angiografía por TC de control a los tres meses del postoperatorio, demostrando permeabilidad completa del injerto.

With the intensifying challenge of global warming driven largely by anthropogenic activities, effective greenhouse gas capture techniques are critical. This paper focuses on the role of deep eutectic solvents (DES) as promising agents for such capture at the source. We review the key DES-based methods for greenhouse gas capture, drawing conclusions from a thorough analysis of the existing literature. In particular, we examine the effect of DES structure on gas solubilities and explore the mechanism of gas solubility in DES through molecular simulation. We present a synthesis of state-of-the-art results in this area, assessing the potential of DES as an alternative to current industrial gas capture methods. Furthermore, we propose future research directions for the design of novel DES tailored to more specific applications.

Abstract Background In recent years, targeted alpha therapy has gained importance in the clinics, and in particular, the alpha-emitter 225Ac plays a fundamental role in this clinical development. Nevertheless, depending on the chelating system no real diagnostic alternative has been established which shares similar chemical properties with this alpha-emitting radionuclide. In fact, the race to launch a diagnostic radionuclide to form a matched pair with 225Ac is still open, and 133La features attractive radiation properties to claim this place. However, in order to enable its translation into clinical use, upscaling of the production of this PET radionuclide is needed. Results A study on optimal irradiation parameters, separation conditions and an exhaustive product characterization was carried out. In this framework, a proton irradiation of 2 h, 60 µA and 18.7 MeV produced 133La activities of up to 10.7 GBq at end of bombardment. In addition, the performance of four different chromatographic resins were tested and two optimized purification methods presented, taking approximately 20 min with a 133La recovery efficiencies of over 98%, decay corrected. High radionuclide purity and apparent molar activity was proved, of over 99.5% and 120 GBq/µmol, respectively, at end of purification. Furthermore, quantitative complexation of PSMA-617 and mcp-M-PSMA were obtained with molar activities up to 80 GBq/µmol. In addition, both 133La-radioconjugates offered high stability in serum, of over (98.5 ± 0.3)% and (99.20 ± 0.08)%, respectively, for up to 24 h. A first dosimetry estimation was also performed and it was calculated that an 133La application for imaging with between 350 and 750 MBq would only have an effective dose of 2.1–4.4 mSv, which is comparable to that of 18F and 68Ga based radiopharmaceuticals. Conclusions In this article we present an overarching study on 133La production, from the radiation parameters optimization to a clinical dose estimation. Lanthanum-133 activities in the GBq range could be produced, formulated as [133La]LaCl3 with high quality regarding radiolabeling and radionuclide purity. We believe that increasing the 133La availability will further promote the development of radiopharmaceuticals based on macropa or other chelators suitable for 225Ac. Graphical abstract

Abstract In small‐scale societies, people learn to identify plant species during childhood. Plant recognition is an important baseline knowledge, immediately useful to avoid intoxication risk due to wrong identification. Plant recognition is the basis of other ethnobotanical knowledge essential for safeguarding biocultural diversity. However, despite many studies on folk classification, we still have a narrow understanding of the criteria locally used for species identification; the gap being even larger regarding children's plant identification criteria. Here, we study the criteria used by Betsileo children and adolescents to identify wild edible plant (WEP) species using a child‐adapted method including drawings and follow‐up interviews. We worked with 80 teenagers (from 12 to 17 years old; 51 girls, and 29 boys). Our results suggest that teenagers use a large spectrum of visual criteria to identify plants and that these criteria match with botanical and ecological knowledge documented in the literature and herbarium vouchers. We found that 35% of the identification criteria used were non‐morphological (e.g. phenology, biotic interactions), suggesting deep ecological knowledge. On average, teenagers use more than nine distinct criteria per plant, which allows them to identify most plant species with a very high level of precision. The precision level of plant representation increases with age for boys, but remains constant for girls, suggesting different dynamics in plant identification knowledge acquisition. We also found that boys and girls use different identification criteria: girls focus on morphological criteria while boys also incorporate ecological criteria, such as landscape features and biotic interactions, in their spectrum of identification keys. Our results highlight the complexity of teenagers' plant knowledge and the importance of the ecological context and gender in plant identification's knowledge acquisition. This knowledge acquired very early in childhood, constitutes the foundation of future interactions with nature and should be at the heart of environmental humanities studies and knowledge co‐production projects to tackle socio‐ecological concerns. Hence, we urge further research to explore innovative methods that complement traditional ethnoecological tools and capture complex sensory aspects of folk children's taxonomy to better understand human‐plant interactions and knowledge. Read the free Plain Language Summary for this article on the Journal blog.

En Colombia, los estudios de calidad del agua se han basado en su gran mayoría en información fisicoquímica o bacteriológica, y solamente en las últimas décadas se ha comenzado a integrar e implementar la bioindicación. El propósito del estudio fue caracterizar la calidad del agua del río Frío, usando macroinvertebrados bentónicos como indicadores biológicos, junto con parámetros fisicoquímicos. Con esta integración entre los índices bióticos y fisicoquímicos se determinó la calidad del agua de forma más precisa, debido a que se generó un acercamiento más detallado al estado del río Frío. Una vez muestreados e identificados los macroinvertebrados, se calcularon los índices de calidad BMWP/Col, ASTP, IBF, EPT, y los índices de biodiversidad Shannon-Weaver, riqueza específica, diversidad de Margalef y Menhinick. El número total de individuos resultado del estudio en la cuenca correspondió a 687, representados por 12 órdenes, 24 familias y 25 géneros. Adicionalmente, se llevaron a cabo un análisis de varianza y un análisis multivariante, a través de una correlación canónica. Finalmente, se determinó que la calidad del agua del río Frío es moderadamente contaminada; además, presenta una baja biodiversidad en las especies de macroinvertebrados, y se encontró que el resultado de los índices son independientes de las temporadas climáticas.

[Objetivo] El razonamiento proporcional es un tipo de corriente compleja que implica reconocer comparaciones como la covariación entre magnitudes y comparaciones múltiples. El objetivo de este estudio fue analizar el razonamiento proporcional de alumnos de telesecundaria unitaria utilizando los niveles propuestos por Karplus (1983) a partir de un micromundo como GeoGebra. En el micromundo, el estudiantado puede explorar y construir significados sobre los objetos matemáticos. [Metodología] Se diseñaron cuatro actividades en GeoGebra, las cuales fueron aplicadas a 18 estudiantes de una telesecundaria unitaria (modalidad educativa en México). [Resultados] Se identificó que los participantes están en niveles iniciales, que responden a estructuras aditivas, cualitativas o erróneas para justificar sus procedimientos. Los niveles más complejos de razonamiento proporcional relacionados con el uso de razones y constantes de proporcionalidad se obtuvieron cuando el estudiantado interactuaba con sus pares y con el micromundo. Los niveles de razonamiento no son mutuamente excluyentes, debido a que el alumnado puede razonar de diferente manera según la situación y las posibilidades del software. [Conclusiones] El uso de micromundos en la exploración del razonamiento proporcional posibilita acciones que no pueden llevarse a cabo en “lápiz y papel”, lo cual brinda la oportunidad de interactuar con construcciones en movimiento, además genera interacciones de reforzamiento o construcción de saberes desarrollados en conjunto.

Abstract Background Mycosis fungoides is the most frequent form of cutaneous T-cell lymphoma. It is characterized by a chronic, slow, and progressive course, and is associated with mortality rates that depend on several factors, such as clinical staging. A median survival time of up to 13 months is found in patients with advanced stages that require more aggressive treatments, with greater toxicity and higher costs. In Latin America, few prognostic studies of the disease are available. Objective To determine the rate of progression from early stages (IA, IB, IIA) to more advanced stages (> IIB) in patients older than 18 years with mycosis fungoides treated at two medical centers in Colombia between January 1, 2010, and December 31, 2019. Methods Retrospective cohort study with a longitudinal design. Results 112 patients diagnosed with early mycosis fungoides were included. 56.2% were male (n = 63), with a median age of 53 years (IQR 43‒67). The most frequent clinical variant was classic (67.9%; n = 76), followed by folliculotropic (16%; n = 18), and hypopigmented (10.7%; n = 12). The most common first-line treatment was NB-UVB phototherapy (27.7%; n = 31), followed by PUVA phototherapy (25.8%; n = 29%), and topical corticosteroids (25%; n = 28). The global rate of disease progression was 8% (n = 9), with an overall mortality of 12.5% (n = 14). Study limitations Its retrospective design and the lack of molecular studies for case characterization. Conclusions Early mycosis fungoides is a disease with a good prognosis in most patients, with a progression rate of 8% (n = 9).

Las Instituciones de Educación Superior (IES) están inmersas en un proceso constante de transformación, lo que implica repensar su quehacer cotidiano, es así que, la toma de decisiones adquiere relevancia para adaptarse y responder a las demandas sociales y los avances tecnológicos. Para ello, las universidades se ven obligadas a evolucionar, empleando diversas estrategias, entre las cuales destaca la transformación tecnológica y digital; estas, complementadas con modelos de gestión eficaces, permitirán una administración eficiente, este proceso da lugar al concepto de "Smart University" o universidad inteligente. La metodología tiene un enfoque cualitativo de alcance descriptivo, que recopila información detallada y particularidades relevantes, además se llevó a cabo entrevistas semiestructuradas con expertos que aportaron sus criterios y se recurrió al método hermenéutico para una mejor comprensión de este nuevo concepto. El objetivo es describir las características de las “Smart University”, como una visión a la que deben orientarse las IES, para dinamizarse acorde a las exigencias de la sociedad. Los resultados se centran en la descripción de estas características desde dos perspectivas: tecnológica y de gestión, estos enfoques permitirán orientar los modelos de gobernanza, procesos y recursos tecnológicos hacia la consecución de altos estándares de calidad y una cultura de mejora continua en beneficio de la colectividad.

Abstract Education needs to be at the forefront of the efforts to mitigate and adapt to Climate Change (CC) effects. We have introduced the Climate Change Competence (C3) to provide a comprehensive route to include the topics of sustainability and CC into the curriculum. This paper analyses how different primary and secondary teachers can improve this competence using a Massive Online Open Course (MOOC) on the basic science of CC. While the improvement in knowledge is expected, we have observed important advances on abilities, and attitudes on CC which are also essential to teach about CC mitigation and adaptation. The present study used a pre-experimental design, with pre-and post-test measurements with a sample of 530 students. While the MOOC focuses on the Science of CC, the participants also advance in attitudes and abilities, revealing an important correlation between these three dimensions of competence. Also, the study reveals that the MOOC improves the C3 in all the participants, but it does in diverse ways for diverse groups.

Abstract Indigenous Peoples and local communities are heavily affected by climatic changes. Investigating local understandings of climate change impacts, and their patterned distribution, is essential to effectively support monitoring and adaptation strategies. In this study, we aimed to understand the consistency in climate change impact reports and factors influencing consistency at site and individual levels. We conducted cross-cultural research among iTaukei (Fiji), Dagomba (Ghana), fisherfolks (Tanzania), Tsimane’ (Bolivia), Bassari (Senegal), ribeirinhos (Brazil), Mapuche (Chile), Mongolian (China), Tibetan (China) and Daasanach (Kenya) communities using semi-structured interviews, focus groups, and surveys among 1860 individuals. We found that cross-culturally more than two-thirds of individual reports of climate change impacts match site-confirmed reports. Consistency in reports is higher for changes related to pastoralism than crop production and wild plant gathering. Individual’s experience with nature, Indigenous and local knowledge, and local family roots are not significantly associated with consistency across sites, but site-specific associations are prevalent. Despite high average consistency among sites, there is considerable variation caused by site-specific factors, including livelihood activities, socio-cultural settings, and environmental conditions. Site contexts and related consistency in climate change impact reports need to be taken into account for climate change monitoring and adaptation planning.

Abstract Background Deciphering the genetic architecture of drought tolerance could allow the candidate genes identification responding to water stress. In the Andean Patagonian forest, the genus Nothofagus represents an ecologically relevant species to be included in different genomic studies. These studies are scarce in South American ecosystems however represent an important source of genomic data in order to interpret future climate-change environment scenarios of these emblematic forests. Here, we achieved the assemblage of the transcriptome of N. alpina while searching for key genes of activated or suppressed metabolic pathways in response to drought stress. Results De novo transcriptome assembly resulted in 104,030 transcripts. Following confirmation of drought conditions, based on reduction of leaf water potential and stomatal conductance, a differential gene expression analysis resulted in 2720 significantly expressed genes (1601 up-regulated and 1119 down-regulated). Enrichment analysis (over-representation analysis and gene set enrichment analysis) resulted in more than one hundred stress-responsive term ontologies (i.e. biological processes) and pathways. Terms such as response to abscisic acid and pathways such as plant hormone signal transduction or starch and sucrose metabolism were over-represented. Protein–protein interaction assessment resulted in networks with significantly expressed top common hub gene clusters (e.g. plant-type cell wall biogenesis among down-regulated or ABA-signalling among up-regulated). These networks evidenced important regulators at gene expression such as transcriptional factors. Conclusions Responses of N. alpina seedlings to drought stress were evidenced by the activation of several genes linked to GO biological processes and KEGG pathways, which were mainly based on over-expression of specific protein kinases, phosphatases, synthases and transcription factors. This suggests an up-regulation of signalling pathways, triggered through plant hormones such as abscisic acid or auxin, which could counteract the osmotic stress created as a probable immediate response to drought. On the other hand, groups of carbon fixation genes related to the galactose metabolism, photosynthesis, secondary wall biogenesis, and fatty acid biosynthesis degradation were down-regulated under drought. Overall, our results provide new genomic data for understanding how non-model long-lived trees of Patagonian forests would acclimate to environmental changes.

Introducción: La fractura de Maisonneuve es una lesión caracterizada por la fractura subcapital del peroné asociada a una lesión capsuloligamentaria de tobillo. Su tratamiento supone la restauración de la anatomía ósea y capsuloligamentaria normal para restablecer las fuerzas de contacto tibioastragalinas fisiológicas. Esta calidad de reducción puede ser difícil de alcanzar, sobre todo, con técnicas percutáneas. Objetivo: Evaluar mediante imágenes la calidad de la reducción de fracturas de Maisonneuve reducidas en forma cerrada (bajo visualización directa artroscópica) y fijadas por vía percutánea. Materiales y Métodos: Se analizaron radiografías e imágenes de tomografía computarizada preoperatorias y posoperatorias, comparativas de los tobillos operado y sano. Resultados: Se evaluaron 13 fracturas. Los parámetros radiográficos posoperatorios (espacio claro medial, solapamiento tibioperoneo distal, espacio claro tibioperoneo) no registraron diferencias, excepto por el intervalo tibioperoneo anterior que aumentó en un caso. La medición tomográfica posoperatoria del solapamiento tibioperoneo distal y el intervalo tibioperoneo anterior reveló que todas las reducciones eran satisfactorias. Dos pacientes tenían valores alterados en la sindesmosis tibioperonea distal con diferencia >2 mm respecto del tobillo sano. Conclusión: Recomendamos la asistencia artroscópica para el manejo de la fractura de Maisonneuve como herramienta de control intraoperatorio para una fijación percutánea más segura.

We present the case of a 14-year-old adolescent boy with a history of poorly controlled asthma and a final diagnosis of a bridge bronchus associated with sling of the left pulmonary artery. Regarding the case report, we describe the characteristic findings in computerized tomography multidetector of the thorax, its classification, and the most relevant information about this malformation. Congenital malformations of the tracheobronchial tree may occur in the context of asymptomatic or symptomatic respiratory patients. These malformations may be associated with other vascular, tracheal, and syndromes with multiorgan involvement. Although most patients are asymptomatic, some of them will have nonspecific symptoms without a clear etiology or will be diagnosed incidentally during the diagnostic evaluation of other pathologies. It is important to know and recognize the normal anatomy and its variations, since radiology undoubtedly plays a fundamental role in the diagnosis and preoperative assessment of these malformations, which although they have low incidence, must be identified in a timely manner by the specialist in diagnostic images.

Background and aimDeficiency of zinc and selenium is common in persons living with human immunodeficiency virus (PLWHIV) and has been associated with the development of non-AIDS related comorbidities, impaired immune system function and mortality. Micronutrient supplementation on long-term-treated PLWHIV could bring potential clinical and immunological benefits improving their health status and quality of life. The aim of the present study is to analyze the effect of zinc and selenium supplementation on body composition, bone mineral density, CD4+ T-cell counts, metabolic profile and immune system status on clinical stable PLWHIV on long-term antiretroviral therapy (ART).MethodsThis is a randomized pilot clinical trial in which we recruited 60 PLWHIV on ART who were assigned to the intervention groups: zinc (30 mg of zinc gluconate), selenium (200 μg of selenium yeast), zinc + selenium (same doses and presentations) or to a control group (without nutritional supplementation) who received supplementation during 6 months. Primary outcome was defined as changes in body composition (weight, muscle and fat mass and bone mineral density) and secondary outcomes as changes in biochemical and immunological parameters (CD4+ T-cell count, cholesterol, glucose, triglycerides and seric zinc and selenium seric concentrations) before and after supplementation. Peripheral blood mononuclear cells (PBMCs) of one individual of each intervention group were analyzed for single cell transcriptomics before and after supplementation.ResultsBMI (p = 0.03), fat mass (p = 0.03), and trunk fat (p = 0.01) decreased after 6 months of selenium supplementation. No changes were observed for cholesterol, glucose or triglycerides after supplementation (p > 0.05 in all cases). CD4+ T cells percentage increased after 6 months of selenium supplementation (p = 0.03). On the transcriptome analysis, zinc and selenium supplementation induced changes on de expression of genes associated with the function of naive and memory CD8+ T-cells (p

Cilia are antenna-like organelles protruding from the surface of many cell types in the human body. Defects in ciliary structure or function often lead to diseases that are collectively called ciliopathies. Cilia and flagella-associated protein 410 (CFAP410) localizes at the basal body of cilia/flagella and plays essential roles in ciliogenesis, neuronal development and DNA damage repair. It remains unknown how its specific basal body location is achieved. Multiple single amino acid mutations in CFAP410 have been identified in patients with various ciliopathies. One of the mutations, L224P, is located in the C-terminal domain (CTD) of human CFAP410 and causes severe spondylometaphyseal dysplasia, axial (SMDAX). However, the molecular mechanism for how the mutation causes the disorder remains unclear. Here, we report our structural studies on the CTD of CFAP410 from three distantly related organisms, Homo sapiens, Trypanosoma brucei and Chlamydomonas reinhardtii. The crystal structures reveal that the three proteins all adopt the same conformation as a tetrameric helical bundle. Our work further demonstrates that the tetrameric assembly of the CTD is essential for the correct localization of CFAP410 in T. brucei, as the L224P mutation that disassembles the tetramer disrupts its basal body localization. Taken together, our studies reveal that the basal body localization of CFAP410 is controlled by the CTD and provide a mechanistic explanation for how the mutation L224P in CFAP410 causes ciliopathies in humans.

Background:. Minimally invasive surgical interventions for metastatic invasion of the pelvis have become more prevalent and varied. Our group hypothesized that the use of percutaneous photodynamic nails (PDNs) would result in decreased pain, improved functional outcomes and level of ambulation, and decreased use of opioid pain medication. Methods:. We performed a retrospective chart review of patients with metastatic pelvic bone disease undergoing stabilization with PDNs (IlluminOss Medical) at 2 institutions. Functional outcome measures assessed include the Combined Pain and Ambulatory Function (CPAF), Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function, and PROMIS Global Health-Physical. Pain was assessed using a visual analog scale (VAS). Outcomes were assessed preoperatively and at 6 weeks, 3 months, 6 months, and 1 year following surgery. Results:. A total of 39 patients treated with PDNs were included. No cases of surgical site infection or implant failure were identified. The median pain VAS score decreased from 8 preoperatively to 0 at the 6-week time point (p < 0.0001). The median CPAF score improved from 5.5 points preoperatively to 7 points at the 3-month mark (p = 0.0132). A significant improvement in physical function was seen at 6 months in the PROMIS Physical Function (p = 0.02) and at both 6 months (p = 0.01) and 1 year (p < 0.01) for the PROMIS Global Health-Physical. The rate of patients prescribed opioid analgesia dropped from 100% preoperatively to 20% at 6 months following surgery (p < 0.001). By 6 weeks, all patients were fully weight-bearing and able to walk independently with or without assistive devices. Conclusions:. Percutaneous stabilization of metastatic periacetabular defects using PDNs is a safe and effective palliative procedure that has been shown to improve patient mobility and provide early pain relief. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Resumen: Las humanidades son consideradas como algo valioso y, al mismo tiempo, como disciplinas blandas, imprecisas o propensas a la confusión. El presente trabajo expone una visión de cómo se puede abordar la educación de las humanidades médicas (HHMM) buscando el rigor. Su objetivo es presentar un texto que pueda ser de utilidad en este tipo de docencia. Para ello se presentan elementos clave recogidos en la literatura biomédica y, además, se muestra el programa formativo en humanidades de la Facultad de Medicina de la Universidad Francisco de Vitoria. En esta primera parte se incluirá el contexto organizacional, los resultados de aprendizaje esperados y los contenidos curriculares. En una segunda parte se presentarán las experiencias de aprendizaje y enseñanza, las formas de evaluación de los estudiantes y las del proceso de mejora continua de calidad. Abstract: Humanities are seen as both valuable and, at the same time, as soft, vague or prone to confusion disciplines. This paper exposes a broad view of how medical humanities education can be approached searching rigor. It aims to present a text that can be useful in this type of teaching. To this purpose, key elements from the biomedical literature are presented and, in addition, the humanities training program of the Faculty of Medicine of the Universidad Francisco de Vitoria is shown. This first part will include the organisational context, the expected learning outcomes and the curricular contents. A second part will present the learning and teaching experiences, the forms of student assessment and those of the continuous quality improvement process.

IntroductionDengue is a significant public health issue in the Urabá region, accounting for 37.5% of morbidity and 41.7% of mortality resulting from dengue in the department of Antioquia (Colombia) in 2018. Clinical Practice Guidelines (CPGs) are tools based on Evidence-Based Medicine, intended for medical personnel to bridge the gap between proven intervention efficacy and clinical decision-making. This study aims to identify barriers and facilitators in the implementation of CPGs for dengue patient care by healthcare officials in the municipalities of the banana axis in the Urabá region.MethodologyFrom a multifaceted approach to implementation research, a mixed method study that combines qualitative and quantitative approaches, was conducted during the years 2020 and 2021, using combined instruments to identify determinants (Guide Indicative Factors, Individual factors of health professionals, Patient factors, Professional interactions, Incentives and resources, Capacity for organizational change, and lastly Social, political, and legal factors) affecting adherence to the Comprehensive Clinical Care Guide for Patients with Dengue (GACIPD). Semi-structured interviews and focus groups with healthcare workers were conducted to assess determinants based on clinical experience. Questionnaires on determinants of GACIPD adherence, using an adapted version of the Chronic Disease Implementation Checklist (TICD), were also employed. Qualitative analysis of the interviews and focus groups used a concept-based coding framework. The questionnaire responses were analyzed using Likert scaling and frequency counts of determinants within and across domains. Participants included general practitioners, other health professionals, researchers, academics, and administrators.ResultsThere was a total of 103 participants in focus groups, 7 in semi-structured interviews, and 136 participants through questionnaires. Among the domains studied, the identification of barriers and facilitators emphasized institutional factors and individual factors. Organizational change capacity was identified as a major barrier, with only 3.6% of respondents indicating that their institution adjusted the prioritization of adequate care according to the guideline. The GACIPD domain received the highest facilitator rating, with 66.7% acceptance due to its practicality, simplicity, clarity, documentation, and ease of implementation, despite this, only 10% of professionals completely agree that their work is in accordance with the GACIPD. The determinant of patient factors was significant in the negative perception of adherence to GACIPD.ConclusionsAlthough barriers outweighed facilitators for GACIPD adherence, determinants for its use were generally positive, as most participants reported it as being a complete, documented, and easy-to-implement guide. The lack of knowledge of the guidelines impacting health professional's decision making was identified as a potentially modifiable barrier, and educational strategies could be implemented to overcome it. The region requires greater emphasis on the management of chronic health conditions, comorbidities, and coinfections of dengue with other endemic diseases.

Hydatidosis is a zoonosis, caused by a cestode ( Echinococcus) . Management will depend on the organs affected by the infection and the response to medical treatment. Therapy may be clinical in early stages, but in case of poor response to drug therapy, surgery is the preferred choice. We present two cases in young females, the first case is with Hydatid cysts in both lungs and liver, she received initial medical treatment with lack of response, and surgery was indicated to resect the pulmonary and hepatic lesions. The second case is of a female with Hydatid cysts in the right lung. She was misdiagnosed at the beginning thinking of pneumonia and pulmonary abscess but after further investigation, hydatid cysts were the diagnosis, due to symptoms consistent with thoracic pain and persistent cough and the size of the cyst, surgery was indicated.

Background: Bacteremia represents high rates of morbidity and mortality, especially in developing countries, highlighting the need for a diagnostic method that allows prompt and appropriate patient treatment. This study compared microbiological performance and adherence of two blood culture protocols for the diagnosis of bacteremia. Methods: Quasi-experimental study conducted between June 2022 and February 2023. Two blood culture protocols were evaluated. Protocol 1 included two aerobic bottles and one anaerobic bottle. Protocol 2 included two aerobic and two anaerobic bottles. Protocols were analyzed in three phases: evaluation of protocol 1 (Phase 1); evaluation of protocol 1 plus educational activities for healthcare staff (Phase 2) and evaluation of protocol 2 (Phase 3). Results: 342 patients and 1155 blood culture bottles (732 aerobic and 423 anaerobic) were included. Positivity was 17.6 %, 22.8 % and 19.4 % in phases 1, 2 and 3, respectively. Among patients with bacteremia, 84.5 % had positive anaerobic bottles, with 9.9 % showing growth only in this bottle. The contamination rates were 1.9 %, 0.3 %, and 0.8 % for each phase, mainly in aerobic bottles. Median positivity time was 11 h for both bottes aerobic and anaerobic. Overall nursing adherence increased from 13.1 % in Phase 1, 25.9 % in Phase 2, and 28.1 % in Phase 3 (p = 0.009). Conclusions: The findings indicate that adding a second anaerobic bottle does not enhance blood culture positivity. Rather than increasing bottle quantity, staff training might be a more effective approach to optimize results.

Background: Chronic psychological stress has widespread implications, including heightened mortality risk, mental and physical health conditions, and socioeconomic consequences. Stratified precision psychiatry shows promise in mitigating these effects by leveraging clinical heterogeneity to personalize interventions. However, little attention has been given to patient self-report. Methods: We addressed this by combining stress-related self-report measures with peripheral biomarkers in a latent profile analysis and survival model. The latent profile models were estimated in a representative U.S. cohort (n = 1255; mean age = 57 years; 57% female) and cross-validated in Tokyo, Japan (n = 377; mean age = 55 years; 56% female). Results: We identified three distinct groups: “Good Mental Health”, “Poor Mental Health”, and “High Inflammation”. Compared to the “Good Mental Health” group, the “High Inflammation” and “Poor Mental Health” groups had an increased risk of mortality, but did not differ in mortality risk from each other. Conclusions: This study emphasizes the role of patient self-report in stratified psychiatry.

Desarrollamos aquí un algoritmo para realizar experimentos numéricos con el billar de Sinai en su versión clásica, junto con una breve discusión de la precisión y limitaciones de tal algoritmo. Algunos resultados de estos experimentos se presentan revelando un comportamiento altamente caótico.

Introducción. El desarrollo de la niñez ha cobrado gran interés en salud pública, pues los cambios a nivel físico, psíquico, social y cultural han generado desequilibrios en la instauración de prácticas saludables, como incorrectos patrones alimentarios, aumento del sedentarismo y alteraciones en el patrón sueño-vigilia. Detectar e intervenir a tiempo estás conductas de riesgo, disminuirá la prevalencia de enfermedades no transmisibles en edades tempranas. El objetivo de estudio fue diseñar y validar un cuestionario para estudiar hábitos saludables en niños de edad escolar. Metodología. Se utilizó el método Delphi, en una fase inicial se seleccionó al panel de expertos, posteriormente, en dos rondas de votación mediante una escala de tipo Likert se valoró cada ítem analizando criterios de pertinencia y adecuación. Además, se obtuvo un análisis estadístico y cualitativo de las aportaciones del panel de expertos. Para tomar como válido el ítem debió alcanzar un promedio de 4.0. Se realizó un pilotaje para evaluar la comprensión y tiempo. La fiabilidad se valoró con alfa de Cronbach. Resultados. Participaron 7 expertos en la primera y segunda ronda. El cuestionario final contó con 24 preguntas y 6 dimensiones. Se obtuvo un alfa de Cronbach de 0.655. Conclusiones. Los resultados garantizan la validez y fiabilidad del instrumento para estudiar prácticas saludables.

Molecular surveillance of viral pathogens and inference of transmission networks from genomic data play an increasingly important role in public health efforts, especially for HIV-1. For many methods, the genetic distance threshold used to connect sequences in the transmission network is a key parameter informing the properties of inferred networks. Using a distance threshold that is too high can result in a network with many spurious links, making it difficult to interpret. Conversely, a distance threshold that is too low can result in a network with too few links, which may not capture key insights into clusters of public health concern. Published research using the HIV-TRACE software package frequently uses the default threshold of 0.015 substitutions/site for HIV pol gene sequences, but in many cases, investigators heuristically select other threshold parameters to better capture the underlying dynamics of the epidemic they are studying. Here, we present a general heuristic scoring approach for tuning a distance threshold adaptively, which seeks to prevent the formation of giant clusters. We prioritize the ratio of the sizes of the largest and the second largest cluster, maximizing the number of clusters present in the network. We apply our scoring heuristic to outbreaks with different characteristics, such as regional or temporal variability, and demonstrate the utility of using the scoring mechanism’s suggested distance threshold to identify clusters exhibiting risk factors that would have otherwise been more difficult to identify. For example, while we found that a 0.015 substitutions/site distance threshold is typical for US-like epidemics, recent outbreaks like the CRF07_BC subtype among men who have sex with men (MSM) in China have been found to have a lower optimal threshold of 0.005 to better capture the transition from injected drug use (IDU) to MSM as the primary risk factor. Alternatively, in communities surrounding Lake Victoria in Uganda, where there has been sustained heterosexual transmission for many years, we found that a larger distance threshold is necessary to capture a more risk factor-diverse population with sparse sampling over a longer period of time. Such identification may allow for more informed intervention action by respective public health officials.

Este estudio investiga cómo los docentes de instituciones públicas en Ecuador valoran los libros proporcionados por el Ministerio de Educación (MINEDUC). Se enfoca en el impacto de estos textos en el desarrollo curricular y la consecución de objetivos educativos, buscando mejorar los recursos y fomentar un ambiente de aprendizaje enriquecedor. La metodología combina enfoques cuantitativos y cualitativos, utilizando un formulario de Google Forms con 27 preguntas que recogen datos de los participantes y evalúan la percepción de los libros. La muestra para este estudio es estratificada no probabilística, centrada en 51 docentes pertenecientes a dos instituciones educativas específicas de la Zona 6, Distrito Cuenca 1, una en la zona rural y otra urbana. Los resultados muestran una percepción positiva de los libros, aunque se identifican áreas de mejora como la necesidad de integrar recursos didácticos adicionales, mejorar la claridad y actualizar los contenidos según las etapas de desarrollo de los estudiantes.

Objetivo: Evaluar el efecto de la movilización activa temprana (MAT) en comparación con el cuidado habitual activo (CHA) en sujetos adultos críticamente enfermos respecto de la fuerza muscular y el estado funcional. Materiales y métodos: Se realizó una revisión sistemática y un metaanálisis. Se incluyeron ensayos clínicos aleatorizados que compararon la MAT con el CHA en sujetos >18 años, de ambos sexos, en estado crítico durante o después del período de ventilación mecánica en la unidad de cuidados intensivos (UCI). La búsqueda se realizó en las bases de datos Cochrane, Medline/Pubmed, Embase (Elsevier), SciELO, LILACS/BVS, www.controlled-trials.com/, clinicaltrials.gov/, www.who.int/ictrp/en/. Se analizó el riesgo de sesgo mediante la herramienta RoB 1. Se generó una síntesis cualitativa y cuantitativa (metaanálisis) de los resultados. Registro: OSF: https://bit.ly/430fF72. Resultados: Se incluyeron siete estudios, con un total de 1905 sujetos. La mayoría de los sujetos eran del sexo masculino (57 %) y tenían entre 54 y 66 años. Los desenlaces reportados mostraron baja certeza de evidencia, según el sistema de clasificación de la evaluación, desarrollo y valoración de las recomendaciones (GRADE, por sus siglas en inglés). En el metaanálisis del estado funcional al alta hospitalaria, se observó un efecto a favor del grupo MAT, con una diferencia de medias estandarizada de 0,26 (IC 95 % 0,11-0,41) y baja heterogeneidad (I2 = 0 %). Conclusión: Con una baja certeza de evidencia, el efecto de la MAT en sujetos adultos críticamente enfermos en la UCI podría mejorar el estado funcional al alta hospitalaria en comparación con el CHA.

This paper deals within a context where technology plays a pivotal role in education. In this sense, it is essential to highlight the emergence of new competencies and skills in education due to technological advancements. Legislative frameworks have been developed to incorporate digital literacy, access to robotics, and computational thinking, between others. Hence, this review and meta-analysis aim at identifying the influence of robotics activities on computational thinking through a PRISMA-guided review. The findings reveal that interventions conducted in early childhood education significantly impact computational thinking. Results also showcase that, despite perceived barriers related to technology accessibility, the presence of legislation and contexts prioritizing these competencies is more relevant than the digital access gap.

Objective: Many studies have observed different characteristics among productive systems in the rural territories of Latin America. Therefore, understanding and characterizing them while they function plays an essential role in determining their relationship between development and environment. A study has been conducted in the Orellana province of NE Ecuador to determine their typology and then classify them according to the variables that describe their main traits or attributes using cluster analysis (CA). Materials and Methods: A survey was structured to investigate physical, productive, environmental, as well as socioeconomic character variables, which were subsequently applied to a random sample of the 5,963 agricultural productive units (APUs) through face-to-face contact with producers during an in situ visit to their farms. Result: The CA allowed us to identify three typologies of APUs in the Orellana Province. The first has been Type 1, which is denominated as the most conventional (40%), while Type 2 uses more efficient natural resources but represents an amount of only 9.4%. In contrast, type 3 (50.6%) depends on a significant part of local or national development programs. Conclusion: All groups indicated some peculiarities in common, as there were marked differences in the use and distribution of land as well as production methods among them. Consequently, this pioneering study allowed us to identify different production methods. Therefore, we encourage local and national governments to establish policies for natural resource conservation in such high-diversity zones. [J Adv Vet Anim Res 2024; 11(1.000): 171-180]

Abstract Memory persistence is a double edge sword. Persistence of adaptive memories is essential for survival and even determines who we are. Neurodegenerative conditions with significant memory loss such as Alzheimer’s disease, testify how defects of memory persistence have severe and irreversible effects on personality, among other symptoms. Yet, maintenance of overly strong maladaptive memories underlies highly debilitating psychiatric conditions including post-traumatic stress disorder, specific phobia, substance dependence and binge eating disorder. Here we review the neurobiological mechanisms supporting memory formation, persistence, inhibition and forgetting. We then shift the focus to how such mechanisms have been exploited to alter the persistence of laboratory-generated memories in human healthy volunteers as a proof of concept. Finally, we review the effect of behavioural and pharmacological interventions in anxiety and addiction disorder patients, highlighting key findings, gaps, and future directions for basic and translational research.

Abstract Background There are only a handful of true theranostic matched pairs, and in particular the theranostic radiocopper trio 61Cu, 64Cu and 67Cu, for diagnosis and therapy respectively, is a very attractive candidate. In fact, the alternative of two imaging radionuclides with different half-lives is a clear advantage over other theranostic pairs, since it offers a better matching for the tracer biological and radionuclide physical half-lives. Due to the high availability of 64Cu, its translation into the clinic is being successfully carried out, giving the example of the FDA approved radiopharmaceutical Detectnet (copper Cu 64 dotatate injection). However, a shorter-lived PET radionuclide such as 61Cu may as well be beneficial. Results Proton irradiation of enriched 62Ni electrodeposited targets with a compact cyclotron produced the desired radionuclide via the 62Ni(p,2n)61Cu nuclear reaction, leading to 61Cu activities of up to 20 GBq at end of bombardment and 8 GBq at end of purification. Furthermore, two purification methods are compared leading to comparable results regarding separation yield and product purity. Following the radiochemical separation, quality assessment of this product [61Cu]CuCl2 solution proved radionuclidic purities (RNP) over 99.6% and apparent molar activities (AMA) of 260 GBq/µmol with the 1,4,8,11-tetraazacyclotetradecane-1,4,8,11-tetraacetic acid (TETA) chelator, end of purification corrected. Conclusions In the current article a comprehensive novel production method for the PET radionuclide 61Cu is presented, providing an alternative to the most popular production routes. Characterization of the [61Cu]CuCl2 product showed both high RNP as well as high AMA, proving that the produced activity presented high quality regarding radiolabeling up to 9 h after end of purification. Furthermore, production scalability could be easily achieved by increasing the irradiation time. Graphical abstract

Abstract Synovial joints, such as the elbow, experience different lubrication regimes, ranging from fluid film to boundary lubrication, depending on locomotion conditions. We explore the relationship between the elbow lubrication regime and the size of quadrupedal mammals. We use allometry to analyze the dimensions, contact stress, and sliding speed of the elbow in 110 quadrupedal mammals. Our results reveal that the average diameter and width of the distal humerus are scaled $$\propto M^{0.35}$$ ∝ M 0.35 , which allowed us to estimate a consistent contact pressure and sliding speed across mammals. This consistency likely promotes fluid film lubrication regardless of body mass. Further, the ratio between the diameter and width is about 0.5 for all analyzed taxa, which is a good compromise between loading capacity and size. Our study deepens our understanding of synovial joints and their adaptations, with implications for the development of treatments, prostheses, and bioinspired joint designs.

Depopulation is currently a major problem in Spain, especially in inland areas. Tourism can help alleviate this problem. Therefore, competitive advantages must be enhanced by developing a capable and sustainable tourism model that can lead to the desired level of development in a given geographical area. A powerful decision-making and diagnostic tool was created for the tourism industry in the Burgos Province, Spain to identify the key factors in tourist satisfaction, which can influence the decision to recommend and revisit a destination. This study presents this tool and a theoretical model of tourism satisfaction. The findings emphasize the significance of the perception that tourists have of the quality of a destination's goods and services and its impact on satisfaction. Enhancing tourist satisfaction can have important implications for improving tourism management and, consequently, addressing the depopulation problem.

Digital competence is a key aspect to be taken into account in training at all stages. It is especially necessary to emphasize higher education stages and specifically on initial teacher training, as future teachers have the responsibility to promote these competencies and to be the first to introduce them into their programs. However, for this to happen, they must have previously established a framework of reference on which to train in digital competence, and they must be prepared to transmit this knowledge in this context that framework is DigCompEdu. For this reason, in the present research a correlational study is carried out with a retrospective ex-post-facto design to analyse the digital competencies of future teachers in the Faculty of Education Sciences at the University of Granada. The main results of the research carried out are that the self-perceived digital competence varies according to the sex of the students, being more positive in the case of men, while other factors such as the course or degree do not have a significant relevance. However, the majority of students at the Faculty of Education of the University of Granada have a self-assessed level of B1 as their level of digital competence, which is insufficient for transmission to future generations. This is also maintained because, according to the students, spaces, and training related to this aspect are not generated, although there are disparities according to the degree of this thinking.

Abstract This study combines volcanic gas compositions, SO2 flux and satellite thermal data collected at Nevado del Ruiz between 2018 and 2021. We find the Nevado del Ruiz plume to have exhibited relatively steady, high CO2 compositions (avg. CO2/ST ratios of 5.4 ± 1.9) throughout. Our degassing models support that the CO2/ST ratio variability derives from volatile exsolution from andesitic magma stored in the 1–4 km depth range. Separate ascent of CO2-rich gas bubbles through shallow (

Abstract The effects of climate change depend on specific local circumstances, posing a challenge for worldwide research to comprehensively encompass the diverse impacts on various local social-ecological systems. Here we use a place-specific but cross-culturally comparable protocol to document climate change indicators and impacts as locally experienced and analyze their distribution. We collected first-hand data in 48 sites inhabited by Indigenous Peoples and local communities and covering all climate zones and nature-dependent livelihoods. We documented 1,661 site-agreed reports of change corresponding to 369 indicators. Reports of change vary according to climate zone and livelihood activity. We provide compelling evidence that climate change impacts on Indigenous Peoples and local communities are ongoing, tangible, widespread, and affect multiple elements of their social-ecological systems. Beyond potentially informing contextualized adaptation plans, our results show that local reports could help identify economic and non-economic loss and damage related to climate change impacts suffered by Indigenous Peoples and local communities.

Resumen: Las humanidades son consideradas como algo valioso y, al mismo tiempo, como disciplinas blandas, imprecisas o propensas a la confusión. El presente trabajo expone una visión de cómo se puede abordar la educación de las humanidades médicas (HHMM) buscando el rigor. Su objetivo es presentar un texto que pueda ser de utilidad en este tipo de docencia. Para ello se presentan elementos clave recogidos en la literatura biomédica y, además, se muestra el Programa Formativo en Humanidades de la Facultad de Medicina de la Universidad Francisco de Vitoria. En una primera parte se incluyó el contexto organizacional, los resultados de aprendizaje esperados y los contenidos curriculares. En esta segunda parte se presentan las experiencias de aprendizaje y enseñanza, las formas de evaluación de los estudiantes y las del proceso de mejora continua de la calidad. Abstract: Humanities are seen as both valuable and, at the same time, as soft, vague or prone to confusion disciplines. This paper exposes a broad view of how medical humanities education can be approached searching rigor. It aims to present a text that can be useful in this type of teaching. To this purpose, key elements from the biomedical literature are presented and, in addition, the Humanities Training Program of the Faculty of Medicine of the Universidad Francisco de Vitoria is shown. The first part included the organizational context, the expected learning outcomes and the curricular contents. In this second part, the learning and teaching experiences, the forms of student assessment and those of the continuous quality improvement process are presented.

El sector ganadero cárnico bovino de Argentina viene evidenciando diversos cambios en los últimos años. Dos de los más relevantes son el aumento del stock bovino y la disminución en el número de establecimientos productores, lo que podría suponer un proceso de crecimiento de producción con concentración. El objetivo del presente trabajo es realizar un análisis sobre la desigualdad y la concentración del ganado y los establecimientos bovinos en las provincias de Argentina en el período 2012-2021. Para esto, se construyeron y obtuvieron los índice GINI e índice de Herfindahl-Hirschman a partir de la estratificación de establecimientos, haciendo un comparativo de la evolución entre los años planteados. Los resultados muestran que existe una buena distribución del stock por estratos, pero con un aumento en la desigualdad y concentración. En base a estos dos resultados, se pudieron conformar tres grupos de provincias.

Background The methods previously proposed in the literature to assess patients with rotator cuff related shoulder pain, based on special orthopedic tests to precisely identify the structure causing the shoulder symptoms have been recently challenged. This opens the possibility of a different way of physical examination. Objective To analyze the differences in shoulder range of motion, strength and thoracic kyphosis between rotator cuff related shoulder pain patients and an asymptomatic group. Method The protocol of the present research was registered in the International Prospective Register of Systematic Review (PROSPERO) (registration number CRD42021258924). Database search of observational studies was conducted in MEDLINE, EMBASE, WOS and CINHAL until July 2023, which assessed shoulder or neck neuro-musculoskeletal non-invasive physical examination compared to an asymptomatic group. Two investigators assessed eligibility and study quality. The Newcastle Ottawa Scale was used to evaluate the methodology quality. Results Eight studies (N = 604) were selected for the quantitative analysis. Meta-analysis showed statistical differences with large effect for shoulder flexion (I2 = 91.7%, p

Summary: Flaviviruses such as dengue virus (DENV), Zika virus (ZIKV), and yellow fever virus (YFV) are spread by mosquitoes and cause human disease and mortality in tropical areas. In contrast, Powassan virus (POWV), which causes severe neurologic illness, is a flavivirus transmitted by ticks in temperate regions of the Northern hemisphere. We find serologic neutralizing activity against POWV in individuals living in Mexico and Brazil. Monoclonal antibodies P002 and P003, which were derived from a resident of Mexico (where POWV is not reported), neutralize POWV lineage I by recognizing an epitope on the virus envelope domain III (EDIII) that is shared with a broad range of tick- and mosquito-borne flaviviruses. Our findings raise the possibility that POWV, or a flavivirus closely related to it, infects humans in the tropics.

In the context of infectious diseases, the dynamic interplay between ever-changing host populations and viral biology demands a more flexible modeling approach than common fixed correlations. Embracing random-effects regression models allows for a nuanced understanding of the intricate ecological and evolutionary dynamics underlying complex phenomena, offering valuable insights into disease progression and transmission patterns. In this article, we employed a random-effects regression to model an observed decreasing median plasma viral load (pVL) among individuals with HIV in Mexico City during 2019–2021. We identified how these functional slope changes (i.e. random slopes by year) improved predictions of the observed pVL median changes between 2019 and 2021, leading us to hypothesize underlying ecological and evolutionary factors. Our analysis involved a dataset of pVL values from 7325 ART-naïve individuals living with HIV, accompanied by their associated clinical and viral molecular predictors. A conventional fixed-effects linear model revealed significant correlations between pVL and predictors that evolved over time. However, this fixed-effects model could not fully explain the reduction in median pVL; thus, prompting us to adopt random-effects models. After applying a random effects regression model—with random slopes and intercepts by year—, we observed potential ''functional changes'' within the local HIV viral population, highlighting the importance of ecological and evolutionary considerations in HIV dynamics: A notably stronger negative correlation emerged between HIV pVL and the CpG content in the pol gene, suggesting a changing immune landscape influenced by CpG-induced innate immune responses that could impact viral load dynamics. Our study underscores the significance of random effects models in capturing dynamic correlations and the crucial role of molecular characteristics like CpG content. By enriching our understanding of changing host-virus interactions and HIV progression, our findings contribute to the broader relevance of such models in infectious disease research. They shed light on the changing interplay between host and pathogen, driving us closer to more effective strategies for managing infectious diseases. Significance of the study: This study highlights a decreasing trend in median plasma viral loads among ART-naïve individuals living with HIV in Mexico City between 2019 and 2021. It uncovers various predictors significantly correlated with pVL, shedding light on the complex interplay between host-virus interactions and disease progression. By employing a random-slopes model, the researchers move beyond traditional fixed-effects models to better capture dynamic correlations and evolutionary changes in HIV dynamics. The discovery of a stronger negative correlation between pVL and CpG content in HIV-pol sequences suggests potential changes in the immune landscape and innate immune responses, opening avenues for further research into adaptive changes and responses to environmental shifts in the context of HIV infection. The study's emphasis on molecular characteristics as predictors of pVL adds valuable insights to epidemiological and evolutionary studies of viruses, providing new avenues for understanding and managing HIV infection at the population level.

Fluorescence is used in various biological assays due to its high sensitivity, versatility, and precision. In recent years, studies using medicinal plant extracts have increased. However, fluorescence-based assays could be biased by plant metabolites autofluorescence. To address this issue, this study investigated the interference caused by methanolic extracts and chloroform fractions of three medicinal plants in three fluorescence-based assays on gastric cancer stem cells(CSC): resazurin reduction, confocal microscopy, and flow cytometry. CSC were isolated based on CD44 surface marker, incubated with methanolic extracts and chloroform fractions of Buddleja incana, Dracontium spruceanum, Piper aduncum. Resazurin assay evidenced that CSC exposed to extracts and fractions from the three plants showed significant differences in relative fluorescence units (RFU) levels (p

Responses to natural stimuli in area V4-a mid-level area of the visual ventral stream-are well predicted by features from convolutional neural networks (CNNs) trained on image classification. This result has been taken as evidence for the functional role of V4 in object classification. However, we currently do not know if and to what extent V4 plays a role in solving other computational objectives. Here, we investigated normative accounts of V4 (and V1 for comparison) by predicting macaque single-neuron responses to natural images from the representations extracted by 23 CNNs trained on different computer vision tasks including semantic, geometric, 2D, and 3D types of tasks. We found that V4 was best predicted by semantic classification features and exhibited high task selectivity, while the choice of task was less consequential to V1 performance. Consistent with traditional characterizations of V4 function that show its high-dimensional tuning to various 2D and 3D stimulus directions, we found that diverse non-semantic tasks explained aspects of V4 function that are not captured by individual semantic tasks. Nevertheless, jointly considering the features of a pair of semantic classification tasks was sufficient to yield one of our top V4 models, solidifying V4's main functional role in semantic processing and suggesting that V4's selectivity to 2D or 3D stimulus properties found by electrophysiologists can result from semantic functional goals.

En 2018 referentes de la Asamblea Popular por el Agua de Luján de Cuyo de Mendoza compartieron su inquietud por posibles afectaciones en la salud de personas de la localidad de El Remanso, ubicada en un territorio cercano a explotaciones petroleras. Al llegar a la comunidad reconocimos diversas afectaciones de las actividades económicas a los bienes comunes que modificaban los modos de vida. Desde la asignatura Salud Mental Comunitaria, perteneciente a la carrera de psicología de la Universidad de Mendoza se han construido espacios de formación superior integral para realizar abordajes interdisciplinarios e intersectoriales en el lugar. De estos han derivado investigaciones epidemiológicas críticas e intervenciones comunitarias participativas entre las que se encuentra una obra de teatro con infancias. El artículo ofrece una reflexión sobre las posibilidades del trabajo territorial en sus distintas modalidades. Recuperamos diarios de campo, informes de investigación y de prácticas profesionales para reconstruir los aportes de la metodología de formación integral. La experiencia permitió generar preguntas en estudiantes de las prácticas profesionales, en vecinos y vecinas, y promovió modificaciones en el programa de la materia para adecuarlo a las particularidades territoriales.

High Pathogenicity Avian Influenza (HPAI) poses a significant threat to public and animal health. Clade 2.3.4.4b recently emerged from the Eastern hemisphere and disseminated globally, reaching the Latin American (LATAM) region in late 2022 for the first time. HPAI in LATAM has resulted in massive mortalities and culling of poultry and wild birds, causing infection in mammals and humans. Despite its meaningful impact in the region, only occasional evidence about the genetic and epitope characteristics of the introduced HPAI is reported. Hence, this study seeks to phylogenetically characterize the molecular features and the source of HPAI in LATAM by evaluating potential antigenic variations. For such a purpose, we analyzed 302 whole genome sequences. All Latin American viruses are descendants of the 2.3.4.4b clade of the European H5N1 subtype. According to genomic constellations deriving from European and American reassortments, the identification of three major subtypes and eight sub-genotypes was achievable. Based on the variation of antigenic motifs at the HA protein in LATAM, we detected three potential antigenic variants, indicating the HA-C group as the dominant variant. This study decidedly contributes to unraveling the origin of the 2.3.4.4b clade in LATAM, its geographic dissemination, and evolutionary dynamics within Latin American countries. These findings offer useful information for public health interventions and surveillance initiatives planned to prevent and manage the transmission of avian influenza viruses.

La no consagración explícita del derecho a una muerte digna en la Constitución y su falta de desarrollo legislativo no han sido un impedimento para que la Corte Constitucional reconozca la existencia de este derecho y determine su naturaleza jurídica como derecho fundamental. Inicialmente esta concesión normativa fue reconocida como un derecho fundamental por conexidad con los derechos a la dignidad humana, la vida y el libre desarrollo de la personalidad. El desarrollo progresivo de la jurisprudencia ha permitido entender que el derecho a una muerte digna es un derecho fundamental complejo y autónomo que se puede traducir en un derecho subjetivo. Es un derecho complejo porque depende de circunstancias muy particulares para su configuración e involucra elementos penales que distorsionan o refuerzan su garantía. Es un derecho autónomo en tanto su vulneración no está condicionada a la transgresión de otros derechos constitucionales y si bien se relaciona con el derecho a la vida, la dignidad, la autonomía, la salud y otros derechos, conserva su independencia como garantía constitucional fundamental.

Introducción: Se ha documentado ampliamente el daño que puede causar la exposición al amianto en los seres humanos, ocasionando enfermedades como la asbestosis, placas pleurales, cáncer pulmonar, mesotelioma, engrosamiento de la pleura, derrames pleurales, entre otras. Objetivo: Describir los efectos en salud que ocasiona la exposición a fibra de amianto, la legislación vigente en torno a la manipulación, la prohibición del uso de Asbesto-Amianto en Chile y la forma de abordar la calificación médico legal por la exposición a fibra de amianto. Métodos: Se realizó una búsqueda exhaustiva en bases de datos médicas reconocidas, entre las que se incluyen PubMed, Scopus, MEDLINE y de la base de datos de la Biblioteca del Congreso Nacional de Chile/BCN, durante los años 2022 y 2023. Resultados: En Chile, las patologías relacionadas con las fibras de amianto, tales como la asbestosis y el mesotelioma, han sido motivo de preocupación debido a los riesgos para la salud asociados con la exposición a este material. La asbestosis es una enfermedad pulmonar intersticial provocada por la inhalación de fibras de amianto. La fisiopatología que conduce a las alteraciones pleurales por fibras de amianto se debe a la infiltración pleural y a la activación de células inflamatorias, como macrófagos, que liberan mediadores inflamatorios y factores de crecimiento. La aparición mesotelioma pleural varía según los niveles de exposición al amianto en la población. Conclusiones: Evitar la exposición al amianto, es la forma más efectiva de prevenir la aparición y/o prevalencia de enfermedades derivadas de este agente.

El presente estudio se enfoca en la evaluación del buen gobierno y la correcta administración pública a través del análisis comparativo de dos instituciones judiciales de alto rango en América Latina: la Corte Constitucional Colombiana y la Suprema Corte de Justicia de la Nación de México. Mediante una metodología cualitativa, esta investigación desglosa los principios y prácticas que definen el buen gobierno y la administración eficaz dentro de estos entornos judiciales, identificando cómo cada Corte contribuye a estos ideales a través de sus providencias judiciales. El método empleado comprende el análisis documental y jurisprudencial, revisando fallos significativos, que permitan entender cómo se alinean con los principios de buen gobierno y buena administración pública. En el caso colombiano, la Corte Constitucional ha desarrollado la buena administración pública como un principio del derecho administrativo y constitucional, mientras que la Suprema Corte de la Nación de México lo ha categorizado como un Derecho fundamental. El buen gobierno, para ambos casos, se clasifica como un principio constitucional. Permitiendo identificar cómo bajo un ejercicio de convencionalidad los Altos Tribunales pretenden facilitar el acceso institucional a los ciudadanos.

Introducción: Las instituciones de salud deben buscar estrategias para garantizar la accesibilidad y equidad de tratamiento de diversas comunidades, incluidas las de necesidades particulares como las personas sordas. Esta comunidad enfrenta obstáculos adicionales en la atención médica, derivados de barreras comunicativas y limitaciones en la comprensión de la información relacionada con salud. Objetivo: Promover la participación de estudiantes sordos en programas de promoción de salud y prevención de enfermedad. Metodología: Se llevó a cabo un estudio descriptivo con enfoque de investigación en acción participación (IAP) durante cuatro meses, realizado en cuatro fases: Contacto con estudiantes sordos interesados en participar de la investigación, solicitud de apoyo a la Universidad de Antioquia para contar con intérpretes, elaboración de cronograma de capacitaciones y ejecución de las capacitaciones diseñadas para los estudiantes sordos. Resultados: Se elaboró un video en lengua de señas que se difundió a través de plataformas digitales con el objetivo de atraer la participación de estudiantes sordos. Entre julio y agosto de 2023 se mejoró y refinó el programa de capacitaciones, y se proporcionó capacitación a tres estudiantes sordos (33.4% de la población total de estudiantes sordos de la Universidad para esa fecha). Se realizaron tres sesiones en las que se observó un notorio grado de desconocimiento entre los participantes en aspectos como uso adecuado de anticonceptivos, riesgos, información y elementos que conforman las etiquetas de los medicamentos, prácticas adecuadas de almacenamiento, uso correcto de antibióticos, automedicación responsable y promoción de estilos de vida saludables. Conclusiones: Se deben generar estrategias de educación sobre prácticas seguras de uso y almacenamiento de medicamentos, y medidas de autocuidado en el contexto de la atención médica de personas sordas.