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El presente artículo pretende comprender, a través de las narrativas, las dinámicas vitales construidas por los migrantes venezolanos y cómo se han reconfigurado, considerando pasado, presente y futuro. La metodología del estudio se centró en el enfoque cualitativo, bajo el paradigma interpretativo y con el método biográfico-narrativo, que permitió identificar los significados subjetivos de las trayectorias e identidades. La muestra estuvo conformada por cinco sujetos, tres en las regiones de Viña del Mar y Valparaíso (Chile), y dos en Barcelona (España), seleccionados bajo diversos criterios. Asimismo, se empleó la técnica de la entrevista semiestructurada en profundidad. En los hallazgos emergen diversas categorías políticas, afectivas, axiológicas y socioculturales, que fueron interpretadas con la teoría fundamentada. También, evidencian cómo se han visto en la necesidad de reajustar trayectorias, mundos de vida, praxis, emociones y sentimientos, a partir de sucesos emblemáticos, que van desde antes del proceso migratorio (pasado), la manera en que lo han hecho, en qué se han transformado (presente) y cómo conciben nuevas identidades (futuro). Finalmente, la visibilización de este hito migratorio latinoamericano implicó desafiar la normalidad de un suceso que ha llevado a más de siete millones de personas a abandonar sus hogares, transformándose en una huella identitaria con incertidumbre, oportunidades y retos.

Abstract Hematological malignancies are associated with an increased risk of complications during SARS-CoV-2 infections. Primary series or monovalent booster vaccines reduce disease severity, hospitalization, and death among multiple myeloma patients. We characterized virus-neutralizing and spike-binding antibody profiles following monovalent (WA1) or bivalent (WA1/BA.5) SARS-CoV-2 booster vaccination in MM patients. Bivalent vaccination improved the breadth of binding antibodies but not neutralization activity against contemporary variants. Hybrid immunity and immune imprinting impact vaccine-elicited immunity.

Streamflow forecasting is essential for water resources management in several social and economic strategic sectors, involving space-temporal variability modeling of the hydrological processes and the influence of several climatic phenomena. Furthermore, high water-dependent sectors such as the Colombian electricity market, require not only the expected streamflow values but also the occurrence probability or reliability bands of such forecast inflows necessary in robust risk analyses. We propose a mathematical approach for monthly streamflow forecasting in Colombia and quantify its predictability, incorporating climate model outcomes as a time series of macroclimatic indexes and punctual hydro-climatological stations. The methodology integrates parametric and non-parametric models, exogenous variables analysis, and uncertainty estimation through stochastic modeling. This research will contribute to the Colombian hydrology understanding and provide elements for risk analysis, planning, and decision-making in social and economic sectors involved with water resources management.

La revolución de la tecnología y las telecomunicaciones ha permitido la innovación en modelos de negocios mediante el uso de plataformas, en particular las de domicilios, que han generado un ecosistema de gestión por algoritmos que en muchos casos somete a los trabajadores a condiciones de control y precarización de sus actividades. El caso de Rappi es un ejemplo de uso de la innovación para la precarización de los trabajadores incluso con la negación misma de su carácter de trabajador, mas aun en contextos como el colombiano con una estructura laboral precaria y una clase empresarial rentista. Este trabajo analiza el caso Rappi en Colombia por medio del uso de entrevistas y encuestas realizadas entre el 2021 y el 2024.

RESUMO Este artigo analisa movimentos de crítica e renovação da Educação Física e suas repercussões sobre a educação infantil no Brasil e no Chile. Realiza um estudo comparado pautado em uma pesquisa bibliográfica e documental. No Brasil, destaca a inserção da Educação Física no currículo da educação infantil e o debate que a área acumulou sobre a temática. No Chile, sobressai a produção de materiais didáticos e os programas para combater a obesidade e o sedentarismo. A despeito das diferenças, esses países também convergem em muitos pontos nas discussões sobre corpo, movimento e infância. As interfaces entre Educação Física e educação infantil refletem as transformações e evoluções nos debates acadêmicos e nas práticas pedagógicas construídas.

Synchronous extreme fire weather can significantly increase the probability of fire ignition and spread, posing compounding threats to fire management efforts and potentially overwhelming firefighting capabilities. While substantial evidence indicates that weather conditions conducive to wildfires will likely become more frequent with higher levels of global warming, changes in extreme fire weather synchronicity remain understudied. Here, we quantify the synchronicity of extreme fire weather in Europe by analysing historical data of the Canadian fire weather index (FWI) from 1981 to 2022 and projecting FWI future scenarios with temperature increases from 1 °C to 6 °C and precipitation changes from −40% to +60%. Our results highlight Central Europe (CEU) as a significant hotspot, with synchronicity increases of up to 389%, while the Mediterranean region could see increases up to 66%. These findings emphasize the growing need for enhanced cross-border coordination and proactive fire management strategies to address the rising likelihood of concurrent extreme fire weather conditions in a warming climate.

Introducción: Diversos estudios han reportado un déficit de autocuidado por parte de estudiantes de enfermería con un predominio de inadecuados hábitos alimentarios, tabaquismo, sedentarismo, elevado consumo de alcohol y mal manejo del estrés. Objetivo: Caracterizar el estilo de vida de los estudiantes de la carrera de Licenciatura en Enfermería de ocho instituciones de educación superior de la República Argentina. Material y métodos: Estudio multicéntrico, descriptivo y cuantitativo. Se implementó el instrumento Health Promoting Lifestile Profile – II de Nola Pender compuesto por 52 reactivos y agrupado en seis dimensiones. Resultados: Participaron 1718 estudiantes de la carrera de Licenciatura en Enfermería de ocho instituciones de nivel superior de Argentina. Los encuestados tenían una edad media de 29,48 años (DE=9,66), de instituciones carácter público (67,00%) y del segundo año del plan de estudios (32,54%). Las dimensiones mejor y peor valoradas fueron Autorrealización y Manejo del estrés con un 61,93% y 19,38% de la muestra con valoración saludable, respectivamente. El Estilo de vida en general fue caracterizado como regular en el 68,92% de los estudiantes y fue saludable solo en el 4,77%. Conclusión: El estilo de vida de los estudiantes fue mayormente regular y se identificaron relaciones con las variables sociodemográficas y educativas. Palabras clave: Estilos de vida saludable; Estudiantes; Enfermería; Autocuidado; Promoción de la Salud. Abstract. Introduction: Several studies have reported a deficit of self-care in nursing students with a predominance of inadequate eating habits, smoking, a sedentary lifestyle, high alcohol consumption, and poor stress management. Objective: the purpose of this research was to characterize the lifestyle of students of the Bachelor's Degree in Nursing at eight institutions of higher education in Argentina. Material and methods: Multicenter, descriptive, and quantitative study. The Nola Pender's Health Promoting Lifestyle Profile - II tool which consist of 52 items that are categorized into six dimensions. Results: A total of 1,718 undergraduate nursing students from eight institutions of higher education in Argentina participated in the study. Respondents had a mean age of 29.48 years (SD: 9.66), were from public institutions (67.00%) and were in the second year of the study plan (32.54%). The best and worst rated dimensions were Self-realization and Stress management with 61.93% and 19.38% of the sample having a healthy rating, respectively. Lifestyle in general was characterized as regular in 68.92% of the students and was healthy in only 4.77%. Conclusion: It can be concluded that the lifestyle of the students was mostly regular, and relationships were identified between the sociodemographic and educational variables. Keywords: Healthy lifestyles; Students; Nursing; Self-care; Health Promotion.

La ley penal de nuestro país, se caracterizaba por su corte inquisitivo materializado con la Ley 600 (2000), y es con la entrada en vigencia de la Ley 906 (2004) donde este paradigma cambia para hacerla de carácter acusatorio, siguiendo como ejemplo el sistema anglosajón e introduciendo una herramienta novedosa y por algunos cuestionables como lo son los preacuerdos y negociaciones entre el ente acusador y el acusado que busca impactar con un cambio de paradigma que traslada lo jurídico a lo sociológico, humanizando así el proceso penal siendo está acorde con el preámbulo de nuestra constitución, y lo que busca en sí es dar solución rápida y eficaz al proceso, descongestionar los despachos judiciales, garantizar verdad y reparación a la víctima y en cuanto al indiciado asegurar rebaja de la pena o beneficios por su aceptación de cargos.

The school institution works following some characteristic principles of a colonial epistemology. In this work we have related, in three voices, the experiences of a child (Lucas, 11 years old), an adolescent (Diego, 16 years old) and a father (Enrique, 44 years old) who moved from Chile to the city of Granada, Spain, and began the school experience in a public and traditional school. Based on qualitative methodological work with a narrative approach foundation and in which we have used testimonial narratives, we show the epistemological limitations of this Eurocentric school and the depoliticization of teaching work. The school narrated and experienced by Diego, Lucas and Enrique is a racialized institution characterized by: excessive homework, denial of differences, dichotomous epistemology, constant fears and adultcentrism. But in that same school there are also pedagogical spaces and times in which acknowledgement, sincerity and trust allow these institutions to be inhabited.

An experimental study on the shear behavior of autoclaved aerated concrete (AAC) confined masonry walls is presented. A total of five reduced-scale walls were tested in the laboratory under reverse lateral loads. Variables studied were the geometric scaling factor and the aspect ratio of walls. Scales considered were 1:2 and 1:3. Based on the behavior of the reduced- and corresponding full-scale walls experimental scaling factors were determined. Existing geometric scaling factors were compared with corresponding experimental scaling factors. It was concluded that geometric scaling factors can be used to predict the shear strength and maximum shear strength of walls with scales of 1:2 and 1:3. Geometric scaling factors can only be used to predict stiffness and drift ratios associated with the maximum shear strength of walls.

Este artículo presenta una revisión interpretativa sobre la relación entre la asignatura de Educación Física y el desarrollo de la ciudadanía en contexto escolar. Para ello, se realizó una búsqueda en las bases de datos Scopus y Web of Science. Se utilizaron los siguientes criterios de inclusión: trabajos que relacionen la EF con la ciudadanía en el periodo 2018-2022, diversos tipos de publicaciones y trabajos que incluyan enfoques cualitativos, cuantitativos o mixtos. Mediante la técnica de análisis de búsqueda de texto se establecieron cinco códigos interpretativos: concepción de EF, Ciudadanía y EF, práctica docente, ciudadanía y currículo, ciudadanía y formación docente. Los resultados revelan una crítica a la Educación Física, ya que, a pesar de su potencial para contribuir al desarrollo de la ciudadanía en la población escolar, el profesorado tiende a mantener estrategias directivas que obstaculizan la adquisición de una formación ciudadana y la reducen a un mero sentido de obediencia. No obstante, también se encontraron diversas propuestas, especialmente relacionadas con manifestaciones deportivas, que efectivamente contribuyen a la formación ciudadana en las clases de Educación Física. Por último, cabe destacar las aproximaciones a la pedagogía crítica desde la Educación Física, las cuales desempeñan un papel relevante en diferentes ámbitos de la ciudadanía, destacando especialmente la dimensión digital y con el medio ambiente. Palabras Claves: Ciudadanía, Formación Ciudadana, Educación Física, Pedagogía Crítica, Deportes. Abstract. This article presents an interpretative review of the relationship between the subject of Physical Education and the development of citizenship in a school context. To do this, a search was conducted in the Scopus and Web of Science databases. The following inclusion criteria were used: works that relate Physical Education to citizenship in the period 2018-2022, various types of publications, and works that include qualitative, quantitative, or mixed approaches. Through the text search analysis technique, five interpretive codes were established: the conception of Physical Education, Citizenship and Physical Education, teaching practice, citizenship and curriculum, citizenship and teacher training. The results reveal a critique of Physical Education, as despite its potential to contribute to the development of citizenship in the student population, teachers tend to maintain directive strategies that hinder the acquisition of civic education and reduce it to a mere sense of obedience. However, various proposals were also found, especially related to sports activities, that effectively contribute to civic education in Physical Education classes. Finally, it is worth noting the approaches to critical pedagogy within Physical Education, which play a significant role in various aspects of citizenship, especially highlighting the digital dimension and the environment. Keywords: Citizenship, Citizenship Training, Physical Education, Critical Pedagogy, Sport.

Background: Pharmacological treatment of depression with antidepressants is well established, but the desired therapeutic effect may take several weeks to manifest. Few studies have compared response time and improvement rates and its prognostic value for different antidepressants. An accurate response predictor could help guide decisions on whether to maintain an antidepressant for longer or switch. Methods: A secondary analysis data from four clinical trials involving four different antidepressants (venlafaxine, sertraline, mirtazapine, and fluoxetine) and placebo was performed to evaluate the relationship between response time and acute treatment outcome. All patients from the four trials were diagnosed as having a Major Depression episode. Contingency tables were built from the combination of dichotomous variables for all groups. Positive predictive value (PPV), negative predictive value (NPV), sensitivity, specificity and accuracy were determined. Results: Response > 50 % after two weeks of treatment was associated with remission at the end of the acute phase (eight weeks) of treatment for all antidepressants tested, except fluoxetine. Response to mirtazapine within one week was a predictor of response and/or remission after acute treatment, having a high level of accuracy as a predictor of remission for early improvement > 50 %. Mirtazapine also promoted a more rapid response compared with the other antidepressants trialed. Limitations: Severity at baseline varied among the trials and only a small sample was included in the fluoxetine group. Conclusions: The present study revealed that early evaluation (at 1 and 2 weeks) might be beneficial as a treatment strategy, given the heterogeneous patterns of response between antidepressants.

El presente artículo profundiza en la composición y determinantes de la informalidad laboral femenina en Colombia. Utilizando la GEIH para los años 2017-2019, y los criterios establecidos por Fernández y Villar (2017) se categoriza la informalidad laboral en cuatro grupos: subsistente, mixta, inducida y voluntaria. Adicional, se analizan las determinantes socioeconómicas que influyen para que una mujer pertenezca a cada categoría de informalidad. Los resultados indican que las mujeres, en su mayoría, se encuentran concentradas dentro de categorías de informalidad más precarias, con salarios por debajo la línea de la pobreza y concentradas en actividades de menor reconocimiento.

The eutrophication of freshwater ecosystems allows the proliferation of cyanobacteria that can produce secondary metabolites such as microcystins. The main aim of this study was to explore the occurrence and concentration of microcystin and the mcyA gene in water bodies located in agricultural, urban, and recreational areas in the karst aquifer of the Yucatan peninsula of Mexico (YPM) and to analyze the water quality variables and chlorophyll-a (Chl-a) associated with their presence. Water samples were collected from 14 sites, and microcystin concentrations were quantified using antibody-based ELISA test. Total DNA was isolated from filters and used for PCR amplification of a fragment of the mcyA gene. Amplicons were cloned and sequenced to identify toxin-producing cyanobacteria present in water. Results showed that water bodies had different trophic status based on Carlson’s trophic state index. Dissolved inorganic nitrogen (DIN: NH4+ + NO3− + NO2−) and P-PO43− concentrations were within a range of 0.077–18.305 mg DIN/L and 0.025–2.5 mg P-PO43−/L, respectively, per sampled site. All sampled sites presented microcystin concentrations within a range of ≥0.14 µg/L to ≥5.0 µg/L, from which 21.4% (3/14) exceeded the limit established in water quality standards for water consumption (1 µg/L). The mcyA gene fragment was detected in 28.5% (4/14) of the sites. A total of 23 sequences were obtained from which 87% (20/23) shared >95% nucleotide identity (nt) with the genus Microcystis and 13% (3/23) shared >87% nt identity with uncultured cyanobacteria. No correlation with the presence of the mcyA gene and microcystins was found; however, a positive correlation was detected between microcystin concentrations with pH and Chl-a.

Abstract Background Distorted thoughts are common in Major Depressive Disorder (MDD), and can impact patients’ perceptions of depression severity, and predict chronicity and treatment response. This study aimed to investigate whether distorted thoughts mediate depressive symptoms in MDD over a 6-month period. Method These are secondary results from a study that followed 119 patients diagnosed with moderate to severe MDD for 6 months. Diagnoses were confirmed by the Structured Interview for DSM-IV (SCID-CV). The analysis was composed of results from the Hamilton Depression Rating Scale (HAMD-17), the Montgomery-Asberg Depression Rating Scale (MADRS), the second edition of the Beck Depression Inventory (BDI-II), and the Depression Thoughts Scale (DTS) collected at weeks 1, 8, 12 and 24. Results Results showed that the DTS mediated the relationship between depressive symptoms experienced approximately 3 months after starting antidepressant treatment. Conclusion Cognitive distortions were linked as a mediator to depressive symptoms, highlighting the importance of early psychological interventions in patients with MDD who exhibit these distortions. Trial registration NCT02268487.

El objetivo de la investigación fue mejorar el proceso de aprendizaje de los estudiantes de matemáticas de nivel licenciatura mediante el uso de la plataforma TikTok y pudieran divertirse explicando problemas matemáticos en videos y, al mismo tiempo, compartir su aprendizaje. Esta metodología busca motivar a los estudiantes a adquirir competencias matemáticas de una manera más atractiva y participativa que los métodos tradicionales de evaluación. El estudio se llevó a cabo en el Tecnológico Nacional de México, Campus Ciudad Madero, con la participación de 182 estudiantes de dos grupos diferentes. La metodología incluyó la creación de un instrumento que ofrecía a los estudiantes la opción de elegir entre un examen tradicional o la creación de videos en TikTok para acreditar la unidad. Se observó que los estudiantes que participaron en la creación de videos en TikTok obtuvieron calificaciones variadas de 70 a 100, indicando diversidad en su desempeño. La calificación promedio fue satisfactoria, y la desviación estándar mostró cierta variabilidad en las calificaciones, reflejando diferentes niveles de satisfacción y desempeño. Además, los resultados revelaron que los estudiantes se sentían cómodos usando TikTok y mostraban un alto nivel de compromiso y diversión al crear videos de matemáticas. La mayoría de los estudiantes prefiere esta forma de evaluación sobre los exámenes escritos. En resumen, TikTok se percibe como una herramienta efectiva para aumentar la satisfacción y el compromiso de los estudiantes en el aprendizaje. Además, el análisis de variables reveló una satisfacción general moderada a alta, con diferencias menores entre géneros y preferencias por ciertas asignaturas y carreras.

ABSTRACT OBJECTIVE To evaluate the evolution of the dietary patterns of adolescents in the northeast region of Brazil. METHODS Secondary analysis of data from the Pesquisa de Orçamentos Familiares (POF – Household Budget Surveys), collected by the Brazilian Institute of Geography and Statistics (IBGE) in the years 2008–2009 and 2017–2018. A total of 3,095 adolescents were evaluated in 2008–2009 and 3,015 in 2017–2018. Food consumption was assessed using two dietary records in 2008–2009 and two 24-hour recalls in 2017–2018, applied on non-consecutive days. Based on these data, principal components factor analysis (PCFA) was performed, followed by orthogonal rotation of the varimax type, to derive dietary patterns, stratified by sex. The results were described as means or percentage frequencies, with their respective 95% confidence intervals. RESULTS Three main dietary patterns were identified among adolescents from the northeast region of Brazil. Among boys, in 2008–2009, the patterns were called snacks, traditional Brazilian, and coffee; and in 2017–2018, traditional Brazilian, snacks, and mixed, in this order of representativeness of the group’s eating habits. Among female adolescents, in 2008–2009, the patterns were snacks, traditional Brazilian, and coffee; and in 2017–2018, traditional Brazilian, snacks, and processed meats. CONCLUSION The dietary patterns identified in 2008–2009 and 2017–2018 were similar in both genders; however, the snacks pattern, which explained most of the data variability in 2008–2009, was replaced by the traditional Brazilian.

ABSTRACTIntroduction: The use of steroids has been proposed as a pharmacological approach to treat the SARS-CoV-2 infection to improve outcomes. However, there are doubts about safety against the development of superinfections and their worse outcomes.Objective: To establish the relative frequency of superinfection associated with using steroids in patients with SARS-CoV-2 infection.Materials and methods: We conducted a systematic literature review and meta-analysis using PRISMA standards in 5 databases (PubMed/Scopus/Cochrane/EMBASE/Google Scholar). The search was carried out between February 2020 and May 2023. The search terms were ‘steroids’ or ‘superinfection’ ‘and’ followed by ‘SARS-CoV-2’ or ‘COVID-19’.Results: We found 77 studies, but only 10 with 3539 patients were included in the systematic review. All patients developed severe disease. The documented OR for superinfection through the meta-analysis was 1.437 (95% IC 0.869–2.378) with a p-value of 0.158 without showing a risk attributed to steroids and the development of superinfections. In the Funnel-plot analysis, no publication biases were found.Conclusion: No relationship was found between using steroids and superinfection in patients with SARS-CoV-2.

Cri Du Chat Syndrome (SCDC) is a genetic syndrome that must be recognized and diagnosed as soon as possible for early follow-up and multidisciplinary intervention. We describe the case of a female newborn who was suspected at SCDC at delivery room due to high-pitched crying and facial asymmetry. We also describe the investigation until the final diagnosis and the clinical evolution up to nine months of age of the child. After the diagnosis was confirmed, our pacient received hospital discharge with follow-up of multidisciplinary team in order to reduce development impairments.

INTRODUCTION: Congenital hypothyroidism results from insufficient secretion of thyroid hormones, which are related to the maturation of the central nervous system, being the main cause of preventable intellectual disability in childhood. The diagnosis can be suspected from the neonatal screening test, revealing its importance, since most cases are asymptomatic or oligosymptomatic at birth with nonspecific manifestations, as well as the classic manifestations become evident only later, causing neurological damage. OBJECTIVE: describe a clinical case of a patient diagnosed with congenital hypothyroidism on the sixth day of life, screened through the neonatal screening test, with subsequent laboratory confirmation, highlighting points of diagnosis, treatment and clinical follow-up, avoiding the progression of late diagnosis. CASE REPORT: male patient, born through normal delivery without complications, who developed asymptomatic hypoglycemia at the first hours of life, treatment resistant. The patient presented alterations compatible with congenital hypothyroidism in the neonatal screening test, with subsequent confirmation through laboratory tests. Thyroglobulin replacement was started on the seventh day of life, with progressive improvement in hypoglycemia and favorable clinical evolution throughout the first months of life. CONCLUSION: Congenital hypothyroidism is the main cause of preventable intellectual disability in childhood, it must be diagnosed as early as possible, demonstrating the importance of neonatal screening tools. After the institution of appropriate treatment and clinical follow-up, the evolution is favorable, avoiding the drastic progression of late diagnosis.

This first checklist of coastal marine fish inhabiting the Department of Atlántico (Colombian Caribbean) was compiled through an exhaustive review of published information, databases, other unpublished sources, and primary data. We recorded 272 fish species, of which twenty were first reported for this region. Carangidae, Lutjanidae, and Scombridae were the richest families, which together represent 14 % of the total number of species. According to the Red List of Marine Fishes of Colombia, 37 species show some degree of threat. Most species are demersal, associated with soft bottoms. However, a significant number of species were also found associated with hard substrates, suggesting that fish congregate around these less abundant substrates, as the coastline is mainly dominated by fine sediments. This study reveals that this region has higher fish richness than previously thought and highlights the need to carry out further studies to increase the knowledge of the ichthyofauna, framed in the environmental setting of the Department’s coastal zone and the anthropogenic influence on the group in question. Bet-ter knowledge of the richness of ichthyic species contributes indirectly to the improvement of current management plans for marine biodiversity conservation.

Abstract Background Infections caused by extended spectrum β-lactamase (ESβL) producing bacteria are common and problematic. When they cause bloodstream infections, they are associated with significant morbidity and mortality. Methods A retrospective cross-sectional observational study was conducted in a single center in Pereira, Colombia. It included people hospitalized with bacteremia due to gram-negative bacilli with the extended-spectrum β-lactamase producing phenotype. A logistic regression analysis was constructed. Clinical characteristics and risk factors for death from sepsis were established. Results The prevalence of bacteremia due to Enterobacterales with extended-spectrum β-lactamase producing phenotype was 17%. 110 patients were analyzed. Most patients were men (62%) with a median age of 58 years, hospital mortality was 38%. Admission to intensive care was 45%. The following risk factors for mortality were established: shock requiring vasoactive support, Pitt score > 3 points, and not having an infectious disease consultation (IDC). Conclusions bacteremia due to Enterobacterales with extended-spectrum β-lactamase producing phenotype have a high mortality. Early recognition of sepsis, identification of risk factors for antimicrobial resistance, and prompt initiation of appropriate empiric antibiotic treatment are important. An infectious disease consultation may help improve outcomes.

Summary: As SARS-CoV-2 becomes endemic, it is critical to understand immunity following early-life infection. We evaluated humoral responses to SARS-CoV-2 in 23 infants/young children. Antibody responses to SARS-CoV-2 spike antigens peaked approximately 30 days after infection and were maintained up to 500 days with little apparent decay. While the magnitude of humoral responses was similar to an adult cohort recovered from mild/moderate COVID-19, both binding and neutralization titers to WT SARS-CoV-2 were more durable in infants/young children, with spike and RBD IgG antibody half-life nearly 4X as long as in adults. IgG subtype analysis revealed that while IgG1 formed the majority of the response in both groups, IgG3 was more common in adults and IgG2 in infants/young children. These findings raise important questions regarding differential regulation of humoral immunity in infants/young children and adults and could have broad implications for the timing of vaccination and booster strategies in this age group.

Measurement(s) parasitemia • blood Chemistry • reticulocyte count • platelet activation status • neutrophil and monocyte activation after stimulation • T-cell phenotyping • B-cell phenotyping • monocyte phenotyping • dendritic cell phenotyping • lymphocyte phenotyping • multiplexed cytokine assay • erythropoietin measurement • total IgG concentration • transcriptome • metabolomics • lipidomics • proteomics Technology Type(s) brightfield microscopy • iSTAT machine • immunological flow cytometry • chemokine receptor markers • intracellular staining • ELISA • LC/MS Factor Type(s) Parasitemia Sample Characteristic - Organism Macaca mulatta • Plasmodium cynomolgi B/M strain • Plasmodium cynomolgi Ceylon Sample Characteristic - Environment venous blood • capillary blood

The blueberry industry is growing significantly in Colombia. For investors, cost analysis plays a key role in project planning for any agribusiness. This paper is an exploratory study, with a descriptive scope to identify components of establishment and production costs of growing blueberries in Colombia. Data were collected and analyzed from a project aimed at establishing a 1 ha blueberry crop in Zipaquirá and 18 blueberry small farms in the Cundiboyacense highlands. Components were applied to estimate the capital investment and to identify the establishment, production, and maintenance costs of this project. Decision investment analysis, including discount rates for the capital asset pricing model (CAPM), were used to compute the net present value (NPV), internal rate of return (IRR), and the return on investment (ROI). Production costs are still expensive due to the Colombian peso (COP) exchange rate compared to the US dollar (USD). Results show advantages for promoting the establishment of blueberry crops because of suitable climatic conditions for continuous production throughout the year in Colombia. Labor costs and utilities are cheaper compared to other countries and represent a competitive advantage in the investment. Intermediation suppliers affect establishment costs for commercial reasons. Blueberry production cost analysis in Colombia may facilitate agribusinesses to promote projects in Colombian agriculture.

Background and purpose: Radiation-induced toxicities are common adverse events in lung cancer (LC) patients undergoing radiotherapy (RT). An accurate prediction of these adverse events might facilitate an informed and shared decision-making process between patient and radiation oncologist with a clearer view of life-balance implications in treatment choices. This work provides a benchmark of machine learning (ML) approaches to predict radiation-induced toxicities in LC patients built upon a real-world health dataset based on a generalizable methodology for their implementation and external validation. Materials and Methods: Ten feature selection (FS) methods were combined with five ML-based classifiers to predict six RT-induced toxicities (acute esophagitis, acute cough, acute dyspnea, acute pneumonitis, chronic dyspnea, and chronic pneumonitis). A real-world health dataset (RWHD) built from 875 consecutive LC patients was used to train and validate the resulting 300 predictive models. Internal and external accuracy was calculated in terms of AUC per clinical endpoint, FS method, and ML-based classifier under analysis. Results: Best performing predictive models obtained per clinical endpoint achieved comparable performances to methods from state-of-the-art at internal validation (AUC ≥ 0.81 in all cases) and at external validation (AUC ≥ 0.73 in 5 out of 6 cases). Conclusion: A benchmark of 300 different ML-based approaches has been tested against a RWHD achieving satisfactory results following a generalizable methodology. The outcomes suggest potential relationships between underrecognized clinical factors and the onset of acute esophagitis or chronic dyspnea, thus demonstrating the potential that ML-based approaches have to generate novel data-driven hypotheses in the field.

Abstract Plasmodium falciparum (Pf) malaria continues to cause considerable morbidity and mortality worldwide. The circumsporozoite protein (CSP) is a particularly attractive candidate for designing vaccines that target sporozoites—the first vertebrate stage in a malaria infection. Current PfCSP‐based vaccines, however, do not include epitopes that have recently been shown to be the target of potent neutralizing antibodies. We report the design of a SpyCatcher‐mi3‐nanoparticle‐based vaccine presenting multiple copies of a chimeric PfCSP (cPfCSP) antigen that incorporates these important “T1/junctional” epitopes as well as a reduced number of (NANP)n repeats. cPfCSP‐SpyCatcher‐mi3 was immunogenic in mice eliciting high and durable IgG antibody levels as well as a balanced antibody response against the T1/junctional region and the (NANP)n repeats. Notably, the antibody concentration elicited by immunization was significantly greater than the reported protective threshold defined in a murine challenge model. Refocusing the immune response toward functionally relevant subdominant epitopes to induce a more balanced and durable immune response may enable the design of a more effective second generation PfCSP‐based vaccine.

Abstract Background A healthy lifestyle decreases the risk of developing type 2 diabetes mellitus. The current cross-sectional study aimed to describe self-reported lifestyle behaviours and compare them to current health guidelines in European Feel4Diabetes-families at risk for developing type 2 diabetes across six countries (Belgium, Finland, Spain, Greece, Hungary and Bulgaria). Methods Parents and their children were recruited through primary schools located in low socio-economic status areas. Parents filled out the FINDRISC-questionnaire (eight items questioning age, Body Mass Index, waist circumference, PA, daily consumption of fruit, berries or vegetables, history of antihypertensive drug treatment, history of high blood glucose and family history of diabetes), which was used for the risk assessment of the family. Sociodemographic factors and several lifestyle behaviours (physical activity, sedentary behaviour, water consumption, fruit and vegetable consumption, soft drink consumption, sweets consumption, snack consumption, breakfast consumption) of both adults and children were assessed by parental questionnaires. Multilevel regression analyses were conducted to investigate families’ lifestyle behaviours, to compare these levels to health guidelines and to assess potential differences between the countries. Analyses were controlled for age, sex and socio-economic status. Results Most Feel4Diabetes-families at risk (parents and their children) did not comply with the guidelines regarding healthy behaviours, set by the WHO, European or national authorities. Less than half of parents and children complied with the physical activity guidelines, less than 15% of them complied with the fruit and vegetable guideline, and only 40% of the children met the recommendations of five glasses of water per day. Clear differences in lifestyle behaviours in Feel4Diabetes-families at risk exist between the countries. Conclusions Countries are highly recommended to invest in policy initiatives to counter unhealthy lifestyle behaviours in families at risk for type 2 diabetes development, taking into account country-specific needs. For future research it is of great importance to focus on families at risk in order to counter the development of type 2 diabetes and reduce health inequity.

La innovación y el desarrollo tecnológico son factores clave en el siglo XXI, la Cuarta Revolución Industrial se visualiza como un eje transversal en las distintas áreas de la sociedad. En este tema se rescata el concepto de tecnoeconomía (Heginbotham & Samuels, 1998) en la región del noreste asiático. El objetivo de esta investigación consiste en determinar el grado de adaptación de una tecno-economía a la nueva normalidad económica del modelo de desarrollo tetrahélice. Los resultados de esta investigación van dirigidos a enfatizar la directriz estatal y el lobbying empresarial en las tecnoeconomías.

Background: Childhood dyslipidemia is a common condition that can lead to atherosclerotic cardiovascular disease in adulthood. It is usually multifactorial. Screening for cholesterol disorders in children varies based on risk factors, with some guidelines recommending cascade screening for children with a clear family history of familial hypercholesterolemia, targeted screening for those with specific risk factors, and universal screening. Point-of-care testing (POCT) cholesterol tests offer potential advantages, including ease of use, portability, increased patient access, low cost, fewer medical or laboratory visits, and instant results. This study aimed to evaluate the effect of POCT cholesterol screening on the diagnosis of hypercholesterolemia in children in a family practice setting. Methods: We used a POCT cholesterol analyzer to perform two different (universal and targeted) screening approaches for dyslipidemia in children. We used the NCEP guidelines for the classification of the results. Results: We screened 183 children, 105 in the universal screening group and 78 in the targeted screening group. Eight patients in the targeted screening group had elevated cholesterol levels (p = 0.02). Conclusions: All participants received instant feedback and recommendations. Using a targeted screening approach, POCT could be a practical and effective tool for identifying at-risk children with hypercholesterolemia.

BackgroundSARS-CoV-2 infection and perinatal neurologic outcomes are still not fully understood. However, there is recent evidence of white matter disease and impaired neurodevelopment in newborns following maternal SARS-CoV-2 infection. These appear to occur as a consequence of both direct viral effects and a systemic inflammatory response, with glial cell/myelin involvement and regional hypoxia/microvascular dysfunction. We sought to characterize the consequences of maternal and fetal inflammatory states in the central nervous system of newborns following maternal SARS-CoV-2 infection.MethodsWe conducted a longitudinal prospective cohort study from June 2020 to December 2021, with follow-up of newborns born to mothers exposed or not exposed to SARS-CoV-2 infection during pregnancy. Brain analysis included data from cranial ultrasound scans (CUS) with grayscale, Doppler studies (color and spectral), and ultrasound-based brain elastography (shear-wave mode) in specific regions of interest (ROIs): deep white matter, superficial white matter, corpus callosum, basal ganglia, and cortical gray matter. Brain elastography was used to estimate brain parenchymal stiffness, which is an indirect quantifier of cerebral myelin tissue content.ResultsA total of 219 single-pregnancy children were enrolled, including 201 born to mothers exposed to SARS-CoV-2 infection and 18 from unexposed controls. A neuroimaging evaluation was performed at 6 months of adjusted chronological age and revealed 18 grayscale and 21 Doppler abnormalities. Predominant findings were hyperechogenicity of deep brain white matter and basal ganglia (caudate nuclei/thalamus) and a reduction in the resistance and pulsatility indices of intracranial arterial flow. The anterior brain circulation (middle cerebral and pericallosal arteries) displayed a wider range of flow variation than the posterior circulation (basilar artery). Shear-wave US elastography analysis showed a reduction in stiffness values in the SARS-CoV-2 exposed group in all analyzed regions of interest, especially in the deep white matter elasticity coefficients (3.98 ± 0.62) compared to the control group (7.76 ± 0.77); p-value

IntroductionSARS-CoV-2 infection during pregnancy can induce changes in the maternal immune response, with effects on pregnancy outcome and offspring. This is a cross-sectional observational study designed to characterize the immunological status of pregnant women with convalescent COVID-19 at distinct pregnancy trimesters. The study focused on providing a clear snapshot of the interplay among serum soluble mediators.MethodsA sample of 141 pregnant women from all prenatal periods (1st, 2nd and 3rd trimesters) comprised patients with convalescent SARS-CoV-2 infection at 3-20 weeks after symptoms onset (COVID, n=89) and a control group of pre-pandemic non-infected pregnant women (HC, n=52). Chemokine, pro-inflammatory/regulatory cytokine and growth factor levels were quantified by a high-throughput microbeads array.ResultsIn the HC group, most serum soluble mediators progressively decreased towards the 2nd and 3rd trimesters of pregnancy, while higher chemokine, cytokine and growth factor levels were observed in the COVID patient group. Serum soluble mediator signatures and heatmap analysis pointed out that the major increase observed in the COVID group related to pro-inflammatory cytokines (IL-6, TNF-α, IL-12, IFN-γ and IL-17). A larger set of biomarkers displayed an increased COVID/HC ratio towards the 2nd (3x increase) and the 3rd (3x to 15x increase) trimesters. Integrative network analysis demonstrated that HC pregnancy evolves with decreasing connectivity between pairs of serum soluble mediators towards the 3rd trimester. Although the COVID group exhibited a similar profile, the number of connections was remarkably lower throughout the pregnancy. Meanwhile, IL-1Ra, IL-10 and GM-CSF presented a preserved number of correlations (≥5 strong correlations in HC and COVID), IL-17, FGF-basic and VEGF lost connectivity throughout the pregnancy. IL-6 and CXCL8 were included in a set of acquired attributes, named COVID-selective (≥5 strong correlations in COVID and

Summary: Current COVID-19 vaccines have been associated with a decline in infection rates, prevention of severe disease, and a decrease in mortality rates. However, SARS-CoV-2 variants are continuously evolving, and development of new accessible COVID-19 vaccines is essential to mitigate the pandemic. Here, we present data on preclinical studies in mice of a receptor-binding domain (RBD)-based recombinant protein vaccine (PHH-1V) consisting of an RBD fusion heterodimer comprising the B.1.351 and B.1.1.7 SARS-CoV-2 variants formulated in SQBA adjuvant, an oil-in-water emulsion. A prime-boost immunisation with PHH-1V in BALB/c and K18-hACE2 mice induced a CD4+ and CD8+ T cell response and RBD-binding antibodies with neutralizing activity against several variants, and also showed a good tolerability profile. Significantly, RBD fusion heterodimer vaccination conferred 100% efficacy, preventing mortality in SARS-CoV-2 infected K18-hACE2 mice, but also reducing Beta, Delta and Omicron infection in lower respiratory airways. These findings demonstrate the feasibility of this recombinant vaccine strategy.

Summary: Background: Anti-COVID-19 hyperimmune immunoglobulin (hIG) can provide standardized and controlled antibody content. Data from controlled clinical trials using hIG for the prevention or treatment of COVID-19 outpatients have not been reported. We assessed the safety and efficacy of subcutaneous anti-COVID-19 hyperimmune immunoglobulin 20% (C19-IG20%) compared to placebo in preventing development of symptomatic COVID-19 in asymptomatic individuals with SARS-CoV-2 infection. Methods: We did a multicentre, randomized, double-blind, placebo-controlled trial, in asymptomatic unvaccinated adults (≥18 years of age) with confirmed SARS-CoV-2 infection within 5 days between April 28 and December 27, 2021. Participants were randomly assigned (1:1:1) to receive a blinded subcutaneous infusion of 10 mL with 1 g or 2 g of C19-IG20%, or an equivalent volume of saline as placebo. The primary endpoint was the proportion of participants who remained asymptomatic through day 14 after infusion. Secondary endpoints included the proportion of individuals who required oxygen supplementation, any medically attended visit, hospitalisation, or ICU, and viral load reduction and viral clearance in nasopharyngeal swabs. Safety was assessed as the proportion of patients with adverse events. The trial was terminated early due to a lack of potential benefit in the target population in a planned interim analysis conducted in December 2021. ClinicalTrials.gov registry: NCT04847141. Findings: 461 individuals (mean age 39.6 years [SD 12.8]) were randomized and received the intervention within a mean of 3.1 (SD 1.27) days from a positive SARS-CoV-2 test. In the prespecified modified intention-to-treat analysis that included only participants who received a subcutaneous infusion, the primary outcome occurred in 59.9% (91/152) of participants receiving 1 g C19-IG20%, 64.7% (99/153) receiving 2 g, and 63.5% (99/156) receiving placebo (difference in proportions 1 g C19-IG20% vs. placebo, −3.6%; 95% CI -14.6% to 7.3%, p = 0.53; 2 g C19-IG20% vs placebo, 1.1%; −9.6% to 11.9%, p = 0.85). None of the secondary clinical efficacy endpoints or virological endpoints were significantly different between study groups. Adverse event rate was similar between groups, and no severe or life-threatening adverse events related to investigational product infusion were reported. Interpretation: Our findings suggested that administration of subcutaneous human hyperimmune immunoglobulin C19-IG20% to asymptomatic individuals with SARS-CoV-2 infection was safe but did not prevent development of symptomatic COVID-19. Funding: Grifols.

Abstract Background Kra monkeys (Macaca fascicularis), a natural host of Plasmodium knowlesi, control parasitaemia caused by this parasite species and escape death without treatment. Knowledge of the disease progression and resilience in kra monkeys will aid the effective use of this species to study mechanisms of resilience to malaria. This longitudinal study aimed to define clinical, physiological and pathological changes in kra monkeys infected with P. knowlesi, which could explain their resilient phenotype. Methods Kra monkeys (n = 15, male, young adults) were infected intravenously with cryopreserved P. knowlesi sporozoites and the resulting parasitaemias were monitored daily. Complete blood counts, reticulocyte counts, blood chemistry and physiological telemetry data (n = 7) were acquired as described prior to infection to establish baseline values and then daily after inoculation for up to 50 days. Bone marrow aspirates, plasma samples, and 22 tissue samples were collected at specific time points to evaluate longitudinal clinical, physiological and pathological effects of P. knowlesi infections during acute and chronic infections. Results As expected, the kra monkeys controlled acute infections and remained with low-level, persistent parasitaemias without anti-malarial intervention. Unexpectedly, early in the infection, fevers developed, which ultimately returned to baseline, as well as mild to moderate thrombocytopenia, and moderate to severe anaemia. Mathematical modelling and the reticulocyte production index indicated that the anaemia was largely due to the removal of uninfected erythrocytes and not impaired production of erythrocytes. Mild tissue damage was observed, and tissue parasite load was associated with tissue damage even though parasite accumulation in the tissues was generally low. Conclusions Kra monkeys experimentally infected with P. knowlesi sporozoites presented with multiple clinical signs of malaria that varied in severity among individuals. Overall, the animals shared common mechanisms of resilience characterized by controlling parasitaemia 3–5 days after patency, and controlling fever, coupled with physiological and bone marrow responses to compensate for anaemia. Together, these responses likely minimized tissue damage while supporting the establishment of chronic infections, which may be important for transmission in natural endemic settings. These results provide new foundational insights into malaria pathogenesis and resilience in kra monkeys, which may improve understanding of human infections.

Previous studies have suggested that a relationship exists between severity and transmissibility of malaria and variations in the gut microbiome, yet only limited information exists on the temporal dynamics of the gut microbial community during a malarial infection. Here, using a rhesus macaque model of relapsing malaria, we investigate how malaria affects the gut microbiome. In this study, we performed 16S sequencing on DNA isolated from rectal swabs of rhesus macaques over the course of an experimental malarial infection with Plasmodium cynomolgi and analyzed gut bacterial taxa abundance across primary and relapsing infections. We also performed metabolomics on blood plasma from the animals at the same timepoints and investigated changes in metabolic pathways over time. Members of Proteobacteria (family Helicobacteraceae) increased dramatically in relative abundance in the animal’s gut microbiome during peak infection while Firmicutes (family Lactobacillaceae and Ruminococcaceae), Bacteroidetes (family Prevotellaceae) and Spirochaetes amongst others decreased compared to baseline levels. Alpha diversity metrics indicated decreased microbiome diversity at the peak of parasitemia, followed by restoration of diversity post-treatment. Comparison with healthy subjects suggested that the rectal microbiome during acute malaria is enriched with commensal bacteria typically found in the healthy animal’s mucosa. Significant changes in the tryptophan-kynurenine immunomodulatory pathway were detected at peak infection with P. cynomolgi, a finding that has been described previously in the context of P. vivax infections in humans. During relapses, which have been shown to be associated with less inflammation and clinical severity, we observed minimal disruption to the gut microbiome, despite parasites being present. Altogether, these data suggest that the metabolic shift occurring during acute infection is associated with a concomitant shift in the gut microbiome, which is reversed post-treatment.

Objective. The study describes health care services utilization contextualized by the needs of the Mexican population during the Covid-19 pandemic. Materials and methods. We used data from the National Health and Nutrition Survey, Covid-19. Among the population with symptoms compatible with Covid-19, we describe the proportion who sought care, received care, were tested, were diagnosed positive, and survived, and whether they received care in public or private services. We estimated factors associated with the probability of seeking and receiving care. Results. Out of 7.1% of the population with symptoms compatible with Covid-19, 64.4% received care, and 15.4% tested positive; 74.5% received care in the private sector, even among the population with social security. Those with social security, in contact with a suspected or confirmed Covid-19 case, and with at least one comorbidity had a higher probability of seeking and receiving care. Conclusions. The most relevant finding of our study is the large proportion of the population with Covid-19 symptoms who sought and received care in private facilities an essential aspect for decision-makers to consider as the current health reform moves forward in Mexico.

Este trabajo tiene como sentido fundamental presentar las aproximaciones y cosmovisiones de las comunidades originarias en torno a la relacionalidad como elemento constitutivo de lo humano y sus posibilidades de operacionalización en una propuesta para la motricidad escolar. Los elementos de análisis se articulan desde la experiencia investigativa del grupo de investigación “Motricidades amazónicas” en comunidades originarias de los departamentos del Cauca y del Caquetá, Colombia, así como de estudios y aproximaciones documentales de la culturas originarias de Chile. Se comparten los lineamientos estructurantes de la teoría enactiva como un puente epistémico entre las culturas originarias y la cultura occidental a fin de visualizar operativamente las posibilidades educativas en la motricidad escolar. Al final se presenta un modelo de motricidad relacional en el contexto de una praxis educativa más pertinente e intercultural.

Resumo Este artigo analisa a teorização que vem sendo empreendida sobre “brincar e se-movimentar” e que pode ser considerada como uma das possibilidades de fundamentar a intervenção da Educação Física com a Educação Infantil. Em termos metodológicos, opera com algumas chaves de leitura e interpretação, na tentativa de compreender as concepções de infância; de corpo e movimento com as quais o “brincar e se-movimentar” dialogam, assim como, identificar a definição do que seria o objeto de ensino da Educação Física na Educação Infantil e qual o papel do professor nesse contexto. Em seguida, tece algumas considerações a respeito das potencialidades, dos limites e dos desafios dessa teorização para a Educação Física na Educação Infantil.

BackgroundCOVID-19 pandemic has revealed the weaknesses of most health systems around the world, collapsing them and depleting their available health care resources. Fortunately, the development and enforcement of specific public health policies, such as vaccination, mask wearing, and social distancing, among others, has reduced the prevalence and complications associated with COVID-19 in its acute phase. However, the aftermath of the global pandemic has called for an efficient approach to manage patients with long COVID-19. This is a great opportunity to leverage on innovative digital health solutions to provide exhausted health care systems with the most cost-effective and efficient tools available to support the clinical management of this population. In this context, the SENSING-AI project is focused on the research toward the implementation of an artificial intelligence–driven digital health solution that supports both the adaptive self-management of people living with long COVID-19 and the health care staff in charge of the management and follow-up of this population. ObjectiveThe objective of this protocol is the prospective collection of psychometric and biometric data from 10 patients for training algorithms and prediction models to complement the SENSING-AI cohort. MethodsPublicly available health and lifestyle data registries will be consulted and complemented with a retrospective cohort of anonymized data collected from clinical information of patients diagnosed with long COVID-19. Furthermore, a prospective patient-generated data set will be captured using wearable devices and validated patient-reported outcomes questionnaires to complement the retrospective cohort. Finally, the ‘Findability, Accessibility, Interoperability, and Reuse’ guiding principles for scientific data management and stewardship will be applied to the resulting data set to encourage the continuous process of discovery, evaluation, and reuse of information for the research community at large. ResultsThe SENSING-AI cohort is expected to be completed during 2022. It is expected that sufficient data will be obtained to generate artificial intelligence models based on behavior change and mental well-being techniques to improve patients’ self-management, while providing useful and timely clinical decision support services to health care professionals based on risk stratification models and early detection of exacerbations. ConclusionsSENSING-AI focuses on obtaining high-quality data of patients with long COVID-19 during their daily life. Supporting these patients is of paramount importance in the current pandemic situation, including supporting their health care professionals in a cost-effective and efficient management of long COVID-19. Trial RegistrationClinicaltrials.gov NCT05204615; https://clinicaltrials.gov/ct2/show/NCT05204615 International Registered Report Identifier (IRRID)DERR1-10.2196/37704

En este trabajo se evaluó el cambio en el comportamiento a flexión de vigas de concreto reforzado. Se consideraron vigas sin corrosión y vigas con parámetros electroquímicos asociados con un nivel de corrosión alto. Los parámetros electroquímicos considerados fueron la velocidad de corrosión, la resistividad eléctrica y la concentración de cloruros. Las vigas se ensayaron bajo cargas verticales incrementales hasta la falla. Se presentan los patrones de agrietamiento, las cargas de fluencia y máxima, la rigidez de fluencia y la ductilidad de desplazamiento de las vigas. Con base en el análisis de estos parámetros estructurales se concluye que el comportamiento a flexión de las vigas con y sin corrosión fue similar.

Objective: To explore whether there is an association between distractibility, anxiety, irritability, and agitation (DAIA) symptoms and the severity of depressive and manic symptoms. Methods: Patients with unipolar and bipolar disorder (I and II) and mixed depression were evaluated. DAIA symptoms were assessed using previously described definitions. Results: The full analysis set comprised 100 patients. The severity of depressive symptoms in mixed depression, assessed by Montgomery-Åsberg Depression Rating Scale (MADRS), was significantly associated with the presence of two or more DAIA symptoms in the bipolar sample, influenced mainly by anxiety. The severity of manic symptoms in mixed depression, assessed by Young Mania Rating Scale (YMRS), was significantly associated with the presence of two or more DAIA symptoms in the bipolar sample and three or four DAIA symptoms in the unipolar sample. Conclusion: DAIA symptoms were associated with greater severity of manic symptoms in mixed depression. DAIA symptoms must be evaluated in all patients with mixed features and are associated with the severity of depressive and manic symptoms in mixed depression. Clinical trial registration: ClinicalTrials.gov (NCT04123301).

Abstract Background The HIV pandemic continues to cause a high burden of morbidity and mortality due to delayed diagnosis. Histoplasmosis is prevalent in Latin America and Colombia, is difficult to diagnose and has a high mortality. Here we determined the clinical characteristics and risk factors of histoplasmosis in people living with HIV (PLWH) in Pereira, Colombia. Materials and methods This was a retrospective cross-sectional study (2014–2019) involving two tertiary medical centers in Pereira, Colombia. People hospitalized with HIV were included. Histoplasma antigen detection was performed in urine samples. Probable histoplasmosis was defined according to European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group/National Institute of Allergy and Infectious Diseases Mycoses Study Group criteria. Results 172 HIV-infected patients were analyzed. Histoplasmosis was confirmed in 29% (n = 50/172) of patients. The logistic regression analysis showed that the risk factors for histoplasmosis were pancytopenia (OR 4.1, 95% CI 1.6–10.3, P = 0.002), 46 IU/L (OR 3.2, 95% CI 1.3–8, P = 0.010). Conclusions Histoplasmosis is highly prevalent in hospitalized patients with HIV in Pereira, Colombia. The clinical findings are nonspecific, but there are some clinical abnormalities that can lead to suspicion of the disease, early diagnosis and prompt treatment. Urine antigen detection is useful for diagnosis, but is not widely available. An algorithmic approach is proposed for low-resource clinical settings.

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Objetivo. Estimar la elasticidad precio y la elasticidad ingreso de la demanda de cerveza en México. Material y métodos. Se utilizaron series mensuales de ventas y precios de cerveza de 2007 a 2019. Se estimó la elasticidad a largo plazo mediante un modelo de mínimos cuadrados ordinarios (MCO). La elasticidad en el corto plazo se estimó mediante un modelo de mínimos cuadrados ordinarios dinámicos (MCOD). Resultados. La elasticidad precio en el largo plazo fue de -1.40 (IC95%: -2.53 a -0.27) y -1.31 (IC95%: -2.46 a -0.15) en el corto plazo. La elasticidad ingreso de la demanda en el largo y en el corto plazo se estimó en 0.86 (IC95%: 0.44-1.29) y 0.93 (IC95%: 0.51-1.34), respectivamente. Conclusión. Los hallazgos de este estudio sugieren que las políticas fiscales pueden tener un impacto positivo en la salud de la población al reducir el consumo de cerveza.

ObjectiveKetamine, an N-methyl D-aspartate (NMDA) receptor antagonist, can promote rapid action in the management of individuals with treatment-resistant depression (TRD) at sub-anesthetic doses. However, few studies have investigated the long-term use of ketamine administered intravenously (IV) and intranasally (IN). We report the design and rationale of a therapeutic trial for assessing the efficacy, safety, and tolerability of repeated-dose intramuscular (IM) ketamine vs. active treatment (escitalopram and aripiprazole) in TRD patients.MethodsA comparative, parallel-group, randomized double-blind trial assessing the efficacy, safety, and tolerability of acute (4 weeks) and maintenance (24 weeks) use of IM ketamine (0.75 mg/kg) vs. active control (escitalopram 15 mg and aripiprazole 5 mg) in individuals with moderate-severe intensity TRD (no psychotic symptoms) with or without suicide risk will be conducted. Patients with TRD (18–40 years) will be randomized and blinded to receive ketamine IM or active treatment at a 1:1 ratio for 4 weeks (active treatment) and 24 weeks (maintenance treatment). Subjects will be assessed using clinical scales, monitored for vital signs (VS) after application of injectable medication, and undergo neuropsychological tests. The primary outcome will be changed on the Montgomery-Åsberg Depression Rating Scale (MADRS) during the course of the trial. The study is in running.ResultsThis study can potentially yield evidence on the use of IM ketamine in the treatment of depressive disorders as an ultra-rapid low-cost therapy associated with less patient discomfort and reduced use of medical resources, and can elucidate long-term effects on different outcomes, such as neuropsychological aspects.ConclusionsThe trial can help promote the introduction of a novel accessible approach for the treatment of complex disease (TRD) and also allow refinement of its long-term use.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/NCT04234776, identifier: NCT04234776.