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ABSTRACT Objectives: To know the meaning of education in the perioperative period, in women undergoing hysterectomy for benign causes and to determine the effectiveness of educational nursing intervention in improving female sexual function, quality of life and self-esteem in women undergoing hysterectomy for benign causes. Methods: Mixed design, exploratory sequential Qualitative phase semi-structured interviews and content analysis. Quasi-experimental study quantitative phase, non-equivalent control group. 26 women in 2 groups. Instruments: Biosociodemographic, Female Sexual Function Index, SF-36 Questionnaire, Rosenberg Scale. Both groups will receive traditional care and the experimental group will receive nursing educational intervention with web page support. Ethical requirements will be considered. Expected results: The women in the experimental group will improve their sexual function, health-related quality of life and self-esteem in relation to the comparison group. Conclusions: Education in the perioperative period of hysterectomy is essential for the recovery of women who go through this experience.

La inestabilidad patelofemoral es uno de los problemas más frecuentes en pacientes jóvenes, y representa del 2 al 3% de todas las lesiones de rodilla.1 Significa una causa importante de morbilidad debido a la limitación de varias actividades de la vida diaria, y a largo plazo el surgimiento de artrosis.2 La inestabilidad patelofemoral es descripta como la deficiencia de la constricción pasiva que genera un desplazamiento lateral de la patela total o parcial de su posición normal con respecto a la tróclea.3 Los desórdenes patelofemorales son el resultado de una anatomía aberrante, están dados por una alteración en la alineación ósea y generan un desequilibrio biomecánico.4 Existen cuatro factores clásicos que generan inestabilidad patelar: patela alta, displasia troclear, alteración en la distancia (TT-TG) y excesiva inclinación patelar.5 Al generarse una luxación, el ligamento patelofemoral medial (LPFM) se ve afectado en al menos el 25% de los casos. El complemento diagnóstico se realiza a través de rayos X, tomografía computarizada y resonancia magnética. La restauración de la función por tratamiento quirúrgico ha mostrado resultados similares al conservador en primoluxaciones, sin embargo, se ha visto que la reconstrucción del ligamento patelofemoral medial presenta mejores resultados clínicos para el paciente.6 Hasta el momento, hemos intervenido diecinueve pacientes con la técnica descripta, para los cuales no hay reportada una reluxación de rótula y tienen una escala de Lysholm de 87 puntos que se encuentra dentro del parámetro “bueno”.

The epidermal growth factor receptor (EGFR) is overexpressed in numerous solid tumors and is the subject of extensive therapeutic efforts. Much of the research on EGFR is focused on protein dynamics and downstream signaling; however, few studies have explored its transcriptional regulation. Here, we identified two enhancers (CE1 and CE2) present within the first intron of the EGFR gene in models of glioblastoma (GBM) and head and neck squamous cell carcinoma (HNSCC). CE1 and CE2 contain open chromatin and H3K27Ac histone marks, enhance transcription in reporter assays, and interact with the EGFR promoter. Enhancer genetic deletion by CRISPR/Cas9 significantly reduces EGFR transcript levels, with double deletion exercising an additive effect. Targeted repression of CE1 and CE2 by dCas9-KRAB demonstrates repression of transcription similar to that of genomic deletion. We identify AP-1 transcription factor family members in concert with BET bromodomain proteins as modulators of CE1 and CE2 activity in HNSCC and GBM through de novo motif identification and validate their presence. Genetic inhibition of AP-1 or pharmacologic disruption of BET/AP-1 binding results in downregulated EGFR protein and transcript levels, confirming a role for these factors in CE1 and CE2. Our results identify and characterize these novel enhancers, shedding light on the role that epigenetic mechanisms play in regulating EGFR transcription in EGFR-dependent cancers. IMPLICATIONS: We identify critical constituent enhancers present in the first intron of the EGFR gene, and provide a rationale for therapeutic targeting of EGFR intron 1 enhancers through perturbation of AP-1 and BET in EGFR-positive malignancies.

Background: Concerns have been raised regarding proton pump inhibitor (PPI) use and risk of severe coronavirus disease 2019 (COVID‐19). Observational studies have yielded heterogeneous results and were subject to important methodological limitations. Aims: To examine the association between the receipt of PPIs and risk of COVID‐19 hospitalizations and severe in‐hospital outcomes or death. Methods: Case–control study among Medicare fee‐for‐service beneficiaries 66+ years old with gastroesophageal reflux disorder (GERD). Within this population, we identified cases by an incident hospital discharge diagnosis of COVID‐19 from April 1 to December 11, 2020, using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD‐10‐CM) U07.1, and randomly selected up to 10 controls per case, matched on date and neighborhood. We defined PPI use as a prescription providing ≥15 days of supply in the 30 days before admission, with H2‐receptor antagonist (H2RA) use as the reference to account for indication. We analyzed uncomplicated hospitalizations and hospitalizations with severe outcomes (intensive/coronary care unit admission, invasive mechanical ventilation, or death), estimating odds ratios (ORs), and 95% confidence intervals (CIs) with multinomial conditional logistic regression adjusted for demographics, comorbidities, chronic medications, and health care utilization. Results: We matched 25,867 uncomplicated and 12,954 severe hospitalized COVID‐19 cases to 146,972 and 73,104 controls, respectively. Cases tended to be older and have more comorbidities. Relative to H2RA use, we found no association of PPI use with uncomplicated COVID‐19 hospitalization (OR 0.99, 95% CI 0.93–1.06) or severe COVID‐19 hospitalization (OR 1.00, 95% CI 0.91–1.10). Conclusions: Relative to H2RA use, PPI use was not associated with uncomplicated or severe COVID‐19 hospitalizations among Medicare beneficiaries with GERD. [ABSTRACT FROM AUTHOR]

Comprehensive measures of quality are a research imperative, yet the development of software quality models is a wicked problem. Definitive solutions do not exist and quality is subjective at its most abstract. Definitional measures of quality are contingent on a domain, and even within a domain, the choice of representative characteristics to decompose quality is subjective. Thus, the operationalization of quality models brings even more challenges. A promising approach to quality modeling is the use of hierarchies to represent characteristics, where lower levels of the hierarchy represent concepts closer to real-world observations. Building upon prior hierarchical modeling approaches, we developed the Platform for Investigative software Quality Understanding and Evaluation (PIQUE). PIQUE surmounts several quality modeling challenges because it allows modelers to instantiate abstract hierarchical models in any domain by leveraging organizational tools tailored to their specific contexts. Here, we introduce PIQUE; exemplify its utility with two practical use cases; address challenges associated with parameterizing a PIQUE model; and describe algorithmic techniques that tackle normalization, aggregation, and interpolation of measurements. [ABSTRACT FROM AUTHOR]

Context. Technical debt (TD) prevention allows software practitioners to apply practices to avoid potential TD items in their projects. Aims. To uncover and prioritize, from the point of view of software practitioners, the practices that could be used to avoid TD items, the relations between these practices and the causes of TD, and the practice avoidance reasons (PARs) that could explain the failure to prevent TD. Method. We analyze data collected from six replications of a global industrial family of surveys on TD, totaling 653 answers. We also conducted a follow up survey to understand the importance level of analyzed data. Results. Most practitioners indicated that TD could be prevented, revealing 89 prevention practices and 23 PARs for explaining the failure to prevent TD. The article identifies statistically significant relationships between preventive practices and certain causes of TD. Further, it prioritizes the list of practices, PARs, and relationships regarding their level of importance for TD prevention based on the opinion of software practitioners. Conclusion. This work organizes TD prevention practices and PARs in a conceptual map and the relationships between practices and causes of TD in a Sankey diagram to help the visualization of the body of knowledge reported in this study. [ABSTRACT FROM AUTHOR]

The water of high Andean lakes is strongly affected by anthropic activities. However, due to its complexity this ecosystem is poorly researched. This study analyzes water quality using Sentinel-2 (S2) images in high Andean lakes with apparent different eutrophication states. Spatial and temporal patterns are assessed for biophysical water variables from automatic products as obtained from versions of C2RCC (Case 2 Regional Coast Color) processor (i.e., C2RCC, C2X, and C2X-COMPLEX) to observe water characteristics and eutrophication states in detail. These results were validated using in situ water sampling. C2X-COMPLEX appeared to be an appropriate option to study bodies of water with a complex dynamic of water composition. C2RCC was adequate for lakes with high transparency, typical for lakes of highlands with excellent water quality. The Yambo lake, with chlorophyll-a concentration (CHL) values of 79.6 ± 5 mg/m3, was in the eutrophic to hyper-eutrophic state. The Colta lake, with variable values of CHL, was between the oligotrophic to mesotrophic state, and the Atillo lakes, with values of 0.16 ± 0.1 mg/m3, were oligotrophic and even ultra-oligotrophic, which remained stable in the last few years. Automatic S2 water products give information about water quality, which in turn makes it possible to analyze its causes.

Background. This study investigated the knowledge, attitude, and practices of residents in the Ho municipality towards intestinal helminth infections and their prevention. Method. A descriptive cross-sectional study involving questionnaire administration was conducted among randomly sampled residents of the Ho municipality of the Volta Region of Ghana. A minimum sample size of 400 was calculated for subjects using Yamane’s formula for population. Pearson’s chi-square analysis was done to determine any relationship between sociodemographic characteristics and the categories of knowledge, attitude, and practices. Results from data analysis were computed as frequencies and percentages. P

ObjectiveTo establish effective methods of obesity prevention among young adults, we analyzed the relationship between obesity-related food intake and metabolic factors in Japanese university students.MethodsWe performed a cross-sectional analysis of nutrient intake information and metabolic parameters among 1,206 Gifu University students categorized by body mass index.ResultsThe overweight/obesity rate was significantly higher in males. Additionally, among males, the intake of protein, potassium, magnesium, phosphorus, iron, zinc, all lipids/fats, and all metabolic parameters including blood sugar, hemoglobin A1c, uric acid, alanine aminotransferase, aspartate aminotransferase, low-density lipoprotein, high-density lipoprotein, triglycerides, and blood pressure significantly differed between the obese and non-obese groups. However, the same comparison among females revealed no significant differences in nutrient intake and significant differences in only half of the parameters. Among males, energy intake from protein and fat was significantly higher in the obese group, while the percentage of total energy intake from carbohydrates and fat was lower and higher, respectively, among females in the obese group.ConclusionsOvereating of protein and fat in males and unbalanced nutrition in females are sex-specific characteristics of Japanese university students with obesity, and metabolic abnormalities in students with obesity are more remarkable in males than in females.

El presente trabajo permite caracterizar las funcionalidades básicas de la trazabilidad y la manera en la que aportan al desarrollo del comercio electrónico en la actualidad. Para el desarrollo de la investigación se utiliza un enfoque cualitativo, empleando los métodos teóricos analítico-sintético e inductivo-deductivo para caracterizar las prácticas de la logística y trazabilidad. Asimismo, se usan estos métodos para analizar conceptos como el comercio electrónico y el modelo de negocio B2C (business to consumer). Como resultados se obtuvieron las bases teóricas sobre la operatividad moderna de la trazabilidad relacionado al comercio electrónico, simplificando procesos tradicionales y ampliando una red tecnológica que aporta a diversas tareas de control, organización y supervisión de productos y servicios. Al culminar este trabajo se presenta una perspectiva general de la influencia de la era digital en los procesos comerciales y logísticos, además de cómo ha cambiado la mente del consumidor virtual respecto de la compra y entrega de los bienes.

Vaccine impact models against rotavirus disease (RD) and pneumococcal disease (PD) in low- and middle-income countries assume vaccine coverage based on other vaccines. We propose to assess the impact on severe disease cases and deaths avoided based on vaccine doses delivered by one manufacturer to Gavi-supported countries. From the number of human rotavirus vaccine (HRV) and pneumococcal polysaccharide protein D-conjugate vaccine (PHiD-CV) doses delivered, we estimated the averted burden of disease 1) in a specific year and 2) for all children vaccinated during the study period followed-up until 5 years (y) of age. Uncertainty of the estimated impact was assessed in a probabilistic sensitivity analysis using Monte-Carlo simulations to provide 95% confidence intervals. From 2009 to 2019, approximately 143 million children received HRV in 57 Gavi-supported countries, avoiding an estimated 18.7 million severe RD cases and 153,000, deaths. From 2011 to 2019, approximately 146 million children received PHiD-CV in 36 countries, avoiding an estimated 5.0 million severe PD cases and 587,000 deaths. The number of severe cases and deaths averted for all children vaccinated during the study period until 5 years of age were about 23.2 million and 190,000, respectively, for HRV, and 6.6 million and 749,000, respectively, for PHiD-CV. Models based on doses delivered help to assess the impact of vaccination, plan vaccination programs and understand public health benefits. In 2019, HRV and PHiD-CV doses delivered over a 5-y period may have, on average, averted nine severe disease cases every minute and one child death every 4 min.

Las iniciativas ciudadanas de producción y consumo de productos sustentables íntegros en sus cualidades constituyen espacios para la construcción de formas alternativas de satisfacer necesidades. También son ámbitos para la reconfiguración de las relaciones sociales basadas en la solidaridad. Este es el caso del Movimiento Cantonal de Mujeres del Pueblo Kayambi, en Ecuador, y Mujeres Cosechando, en México. El propósito de este trabajo es mostrar el despliegue espacial del trabajo realizado por estos grupos de mujeres que enarbolan procesos de vida digna, tanto en sus espacios de vida, como en las áreas urbanas donde intercambian sus productos. Estos procesos son leídos en el diálogo de la geografía crítica y la epidemiología crítica en torno al proceso productivo centrado en el valor de uso, su enfoque apunta a la contribución de crear una civilización para la vida. La exposición de los casos de estudio se basa en el análisis cualitativo de entrevistas, investigación-acción participativa, así como en el análisis de información socioespacial. A partir de los múltiples diálogos de conocimiento, se considera que la organización productiva de las mujeres ha generado movimientos urbano-rurales que contribuyen a la construcción de espacios de protección en las escalas de la vida familiar cotidiana, local y regional. En este sentido, los estudios de caso constituyen ejemplos sólidos de la utilidad del trabajo productivo-colectivo para el imprescindible restablecimiento de la relación metabólica sociedad-naturaleza y la génesis de espacios donde prevalezca el respeto y la protección a la vida.