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Resumen: Introducción y objetivos: La tasa de reingresos hospitalarios es un indicador de calidad de la asistencia hospitalaria. El objetivo de este trabajo es describir factores de riesgo de reingreso prevenible en la hospitalización pediátrica. Material y métodos: Estudio analítico, retrospectivo, unicéntrico realizado en las plantas de Pediatría de un hospital terciario (junio de 2012 a noviembre de 2015). Se definió reingreso al que acontecía en los primeros 30 días del ingreso previo: muy precoz (en menos de 48 h), precoz (2-7 días) y tardío (a partir de 7 días). Se definió reingreso prevenible al que ocurrió en los primeros 15 días y por la misma causa del primer ingreso. Se analizaron variables epidemiológicas y clínicas. Se realizó un estudio univariante y posteriormente multivariante. Resultados: En el período de estudio ingresaron en las plantas de Pediatría General Hospitalaria 5.459 pacientes y reingresaron 226 (tasa de reingreso del 4,1%). Cuando la tasa de ocupación hospitalaria es mayor del 70%, el porcentaje global de reingresos es significativamente mayor (8,5 vs. 2,5%), p

A water distribution system must maintain water quality throughout the entire network to guarantee public health. Although several studies have focused on changes in water quality along distribution systems, very few have evaluated the entire process from the water source to household containers. The aim of this study was to evaluate the effectiveness of bacteriological control and to determine the critical points of potential contamination along the distribution system in Cancún, Mexico. We addressed three aspects: 1) physicochemical and bacteriological analysis of water, 2) biochemical oxygen demand (BOD5) and nitrate-nitrite associated with organic matter, and 3) trihalometanes (THMs) as chlorine by-products from the disinfection process. The results showed that the water supply met the required quality standards in most parts of the distribution system but that there are critical points that could increase the risk of recontamination, specifically the geological setting and the critical aspects in irregular urban development in the area of water extraction. Mexico and any other country that relies on groundwater as a drinking water source must review and reinforce the regulations to protect areas with extraction wells and encourage the maintenance of containers to ensure water quality.

A large amount of onion wastes are produced by both domestically and industrially, making it necessary to search for a reuse process. These wastes causing odor and in some cases causes harm to the environment. At 2017, Mexico produced 1.6 million tons of which 10% are classified as organic waste. The aim of this study was to contribute to the reduction of onion peel residues, using chemical pretreatments (H2SO4, HCl, H3PO4 and NaOH) to enrich the acidogenic phase in the anaerobic digestion (AD) to improve the yield of methane in a system coupled packed bed reactor with an Up-flow Anaerobic Sludge Blanket reactor (UASB) using peels and rotten onion waste. In anaerobic digestion of white onion residues in a single stage (PBR1) presented inhibition due to the accumulation of VFA during the first days, which delay the onset of the methanogenic phase, which occurred 63 days after the start of the experiment. Pretreatment with H2SO4 (PBR2) decreased the start time of the methanogenic pathway, from 63 days to 35. In the same way, the coupling of the UASB reactor to the packed reactor (PBR3) allowed the decrease of the methanogenic step after 14 days, and the total time for this process was 35 days. The yield for PBR1 was 0.013 m3 CH4 kg VSrem−1, for PBR2 0.014 m3 CH4 kg VSrem−1 and PBR3 0.017 m3 CH4 kg VSrem−1. The total yield of PBR3 + UASB was 0.41 m3 CH4 kg VSrem−1.

Introducción: Actualmente, la simulación clínica ha transformado la enseñanza de la medicina favoreciendo el aprendizaje experiencial y significativo de los médicos en formación, por lo que el objetivo de este estudio es evaluar el desempeño del profesionalismo y la comunicación, durante un escenario de simulación clínica con paciente estandarizado para estudiantes del quinto grado de la licenciatura de Médico Cirujano de la Facultad de Medicina de la Universidad Nacional Autónoma de México. Métodos: Es un estudio observacional, descriptivo y transversal, se obtuvo una muestra n=387 (45.6% del total) estudiantes de quinto grado de la Licenciatura de Medicina de la universidad. Se utilizó un escenario de simulación clínica con pacientes estandarizados, además de una rúbrica para evaluar el profesionalismo y la comunicación. Se realizó el cálculo estadístico con análisis de porcentajes por ítem y categoría. Resultados: Se realizó la base de datos y análisis estadístico con Excel de los 387 estudiantes y se encontró que la competencia profesionalismo es excelente en el 62%, bueno en el 33 % y deficiente en el 5% de la población, mientras que en comunicación es excelente en 60%, bueno en 37% y deficiente en 3%. Discusión: Se demuestra que en la relación médico-paciente existe justicia social, respeto y confidencialidad, pero carece de la conservación del principio de autonomía del paciente, empatía y compasión. Es posible evaluar el desempeño del profesionalismo y comunicación a través de la simulación clínica.

he relationship between detritivore diversity and decomposition can provide information on how biogeochemical cycles are affected by ongoing rates of extinction, but such evidence has come mostly from local studies and microcosm experiments. We conducted a globally distributed experiment (38 streams across 23 countries in 6 continents) using standardised methods to test the hypothesis that detritivore diversity enhances litter decomposition in streams, to establish the role of other characteristics of detritivore assemblages (abundance, biomass and body size), and to determine how patterns vary across realms, biomes and climates. We observed a positive relationship between diversity and decomposition, strongest in tropical areas, and a key role of abundance and biomass at higher latitudes. Our results suggest that litter decomposition might be altered by detritivore extinctions, particularly in tropical areas, where detritivore diversity is already relatively low and some environmental stressors particularly prevalent., This study was part of the DecoDiv project conducted by the GLoBE network (www.globenetwork.es), which is coordinated by L. B. Most research was based on crowdfunding (details on specific funding sources at each region are given in Supplementary Information). Project coordination was funded by Basque Government funds (Ref. IT951-16) to the Stream Ecology Group (UPV/EHU, Spain).

Herbicides are used to increase the yield of crops and pastures. The herbicide 2, 4-D has high leaching potential in karstic environments because it is water soluble, which causes that the herbicide has been found in groundwater and submerged caves in the Yucatan Peninsula. We detected the presence of the herbicide in groundwater in agricultural non-agricultural zones in the northeaster of the Yucatán Peninsula by using the UV spectrum obtained from HPLC-DAD as qualitative indicator. This finding supports the notion that application of 2, 4-D before and during the wet season promotes the presence of the herbicide in groundwater.

Plant litter functional diversity effects on instream decomposition change across latitudes., Running waters contribute substantially to global carbon fluxes through decomposition of terrestrial plant litter by aquatic microorganisms and detritivores. Diversity of this litter may influence instream decomposition globally in ways that are not yet understood. We investigated latitudinal differences in decomposition of litter mixtures of low and high functional diversity in 40 streams on 6 continents and spanning 113° of latitude. Despite important variability in our dataset, we found latitudinal differences in the effect of litter functional diversity on decomposition, which we explained as evolutionary adaptations of litter-consuming detritivores to resource availability. Specifically, a balanced diet effect appears to operate at lower latitudes versus a resource concentration effect at higher latitudes. The latitudinal pattern indicates that loss of plant functional diversity will have different consequences on carbon fluxes across the globe, with greater repercussions likely at low latitudes.

Background: Sunscreens are widely used to protect the skin against the harmful effects of solar radiation. It is not known whether solar protection factor of a sunscreen is altered by the concomitant use of other cosmetic products. Objectives: The aim of this study was to analyze changes in the protective effect of different commercial and ISO standards sunscreens with high SPF applied shortly before and after application of non-sunscreens galenic formulas type moisturizing creams. Methods: ISO 24444:2019 standard sunscreens, which claimed SPF 16 and 63, as well as 4 different claimed SPF 50 and 50+ commercial sunscreens were prepared and applied in different sequential order to the back of 25 volunteers and compared with different commercial moisturizing formulas. Ultraviolet (UV) reflectance photography followed by image analysis was used to compare untreated skin and skin treated with moisturizing creams alone and combined with sunscreens. Results: The UV reflectance analysis showed no significant changes of the skin color reflectance treated with moisturizing cream compared with untreated skin. Application of the sunscreen formulations were associated with a 35% - 70% decrease in color related to the in vivo expected SPF, indicating significant UV absorption for all sunscreen formulas. All standard and commercial sunscreens showed no significant differences in UV reflection color level when combined with the different moisturizing creams applied before or after the sunscreen. Conclusions: Effectiveness of low- and high-protection sunscreens were not altered by the concomitant use of a moisturizing creams applied shortly before and after the sunscreens. This work has been supported by the project no. PID2020-117224RB-100 of State Programs of Generation of Knowledge and Scientific and Technological Strengthening of the System from the Spanish Ministry of Science and Innovation. This is part of the research of the Institute of Biomedicine of Málaga (IBIMA) and the Junta de Andalucía working group CTS-162. Funding for open access charge: Universidad de Málaga/CBUA

Numerous urban scholars have been studying Mexico City—the capital of Mexico—since at least the 1970s, drawn to its remarkable growth during the second half of the 20th century and to its specific patterns of urbanization. The city is located at more than 7,000 feet above sea level in the southern section of a large, enclosed basin known as the Valley of Mexico. Its name officially designates what until recently was the Federal District, an area of 550 square miles divided into sixteen administrative jurisdictions and which, until 1997, lacked a democratically elected government. A 2016 reform transformed Mexico City into the country’s thirty-second state. In common usage, the name Mexico City also refers to the greater Mexico City Metropolitan Area, which as of 2010 also included fifty-nine adjacent municipalities in the State of Mexico and one in the State of Hidalgo, with a total extent of nearly 3,100 square miles. According to the 2010 census, Mexico City’s population is around nine million, while the greater Metropolitan Area has more than twenty million inhabitants. The city was founded in 1521 on the ruins of the Aztec capital on a small island in Lake Texcoco and gradually expanded onto the increasingly desiccated lakebed, which has created a particular set of environmental problems, such as constant flooding. Like other major Latin American cities, Mexico City—and later the Metropolitan Area—grew exponentially after the 1940s, as industrialization attracted massive migration. Its population jumped from three million in 1930 to around fifteen million in 1985. Mexico’s most important city, as well as its political, cultural, and economic center, Mexico City is a study in contrasts. It displays wealth and poverty extremes, world-class architecture next to marginal shantytowns, and a vibrant, cosmopolitan cultural life alongside high criminal rates and seemingly intractable environmental problems, which continue to attract the interest of a wide variety of urban scholars. This bibliography is selective rather than exhaustive. It privileges recent English- and Spanish-language scholarship, but also includes key texts that continue to inform the field, as well as recent urban historiography. It is divided into the main topics covered by urban scholars of Mexico City since the 1970s. These range from urban planning, urban politics, informality, poverty, and marginality, which were dominant themes until the 1980s, to urban protest and social movements, gentrification, and environmental, gender, and cultural studies, which have expanded the field more recently. The author wishes to thank Carlos Humberto Arroyo Batista for his research assistance in elaborating this bibliography.

La falta de acceso a fuentes de agua segura es un problema en el Caribe Mexicano, particularmente en comunidades con irregularidad en servicios. Ante esto, la captación de agua de lluvia (CALL) podría representar una alternativa para satisfacer necesidades básicas. Sin embargo, los esquemas de implementación a menudo son verticales y jerárquicos. En este trabajo se aportó conocimiento sobre las percepciones y formas de uso del agua de lluvia, para contribuir a la toma decisiones. La información se obtuvo mediante observaciones etnográficas y encuestas a 60 representantes de hogar de una muestra de 253 viviendas en la comunidad de Puerto Morelos, Quintana Roo. El 95 % de los encuestados fueron foráneos, por lo que sus percepciones y formas de manejo del recurso fueron heterogéneas: desde sistemas simples (cubetas y tambos) hasta sistemas complejos integrados a las viviendas. En general, la CALL cuenta con una percepción positiva por parte de la población estudiada, lo cual permitiría su implementación en proyectos más estructurados que promuevan el mejoramiento de las técnicas de captación en la localidad.

The hydrogen and oxygen isotopic composition of water is a very important tool to estimate water balance, groundwater recharge, and evaporation. Water isotopes have been used to increase our understanding of the distribution and amounts of renewable and non-renewable groundwater. Isotopic data from precipitation and groundwater is available in much of Mexico but there is little information from the Peninsula of Yucatan, an area heavily relying in groundwater in which current estimates of groundwater availability are uncertain. In this paper, we compiled published and unpublished δ2H and δ18O data in meteoric (waters derived from precipitation), ground- and pore-waters, to obtain a regional meteoric water line (RMWL) expressed by the equation δ2H = 8.1846 δ18O + 10.289. The data suggest that precipitation originates in convective systems, low-pressure events, moisture from frontal events, and from re-condensed moisture. The evaporation lines from groundwater suggest mixing of water with different isotopic composition, but also provide clues to recent meteoric water rapid recharge, likely from rain events of great intensity. We present a groundwater isoscape of the Peninsula of Yucatan and finally address the lack of conciliation between hydrogeology and groundwater management.

Since 2011, tourism to Mexico&rsquo, s Yucat&aacute, n Peninsula has been heavily impacted by large masses of sargassum seaweed washing up on the beaches, with the largest seaweed event occurring in 2019. Seaweed deters beach tourism, potentially shifting tourism inland towards other activities such as swimming in cenotes (sinkholes). Our mixed methods study combined data from surveys of visitors to the region, interviews with tourists and tour operators, thematic analysis of newspaper articles, laws and policies and analysis of water samples from a cenote to understand the environmental impact on cenotes of this shifting tourism industry. We identified intentional efforts by the tourism industry to encourage cenote tourism in response to the seaweed problem, and our survey and interview data confirmed that tourists are choosing to visit cenotes in lieu of beaches. Water samples from one tourist cenote in 2019 indicated increased pollution relative to previous years. Current regulations and management of tourist cenotes are weak, creating the potential for significant long term harm to the environment and to the water sovereignty of surrounding communities. Regulation of cenotes should be strengthened to protect these fragile karst ecosystems and to give local and indigenous residents a formal voice in the management process.

In an anaerobic digestion (AD) process, the hydrolysis phase is often limited when substrates with high concentrations of solids are used. We hypothesized that applying micro-aeration in the hydrolysis phase and the application of granular activated carbon (GAC) in the methanogenesis phase could make the AD process more efficient. A packed bed reactor (PBR) coupled with an up-flow anaerobic sludge blanket (UASB) was conducted, and its effects on methane generation were evaluated. The micro-aeration rate applied in PBR was 254 L-air/kg-Total solids (TS)-d was compared with a control reactor. Micro-aeration showed that it reduced the hydrolysis time and increased the organic matter solubilization as chemical oxygen demand (COD) increasing 200%, with a volatile fatty acids (VFAs) increment higher than 300%, compared to the control reactor (without aeration). Our findings revealed that the implementations of microaeration and GAC in the two-phase AD system could enhance methane production by reducing hydrolysis time, increasing solid waste solubilization.

Microbial community composition in selected karst groundwater sites in the Yucatan Peninsula, Mexico, was assessed to determine the environmental variables influencing groundwater microbial diversity. The karst aquifer system is a groundwater-dependent ecosystem and is the world’s second largest underwater karst cave system. The area’s geology allows precipitation to infiltrate into the groundwater system and prevents accumulation of surface water; as such, groundwater is the only source of fresh water on the peninsula. The sampling locations consisted of three karst sinkholes that extend through the freshwater zone into the saline water, and an abandoned drinking water well of an ocean-side resort, during the dry and rainy seasons. The analysis showed that highly diverse microbial communities are present in the Yucatan groundwater, sustained by permanently warm temperatures and high nutrient input from human activity. Proximity to densely populated areas, such as tourist resorts, is the most important factor influencing both the diversity and presence of fecal bacteria and the antibiotic resistance profile.

This paper explores strong indirect evidence for existence of a previously unrecognized deep groundwater aquifer in southern Quintana Roo, adjacent parts of Campeche, and (probably) northern Belize. The region contains rocks of Cretaceous-to-Holocene age, including: 1) an up-thrust block of the late Cretaceous carbonate known in Belize as the Barton Creek Formation, which is the oldest formation exposed in the Mexican Yucatán Peninsula, 2) the Cretaceous/Paleogene Albion Formation consisting of weakly consolidated Chicxulub impact air-fall deposits, 3) the Paleocene-Eocene Icaiche Formation, containing a massive 25-35 m thick gypsum member that crops out over an estimated area of more than 10,000 km2 in the elevated interior region of the northern lowlands, and 4) younger rocks of relatively low permeability that flank the region on the east. Hydrogeology is dominated by groundwater and surface flow in and adjacent to the Rio Hondo Fault Zone (RHFZ) and by recharge in the elevated interior region. Groundwater in the elevated region has a high sulfate concentration and is approximately saturated with gypsum dissolved from the Icaiche Formation. High-sulfate groundwater and river water with a slightly lower gypsum saturation index than in the elevated region also occurs in the RHFZ, but no water of comparably high sulfate content is present elsewhere in the study area. This suggests that the elevated region is a recharge zone for high-sulfate groundwater carried eastward beneath a 50 km gap by a deep, previously unrecognized aquifer and then discharged into the RHFZ. Based on chemistry of chloride, sulfate and other ions it is proposed here that a deep aquifer comprising the strongly weathered upper surface of the Barton Creek Formation plus the overlying weakly consolidated Albion Formation connects the elevated recharge area with the RHFZ discharge area. If this composite permeable zone does extend westward beneath the elevated recharge zone, it is probably an excellent aquifer.

Concentrated agave sap (CAS) has gained popularity as an unrefined sweetener. It is obtained by boiling "aguamiel" that contains phytochemicals with diverse bioactivities. Saponins have been the most widely studied agave phytochemicals due to their cancer antiproliferative effect but their concentration may vary due to maturity of the agave plant and collection site. In this study, 18 CAS samples produced in different states of Mexico were analyzed using multivariate methods to determine which physicochemical or phytochemical parameters were responsible for variation. Additionally, extracts with different saponin profiles were tested to determine possible correlations with antiproliferative activity. Total soluble solids, pH, and water activity were similar to those reported for other agave sweeteners. Antioxidant capacity of samples was correlated to browning index. Eleven steroidal saponins were found in CAS samples and they were the main source of variability. Magueyoside B, a kammogenin tetraglycoside, was the most abundant saponin in all samples. With respect to bioactivity, multivariate analysis indicated that magueyoside B and a gentrogenin tetraglycoside were compounds strongly related with bioactivity. CAS from Hidalgo, Puebla, and Veracruz had higher concentration of magueyoside B than from the other kamogenin tetraglycoside found in the samples from other Mexican states. These results could be used as a first approach to characterize and standardize CAS to validate the potential health benefits derived from its consumption.

Sap from agave plants (“aguamiel”) is traditionally consumed in Mexico as a fresh beverage, fermented or concentrated. Concentrated agave sap (CAS) is used as a sweetener but, due to heating, a brown color develops and intensifies during storage. Browning varies among CAS batches and this work was focused on its correlation with the chemical composition changes observed during 20 weeks of storage. The browning index (BI), measured as the optical density at 490 nm (OD 490 nm ) per gram of sample, increased 54.4% in the batch that initially had 57 OD 490 nm /g but in the other two batches that had a lower BI, the increase was less than 26.1%. Antioxidant capacity only increased in the batch with the highest BI going from 18 to 23 Trolox equivalent μmol/g dry weight. Saponin content was different in the three batches (224.2–434.7 protodioscin equivalents/gram dry weight) but did not change after 20 weeks of storage. Browning index and antioxidant capacity were negatively correlated with free amino acid concentration, particularly serine, phenylalanine and lysine decreased 29.4, 50 and 30%, respectively. Browning was positively correlated to furosine, an early Maillard reaction derivative of lysine previously reported as a free radical scavenger.

The Yalahau region, located in the northeastern portion of the Yucat&aacute, n Peninsula, hosts a series of elongated depressions trending north/south in the direction of Isla Holbox, identified as the Holbox Fracture Zone. Previous studies have explored the geomorphology and various hydrologic characteristics of the Yucat&aacute, n Peninsula, however, there is a paucity of data concerning the interior region where the fractures are located. Strontium isotope ratios and major ion geochemistry data of the surface water and groundwater of this region serve as a hydrogeochemical fingerprint, aiding in constraining the hydrological boundaries, determining flow paths, and characterizing hydrogeochemical processes that impact the composition of the groundwater within the region. 87Sr/86Sr isotope ratios indicate a different signature than the surrounding bedrock Sr ratio, suggesting that the flow throughout the Yalahau region is moving through channels faster than that of much of the Yucat&aacute, n. Through major ion geochemistry and 87Sr/86Sr isotope ratios, we were able to delineate at least two flow paths within the Yalahau region and identify a point of saline intrusion at least 35 km from the coast. Gaining an understanding of the hydrogeochemistry and water flow regions is crucial in determining the impact of various activities (e.g., extensive tourism, drinking water withdrawal, wastewater discharge/injection) that occur within the Yucat&aacute, n Peninsula.

Introduction and objectives: Readmission rate is an indicator of the quality of hospital care. The aim of the study is to identify potential preventable factors for paediatric readmission. Material and methods: A descriptive, analytical, longitudinal, and single centre study was carried out in the Paediatric Hospitalisation ward of a tertiary hospital during the period from June 2012 to November 2015. Readmission was defined as the one that occurs in the first 30 days of previous admission, as very early readmission if it occurs in the first 48 h, early readmission in the 2–7 days, and late readmission after 7 days. Preventable readmission is defined as one that takes place in the first 15 days and for the same reason as the first admission. Epidemiological and clinical variables were analysed. A univariate and multivariate study was carried out. Results: In the study period, 5459 patients were admitted to the paediatric hospital, of which 226 of them were readmissions (rate of readmission: 4.1%). When the hospital occupation rate was greater than 70%, the overall percentage of readmissions was significantly higher (8.5% vs 2.5%; P

Este trabajo expone el debate en la prensa respecto a la inmigracion judia en Colombia entre 1933 y 1939. La discusion encarna los argumentos de intelectuales y politicos colombianos a favor y en contra de esta inmigracion, que cargan con una serie de imagenes y estereotipos sobre “lo judio”. Como producto de este debate, el gobierno colombiano –a la cabeza de Eduardo Santos, tio abuelo del actual presidente de Colombia– restringe la llegada de judios al pais en 1939. Por ultimo, el epilogo construye el entramado de relaciones tejido en torno al debate, y tiene como proposito demostrar que la “cuestion Judia” en la prensa colombiana contuvo argumentos economicos y nacionalistas, mas que religiosos o raciales, para restringir la entrada de judios al pais.

The Yucatan Peninsula of Mexico hosts a karst aquifer system that is the only source of freshwater for the area; however, it is vulnerable to human-mediated contamination. Pepper mild mottle virus (PMMoV) is one of the most abundant RNA viruses associated with human feces, making it a viable indicator for tracking fecal pollution in aquatic environments, including groundwater. In this study, groundwater samples collected from a karst aquifer from fresh and brackish water locations were analyzed for fecal indicator bacteria, somatic and male F+ specific coliphages, and PMMoV during the rainy and dry seasons. Total coliform bacteria were detected at all sites, whereas Escherichia coli were found at relatively low levels40 MPN/100 ml. The highest average concentrations of somatic and male F+ specific coliphages were 920 and 330 plaque forming units per 100 ml, respectively, detected in freshwater during the rainy season. PMMoV RNA was detected in 85% of the samples with gene sequences sharing 99-100% of nucleotide identity with PMMoV sequences available in GenBank. Quantification of PMMoV genome copies (GC) by quantitative real-time PCR indicated concentrations ranging from 1.7 × 10

The objective of the present study was to investigate the efficacy of a four-factor prothrombin complex concentrate (Prothromplex, PTX) in shortening prolonged international normalized ratio or controlling life-threatening bleeding. The study was a retrospective single-centre study that included 142 patients treated with PTX and allocated in three groups: patients on vitamin K antagonists (VKA) (acenocumarol) and undergoing invasive procedure or presenting with severe bleeding (n = 76), patients treated with VKA presenting with intracranial haemorrhage (n = 22), and patients not on VKA and presenting with uncontrolled bleeding (n = 44). The primary outcome variable was international normalized ratio (INR) return to the norm after PTX infusion. Secondary outcome variables included bleeding control and reduction of transfusion rate. Overall, patients received a median of 1200 IU (≈15 IU/kg) of PTX, and INR decreased from 4 ± 3 to 1.7 ± 1.2 (P 0.01) in all groups, although it remained at least 1.4 in 38% of patients (29.3% among patients receiving 25 IU/kg vs. 42.6% among those receiving 15 IU/kg; P 0.05). Patients with initial INR at least 4 benefited the most from treatment. After PTX administration, there was a significant reduction in both transfused blood components units (P 0.01) and estimated blood loss volume (from 1500 ± 1500 to 200 ± 100 ml; P 0.01), and only one episode of deep venous thrombosis was observed. Administration of fixed doses of PTX shortened prolonged international normalized ratio and improved life-threatening bleeding in patients with or without VKA therapy. Higher dose attained a more adequate post-infusion INR.

Obesity and its comorbidities are a severe public health problem worldwide. The use of bioactive compounds found in some foods has been demonstrated to ameliorate the metabolic abnormalities associated with obesity. The purpose of this study was to assess whether the bioactive compounds present in aguamiel concentrate (AC) from Agave salmiana could attenuate glucose intolerance and hepatic steatosis in mice fed a high fat (HF) diet. HPLC-ELSD analysis showed that AC contained several saponins. The consumption of an AC extract rich in saponins reduced weight gain and fat mass and lowered serum glucose, insulin and LDL-cholesterol levels in mice fed a HF diet. Additionally, mice fed the saponin extract exhibited a reduced HOMA index and hepatic lipid levels and increased expression of genes involved in fatty acid oxidation. Saponins increased white adipose tissue browning, AMPK phosphorylation, fatty acid oxidation and mitochondrial activity in skeletal muscle and energy expenditure in mice fed the HF diet. These metabolic changes were accompanied by an increase in the abundance of Akkermansia muciniphila in the gut microbiota. Therefore, Agave salmiana saponins can be an alternative to attenuate the metabolic changes that accompany obesity.

Concentrated agave sap (CAS) has gained popularity as an unrefined sweetener. It is obtained by boiling "aguamiel" that contains phytochemicals with diverse bioactivities. Saponins have been the most widely studied agave phytochemicals due to their cancer antiproliferative effect but their concentration may vary due to maturity of the agave plant and collection site. In this study, 18 CAS samples produced in different states of Mexico were analyzed using multivariate methods to determine which physicochemical or phytochemical parameters were responsible for variation. Additionally, extracts with different saponin profiles were tested to determine possible correlations with antiproliferative activity. Total soluble solids, pH, and water activity were similar to those reported for other agave sweeteners. Antioxidant capacity of samples was correlated to browning index. Eleven steroidal saponins were found in CAS samples and they were the main source of variability. Magueyoside B, a kammogenin tetraglycoside, was the most abundant saponin in all samples. With respect to bioactivity, multivariate analysis indicated that magueyoside B and a gentrogenin tetraglycoside were compounds strongly related with bioactivity. CAS from Hidalgo, Puebla, and Veracruz had higher concentration of magueyoside B than from the other kamogenin tetraglycoside found in the samples from other Mexican states. These results could be used as a first approach to characterize and standardize CAS to validate the potential health benefits derived from its consumption.

This study was undertaken to investigate the efficacy of red blood cell transfusion (RBCT) at reversing the deleterious effects of moderate anemia in critically ill, non-bleeding patients. This was a retrospective, pair-matched (ratio 1:1) cohort study. Non-bleeding critically ill patients with moderate anemia (nadir hemoglobin level between 70 and 95 g/l), admitted to the ICU over a 27-month period, were included. Anemic patients were included upon meeting five matching criteria of having the same nadir hemoglobin (±5 g/l), APACHE II score (±5), SOFA score (±2), admission diagnostic group, and age (±5 years). Outcome events occurring over the whole ICU stay and after RBCT were collected. After hospital discharge, all patients had a 2-year follow-up period. Two hundred fourteen non-transfused anemic patients (NTAPs) were successfully matched with 214 transfused anemic patients (TAPs). In addition to the matching criteria, at baseline, both groups were homogenous with respect to multiple comorbidities. Compared with TAPs, NTAPs showed significantly lower rates of hospital mortality (21 vs.13 %, respectively; p

Agave has been used as a raw material for food and folklore medicinal purposes. Traditional processing in- volves the use of agave as a source of carbohydrate-rich syrups for direct use or as substrate to yield hydrolyzed fer- mented products and spirits. Agave plants can accumulate significant amounts of inulin, important molecule with prebi- otic activity. The agave plant has been used to feed ruminants in arid areas where drought episodes are prevalent. This plant is an important source of saponins, considered as antinutritional factors but also as anticancer, antifungal, and anti- inflammatory agents. Considering the low hydrosolubility of saponins, these compounds are not being recovered from the plant and alternative processes need to be devised. Agave also contains polyphenols with activities such as: anticancer, an- tioxidant, antidiabetic, anti-inflammatory, antiparasitical, antimicrobial, prebiotics and coadjuvant in mineral absorption. The full phytochemical characterization of the sap, leaves and byproducts generated from the traditional food uses is needed to validate the beneficial effects of agave consumption and its potential use as a source of functional ingredients.

Como aspectos relevantes de la Tercera Revolución Educacional, está el proceso de formación de profesores de Ajedrez y la inserción de la tecnología educativa, constituidos en complemento significativo para los procesos instructivos y educativos que se desarrollan en la escuela y como base del modelo cubano de Escuela Primaria. Este modelo promueve la integración de los contenidos a partir de la interdisciplinariedad, para lo cual están conformados Programas Directores para la Enseñanza Primaria, donde todas las asignaturas deben tributar mediante acciones, a sus ejes principales: las asignaturas de: Matemática, Lengua Materna e Historia. Sin embargo, el Ajedrez tiene limitaciones en el campo de la historia de las figuras del arbitraje en Cuba. Al no tener concebidas acciones en este campo, cuestión esta corroborada en entrevistas a profesores y en la revisión de documentos; tomándose como referencia para la exploración de este problema.

Mientras algunos auguran con el desarrollo, la desaparición de la enseñanza tradicional, otros entienden que es la escuela con su enseñanza más integradora y perfeccionada, la que asumirá con nuevos bríos la misión formativa de preparar a un hombre más culto para la vida. Por otra parte, esta la Revolución Científico-Técnica, cuyo elemento más significativo radica en el desarrollo tecnológico; muy en especial la computación, que permite una acumulación mayor de información. Estos elementos permiten comprender, cuan importante es la función de la escuela, de enseñar a aprender para afrontar los retos que la contemporaneidad depara. En 1989, se introduce un plan masificador de Ajedrez, dimensionado a todos los niveles de la enseñanza, comenzando desde la enseñanza primaria, a impartirse en el segundo y sexto grado, definido por la Circular Ministerial Conjunta INDER-MINED (No.2 del 1989), acompañada por las Indicaciones Conjuntas que definen sus precisiones y que responsabiliza al profesor de Educación Física con el desarrollo de las clases de Ajedrez. En 1992, como consecuencia de los resultados favorables de la Circular No.2 del 1989, surge la Resolución Ministerial INDER– MINED (No.2 del 1992), acompañada por las indicaciones conjuntas que definen sus precisiones, para su aplicación en todos los grados del segundo al sexto grado, excluyendo solamente el primer grado, que posteriormente es incluido en el año 2005. Estos acontecimientos de masificación, permitieron que el Ajedrez ganara un espacio para exponer sus avances, lográndose una participación en diferentes eventos como lo son: los Congresos Internacionales de Pedagogía 99, 2001 y la Convención Internacional Universitaria 2004 y 2006.