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Las universidades enfrentan desafíos complejos y cambiantes, desde aspectos tecnológicos hasta cambios geopolíticos. La falta de un modelo adaptado podría resultar en ineficiencias. Por lo tanto, crear un modelo de gestión específico es esencial para garantizar la eficacia y sostenibilidad en este entorno educativo en constante evolución. El objetivo principal del artículo fue analizar estos retos, e identificar las tendencias tecnológicas, sociales, geopolíticas y ambientales, con la finalidad de proponer un modelo de gestión para universidades glonacales. La metodología utilizada fue de tipo cuantitativa de alcance descriptivo y de corte transversal, para lo cual en la fase inicial se realizó una revisión bibliográfica para la construcción de los instrumentos de recolección de datos. La técnica utilizada fue la encuesta, estructurada por 46 ítems que alcanzaron un coeficiente de confiabilidad de 0,932 tanto para el instrumento como para cada uno de los elementos. A través de un censo participación 362 miembros de una universidad del Ecuador, entre docentes y directivos expertos en los ejes de docencia, investigación y gestión. En conclusión, se propone un modelo de gestión, que se caracteriza por su enfoque en la flexibilidad, adaptabilidad, visión estratégica, compromiso con la excelencia académica y la colaboración con la comunidad. Este modelo alcanzo un índice de validez de contenido de 0,875, que es alto y sugiere que se considera como relevante.

Abstract A number of diagrammatic “cutting rules” have recently been developed for the wavefunction of the Universe which determines cosmological correlation functions. These leverage perturbative unitarity to relate particular “discontinuities” in Feynman-Witten diagrams (with cosmological boundary conditions) to simpler diagrams, in much the same way that the Cutkosky rules relate different scattering amplitudes. In this work, we make use of a further causality condition to derive new cutting rules for Feynman-Witten diagrams on any time-dependent spacetime background. These lead to the cosmological analogue of Feynman’s tree theorem for amplitudes, which can be used to systematically expand any loop diagram in terms of (momentum integrals of) tree-level diagrams. As an application of these new rules, we show that certain singularities in the wavefunction cannot appear in equal-time correlators due to a cancellation between “real” and “virtual” contributions that closely parallels the KLN theorem. Finally, when combined with the Bunch-Davies condition that certain unphysical singularities are absent, these cutting rules completely determine any tree-level exchange diagram in terms of simpler contact diagrams. Altogether, these results remove the need to ever perform nested time integrals when computing cosmological correlators.

Introducción. El autocuidado se refiere a las actividades y prácticas realizadas e iniciadas por un individuo para mantener la vida, la salud y el bienestar, pero su mantenimiento requiere de conocimientos adecuados por parte de los pacientes. Objetivo. Determinar la relación entre los conocimientos y el autocuidado para un envejecimiento con bienestar en adultos mayores de un hospital público de Lima, 2022. Materiales y métodos. Estudio observacional, analítico y transversal. La muestra estuvo conformada por 176 pacientes geriátricos del consultorio de geriatría del hospital Sergio E. Bernales. Se emplearon cuestionarios para medir las variables. En el análisis bivariado se emplearon las pruebas de Chi-cuadrado y la regresión de Poisson para calcular la razón de prevalencia (RP) con una significancia estadística de 0,05. Resultados. Un mayor porcentaje se centra en los adultos mayores que no conocen (52,84%) y tienen prácticas inadecuadas de autocuidado para un envejecimiento con bienestar (52,27%), asimismo, los que tienen educación primaria (58,52%), cuentan con seguro integral de salud (90,34%), no trabajan (95,45), viven sin hijos (54,55%) y tienen antecedentes familiares (71,02%). En el análisis bivariado, los conocimientos se relacionan con las prácticas de autocuidado (PR: 1,49, IC 95%: 1,09-2,05 p valor=0,013). Conclusión. Más de la mitad de todos los pacientes no conocen y practican adecuadamente el autocuidado para un envejecimiento con bienestar. Asimismo, los conocimientos se relacionaron estadísticamente con el autocuidado. Se recomienda considerar estos hallazgos y el perfil sociodemográfico y clínico de los participantes para crear estrategias integrales de salud que consideren sus particularidades y necesidades.

Abstract Objective To assess SARS-CoV-2 antibody prevalence and titers in people living with HIV (PLWHIV) on antiretroviral treatment (ART) enrolled at a tertiary reference hospital in Mexico. Methods Two plasma aliquots per person, used for HIV viral load follow-up between 01/2020 and 09/2021, were used to assess total anti-N and neutralizing SARS-CoV-2 antibodies. Sociodemographic, clinical, and SARS-CoV-2 exposure risk information were collected. The risk associated with SARS-CoV-2 exposure and associations with antibody titers were analyzed with logistic, Cox, and linear multivariable models. Results 803 PLWHIV participated; 233 had detectable SARS-CoV-2 antibodies (prevalent cases), and 132 seroconverted (incident cases). Overall, the adjusted prevalence was 46.45%, with an incidence rate of 3.78 cases/100 person-months. Factors associated with prevalent cases included lower age, location (western zone of Mexico City and the neighboring Mexico State), use of public transport, attendance at meetings without social distancing, and higher CD4 + T cell counts (p

Abstract Background Prostate cancer exhibits a very diverse behaviour, with some patients dying from the disease and others never needing treatment. Active surveillance (AS) consists of periodic PSA assessment (prostate-specific antigen), DRE (digital rectal examination) and periodic prostate biopsies. According to the main guidelines, AS is the preferred strategy for low-risk patients, to avoid or delay definitive treatment. However, concerns remain regarding its applicability in certain patient subgroups, such as African American men, who were underrepresented in the main cohorts. Brazil has a very racially diverse population, with 56.1% self-reporting as brown or black. The aim of this study is to evaluate and validate the AS strategy in low-risk prostate cancer patients following an AS protocol in the Brazilian public health system. Methods This is a multicentre AS prospective cohort study that will include 200 patients from all regions of Brazil in the public health system. Patients with prostate adenocarcinoma and low-risk criteria, defined as clinical staging T1–T2a, Gleason score ≤ 6, and PSA

This study evaluated short-term immune responses of dairy ewes supplemented with barley β-glucan (BG) following an intramammary Escherichia coli lipopolysaccharide (LPS) challenge. In the adaptation period, 36 ewes were fed an alfalfa hay diet ad libitum and barley grain cv. Hispanic (3.8% BG). Then, ewes were assigned into three experimental groups: (1) Control (CON), the same previous diet (13.3 g BG/d); (2) high β-glucans barley (HBG), new barley (cv. Annapurna) containing 10% BG (35 g BG/d); (3) intraperitoneally injected (INP) with a 1.4% BG solution dose (2 g BG/ewe). At d 9, all ewes were infused with an E. coli LPS or saline solution in each udder half. After the challenge, rectal temperature (RT), milk yield and composition, somatic cell count (SCC), and plasma interleukins (IL-1α and IL-1β) were monitored daily. The INP treatment revealed a transitory increase in RT and decreased milk yield by 38%. Milk fat, protein, and SCC increased in LPS-treated udders but not by BG treatment. The IL-1α plasma concentration was similar among groups but INP ewes showed a lower IL-1β concentration suggesting a lower inflammatory response. The BG administration appears more effective intraperitoneally than orally, which needs additional study.

Objectives: The main objective of this study was to assess whether there are differences in the muscular and occlusal levels between wind players and the general population, in addition to assessing the different repercussions depending on the embouchure type. Material and Methods: Two cohorts were chosen: one of them comprised intermediate students related to the practice of a wind instrument (n = 39), and the other one, harmonized with the former, comprised secondary students that served as a control group (n = 19). Overjet, overbite, presence of lip abrasion and/or erosion, Angle’s molar class, Little’s irregularity index, dental abrasion, presence of labial herpes, presence of tooth sensitivity, and presence of articular noises muscle pain were evaluated. Results: Significant statistical differences between the groups were found regarding overjet, overcrowding of teeth, lower lip erosion, and dental abrasion, which was higher in musicians. Lastly, within the group of musicians, it was proven that tooth sensitivity was higher in the group of brass musicians. Conclusions: Wind instrument practice may be a risk factor for developing some orofacial involvement, and there are no differences among the various existing mouthpieces.

Increasing crop yield with low-N supplies has become one of the main aims of current agriculture to reduce the excessive use of chemical fertilizers. A sustainable strategy to improve crop productivity, N assimilation, and N Use Efficiency (NUE) under limit-N growth conditions is the application of biostimulants, such as humic substances (HS). Here, we evaluated the effectiveness of an HS-based biostimulant, BLACKJAK®, in improving lettuce growth and NUE under N-deficit conditions. Thus, BLACKJAK® was applied radicularly (R) and foliarly (F) at the following doses: R-HS 0.40 mL/L, R-HS 0.60 mL/L, F-HS 7.50 mL/L, and F-HS 10.00 mL/L. Three N levels were applied: optimal (7 mM) and N-deficit (3 mM and 1 mM). The results showed that shoot dry weight (DW) was reduced at 3 mM N (−32%) and 1 mM N (−42%). However, R and F BLACKJAK® enhanced plant growth at all three N levels, especially with F-HS at 10.00 mL/L, which showed an increase of 43% in shoot DW at 3 and 1 mM N, compared to plants not treated with HS. BLAKCJAK® also improved photosynthesis, NO3− and organic N accumulation, the activity of N assimilation enzymes, and the concentration of amino acids and proteins, regardless of the N level. In addition, HS enhanced NUE parameters under all N conditions, except for R-HS 0.60 mL/L at 1 mM N. Hence, our study suggests that the HS-based product BLACKJAK® could be a good candidate for reducing chemical fertilizer use and improving lettuce growth and NUE under low N conditions, although further research is required.

Abstract The mechanisms driving SARS-CoV-2 susceptibility remain poorly understood, especially the factors determining why unvaccinated individuals remain uninfected despite high-risk exposures. To understand lipid and metabolite profiles related with COVID-19 susceptibility and disease progression. We collected samples from an exceptional group of unvaccinated healthcare workers heavily exposed to SARS-CoV-2 but not infected (‘non-susceptible’) and subjects who became infected during the follow-up (‘susceptible’), including non-hospitalized and hospitalized patients with different disease severity providing samples at early disease stages. Then, we analyzed their plasma metabolomic profiles using mass spectrometry coupled with liquid and gas chromatography. We show specific lipids profiles and metabolites that could explain SARS-CoV-2 susceptibility and COVID-19 severity. More importantly, non-susceptible individuals show a unique lipidomic pattern characterized by the upregulation of most lipids, especially ceramides and sphingomyelin, which could be interpreted as markers of low susceptibility to SARS-CoV-2 infection. This study strengthens the findings of other researchers about the importance of studying lipid profiles as relevant markers of SARS-CoV-2 pathogenesis.

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

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

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

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

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

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

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

Fractures and dislocations of the sternoclavicular joint (SCJ) are uncommon, accounting for

La presente reseña pretende sintetizar los conceptos más importantes relacionados con el requisito de la novedad de los diseños industriales, a partir de las interpretaciones prejudiciales del Tribunal de Justicia de la Comunidad Andina que constituyen la doctrina del acto aclarado, y a partir de la reciente jurisprudencia del Consejo de Estado y del Tribunal Superior de Bogotá. Para tales efectos, en un primer momento se precisará el concepto de la doctrina del acto aclarado y se abordará la noción y el alcance de protección del diseño industrial. Posteriormente, de modo ilustrativo, se expondrá el marco histórico y normativo de los diseños industriales. A continuación, se expondrá el alcance del concepto de novedad a la luz de la jurisprudencia reciente. Finalmente, se traerá a colación algunos extractos jurisprudenciales que condensan los temas tratados a lo largo de la presente reseña.

Erratum to: Progress Note 2024: Curing HIV; Not in My Lifetime or Just Around the Corner? doi: 10.20411/pai.v8i2.665 In the original publication, the comments provided by Santiago Ávila-Ríos were mistakenly omitted. In this version, his comments are included in the “Comments by Leaders” section, and his name has been included in the list of authors. --- Once a death sentence, HIV is now considered a manageable chronic disease due to the development of antiretroviral therapy (ART) regimens with minimal toxicity and a high barrier for genetic resistance. While highly effective in arresting AIDS progression and rendering the virus untransmissible in people living with HIV (PLWH) with undetectable viremia (U=U) [1, 2]), ART alone is incapable of eradicating the “reservoir” of resting, latently infected CD4+ T cells from which virus recrudesces upon treatment cessation. As of 2022 estimates, there are 39 million PLWH, of whom 86% are aware of their status and 76% are receiving ART [3]. As of 2017, ART-treated PLWH exhibit near normalized life expectancies without adjustment for socioeconomic differences [4]. Furthermore, there is a global deceleration in the rate of new infections [3] driven by expanded access to pre-exposure prophylaxis (PrEP), HIV testing in vulnerable populations, and by ART treatment [5]. Therefore, despite outstanding issues pertaining to cost and access in developing countries, there is strong enthusiasm that aggressive testing, treatment, and effective viral suppression may be able to halt the ongoing HIV epidemic (ie, UNAIDS’ 95-95-95 targets) [6–8]; especially as evidenced by recent encouraging observations in Sydney [9]. Despite these promising efforts to limit further viral transmission, for PLWH, a “cure” remains elusive; whether it be to completely eradicate the viral reservoir (ie, cure) or to induce long-term viral remission in the absence of ART (ie, control; Figure 1). In a previous salon hosted by Pathogens and Immunity in 2016 [10], some researchers were optimistic that a cure was a feasible, scalable goal, albeit with no clear consensus on the best route. So, how are these cure strategies panning out? In this commentary, 8 years later, we will provide a brief overview on recent advances and failures towards identifying determinants of viral persistence and developing a scalable cure for HIV. Based on these observations, and as in the earlier salon, we have asked several prominent HIV cure researchers for their perspectives.

Este artículo busca sacar a flote y estudiar diferentes historias de la materia presentes en el río Magdalena en Colombia, a través de la novela En el brazo del río (2006) de Marbel Sandoval Ordoñez, y la crónica Los escogidos (2012), de Patricia Nieto. El objetivo de mi lectura es analizar el fenómeno del río, mediante el concepto de ‘viscosidad porosa’, es decir, evidenciando el enmarañamiento entre cuerpos humanos y no humanos que se da en este y cómo estos reconfiguran los discursos alrededor del Magdalena. Usando una metodología que parte desde los presupuestos de los nuevos materialismos y las humanidades azules, propongo una mirada desde una ontología relacional que reconoce la capacidad expresiva (creativa) y el potencial de acción (agenciamiento) del río. A partir de esto realizo una lectura atenta de las dos obras, identificando dónde se visualizan dichos enmarañamientos y cómo la forma de dichas obras literarias permite una reconfiguración del sentido del río. Esto me permite mostrar que las historias de violencia y riqueza que han configurado el Magdalena están, indudablemente, conectadas con la materialidad del mismo, de los cuerpos humanos asesinados que recorren el río en constante interacción con otros animales, o de las aguas del Magdalena entrelazadas con el petróleo que se filtra por el extractivismo de su subsuelo. Por lo tanto, en estos textos literarios el fenómeno del río Magdalena se complejiza y se densifica, permitiéndonos reconocer cómo nuestra realidad esta enmarañada con otros cuerpos humanos y no humanos que habitan nuestro mundo.

Abstract Monitoring livestock feeding behavior may help assess animal welfare and nutritional status, and to optimize pasture management. The need for continuous and sustained monitoring requires the use of automatic techniques based on the acquisition and analysis of sensor data. This work describes an open dataset of acoustic recordings of the foraging behavior of dairy cows. The dataset includes 708 h of daily records obtained using unobtrusive and non-invasive instrumentation mounted on five lactating multiparous Holstein cows continuously monitored for six non-consecutive days in pasture and barn. Labeled recordings precisely delimiting grazing and rumination bouts are provided for a total of 392 h and for over 6,200 ingestive and rumination jaw movements. Companion information on the audio recording quality and expert-generated labels is also provided to facilitate data interpretation and analysis. This comprehensive dataset is a useful resource for studies aimed at exploring new tools and solutions for precision livestock farming.

Mining has led to multiple social conflicts between communities and companies. However, at the same time, it has been the activity with the greatest contribution to Peru’s gross domestic product for more than a decade, especially copper mining. The importance of copper lies in the fact that it is one of the basic raw materials for the manufacture of products and the expansion of global industries. This research seeks to identify and analyze the possible behavioral scenarios that will support copper mining in the next five years. Foresight (projection of future scenarios), along with the judgment of experts in the field, was used for conducting the research. This methodology employs a non-experimental design and aims at both exploratory and descriptive results. The main findings include an increase in the electricity cost for mining and the continuation of an unfavorable political leadership for its development. It is clear that this issue is taking place in a sensitive context due to the constant social conflicts that occur in favor of the growth of industry. This study will undoubtedly propose solutions to this disparity and will research whether, in any scenario, copper mining and the total population of a copper-rich country can really coexist.

In this introduction, we argue for a basic idea. Community-based spaces for promoting forgiveness and memory-making bear the promise of promoting some of the cultural transformations needed for thick, structural reconciliation. As we show by discussing some recent examples taken from the Colombian context of the past decade, these spaces do not compete, but actually complement a pragmatic, thin institutional design for reconciliation. This idea, as we discuss here, serves as the common thread connecting the articles in this special issue. The texts reflect on the practice of forgiveness and some of its specific contours in the context of the Colombian conflict.

Estudiamos la dinámica de la desigualdad de los ingresos antes y después de impuestos a los ingresos del trabajo personal durante el período que va de 1996 a 2015 en Argentina. Luego de la crisis de 2001-2002, el país observó cambios en la estructura de su economía, en las instituciones del mercado laboral y en las políticas fiscales, con un incremento del peso del sector público en la economía. La trayectoria del impuesto no fue monótona sino dependiente del ciclo político. El documento describe la evolución histórica de los parámetros del tributo y sus principales reformas. Luego empleamos datos administrativos de los empleos en relación de dependencia privados para simular su determinación para cada año y calcular así indicadores de desigualdad. Encontramos una tendencia decreciente de la desigualdad de los ingresos después de impuestos, especialmente sobre el final del período. Las distorsivas reformas al impuesto motivadas por las elecciones generan regresiones limitadas pero perceptibles en los indicadores de desigualdad.

Abstract Background In 2020, Ecuador had one of the highest death rates because of COVID-19. The role of clinical and biomolecular markers in COVID disease prognosis, is still not well supported by available data. In order for these markers to have practical application in clinical decision-making regarding patient treatment and prognosis, it is necessary to know an optimal cut-off point, taking into consideration ethnic differences and geographic conditions. Aim To determine the value of clinical and biomolecular markers, to predict mortality of patients with severe COVID-19 living at high altitude. Methods In this study, receiver operating characteristic (ROC) curves, area under the curve (AUC) of ROC, sensitivity, specificity and likelihood ratios were calculated to determine levels of clinical and biomolecular markers that best differentiate survivors versus non-survivors in severe COVID subjects that live at a high altitude setting. Results Selected cut-off values for ferritin (≥ 1225 ng/dl, p = 0.026), IL-6 (≥ 11 pg/ml, p = 0.005) and NLR (≥ 22, p = 0.008) at 24 h, as well as PaFiO2 (≤ 164 mmHg, p = 0.015), NLR (≥ 16, p = p = 0.013) and SOFA (≥ 6, p = 0.031) at 72 h, appear to have good discriminating power to differentiate survivors versus non-survivors. Additionally, odds ratios for ferritin (OR = 3.38); IL-6 (OR = 17.07); PaFiO2 (OR = 4.61); NLR 24 h (OR = 4.95); NLR 72 h (OR = 4.46), and SOFA (OR = 3.77) indicate increased risk of mortality when cut-off points were taken into consideration. Conclusions We proposed a straightforward and understandable method to identify dichotomized levels of clinical and biomolecular markers that can discriminate between survivors and non-survivors patients with severe COVID-19 living at high altitudes.

Abstract Shallow magmatic reservoirs that produce measurable volcanic surface deformation are often considered as discrete independent systems. However, petrological analyses of erupted products suggest that these may be the shallowest expression of extensive, heterogeneous magmatic systems that we show may be interconnected. We analyse time series of satellite-radar-measured displacements at Western Galápagos volcanoes from 2017 to 2022 and revisit historical displacements. We demonstrate that these volcanoes consistently experience correlated displacements during periods of heightened magma supply to the shallow crust. We rule out changes in static stress, shallow hydraulic connections, and data processing and analysis artefacts. We propose that episodic surges of magma into interconnected magmatic systems affect neighbouring volcanoes, simultaneously causing correlations in volcanic uplift and subsidence. While expected to occur globally, such processes are uniquely observable at the dense cluster of Western Galápagos volcanoes, thanks to the high rate of surface displacements and the wealth of geodetic measurements.

Abstract Introduction Neuroimaging has revealed that migraine is linked to alterations in both the structure and function of the brain. However, the relationship of these changes with aging has not been studied in detail. Here we employ the Brain Age framework to analyze migraine, by building a machine-learning model that predicts age from neuroimaging data. We hypothesize that migraine patients will exhibit an increased Brain Age Gap (the difference between the predicted age and the chronological age) compared to healthy participants. Methods We trained a machine learning model to predict Brain Age from 2,771 T1-weighted magnetic resonance imaging scans of healthy subjects. The processing pipeline included the automatic segmentation of the images, the extraction of 1,479 imaging features (both morphological and intensity-based), harmonization, feature selection and training inside a 10-fold cross-validation scheme. Separate models based only on morphological and intensity features were also trained, and all the Brain Age models were later applied to a discovery cohort composed of 247 subjects, divided into healthy controls (HC, n=82), episodic migraine (EM, n=91), and chronic migraine patients (CM, n=74). Results CM patients showed an increased Brain Age Gap compared to HC (4.16 vs -0.56 years, P=0.01). A smaller Brain Age Gap was found for EM patients, not reaching statistical significance (1.21 vs -0.56 years, P=0.19). No associations were found between the Brain Age Gap and headache or migraine frequency, or duration of the disease. Brain imaging features that have previously been associated with migraine were among the main drivers of the differences in the predicted age. Also, the separate analysis using only morphological or intensity-based features revealed different patterns in the Brain Age biomarker in patients with migraine. Conclusion The brain-predicted age has shown to be a sensitive biomarker of CM patients and can help reveal distinct aging patterns in migraine.

Abstract Background Clinical Practice Guidelines for Gulf War Illness (GWI) recommend integrative health approaches such as yoga for relief from symptoms, yet little is known about the long-term efficacy of yoga in reducing symptoms of GWI. Here, we evaluated the long-term efficacy of yoga and cognitive-behavioral therapy (CBT) chronic pain treatment in a randomized controlled trial (RCT) of 75 Veterans (57 men, 42–71 ± 7.1 years of age) with Gulf War Illness (GWI). Methods Participants received either 10 weeks of yoga or 10 weeks of CBT for chronic pain. The primary outcome measures were pain severity, and pain interference (Brief Pain Inventory-Short Form). The secondary outcome measures were fatigue, as indicated by a measure of functional exercise capacity (6-Minute Walk Test), depression, autonomic symptom severity, and quality of life. Piecewise linear mixed models were used to examine study hypotheses. Results Compared to the CBT group, yoga was associated with greater reductions in pain severity during the 6-month follow-up period (group × time interaction: b = 0.036, se = 0.014, p = .011). Although we did not find between-group differences in the other primary or secondary outcome measures during follow-up (p’s > 0.05), exploratory analyses revealed within-group improvements in pain interference, total pain (an experimental outcome variable which combines pain severity and interference), and fatigue in the yoga group (p’s

Ophidism is a public health problem in tropical countries, occurring predominantly in rural areas. In Colombia, among the species responsible for snakebite envenomation, inflicting high mortality, is the Chocoan bushmaster, Lachesis acrochorda, better known locally by the names “verrugosa (warty)” and “pudridora (rot-causing)”. In this research, the cardiotoxic effect of the venom of L. acrochorda in male Wistar rats weighing 230 ± 20 g was evaluated. A statistical design of randomized blocks was implemented with three treated groups, injected with lyophilized venom (doses of 3.22 μg/g, 6.43 μg/g, 12.86 μg/g), and a control group injected with 0.9% saline solution. Electrocardiographic (ECG) recordings were taken from the anesthetized animals, revealing an increase in the amplitude of the P and T waves and an increase in the duration of the QT intervals in the electrocardiographic recordings. These increases were not observed in the control biomodels. In the analysis of the CK and CK-MB enzyme levels, increases were also observed in the levels of cardiac isoenzymes in the injected animals, but none in the control animals. The histopathological analyses carried out reveal that the injected animals showed effects such as interfibrillar and perivascular edema, cellular shortening of the cardiomyocytes, foci with tissue destructuring, and necrosis with contraction bands. In conclusion, the venom of the Lachesis acrochorda snake increases the P and T waves and the QT interval and increases the CK and CK-MB enzymes in the blood. Additionally, it causes interfibrillar and perivascular edema in the cardiac tissue, cardiocytolysis, and contraction bands.

Follicular helper CD4hi T cells (TFH) are a major cellular pool for the maintenance of the HIV reservoir. Therefore, the delineation of the follicular (F)/germinal center (GC) immune landscape will significantly advance our understanding of HIV pathogenesis. We have applied multiplex confocal imaging, in combination with the relevant computational tools, to investigate F/GC in situ immune dynamics in viremic (vir-HIV), antiretroviral-treated (cART HIV) People Living With HIV (PLWH) and compare them to reactive, non-infected controls. Lymph nodes (LNs) from viremic and cART PLWH could be further grouped based on their TFH cell densities in high-TFH and low-TFH subgroups. These subgroups were also characterized by different in situ distributions of PD1hi TFH cells. Furthermore, a significant accumulation of follicular FOXP3hiCD4hi T cells, which were characterized by a low scattering in situ distribution profile and strongly correlated with the cell density of CD8hi T cells, was found in the cART-HIV low-TFH group. An inverse correlation between plasma viral load and LN GrzBhiCD8hi T and CD16hiCD15lo cells was found. Our data reveal the complex GC immune landscaping in HIV infection and suggest that follicular FOXP3hiCD4hi T cells could be negative regulators of TFH cell prevalence in cART-HIV.

A multifaceted, participatory, open program based on a qualitative and quantitative approach was developed in the Region of Murcia (Spain) aimed to reduce antibiotic use in children under 3 years of age diagnosed with upper respiratory tract infections (acute otitis media, pharyngitis, and common cold). Antibiotic consumption was measured using the defined daily dose per 1000 inhabitants per day (DHD). Pre-intervention data showed a prevalence of antibiotic prescriptions in the primary care setting of 45.7% and a DHD of 19.05. In 2019, after the first year of implementation of the program, antibiotic consumption was 10.25 DHD with an overall decrease of 48% as compared with 2015. Although antibiotic consumption decreased in all health areas, there was a large variability in the magnitude of decreases across health areas (e.g., 12.97 vs. 4.77 DHD). The intervention program was effective in reducing the use of antibiotics in children under 3 years of age with common upper respiratory diseases, but reductions in antibiotic consumption were not consistent among all health areas involved.

Abstract The objective of this study was to evaluate volumetric changes in the upper airway using Cone Beam Computed Tomography (CBCT) in orthodontic patients with maxillary transversal hypoplasia undergoing maxillary disjunction. The influence of factors such as sex, age, and growth pattern on airway volumetric changes was also assessed. The sample consisted of 50 growing patients from the dental clinic of Cardenal Herrera CEU University of Valencia. Airway volume was measured in mm3 before treatment (T0) and after palatal disjunction (T1). The final sample included 37 subjects in the treatment group and 13 in the control group. The volume gained exclusively from the disjunction treatment was determined to differentiate it from natural growth. The control group showed a mean volume increase from 10,911.3 ± 1,249.6 mm3 to 13,168.9 ± 1,789.7 mm3, representing a mean increase of 2,257.6 mm3 or + 20.9%. The treatment group exhibited an increase from 14,126.3 ± 4,399.8 mm3 at T0 to 18,064.1 ± 4,565.9 mm3 at T1, corresponding to a gain of 3,937.8 mm3 or + 31.8%. Significant differences in airway volume were observed after palatal disjunction compared to the control group. The expansion of the maxilla led to a significant increase in airway volume in the treated patients, estimated at 5,183 mm3 (+ 41.5%).

Abstract Background Carbon-fibre (CF) plates are increasingly used for fracture fixation. This systematic review evaluated complications associated with CF plate fixation. It also compared outcomes of patients treated with CF plates versus metal plates, aiming to determine if CF plates offered comparable results. The study hypothesized that CF plates display similar complication rates and clinical outcomes as metal plates for fracture fixation. Methods The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The following databases were searched from database inception until June 2023: PubMed, MEDLINE, Embase, Web of Science, Cochrane Library, Emcare, Academic Search Premier and Google Scholar. Studies reporting on clinical and radiological outcomes of patients treated with CF plates for traumatic fractures and (impending) pathological fractures were included. Study quality was assessed, and complications were documented as number and percentage per anatomic region. Results A total of 27 studies of moderate to very low quality of evidence were included. Of these, 22 studies (800 patients, median follow-up 12 months) focused on traumatic fractures, and 5 studies (102 patients, median follow-up 12 months) on (impending) pathological fractures. A total of 11 studies (497 patients, median follow-up 16 months) compared CF plates with metal plates. Regarding traumatic fractures, the following complications were mostly reported: soft tissue complications (52 out of 391; 13%) for the humerus, structural complications (6 out of 291; 2%) for the distal radius, nonunion and structural complication (1 out of 34; 3%) for the femur, and infection (4 out of 104; 4%) for the ankle. For (impending) pathological fractures, the most frequently reported complications were infections (2 out of 14; 14%) for the humerus and structural complication (6 out of 86; 7%) for the femur/tibia. Comparative studies reported mixed results, although the majority (7 out of 11; 64%) reported no significant differences in clinical or radiological outcomes between patients treated with CF or metal plates. Conclusion This systematic review did not reveal a concerning number of complications related to CF plate fixation. Comparative studies showed no significant differences between CF plates and metal plates for traumatic fracture fixation. Therefore, CF plates appear to be a viable alternative to metal plates. However, high-quality randomized controlled trials (RCTs) with long-term follow-up are strongly recommended to provide additional evidence supporting the use of CF plates. Level of evidence: III, systematic review.

Objetivo. Determinar los efectos de un programa de autoliderazgo (PAL), formado por ocho talleres y un enfoque de aprendizaje experiencial, en estudiantes de nivel máster que tienen una puntuación elevada en el RP antagonismo. Con la finalidad de procurar un aprendizaje más integral del alumnado, incorpora el desarrollo competencial emocional (DCE) y facilita, con ello, el desempeño de un estilo de liderazgo más prosocial. Metodología. Diseño cuasi experimental ex post facto (n=126), se aplican los instrumentos autoinformados de desarrollo competencial emocional (DCE) (QDE_A35) de Bisquerra y Pérez-Escoda, así como la subescala de amabilidad-antagonismo del Big Five. Resultados. Las pruebas ANCOVA revelan cambios significativos en las personas participantes con RP antagónico, al compararlas con otro grupo de estudiantes que teniendo el mismo rasgo de personalidad no participaron en el programa (Grupo de Control), en: (i) DCE total, y (ii) las subdimensiones de consciencia emocional (CoE), regulación emocional (RE), y autonomía emocional (AE). Por el contrario, no se apreciaron diferencias en: competencias sociales (CS) y bienestar emocional (BE). Conclusión. El programa de autoliderazgo analizado demuestra ser una formación que contribuye de manera clara al DCE del alumnado con puntuaciones altas en antagonismo.

Abstract Background Esophageal duplication cysts are rare congenital tumors usually diagnosed and treated during childhood. Most of them are located in the mediastinum and appear as a mass besides the esophagus. Unfortunately, symptoms are non-specific and depend on the size and location of the mass; therefore, they can easily be missed. If symptoms appear, surgical resection is necessary to prevent troublesome complications. Case Presentation We present the case of a 60-year-old woman who presented with severe progressive dysphagia and epigastric pain. After further evaluation, a paraesophageal cystic mass was found, and surgery was required. Non-communicating esophageal duplication cyst was the final diagnosis. Conclusion Esophageal duplication cysts are a rare pathology in adults; their symptoms will vary depending on their size and location. Preoperative diagnosis is difficult as symptoms are non-specific and can be missed. If severe dysphagia, pain, or any other complication appears, surgery should not be delayed.

Abstract The development of novel advanced nanomaterials (NMs) with outstanding characteristics for their use in distinct applications needs to be accompanied by the generation of knowledge on their potential toxicological impact, in particular, that derived from different occupational risk exposure routes, such as inhalation, ingestion, and skin contact. The harmful effects of novel graphene-metal oxide composites on human health are not well understood, many toxicological properties have not been investigated yet. The present study has evaluated several toxicological effects associated with graphene decorated with manganese oxide nanoparticles (GNA15), in a comparative assessment with those induced by simple graphene (G2), on human models representing inhalation (A549 cell line), ingestion (HT29 cell line) and dermal routes (3D reconstructed skin). Pristine and degraded forms of these NMs were included in the study, showing to have different physicochemical and toxicological properties. The degraded version of GNA15 (GNA15d) and G2 (G2d) exhibited clear structural differences with their pristine counterparts, as well as a higher release of metal ions. The viability of respiratory and gastrointestinal models was reduced in a dose-dependent manner in the presence of both GNA15 and G2 pristine and degraded forms. Besides this, all NMs induced the production of reactive oxygen species (ROS) in both models. However, the degraded forms showed to induce a higher cytotoxicity effect. In addition, we found that none of the materials produced irritant effects on 3D reconstructed skin when present in aqueous suspensions. These results provide novel insights into the potentially harmful effects of novel multicomponent NMs in a comprehensive manner. Furthermore, the integrity of the NMs can play a role in their toxicity, which can vary depending on their composition and the exposure route.

Abstract Aims In Envigado, Colombia, the Secretariat of Health has implemented, since 2011, an interprofessional program involving nurses to support and train relatives to improve the quality of life of people with a loss of autonomy and their family caregivers. The objectives of this study are to assess the outcomes of this program and to explore the contextual elements and mechanisms that can explain these outcomes. Design This article presents the research protocol for a realist evaluation that will be carried out to gather the perspectives of various local stakeholders involved. Methods Four outcomes on family caregivers will be measured quantitatively using self‐administered questionnaires and numerical scales. Contextual elements and mechanisms will then be explored qualitatively through focus groups and individual interviews. An iterative analysis will enable the refinement of a program theory. Results The results will inform a program theory that underlies the outcomes of the family caregiver support and training program. Patient or Public Contribution Community stakeholders, family caregivers, people with a loss of autonomy and their relatives will be involved in data collection and/or in the validation of the program theory.

Background Obstructive sleep apnoea (OSA) has been described as a risk factor for arterial hypertension (HT). One of the proposed mechanisms linking these conditions is non dipping (ND) pattern in nocturnal blood pressure, however evidence is variable and based on specific populations with underlying conditions. Data for OSA and ND in subjects residing at high altitude are currently unavailable.

RESUMEN La huella de carbono (HC) representa la sumatoria de gases de efecto invernadero emitidos por una persona, institución, programa o producto, y es la medida de uno de los impactos que provocan las actividades de la humanidad sobre el ambiente. El objetivo general de este trabajo fue estimar la HC del maíz producido en Córdoba, Argentina. El objetivo específico fue analizar la diferencia de HC a través de un manejo sitio-específico de la fertilización nitrogenada. La unidad declarada es: 1 t de grano en la puerta del campo. Los métodos utilizados siguen las normas ISO 14067 y las directrices del Panel Intergubernamental de Expertos sobre el Cambio Climático. Se utilizó información provista por la Bolsa de Cereales de Córdoba y de un ensayo a campo en Alejandro Roca, Córdoba. La HC resultó en 156,5 kg CO2 eq t-1 de maíz, promedio ponderado por departamento de la provincia de Córdoba. En el ensayo a campo, la dosis variable de N permitió reducir un 21,45% la HC, de 150,75 kg CO2 eq t-1 a 124,13 kg CO2 eq t-1. Los resultados están en un rango bajo, con respecto a la bibliografía, utilizando los mismos métodos. Una posible explicación es el bajo nivel de insumos que se aplican al cultivo, en términos comparativos, como así también la siembra directa, con menor consumo de combustible. En el ensayo, se explica por un uso más eficiente del fertilizante. the literature using the same methods. A possible explanation is the low level of inputs applied to the crop, in comparative terms, as well as the use of no-tillage which reduces fuel consumption. The lower impact observed in the field test was due to a more efficient use of fertilizer.

Abstract The wavefunction in quantum field theory is an invaluable tool for tackling a variety of problems, including probing the interior of Minkowski spacetime and modelling boundary observables in de Sitter spacetime. Here we study the analytic structure of wavefunction coefficients in Minkowski as a function of their kinematics. We introduce an off-shell wavefunction in terms of amputated time-ordered correlation functions and show that it is analytic in the complex energy plane except for possible singularities on the negative real axis. These singularities are determined to all loop orders by a simple energy-conservation condition. We confirm this picture by developing a Landau analysis of wavefunction loop integrals and corroborate our findings with several explicit calculations in scalar field theories. This analytic structure allows us to derive new UV/IR sum rules for the wavefunction that fix the coefficients in its low-energy expansion in terms of integrals of discontinuities in the corresponding UV-completion. In contrast to the analogous sum rules for scattering amplitudes, the wavefunction sum rules can also constrain total-derivative interactions. We explicitly verify these new relations at one-loop order in simple UV models of a light and a heavy scalar. Our results, which apply to both Lorentz invariant and boost-breaking theories, pave the way towards deriving wavefunction positivity bounds in flat and cosmological spacetimes.

Abstract Background The mental health and medical follow-up of people living with HIV (PLWH) have been disrupted by the COVID-19 pandemic. The objectives of this study were to assess anxiety, depression and substance use in Mexican PLWH during the pandemic; to explore the association of these symptoms with adherence to antiretroviral therapy (ART), and to compare patients with and without vulnerability factors (low socioeconomic level, previous psychological and/or psychiatric treatment). Methods We studied 1259 participants in a cross-sectional study, PLWH receiving care at the HIV clinic in Mexico City were contacted by telephone and invited to participate in the study. We included PLWH were receiving ART; answered a structured interview on sociodemographic data and adherence to ART; and completed the psychological instruments to assess depressive and anxiety symptoms and substance use risk. Data collection was performed from June 2020 to October 2021. Results 84.7% were men, 8% had inadequate ART adherence, 11% had moderate-severe symptoms of depression, and 13% had moderate-severe symptoms of anxiety. Adherence was related to psychological symptoms (p

Background and purposeImplementing any radiopharmaceutical therapy (RPT) program requires a comprehensive review of system readiness, appropriate workflows, and training to ensure safe and efficient treatment delivery. A quantitative assessment of the dose delivered to targets and organs at risk (OAR) using RPT is possible by correlating the absorbed doses with the delivered radioactivity. Integrating dosimetry into an established RPT program demands a thorough analysis of the necessary components and system fine-tuning. This study aims to report an optimized workflow for molecular radiation therapy using 177Lu with a primary focus on integrating patient-specific dosimetry into an established radiopharmaceutical program in a radiation oncology setting.Materials and methodsWe comprehensively reviewed using the Plan–Do–Check–Act (PDCA) cycle, including efficacy and accuracy of delivery and all aspects of radiation safety of the RPT program. The GE Discovery SPECT/CT 670DR™ system was calibrated per MIM protocol for dose calculation on MIM SurePlan™ MRT software. Jaszcak Phantom with 15–20 mCi of 177Lu DOTATATE with 2.5 µM EDTA solution was used, with the main energy window defined as 208 keV ±10% (187.6 to 229.2 keV); the upper scatter energy window was set to 240 keV ±5% (228 to 252 keV), while the lower scatter energy window was 177.8 keV ±5% (168.9 to 186.7 keV). Volumetric quality control tests and adjustments were performed to ensure the correct alignment of the table, NM, and CT gantry on SPECT/CT. A comprehensive end-to-end (E2E) test was performed to ensure workflow, functionality, and quantitative dose accuracy.ResultsWorkflow improvements and checklists are presented after systematically analyzing over 400 administrations of 177Lu-based RPT. Injected activity to each sphere in the NEMA Phantom scan was quantified, and the MIM Sureplan MRT reconstruction images calculated activities within ±12% of the injected activity. Image alignment tests on the SPECT/CT showed a discrepancy of more than the maximum tolerance of 2.2 mm on any individual axis. As a result of servicing the machine and updating the VQC and COR corrections, the hybrid imaging system was adjusted to achieve an accuracy of

Insulin-induced type III hypersensitivity reactions (HSRs) are exceedingly rare and pose complex diagnostic and management challenges. We describe a case of a 43-year-old woman with type 1 diabetes mellitus (DM), severe insulin resistance, and subcutaneous nodules at injection sites, accompanied by elevated anti-insulin IgG autoantibodies. Treatment involved therapeutic plasma exchange (TPE) and intravenous immunoglobulin (IVIg) as bridge therapy, followed by long-term immunosuppression, which reduced autoantibody levels and improved insulin tolerance. Given the limited treatment guidelines, we conducted a comprehensive literature review, identifying 16 similar cases. Most patients were females with a median age of 36.5 years; 63% had type 1 DM, and 44% had concurrent insulin resistance (56% with elevated autoantibodies). Treatment approaches varied, with glucocorticoids used in 67% of cases. Patients with type 1 DM were less responsive to steroids than those with type 2 DM, and had a more severe course. Of those patients with severe disease necessitating immunosuppression, 66% had poor responses or experienced relapses. The underlying mechanism of insulin-induced type III HSRs remains poorly understood. Immunosuppressive therapy reduces anti-insulin IgG autoantibodies, leading to short-term clinical improvement and improved insulin resistance, emphasizing their crucial role in the condition. However, the long-term efficacy of immunosuppression remains uncertain and necessitates continuous evaluation and further research.

IntroductionNipocalimab is a high-affinity, fully human, aglycosylated, effectorless, immunoglobulin G (IgG) 1 monoclonal antibody that targets the neonatal Fc receptor (FcRn), decreases systemic IgG including autoantibodies, and is under development in several IgG autoantibody- and alloantibody-mediated diseases, including generalized myasthenia gravis, chronic inflammatory demyelinating polyneuropathy, maternal-fetal medicine, and multiple other therapeutic areas. An initial phase 1 study with single and multiple ascending doses of nipocalimab infused intravenously (IV) over 2 h demonstrated dose-dependent serum pharmacokinetics and IgG reductions, with an adverse event (AE) profile comparable to placebo.MethodsThe current investigation evaluates the safety, tolerability, pharmacokinetics, and pharmacodynamics of single doses of nipocalimab across various IV infusion rates in a randomized, double-blind, placebo-controlled, sequential-dose study. Forty participants were randomized to receive nipocalimab 30 mg/kg over 60, 30, 15 or 7.5 min (0.5, 1, 2, or 4 mg/kg/min); nipocalimab 60 mg/kg over 15 min (4 mg/kg/min); or matching placebo.ResultsAt doses up to 60 mg/kg and infusion rates up to 4 mg/kg/min (maximum clinically feasible rate), single doses of nipocalimab were tolerable, with 12 (40%) participants experiencing AEs across nipocalimab cohorts compared with 1 (10%) participant in the placebo cohort. AEs deemed treatment related occurred in 6 (20%) participants receiving nipocalimab and 1 (10%) participant receiving placebo. None of the AEs were severe, and no participants discontinued treatment due to AEs. Nipocalimab provided consistent, dose-dependent serum pharmacokinetics and IgG reductions, regardless of infusion rate.DiscussionThis study supports the use of shortened durations of nipocalimab infusion for future studies.

El tumor de células gigantes (TCG) y el tumor pardo (TP) son entidades raras. EL TCG representa el 4% de las neoplasias primarias de hueso y solo el 2% aparece en el esqueleto craneofacial. Presentamos el caso de un paciente con una lesión lítica y expansiva en maxilar inferior; la biopsia determinó un patrón de TCG, sin descartar el TP dados los antecedentes. Se inició terapia con denosumab, mostrando mejoría clínica. La dificultad del diagnóstico radica en las entidades que muestran células gigantes. La terapia con denosumab ha demostrado ser efectiva, pero aún hace falta más evidencia, en especial para el caso del TCG.

Certain open access publishers based on the article processing charges model have found it highly profitable to operate within a gray zone that encompasses both legitimate and predatory publishing practices. In this context, maximum profits can be obtained by adequate combinations of journal acceptance rates and elevated article processing charges. Considering that the gray zone can be particularly challenging to identify and that it poses risks for authors aiming to establish academic carreers, we believe it is important to provide a comprehensive description of it.

Fabry disease (FD) is a multisystem lysosomal storage disorder induced by genetic variants in the alpha-galactosidase A (αGalA) gene. Some FD patients have GLA variants with a reduction in overall αGalA enzymatic activity due to mutated proteins with reduced stability, caused by protein misfolding and premature degradation, but the αGalA catalytic activity remains conserved (“amenable” genetic variants). To correct this misfolding and to prevent premature degradation, migalastat, a small iminosugar molecule was developed. We report the clinical characteristics of FD “amenable” cohort patients from Argentina, prior to starting treatment with migalastat. Seventeen Fabry adult patients were recruited from 13 Argentinian Centers; 8 males (47.1%) and 9 females (52.9%) were included. All genotypes included were missense-type “amenables” mutations. Some classic FD typical early manifestations were more frequent in patients with “classic” versus “late-onset” FD phenotype (pain, p=0.002; cornea verticillata, p=0.019). There was a statistically significant difference in estimated glomerular filtration rate in the “classic” versus “late-onset” phenotype (p=0.026) but no difference between genders (p=0.695). Left ventricular mass was similar between genders (p=0.145) and phenotypes (p=0.303). Cardiovascular risk factors were present among “late-onset” females (obesity 50% and smoke 25%). In patients who started “de novo” migalastat, the main indications were (i) heart disease, (ii) kidney damage, and (iii) pain, while in “switched from prior enzyme replacement therapy” patients, the most frequent indication was “patient decision;” this coincides with publications by other authors.

Constructed wetlands have been used worldwide as an alternative for wastewater treatment. The purpose of this study was to evaluate two constructed wetlands for wastewater treatment using two different species of macrophyte in order to reduce pollution levels in the Curiquingue Creek belonging to the Baños parish in Cuenca, Ecuador. A pilot plant was constructed using Equisetum spp and Zantedeschia aethiopica with a constant flow of 0.32m3d−1. Each unit was filled with sand and gravel as the porosity medium with a hydraulic retention time of 5 days. To analyze the efficiency of the wetlands, physical and chemical parameters were analyzed in the laboratory. The results obtained in the laboratory showed that the two species of macrophyte showed good efficiency in the removal of organic matter (100% COD-100% BOD5). On the other hand, Equisetum spp showed better efficiency in the removal of NO3− (80.28%) and PO43− (98.57%) meanwhile, Zantedeschia aethiopica showed better efficiency in the removal of TSS (85.71%). Constructed wetlands are an effective and sustainable option for wastewater treatment.