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Smoking can play a key role in SARS-CoV-2 infection and in the course of the disease. Previous studies have conflicting or inconclusive results on the prevalence of smoking and the severity of the coronavirus disease (COVID-19).Observational, multicenter, retrospective cohort study of 14,260 patients admitted for COVID-19 in Spanish hospitals between February and September 2020. Their clinical characteristics were recorded and the patients were classified into a smoking group (active or former smokers) or a non-smoking group (never smokers). The patients were followed up to one month after discharge. Differences between groups were analysed. A multivariate logistic regression and Kapplan Meier curves analysed the relationship between smoking and in-hospital mortality.The median age was 68.6 (55.8-79.1) years, with 57.7% of males. Smoking patients were older (69.9 (59.6-78.0 years)), more frequently male (80.3%) and with higher Charlson index (4 (2-6)) than non-smoking patients. Smoking patients presented a worse evolution, with a higher rate of admission to the intensive care unit (ICU) (10.4 vs. 8.1%), higher in-hospital mortality (22.5 vs. 16.4%) and readmission at one month (5.8 vs. 4.0%) than in non-smoking patients. After multivariate analysis, smoking remained associated with these events.Active or past smoking is an independent predictor of poor prognosis in patients with COVID-19. It is associated with higher ICU admissions and in-hospital mortality.El tabaquismo puede tener un papel importante en la infección por SARS-CoV-2 y en el curso de la enfermedad. Los estudios previos muestran resultados contradictorios o no concluyentes sobre la prevalencia de fumar y la severidad en la enfermedad por coronavirus (COVID-19).Estudio de cohortes observacional, multicéntrico y retrospectivo de 14.260 pacientes que ingresaron por COVID-19 en hospitales españoles desde febrero a septiembre de 2020. Se registraron sus características clínicas y se clasificaron en el grupo con tabaquismo si tabaquismo activo o previo o en el grupo sin tabaquismo si nunca habían fumado. Se realizó un seguimiento hasta un mes después del alta. Se analizaron las diferencias entre grupos. La relación entre tabaquismo y mortalidad intrahospitalaria se valoró mediante una regresión logística multivariante y curvas de Kapplan Meier.La mediana de edad fue 68,6 (55,8–79,1) años, con un 57,7% de varones. El grupo con tabaquismo presentó mayor edad (69,9 (59,6–78,0 años)), predominio masculino (80,3%) y mayor índice de Charlson (4 (2−6)). La evolución fue peor en estos pacientes, con una mayor tasa de ingreso en UCI (10,4 vs 8,1%), mayor mortalidad intrahospitalaria (22,5 vs 16,4%) y reingreso al mes (5,8 vs 4,0%) que el grupo sin tabaquismo. Tras el análisis multivariante, el tabaquismo permanecía asociado a estos eventos.El tabaquismo de forma activa o pasada es un factor predictor independiente de mal pronóstico en los pacientes con COVID-19, estando asociada a mayor probabilidad de ingreso en UCI y a mayor mortalidad intrahospitalaria.

The most representative indicator of vitamin D status in clinical practice is 25(OH)D3, but new biomarkers could improve the assessment of vitamin D status and metabolism. The objective of this study is to investigate the association of serum vitamin D metabolites and vitamin D metabolite ratios (VMRs) with potentially influential factors in premenopausal women. This is a cross-sectional study based on 1422 women, aged 39-50, recruited from a Madrid Medical Diagnostic Center. Participants answered an epidemiological and a food frequency questionnaire. Serum vitamin D metabolites were determined using an SPE-LC-MS/MS platform. The association between participant's characteristics, vitamin D metabolites, and VMRs was quantified by multiple linear regression models. Mean 25(OH)D3 concentration was 49.2 + 18.9 nmol/L, with greater deficits among obese, nulliparous, dark-skinned women, and with less sun exposure. A lower R2 ratio (1,25(OH)2D3/25(OH)D3) and a higher R4 (24,25(OH)2D3/1,25(OH)2D3) were observed in nulliparous women, with high sun exposure, and those with low caloric intake or high consumption of calcium, vitamin D supplements, or alcohol. Nulliparous women had lower R1 (25(OH)D3/Vit D3) and R3 (24,25(OH)2D3/25(OH)D3), and older women showed lower R3 and R4. Vitamin D status modified the association of the VMRs with seasons. VMRs can be complementary indicators of vitamin D status and its endogenous metabolism, and reveal the influence of certain individual characteristics on the expression of hydroxylase enzymes. This study was funded by the Spanish Ministry of Health (EC11–273) and by the Carlos III Institute of Health (PI15CIII/0029). The article presents independent research. The views expressed are those of the authors and not necessarily those of the Carlos III Institute of Health. Sí

This article proposes a measurement solution designed to monitor instantaneous frequency in power systems. It uses a data acquisition module and a GPS receiver for time stamping. A program in Python takes care of receiving the data, calculating the frequency, and finally transferring the measurement results to a database. The frequency is calculated with two different methods, which are compared in the article. The stored data is visualized using the Grafana platform, thus demonstrating its potential for comparing scientific data. The system as a whole constitutes an efficient low cost solution as a data acquisition system.

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90‐day and 1‐year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90‐day all‐cause (odds ratio [OR], 2.81; 95% CI, 2.33–3.38) and PE‐related mortality (OR, 2.38; 95% CI, 1.37–4.14) and increased 1‐year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10–9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all‐cause mortality (OR, 1.91; 95% CI, 1.57–2.32) but not PE‐related mortality (OR, 1.50; 95% CI, 0.85–2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90‐day all‐cause (OR, 2.28; 95% CI, 1.75–2.97) and PE‐related (OR, 3.64; 95% CI, 2.01–6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.

Resumen Introduccion El suicidio es la tercera causa de muerte de jovenes entre 15 y 19 anos, poblacion en la que esta conducta esta en aumento desde 2014. Determinar los factores asociados con este comportamiento complejo es el primer paso en el desarrollo de estrategias de intervencion temprana. E objetivo es analizar los factores sociodemograficos y clinicos psiquiatricos asociados con el comportamiento suicida de los adolescentes de Envigado en 2017. Metodos Estudio transversal analitico de base poblacional, anidado en el Estudio Poblacional de Salud Mental de Envigado, 2017. Se incluyo a 201 adolescentes de 15-18 anos a quienes se aplico el CIDI-3. Se calculo la prevalencia de comportamiento suicida y se analizaron los factores sociodemograficos y clinicos asociados mediante regresion logistica multivariada. Se presentan las OR con sus IC95%. Resultados La media de edad fue 15 anos, con el 51,7% de mujeres. Las prevalencias de comportamiento suicida fueron del 20,9% para ideacion, el 12,9% para planeacion y el 10,9% para intento. Ser mujer (OR = 1,12; IC95%, 1,02-4,87), de bajo nivel socioeconomico (OR = 4,09; IC95%, 1,80-9,23), con antecedente de trastorno negativista desafiante (OR = 4,89; IC95%, 1,17-20,39) o con antecedente de trastorno depresivo mayor (OR = 5,26; IC95%, 1,91-14,48) se asociaron con comportamiento suicida. Conclusiones Entre los adolescentes de la ciudad de Envigado, el comportamiento suicida tiene una alta prevalencia, mayor entre quienes estan en desventaja social y economica, particularmente las mujeres. Este perfil se debe considerar en la planeacion de estrategias de promocion de la salud mental y prevencion de los trastornos mentales.

Background: Carriers of the G2019S mutation of LRRK2 provide a great opportunity to investigate the premotor stages of Parkinson's disease (PD). We have studied by serial clinical and dopamine transporter single photon emission computed tomography (DaT-SPECT) evaluations a cohort of asymptomatic carriers of the LRRK2-G2019S mutation in order to evaluate the usefulness of these tools as biomarkers. Here we report the results of the extended follow-up of this cohort at 8 years. Methods: Seventeen participants, of the 25 available from the 4-year evaluation, completed the 8-year assessment. UPDRS-III, UPSIT test and DaT-SPECT imaging (123I-ioflupane) were performed. We used repeated-measures linear mixed effects models to examine the changes in DaT binding over time. Results: Three carriers had converted to PD at 4 years. One additional carrier converted at 8 years. PD-converters had lower striatal DaT binding at baseline than non-converters. There was a significant decline of DaT binding over time, with a mean annual rate of 3.5%, with somewhat inter-individual and intra-individual variability and comparable between PD-converters and non-converters. No carrier with DAT binding ratio above an undefined threshold between 0.5 and 0.8 developed PD symptoms. The age-adjusted UPSIT score did not change significantly over time. Conclusions: The rate of conversion to PD at 8 years in this cohort aged ~58 years at baseline was 16%. The observed decline of DaT binding over time and its association with the phenotype render DaT-SPECT a potentially useful tool for monitoring the premotor stage of the disease, although at the individual level its ability to predict phenoconversion is limited.

Resumen Este artículo pretende identificar y analizar en la literatura la producción relacionada con la fatiga por compasión y el agotamiento psicológico presente en el personal sanitario que brinda atención y cuidado a personas durante los procesos de muerte y duelo de pacientes y sus familiares, respectivamente. Esta es una revisión integradora en las bases de datos JSTOR, ProQuest, Medline (vía PubMed), LILACS y Google Scholar en el periodo 2005-2018. La revisión permitió la identificación de tres cuerpos importantes de producción académica: trabajos de corte cualitativo que describen el fenómeno; los que desarrollan escalas y herramientas de medición del problema; y los que describen estrategias desarrolladas frente al mismo. En los contextos hospitalarios al personal de salud que acompaña a persona durante el proceso de muerte se le impide demostrar sentimientos y vivir el duelo por la pérdida de sus pacientes. Los trámites administrativos, la despersonalización sanitaria, el número de pacientes a cargo y la baja conciencia en relación con la muerte regulan de cierta forma lo acontecido, impidiendo que exista por parte del personal de salud descarga de sentimientos, llevándolos a presentar agotamiento psicológico y fatiga por compasión.

Resumen La exposición a situaciones de vulnerabilidad y violencia, como el desplazamiento forzado, generan en la población víctima efectos nocivos para su salud mental. El objetivo del presente estudio es describir el estado actual de la salud mental y algunos factores sociodemográficos y del entorno asociados, de 471 adolescentes y jóvenes entre 13 y 28 años, víctimas de desplazamiento forzado en tres ciudades colombianas. Se aplicó la entrevista Composite International Diagnostic Interview (CIDI), versión CAPI (Computer Assisted Personal Interview); un cuestionario ad hoc sobre aspectos del desplazamiento forzado y el consumo de sustancias psicoactivas; la escala de funcionamiento familiar APGAR y la escala MOS (Medical Outcomes Study) de apoyo social. Se encontró una prevalencia de cualquier trastorno mental en el último año del 24,4% y cualquier trastorno por uso de sustancias del 4,7%. Los trastornos más prevalentes fueron fobia específica (6,8%), trastorno por estrés postraumático (5,7%) y trastorno depresivo mayor (5,1%). La dependencia a la marihuana se presentó en 2,1% de los participantes y el abuso de alcohol en 1,9%. Un 14,6% de los adolescentes y jóvenes víctimas de desplazamiento forzado han pensado suicidarse alguna vez en la vida. Ser hombre, menor de edad, con buen funcionamiento familiar y apoyo social adecuado, fueron factores protectores para la presencia de trastornos mentales. Abstract Exposure to vulnerable and violent events, such as forced displacement, generate several adverse effects on the mental health of victim population. The objective of this study is to describe the current mental health condition and some associated sociodemographic and environmental factors in 471 adolescents and young people between 13 and 28 years of age, who have been victims of forced displacement in three Colombian cities. The Composite International Diagnostic Interview (CIDI) interview, CAPI (Computer Assisted Personal Interview) version was administered; an ad hoc questionnaire on aspects of forced displacement and the consumption of psychoactive substances; the APGAR family function scale and the MOS (Medical Outcomes Study) scale of social support. It was found a prevalence of any mental disorder in the last years of 24.4% and any substance use disorder of 4.7%. The most prevalent disorders were specific phobia (6.8%), post-traumatic stress disorder (5.7%) and major depressive disorder (5.1%). Dependence on marijuana was found at 2.1% and alcohol abuse at 1.9%. 14.6% of adolescents and young victims of forced displacement have considered committing suicide at some point along their lives. Being a minor- age man, with a functional family and adequate social support, were protective factors from mental disorders.

In Europe, gastric adenocarcinoma (GADC) is commonly regarded as a disease of the elderly. This study aims to assess the proportion, characteristics, and survival of patients diagnosed with GADC under the age of 60.This is a retrospective, multicentric, and analytical study conducted at four tertiary Spanish hospitals. All patients diagnosed with GADC between 2008 and 2015 were included. Demographic, clinical, endoscopic, histologic, and survival data were retrieved. A multivariate analysis was performed to compare GADC in young (age≤60 years) and elderly patients.A total of 1374 patients with GADC were included. The mean age was 74 years (SD:11.1); 62.2% were males. There were 177 patients under the age of 60 (12.9%, 95% CI: 11.2-14.8%). GADC was frequently encountered as a metastatic disease in both young and elderly patients (Stage IV: 45.7% and 41%, respectively). In the multivariate analysis, alcohol abuse, ASA functional status I-II, diffuse subtype, neoadjuvant, and palliative therapy were independently associated (P0.05) with age ≤60 years. No differences were found in 2-year survival (GADC ≤60: 39% vs. 35%, P=0.45). Curative-intent surgery, TNM stage I-II, body mass index30kg/mOne out of eight cases of GADC were diagnosed under the age of 60. Metastatic disease was frequent at diagnosis and overall survival was poor regardless of age. Factors associated with localized disease correlated with improved survival in younger patients. Our results underline the need for early diagnosis strategies in our country.

Missed gastric cancer (MGC) is poorly documented in Mediterranean populations.(1) To assess the rate, predictors and survival of MGC. (2) To compare MGC and non-MGC tumors.This is a retrospective-cohort study conducted at four centers. MGC was defined as cancer detected within three years after negative esophagogastroduodenoscopy. Gastric adenocarcinomas diagnosed between 2008-2015 were included. Patients with no follow-up were excluded.During the study period 123,395 esophagogastroduodenoscopies were performed, with 1374 gastric cancers being diagnosed (1.1%). A total of 1289 gastric cancers were finally included. The overall rate of MGC was 4.7% (61/1289, 3.7-6%). A negative esophagogastroduodenoscopy in MGC patients was independently associated with PPI therapy (p 0.001), previous Billroth II anastomosis (p = 0.002), and lack of alarm symptoms (p 0.001). The most frequent location for MGC was the gastric body(52.4%). MGCs were smaller than non-MGCs (31 vs 41 mm, p = 0.047), more often flat or depressed (p = 0.003) and less likely to be encountered as advanced disease. Overall 2-year survival was similar between MGC (34.1%) and Non-MGC (35.3 %) (p = 0.59).MGC accounted for nearly five percent of newly-diagnosed gastric adenocarcinomas. Overall survival was poor and not different between MGC and non-MGC.

The role of vitamin D in mammographic density is still unclear. This study examines the association between serum 25-hydroxyvitamin D (25(OH)D) and mammographic density, overall and by specific women characteristics. DDM-Madrid is a cross-sectional study that recruited 1403 premenopausal women in a breast radiodiagnosis unit of Madrid City Council. Information was collected with a questionnaire and plasma 25(OH)D was measured by solid-phase extraction on-line coupled to liquid chromatography–tandem mass spectrometry. Percent mammographic density was assessed using a semi-automated computer tool (DM-Scan). Multivariable linear regression models were used to quantify the associations, categorizing 25(OH)D levels (nmol/L) into 3 groups according to the cut-offs established by the US Endocrine Society. Models were adjusted for age, education, body mass index, age at menarche, parity, previous breast biopsies, family history of breast cancer, physical activity, energy intake, use of corticoids, hypercholesterolemia and day of sample extraction. Mean serum 25(OH)D level was 49.4 + 18.9 nmol/L. Women with sufficient concentrations of 25(OH)D showed a slight decrease in mammographic density (β >75nmol/L=-3.40; p = 0.037). No differences were observed according to women characteristics except for parity, where the protective effect of 25(OH)D was only seen among nulliparous (β >75nmol/L=-13.00; p-heterogeneity = 0.006). In light of the protective effect of vitamin D on mammographic density and the high prevalence of vitamin D insufficiency in our population, improving these levels could be an effective measure for the prevention of health problems related to the lack of this essential vitamin.

espanolIntroduccion El trasplante autologo de precursores hematopoyeticos (TPHA) es una modalidad de tratamiento aceptada para la enfermedad de Crohn (EC) refractaria. Material y metodos Se recogen los pacientes con EC refractaria sometidos a TPHA en el hospital Universitario Ramon y Cajal de Madrid y se describen de forma retrospectiva los resultados obtenidos. Resultados Un total de 7 pacientes han recibido TPHA debido a EC refractaria en nuestro centro. Tres pacientes (43%) presentaron remision clinica y endoscopica; un paciente (14%) mejoria clinica sin remision y 3 pacientes (43%) permanecian activos con necesidad de reinicio del tratamiento en la valoracion de la respuesta inicial al TPHA (a 6 meses). Los sintomas recurrieron en 5 de los 7 pacientes (71%), y todos ellos requirieron reinicio de tratamiento medico a una media de 13,8 meses (rango: 3-30 meses). Solo un paciente requirio cirugia tras el TPHA. Al final del seguimiento a una media de 48 meses (rango: 17-78 meses) 5/7 (71%) de los pacientes estaban en remision clinica con o sin tratamiento. Conclusion El TPHA puede ser una opcion terapeutica prometedora para pacientes con EC refractaria. Su utilidad radica en que puede producir la remision clinica sin tratamiento en algunos pacientes, pero tambien en que puede hacer la enfermedad tratable, consiguiendo respuesta a determinados tratamientos en pacientes que la habian perdido previamente. EnglishAbstract Introduction Autologous haematopoietic stem cell transplantation (AHSCT) is an accepted treatment in refractory Crohn's disease (CD). Material and methods Data on patients with refractory CD subjected to AHSCT are collected at the Hospital Universitario Ramon y Cajal in Madrid and the results obtained are described retrospectively. Results Seven patients in total have received AHSCT due to refractory CD in our centre. Three patients (43%) presented with clinical and endoscopic remission; one patient (14%) clinical improvement without remission and three patients (43%) remained active with the need to restart treatment in the assessment of the initial response to the AHSCT (after six months). Symptoms recurred in five of the seven patients (71%) and all of them had to restart medical treatment after an average of 13.8 months (range: 3–30 months). Only one patient needed surgery after the AHSCT. At the end of the follow-up, after a mean of 48 months (range: 17–78 months), 5/7 (71%) of the patients were in clinical remission with or without treatment. Conclusion AHSCT may be a promising therapeutic option for patients with refractory CD. Its usefulness lies in the fact that it can produce clinical remission without treatment in some patients, but also that it can make the disease treatable, obtaining a response to certain treatments in patients who had previously lost it.

Resumen Introduccion Al menos el 10% de pacientes con trastorno obsesivo-compulsivo (TOC) son refractarios al tratamiento psicofarmacologico. La aparicion de nuevas tecnologias neuroquirurgicas (estimulacion cerebral profunda[ECP]) de modulacion de la actividad neuronal alterada esta posibilitando su extension a casos graves y refractarios de TOC en los que anteriormente se utilizaban tecnicas quirurgicas no reversibles. El objetivo de este articulo es revisar la evidencia cientifica existente sobre la eficacia y aplicabilidad de esta tecnica en este grupo de pacientes. Metodo Se ha realizado una revision sistematica de la literatura en las bases de datos PubMed/Medline, Embase y PsycINFO usando las palabras clave relacionadas con «deep brain stimulation», «DBS» y «obsessive-compulsive disorder», «OCD». Dos de los autores seleccionaron los articulos, de manera independiente, a partir de sus abstracts y en funcion de si describian alguno de los aspectos principales de la tecnica en el TOC: aplicabilidad; mecanismo de accion; dianas terapeuticas cerebrales; efectividad; efectos secundarios, y coterapias. Toda la informacion fue sistematicamente extraida y evaluada. Resultados El analisis critico de la evidencia senala que la aplicacion de la ECP en el tratamiento del TOC refractario esta aportando resultados satisfactorios, con rangos asumibles de efectos secundarios. Sin embargo, todavia no hay evidencia suficiente que permita priorizar el uso de una determinada diana cerebral. La seleccion de pacientes ha de seguir un analisis de riesgo/beneficio, debiendose individualizar la decision de mantener un tratamiento concomitante farmacologico/psicoterapeutico. Conclusiones La ECP se encuentra todavia en el ambito de la investigacion, pero su aplicacion en el TOC-refractario es cada vez mas frecuente, produciendo en la mayoria de los estudios una significativa mejoria de los sintomas, y tambien del funcionamiento y calidad de vida. Es preciso realizar mas estudios controlados y aleatorizados sobre su efectividad a largo plazo, y sobre su relacion riesgo/beneficio y costes.

Introduction Autologous haematopoietic stem cell transplantation (AHSCT) is an accepted treatment in refractory Crohn's disease (CD). Material and methods Data on patients with refractory CD subjected to AHSCT are collected at the Hospital Universitario Ramon y Cajal in Madrid and the results obtained are described retrospectively. Results Seven patients in total have received AHSCT due to refractory CD in our centre. Three patients (43%) presented with clinical and endoscopic remission; one patient (14%) clinical improvement without remission and three patients (43%) remained active with the need to restart treatment in the assessment of the initial response to the AHSCT (after six months). Symptoms recurred in five of the seven patients (71%) and all of them had to restart medical treatment after an average of 13.8 months (range: 3–30 months). Only one patient needed surgery after the AHSCT. At the end of the follow-up, after a mean of 48 months (range: 17–78 months), 5/7 (71%) of the patients were in clinical remission with or without treatment. Conclusion AHSCT may be a promising therapeutic option for patients with refractory CD. Its usefulness lies in the fact that it can produce clinical remission without treatment in some patients, but also that it can make the disease treatable, obtaining a response to certain treatments in patients who had previously lost it.

A systematic investigation on the cellular uptake, intracellular dissolution, and in vitro biological effects of ultra-small (

The pitting corrosion resistance of the UNS S-32760 super duplex stainless steel (SDSS) in synthetic NaOH-Na2S solution at different working temperatures of 25, 50, and 70°C has been evaluated in the current investigation to assess the alloy behaviour under the caustic environments used in the pulp and paper industry. The temperature effect on pitting (Ep) and repassivation (Erp) potentials was studied with the Cyclic Potentiodynamic Polarisation (CPP) technique according to the ASTM G61. Results demonstrated that pitting corrosion is prone to occur when increasing alloy temperature since both pitting and repassivation potentials lean towards more negative values while the repassivation zone is reduced. Furthermore, the morphology of the found pits was determined using Scanning Electron Microscopy (SEM). The pitting corrosion mechanism for the studied super duplex stainless steel under the exposed conditions was introduced. The thiosulphate ion is attributed to be responsible for the initiation of the localised corrosion.

[EN] Introduction: Mammographic density (MD), the proportion of radiologically dense breast tissue, is a strong risk factor for breast cancer. Our objective is to investigate the influence of occupations and occupational exposure to physical, chemical, and microbiological agents on MD in Spanish premenopausal women. Methods: This is a cross-sectional study based on 1362 premenopausal workers, aged 39-50, who attended a gynecological screening in a breast radiodiagnosis unit of Madrid City Council. The work history was compiled through a personal interview. Exposure to occupational agents was evaluated using the Spanish job-exposure matrix MatEmESp. MD percentage was assessed using the validated semi-automated computer tool DM-Scan. The association between occupation, occupational exposures, and MD was quantified using multiple linear regression models, adjusted for age, educational level, body mass index, parity, previous breast biopsies, family history of breast cancer, energy intake, use of oral contraceptives, smoking, and alcohol consumption. Results: Although no occupation was statistically significantly associated with MD, a borderline significant inverse association was mainly observed in orchard, greenhouse, nursery, and garden workers (beta = -6.60; 95% confidence interval (95%CI) = -14.27; 1.07) and information and communication technology technicians (beta = -7.27; 95%CI = -15.37; 0.84). On the contrary, a positive association was found among technicians in art galleries, museums, and libraries (beta = 8.47; 95%CI = -0.65; 17.60). Women occupationally exposed to fungicides, herbicides, and insecticides tended to have lower MD. The percentage of density decreased by almost 2% for every 5 years spent in occupations exposed to the mentioned agents. Conclusions: Although our findings point to a lack of association with the occupations and exposures analyzed, this study supports a deeper exploration of the role of certain occupational agents in MD, such as pesticides., This work was supported by the Carlos III Institute of Health (AESI PI15CIII/00029 and AESI PI15CIII/00013). The article presents independent research. The views expressed are those of the authors and not necessarily those of the Carlos III Institute of Health.

Le présent article vise à analyser les différentes rééditions des traductions espagnole et catalane d'un classique de la littérature canadienne-française, soit Maria Chapdelaine. À partir des préfaces conçues en tant que prises de position (au sens bourdieusien), sont analysés les différents agents derrière l'initiative de faire traduire ce roman en Espagne et en Catalogne, ainsi que le rapport de ces agents envers l'altérité canadienne-française du texte source. Est révélée la fonction idéologique des préfaces en tant que dispositifs discursifs qui permettent aux agents des champs cibles de réveiller certains débats qui vont (thématiquement et chronologiquement) bien au-delà des questions liées au texte original. This article aims to analyse the different editions of the Spanish and Catalan translations of Maria Chapdelaine, a classic of French-Canadian literature. Viewing prefaces as position-takings (in a Bourdieusien sense), I analyse the agents behind the initiation of the novel's translations in Spain and in Catalonia and how they relate to the alterity of the source text. The article brings to light the function of translation prefaces as discursive devices that allow target society agents to stir up ideological debates that go well beyond those (re)presented in the source text.

En estos últimos años ha aumentado la demanda del consumo de productos animales, lo que ha llevado a una necesidad del aumento de productividad y eficacia alimenticia en el sector. Para obtener un mayor rendimiento productivo se les suministra antibióticos a los animales y en consecuencia aparecen mecanismos de resistencia a estos antibióticos en los consumidores de productos animales. Dentro del emergente mundo de los nanomateriales, los nanomateriales base plata han surgido como una alternativa al uso de antibióticos en producción animal.El objetivo general de este trabajo es la caracterización de distintas especies de plata (Nanopartículas de plata (AgNPs) y Ag (I)) en distintas muestras de pienso para pollos sometidas a procesos de lixiviación en agua y digestión "in vitro" y además estudiar la acumulación de dichas especies de plata en diversos tipos de tejidos animales. Se ha determinado el contenido total de plata en las muestras de pienso para así, poder determinar cuánta plata es liberada al medio acuoso tras una lixiviación mediante las técnicas de Espectroscopía de Absorción Atómica con llama (EAA-llama) y Espectrometría de Masas con Plasma de Acoplamiento Inductivo (ICP-MS). Además, mediante ambas técnicas se ha determinado la concentración total de plata liberada tras un proceso de digestión “in vitro” simulado para pollos. Utilizando el acoplamiento de Cromatografía Hidrodinámica (HDC) – ICP – MS se ha podido determinar que a partir de las muestras de pienso sólo se libera Ag(I) debido a que las AgNPs (presentes en el pienso) se transforman a Ag(I) durante dicho proceso de digestión “in vitro” simulado. Finalmente se ha determinado el contenido total de Ag acumulada en distintos tipos de tejidos (hígado y músculo) de pollos sometidos a un experimento “in vivo” alimentados con las muestras pienso estudiadas.

Objetivo: Evaluar la pérdida celular endotelial en pacientes operados mediante facoemulsificación de catarata no complicada, comparando datos de cirujanos noveles y cirujanos expertos. Método: Se realizó un estudio observacional y prospectivo en el que se evaluaron 50 ojos consecutivos aleatorizados en dos grupos de 25 ojos cada uno. Se realizó a cada ojo recuento de células endoteliales mediante microscopía especular preoperatoriamente y al mes de la cirugía. Los ojos con cataratas complicadas fueron excluidos. Resultados: La mayoría de los pacientes eran mujeres, con una edad media de 75.5 años. La disminución de la densidad celular al mes de la cirugía fue significativa tanto en ojos operados por cirujanos expertos como por cirujanos noveles, con una pérdida del 14.8% y el 15.6%, respectivamente, sin diferencia estadísticamente significativa (p = 0.491). Además, la correlación entre la pérdida de ambos grupos fue de 0.58 (p = 0.0094). La pérdida celular en ojos operados por cirujanos noveles demostró una buena correlación (0.577) con la energía acumulada disipada del ultrasonido durante la facoemulsificación (p = 0.0025), frente a los expertos, en los que no pudo demostrarse esta asociación. El total de energía acumulada disipada empleada por cirujanos noveles fue significativamente mayor (p = 0.045), un 63% más que los expertos. Conclusiones: La diferencia en el recuento endotelial tras cirugía de catarata se demuestra asociada a la propia cirugía, con cifras similares para cirujanos noveles y expertos, y se observa una buena correlación entre ambos grupos. Teniendo en cuenta la pérdida de celularidad endotelial corneal, la seguridad del procedimiento realizado por cirujanos noveles es equivalente a la del realizado por expertos.

Desde inicios del siglo XX Colombia ha sufrido las consecuencias de la violencia en todas sus dimensiones, tanto sociales y económicas, como culturales y territoriales, este último hecho, ha dejado múltiples afectaciones en el tejido que conforma los procesos de comunicación entre los sujetos y los territorios, tales como el desarraigo y la desterritorialización producida por el desplazamiento forzado. Tener claras las consecuencias de este acto atroz y en contrapartida el acto del retorno, como una acción de reconciliación y recomposición de la urdimbre elemental, es poner a disposición una serie de retos que se deben enfrentar de cara a la planeación y construcción del territorio en el marco del postconflicto, para los habitantes, las comunidades académicas y las entidades territoriales. La investigación en el aula, realizada desde la asignatura de Diseño y Metodología y la proyección social del programa de Arquitectura de la Corporación Universitaria del Caribe CECAR.

The problem concerning facilities delocation in the retail sector is addressed in this paper by proposing a novel mixed 0-1 linear optimization model. For this purpose, the aim of the problem is to decide whether to close existing stores or consider an alternative type of store management policy aimed at optimizing the profit of the entire retail network. Each management policy has a different repercussion on the final profit of the stores due to the different margins obtained from the customers. Furthermore, closing stores can cause customers to leave the whole retail network according to their behavior. This behavior is brought about through their tendency to abandon this network. There are capacity constraints imposed depending on the number of stores that should stay open and cease operation costs, customer behavior and final prices. These constraints depend on the type of management policy implemented by the store. Due to the commercial requirements concerning customer behavior, a set of non-linear constraints appears in the definition of the model. Classical Fortet inequalities are used in order to linearize the constraints and, therefore, obtain a mixed 0-1 linear optimization model. As a result of the size of the network, border constraints have been imposed to obtain results in a reasonable computing time. The model implementation is done by introducing smart sets of indices to reduce the number of constraints and variables. Finally, the computational results are presented using data from a real-world case study and, additionally, a set of computational experiments using data randomly generated as shown.

Introduction: Single nucleotide polymorphisms (SNPs) in the BDNF, COMT, CBR1 and CCK genes have been associated with the process of fear extinction in humans. Since fear extinction plays a key role in recovering from psychological trauma, there is a possibility that these genes modulate the risk of developing post-traumatic stress disorder (PTSD). Objective: To assess unilocus and multilocus associations between SNPs in the BDNF, COMT, CBR1 and CCK genes and the risk of developing PTSD. Materials and methods: 129 inhabitants of the municipality of Itagüí, Colombia, who had experienced psychological trauma at least once, were genotyped for these polymorphisms (38 cases of PTSD and 91 controls). Logistic regression was used to perform unilocus and multilocus association tests for single SNPs and existing SNP-SNP genotypic combinations. Results: No unilocus associations were found, but interactions between the BDNF and CBR1 genes and between the COMT and CCK genes were observed. Of these interactions, the genotypic combinations that behaved as risk factors were AG-AA (OR=13.52, p

Objective: To identify the causes of breastfeeding abandonment and the success factors associated with relactation in mothers with children attended in a specialised health institution. Methodology: Descriptive transversal design through non-probabilistic convenience sampling, with 100 mothers and their children. A structured survey was used and central tendency measurements and frequencies were analysed. The study was approved by the Ethics committee of the School of Health Sciences at the University Pontificia Bolivariana. Results: The average age was 26.8 years; 73 % had a low socioeconomic level; 59 % were cohabitating; 46 % were housewives; 32 % had a high school degree; 57 % were first-time mothers; 74 % had a high obstetric risk; and 59 % had children by caesarean section. Causes of breastfeeding abandonment were newborn hospitalization (79 %) and low birth weight (52 %). Health professionals suggested substitutes for hypogalactia in 18 % of the mothers. Incorrect maternal posture: 66.1 and 61 % with no previous experience. Relactation success factors were: chronological age under one month (48 %); effective newborn breast sucking (89 %); good newborn breast grasping (71 %). During the non-breastfeeding period, 72 % received mixed milk, 82 % did not breastfeed between 8 and 30 days, 98 % of the mothers were willing to relactate, 91 % considered the support of their families and health professionals as good. Conclusion: Children hospitalization was the main cause of breastfeeding abandonment and the main success factors for relactation were effective breast sucking, mothers’ readiness and support. RESUMEN Objetivo: identificar las causas de abandono de la lactancia materna y los factores de éxito para la relactación en madres con hijos atendidos en una institución de salud. Metodología: descriptivo, transversal. Muestreo no probabilístico a conveniencia, con una muestra de cien madres y sus hijos. Se utilizó una encuesta estructurada y se analizaron las medidas de tendencia central y las frecuencias. El estudio fue aprobado por el comité de ética de la Escuela de Ciencias de la Salud de la Universidad Pontificia Bolivariana. Resultados: las participantes tenían una media de edad de 26,8 años; el 73 % era de estrato socioeconómico bajo; el 59 % se encontraba en unión libre; el 46 % eran amas de casa; el 32 % contaba con bachillerato completo; el 57 % eran primigestantes; el 74 % tenía un alto riesgo obstétrico; y el 59 % tuvieron a su hijo por cesárea. Causas de abandono de la lactancia: hospitalización de los neonatos (79 %) y bajo peso al nacer (52 %). El personal de salud sugirió sucedáneos por hipogalactia en el 18 % de las madres. Postura incorrecta de la madre: 66,1 y 61 %, sin experiencias previas. Factores de éxito para relactar: edad cronológica menor de un mes (48 %); el bebé succionó al ponerlo al pecho (89 %); buen agarre (71 %). Durante el periodo de no lactancia, el 72 % recibió leche mixta, el 82 % no lactó entre 8 y 30 días, el 98 % de las madres estuvieron dispuestas a relactar, el 91 % consideró bueno el apoyo de sus familias y del personal de salud. Conclusión: la hospitalización del hijo fue la principal causa de abandono de la lactancia, y los principales factores de éxito para la relactación fueron la succión efectiva, la disposición de las madres y el apoyo. RESUMO Objetivo: identificar as causas de abandono do aleitamento materno e os fatores de sucesso para a relactação em mães de filhos atendidos em uma unidade de saúde. Metodologia: descritiva e transversal. Amostragem não probabilística por conveniência, com 100 mães e seus filhos. Um questionário estruturado foi utilizado e as medidas de tendência central e as frequências foram analisadas. O estudo foi aprovado pelo comitê de ética da Escola de Ciências da Saúde da Universidad Pontificia Bolivariana, Colômbia. Resultados: as participantes tinham em média 26,8 anos de idade; 73 % eram de classe social baixa; 59 % estavam em união estável; 46 % eram donas de casa; 32 % contavam com ensino médio completo; 57 % eram primigestas; 74 % tinham alto risco obstétrico, e 59 % tiveram seu filho por cesariana. Causas de abandono do aleitamento: hospitalização dos recém-nascidos (79 %) e baixo peso ao nascer (52 %). A equipe de saúde sugeriu a hipogalactia como causa da substituição do leite materno em 18 % das mães; postura incorreta da mãe em 66,1 % e 61 % devido à falta de experiência. Fatores de sucesso para relactar: idade cronológica menor de um mês (48 %); sucção do peito por parte bebê (89 %); pega correta (71 %). Durante o período de não aleitamento materno, 72 % receberam aleitamento misto; 82 % não lactaram entre 8 e 30 dias; 98 % das mães estiveram dispostas a relactar; 91 % consideraram o apoio de suas famílias e da equipe de saúde como bom. Conclusões: o internamento do filho foi a principal causa do abandono do aleitamento materno, e os principais fatores de relactação foram a sucção efetiva, a disposição das mães e o apoio.

El artículo nace en el contexto urbano de la periferia de Bogotá, en el albergue por excelencia de los hombres y mujeres desplazados, de las víctimas de la violencia en Colombia, a quienes hemos nombrado con el término teológico pároikos (desplazados); ellos, los que son estigmatizados, invisibilizados y oprimidos culturalmente, en cuanto llegan, como extranjeros, a la Ciudad. Sus clamores se recogen en cuatro testimonios, los cuáles, en conjunto con la parábola del Buen Samaritano, se analizan desde la narrativa y con la ayuda del método hermenéutico, se propone el desarrollo de una espiritualidad urbana de la samaritaneidad con tres características que desafían la pastoral urbana en los márgenes de la Ciudad: una espiritualidad de ojos abiertos que permita no solo mirar sino también ser mirados, una espiritualidad que mantenga viva la memoria de las víctimas y una espiritualidad que promueva una posada segura para las personas desplazadas.

Besides their crucial role in cell electrogenesis and maintenance of basal membrane potential, the voltage-dependent K