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Vascular smooth muscle cells (VSMCs) envelop vertebrate brain arteries and play a crucial role in regulating cerebral blood flow and neurovascular coupling. The dedifferentiation of VSMCs is implicated in cerebrovascular disease and neurodegeneration. Despite its importance, the process of VSMC differentiation on brain arteries during development remains inadequately characterized. Understanding this process could aid in reprogramming and regenerating dedifferentiated VSMCs in cerebrovascular diseases. In this study, we investigated VSMC differentiation on zebrafish circle of Willis (CoW), comprising major arteries that supply blood to the vertebrate brain. We observed that arterial specification of CoW endothelial cells (ECs) occurs after their migration from cranial venous plexus to form CoW arteries. Subsequently, acta2+ VSMCs differentiate from pdgfrb+ mural cell progenitors after they were recruited to CoW arteries. The progression of VSMC differentiation exhibits a spatiotemporal pattern, advancing from anterior to posterior CoW arteries. Analysis of blood flow suggests that earlier VSMC differentiation in anterior CoW arteries correlates with higher red blood cell velocity and wall shear stress. Furthermore, pulsatile flow induces differentiation of human brain PDGFRB+ mural cells into VSMCs, and blood flow is required for VSMC differentiation on zebrafish CoW arteries. Consistently, flow-responsive transcription factor klf2a is activated in ECs of CoW arteries prior to VSMC differentiation, and klf2a knockdown delays VSMC differentiation on anterior CoW arteries. In summary, our findings highlight blood flow activation of endothelial klf2a as a mechanism regulating initial VSMC differentiation on vertebrate brain arteries.

With the widespread adoption of intranasal radiofrequency (RF) devices, our objective was to report national adverse events (AEs) associated with their use. The Food and Drug Administration's Manufacturer and User Facility Device Experience was queried. A total of 24 device-related AEs were reported, 11 (45.8%) for Celon® (Olympus), 3 (12.5%) for Vivaer® (Aerin), 2 (8.3%) for Neuromark® (Neurent), and 8 (33.3%) for Rhinaer® (Aerin). Seven (63.6%) of the Celon®-related complications were related to tissue necrosis (largely user error-related), but 1 (9.1%) episode of pediatric ocular palsy was also reported. Vivaer® complications included synechiae formation, a mucosal perforation, and a case of empty nose syndrome. Of the posterior nasal nerve ablating devices, 9 of 10 AEs were epistaxes, of which 7 (77.8%) required operative intervention. Surgeons should exercise vigilance and tissue-appropriate device settings when utilizing RF devices. Epistaxis and tissue necrosis may occur, as well as more rare, but devastating, complications.

The Philippines had several COVID-19 infection waves brought about by different strains and variants of SARS-CoV-2. This study aimed to describe COVID-19 outcomes by infection waves using machine learning. A cross-sectional surveillance data review design was employed using the DOH COVID Data Drop dataset as of September 24, 2022. The predominant variant(s) of concern divided the dataset into time intervals representing the infection waves: ancestral (A0), Alpha/Beta (AB), Delta (D), and Omicron (O). Descriptive statistics and machine learning models were generated from each infection. The final data set consisted of 3,896,206 cases wherein 98.39% of cases recovered while 1.61% died. The highest and lowest CFR was observed during the ancestral wave (2.49) and the Omicron wave (0.61%), respectively. In all four data sets, higher age groups had higher CFRs, and F-score and specificity were highest using naïve Bayes. Area under the curve (AUC) was highest in the naïve Bayes models for the A0, AB and D models, while sensitivity was highest in the decision tree models for the A0, AB and O models. The ancestral, Alpha/Beta and Delta variants seem to have similar transmission and mortality profiles, while the Omicron variant caused lesser deaths despite increased transmissibility.

Bone repair via endochondral ossification is a complex process for the critical size reparation of bone defects. Tissue engineering strategies are being developed as alternative treatments to autografts or allografts. Most approaches to bone regeneration involve the use of calcium composites. However, exploring calcium-free alternatives in endochondral bone repair has emerged as a promising way to contribute to bone healing. By analyzing researches from the last ten years, this review identifies the potential benefits of such alternatives compared to traditional calcium-based approaches. Understanding the impact of calcium-free alternatives on endochondral bone repair can have profound implications for orthopedic and regenerative medicine. This review evaluates the efficacy of calcium-free alternatives in endochondral bone repair through in vivo trials. The findings may guide future research to develop innovative strategies to improve endochondral bone repair without relying on calcium. Exploring alternative approaches may lead to the discovery of novel therapies that improve bone healing outcomes.

ObjectiveNasal airway obstruction (NAO) is caused by various disorders including nasal valve collapse (NVC). A bipolar radiofrequency (RF) device (VivAer®, Aerin Medical, Sunnyvale, CA) has been used to treat NAO through RF heat generation to the upper lateral cartilage (ULC). The purpose of this study is to measure temperature elevations in nasal tissue, using infrared (IR) radiometry to map the spatial and temporal evolution of temperature.Study designExperimental and computational.MethodsComposite porcine nasal septum was harvested and sectioned (1 mm and 2 mm). The device was used to heat the cartilage in composite porcine septum. An IR camera (FLIR® ExaminIR, Teledyne, Wilsonville, OR) was used to image temperature on the back surface of the specimen. These data were incorporated into a heat transfer finite element model that also calculated tissue damage using Arrhenius rate process.ResultsIR temperature imaging showed peak back surface temperatures of 49.57°C and 42.21°C in 1 and 2 mm thick septums respectively. Temperature maps were generated demonstrating the temporal and spatial evolution of temperature. A finite element model generated temperature profiles with respect to time and depth. Rate process models using Arrhenius coefficients showed 30% chondrocyte death at 1 mm depth after 18 s of RF treatment.ConclusionThe use of this device creates a thermal profile that may result in thermal injury to cartilage. Computational modeling suggests chondrocyte death extending as deep as 1.4 mm below the treatment surface. Further studies should be performed to improve dosimetry and optimize the heating process to reduce potential injury. Laryngoscope, 2023.

Este artículo de investigación indaga por indicadores que permitan identificar formas de regular el aprendizaje en el aula, y examina la relación entre estas formas y la disposición del estudiante frente a la heterorregulación ejercida por el profesor. Participaron en el estudio 189 estudiantes universitarios colombianos, quienes respondieron un cuestionario compuesto por cuatro escalas: autorregulación, arregulación, desregulación y disposición a la heterorregulación. El análisis muestra un patrón de correlaciones en donde, en una dirección, se encuentra la escala de autorregulación, y en otra, las escalas de arregulación y desregulación. Un resultado muy sugerente es la ausencia de relación entre la autorregulación y la disposición a la heterorregulación.

The dynamics of oil markets are influenced by both international and local contexts, which determine their potential for success and sustainability. This article uses a conceptual methodology to analyze the characteristics that are present in successful energy markets. These characteristics can help identify inhibitors and barriers that may hinder the growth and development of the market. The analytical-propositive methodological design consists of three phases: firstly, a diagnosis is conducted to describe the costs associated with oil production, which will allow for the identification of economic characteristics. Secondly, attributes of the Colombian oil market are identified through a documentary and regulatory analysis. Finally, strategic guidelines are inferred, which can be used as inputs for the formulation of energy policies. The results highlight that sustainable development policies must involve both public and private actors to strengthen decision-making and the quality of processes, thereby providing greater scope.

This Investigation aims to analyze scientific production and thematic trends in the field of leadership in institutions of higher education. This is a documentary type review which seeks to shows how a bibliometric analysis of the Web of Science database is conducted. Information processing was carried out using the Biblioshiny and VOSviewer tools. The criterias for the searches and analysis were: The evolution in publications by areas of knowledge, countries, affiliations, authors and their collaborations, relevant journals and articles, as well as topics, with emphasis on the areas of education and management. The results suggest a considerable increase, 120% between 2017 and 2018, with an impact on related areas such as psychology and sustainability. Production is concentrated in the United States and England, however, when it comes to authors, attention needs to be paid to groups from the United Kingdom, China and Norway. In terms of themes, competencies, soft skills and well-being stand out. It is concluded that scientific production on leadership in higher education is expanding, which represents a research niche with development possibilities, whose interests in recent times have leaned towards practices necessary to guarantee success when exercising leadership.

Abstract Background Peru is facing a double burden of malnutrition (DBM), characterized by the co-existence of undernutrition and overnutrition. Double-duty actions that concurrently target common drivers of undernutrition and overnutrition, while ensuring no unintended side effects, are recommended to effectively address the DBM. To understand these complex common mechanisms and design context-specific double-duty actions, there is a need for participatory systems approaches. This paper provides a case study of applying a community-based system dynamics approach to capture stakeholder perspectives of food system drivers of the DBM in two regions in Peru. Methods We implemented a multi-stage community-based system dynamics approach, which included processes for research capacity building for systems approaches, and the designing, piloting, and implementation of stakeholder workshops. A total of 36 stakeholders, representing diverse perspectives, participated in five group model building workshops. Stakeholder views are presented in a causal loop diagram that showcases the feedback mechanisms between key food system drivers of overweight and stunting in Peru. Results The causal loop diagram highlights that prioritization of undernutrition over overnutrition in the policymaking process, due to Peru’s historically high levels of undernutrition, may undermine action against the DBM. It also describes potential mechanisms of unintended impacts of undernutrition policies on the DBM in Peru, including impacts related to within-family distribution and quality of food provided through food assistance programs, and unintended impacts due to regional dynamics. Conclusions This paper highlights the importance of a participatory approach to understand local needs and priorities when recommending double-duty actions in Peru and shares practical methodological guidance on applying participatory systems approaches in public health.

BACKGROUND AND PURPOSE: There is active research involving the radiographic appearance of the skull base following reconstruction. The purpose of this study was to describe the radiographic appearance of the vascularized pedicle nasoseptal flap after endoscopic skull base surgery across time. MATERIALS AND METHODS: We performed chart and imaging review of all patients with intraoperative nasoseptal flap placement during endoscopic skull base surgery at a tertiary academic skull base surgery program between July 2018 and March 2021. All patients underwent immediate and delayed (>3 months) postoperative MR imaging. Primary outcome variables included flap and pedicle enhancement, flap thickness, and flap adherence to the skull base. RESULTS: Sixty-eight patients were included. Flap (P = .003) enhancement significantly increased with time. Mean nasoseptal flap thickness on immediate and delayed postoperative scans was 3.8 and 3.9 mm, respectively (P = .181). The nasoseptal flap adhered entirely to the skull base in 37 (54.4%) and 67 (98.5%) patients on immediate and delayed imaging, respectively (P

This study aims to adapt and validate the Classroom Motivational Climate Questionnaire and Attribution of Motivational Changes to the Teacher Questionnaire, for their administration in Higher Education and thus having adequate instruments to assess motivational climate and student preferences in this educational level. Data from 624 university students were analyzed through a Confirmatory Factor Analysis based on the original models proposed for each questionnaire. Then, a cross-validation analysis was performed for each questionnaire between two random sub-samples. Subsequently, a Path Analysis was conducted on both instruments to measure predictive validity on performance. A multigroup analysis was also conducted with two categories of students: those in their initial studies (basic) and those in practice-oriented studies (in-depth). The results confirm the factor structure for both questionnaires with configurations slightly different from those found in previous studies with high school samples. The Classroom Motivational Climate Questionnaire was found to influence performance and to identify differences in student's motivational profile depending to the year of their study.

Vascular smooth muscle cells (VSMCs) envelop vertebrate brain arteries and play a crucial role in regulating cerebral blood flow and neurovascular coupling. The dedifferentiation of VSMCs is implicated in cerebrovascular disease and neurodegeneration. Despite its importance, the process of VSMC differentiation on brain arteries during development remains inadequately characterized. Understanding this process could aid in reprogramming and regenerating dedifferentiated VSMCs in cerebrovascular diseases. In this study, we investigated VSMC differentiation on zebrafish circle of Willis (CoW), comprising major arteries that supply blood to the vertebrate brain. We observed that arterial specification of CoW endothelial cells (ECs) occurs after their migration from cranial venous plexus to form CoW arteries. Subsequently, acta2+ VSMCs differentiate from pdgfrb+ mural cell progenitors after they were recruited to CoW arteries. The progression of VSMC differentiation exhibits a spatiotemporal pattern, advancing from anterior to posterior CoW arteries. Analysis of blood flow suggests that earlier VSMC differentiation in anterior CoW arteries correlates with higher red blood cell velocity and wall shear stress. Furthermore, pulsatile flow induces differentiation of human brain PDGFRB+ mural cells into VSMCs, and blood flow is required for VSMC differentiation on zebrafish CoW arteries. Consistently, flow-responsive transcription factor klf2a is activated in ECs of CoW arteries prior to VSMC differentiation, and klf2a knockdown delays VSMC differentiation on anterior CoW arteries. In summary, our findings highlight blood flow activation of endothelial klf2a as a mechanism regulating initial VSMC differentiation on vertebrate brain arteries.

Abstract Objective Cartilaginous tumors of the larynx are rare, representing less than 1% of all laryngeal tumors. Chondromas are benign mesenchymal tumors characterized by a slow‐paced growth, primarily originated in the cricoid cartilage, followed by the thyroid, arytenoid, and epiglottic cartilages. This scoping review aims to understand the extent of evidence on the epidemiology, clinical characteristics, morbidity, and recurrence of the laryngeal chondroma (LC). Data sources MEDLINE (Ovid), Embase (Elsevier), Web of Science (Clarivate), Cochrane Central Register of Controlled Trials and Systematic Reviews, Lilacs, Scopus, and Google Scholar databases. Review methods The scoping review was conducted from 1816 to 2023, for observational studies describing LC. Titles and abstracts were screened for relevance, followed by an evaluation of the full text for eligibility. The data were collected from the qualifying articles, and a narrative summary of the outcomes was prepared. Results One hundred and nineteen studies met the inclusion criteria. Ninety‐four case reports, 22 case series, and 3 cohorts. Two hundred and four participants with a diagnosis of LC were described. Male:female ratio was 2.8:1. The most common localization was the cricoid (113; 47.08%), followed by the thyroid (45; 18.75%), and the arytenoid cartilage (27; 11.25%). Dyspnea (78.85%) and hoarseness (74.28%) were the most reported symptoms. The recurrence rate was 11.25%, and complications were uncommon following the resection. Conclusion This scoping review found a low‐frequency rate over all the cartilaginous laryngeal tumors. Most patients were treated with resection, with a low rate of malignancy conversion. This population has low attributable mortality, morbidity, and recurrence according to the current literature.

Dermal substitutes bear a high clinical demand because of their ability to promote the healing process of cutaneous wounds by reducing the healing time the appearance and improving the functionality of the repaired tissue. Despite the increasing development of dermal substitutes, most of them are only composed of biological or biosynthetic matrices. This demonstrates the need for new developments focused on using scaffolds with cells (tissue construct) that promote the production of factors for biological signaling, wound coverage, and general support of the tissue repair process. Here, we fabricate by electrospinning two scaffolds: poly(ε-caprolactone) (PCL) as a control and poly(ε-caprolactone)/collagen type I (PCol) in a ratio lower collagen than previously reported, 19:1, respectively. Then, characterize their physicochemical and mechanical properties. As we bear in mind the creation of a biologically functional construct, we characterize and assess in vitro the implications of seeding human Wharton's jelly mesenchymal stromal cells (hWJ-MSCs) on both scaffolds. Finally, to determine the potential functionality of the constructs in vivo, their efficiency was evaluated in a porcine biomodel. Our findings demonstrated that collagen incorporation in the scaffolds produces fibers with similar diameters to those in the human native extracellular matrix, increases wettability, and enhances the presence of nitrogen on the scaffold surface, improving cell adhesion and proliferation. These synthetic scaffolds improved the secretion of factors by hWJ-MSCs involved in skin repair processes such as b-FGF and Angiopoietin I and induced its differentiation towards epithelial lineage, as shown by the increased expression of Involucrin and JUP. In vivo experiments confirmed that lesions treated with the PCol/hWJ-MSCs constructs might reproduce a morphological organization that seems relatively equivalent to normal skin. These results suggest that the PCol/hWJ-MSCs construct is a promising alternative for skin lesions repair in the clinic.

We studied yeast hand carriage of 260 healthcare students. We isolated yeasts in 27 students (10.4%), without differences between medicine, nursing, and medical laboratory science programs and gender. A significant lower prevalence of carriage was shown in the clinical cycle (2.7%) compared to the basic cycle (13.5%) (p = 0.022) and the preclinical cycle (13.5%) (p = 0.014). Increased handwashing frequency and the use of alcohol gel and antiseptic soap decreased yeast carriage. Students who applied moisturizing hand cream two or more times a day had a lower frequency of yeast carriage (3.4%) than those who did not use it or used it once a day (16.5%), showing a significant difference (p = 0.016). The most prevalent species was C. parapsilosis sensu stricto (81.5%), followed by Meyerozyma guilliermondii (C. guillermondii) (7.4%), Trichosporon mucoides (7.4%), and R. mucilagenosa (3.7%). One case showed mixed carriage of C. parapsilosis and C. albicans. All strains were sensitive to voriconazole, caspofungin, and anidulafungin. This study shows hand carriage of yeast in health students, mainly by C. parapsilosis, and the frequency of infection control measures and moisturizing hand cream is associated with colonization control.

The childhood national policy in Colombia recognizes the importance of quality in early childhood education (ECE). In this context, the government of the district of Bogota (2012-2016) proposed the program "Quality preschool in the Public Educational System" to expand the coverage of early education and provide comprehensive care to children aged 3-5 years within the public educational system. This article explores the ways in which the policy program is implemented in schools. Employing an ethnographic approach, this study focuses on the experiences of teachers from five schools that have faced the challenges of integrating the two new grades of early childhood education in formal school settings. By analyzing the educational strategies designed and implemented by teachers in their daily routines and the meaning they assign to these strategies, this study provides evidence that teachers do not simply reproduce the institutionalized discourses; instead, teachers negotiate, resist, adapt, and recreate experiences in relation to school times, spaces, activities, and materials by developing strategies more responsive to children's needs. The concept of agency is central to understand how teachers end up generating practices that lead to new forms of individual and social transformation.

This study has a two-fold objective: First, to adapt and validate the Emotions and Motivation Self-Regulation Questionnaire (EMSR-Q) with university students in Colombia, and secondly, to verify whether the relationship model between emotional and motivational self-regulation and academic performance coincides with what was initially proposed by the questionnaire's authors. A total of 644 higher education students participated in the study. To test the questionnaire's structural validity and generalizability across cultures and educational levels, confirmatory factor and cross validation analyses were carried out. Besides, to test its predictive validity, a multiple linear regression analysis was carried out. Results showed that the data fit the model well, that the scales of the questionnaire have adequate reliability, and that negative self-regulation of stress and avoidance-oriented self-regulation related negatively and significantly to academic performance. The results support the emotion and motivation self-regulation model proposed by the authors.

Abstract Background Skin tissue engineering is a rapidly evolving field of research that effectively combines stem cells and biological scaffolds to replace damaged tissues. Human Wharton’s jelly mesenchymal stromal cells (hWJ-MSCs) are essential to generate tissue constructs, due to their potent immunomodulatory effects and release of paracrine factors for tissue repair. Here, we investigated whether hWJ-MSC grown on human acellular dermal matrix (hADM) scaffolds and exposed to a proinflammatory environment maintain their ability to produce in vitro growth factors involved in skin injury repair and promote in vivo wound healing. Methods We developed a novel method involving physicochemical and enzymatic treatment of cadaveric human skin to obtain hADM scaffold. Subsequently, skin bioengineered constructs were generated by seeding hWJ-MSCs on the hADM scaffold (construct 1) and coating it with human platelet lysate clot (hPL) (construct 2). Either construct 1 or 2 were then incubated with proinflammatory cytokines (IL-1α, IL-1β, IL-6, TNF-α) for 12, 24, 48, 72 and 96 h. Supernatants from treated and untreated constructs and hWJ-MSCs on tissue culture plate (TCP) were collected, and concentration of the following growth factors, bFGF, EGF, HGF, PDGF, VEGF and Angiopoietin-I, was determined by immunoassay. We also asked whether hWJ-MSCs in the construct 1 have potential toward epithelial differentiation after being cultured in an epithelial induction stimulus using an air–liquid system. Immunostaining was used to analyze the synthesis of epithelial markers such as filaggrin, involucrin, plakoglobin and the mesenchymal marker vimentin. Finally, we evaluated the in vivo potential of hADM and construct 1 in a porcine full-thickness excisional wound model. Results We obtained and characterized the hADM and confirmed the viability of hWJ-MSCs on the scaffold. In both constructs without proinflammatory treatment, we reported high bFGF production. In contrast, the levels of other growth factors were similar to the control (hWJ-MSC/TCP) with or without proinflammatory treatment. Except for PDGF in the stimulated group. These results indicated that the hADM scaffold maintained or enhanced the production of these bioactive molecules by hWJ-MSCs. On the other hand, increased expression of filaggrin, involucrin, and plakoglobin and decreased expression of vimentin were observed in constructs cultured in an air–liquid system. In vivo experiments demonstrated the potential of both hADM and hADM/hWJ-MSCs constructs to repair skin wounds with the formation of stratified epithelium, basement membrane and dermal papillae, improving the appearance of the repaired tissue. Conclusions hADM is viable to fabricate a tissue construct with hWJ-MSCs able to promote the in vitro synthesis of growth factors and differentiation of these cells toward epithelial lineage, as well as, promote in a full-thickness skin injury the new tissue formation. These results indicate that hADM 3D architecture and its natural composition improved or maintained the cell function supporting the potential therapeutic use of this matrix or the construct for wound repair and providing an effective tissue engineering strategy for skin repair.

Maria Teresa Cacua Sanchez,1 Lina M Vargas Abello,2 Álvaro Orrego,3 Paola Ortiz,4 Héctor Segura,5 Jhon Jairo Berrio Caicedo,6 Luz Marina Zuluaga,7 José Ordoñez,8 José Ignacio Fernández Montequin,9 Jorge Ulloa10 1Ambulatory Surgery Center, Kennedy Hospital, Vascular Laboratory SURA, Bogotá, Colombia; 2Lumina Vein & Aesthetic Institute, Windermere, FL, USA; 3Laser & Veins Clinic, Viña del Mar, Chile; 4Uruguay Vein Center, Universidad de la República Oriental de Uruguay, Montevideo, Uruguay; 5Vascular and Endovascular Surgery Department, Hospital Español, Mexico City, Mexico; 6Universidad Del Valle, San José de Buga Hospital Foundation, Buga, Colombia; 7San Juan de Dios Hospital, Cartago Valle, Colombia; 8Department of Vascular Surgery, Fundación Santa Fe, Bogotá, Colombia; 9National Institute of Angiology and Vascular Surgery, Havana, Cuba; 10Department of Vascular Surgery, Fundación Santa Fe de Bogotá, Universidad de los Andes, Bogota, ColombiaCorrespondence: Maria Teresa Cacua Sanchez, Email mcacua@gmail.comAbstract: Venous Ulcers (VU) represent 60– 80% of all leg ulcers and are the final stage of the disease secondary to venous hypertension or valve insufficiency. Conventional treatment that focuses on its etiological factors continues to be the gold standard; however, 30% of ulcers do not heal with this treatment; thus, it has been seen that the use of growth factor can be used as an adjuvant for this pathology. A literature review was carried out to evaluate the evidence from systematic reviews, meta-analyses, case studies, and quantitative studies that respond to the objective of this analysis review in the different databases with specific inclusion criteria with publications between 2002 and 2022, initially finding the topical application of the factor and later, more recently, the intralesional and perilesional application, the latter being an alternative treatment for this type of pathology and generating some recommendations for using the Factor.Keywords: chronic venous fibroblast dysfunctions, recombinant human epidermal growth factor, rhEGF, intralesional, perilesional, fibroblast dysfunctions

Abstract Although the number of empirical studies on prison inmates in Latin America has increased in recent years, an aspect that still remains little studied is the situation of prison workers. This article analyzes the labor situation of prison officers in Latin America, and considers their working conditions, quality of life and the problems that affect them, in a region marked by precarious, overcrowded and violent prison systems. To do so, a systematic review of articles published in Spanish or Portuguese on the Scielo platform between 2000-2021 was carried out. Our main findings show that prison officers suffer from significant levels of stress and work overload; and carry out their work in poor conditions; with long working hours; performing an invisible and socially undervalued job; with important risks of negative consequences for their physical and mental health. Finally, some implications of the findings and some lines of intervention are discussed.

La pandemia Covid-19 supuso un fuerte impulso al teletrabajo y la formación virtual. El alumnado y el personal empleado tuvieron que desarrollar nuevas competencias para adaptarse al formato on-line. Ante esta situación, si bien han proliferado los estudios sobre los efectos de la pandemia tanto en el ámbito laboral como en el educativo, es poca la literatura acerca de su impacto en las prácticas curriculares. El presente estudio aborda el análisis, desde la perspectiva empresarial, de las competencias requeridas para la realización de teleprácticas eficaces. Se elaboró una encuesta exploratoria para conocer la opinión de las empresas que habían acogido estudiantes en prácticas on-line acerca de su intención de mantener esta modalidad en el futuro y de las competencias que más valoraban en su desempeño. A partir de esta, se ha realizado un análisis descriptivo de los resultados obtenidos, seguido de una prueba de proporciones Chi-Cuadrado. A continuación, se ha desarrollado un análisis factorial exploratorio y ejecutado un análisis de componentes principales (PCA). El objetivo era detectar relaciones de interdependencia entre las distintas competencias y, así, sintetizar la información mediante la creación de factores que las agrupan. Asimismo, se ha realizado un análisis cualitativo del contenido de la pregunta abierta sobre otras competencias requeridas. Los resultados del estudio introducen la singularidad competencial de las teleprácticas y permiten vislumbrar la necesidad de seguir investigando para crear un modelo eficaz que mejore la empleabilidad de los futuros egresados.

Desde hace algunos años se ha venido estudiando la calidad de vida vinculada a diferentes perspectivas, circunstancias, contextos y poblaciones, todo con el propósito de entender cómo este constructo influye en los diversos ámbitos en que se ve inmerso; uno de estos contextos, por ejemplo, es el rendimiento académico. El objetivo de esta investigación es determinar la relación entre la calidad de vida global, la calidad de vida relacionada a la salud y sus dimensiones con el rendimiento académico en jóvenes estudiantes. Se realizó un estudio cuantitativo, de alcance descriptivo-correlacional, con un corte transversal, en una población de estudiantes residentes del departamento de Caldas, Colombia. Para medir la calidad de vida, se utilizó la escala WHOQOL-BREF. Para la evaluación del rendimiento académico se pidió a los participantes que indicaran el promedio total acumulado del semestre o período anterior. Toda la información fue trasladada al software SPSS 25. Se realizaron pruebas de normalidad, tendencia central y dispersión, así como la prueba de correlación de Spearman. Se identificaron dos relaciones positivas y estadísticamente significativas en los dominios ambiental y psicosocial; la única relación negativa fue la del dominio social. Los jóvenes mostraron puntajes adecuados en la autopercepción de calidad de vida en general y relacionada con la salud. El rendimiento académico fue de 3,6 ± 0,49. En conclusión, no existe una correlación significativa entre la calidad de vida, la calidad de vida relacionada con la salud y el rendimiento académico. Por otra parte, se pudo identificar que existe una relación positiva y significativa entre el dominio ambiental y psicosocial y el rendimiento académico, lo que podría sugerir que una mayor satisfacción de las condiciones del entorno y una adecuada salud psicológica podrían favorecer el desempeño académico.

Background: Omphalocele is the result of the abnormal interaction between biological/molecular mechanisms and a genetic predisposition during the first twelve weeks of development, where the return of the intestinal loops to the abdominal cavity is disturbed. Muscle relaxation with botulinum toxin A (TxBtA) has been used as an adjuvant postnatal therapy for the repair of complex abdominal wall defects. Case presentation: A female fetus was diagnosed with a giant omphalocele at 14 weeks of gestation. At 34 weeks and 5 days of gestation, 35 units of TxBtA (diluted at 100 units per 10 ml) were injected under ultrasound guidance into each muscle of the left and right sides of the abdominal wall with a 25G spinal needle. The fetus tolerated the procedure well. Two weeks after the injection, the first ultrasound examination was done and revealed a noteworthy change in the shape of the abdominal circumference, with a 50 % decrease in the omphalocele size. The newborn was delivered at 38 weeks and 3 days of gestation. The omphalocele had a maximum diameter of 7 cm. The patient required mechanical ventilation for 24 hours. The reconstruction of the anterior abdominal wall was completed on the fifth day of life using a component separation technique. Feedings were initiated one day after the closure and the patient was discharged home on the 12th day of life. The patient has not experienced any complications at 2 months of follow up. Conclusion: Our case suggests that prenatal muscle relaxation of the abdominal wall with TxBtA could reduce the need for mechanical ventilation, the time on parenteral nutrition, and the overall hospital stay in newborns with giant omphalocele.

Background: Congenital diaphragmatic hernia (CDH) is a pathology found in neonates, though it can affect individuals of various ages. The definitive treatment for this condition is surgical, either through an open or minimally invasive approach. Hernial defects not allowing primary closure must be corrected with a mesh. There is no specific mesh for this pathology. We describe the use of a self-extendable mesh based on a market-available mesh for the closure of a CDH that facilitates its placement and suture to the diaphragm using a minimally invasive technique. Methods: We conducted a retrospective longitudinal study from January 2019 to January 2023. The study included patients under the age of 18 with a confirmed diagnosis of CDH who underwent minimally invasive surgery with the placement of a self-extendable mesh. A minimum follow-up period of six months was established. Descriptive statistics were applied to analyze various variables, including age at diagnosis, associated pathologies, hernia classification, surgical time, and postoperative parameters, such as complications, respiratory and gastrointestinal symptoms, recurrence, and thoracic alterations. Results: We included five patients with CDH. Two patients were diagnosed in the neonatal period, two between 28 days of life and one year, and one after the first year of life. All patients had posterolateral hernias; three were left-sided, and two were right-sided. Four had a type C defect, and one had a type B defect. All patients were treated by minimally invasive surgery, through thoracoscopy, with a surgical time between 89 and 120 min. There were no intraoperative complications or conversions to open surgery. Short and medium-term follow-up was performed in the remaining patients, the shortest follow-up period being 19 months and the longest reaching 36 months. No recurrence of the defect or thoracic or vertebral deformities were reported. Conclusions: The modified self-extendable mesh is a device that offers a safe and effective way of correcting CDH, facilitating the placement and suture process to the native tissue while reducing the risk of injury to the abdominal viscera. Although we cannot definitively conclude that the surgical time decreases based on our limited number of cases, the mesh shows promise as a valuable tool in treating CDH. Further research and a larger sample are necessary to determine the effects on surgical time.

Background: Surgical pathologies of the esophagus in the pediatric age are not unusual. However, when they appear, they are not complications-free. These include anastomotic dehiscence or pleural fistulas. Classically they are treated clinically, and this treatment is associated with complications such as mediastinitis, pleural effusion, sepsis, and death. We propose treating esophageal dehiscence using a negative pressure system placed endoscopically. This minimally invasive procedure can be used as definitive treatment or bridging therapy for surgical correction. Methods: This is a retrospective longitudinal multicenter study from January 2018 to January 2022 in five medical centers, three located in Colombia and two in Mexico. The patients had esophageal dehiscence or pleural fistula diagnosed by contrast leakage in postoperative esophagogram or endoscopy and treated with an endoscopic negative pressure system, with a 30-day follow-up after the diagnosis. We analyze the time of placement, pressure and E-VAC (Endoscopic- Vacuum Assisted Closure) replacements, as well as the efficacy and inherent complications. Results: We present nine patients diagnosed with esophageal dehiscence or pleural fistula treated with endoscopic VAC. The oldest was 14-years old and the youngest was 2-day-old. Six patients were diagnosed with esophageal atresia, either type III or type I. The other three patients had gastric volvulus, short esophagus, and embryonic esophageal remnants. The most frequent initial surgical procedures were the correction of esophageal atresia and esophageal-jejunal anastomosis. The esophageal dehiscence or pleural fistula was diagnosed by esophagogram with hydrosoluble contrast. Four patients had E-VAC as initial therapy; the remaining five used it after expectant management failed. Fistula closure took an average of 13 days, with fewer than three VAC changes required. Two of the nine patients presented with subsequent anastomotic stenosis, which was treated with endoscopic dilation using a balloon dilation. Conclusions: Using the E-VAC system in esophageal and pleural fistulas is effective in all our patients. It also shortens hospitalization and treatment time when performed as the first management line. We recommend using E-VAC at a pressure of 50 - 125 mmHg and preferably of the continuous type. System changes are indicated when there are suction problems, system clogging, or E-VAC migration when relocation is impossible. The other methods described do not use the transparent dressing, so it must be completely changed at each control. Level evidence: IV

Background: Esophageal atresia (EA) is the most common congenital anomaly affecting the esophagus, and recurrent tracheoesophageal fistula (rTEF) is one of its most serious complications, usually occurring after primary surgical closure in 3–14 % of patients. Endoscopic management involving the topical application of 50 % trichloroacetic acid (TCA) and clipping systems has favorable results and a low incidence of complications. However, it has been reported that multiple applications are necessary to achieve adequate closure. Methods: This therapeutic study describes a preliminary 5-step double endoscopic approach involving topical application of 50 % TCA and clips such as the OTS/OVESCO System. Results: The rTEF was completely closed in three patients (n = 3); in 2/3 of patients, the OTS/OVESCO system was used. Postoperative esophagogram confirmed the obliteration of the defect, and no patient presented with complications during the 3-year follow-up, with complete resolution of respiratory symptoms. Conclusions: This preliminary study suggests that the 5-step dual endoscopic approach for closure of the rTEF is effective for both symptom resolution and complete closure of the tracheoesophageal communication.

Using data from the largest survey of LGBTQ people in Colombia to date, this article examines the prevalence of suicidal ideation, planning, and attempts of LGBTQ adults in the country. It also assesses the association between exposure to conversion therapy and suicide. It appeared in LGBT Health in July 2021.

Abstract The childhood national policy in Colombia recognizes the importance of quality in early childhood education (ECE). In this context, the government of the district of Bogota (2012–2016) proposed the program “Quality preschool in the Public Educational System” to expand the coverage of early education and provide comprehensive care to children aged 3–5 years within the public educational system. This article explores the ways in which the policy program is implemented in schools. Employing an ethnographic approach, this study focuses on the experiences of teachers from five schools that have faced the challenges of integrating the two new grades of early childhood education in formal school settings. By analyzing the educational strategies designed and implemented by teachers in their daily routines and the meaning they assign to these strategies, this study provides evidence that teachers do not simply reproduce the institutionalized discourses; instead, teachers negotiate, resist, adapt, and recreate experiences in relation to school times, spaces, activities, and materials by developing strategies more responsive to children’s needs. The concept of agency is central to understand how teachers end up generating practices that lead to new forms of individual and social transformation.

Federated ML (FL) provides an alternative to train accurate and generalizable ML models, by only sharing numerical model updates. Here, the authors present the largest FL study to-date to generate an automatic tumor boundary detector for glioblastoma.