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The quality of higher education has always been a complex issue in Latin America, but although there has been progress, it seems isolated and distant from other regions. Situation deepened with COVID-19, because between improvisation and reactive actions, it is questioned that it has maintained the parameters of demand, and therefore of quality. This motivated the objective of the work, to know the state of the art of quality in higher education in Latin America. The method used was the systematic review of primary studies between the years 2020-2021. The search was carried out in multiple databases: Scielo, Redalyc, Education Resouces Information Center, ScienceDirect and Google Scholar, using inclusion and exclusion criteria. Starting from 10,755 articles, a systematic filtering was carried out, resulting in the analysis of 22 scientific articles. It is obtained as a result that, the research works presented in the various groups and those independent, show a process of construction and / or configuration of the quality assurance system for the region, still in process and with great expectations towards the region. future. The conclusions reveal the interest on the subject in the region, with a series of subtopics that focus on tools, models, methodologies and indicators, evaluation, standards, accreditation and external mechanisms, among others. And although it is not a new topic, the one referring to the virtual environment is being promoted. © 2021, Universidad del Zulia. All rights reserved.

Background Complex perianal disease in patients with Crohn’s disease (CD) represents a therapeutic challenge since, despite biological treatment, half of the patients do not achieve an adequate response. Treatment with allogenic expanded adipose-derived mesenchymal stem cells (Darvadstrocel) has proven to be an innovative treatment in patients refractory to treatment with immunomodulators and anti-TNF antibodies. Methods To assess the efficacy of Darvadstrocel treatment in clinical practice in patients with CD and complex perianal fistula. Method: We performed a prospective descriptive study in patients with CD and complex perianal fistula (high intersphincteric, transsphincteric, extrasphincteric or suprasphincteric; presence or ≥ 2 external opening or abscesses), refractory to antiTNF treatment, treated consecutively with Darvadstrocel at our Crohn’s and Colitis Attention Unit. Each patient was treated with 120 million stem cells (half of the dose was injected along the tract walls and the other half around the internal opening/s). Response to treatment was assessed as combined remission according to the criteria of the ADMIRE study (clinical assessment of closure of all treated external openings that drained before treatment and absence of collections> 2 cm confirmed by MRI). Results From July 2020 to October 2021 12 patients (10M / 2H) have been treated with Darvadstrocel. All patients were in clinical remission (luminal disease) and had perianal disease refractory to anti-TNF treatment. In addition, 7/12 patients were also refractory to ustekinumab. The patients had previously been treated with a mean of 5.7 perianal surgeries (1–16), most of them curettage and seton placement or replacement. One patient had previously been treated with mesenchymal stem cells in 2014 (ADMIRE participant). All fistulas were complex, 5 with a single tract, 2 with a branched tract and 5 with a double tract; 7 were transsphincteric, 1 intersphincteric (double), 1 supraelevator, 1 suprasphincteric, and 2 extrasphincteric. 6/10 patients underwent a previous conditioning surgery (cleaning, curettage and seton placement) two weeks before cell administration. Six of the 10 patients with a follow-up of at least 6 months had combined remission (60%). Two of the three patients with a 1-year follow-up presented combined remission. Regarding safety, no relevant adverse effects have been observed: 2 patients presented abscesses in the immediate postoperative period (self-drained without subsequent recurrence). Conclusion In real-life clinical practice, treatment with Darvadstrocel can be an effective and safe therapy in patients with CD and complex perianal disease refractory to biological treatment.

Intramyocardial hemorrhage (IMH) is considered a marker of tissue damage severity in patients with reperfused ST-segment elevation myocardial infarction (STEMI) and has been associated with a poor prognosis despite successful revascularization of the culprit artery . We aim to study the impact of cardiovascular risk factors and treatment strategies on the presence of IMH studied with T2* -w cardiovascular magnetic resonance (CMR) in this clinical setting METHODS A prospective observational study including patients with repefused STEMI who underwent an MRI during the first week post-revascularization were conducted . The presence of IMH was analyzed in ECG triggered T2 * w sequences as presence of hipointensity area . Clinical data including cardiovascular risk factors and treatment strategies at cath lab were studied. RESULTS 94 patients with reperfused STEMI were included. Demographic data are shown at the the table. No significant association was observed between the presence of IMH and the different treatment strategies used. All data were introduced in a multivariate model including presence of thrombus, total ischemia time and culprit coronary artery. The analysis showed previous infarction as an independent risk factor (OR: 6 p = 0.03, CI: 1.1-29) while history of hypertension (OR: 0.9, p = 0.04, CI: 0.1- 0.9) and systolic blood pressure showed independent protective effect (OR: 0.3 p = 0.02 IC: 0.9-0.99.) CONCLUSIONS. 1. Previous infarction was shown to be an independent risk factor for IMH . 2. Arterial hypertension and systolic blood pressure showed a protective effect. Age (years) 62 ±13 Male sex 72 (77) Diabetes mellitus 32 (34) Hypertension 53 (56) Hyperlipidaemia 52 (55) Current or prior smoking 55 (58) Time to reperfusion 203 (142-300) Infarct-related artery LAD 38 (41) RCA 49 (52) Cx 7 (7) Infarct size (% LV mass) 18 ± 11 MO (% LV mass) 3.15 (1.44-5.48) Abstract P824 Figure. Intramyocardial hemorraghe T2* sequences

Our paper is based on a big size commercial building in Romania, in relation to the energy consumption monitoring, to the building energy performances and to the monitoring data analysis. It contains data which will allow us to compare an existing building with the retail industry norms in terms of the building energy consumption and energy costs. The building management system (BMS) is based on SAIA Burgess Controllers with IP interface, with input/output modules both analog and digital and remote I/O modules with S-NET interface collecting signals integrated in the entire building.

Background:ANCA can be detected in sera from patients with autoimmune, inflammatory, infectious or neoplastic diseases.Objectives:To issue a Consensus Statement on ANCA testing and interpretation beyond systemic vasculitis.Methods:This Statement was prepared by a group of experts, based on the results of a comprehensive search in PubMed.Results:In certain settings beyond systemic vasculitis, ANCA may have diagnostic, clinical, and/or prognostic relevance. Testing for PR3- and MPO-ANCA by specific immunoassays should be performed in any patient with clinical features suggesting ANCA-associated vasculitis and in patients with anti-GBM disease and idiopathic interstitial pneumonia. Routine ANCA testing is not recommended in patients with connective tissue diseases (CTD), autoimmune liver diseases, inflammatory bowel diseases, infections, and/or malignancy unless there is evidence for small vessel vasculitis. ANCA testing by specific immunoassays may be useful in patients with rheumatoid arthritis, systemic sclerosis or primary Sjögren’s syndrome who have kidney disease with a nephritic sediment or in patients with systemic lupus erythematosus if a kidney biopsy shows prominent necrotizing and crescentic lesions or proliferative lupus nephritis. ANCA testing may be justified in patients with suspected autoimmune hepatitis type 1, who do not have conventional disease-related autoantibodies, or in patients with inflammatory bowel diseases in case of diagnostic uncertainty to discriminate ulcerative colitis from Crohn’s disease. In these cases, ANCA should be tested by indirect immunofluorescence since target antigens are not well characterized. ANCA against bactericidal/permeability-increasing protein may be a biomarker for deteriorating lung function and a poor prognosis in patients with cystic fibrosis.Conclusion:ANCA testing is clinically relevant not only in patients with manifestations suggesting systemic vasculitis, but also in patients with certain other disorders, particularly in patients with anti-GBM disease or idiopathic interstitial pneumonia.Disclosure of Interests:Sergey Moiseev Grant/research support from: This work was supported by the 5-100 Project, Sechenov University, Moscow, Jan Willem Cohen Tervaert: None declared, Yoshihiro Arimura: None declared, Dimitrios Bogdanos: None declared, Csernok Elena: None declared, Jan Damoiseaux: None declared, Marc Ferrante: None declared, Luis Felipe Flores-Suárez: None declared, Marvin Fritzler: None declared, Pietro Invernizzi: None declared, David Jayne Grant/research support from: ChemoCentryx, GSK, Roche/Genentech, Sanofi-Genzyme, Consultant of: Astra-Zeneca, ChemoCentryx, GSK, InflaRx, Takeda, Insmed, Chugai, Boehringer-Ingelheim, J. Charles Jennette: None declared, Mark Little: None declared, Stephen P. McAdoo: None declared, Pavel Novikov Grant/research support from: This work was supported by the 5-100 Project, Sechenov University, Moscow, Charles D. Pusey: None declared, Antonella Radice: None declared, Alan D. Salama: None declared, Judith Savige: None declared, Mårten Segelmark: None declared, Yehuda Shoenfeld: None declared, Renato Alberto Sinico: None declared, Maria Jose Rego de Sousa: None declared, Ulrich Specks: None declared, Benjamin Terrier: None declared, Athanasios Tzioufas: None declared, Severine Vermeire: None declared, Ming-hui Zhao: None declared, Xavier Bossuyt: None declared

The prognostic impact of coronary revascularization in patients with stable angina is limited being reserved nowadays for patients with symptoms or severe ischemia in imaging tests. We propose to study the usefulness of stress CMR to assess the utility of coronary revascularization in patients with stable angina. Methods A retrospective cohort study was conducted including consecutive patients with inducible ischemia in dypiridamol stress CMR. Patients with acute coronary syndrome or severe valvular disease were excluded. The decision to revascularize after MRI was made by the responsible medical team following the guidelines of clinical practice. The presence of cardiovascular events (death, admission or need for new revascularization) was analyzed during follow-up. The stress cardiac MR imaging protocol included a baseline functional study (b-SSFP sequences) and after administration of 0.84 mg / kg IV dipyridamole, perfusion sequences (b-SSFP) obtained during the administration of IV gadolinium contrast and F-GRE viability sequences. Clinical data such as the severity of coronary involvement, the type of coronary revascularization and if it was complete as well as data derived from the baseline functional study of ventricular volumes, segmental contractility score, transmurality and extension of necrosis, extension of hypoperfusion and also number of segments with severe ischemia considering as such those segments with transmural hypoperfusion or stress-induced systolic dysfunction. Results We included 424 patients of mean age of 65+ 10 years, 182 (43%) of them had known coronary artery disease and 93 (20%) of them had pevious percutaneous revascularization. Thirty-five (8%) had left main disease and 176 (41%) multivessel disease. Twenty five patients had normal stroke volume (SV) and depressed left ventricle ejection fraction (LVEF) and 60p had normal LVEF and low SV . One hundred and seven patients of the total group were revascularized (2.5% surgically). Coronary revascularization showed a significant increase in survival only if it was complete (p Conclusions 1. SV is the most powerful predictor of events in patients with stable angina and ischemia in CRM dypiridamol stress test. 2. Patients with an SVi Abstract P359 Figure. Survival curves regarding SV

The objective of the study is to evaluate the environmental impacts generated by the industry of the panela in Ecuador, using the Life Cycle Analysis methodology. The in situ information gathered allowed the identification of the sensitive environmental factors that are affected in all the operations that are carried out in the agroindustry of panela. The results show that the craft activities prevail rather than the industrial activities, due to the low industrial development, application and control of regulations, rudimentary manufacturing practices, among others; which have led to insufficient productivity, competitiveness, quality and safety of their products. The results of the Environmental Impact Assessment, using the Eco-Indicator 99 method, according to the Life Cycle Analysis technique, show that the industrial stage has the greatest contribution to the impact, being more representative the impact to the effects by respiration of inorganic compounds, acidification / eutrophication, climate change and land use. The impact level of this type of industry according to Ecuador's environmental legislation, places it as an industry that generates moderate environmental impacts, it does not require intensive protective or corrective practices. However, it requires environmental executive actions oriented to the control and prevention to mitigate these impacts.

La presente investigación tiene como primer objetivo comprobar si existe correlación general entre la competencia gramatical y la competencia de comprensión lectora. Otro objetivo es verificar correlaciones específicas entre la comprensión lectora y distintos niveles de reflexión y análisis metalingüísticos. Para ello, se pasaron dos pruebas a un grupo de 37 estudiantes de segundo curso de la ESO.La primera–elaborada expresamente para este trabajo- medía la competencia gramatical a partir de ejercicios promovidos por el proyecto GrOC. La segunda era una prueba de comprensión lectora estandarizada. Los resultados confirmaron tanto la correlación general significativa, como varias correlaciones específicas. Estos resultados son un indicio a favor de las propuestas del GrOC, según el cual la reflexión gramatical puede contribuir a mejorar la comprensión lectora de los estudiantes.

Apoptosis is a highly regulated form of programmed cell death, essential to the development and homeostasis of multicellular organisms. Cytochrome c is a central figure in the activation of the apoptotic intrinsic pathway, thereby activating the caspase cascade through its interaction with Apaf-1. Our recent studies have revealed 14-3-3 epsilon (a direct inhibitor of Apaf-1) as a cytosolic cytochrome c target. Here we explore the cytochrome c / 14-3-3 epsilon interaction and show the ability of cytochrome c to block 14-3-3 epsilon-mediated Apaf-1 inhibition, thereby unveiling a novel function for cytochrome c as an indirect activator of caspase-9/3. We have used calorimetry, NMR spectroscopy, site mutagenesis and computational calculations to provide an insight into the structural features of the cytochrome c / 14-3-3 epsilon complex. Overall, these findings suggest an additional cytochrome c-mediated mechanism to modulate apoptosome formation, shedding light onto the rigorous apoptotic regulation network.

The training of medical specialists is a long and complex process. Its purpose is to guarantee the society that they are the right professionals to meet the health needs of the population. The first step to ensure this objective is the admission process. In psychiatry this process, monitoring resident students and the criteria for each one are different in each country. Admission in Colombia is a heterogeneous process, not standardized, which varies greatly from one university to another, even between private and public universities. At the National University of Colombia, the admissions process is handled by the Admissions Office and includes: a written test for which you must obtain a minimum score, a resume rating and an interview. The Teaching Committee and the Department of Psychiatry considered the admission procedure in general to be good, but in need of refinement. Due to the experience of some teachers and given the current rules, a "comprehensive assessment" for master and doctoral students was required and in 1996 it was decided that this method of assessment for admission to a specialization in Psychiatry would serve to complement the admission process. The article describes the experience of the process and its outcomes, strengths and weaknesses.

The effect of online trading on investors' trading behavior is analyzed based on investors' trading data provided by a major security firm in Taiwan. Findings are as follows: (1) Male and younger traders preferred online trading. Investors who had a higher gross return tended to switch to using online trading. (2) Even though investors traded more actively after going online, their trading performance was not negatively affected. (3) Online trading did not significantly increase speculative trading even though more information can be assessed online. (4) The order execution efficiency of online trading was better than that of phone-based trading.