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Purpose: To describe the clinical findings in an 11-year-old male with a history of hemifacial microsomia presenting with ocular ischemic syndrome secondary to large cerebral aneurysms. Observations: An 11-year-old male with a history of hemifacial microsomia presented to the Bascom Palmer Eye Institute Emergency Department complaining of nausea, diarrhea, headache, and decreased vision in the left eye. Visual acuity was light perception in the left eye and intraocular pressure was within normal limits. Gonioscopy revealed the presence of diffuse neovascularization of the angle. Posterior segment examination revealed mild vitreous hemorrhage, optic disc pallor, preretinal hemorrhage, generalized arteriolar narrowing, retinal microaneurysms, and abnormal arteriovenous communications with branching retinal vessels. Fluorescein angiography demonstrated patchy and delayed choroidal filling, a prolonged venous filling time, arteriolar attenuation, and vascular staining consistent with ocular ischemic syndrome. Magnetic resonance angiography was obtained which revealed large left internal carotid and anterior cerebral artery aneurysms. The patient underwent successful cerebral revascularization via bypass, ligation, clipping, and coiling procedures. At postoperative year 1, there was no evidence of ocular neovascularization and visual acuity remained light perception. Conclusion and Importance: Ocular ischemic syndrome is uncommon in children but may occur with any cause of ocular hypoperfusion. Hemifacial microsomia is a rare congenital disorder of craniofacial development caused by a vascular event in utero affecting the first and second branchial arches. This case demonstrates a rare cause of ocular ischemic syndrome and illustrates the potential for the development of clinically significant vascular abnormalities in patients with disorders of craniofacial development.

The treatment of arteritic anterior ischemic optic neuropathy (AAION), non-arteritic ischemic optic neuropathy (NAAION), and posterior ischemic optic neuropathy (PION) is a topic of ongoing research with mixed evidence on some pharmacotherapies and a need for more consensus. This manuscript provides an overview of these conditions’ current, potential future, and attempted pharmacotherapies. AAION’s current treatment regimen consists of high-dose steroids, with methotrexate, tocilizumab, and abatacept, being the most viable steroid-sparing therapy candidates. As for NAAION, the treatments being tried are vast, with mixed evidence supporting each modality. Similarly, despite the various treatment options explored, there still needs to be a universally effective therapy for PION. More research is needed to formulate an agreed-upon treatment regimen for these conditions.

Vaccination against infectious disease affords direct protection from vaccine-induced immunity and additional indirect protection for unvaccinated persons. A systematic review was conducted to estimate the indirect effect of COVID-19 vaccination. From PubMed and Embase, 31 studies were included describing the impact of original wild-type COVID-19 vaccines on disease transmission or viral load. Overall, study results showed the effectiveness of COVID-19 vaccination against SARS-CoV-2 transmission (range 16–95%), regardless of vaccine type or number of doses. The effect was apparent, but less pronounced against omicron (range 24–95% for pre-omicron variants versus 16–31% for omicron). Results from viral load studies were supportive, showing SARS-CoV-2 infections in vaccinated individuals had higher Ct values, suggesting lower viral load, compared to infections among the unvaccinated. Based on these findings, well-timed vaccination programs may help reduce SARS-CoV-2 transmission—even in the omicron era. Whether better-matched vaccines can improve effectiveness against transmission in the omicron era needs further study.

Introduction SARS-CoV-2 has impacted globally the care of chronic diseases. However, direct evidence from certain vulnerable communities, such as Indigenous communities in Latin America, is missing. We use observational data from a health district that primarily serves people of Maya K’iche’ ethnicity to examine the care of type 2 diabetes in Guatemala during the pandemic.Methods We used a parallel convergent mixed methods design. Quantitative data (n=142 individuals with diabetes) included glycated haemoglobin (HbA1c), blood pressure, body mass index and questionnaires on diabetes knowledge, self-care and diabetes distress. Quantitative data was collected at two points, at baseline and after COVID restrictions were lifted. For quantitative outcomes, we constructed multilevel mixed effects models with multiple imputation for missing data. Qualitative data included interviews with providers, supervisors and individuals living with diabetes (n=20). We conducted thematic framework analysis using an inductive approach.Results Quantitative data was collected between June 2019 and February 2021, with a median of 487 days between data collection points. HbA1c worsened +0.54% (95% CI, 0.14 to 0.94) and knowledge about diabetes decreased −3.54 points (95% CI, −4.56 to –2.51). Qualitatively, the most important impact of the pandemic was interruption of the regular timing of home visits and peer group meetings which were the standard of care.Conclusions The deterioration of diabetes care was primarily attributed to the loss of regular contact with healthcare workers. The results emphasize the vulnerability of rural and Indigenous populations in Latin America to the suspension of chronic disease care.

Introducción: El hallux valgus es el trastorno más común del primer dedo del pie. Provoca dolor, discapacidad funcional y altera los patrones de la marcha. Las deformidades leves o moderadas se han corregido con osteotomías distales del primer metatarsiano, como la osteotomía en chevron, un procedimiento seguro, pero no exento de complicaciones. Los objetivos de este estudio fueron determinar la incidencia de seudoartrosis por dicha osteotomía y comunicar nuestro método terapéutico, el seguimiento y la evolución. Materiales y Métodos: Se realizó un estudio multicéntrico, retrospectivo que incluyó a pacientes operados entre 2009 y 2018. Se evaluaron 1156 osteotomías en chevron como tratamiento del hallux valgus leve o moderado en 1017 pacientes (rango etario 16-83 años; promedio 57.5) realizadas por 4 cirujanos experimentados. El criterio de inclusión fue que el paciente contara con estudios por imágenes compatibles con seudoartrosis a los 6 meses de la cirugía. Resultados: Se evaluó a 5 pacientes con diagnóstico de seudoartrosis después de una osteotomía en chevron para tratar el hallux valgus. Los puntajes promedio de la AOFAS fueron 51 antes del tratamiento del hallux valgus y 87,8 después del tratamiento de la seudoartrosis. Conclusiones: La incidencia de seudoartrosis fue del 0,4% en el posoperatorio alejado. Nuestro abordaje y el tratamiento de la seudoartrosis lograron una excelente mejoría clínica y funcional en todos los pacientes operados.

Abstract Purpose There is currently no information on how caregivers for women diagnosed with cervical cancer in Guatemala, particularly daughters, are affected by their supportive role. This study’s objective was to describe the support role of caregivers in the country, with a focus on daughters with a mother diagnosed with cervical cancer. Methods This analysis utilizes data from a cross-sectional study which aimed to understand pathways to cervical cancer care. Women seeking cervical cancer treatment at the Instituto de Cancerologia (INCAN) in Guatemala City, Guatemala and their companions were surveyed. Descriptive statistics were calculated. Results One hundred forty-five women seeking treatment and 71 companions participated in the study. Patient's daughters were most frequently reported as the person who provided the most support (51%) and as the most reported to have encouraged the patient to seek care. Furthermore, daughters were noted as the person most reported to fulfill the major household and livelihood roles of the patient while they were seeking or receiving treatment (38.0%). Most daughters reported that they were missing housework (77%), childcare (63%), and income-earning activities (60%) to attend the appointment with their mothers. Conclusion Our study suggests that in Guatemala cervical cancer patient's daughters have a significant support role in their mother’s cancer diagnosis. Furthermore, we found that while caring for their mothers, daughters in Guatemala are often unable to participate in their primary labor activities. This highlights the additional burden that cervical cancer has on women in Latin America.

Introducción: los meniscos juegan un papel crucial para la correcta biomecánica y función adecuada de la rodilla. Las lesiones, según sean traumáticas o degenerativas, tienen orígenes, algoritmos diagnósticos y tratamientos distintos. En el pasado, la meniscectomía era el tratamiento de elección; a medida que se fue comprendiendo la importancia de estas estructuras anatómicas estos fueron migrando hacia opciones de preservación, intentando resguardar la mayor cantidad de tejido meniscal, fomentar su reparación y así disminuir el riesgo de osteoartritis de manera temprana. El objetivo de este trabajo es mostrar los resultados de las reparaciones meniscales efectuadas entre 2012 y 2018, y complementar con una revisión de las técnicas quirúrgicas que hemos realizado en el trascurso de estos años, y las causas de fallas en nuestra serie de pacientes. Materiales y métodos: evaluamos doscientas treinta y cuatro reparaciones meniscales realizadas entre el 2012 y el 2018. El promedio de edad fue de veintiocho años. Un 72% se asoció a lesión y reconstrucción del ligamento cruzado anterior. Incluimos las reparaciones meniscales aisladas, como también asociadas a plástica de LCA, de ambos sexos, con técnicas dentro-fuera, fuera-dentro, todo-adentro y la asociación de estas técnicas. Por otra parte, excluimos pacientes con datos incompletos en la historia clínica, revisiones de suturas realizadas por otro equipo quirúrgico y por falta de seguimiento. La evaluación se basó en el examen físico, la escala visual análoga (EVA) para el dolor y la funcionalidad mediante los scores de IKDC, Lysholm y Tegner. Resultados: la reparación meniscal artroscópica estuvo asociada a la reconstrucción ligamentaria del LCA en un 72% (169 casos) y en un 28% (65 casos) la sutura meniscal como único procedimiento. Se repararon ciento setenta y un meniscos internos y sesenta y tres externos. Con respecto a la técnica utilizada, la distribución fue la siguiente: 151 fueron fuera-dentro; 31, todo-adentro y 52, híbrida (mixta). El promedio de puntos de sutura fue de 3.11 (rango 2 – 10). El seguimiento promedio fue de sesenta meses (rango 48 – 72). El score de Lysholm postoperatorio fue de 94 (rango 87 – 96), el IKDC postoperatorio de 88 (rango 84 – 92) y la escala EVA fue de 1/10. Se registraron veintitrés fallas de reparación meniscal (9.8% del total), trece asociadas a plástica de ligamento cruzado anterior (LCA) (56% de las fallas y el promedio de edad de esta población fue el mismo que el de la serie general, veintiocho años). Las fallas fueron consideradas con los criterios de Barret y se confirmaron en el intraoperatorio con visualización artroscópica. Conclusión: comprendiendo la biomecánica articular y la importancia de las estructuras meniscales en la prevención de lesiones degenerativas de la rodilla, debemos intentar la reparación meniscal en todos los casos que sean posibles. En nuestra serie utilizamos técnicas reproducibles con bajo índice de complicaciones, con un índice de falla del 9.8%. Es por eso que pregonamos la importancia de “salvar el menisco”.

This work aims to contextualize and analyze the potential contribution of pecan to SDG2 under the dual perspective of carbon storage and human nutrition. Particularly, the study focuses on the pecan agroecosystems in the Americas, representing the most important pecan-producing countries (the United States, Mexico, Brazil, Argentina, Uruguay, and Peru). We observed that pecan is a reliable sink for storing atmospheric C and also for quality nuts with high nutritional density. The Americas, hold a population of ca. 23 M pecan trees, with the younger tree populations and the highest C-storing potential in South America. This pecan tree population has removed 51.3 Mt CO2eq immobilizing the OC in their aboveground biomass, but if the C sequestration for the whole system is considered, the value reaches nearly 80 Mt CO2eq. From a nutritional perspective, there are different dietary needs to cover according to the country, although the common analysis output is a low proportion of nuts in the diet, which is expected to improve, given the efforts of each country to promote domestic consumption. All the mentioned countries in this study have a low pecan consumption going from 8 to 293 g per capita yr-1, which in the light of the Global Burden of Disease represents 0.08 to 3.2% of the recommended yearly dietary basis for nuts overall. The inclusion of pecan nuts in the daily diet is of utmost importance to offset the food nutrient dilution carbohydrates-based, linked to the excess of atmospheric CO2. Also, pecan orchards function as a platform to integrate sustainable systems. The global benefit of having pecan and alley crops has been proved in regions other than the Americas with interesting economic outputs leading to energizing the life of rural communities. Pecan orchards and pecan agroforestry may lead to sustainable agri-food systems, with global gains in SOC and nutritional richness and diversity. Therefore, more in-depth studies are needed not only to fully understand the functioning of the systems at a productive level but also to design and plan sustainable landscapes in rural land.

Introducción: La progresión de la enfermedad renal crónica podría estar asociada directa o indirectamente al sobrepeso y la obesidad; sin embargo, hasta el momento no hay evidencias suficientes para constatar esta relación. Objetivo: Determinar si el sobrepeso y obesidad son factores que contribuyen a una progresión más acelerada de la enfermedad renal crónica en una muestra de pacientes del Centro Médico Naval. Material y Método: A través de un estudio cuantitativo y observacional, de tipo comparativo, longitudinal y retrospectivo, se determinaron los cambios en el normopeso, sobrepeso y obesidad en 44 pacientes. La progresión de la enfermedad renal crónica se determinó con base en la tasa de filtración glomerular y niveles de albuminuria que presentaron estos pacientes. Los datos se recabaron con un instrumento de registro de diseño propio, durante un seguimiento de 3 años que se llevó a cabo de enero de 2019 a diciembre de 2021. Resultados: Los resultados muestran una tendencia al aumento en la progresión de la enfermedad renal crónica. Conclusiones: A pesar de que se encontró una tendencia al aumento, no se pudo probar una asociación estadísticamente significativa entre la obesidad y el sobrepeso con la progresión de esta enfermedad.

El schwannoma es el tumor benigno de nervio periférico más frecuente, siendo excepcional su presencia en los nervios de miembros inferiores, donde representan el 1% de todos los schwannomas. Presentamos el caso de una mujer de 31 años que consulta por dolor en cara anterior de rodilla derecha, donde se palpa una masa blanda, dolorosa, de 1cm aproximadamente y dolor en interlinea externa con signo de Mc Murray positivo. La RMN evidenció una estructura ovoidea de señal quística, superficial al retináculo medial en su tercio proximal, de 10 X 8 X 8 mm. y lesión del menisco externo en su tercio medio. Se realizó tratamiento artroscópico de la lesión meniscal externa y por vía abierta la exéresis marginal quirúrgica del tumor de partes blandas, con diagnóstico histopatológico de Schwannoma. Los schwannomas de nervio periférico, aunque sea una entidad poco frecuente, deben considerarse en el diagnóstico diferencial de las masas dolorosas de la rodilla, siendo su tratamiento la exéresis quirúrgica.

El tumor glómico es una neoplasia benigna poco común que surge del aparato glómico de la piel. Ocurre con mayor frecuencia en los dedos de manos y pies y representa el 1.6% de todos los tumores de tejidos blandos. El diagnóstico clínico puede resultar difícil si el tumor aparece en una ubicación extradigital. Presentamos un caso de tumor glómico de tipo vascular (glomangioma) de localización atípica, suprapatelar externa y de presentación inusual ya que no evidenciaba cambios de color en la superficie, indicando su componente vascular.

Background: Nearly 50% of Guatemalans are Indigenous Maya, yet few studies have examined the prevalence of modifiable cardiovascular disease (CVD) risk factors in Indigenous Maya populations. Therefore, we sought to estimate the prevalence of modifiable CVD risk factors in two Indigenous Maya areas in Guatemala. Methods: We conducted, between June 2018 and October 2019, a population-representative survey of adults aged 18 years and older in two rural Indigenous Maya municipalities in Guatemala. Our primary outcomes were five modifiable CVD risk factors: diabetes, hypertension, obesity, smoking, and alcohol use. We estimated the crude and age-standardized prevalence of each outcome. We also constructed multivariable logistic regression models to assess prevalence over covariates including age, sex, education level, ethnicity, and poverty. Sampling weights adjusted for nonresponse, and appropriate survey commands were used in all analyses. Results: The crude prevalence of diabetes was 12.5% (95% confidence Interval [CI] 9.6% to 16.1%), hypertension 20.3% (95% CI 17.1% to 23.9%), obesity 23.7% (95% CI 19.4% to 28.6%), smoking 10.7% (95% CI 7.8% to 14.5%), and high alcohol use 0.9% (95% CI 0.5% to 1.6%). Age-standardized prevalence of each outcome was similar to the crude prevalence. The prevalence of multiple CVD risk factors increased between the age groups 18–29 years and 50–59 years before decreasing among older age groups. Men had twenty-fold higher smoking prevalence than women (20.5% vs. 1.2%, respectively) and women had nearly double the age-adjusted prevalence of obesity as men (30.1% vs. 17.0%, respectively). Conclusion: There is a substantial prevalence of modifiable CVD risk factors in rural, Indigenous populations in Guatemala, in particular hypertension, diabetes, obesity (among women), and smoking (among men). These findings can help catalyze policy and clinical investments to improve the prevention, management, and control of CVD risk factors in these historically marginalized communities.

Introducción: el objetivo del siguiente trabajo es mostrar los resultados clínicos de una serie de pacientes mayores de cuarenta años, tratados con reparación meniscal, evaluar detalles de las técnicas utilizadas, índice y causa de fallas y vuelta al deporte. Materiales y métodos: analizamos retrospectivamente pacientes intervenidos quirúrgicamente por nuestro equipo entre enero de 2012 y enero de 2018, a los que se les realizó reparación de lesión meniscal, asociada o no a lesión de LCA. Se excluyeron los pacientes menores de cuarenta años, aquellos con cirugías previas y seguimiento menor a cuatro años. Resultados: evaluamos cuarenta pacientes con edad promedio de cuarenta y ocho años (rango 40–61). El seguimiento promedio fue de sesenta y seis meses (rango 48–84). El promedio de suturas utilizadas fue 3 (rango 1 a 8 puntos). Cinco pacientes presentaron fallas (12.5%): cuatro asociadas a plástica de LCA y la restante por una reparación aislada. Los scores de Lysholm, IKDC y Tegner mostraron mejoría en el postoperatorio. Conclusión: según la evidencia disponible hasta la fecha, y los muy buenos resultados obtenidos en este estudio con un índice de falla del 12.5%, la edad, como factor independiente, no debe ser tomada como una contraindicación para la reparación meniscal. La reparación meniscal en pacientes mayores de cuarenta años tiene índices de fallas comparables a las reparaciones realizadas en pacientes jóvenes después de cuatro años de seguimiento.

A chromate of copper and cobalt (Φy) was synthesized and characterized. Φy activated peroxymonosulfate (PMS) to degrade ciprofloxacin (CIP) in water. The Φy/PMS combination showed a high degrading capability toward CIP (~100% elimination in 15 min). However, Φy leached cobalt (1.6 mg L−1), limiting its use for water treatment. To avoid leaching, Φy was calcinated, forming a mixed metal oxide (MMO). In the combination of MMO/PMS, no metals leached, the CIP adsorption was low (4•− dominated, leading to a synergistic effect on pollutant elimination (>95% after 15 min of treatment). MMO/PMS promoted the opening and oxidation of the piperazyl ring, plus the hydroxylation of the quinolone moiety on CIP, which potentially decreased the biological activity. After three reuse cycles, the MMO still presented with a high activation of PMS toward CIP degradation (90% in 15 min of action). Additionally, the CIP degradation by the MMO/PMS system in simulated hospital wastewater was close to that obtained in distilled water. This work provides relevant information on the stability of Co-, Cu-, and Cr-based materials under interaction with PMS and the strategies to obtain a proper catalyst to degrade CIP.

La ruptura del ligamento cruzado anterior (LCA) es una lesión frecuente en la población general, con una incidencia de hasta 75/100.000 personas por año. Hombres y mujeres jóvenes, involucrados en deportes de contacto y colisión, suelen ser los más afectados. La reconstrucción artroscópica se ha convertido en el estándar de tratamiento, con cerca de doscientos mil procedimientos por año en EE. UU. Los injertos se clasifican según sus elementos constituyentes (hueso-tendón-hueso, hueso-tendón o tendón), o el origen del dador (autoinjerto o aloinjerto). A pesar de su alta prevalencia, el injerto ideal sigue siendo motivo de debate en la bibliografía. Consideramos que su elección debe basarse en la experiencia del cirujano con los diferentes injertos y en las características individuales de cada paciente.

Abstract Background Population-representative household survey methods require up-to-date sampling frames and sample designs that minimize time and cost of fieldwork especially in low- and middle-income countries. Traditional methods such as multi-stage cluster sampling, random-walk, or spatial sampling can be cumbersome, costly or inaccurate, leading to well-known biases. However, a new tool, Epicentre’s Geo-Sampler program, allows simple random sampling of structures, which can eliminate some of these biases. We describe the study design process, experiences and lessons learned using Geo-Sampler for selection of a population representative sample for a kidney disease survey in two sites in Guatemala. Results We successfully used Epicentre’s Geo-sampler tool to sample 650 structures in two semi-urban Guatemalan communities. Overall, 82% of sampled structures were residential and could be approached for recruitment. Sample selection could be conducted by one person after 30 min of training. The process from sample selection to creating field maps took approximately 40 h. Conclusion In combination with our design protocols, the Epicentre Geo-Sampler tool provided a feasible, rapid and lower-cost alternative to select a representative population sample for a prevalence survey in our semi-urban Guatemalan setting. The tool may work less well in settings with heavy arboreal cover or densely populated urban settings with multiple living units per structure. Similarly, while the method is an efficient step forward for including non-traditional living arrangements (people residing permanently or temporarily in businesses, religious institutions or other structures), it does not account for some of the most marginalized and vulnerable people in a population–the unhoused, street dwellers or people living in vehicles.

Purpose: Meeting “others,” especially so-called “local” students, is usually seen as a sign of success for intercultural learning and integration in research on study abroad and internationalization of higher education. Previous studies have focused on how international students themselves describe their (mis-)encounters. In this article, the authors consider lecturers’ voices about this phenomenon. Lecturers have an influence on the students’ experiences since they spend a lot of time together in and outside class. Design/Approach/Methods: Using a thematic analysis and social network analysis of interview data with lecturers, and a critical perspective toward the dichotomy of “local” versus “international” students, a university in Finland, a popular destination thanks to its positive image in global education, serves as a case study. Findings: The article identifies privileges, limits, and (missed) opportunities of encounters, as shared by the lecturers in focus group discussions. Furthermore, the lecturers created hierarchies in the way they described the encounters between different kinds of students. Some signs of pluralizing both local and international students were also found in some lecturers’ discourses. Originality/Value: The article ends with recommendations for institutions regarding the lecturers’ problematic role of gatekeepers in student encounters and the limiting categories used in institutions of higher education to refer to students.

On October 14–15, 2019, the 1st Symposium to Promote Chronic Kidney Disease (CKD) Research in Guatemala was held in Guatemala City, Guatemala. The Symposium hosted more than 50 attendees, including health care professionals, policy makers, researchers, and leaders of nongovernmental organizations. The meeting’s objectives were to (1) share clinical and health delivery experiences, (2) disseminate local research, and (3) establish consensus priorities for future research. In this report, we review the state of CKD nephrology in Guatemala, summarize experiences shared during the meeting from representatives of the clinical settings in Guatemala where CKD care is provided, and describe consensus priorities for future research.

Abstract Background Cervical cancer is a leading cause of death in low- and middle-income countries. Self-collection testing for human papillomavirus (HPV) is an alternative form of cervical cancer screening that can be completed privately and at home. Understanding how the use of HPV testing influences follow-up care in low-resourced settings is crucial before broad implementation. This study aimed to identify if access to self-collection HPV testing impacts participation in established cervical cancer screening programs among women in two rural communities in Guatemala. Methods A cohort of 956 women was recruited in 2016 and followed for 2 years for the HPV Multiethnic Study (HPV MES). At baseline, women answered a questionnaire assessing cervical cancer screening history and were offered self-collection HPV testing. Women were re-contacted yearly to determine receipt of additional screening. Statistical changes in screening behavior before and throughout study participation, stratified by self-collection status, were assessed using McNemar pair tests for proportions. Alluvial plots were constructed to depict changes in individual screening behavior. The odds of changes in Pap-compliance (screened in past 3 years), given collection status, were assessed using multivariate logistic regressions. Results Reported screening rates increased 2 years after enrollment compared to rates reported for the 3 years before study entry among women who collected a sample (19.1% increase, p

Abstract Background Chronic kidney disease (CKD) is increasing worldwide, and the majority of the CKD burden is in low- and middle-income countries (LMICs). However, there is wide variability in global access to kidney care therapies such as dialysis and kidney transplantation. The challenges health professionals experience while providing kidney care in LMICs have not been well described. The goal of this study is to elicit health professionals’ perceptions of providing kidney care in a resource-constrained environment, strategies for dealing with resource limitations, and suggestions for improving kidney care in Guatemala. Methods Semi-structured interviews were performed with 21 health professionals recruited through convenience sampling at the largest public nephrology center in Guatemala. Health professionals included administrators, physicians, nurses, technicians, nutritionists, psychologists, laboratory personnel, and social workers. Interviews were recorded and transcribed in Spanish. Qualitative data from interviews were analyzed in NVivo using an inductive approach, allowing dominant themes to emerge from interview transcriptions. Results Health professionals most frequently described challenges in providing high-quality care due to resource limitations. Reducing the frequency of hemodialysis, encouraging patients to opt for peritoneal dialysis rather than hemodialysis, and allocating resources based on clinical acuity were common strategies for reconciling high demand and limited resources. Providers experienced significant emotional challenges related to high patient volume and difficult decisions on resource allocation, leading to burnout and moral distress. To improve care, respondents suggested increased budgets for equipment and personnel, investments in preventative services, and decentralization of services. Conclusions Health professionals at the largest public nephrology center in Guatemala described multiple strategies to meet the rising demand for renal replacement therapy. Due to systems-level limitations, health professionals faced difficult choices on the stewardship of resources that are linked to sentiments of burnout and moral distress. This study offers important lessons in Guatemala and other countries seeking to build capacity to scale-up kidney care.

During a survey of helminth parasites of the brown ground snake, Atractus major Boulenger, 1894 (Serpentes: Dipsadidae) from Moyobamba, region of San Martin (northeastern Peru), a new species of Glossidiella Travassos, 1927 (Plagiorchiida: Plagiorchiidae) was found and is described herein based on morphological and ultrastructural data. The digeneans found in the lung were measured and drawings were made with a drawing tube. The ultrastructure was studied using scanning electron microscope. Glossidiella peruensis sp. nov. is easily distinguished from the type- and only species of the genus, Glossidiella ornata Travassos, 1927, by having an oblong cirrus sac (claviform in G. ornata), distinctly ovate testes (rounded testes in G. ornata) and button-like papillae on the dorsal edge of the oral sucker region (absent in G. ornata). In addition, G. peruensis sp. nov. differs from G. ornata by possessing a longer distance between testes and substantially wider oral and ventral suckers. This is the first time that a species of digenean is described and reported parasitizing snakes in Peru.

A series of novel 1-N-α-d-glucopyranosyl-1H-1,2,3-triazole xanthines was synthesized from azido sugars (glucose, galactose, and lactose) and propargyl xanthines (theophylline and theobromine) using a typical copper (I)-catalyzed azide–alkyne 1,3-dipolar cycloaddition. The corrosion inhibition activities of these new carbohydrate-xanthine compounds were evaluated by studying the corrosion of API 5 L X70 steel in a 1 M HCl medium. The results showed that, at 10 ppm, a 90% inhibition efficiency was reached by electrochemical impedance spectroscopy. The inhibitory efficiency of these molecules is explained by means of quantum chemical calculations of the protonated species with the solvent effect, which seems to better represent the actual situation of the experimental conditions. Some quantum chemical parameters were analyzed to characterize the inhibition performance of the tested molecules.

Liver flukes Fasciola hepatica, Opisthorchis viverrini and Clonorchis sinensis are causing agents of liver and hepatobiliary diseases. A remarkable difference between such worms is the fact that O. viverrini and C. sinensis are carcinogenic organisms whereas F. hepatica is not carcinogenic. The release of secretory factors by carcinogenic flukes seems to contribute to cancer development however if some of these target the host cell nuclei is unknown. We investigated the existence of O. viverrini and C. sinensis secretory proteins that target the nucleus of host cells and compared these with the corresponding proteins predicted in F. hepatica. Here we applied an algorithm composed by in silico approaches that screened and analyzed the potential genes predicted from genomes of liver flukes. We found 31 and 22 secretory proteins that target the nucleus of host cells in O. viverrini and C. sinensis, respectively, and that have no homologs in F. hepatica. These polypeptides have enriched the transcription initiation process and nucleic acid binding in O. viverrini and C. sinensis, respectively. In addition, other 11 secretory proteins of O. viverrini and C. sinensis, that target the nucleus of host cells, had F. hepatica homologs, have enriched RNA processing function. In conclusion, O. viverrini and C. sinensis have 31 and 22 genes, respectively, that may be involved in their carcinogenic action through a direct targeting on the host cell nuclei.

Nuevos complejos de titanio de fórmula general Ti(OAr)4•HOR con diferente grupo sustractor (Cl,CN, NO2), se sintetizaron por el método intercambio alcohol-fenol y se caracterizaron por resonancia magnética nuclear (1H NMR) que dio evidencia de la formación de estructuras diméricas con centros de Ti coordinado octaédricamente; y por análisis termogravimétrico (TGA) que registró pérdida de volátiles y permitió ajustar el peso molecular experimental de cada pre-catalizador. Mediante el análisis químico por absorción atómica se determinó el porcentaje elemental de aluminio en el co-catalizador de composición trietilaluminio. Los complejos de Ti en presencia de trietilaluminio se evaluaron en la reacción de dimerización de etileno a 50 °C, presión atmosférica y con flujo de etileno igual a 100 mL/min donde se observó en todos los catalizadores actividad hacia la producción de 1-buteno.

El pensamiento “decolonial” se encuentra ligado al pensamiento crítico de cuño marxista que se elaboró en el norte epistémico sensible a la colonialidad eurocéntrica y patriarcal. Pero cuando hacemos su genealogía explorando las raíces del pensamiento africano en Europa, de los feminismos comunitarios y del pensamiento de los pueblos originarios de América Latina, vemos otras fuentes epistémicas que es preciso recuperar con el término “descolonial” En este contexto, este artículo plantea los ejes para una “teología descolonial”, aún en construcción, surgida de la experiencia de las resistencias múltiples de víctimas sistémicas que realizan prácticas de subversión del mundo hegemónico. Los ámbitos son tan diversos como la búsqueda de personas desaparecidas, el desmantelamiento del patriarcado heteronormativo por parte de las mujeres y sus organizaciones llamadas “colectivas” para señalar así su carácter anti-patriarcal, junto con Lesbianas, Gays, Transexuales, Bisexuales, Intersexuales, Queer y otras identidades, así como personas y colectivos sometidos a movilidad forzada y pueblos originarios que defienden sus territorios y sus saberes ancestrales. Todas esas resistencias comparten un horizonte común que busca explorar la interioridad posible como sobrevivientes, según modos alternativos de vivir sus espiritualidades diversas, más allá del modelo sacrificial de religión. Tales experiencias de “espiritualidades descoloniales” – con la teología que de ahí surge – son la expresión narrativa y epistémica de un nuevo modo de vivir la temporalidad mesiánica y kairológica que caracterizó la tradición hebrea y cristiana en su crítica a los ídolos que suplantan la gloria divina y en su capacidad para potenciar las resistencias de los olvidados de la tierra de todos los tiempos en su dimensión escatológica como promesa cumplida.

Evidence is accumulating that cognitive function, and visual impairment may be related. In this pilot study, we investigated whether multifractal dimension and lacunarity analyses performed in sectoral regions of the retina may reveal changes in patients with cognitive impairment (CI) that may be masked in the study considering the whole retinal branching pattern. Prospective age-matched subjects (n = 69) with and with no CI and without the presence of any ophthalmic history were recruited (age > 55+ years). The Montreal Cognitive Assessment (MoCA) was used to measure CI, and full-field electroretinogram (ERG) was performed. Also, visual performance exams were conducted using the Rabin cone contrast test (CCT). Quantification of the retinal structure was performed in retinal fundus images [45o field of view (FOV), optic disk centered] with excellent quality for all individuals [19 healthy controls (HC) and 20 patients with CI] after evaluating the inclusion and exclusion criteria in all study participants recruited (n = 69). The skeletonized vasculature network that comprised the whole branching pattern observable in the full 45° FOV was obtained for each image and divided into nine equal regions (superotemporal, superior, superonasal, macular, optic disk, nasal, inferotemporal, inferior, and inferonasal). The multifractal behavior was analyzed by calculating the generalized dimension Dq (Do, D1, and D2), the lacunarity parameter (Λ), and singularity spectrum f(α) in the nine sectoral skeletonized images as well as in the skeletons that comprised the whole branching pattern observable in the full 45° FOV. The analyses were performed using the ImageJ program together with the FracLac plug-in. Independent sample t-tests or Mann Whitney U test and Pearson correlation coefficient were used to find associations between all parameters in both groups. The effect size (Cohen’s d) of the difference between both groups was also assessed. A p-value < 0.05 was considered statistically significant. Significant correlations between multifractal and Λ parameters with the MoCA and implicit time ERG-parameter were observed in the regional analysis. In contrast, no trend was found when considering the whole retinal branching pattern. Analysis of combined structural-functional parameters in sectoral regions of the retina, instead of individual retinal biomarkers, may provide a useful clinical marker of CI.

Purpose: We report two cases of Wyburn-Mason syndrome that illustrate the spectrum of peripheral retinal ischemia seen in this condition. Observations: A 12-year-old female presented with a retinal arteriovenous malformation and sclerotic vessels associated with retinal ischemia on fluorescein angiography, as well as an ipsilateral ophthalmic arteriovenous malformation on magnetic resonance imaging. An 11-year-old male presented with retinal vascular engorgement and tortuosity along with a central retinal vein occlusion and secondary neovascularization. Conclusions and Importance: Retinal ischemia in Wyburn-Mason syndrome is heterogeneous and may be progressive, with secondary complications that result in neovascularization. Furthermore, it is necessary to recognize that this is a systemic condition that requires neurological evaluation.

Natural disasters are unavoidable and can cause serious damage to bridges, which may lead to catastrophic losses, both human and economic. Therefore, the assessment of bridges exposed to these events is of paramount importance to identify possible mitigation needs. The objective of the present work is to present consistent tools that may allow us to obtain the failure probability of a masonry arch bridge under a flood event, leading to local scour. Surrogate models were implemented to ease the computational cost of the probabilistic analysis. Moreover, a stochastic parametric analysis based on the geotechnical properties of the soil components of masonry arch bridges located in Portugal was performed. The results show the failure mechanism of the masonry arch bridges when subjected to scour-induced settlements and the influence of soil density on the failure probability obtained for different flow discharge values and angles of attack. The presented methodology and derived fragility curves can be used to assess bridge performance under a flood event, thus providing useful information for bridge management and monitoring.

Purpose: Cervical cancer rates in Latin America are higher than those in developed countries, likely because of the lower prevalence of screening. Specifically, less than 40% of women in Guatemala are regularly screened and even fewer women are screened in indigenous communities. Current screening strategies—Pap smears and visual inspection with acetic acid—might not be the most effective methods for controlling cancer in these settings. We thus investigated the potential of self-collection of cervical samples with testing for human papillomavirus (HPV) to help prevent cervical cancer in an indigenous community in Guatemala. Patients and Methods: A community representative random sample of 202 indigenous women age 18 to 60 years residing in Santiago Atitlan, Guatemala, were surveyed to assess knowledge of and risk factors for HPV and cervical cancer. Women were then invited to self-collect a cervical sample using HerSwab collection kits to assess the prevalence of HPV and the acceptability of self-sampling. Results: Of 202 women who completed the survey, 178 (89%) provided a self-sample. In all, 79% of these women found the test comfortable, 91% found the test easy to use, and 100% reported they were willing to perform the test periodically as a screening method. Thirty-one samples (17%) were positive for at least one of 13 high-risk HPV types, and eight (4.5%) were positive for HPV 16/18. Conclusion: HPV testing by using self-collected samples was well accepted, suggesting that it is a plausible modality for cervical cancer screening in indigenous communities. Further studies are needed to assess rates of follow-up after a positive test and to determine whether these findings extend to other indigenous and nonindigenous communities in Guatemala and Latin America.

The objective of the study was to determine the volume, weight, measures, ovarian location and shape of the corpus luteum of pregnant and non - pregnant cows from zebu cows of the Colombian tropics. 528 reproductive tracts were collected; 264 pregnant and 264 non-pregnant of cows benefited at the local slaughterhouse in Monteria, Córdoba, Colombia. The period of collection of the samples was extended for three months. After collection of each reproductive tract, the ovaries were separated, identified as right and left, weighed and measured. Then the drawing of the location of the corpus luteum was performed on the ovary according to the anatomical planes previously established in the corresponding form. Subsequently the corpus luteum was removed to perform their measurements, weighings and visualization of their shape. There were statistical differences between the locations of the corpus luteum in the ovary: Anterior pole, posterior pole, free edge, upper face and lower face (p≤0.05). The weight and volume of gestational corpus luteum was greater by 30 and 27.9% than the corpus luteum of non-pregnant cows. The predominant form por shape of the corpus luteum in both pregnant and non-pregnant cows was oval, then pyramidal and finally rounded. No gestation was observed contralateral to the location of the corpus luteum.

Se aplica un procedimiento de inversión de falla finita para obtener un modelo de deslizamiento del sismo Mw 7.3 de Papanoa, México, del 18 de abril 2014 utilizando ondas de cuerpo telesísmicas de banda ancha. La inversión de ondas P y SH en desplazamiento identifica un modelo de ruptura caracterizado por dos fuentes principales de deslizamiento en la costa noroeste de Guerrero donde también ocurrieron varios sismos de M > 7 en 1943, 1979 y 1985. Una comparación del modelo de deslizamiento de 2014 con las rupturas observadas para los sismos de 1979 y 1985 sugiere que las zonas de alto deslizamiento no coinciden espacialmente, a pesar de la similitud en el tamaño y la ubicación de las áreas de réplicas de los tres eventos. Las zonas de mayor deslizamiento cosísmico se interpretan como asperezas en la frontera entre las placas de Cocos y Norteamérica. El empalme limitado de asperezas entre un evento y otro indica que las caracteristicas de la ruptura para sismos inversos M > 7 en la costa noroeste de Guerrero no se han repetido en los últimos 70 años. Este comportamiento sugiere que es mas probable que sismos futuros de M > 7 involucren áreas en el contacto interplaca ubicadas entre las zonas principales del fallamiento cosísmico observado recientemente. Además, las aspere-zas observadas y los espacios entre ellas podrían identificar lugares de fallamiento cosís-mico en megasismos futuros. Los resultados tienen implicaciones importantes para el po-tencial sísmico y la recurrencia de sismos de subducción M > 7 además de la simulación del movimiento fuerte esperado para estos eventos. doi: https://doi.org/10.22201/igeof.00167169p.2017.56.1.1731

A relação da universidade ocidental com o ambiente social e ecológico em tempos de modernidade tardia é complexa, porque se move entre os polos de um modelo de civilização em crise e a alvorada de uma nova configuração de conhecimento que torne sustentável a vida do planeta e da humanidade. Nesse contexto, colocam-se as coordenadas do complexo conhecimento em que a universidade e os movimentos sociais de vítimas sistémicas – como testemunhas do outro lado da modernidade – se abrem para uma nova relação epistémica. Nesta hora crucial, é urgente resgatar o estatuto cognitivo do conhecimento tradicional negado pela racionalidade instrumental, para preservar a vida, dialogando com o pensamento crítico próprio do Ocidente, por fim consciente dos seus próprios limites. Desenha-se assim um modelo de teologia decolonial, nas suas características iniciais – como parte de um diálogo crítico – para construir um novo ethos cultural, político e espiritual, nesta hora marcada por uma racionalidade apocalíptica. Repensar a interdisciplinaridade exige, portanto, não apenas um diálogo científico, mas também a capacidade de construir o conhecimento como uma “ecologia de saberes”, para além de um modelo hegemónico de conhecimento, baseado numa racionalidade instrumental, que está a chegar ao fim. Dentro desse diálogo, a teologia tem um papel irrevogável, que reside em regressar à sua intencionalidade messiánica e kairológica, para pensar sobre a redenção que ocorre neste “tempo do fim”.

En vista de la importancia respecto al tema, el presente trabajo tuvo como objetivo evaluar el efecto del ácido giberélico en la germinación de semillas de Moringa oleífera Lam. El material utilizado en este trabajo procedió del biohuerto Agroline 360 en el Departamento de Piura, a una latitud 5°27'10.62"S, longitud 80°46'9.77"O y 13 m sobre el nivel del mar, mientras que el desarrollo del trabajo se realizó en el Laboratorio de Biotecnología del Instituto de la Papa y Cultivos Andinos de la Universidad Nacional de Trujillo. Las semillas se distribuyeron en tres tratamientos de 75 semillas cada uno, las cuales se sumergieron en soluciones de ácido giberélico con concentraciones de 0,00 ppm, 35,00 ppm, 70,00 ppm por 24 horas, los cuales corresponden al tratamiento 1, tratamiento 2 y tratamiento 3 respectivamente. Luego el número de semillas por tratamiento se distribuyeron en 3 placas Petri con 25 semillas cada uno. En los resultados se obtuvieron que el testigo tiene un 60 % de germinación, mientras que a las concentraciones de 35 ppm y 70 ppm se obtuvo 56% y 26.7% de germinación respectivamente, aspecto que nos está mostrando que, el ácido giberélico no ejerce ningún estímulo para el proceso a las concentraciones trabajadas, y se concluyó que el ácido giberélico a concentraciones de 35 ppm y 75 ppm, no afectan el porcentaje de germinación de semillas de Moringa oleífera Lam. “Moringa”. Palabras clave: Moringa oleífera, ácido giberélico, germinación de semillas.

Previous studies have demonstrated that cognitive impairment (CI) is not limited to the brain but also affects the retina. In this pilot study, we investigated the correlation between the retinal vascular complexity and neurodegenerative changes in patients with CI using a low-cost multimodal approach. Quantification of the retinal structure and function were conducted for every subject (n = 69) using advanced retinal imaging, full-field electroretinogram (ERG) and visual performance exams. The retinal vascular parameters were calculated using the Singapore Institute Vessel Assessment software. The Montreal Cognitive Assessment was used to measure CI. Pearson product moment correlation was performed between variables. Of the 69 participants, 32 had CI (46%). We found significantly altered microvascular network in individuals with CI (larger venular-asymmetry factor: 0.7 ± 0.2) compared with controls (0.6 ± 0.2). The vascular fractal dimension was lower in individuals with CI (capacity, information and correlation dimensions: D0, D1, and D2 (mean ± SD): 1.57 ± 0.06; 1.56 ± 0.06; 1.55 ± 0.06; age 81 ± 6years) vs. controls (1.61 ± 0.03; 1.59 ± 0.03; 1.58 ± 0.03; age: 80 ± 7 years). Also, drusen-like regions in the peripheral retina along with pigment dispersion were noted in subjects with mild CI. Functional loss in color vision as well as smaller ERG amplitudes and larger peak times were observed in the subjects with CI. Pearson product moment correlation showed significant associations between the vascular parameters (artery-vein ratio, total length-diameter ratio, D0, D1, D2 and the implicit time (IT) of the flicker response but these associations were not significant in the partial correlations. This study illustrates that there are multimodal retinal markers that may be sensitive to CI decline, and adds to the evidence that there is a statistical trend pointing to the correlation between retinal neuronal dysfunction and microvasculature changes suggesting that retinal geometric vascular and functional parameters might be associated with physiological changes in the retina due to CI. We suspect our analysis of combined structural-functional parameters, instead of individual biomarkers, may provide a useful clinical marker of CI that could also provide increased sensitivity and specificity for the differential diagnosis of CI. However, because of our study sample was small, the full extent of clinical applicability of our approach is provocative and still to be determined.

El presente artículo busca analizar la relación que guarda la filosofía de Martín Heidegger con el cristianismo en un contexto de modernidad tardía; más específicamente entre las nociones de olvido del Ser de Heidegger y de tiempo mesiánico (encuanto tiempo kairológico) de Giorgio Agamben. En otras palabras, el artículo trata de la relación entre la filosofía existencial alemana y la teología postmoderna, sobre la idea de tiempo. Para tal, se ha propuesto tres cuestiones básicas: 1) Que implicaciones históricas puede haber la “superación de la metafísica” de Heidegger a la luz de una historia marcada por la guerra y la violencia? 2) El llamado “fin de la metafísica” implica el abandono de la tradicional idea de Dios? 3) Pueden ponerse en diálogo la teología cristiana y la filosofía de Heidegger? Si la respuesta es si, entonces: que contribuciones este diálogo puede nos aportar, en tiempos de violencia sistemática? Desde estas cuestiones sigue el desarrollo de la reflexión.

Casimiroa edulis “charalina” (Rutaceae) es una especie oriunda de México que posee propiedades medicinales y nutritivas y se cultiva en los valles interandinos del Perú; sin embargo, no es muy conocida a nivel comercial en el norte peruano, por lo que se llevó a cabo la caracterización morfométrica de los frutos y semillas, a fin de que sirva de base de estudios posteriores que conlleven al aprovechamiento de este recurso. La colecta de frutos se realizó en el Jardín Botánico “Manuel Fernández Honores” de la universidad nacional de Trujillo (Trujillo-Perú). Los estudios de las variables morfométricas, tanto de frutos como de semillas, se realizaron en 30 frutos en buen estado. Se encontró que los frutos, en promedio, poseen 4.238 cm de diámetro mayor (largo), 3.882 cm de diámetro menor (ancho), un mínimo de 1 y un máximo de 6 semillas por fruto un promedio de 0.5 semillas buenas por fruto) y 41.872 g de pulpa. Las semillas, por su párte: un largo de 2.129 cm, un ancho de 1.166 cm y un peso total de 1.736 g de semillas por fruto, valores que difieren de los registrados por otros autores. Se concluye que las características morfométricas de C. edulis se ven afectadas por el lugar de procedencia y las condiciones climáticas a las cuales está sujeta. Palabras clave: Morfometría, frutos, semillas, Casimiroa edulis.

Background: We have found that community health workers (CHWs) with appropriate training are able to accurately identify people at high cardiovascular disease (CVD) risk in the community who would benefit from the introduction of preventative management, in Bangladesh, Guatemala, Mexico, and South Africa. This paper examines the attendance pattern for those individuals who were so identified and referred to a health care facility for further assessment and management. Design: Patient records from the health centres in each site were reviewed for data on diagnoses made and treatment commenced. Reasons for non-attendance were sought from participants who had not attended after being referred. Qualitative data were collected from study coordinators regarding their experiences in obtaining the records and conducting the record reviews. The perspectives of CHWs and community members, who were screened, were also obtained. Results: Thirty-seven percent (96/263) of those referred attended follow-up: 36 of 52 (69%) were urgent and 60 of 211 (28.4%) were non-urgent referrals. A diagnosis of hypertension (HTN) was made in 69% of urgent referrals and 37% of non-urgent referrals with treatment instituted in all cases. Reasons for non-attendance included limited self-perception of risk, associated costs, health system obstacles, and lack of trust in CHWs to conduct CVD risk assessments and to refer community members into the health system. Conclusions: The existing barriers to referral in the health care systems negatively impact the gains to be had through screening by training CHWs in the use of a simple risk assessment tool. The new diagnoses of HTN and commencement on treatment in those that attended referrals underscores the value of having persons at the highest risk identified in the community setting and referred to a clinic for further evaluation and treatment.

This article describes the preferences of the teachers working in the No. 9 School at the High School Education System of the University of Guadalajara, with respect to the different ways of defining the quality of education. This research establishes a relationship between teachers’ adherence to the concepts of quality and their attitudes towards some central features of the Reform of High School Education (RIEMS). We use multiple linear regressions with some dummy variables and stepwise procedures. The conclusions suggest that the teacher´s adherence to certain concepts of quality favourably influences the attitudes of the teachers towards RIEMS and, therefore, facilitates the implementation of this reform.

Se aplica un procedimiento de inversión de falla finita para obtener un modelo de deslizamiento sobre el plano de falla para el sismo MW 7.4 de Ometepec-Pinotepa Nacional del 20 de marzo 2012, utilizando ondas P telesísmicas registradas por la red del Global Seismographic Network. La inversión se hace en tiempo casi-real utilizando parámetros de la fuente reportados por el Servicio Geológico de Estados Unidos (USGS) y el proyecto del Global Centroid Moment Tensor (gCMT). La orientación de la falla y el ángulo de deslizamiento se obtienen del mecanismo del gCMT, asumiendo que la falla coincide con el plano nodal con bajo ángulo de buzamiento. Las dimensiones de la falla y la duración máxima de la función fuente se definen en base a la magnitud reportada para el evento. Datos telesísmicos obtenidos de la base de datos del Continuous Waveform Buffer del USGS se utilizan en la inversión con tiempos de inicio que corresponden a los arribos de la onda P implementados en el cálculo del hipocentro. La inversión se estabiliza aplicando una transición suave de deslizamiento a lo largo de la falla y una reducción simultánea del momento sísmico. Estas restricciones se implementan utilizando un peso de suavizamiento estimado directamente del problema inverso, permitiendo así la recuperación en un solo paso del patrón de ruptura menos complicado. La inversión de los registros en desplazamiento revela una simple ruptura circular similar al área de deslizamiento determinada por el USGS utilizando ondas de cuerpo y ondas superficiales, indicando que las ondas P telesismicas pueden identificar los rasgos principales de la fuente en tiempo casi-real. Inversiones adicionales realizadas utilizando registros en velocidad identifican una fuente mas detallada que cubre una zona elíptica de 2500 km2 y que se extiende hacia arriba y hacia abajo del hipocentro a lo largo de la falla. Esta zona elíptica tiene dimensiones que cubren el área definida por dos fuentes separadas determinadas por otros investigadores utilizando datos locales y ondas sísmicas globales. Los resultados indican que los registros en velocidad podrían aportar mayor información sobre los detalles de la ruptura en inversiones realizadas en tiempo casi-real utilizando ondas P telesísmicas. doi: https://doi.org/10.1016/S0016-7169(14)71501-6

Resumen: El artículo reflexiona sobre los desafíos que ha enfrentado la teologia de la liberación en el contexto posmoderno. Señala las aportaciones del pensamento antisistémico. Propone tres rasgos de la teología posmoderna latinoamericana en clave descolonial. El primero es la subjetividad vulnerable, como apertura constitutiva a los demás. El segundo son las resistencias múltiples que surgen como prácticas de resistencia propuestas por los movimientos sociales, indígenas y contraculturales en nuestro continente. Y el tercer rasgo es la gratuidad como gesto mesiánico que irrumpe en la historia y transforma las estructuras de injusticia. Abstract: This article reflects on the challenges faced by the theology of liberation in the postmodern context. It points out the contributions of anti-systemic thinking. He proposes three characteristics of Latin American postmodern theology in decolonial key. The first is the vulnerable subjectivity, which is a human capacity to be open to the others. The second is the multiple resistances that arise as resistance practices proposed by social, indigenous and counterculture movements in our continent. The third feature is the gratuitousness as a messianic gesture that breaks into history to transform the structures of injustice.

El quiste hidatídico es una enfermedad parasitaria humana causada por el estado quístico del parasito Echinococcus granulosus. En el Perú la prevalencia de hidatidosis humana en los últimos 5 años oscila de 7 - 11 / 100 000 habitantes. Se localizan principalmente en hígado (> 65% de los casos) y en pulmones (25%). La localización cardiaca es infrecuente; reportándose entre 0,5 a 2%. Presentamos el caso de un niño de 11 años con quiste hidatídico cardíaco tratado quirúrgicamente utilizando circulación extracorpórea y clamplaje aórtico, en forma exitosa.

Se presenta un caso de cierre espontáneo de agujero macular idiopático seguido por tomografía de coherencia óptica y microperimetría MP1 antes y después del cierre. El cierre espontáneo de un estadio 4 no ocurre con frecuencia, sin embargo, puede aparecer fundamentalmente en pacientes con diámetro superior del agujero menor a 150 micras. La tomografía de coherencia óptica y la microperimetría constituyen herramientas útiles en el diagnóstico, pronóstico y seguimiento de esta entidad.The case of spontaneous closure of a stage 4 idiopathic macular hole at followed up by Optical Coherence Tomography and microperimetry MP1 before and after the closure was presented. The spontaneous closure of a stage 4 macular hole is rare but it can occur in patients with hole upper diameters less than 150 µm. The OCT and the microperimetry MP1 are very useful tools in the diagnosis, prognosis and follow-up of this maculopathy.

OBJETIVO: Realizar una caracterización clínica y anatómica de pacientes con agujero macular idiopático atendidos en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" durante los años 2006 y 2007. MÉTODOS: El universo de estudio estuvo conformado por 60 ojos de 30 pacientes diagnosticados de agujero macular idiopático con diferentes estadios evolutivos que cumplieron los criterios de inclusión. A cada paciente se le realizó un examen oftalmológico completo, incluyendo oftalmoscopia indirecta, biomicroscopia de polo posterior, rejilla de Amsler, prueba de proyección de la luz guía y tomografía de coherencia óptica en ambos ojos. RESULTADOS: El sexo más afectado fue el femenino con edades comprendidas entre 61 y 70 años. La bilateralidad se observó en el 30 % de los casos y el estadio más frecuente fue el 4, se encontraron 7 pacientes con estadio 0 por tomografía de coherencia óptica en el ojo contralateral. Se evidenció la presencia de metamorfopsia según rejilla de Amsler en todos los pacientes a partir del estadio 1b. Las alteraciones cualitativas más frecuentes mostradas por tomografía de coherencia óptica fueron el defecto completo de la retina neurosensorial a nivel foveal y los quistes intrarretinianos. Se observó una correlación directa estadísticamente significativa entre la agudeza visual y el grosor retiniano a nivel foveolar. CONCLUSIONES: La tomografía de coherencia óptica en asociación con una correcta valoración clínica constituye un pilar fundamental en la valoración de este tipo de pacientes.OBJECTIVE: To make a clinical and anatomic characterization of the patients with Idiopathic macular hole at "Ramón Pando Ferrer", Cuban Institute of Ophthalmology during 2006 and 2007. METHODS: The universe of study was 60 eyes of 30 patients diagnosed with Idiopathic Macular Hole at different stages, who met the inclusion criteria. The patients underwent a complete ophthalmological examination that included indirect ophthalmoscopy, posterior pole biomicroscopy, an Amsler test, the light projection test and the optical coherence tomography on both eyes. RESULTS: The females, aged 61-70 years were the most affected; 30 % of the cases were bilateral, and the Idiopathic Macular Hole at stage 4 was the most often found, although 7 patients had a stage 0, diagnosed by optical coherence tomography on the contralateral eye. All the patients with disease stage above 1b had metamorphopsia as shown by the Amsler grid. The complete defect of the neurosensorial retina at the fovea and the intrarretinal cysts were the most frequent qualitative abnormalities revealed by optical coherence tomography. It was found a direct correlation between the visual acuity and the foveolar retinal thickness, with statistical significance. CONCLUSIONS: The optical coherence tomography and an accurate clinical evaluation are essential for the appropriate assessment and management of these patients.

This paper represents the first study of the helminth parasites of freshwater fishes from the Nazas River basin in northern Mexico. Between July 2005 and December 2008, 906 individual fish were collected and examined for helminth parasites in 23 localities along the river basin. Twenty-three species of fish were examined as a part of this inventory work. In total, 41 helminth species were identified: 19 monogeneans, 10 digeneans, seven cestodes, one acanthocephalan, and four nematodes. The biogeographical implications of our findings are briefly discussed.

Los grandes sismos en la zona de subducción de México presentan, en ocasiones, agrupamientos espacio–temporales. Ha sido sugerido que dichos agrupamientos pueden ser debidos a la interacción de esfuerzos entre estos eventos. En este trabajo se investiga esta posibilidad mediante el cálculo del cambio en los esfuerzos de Coulomb cosísmicos producidos por siete grandes eventos de subducción (Mw>7.4), ocurridos en una secuencia entre 1973 y 1985 en la placa de Cocos y entre 1995 y 2003 en la placa de Rivera, ambas subducentes bajo la placa de Norte–América. Dichos cálculos están basados en las distribuciones de deslizamientos obtenidas, para estos sismos, mediante previas inversiones cinemáticas. Los cambios de esfuerzos calculados son superpuestos acumulativamente en función del tiempo y el espacio. Los resultados muestran que dichos eventos pueden estar relacionados unos con otros y que, al menos una parte de dicha relación, podría ser atribuida al incremento en los esfuerzos cosísmicos debido a la ocurrencia de grantes eventos previos en zonas adyacentes. doi: https://doi.org/10.22201/igeof.00167169p.2007.46.4.50

Large interplate earthquakes in the Mexican subduction zone may cluster in space and time. This clustering could be due to stress interactions between large events. We investigate this possibility by calculating the coseismic Coulomb failure stress change due to seven large thrust earthquakes (Mw>7.4) that occurred from 1973 to 1985 on the Cocos plate, and from 1995 to 2003 on the Rivera plate subducting beneath the North America plate. The calculations are based on the slip distribution obtained from previous kinematic waveform inversion for these earthquakes. The calculated stress changes are superposed in a cumulative way as a function of time and space. Our results show that these earthquakes could be related to each other. At least part of the relation may possibly be attributed to the coseismic stress increase from the occurrence of previous large events in adjacent zones.

Background: Cardiovascular disease contributes substantially to the non-communicable disease (NCD) burden in low-income and middle-income countries, which also often have substantial health personnel shortages. In this observational study we investigated whether community health workers could do community-based screenings to predict cardiovascular disease risk as effectively as could physicians or nurses, with a simple, non-invasive risk prediction indicator in low-income and middle-income countries. Methods: This observation study was done in Bangladesh, Guatemala, Mexico, and South Africa. Each site recruited at least ten to 15 community health workers based on usual site-specific norms for required levels of education and language competency. Community health workers had to reside in the community where the screenings were done and had to be fluent in that community's predominant language. These workers were trained to calculate an absolute cardiovascular disease risk score with a previously validated simple, non-invasive screening indicator. Community health workers who successfully finished the training screened community residents aged 35–74 years without a previous diagnosis of hypertension, diabetes, or heart disease. Health professionals independently generated a second risk score with the same instrument and the two sets of scores were compared for agreement. The primary endpoint of this study was the level of direct agreement between risk scores assigned by the community health workers and the health professionals. Findings: Of 68 community health worker trainees recruited between June 4, 2012, and Feb 8, 2013, 42 were deemed qualified to do fieldwork (15 in Bangladesh, eight in Guatemala, nine in Mexico, and ten in South Africa). Across all sites, 4383 community members were approached for participation and 4049 completed screening. The mean level of agreement between the two sets of risk scores was 96·8% (weighted κ=0·948, 95% CI 0·936–0·961) and community health workers showed that 263 (6%) of 4049 people had a 5-year cardiovascular disease risk of greater than 20%. Interpretation: Health workers without formal professional training can be adequately trained to effectively screen for, and identify, people at high risk of cardiovascular disease. Using community health workers for this screening would free up trained health professionals in low-resource settings to do tasks that need high levels of formal, professional training. Funding: US National Heart, Lung, and Blood Institute and National Institutes of Health, UnitedHealth Chronic Disease Initiative.