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Stress in the pre-slaughter stage is a critical period in the production chain because it causes losses in animal live weight, affects carcass yield and quality, and leads to a loss of animal welfare due to an alteration in the homeostasis of the organism as a result of exposure to stressful situations. This review identifies and describes the stressors that have been reported in the last 5 years as the main causes of meat quality deterioration, including animal handling activities by farm or plant personnel (transport, loading and unloading, in the slaughter plant), environmental conditions (temperature, vibrations), waiting time prior to slaughter and mixing of lots, water and food fasting period, and fatigue states, as well as the biomarkers routinely used for the study of conditions associated with stress. Although research on the subject is abundant, the biochemical mechanisms involved in obtaining certain organoleptic characteristics of meat with respect to stress levels and the individual variations observable in different groups of animals are still not completely clear, and more research is needed on stress biomarkers that allow a more specific, effective and non-invasive identification and measurement.

In the Ecuadorian Amazonia, there is a concern about the presence of high concentrations of cadmium (Cd) in rivers and sediments because of changes in land use and anthropogenic activities, e.g., mining and oil exploitation. Hence, the research related to water treatment processes to meet environmental standards has gained relevance. The use of biochar (BC) as adsorbent is considered a promising and low-cost alternative to improve the water quality in developing countries. In this work, lignocellulosic wastes from Guadua angustifolia were transformed through thermochemical treatments, into a promising carbonaceous material, such as BC. BC samples were prepared by pyrolysis (termed pyrochar, PC) and hydrothermal carbonization (termed hydrochar, HC). Their physicochemical properties were correlated with the Cd adsorption removal performance, analyzing the effect of adsorbent dosage, initial solution pH, adsorption kinetics and adsorption isotherms. HC showed the highest Cd adsorption performance, due to the presence of a higher number of oxygenated functional groups, as confirmed by FTIR, XPS and Raman spectroscopy. This research has proposed a sustainable alternative for the recovery of an available waste, contributing to mitigate the effects of the presence of metals on the health and economy of the most vulnerable sectors of society.

Professional self-concept in nurses is understood as the way nurses think and feel about themselves in their nursing role and is both a predictor of quality of care and a protective factor against burnout. The aim of this study was to translate, culturally adapt and validate the Spanish version of the Nurses Self-Concept Instrument in a sample of 483 Spanish registered nurses. In addition, we analyzed gender differences in its dimensions in the same sample. Internal reliability was evaluated using Cronbach’s Alpha, while construct validity was assessed using both exploratory and confirmatory factor analysis. The differences between groups were analyzed using the Mann-Whitney U test. Factor distribution was different from the original model. A gender gap was observed in the Nurse Thinking and Perception of Capabilities dimensions with higher values in the women group, while in the Leadership dimension, higher values were observed in the men group. While the Spanish version of the Nurses Self-Concept Instrument is a valid and reliable tool to measure this construct, the differences in its dimensions lead to a deeper understanding of the cultural differences in the construction of professional self-concept.

Resumen Introducción: Las secuencias ponderaras en T2 con tiempo de eco largo son tradicionalmente usadas para la evaluación de las lesiones de la médula espinal en esclerosis múltiple (EM). Existen otras secuencias, como la densidad de protones (primer eco T2), que pueden ser útiles en el plano axial pero que no se han estudiado lo suficiente. Objetivos Establecer la concordancia entre la densidad de protones (DP) y las secuencias axiales ponderadas en T2 en las lesiones de la médula espinal cervical en pacientes con EM. Métodos: Se trata de un estudio de concordancia entre secuencias DP y T2 axiales en magneto de 1,5 Tesla en sujetos colombianos. Las imágenes fueron revisadas por dos radiólogos, que determinaron el número de lesiones, así como la intensidad de señal - mediante la relación contraste- ruido (RCR). La comparación se realizó con el coeficiente de correlación y concordancia de Lin. Resultados: Se evaluaron 56 pacientes, 30,36% hombres y 69,64% mujeres. Se encontraron diferentes números de lesiones entre las secuencias axiales DP vs T2 (210 vs 144), coeficiente de concordancia entre el número de lesiones 0,72 (IC95%: 0,6-0,82, error estándar 0,05, desviación estándar 1,37) y en la conspicuidad -RCR- 0,62 (IC95%: 0,48-0,75, SE 0,05, DE 12,25). Conclusión: No encontramos concordancia en la evaluación del número o intensidad de la señal entre secuencias axiales DP y T2. Aunque las secuencias ponderadas en T2 son las más utilizadas, investigaciones recientes han demostrado falta de concordancia e incluso superioridad de las secuencias DP en otros planos, lo que sugiere que es necesario realizar estudios para evaluar la efectividad de las secuencias DP en el plano axial. Abstract Introduction: Traditionally, T2 long echo time sequences are used for the evaluation of spinal cord lesions in multiple sclerosis. There are other sequences, like proton density (first echo of T2) that may be useful in the axial plane but have not been sufficiently studied. Objectives: To establish the agreement between axial PD and T2 sequences in cervical spinal cord lesions in patients with multiple sclerosis. Methods: This is a concordance study between axial PD and T2 sequences in a 1.5 Tesla magnet. The images were reviewed by two radiologists, who determined the number of lesions and signal intensity with the Contrast to Noise Ratio. The comparison was made with the Lin’s concordance correlation coefficient. Results: 56 patients were evaluated, 30.36% men and 69.64% women; there were 210 lesions with PD vs 144 with T2, LCC for the number of lesions was 0.72 (95% CI: 0.6-0.82, SE 0.05) and for conspicuity was 0.62 (95% CI: 0.48-0.75, SE 0.05). Conclusion: This study did not find a satisfactory agreement in the evaluation of the number or signal intensity between PD and T2. Recent research has shown superiority of PD over T2 in other planes, suggesting that further studies are needed to evaluate the effectiveness of PD in the axial plane.

Bi-based photocatalysts have been considered suitable materials for water disinfection under natural solar light due to their outstanding optical and electronic properties. However, until now, there are not extensive reviews about the development of Bi-based materials and their application in bacterial inactivation in aqueous solutions. For this reason, this work has focused on summarizing the state of the art related to the inactivation of Gram- and Gram + pathogenic bacteria under visible light irradiation using different Bi-based micro and nano structures. In this sense, the photocatalytic bacterial inactivation mechanisms are analyzed, considering several modifications. The factors that can affect the photocatalytic performance of these materials in real conditions and at a large scale (e.g., water characteristics, pH, light intensity, photocatalyst dosage, and bacteria level) have been studied. Furthermore, current alternatives for improving the photocatalytic antibacterial activity and reuse of Bi-based materials (e.g., surface engineering, crystal facet engineering, doping, noble metal coupling, heterojunctions, Z-scheme junctions, coupling with graphene derivatives, magnetic composites, immobilization) have been explored. According to several reports, inactivation rate values higher than 90% can be achieved by using the modified Bi-based micro/nano structures, which become them excellent candidates for photocatalytic water disinfection. However, these innovative photocatalytic materials bring a variety of future difficulties and opportunities in water disinfection.

El compromiso en las redes sociales es un concepto complejo, en el que interactúan muchos componentes interconectados y difíciles de evaluar. Es precisamente esta complejidad la que motivó este trabajo, que propone un índice compuesto como herramienta para medir el engagement. Utilizando TOPSIS, un método multicriterio que basa su ranking en minimizar la distancia al punto ideal y maximizar la distancia al anti-ideal, se utiliza una combinación de indicadores basados ​​en dos enfoques: el enfoque del tweet y el enfoque del seguidor. El primero refleja el compromiso basado en la producción del usuario y el segundo mide el compromiso por popularidad. Este índice se aplicó a un grupo de Social Media Influencers y se obtuvo un ranking general, así como un ranking por cada enfoque de medición del engagement. La comparación de los rankings generados por los diferentes enfoques muestra la idoneidad y pertinencia de ambos, ya que se confirma que miden aspectos diferentes, y que ambos son necesarios para ofrecer una visión holística del engagement que genera un usuario en Twitter; este es un hallazgo nuevo en comparación con estudios anteriores, que solo se centraron en un enfoque u otro. Funding for open access charge: Universidad de Málaga

In order to maximise European, national and regional research and innovation potential the European Union is investing in these fields through different funding mechanisms such as the ESIF or H2020 programme. This investment plan is part of the European 2020 strategy, where the concept of Smart Specialisation is also included. Smart Specialisation is an innovation policy concept designed to promote the efficient and effective use of public investment in regional innovation in order to achieve economic growth. The Smart Specialisation Platform was created to support this concept by assisting regions and Member States in developing, implementing and reviewing their research and innovation Smart Specialisation strategies. The Smart Specialisation Platform comprises several thematic platforms. The thematic Smart Specialisation Platform on energy (S3PEnergy) is a joint initiative of three European Commission services: DG REGIO, DG ENER, and the Joint Research Centre (JRC). The main objective of the S3PEnergy is to support the optimal and effective uptake of the Cohesion Policy funds for energy, and to better align energy innovation activities at national, local and regional level through the identification of the technologies and innovative solutions that support in the most cost-effective way the EU energy policy priorities. In the particular case of hydrogen technologies, the activities of the platform are mainly focused on supporting the new Fuel Cells and Hydrogen Joint Undertaking (FCH JU) initiative involving regions and cities. To date, more than 80 European cities and regions have committed to participate in this initiative through the signature of a Memorandum of Understanding, and more participants are expected to join. S3PEnergy is helping in the identification of potential combination of H2020 funding (provided through FCH JU) and ESIF. To identify potential synergies among these two funding sources, a mapping of the different ESIF opportunities has been performed. In order to map these opportunities, Operational Programmes (OPs) and research and innovation strategies for Smart Specialisation (RIS3) of the different European regions and Member States were analysed. The results of this mapping and analysis are presented in this paper.

In this work, the catalytic properties of Pt/MOx/TiO2 (M = Fe, Co) catalysts prepared by strong electrostatic adsorption (SEA), were investigated for the preferential oxidation (PROX) of CO in H2. The SEA method was chosen to achieve a preferential adsorption of Pt onto supported MOx nanoparticles rather than onto the TiO2 surface. XPS, TPR and TEM analysis indicate that the enhancement in the catalytic activity of Pt/MOx/TiO2 is related to a synergetic effect originated by a close contact between Pt and MOx (M = Fe, Co) surface. The results clearly show that Pt supported on CoOx/TiO2 calcined at 300 °C, and then reduced at 100 °C, exhibits the highest activity, e.g. higher CO conversion and CO2 selectivity, among the supported catalysts studied in this work, that was attributed to a higher concentration of Pt-CoOx moieties over the catalytic surface. This study reports a simple and efficient way to synthesize Pt-promoted catalysts where strong metal-support interactions are highly desired to improve the catalytic performance of selective oxidation reactions.

Background: In the 2-year (y) CARE-MS II phase 3 trial (NCT00548405), alemtuzumab (12 mg/day; baseline: 5 consecutive days; 12 months later: 3 consecutive days) significantly improved clinical and MRI outcomes versus SC IFNB-1a in RRMS patients with inadequate response to prior therapy. In a 4-y extension (NCT00930553), patients could receive additional courses of alemtuzumab (12 mg/day on 3 consecutive days; ⩾12 months apart) as needed for disease activity or receive other disease-modifying therapy (DMT) per investigator’s discretion. Efficacy on clinical/MRI outcomes was maintained through Y6, with 50% receiving no additional alemtuzumab or other DMTs in the extension. Following the initial 4-y extension, patients could continue in TOPAZ (NCT02255656), an additional 5-y extension study, for further evaluation. Objectives: To evaluate 8-y efficacy and safety outcomes in alemtuzumab-treated CARE-MS II patients. Methods: At the investigator’s discretion, patients in TOPAZ can receive additional as-needed alemtuzumab (⩾12 months apart; no criteria) or receive other DMT (at any time). Results: Of 435 alemtuzumab-treated CARE-MS II patients, 300 (69%) completed 8-y total follow-up; 44% received neither additional courses of alemtuzumab nor another DMT. Of 393 patients who entered the extension, 200 (51%) received ⩾3 courses of alemtuzumab (3 courses, 29%; 4 courses, 16%; 5 courses, 3%, >5 courses, 3%). Course 3 was given in Y3 (20%), Y4 (11%), Y5 (9%), Y6 (5%), Y7 (2%), and Y8 (3%). In Y8, the annualized relapse rate was 0.18, with 85% of patients relapse-free. Compared with core study baseline, 70% of patients had stable/improved EDSS scores at Y8, and mean change in EDSS score was 0.17. Over 8 y, 64% of patients were free of 6-month confirmed disability worsening, and 47% had 6-month confirmed disability improvement. In Y8, 58% of patients achieved no evidence of disease activity, and 70% were free of MRI disease activity. Median percent cumulative brain volume loss (BVL) from baseline through Y8 was −1.06%; median annual BVL from Y3 to Y8 was ⩽−0.19%. The safety profile in Y8 was consistent with the previous years; incidence of AEs, infections, and thyroid AEs continued to decline. No new cases of immune thrombocytopenia or nephropathy were seen. Conclusion: Alemtuzumab efficacy on clinical, MRI, and BVL outcomes was maintained over 8 y, with 44% of CARE-MS II patients receiving no additional treatment. Safety was consistent and manageable through Y8.

Este estudio presenta un análisis traductológico de las leyendas sorianas de Gustavo Adolfo Bécquer traducidas en italiano. La muestra analizada se ha compuesto por dos de las leyendas más conocidas de Bécquer, como son Los ojos verdes y El rayo de luna, traducidas por Rosario Trovato (2014). Para ello, se ha llevado a cabo una revisión de la bibliografía sobre el análisis literario y traductológico que ha permitido el diseño de una herramienta metodológica para el análisis integrado de diferentes variables. Estas variables son la indización temática de los segmentos de traducción analizados, las referencias culturales, la variación lingüística y la técnica de traducción empleada. El planteamiento de este estudio desde la perspectiva de la traducción ofrece un enfoque novedoso dentro de la investigación sobre las Leyendas de Gustavo Adolfo Bécquer, pues no existe gran cantidad de literatura científica al respecto en el ámbito de la traducción literaria. Asimismo, permite un análisis comparado exhaustivo del texto origen y el texto meta dentro de una misma herramienta metodológica, que podría ser aplicable a otros tipos de traducción., Universidad de Granada. Grado en Traducción e Interpretación

Alemtuzumab; Efficacy; Safety Alemtuzumab; Eficacia; Seguridad Alemtuzumab; Eficàcia; Seguretat Background Alemtuzumab significantly improved clinical and MRI outcomes vs. subcutaneous interferon beta-1a (SC IFNB-1a) in the CARE-MS trials (NCT00530348, NCT00548405), with sustained efficacy in 2 consecutive extensions (NCT00930553, NCT02255656 [TOPAZ]). Methods Post hoc analysis of 8-year alemtuzumab efficacy and safety in pooled CARE-MS patients (N=811) stratified by baseline age (≥18 to ≤25, >25 to ≤35, >35 to ≤45, >45 to ≤55 years). Results Compared with SC IFNB-1a over 2 years across age cohorts, alemtuzumab lowered annualized relapse rates (ARR; 0.22–0.24 vs. 0.38–0.51), improved or stabilized disability (freedom from 6-month confirmed disability worsening [CDW]: 85%–92% vs. 62%–88%; achievement of 6-month confirmed disability improvement [CDI]: 20%–31% vs. 13%–25%), increased proportions free of MRI disease activity (70%–86% vs. 42%–63% per year), and slowed brain volume loss (BVL; –0.45% to –0.87% vs. –0.50% to –1.39%). Through Year 2, the treatment effect with alemtuzumab did not significantly differ among age groups for ARR (p-interaction=0.6325), 6-month CDW-free (p-interaction=0.4959), 6-month CDI (p-interaction=0.9268), MRI disease activity-free (p-interaction=0.6512), and BVL (p-interaction=0.4970). Alemtuzumab remained effective on outcomes through Year 8 across age groups. Age-related increases in malignancies (≤45 years: 0.9%–2.2% vs. >45 years: 8.1%) and deaths (0%–1.7% vs. 7.0%) were observed. Serious infections also increased from the youngest (5.1%) to oldest (12.8%) age cohorts. Conclusions Alemtuzumab had greater efficacy than SC IFNB-1a over 2 years across comparable age groups, with no significant differences between alemtuzumab-treated age groups. Efficacy on relapse, disability, and MRI outcomes continued through Year 8 across age groups. Age-related increases in serious infections, malignancies, and deaths were observed. The study was supported by Sanofi and Bayer HealthCare Pharmaceuticals.

Com o surgimento da pandemia houve um crescimento exponencial no consumo de Equipamentos de Proteção Individual (EPI) e Equipamentos de Proteção Coletiva (EPC), causando escassez momentânea. Nesse sentido com o intuito de proteger contra a contaminação de bactérias e vírus presentes no ambiente, o seu uso se tornou obrigatório para os profissionais da saúde de modo a evitar a contaminação e proliferação do COVID-19. Portanto, visando mitigar e auxiliar pontualmente as demandas, foram desenvolvidos e doados diversos tipos de EPI e EPC à rede pública de atendimento à saúde. Além disso, junto o agravamento da pandemia, verificou-se uma maior conscientização e preocupação com o bem bem-estar e integridade física dos agentes de saúde em relação ao risco de contaminação associado às atividades laborais. Consequentemente, fez-se fundamental o uso mais prolongado dos EPIs, em especial as máscaras, bem como de EPCs. Diante do exposto, este artigo apresenta o desenvolvimento open source de um sistema auxiliar de desinfecção denominado sistema de descontaminação de máscaras baseado no efeito luminescente causado por espectro ultravioleta (UV-C). Considerando essas premissas foi desenvolvido um sistema de higienização de máscaras que consiste em uma caixa de higienização por radiação ultravioleta (UV-C), composto por um circuito eletrônico integrado à estrutura e com comando remoto por aplicativo. Finalmente, destaca-se que radiação UV-C é um método de desinfecção consagrado e amplamente utilizado em ambientes hospitalares e laboratoriais na descontaminação de superfícies.

Background: The Fitzpatrick skin phototype scale (FSPTS) is a widely used instrument to assess skin type. Methods: A cross-sectional survey collected responses from 254 subjects from Quito regarding self-reported FSPTS, gender, age, education, and tobacco and alcohol consumption. Univariate and multivariate logistic regression analyses were performed to determine if ethnicity, hair color, and eye color significantly predict FSPTS. In addition, we studied the correlation between FSPTS and the SCINEXA scale with Pearson’s correlation coefficient. Results: Ethnicity, eye color, and hair color are significant independent predictors of FSPTS (p < 0.0001). Conclusions: Patient self-reported race and pigmentary phenotypes are inaccurate predictors of sun sensitivity as defined by Fitzpatrick skin phototype. Our study does not fully represent the population of the country. There are limitations to using patient-reported race and appearance in predicting individual sunburn risk.

The COVID-19 pandemic required higher education institutions to change the modality of face-to-face to online learning overnight. Adaptations were needed, particularly in industrial process training in Chemical Engineering and related careers. Students could not access companies and industries for internships or industrial visits, intended to allow undergraduate students to observe the process engineers’ work in professional spaces. This paper describes a pedagogical strategy to overcome this limitation. Here, we report an approach applied in an Industrial Processes course, with students from the 8th to 10th semesters and alumni, from the undergraduate Petrochemical Engineering program at Yachay Tech University (Ecuador). In this course, the students developed group projects involving an industrial process analysis focused on economic sectors of interest in the country. The projects also included a revision of official figures and statistics on production data, consumption, and perspectives of the different markets. The execution of these projects promoted students’ active participation through technical discussions by exchanging ideas. A high level of attendance at synchronic classes reflected a high motivation. Through feedback and interviews, the students’ comments confirmed the relevance and value of the strategy applied in the course.

Background: In CARE-MS II (NCT00548405), alemtuzumab (two courses; 12 mg/day; baseline: 5 days; 12 months later: 3 days) significantly improved outcomes versus subcutaneous interferon beta-1a (SC IFNB-1a) in relapsing-remitting multiple sclerosis (RRMS) patients with inadequate response to prior therapy. In a 4-year extension (NCT00930553), patients could receive additional alemtuzumab courses (12 mg/day on 3 days; at least 12 months apart) as needed for disease activity or receive another disease-modifying therapy (DMT; investigator discretion); efficacy was maintained with 50% receiving no additional alemtuzumab or DMT through Year 6. Following this extension, patients could continue in TOPAZ (NCT02255656), an additional 5-year extension. Objectives: Evaluate alemtuzumab efficacy/safety through Year 8 in CARE-MS II patients. Methods: In TOPAZ, patients can receive as-needed alemtuzumab (at least 12 months apart) or receive another DMT. Results: 300/435 (69%) patients completed TOPAZ Year 2 (Year 8 post-alemtuzumab); 44% received neither additional alemtuzumab nor another DMT. In Year 8, annualized relapse rate was 0.18; 85% were relapse-free. From baseline through Year 8, 70% had stable/improved EDSS, mean change in EDSS was +0.17, 64% were free from 6-month confirmed disability worsening, and 47% achieved 6-month confirmed disability improvement. In Year 8, 70% were free of magnetic resonance imaging (MRI) disease activity; 58% achieved no evidence of disease activity. Median percent cumulative brain volume loss from baseline through Year 8 was −1.06%. Safety remained consistent through Year 8. Conclusion: Alemtuzumab efficacy and safety were maintained through Year 8 in the absence of continuous treatment, with 69% of patients completing Year 8 post-alemtuzumab and 44% receiving no additional treatment after the initial two courses.

Objective Currently, there are several reasons to promote worldwide the concept of multiple sclerosis care units (MSCU) for a better management of affected patients. Ideally, the MSCU should have some human and technical resources that distinguish and improve the care of affected patients; however, local, and regional aspects should be considered when recommending how these units should operate. The objective of these consensus recommendations was to review how MSCU should work in Latin America to improve long-term outcomes in MS patients. Methods A panel of neurology experts from Latin America dedicated to the diagnosis and care of MS patients gathered virtually during 2019 and 2020 to carry out a consensus recommendation about objectives and functioning implementation of MSCU in Latin America. To achieve consensus, the methodology of “formal consensus-RAND/UCLA method” was used. Results Recommendations focused on the objectives, human and technical resources, and the general functioning that MSCU should have in Latin America. Conclusions The recommendations of these consensus guidelines attempt to optimize the health care and management of MS patients by setting how MSCU should work in our region.

Background The validity and reliability of the objective structured clinical evaluation (OSCE) with nursing students, accordingly to the published evidence, were analyzed. Methods A systematic review was developed. This study followed the methodology proposed in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The databases searched included PubMed, Embase, Web of Science, Cochrane Plus, Scielo, Dialnet, Lilacs, and Cuiden Plus. Studies were included if they developed an OSCE, described validity and/or reliability of an OSCE, and used nursing student as sample. Studies were excluded when they were written in languages other than English, Spanish, Portuguese, or Catalan. The search was conducted up to and including April 25, 2016. Results Nineteen studies were included in the review. The quality of studies was mixed, and risk of bias was moderate to high. The characteristics of the OSCE were variable and move away to the original model. The validity and reliability were adequate in the majority of the studies. Conclusion The OSCE is a valid and reliable evaluation system to assess nursing students' competences.

As human and economic resources are limited, especially in Latin America (LATAM), it is important to identify research priorities to improve multiple sclerosis (MS) patients care in the region. The objective was to generate a multidisciplinary consensus on research priorities in MS for patients care in LATAM by involving healthcare professionals and MS patient associations. METHODS: consensus was reached through a four-step modified Delphi method designed to identify and rate research priorities in MS in LATAM. The process consisted of two qualitative assessments, a general ranking phase and a consensus meeting followed by a more detailed ranking phase RESULTS: a total of 62 participants (35 neurologists, 4 nurses, 12 kinesiologists, 7 neuropsychologists and 4 patient association members) developed the process. At the final ranking stage following the consensus meeting, each participant provided their final rankings, and the top priority research questions were outlined. 11 research priorities were identified focusing on healthcare access, costs of the disease, physical and cognitive evaluation and rehabilitation, quality of life, symptoms management, prognostic factors, the need of MS care units and patient's management in emergencies like COVID-19. CONCLUSION: this work establishes MS research priorities in LATAM from multiple perspectives. To pursue the actions suggested could launch the drive to obtain information that will help us to better understand the disease in our region and, especially, to better care for affected patients.

Background During the last two decades, neuromyelitis optica spectrum disorder (NMOSD) has undergone important changes, with new diagnostic markers and criteria, better recognition of clinical phenotypes, better disease prognosis and new therapeutic approaches. Consequently, management of NMOSD patients in Latin American (LATAM) has become more complex and challenging in clinical practice. In making these consensus recommendations, the aim was to review how the disease should be managed and treated among LATAM patients, in order to improve long-term outcomes in these populations. Methods A panel of LATAM neurologists who are experts in demyelinating diseases and dedicated to management and care of NMOSD patients gathered virtually during 2019 and 2020 to make consensus recommendations on management and treatment of NMOSD patients in LATAM. To achieve this consensus, the RAND/UCLA methodology for reaching formal consensus was used. Results The recommendations focused on diagnosis and differential diagnoses, disease prognosis, tailored treatment, identification of suboptimal treatment response and special circumstances management. They were based on published evidence and expert opinions. Conclusions The recommendations of these consensus guidelines seek to optimize management and specific treatment of NMOSD patients in LATAM

Background Few studies have been published related to the analysis of different skin aging parameters for whole-body skin using the SCINEXA scale for skin damage. The aim of this study was to evaluate the reproducibility of the SCINEXA scale (SCore for INtrinsic and EXtrinsic skin Aging) in South-Americans non-Caucasian population of a region of Ecuador. Methods Exploratory observational study. Thirty subjects of both genders, over 40 years old and living in a rural area with particular characteristics regarding sun exposure were included. The SCINEXA scale was applied at three different time points to assess its reproducibility. Repeated measures analysis of variance was used for comparison of mean SCINEXA scores. Intraclass correlation coefficient, 95% CI and “Cronbach’s alpha” coefficient were performed to measure reproducibility. Results Among participants, 86.7% were female; mean age was over 67 years old, with mainly low educational level, and almost half had more than six hours of sun exposure per day. Test-retest reproducibility of this scale demonstrated almost perfect agreement. The SCINEXA score was greater than 2 points in half of the subjects, reflecting aging due to sun exposure. Limitations Most participants were women from one town in a particular geographical area, and the sample size was small. Genetic determinants of skin phenotypes were not assessed. Conclusions The SCINEXA score is reproducible in South American non-Caucasian subjects of a particular region of the country. Damage from sun exposure was evident in participants.

Background Multiple sclerosis is an inflammatory and neurodegenerative demyelinating disease. Current treatment of multiple sclerosis focuses on the use of immunomodulatory, immunosuppressant, and selective immunosuppressant agents. Some of these medications may result in high risk of opportunistic infections including tuberculosis. Objective The purpose of this study was to obtain consensus from a panel of neurologists, pulmonologists, infectious disease specialists, and epidemiology experts regarding the diagnosis, treatment, and monitoring of latent tuberculosis in patients with multiple sclerosis. Methods A panel of experts in multiple sclerosis and tuberculosis was established. The methodological process was performed in three phases: definition of questions, answer using Delphi methodology, and the discussion of questions not agreed. Results Tuberculosis screening is suggested when multiple sclerosis drugs are prescribed. The recommended tests for latent tuberculosis are tuberculin and interferon gamma release test. When an anti-tuberculosis treatment is indicated, monitoring should be performed to determine liver enzyme values with consideration of age as well as comorbid conditions such as a history of alcoholism, age, obesity, concomitant hepatotoxic drugs, and history of liver disease. Conclusion Latent tuberculosis should be considered in patients with multiple sclerosis who are going to be treated with immunomodulatory and immunosuppressant medications. Transaminase level monitoring is required on a periodic basis depending on clinical and laboratory characteristics. In addition to the liver impairment, other side effects should be considered when Isoniazid is prescribed.

Introducción: Recientemente, algunos estudios han informado acumulación de gadolinio en el cerebro de los pacientes con múltiples administraciones de contraste basado en gadolinio. Los pacientes con esclerosis múltiple son sometidos a múltiples resonancias contrastadas y podrían convertirse en una población de riesgo. Objetivo: Determinar si la exposición repetida por vía intravenosa a gadolino se asocia con mayor intensidad en el tálamo, el dentado, el puente y el globo pálido. Métodos: Se realizó un estudio retrospectivo núcleo de 60 pacientes con EM que habían sido sometidos a dos o más RM contrastadas entre 2007 - 2015. Se calcularon las razones núcleo dentado - puente (DNP), tálamo-puente (TP), núcleo caudado- puente (CNP), globus pallidus - tálamo (GPT), globus pallidos - puente (GPP), revisando secuencias T1 axiales simples. Se calcularon los cambios relativos y se compararon con el número de RM contrastadas. Se evaluó la concordancia entre observadores con el coeficiente de correlación intraclase. Resultados: No hubo evidencia de aumento de la intensidad de la señal en secuencias T1 (DNP 0,524, 0,446 GPT, GPP 0,684, 0,771 PT, CNP 0.352). Al no existir diferencias, el coeficiente de Spearman no mostró correlación entre los cambios relativos y el número de resonancias realizadas. La concordancia interobservador fue casi perfecta (0.982) para todas las estructuras. Conclusión: Nuestro estudio no encontró un aumento estadísticamente significativo en la intensidad de la señal T1 en pacientes con esclerosis múltiple. Sin embargo, hay factores a considerar, tales como el tipo de gadolinio y el lapso de tiempo entre las administraciones.

Es materia de este ensayo el estudio y análisis de las consecuencias mercantiles a raíz de la vigencia del Tratado de Libre Comercio entre Perú y Estados Unidos de Norteamérica que ha propiciado una serie de cambios legislativos, comerciales, laborales, tributarios y de interés para diversos sectores de nuestra economía. Esto hace necesario conocer, analizar y difundir los efectos que se vienen produciendo desde que se inició la aplicación del referido tratado, así como las consecuencias presentadas dentro del comercio internacional, que cada vez demuestra un mayor interés en su desarrollo, sin olvidar que permite obtener mejores resultados en las compras gubernamentales.

We can find in Spain several university studies concerning diet and lifestyle, showing them as an effective strategy to prevent chronic diseases.To evaluate the energy and nutrient intake and adherence to the Mediterranean Diet (DM) in a group of college students with different academic profile and to compare the quality of the diet among students attending degrees in Health Science (HS) and those attending other degree courses (not HS).77 students (80.3% female) from the Campus of Soria, 37 HS students and 40 not HS (mean age 21.2 ± 2.1 years), completed a questionnaire on socio-biographical data, the test KIDMED of adhesion to Mediterranean diet and recorded food intake for seven days. The amount of energy and nutrients was estimated using the software Nutriber (version 1.1.1.3r). Student t test or U Mann-Whitney were used to compare means of independent samples and the criterion of significance was set at p0,05.The respondent students, regardless of their academic profile, follow a low calorie diet with more protein and fat consumption than the recommended amount, and less carbohydrate and fiber, which is reflected in the insufficient intake of some vitamins and minerals. However, we observed a higher percentage of respondents with high adhesion to the parameters of the DM in the HS group (51.4%) than in the No HS group (30.8%).Introducción: En España son varios los estudios universitarios que abordan los temas de alimentación y estilo de vida, y demuestran que éstos son una estrategia eficaz para la prevención de enfermedades crónicas. Objetivos: Evaluar la ingesta de energía y nutrientes y la adhesión a la Dieta Mediterránea (DM) en un grupo de estudiantes universitarios con distinto perfil académico y comparar la calidad de la dieta entre estudiantes que cursan grados en Ciencias de la Salud (CS) y los de otras carreras (No CS). Métodos: 77 estudiantes (80,3% mujeres) del Campus de Soria, 37 de grados en CS y 40 de No CS de edad media 21,2 ± 2,1 años, cumplimentaron un cuestionario sobre datos socio-biográficos, el test KIDMED y registraron la ingesta de alimentos durante siete días. La estimación de la cantidad de energía y nutrientes se realizó mediante el programa informático NUTRIBER (versión 1.1.1.3r) y para la comparación de medias de muestras independientes se utilizaron las pruebas t de Student o U de Mann-Whitney y el criterio de significación se estableció en p0,05. Resultados y Discusión: Los estudiantes encuestados, con independencia de su perfil académico, siguen una dieta hipocalórica con mayor consumo de proteínas y de grasas de las recomendadas y menor de hidratos de carbono y fibra, lo que se refleja en el aporte insuficiente de algunas vitaminas y minerales. A pesar de ello, observamos un mayor porcentaje de encuestados con adhesión alta a los parámetros de la DM en el grupo CS (51,4%) que en el grupo no CS (30,8 %).

We carried out a door-to-door survey to assess the prevalence, incidence, risk factors and possible etiology of major neurological diseases in Atahualpa, a rural village located in the coastal region of Ecuador. A total of 2,548 individuals were interviewed with standardized screening questionnaires to detect suspected cases of epilepsy, stroke and dementia, and they underwent a serum immunoblot test for the detection of anticysticercal antibodies (phase I). Positive individuals and a random sample of negative subjects were examined by neurologists (phase II). Then, patients with clinically confirmed disease and a control group of healthy subjects were further evaluated with complementary examinations (phase III). Here, we describe the methodology of this field study that may be used as a model for the evaluation of neurological disorders in rural communities of developing countries.

Objective: To compare the costs to the Spanish healthcare system of 35 days’ treatment with triflusal (600 mg/day) and aspirin (300 mg/day) in patients with confirmed acute myocardial infarction within 24 hours of onset of symptoms. Design: A cost minimisation analysis based on the results of the Triflusal in Acute Myocardial Infarction study (TIM) was conducted. The hypothesis was that despite a higher acquisition cost of triflusal, savings would result because of differences in efficacy and safety outcome (non-fatal cerebrovascular event and haemorrhagic events). Diagnostic Related Groups were used as a proxy for determining hospital costs in Spain and the values were obtained from different sources and refer to year 2000 costs. Only direct medical costs were considered for the economic analysis. Results: Although the acquisition cost of triflusal was more expensive than that of aspirin, the cost of prevented events — non-fatal ischaemic cerebrovascular events and cerebral haemorrhages — entirely compensated for the cost of triflusal. The overall cost of treating patients with triflusal, compared with aspirin, represented a net saving of 28.4% per patient treated. Conclusion: Our study showed that triflusal is cost saving compared with aspirin in the treatment of the acute phase of myocardial infarction.

A series of doped Ruddlesden‐Popper phases, of general formula Sr3Ti2-xMxO7- (Ma Al;Ga;Co), were synthesized and their electrical conductivity characterized as a function of temperature and oxygen partial pressure. For fixed-valent dopants, p-type conductivity predominates at p(O2)> 10 ˇ5 atm, followed by a p(O2)-independent electrolytic regime, and n-type electronic conductivity at very low p(O2). The electrolytic regime exhibits activation energies in the range 1.7‐1.8eV. Doping with transition metals such as Co results in a very significant increase in total conductivity with a p-type conductivity at high p(O2). Furthermore, an apparent ionic regime at intermediate p(O2) is observed, characterized by high conductivity (> 10 ˇ2 S/cm at 700C) and low activation energy (0.6eV). This interpretation is consistent with iodometric measurements as interpreted by a defect chemical model. Other measurements are in progress to confirm this conclusion. # 1999 Elsevier Science Limited. All rights reserved