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Background: Hemolysis due to ABO incompatibility is an important differential diagnosis in newborns presenting with jaundice. Clinical studies evaluating ABO hemolytic disease of fetus and newborn (ABO-HDFN) question the diagnostic value of the direct antiglobulin test (DAT) in this situation. Goals: To determine the clinical and laboratorial findings associated with the occurrence of ABO-HDFN and to evaluate the accuracy of DAT as a diagnostic tool. Methods: This was a nested case control study with a cohort of 4122 newborns. Clinical and immunohematological data were retrieved from medical files including clinical and laboratorial factors associated with ABO-HDFN. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of positive DAT were calculated. Results: Among the 4122 newborns, 44 had the diagnosis of ABO-HDFN. Positive DAT, group O mother and group A newborn were significantly associated with the occurrence of neonatal jaundice and this association persisted in a multivariable model (p-value

Abstract Understanding the origin of superconductivity in correlated two-dimensional materials is a key step in leveraging material engineering techniques for next-generation nanoscale devices. While it is widely accepted that phonons fluctuations only mediate conventional (s-wave) superconductivity, the common phenomenology of superconductivity in Bernal bilayer and rhombohedral trilayer graphene, as well as in a large family of graphene-based moiré systems, suggests a common superconducting mechanism across these platforms. In particular, in all these platforms some superconducting regions violate the Pauli limit, indicating unconventional superconductivity, naively ruling out conventional phonon-mediated pairing as the underlying mechanism. Here we combine first principles simulations with effective low-energy theories to investigate the superconducting mechanism and pairing symmetry in rhombohedral stacked graphene multilayers. We find that phonon-mediated superconductivity explains the main experimental findings, namely the displacement field and doping level dependence of the critical temperature, and the presence of two superconducting regions with different pairing symmetries that depend on the parent normal state. In particular, we find that intra-valley phonon scattering favors a triplet f-wave pairing when combined with electronic correlations stabilizing a spin- and valley-polarized normal state. We also propose a so far unexplored superconducting region at higher hole doping densities n h ≈ 4 × 1012 cm−2, and demonstrate how this highly hole-doped regime can be reached in heterostructures consisting of monolayer α-RuCl3 and rhombohedral trilayer graphene. Our findings promote phonon-mediated pairing as a strong contender to explain superconductivity across a wide range of graphene platforms, and demonstrate that phonons can, in fact, stabilize unconventional superconducting orders.

Abstract The pan-immune-inflammation value (PIV), calculated as (neutrophil × platelet × monocyte)/lymphocyte count, may be useful for estimating survival in breast cancer patients. To determine the prognostic value of PIV for overall survival in breast cancer patients in Lima, Peru. A retrospective cohort study was conducted. 97 breast cancer patients diagnosed between January 2010 and December 2016 had their medical records analyzed. The primary dependent variable was overall survival, and the key independent variable was the PIV, divided into high (≥ 310) and low (

Abstract The pairing symmetry of Sr2RuO4 is a long-standing fundamental question in the physics of superconducting materials with strong electronic correlations. We use the functional renormalization group to investigate the behavior of superconductivity under uniaxial strain in a two-dimensional realistic model of Sr2RuO4 obtained with density functional theory and incorporating the effect of spin-orbit coupling. We find a dominant $${d}_{{{{{\rm{x}}}}}^{2}-{{{{\rm{y}}}}}^{2}}$$ d x 2 − y 2 superconductor mostly hosted by the d xy-orbital, with no other closely competing superconducting state. Within this framework, we reproduce the experimentally observed enhancement of the critical temperature under strain and propose a simple mechanism driven by the density of states to explain our findings. We also investigate the competition between superconductivity and spin-density wave ordering as a function of interaction strength. By comparing theory and experiment, we discuss constraints on a possible degenerate partner of the $${d}_{{{{{\rm{x}}}}}^{2}-{{{{\rm{y}}}}}^{2}}$$ d x 2 − y 2 superconducting state.

Abstract Optical driving of materials has emerged as a versatile tool to control their properties, with photo-induced superconductivity being among the most fascinating examples. In this work, we show that light or lattice vibrations coupled to an electronic interband transition naturally give rise to electron-electron attraction that may be enhanced when the underlying boson is driven into a non-thermal state. We find this phenomenon to be resonantly amplified when tuning the boson’s frequency close to the energy difference between the two electronic bands. This result offers a simple microscopic mechanism for photo-induced superconductivity and provides a recipe for designing new platforms in which light-induced superconductivity can be realized. We discuss two-dimensional heterostructures as a potential test ground for light-induced superconductivity concretely proposing a setup consisting of a graphene-hBN-SrTiO3 heterostructure, for which we estimate a superconducting T c that may be achieved upon driving the system.

Abstract Using light irradiation to manipulate quantum materials has opened up avenues for transiently inducing superconductivity in some systems. Despite experimental confirmation across various compounds, the mechanism behind the dynamic formation of Cooper pairs remains highly debated, in part due to the strong electronic correlations at play, which pose challenges for theoretical investigations relying on perturbative or phenomenological approaches. Here, we investigate the dynamical onset of superconductivity in the strongly correlated, yet exactly solvable Yukawa-Sachdev-Ye-Kitaev model. Analyzing dynamical protocols motivated by theoretical mechanisms proposed for light-induced superconductivity, that is light-induced cooling and the dressing of Hamiltonian parameters, we investigate the exact relaxation resulting out of undercooling and interaction quenches. While, in contrast to BCS theory, it is not possible for superconductivity to emerge following interaction quenches across the superconducting phase transition, we find that the dynamical relaxation of undercooled states universally leads to superconductivity. Despite the strong correlations, the emerging order parameter dynamics are well captured by a coarse grained Ginzburg-Landau theory. Our study provides an integral stepping stone towards exploring light-induced superconductivity in strongly correlated systems in a theoretically controlled way.

The recent discovery of a variety of intricate electronic order in kagome metals has sprouted significant theoretical and experimental interest. From an electronic perspective on the potential microscopic origin of these phases, the most basic model is given by a Hubbard model on the kagome lattice. We employ a functional renormalization group (FRG) to analyze the kagome Hubbard model. Through our methodological refinement of FRG both within its N-patch and truncated unity formulation, we resolve previous discrepancies of different FRG approaches [Wang et al., Phys. Rev. B 87, 115135 (2013)1098-012110.1103/PhysRevB.87.115135 vs Kiesel et al., Phys. Rev. Lett. 110, 126405 (2013)0031-900710.1103/PhysRevLett.110.126405], and analyze both the pure (p-type) and mixed (m-type) van Hove fillings of the kagome lattice.

Understanding of unconventional superconductivity is crucial for engineering materials with specific order parameters or elevated superconducting transition temperatures. However, for many materials, the pairing mechanism and symmetry of the order parameter remain unclear: reliable and efficient methods of predicting the order parameter and its response to tuning parameters are lacking. Here, we investigate the response of superconductivity in Sr_{2}RuO_{4} to structural distortions via the random phase approximation (RPA) and functional renormalization group (FRG), starting from realistic models of the electronic structure. Our results suggest that RPA misses the interplay of competing fluctuation channels. FRG reproduces key experimental findings. We predict a magic octahedral rotation angle, maximizing the superconducting T_{c} and a dominant d_{x^{2}−y^{2}} pairing symmetry. To enable experimental verification, we provide calculations of the phase-referenced Bogoliubov Quasiparticle Interference imaging. Our work demonstrates a designer approach to tuning unconventional superconductivity with relevance and applicability for a wide range of quantum materials.

Abstract Strong light-matter interactions as realized in an optical cavity provide a tantalizing opportunity to control the properties of condensed matter systems. Inspired by experimental advances in cavity quantum electrodynamics and the fabrication and control of two-dimensional magnets, we investigate the fate of a quantum critical antiferromagnet coupled to an optical cavity field. Using unbiased quantum Monte Carlo simulations, we compute the scaling behavior of the magnetic structure factor and other observables. While the position and universality class are not changed by a single cavity mode, the critical fluctuations themselves obtain a sizable enhancement, scaling with a fractional exponent that defies expectations based on simple perturbation theory. The scaling exponent can be understood using a generic scaling argument, based on which we predict that the effect may be even stronger in other universality classes. Our microscopic model is based on realistic parameters for two-dimensional magnetic quantum materials and the effect may be within the range of experimental detection.

Maca (Lepidium meyenii), a biennial herbaceous plant indigenous to the Andes Mountains, has a rich history of traditional use for its purported health benefits. Maca’s chemical composition varies due to ecotypes, growth conditions, and post-harvest processing, contributing to its intricate phytochemical profile, including, macamides, macaenes, and glucosinolates, among other components. This review provides an in-depth revision and analysis of Maca’s diverse bioactive metabolites, focusing on the pharmacological properties registered in pre-clinical and clinical studies. Maca is generally safe, with rare adverse effects, supported by preclinical studies revealing low toxicity and good human tolerance. Preclinical investigations highlight the benefits attributed to Maca compounds, including neuroprotection, anti-inflammatory properties, immunoregulation, and antioxidant effects. Maca has also shown potential for enhancing fertility, combating fatigue, and exhibiting potential antitumor properties. Maca’s versatility extends to metabolic regulation, gastrointestinal health, cardio protection, antihypertensive activity, photoprotection, muscle growth, hepatoprotection, proangiogenic effects, antithrombotic properties, and antiallergic activity. Clinical studies, primarily focused on sexual health, indicate improved sexual desire, erectile function, and subjective wellbeing in men. Maca also shows promise in alleviating menopausal symptoms in women and enhancing physical performance. Further research is essential to uncover the mechanisms and clinical applications of Maca’s unique bioactive metabolites, solidifying its place as a subject of growing scientific interest.

Solid pseudopapillary neoplasm is an extremely rare tumor that represents approximately 0.9-2.7% of all exocrine pancreatic tumors. This entity tends to have a greater predilection for young women between the ages of 18 and 35 and usually presents as a slow-growing abdominal mass with nonspecific manifestations. Its proper diagnosis consists mainly of imaging studies since it presents characteristics that distinguish it from other entities. Likewise, its management requires a multidisciplinary approach, where surgery has shown to play a crucial role.

Motivated by the recent experimental realization of ABCB stacked tetralayer graphene [Wirth et al., ACS Nano 16, 16617 (2022)1936-085110.1021/acsnano.2c06053], we study correlated phenomena in moiré-less graphene tetralayers for realistic interaction profiles using an orbital resolved random phase approximation approach. We demonstrate that magnetic fluctuations originating from local interactions are crucial close to the van Hove singularities on the electron- and hole-doped side promoting layer selective ferrimagnetic states. Spin fluctuations around these magnetic states enhance unconventional spin-triplet, valley-singlet superconductivity with f-wave symmetry due to intervalley scattering. Charge fluctuations arising from long range Coulomb interactions promote doubly degenerate p-wave superconductivity close to the van Hove singularities. At the conduction band edge of ABCB graphene, we find that both spin and charge fluctuations drive f-wave superconductivity. Our analysis suggests a strong competition between superconducting states emerging from long- and short-ranged Coulomb interactions and thus stresses the importance of microscopically derived interaction profiles to make reliable predictions for the origin of superconductivity in graphene-based heterostructures.

Abstract This study discusses the effect of long‐range interactions within the self‐consistent Hartree‐Fock (HF) approximation in comparison to short‐range atomic Hubbard interactions on the band structure of twisted bilayer graphene (TBG) at charge neutrality for various twist angles. Starting from atomistic calculations, it determines the quasi‐particle band structure of TBG with Hubbard interactions for three magnetic orderings: modulated anti‐ferromagnetic (MAFM), (NAFM) and hexagonal anti‐ferromagnetic (HAFM). Then, it develops an approach to incorporate these magnetic orderings along with the HF potential in the continuum approximation. Away from the magic angle, it observes a drastic effect of the magnetic order on the band structure of TBG compared to the influence of the HF potential. Near the magic angle, the HF potential plays a major role in the band structure, with HAFM and MAFM being secondary effects, but NAFM appears to still significantly distort the electronic structure at the magic angle. These findings suggest that the spin‐valley degenerate broken symmetry state often found in HF calculations of charge neutral TBG near the magic angle should favor magnetic order, since the atomistic Hubbard interaction will break this symmetry in favor of spin polarization.

Essential oils supplementation has potential growth-promoting, antibacterial, and immunostimulatory effects for various fish species. Dietary supplementation with essential oils improves Nile tilapia's growth and intestinal morphology. The aim of the study was to assess the effect of supplementation with microencapsulated essential oils (MEOs) containing cinnamaldehyde (53.9 %), thymol (24.2 %), and carvacrol (18.7 %) in Nile tilapia fingerlings on growth parameters and foregut histomorphometry. Six thousand fishes with initial body weights and lengths of 1.20 ± 0.32 g and 2.03 ± 0.40 cm, respectively, were reared in two separate 60 m3 circular tanks (control and supplemented with 500 mg/kg of MEOs) at a 5 kg/m3 density. Growth parameters included weight and length. Ten foregut samples per tank were collected at 0-, 15- and 30-days post-treatment. The histological analysis involved the size of intestinal folds and the number of goblet cells. Our results showed that fingerling growth parameters such as final body weight and length increased by 16.9 % and 10.43 %, respectively, with MEOs supplementation compared to the control group. Furthermore, histomorphometry results showed that the supplementation of MEOs led to a significant increase in the growth of both the width and length of intestinal folds and the number of goblet cells (p

Abstract The electronic and structural properties of atomically thin materials can be controllably tuned by assembling them with an interlayer twist. During this process, constituent layers spontaneously rearrange themselves in search of a lowest energy configuration. Such relaxation phenomena can lead to unexpected and novel material properties. Here, we study twisted double trilayer graphene (TDTG) using nano-optical and tunneling spectroscopy tools. We reveal a surprising optical and electronic contrast, as well as a stacking energy imbalance emerging between the moiré domains. We attribute this contrast to an unconventional form of lattice relaxation in which an entire graphene layer spontaneously shifts position during assembly, resulting in domains of ABABAB and BCBACA stacking. We analyze the energetics of this transition and demonstrate that it is the result of a non-local relaxation process, in which an energy gain in one domain of the moiré lattice is paid for by a relaxation that occurs in the other.

Abstract Experimental demonstrations of tunable correlation effects in magic-angle twisted bilayer graphene have put two-dimensional moiré quantum materials at the forefront of condensed-matter research. Other twisted few-layer graphitic structures, boron-nitride, and homo- or hetero-stacks of transition metal dichalcogenides (TMDs) have further enriched the opportunities for analysis and utilization of correlations in these systems. Recent experiments within the latter material class confirmed the relevance of many-body interactions and demonstrated the importance of their extended range. Since the interaction, its range, and the filling can be tuned experimentally by twist angle, substrate engineering and gating, we here explore Fermi surface instabilities and resulting phases of matter of hetero-bilayer TMDs. Using an unbiased renormalization group approach, we establish in particular that hetero-bilayer TMDs are platforms to realize topological superconductivity with winding number $$| {{{\mathcal{N}}}}| =4$$ ∣ N ∣ = 4 . We show that this state reflects in pronounced experimental signatures, such as distinct quantum Hall features.

Studies of twisted bilayer transition metal dichalcogenides have so far focused only on those containing group-VI metals. Here, the authors predict that twisted bilayers of ZrS2, with the group-IV metal Zr, form an emergent moiré Kagome lattice with a uniquely strong spin-orbit coupling, leading to quantum-anomalous-Hall and fractional-Chern-insulating states.

El presente trabajo tiene como objetivo establecer el correcto alcance del derecho de acceso a la información pública a través de la conceptualización de sus elementos fundamentales. Un aspecto importante será entender la correcta aplicación del principio de máxima publicidad (eje central sobre el que se asienta esta temática) en armonía con el régimen de excepciones tal como está definido en la Ley Modelo Interamericana 2.0. En efecto, el derecho de acceso a la información pública no es ilimitado. Existen circunstancias en las cuales pueden establecerse restricciones al mismo. Debido a que todos los derechos fundamentales tienen la misma jerarquía, ante una colisión de los mismos la solución no es hacer simplemente prevalecer unos sobre otros, sino resolverla sobre la base de la técnica de la ponderación. En ese sentido, la Ley Modelo 2.0 intenta dos cosas: dar el mayor alcance posible al derecho de acceso a la información pública, garantizando la adecuada entrega de la información de tal forma que sea útil y sirva a su propósito esencial, y garantizar la efectiva concordancia en la aplicación de los diferentes intereses y derechos que pueden quedar involucrados en una situación concreta.

For solid-state experiments, exactly solvable quantum light matter models, where the quantum nature of light is relevant, are scarce. Here, the authors introduce an exactly solvable model, where a one-dimensional tight-binding chain is coupled to a single cavity mode and derive analytic expressions for the ground state, where the photons are squeezed due to the light-matter coupling.

To assess whether high-dose coronavirus disease (COVID-19) convalescent plasma (CCP) transfusion may benefit patients with severe COVID-19, we conducted a multicenter randomized trial in Brazil. Patients with severe COVID-19 who were within 10 days of initial symptom onset were eligible. Patients in the CCP group received 3 daily doses of CCP (600 mL/d) in addition to standard treatment; control patients received standard treatment only. Primary outcomes were death rates at days 30 and 60 of study randomization. Secondary outcomes were ventilator-free days and hospital-free days. We enrolled 107 patients: 36 CCP and 71 control. At day 30, death rates were 22% for CCP and 25% for the control group; at day 60, rates were 31% for CCP and 35% for control. Needs for invasive mechanical ventilation and durations of hospital stay were similar between groups. We conclude that high-dose CCP transfused within 10 days of symptom onset provided no benefit for patients with severe COVID-19.

Abstract Magic-angle twisted trilayer graphene (MATTG) recently emerged as a highly tunable platform for studying correlated phases of matter, such as correlated insulators and superconductivity. Superconductivity occurs in a range of doping levels that is bounded by van Hove singularities, which stimulates the debate of the origin and nature of superconductivity in this material. In this work, we discuss the role of spin-fluctuations arising from atomic-scale correlations in MATTG for the superconducting state. We show that in a phase diagram as a function of doping (ν) and temperature, nematic superconducting regions are surrounded by ferromagnetic states and that a superconducting dome with T c ≈ 2 K appears between the integer fillings ν = −2 and ν = −3. Applying a perpendicular electric field enhances superconductivity on the electron-doped side which we relate to changes in the spin-fluctuation spectrum. We show that the nematic unconventional superconductivity leads to pronounced signatures in the local density of states detectable by scanning tunneling spectroscopy measurements.

Evidence for correlated insulating and superconducting phases around regions of high density of states was reported in the strongly spin-orbit coupled van der Waals material twisted tungsten diselenide (tWSe_{2}). We investigate their origin and interplay by using a functional renormalization group approach that allows one to describe superconducting and spin/charge instabilities in an unbiased way. We map out the phase diagram as a function of filling and perpendicular electric field, and find that the moiré Hubbard model for tWSe_{2} features mixed-parity superconducting order parameters with s/f-wave and topological d/p-wave symmetry next to (incommensurate) density-wave states. Our work systematically characterizes competing interaction-driven phases in tWSe_{2} beyond mean-field approximations and provides guidance for experimental measurements by outlining the fingerprint of correlated states in interacting susceptibilities.

Aquaculturists, local beach managers, and other stakeholders require forecasts of harmful biotic events, so they can assess and respond to health threats when harmful algal blooms (HABs) are present. Based on this need, we are developing empirical habitat suitability models for a variety of Chesapeake Bay HABs to forecast their occurrence based on a set of physical-biogeochemical environmental conditions, and start with the dinoflagellate Prorocentrum minimum (also known as P. cordatum).To identify an optimal set of environmental variables to forecast P. minimum blooms, we first assumed a linear relationship between the environmental variables and the inverse of the logistic function used to forecast the likelihood of bloom presence, and repeated the method using more than 16,000 combinations of variables. By comparing goodness-of-fit, we found water temperature, salinity, pH, solar irradiance, and total organic nitrogen represented the most suitable set of variables. The resulting algorithm forecasted P. minimum blooms with an overall accuracy of 78%, though with a significant variability ~ 30-90% depending on region and season. To understand this variability and improve model performance, we incorporated nonlinear effects into the model by implementing a generalized additive model. Even without considering interactions between the five variables used to train the model, this yielded an increase in overall model accuracy (~ 81%) due to the model’s ability to refine the regions in which P. minimum blooms occurred. Including nonlinear interactions increased the overall model accuracy even further (~ 85%) by accounting for seasonality in the interaction between solar irradiance and water temperature. Our findings suggest that the influence of predictors of these blooms change in time and space, and that model complexity impacts the model performance and our interpretation of the driving factors causing P. minimum blooms. Apart from their forecasting potential, our results may be particularly useful when constructing explicit relationships between environmental conditions and P. minimum presence in mechanistic models.

We explore unconventional superconductivity of repulsive spinless fermions on square and honeycomb lattices with staggered sublattice potentials. The two lattices can exhibit staggered d-wave and f-wave pairing, respectively, at low doping stemming from an effective two-valley band structure. At higher doping, in particular, the square lattice displays a much richer phase diagram including topological p+ip superconductivity which is induced by a qualitatively different mechanism compared to the d-wave pairing. We illuminate this from several complementary perspectives: We analytically perform sublattice projection to analyze the effective continuum low-energy description and we numerically calculate the binding energies for pair and larger bound states for few-body doping near half filling. Furthermore, for finite doping, we present phase diagrams based on extensive functional renormalization group and and density matrix renormalization group calculations.

Introduction: A correct lifestyle is vital in older adults to reduce their risk of diseases and loss of functionality. Objective: To determine the lifestyles of elderly patients in a Health Center in the Peruvian Andes. Method: Observational, descriptive study with elderly patients from a health center. We worked with a previously collected database. Descriptive statistics were used. The study was approved by the institutional ethics committee. Results: Of the 74 patients evaluated, the mean age was 75.4 years and 52% were females. The mean BMI was 24.8 kg / m2 and that of the abdominal circumference was 86.8 cm. 32.7% had a visual acuity of 70 in the right eye and 36.4% of 50 in the left eye. Glucose (mg / dL), hemoglobin (g / dL) and uric acid (mg / dL) had a median of 97, 15.4 and 7; respectively. Triglycerides and cholesterol had a mean of 182.2 mg / dL and 189.9 mg / dL; respectively. 5.4% of men had reactive PSA. 4% had diabetes, 21.6% hypertension, and 22.2% anemia; while 70.3% consumed alcohol, 6.8% smoked and 89.2% consumed soda. Conclusions: Some indicators of poor lifestyle were found, such as the consumption of alcohol and soft drinks, as well as indicators of conditions related to a poor lifestyle such as an average BMI close to being overweight, high triglycerides and cholesterol.

Superconductivity reported in metals driven away from equilibrium via optical pumping has been proposed to arise from nonlinear coupling between electrons and optically excited phonons. The authors use an exact approach to show that here, disorder, which disfavors superconductivity, emerges even though the system is translationally invariant.

Twisted van der Waals systems are known to host flat electronic bands, originating from moire potential. Here, the authors predict from purely geometric considerations a new type of nearly dispersionless bands in twisted bilayer MoS2, resulting from destructive interference between effective lattice hopping matrix elements.

Objective: To determine the associated factor with the non-use of health services in a sample of the lesbian, gay, bisexual, transgender, and intersex population of Peru. Materials and methods: Analytical cross-sectional study, analysis of secondary data from the First LGBTI Survey of Peru. Those who suffered from a medical condition during the last twelve months who had to receive medical attention were considered a variable of interest. Crude prevalence ratios (PRc) and adjusted (PRa), with 95% confidence intervals (95% CI) were calculated using Poisson regressions with robust variance. Three models were developed, adjusted to variables grouped according to sexual orientation, gender identity, and intersexuality. Results: 55.4% were male at birth, the median age was 25 years (IR: 21-30). 16% stated that they had not sought medical attention. The three models presented a negative association in having suffered a chronic disease, infectious, contagious diseases, and mental illness and those who expressed their orientation openly. Not being respected for the gender they identified was related to not using the services in model 3. Models 1 and 3 included a positive association with not being respected with the gender identified. Conclusion: Suffering from a mental illness, an infectious contagious disease, a chronic disease, and not being treated with respect according to their gender identity are factors associated with the non-use of health services.

Here, a combined experiment-theory framework based on different nano-imaging techniques and first-principle calculations is used to analyse the shapes of moiré patterns in twisted van der Waals structures, enabling an accurate description of the coupling between the atomically thin layers.

COVID-19 represents a global crisis. Rapidly conducting a clinical trial with the rigor necessary to obtain reliable results requires the collaboration of various participants involved in the development, evaluation and authorization of clinical trials (CT) such as the trial sponsor, researchers, regulatory authority and the ethics committee (EC). Carrying out these studies is not only scientifically appropriate, but an ethical and moral obligation to guarantee our patients effective treatment. SOLIDARITY is a mega clinical trial that recruited thousands of subjects with moderate to severe disease, who were randomly assigned to one of the treatment groups under evaluation, including hydroxychloroquine, lopinavir/ritonavir associated or not with interferon; or remdesivir compared to standard therapy. Peru has joined the list of countries where the trial will be reproduced, through which it will be possible to quickly identify if any of these drugs offers a real benefit to patients

Objetivo: Determinar los factores asociados al nivel de conocimiento de las señales de alarma en el embarazo en gestantes atendidas en los consultorios externos pertenecientes al Departamento de Ginecología y Obstetricia en el Hospital Nacional Hipólito Unanue en 2017. Materiales y métodos: Estudio transversal, observacional, analítico; con muestro no probabilístico por conveniencia a 196 gestantes de consultorios externos del Departamento de Ginecología y Obstetricia en el Hospital Nacional Hipólito Unanue durante los meses de octubre, noviembre y diciembre 2017. Los datos fueron recolectados con una encuesta estructurada y las variables categóricas se analizaron con test de chi2 y se utilizó el modelo de regresión logística, calculándose OR ajustados con sus respectivos intervalos de confianza. Resultados: Edad promedio de 26 años ± 5.36 años. La soltería en las gestantes actúo como un factor protector del nivel de conocimiento alto de las señales de alarma del embarazo (OR: 0.362; IC95%: 0.362-0.947; p=0.033). Conclusiones: Existe una relación entre gestantes solteras con el nivel de conocimiento alto de las señales de alarma en el embarazo en la población del Hospital Nacional Hipólito Unanue en el 2017, si la gestante es soltera presenta 0.3 veces la posibilidad de tener un nivel alto de conocimiento de las señales de alarma en el embarazo; actúa como factor protector.

Resumo: O Humanismo é parte da formação do médico para construir-se como um profissional capaz de entender e cuidar de seus pacientes. As humanidades e as artes são recursos educacionais para promover o humanismo nos futuros médicos. O cinema é particular mente útil para educar a afetividade do estudante. Educar as emoções requer estratégias inovadoras modernas que não ao encontro das necessidades do estudante. O processo vai além do ensino teórico de atitudes para, utilizando a cultura da emoção e da imagem na qual o estudante está imerso, promover a reflexão vital. A abordagem metodológica trabalha as emoções do estudante como ponto de partida para, através de grupos de reflexão, possibilitar a construção de conceitos na relação médico-paciente e criar o hábito da reflexão habitual que pode ser transportada para as atividades do cotidiano. O objetivo deste aprendizado é promover no futuro médico exercício da reflexão, base do compromisso vocacional profissional. A metodologia pode ser usada em vários cenários de educação médica, sempre que os professores tenham familiaridade e gosto pelas humanidades e priorizem o aprendizado centrado no aluno.

Introduction COVID-19 has caused great fear on health professionals and could affect their mental health, therefore it is important to determine the association between the perception of risk to COVID-19 and mental health in workers of a Peruvian hospital. Methods Analytical cross-sectional study, through virtual survey. The dependent variables were: depression, anxiety and stress; The independent variable was perception of risk to COVID-19 and the covariates: sociodemographic, family, work and clinical data. Crude and adjusted prevalence ratios were found with a 95% confidence interval and a significance level of 5%. Results There was no association between risk perception and depression (adjusted prevalence ratio: 0.98 95% confidence interval: 0.89 to 1.08), anxiety (adjusted prevalence ratio: 0.94 95% confidence interval: 0.89 to 1.00), stress (adjusted prevalence ratio: 0.89 95% confidence interval 0.76 to 1.04). In the multivariate analysis, an association was found between depression with direct contact with the COVID-19 patient (adjusted prevalence ratio: 2.06, 95% confidence interval: 1.14 to 3.70) and with having a comorbidity (adjusted prevalence ratio: 2.56 95% confidence interval: 1.52 to 4.30); likewise, between anxiety with number of children (adjusted prevalence ratio: 1.09 95% confidence interval: 1.00 to 1.18), with direct contact with COVID-19 patient (adjusted prevalence ratio: 2.67 95% confidence interval 1.46 to 4.85) and having comorbidity (adjusted prevalence ratio: 2.00 95% confidence interval: 1.40 to 2.86); finally, between stress with direct contact with the COVID-19 patient (adjusted prevalence ratio: 2.86, 95% confidence interval: 1.20 to 6.83). Conclusions No statistically significant association was found between risk perception and depression, anxiety, or stress. However, there was an association between depression, anxiety, and stress, each with direct contact with COVID-19 patients; between anxiety and depression, each with having comorbidities and, finally, anxiety with the number of children.

The advent of twisted moiré heterostructures as a playground for strongly correlated electron physics has led to a plethora of experimental and theoretical efforts seeking to unravel the nature of the emergent superconducting and insulating states. Among these layered compositions of two-dimensional materials, transition metal dichalcogenides are now appreciated as highly tunable platforms to simulate reinforced electronic interactions in the presence of low-energy bands with almost negligible bandwidth. Here, we focus on the twisted homobilayer WSe2 and the insulating phase at half-filling of the flat bands reported therein. More specifically, we explore the possibility of realizing quantum spin liquid (QSL) physics on the basis of a strong coupling description, including up to second-nearest neighbor Heisenberg couplings J1 and J2 as well as Dzyaloshinskii–Moriya (DM) interactions. Mapping out the global phase diagram as a function of an out-of-plane displacement field, we indeed find evidence for putative QSL states, albeit only close to SU(2) symmetric points. In the presence of finite DM couplings and XXZ anisotropy, long-range order is predominantly present with a mix of both commensurate and incommensurate magnetic phases.

ObjectivesTo determine the risk factors for in-hospital mortality in patients with COVID-19 from a Peruvian national hospital.MethodsRetrospective cohort study of medical records of patients with COVID-19 hospitalized at Hospital Nacional Hipólito Unanue (HNHU) during the months of April to August 2020. The dependent variable was in-hospital mortality. Independent variables included sociodemographic and clinical characteristics, physical examination findings, oxygen saturation (SaO2) at admission, treatment received during hospitalization and laboratory results at admission. A Cox regression model was used to evaluate the crude and adjusted hazard ratios for associated factors.ResultsWe included 1418 patients. Median age was 58 years (IQR 47-68 years) and 944 (66.6%) were male. The median length of hospitalization was 7 (4-13) days, and the mortality rate was 46%. The most frequent comorbidities were type 2 diabetes mellitus, hypertension, and obesity. In the adjusted analysis, mortality was associated with age (HR 1.02; 95%CI 1.02-1.03), history of surgery (HR 1.89; 95%CI 1.31-2.74), lower oxygen saturation at admission (HR 4.08; CI95% 2.72-8.05 for SaO294%), the presence of poor general condition (HR 1.81; 95% CI 1.29-2.53), altered state of consciousness (HR 1.58; 95%CI 1.18-2.11) and leukocyte levels (HR 1.01; 95%CI 1.00-1. 02). Treatment with ivermectin (HR 1.44; 95%CI 1.18-1.76) and azithromycin (HR 1.25; 95%CI 1.03-1.52) were associated with higher mortality. Treatment with corticosteroids at low to moderate doses was associated with lower mortality (HR 0.56 95%CI 0. 37-0. 86) in comparison to no steroid use.ConclusionA high mortality was found in our cohort. Low oxygen saturation at admission, age, and the presence of hematological and biochemical alterations were associated with higher mortality. The use of hydroxychloroquine, ivermectin or azithromycin was not useful and was probably associated with unfavorable outcomes. The use of corticosteroids at moderate doses was associated with lower mortality.