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Introduction: Infections represent a significant cause of morbidity and mortality in patients with multiple myeloma (MM). In Latin America, data on infectious complications in newly diagnosed MM (NDMM) patients are limited. Methods: We conducted a multicenter, prospective cohort study of patients with NDMM in Uruguay between June 2019 and December 2020. Patients with active disease, on active therapy and who provided written informed consent were included. Elegible patients were followed for 6 months from the time of diagnosis and before proceeding to autologous stem cell transplantation or until death, whichever occurred first. Our primary endpoint was the number of infectious events that required hospitalization for ≥ 24 h. Main results: Of 124 patients with NDMM, 54 (43.5 %) had infectious complications (74 infectious events), the majority (74.3 %) within the first 3 months from diagnosis. The most common sites of infection were urinary (39.2 %) and respiratory tracts (33.8 %). The microbial agent was identified in 60.8 % of patients with Gram-negative bacteria (71.4 %) as the most common pathogen. Viral and fungal infections were infrequent. In the multivariable analysis, the Eastern Cooperative Oncology Group (ECOG) performance status was ≥ 2 (odds ratio [OR], 2.16; 95 % confidence interval [95 %CI], 1.23 - 3.79; p = 0.008) and creatinine ≥ 2 mg/dl (OR, 2.33; 95 %CI, 1.33 - 4.07; p = 0.003) were independent factors associated with bacterial infections. At 6 months, 14 patients (11.3 %) had died, 50 % related to infectious complications. Conclusion: Bacterial infections are a substantial cause of hospital admissions and early death in patients with NDMM. Antibiotic prophylaxis should be considered to reduce infectious complications in patients with MM.

Introduction: Autologous stem cell transplantation (ASCT) is the standard consolidation option for transplant-eligible patients with multiple myeloma (MM). The aim of this study is to report the overall survival (OS) and progression-free survival (PFS) outcomes after frontline ASCT in newly-diagnosed MM (NDMM) patients in a real-world setting. Methods: We conducted a retrospective, survival analysis of all NDMM patients included in the MM Uruguayan Registry. Results: We included 151 NDMM patients treated with induction therapy followed by high-dose melphalan and ASCT as consolidation. The median age at diagnosis was 59 years, and the international staging system (ISS) risk groups were ISS-III 32.9%, ISS-II 37.8%, and ISS-I 29.4%. Frontline induction regimens included bortezomib in 61.6% of cases, and maintenance therapy was used in 63.9% of reported cases. With a median follow-up of 42 months, the 36-month OS and PFS for the whole group were 82.4% (95% CI 75.9% to 89.4%) and 63.8% (95% CI 55.6% to 73.3%), respectively, median OS of 98 months and median PFS of 47 months. The 100-month OS and PFS for the entire group were 48.0% (95% CI 34.9% to 66.0%) and 17.3% (95% CI 8.4% to 35.8%), respectively. Conclusion: ASCT is a feasible, safe, and potent strategy that provides a prolonged median OS and PFS in NDMM patients. This approach can be implemented in low-income countries.

Introduction: During the last decades the use of erythropoiesis stimulating agents has significantly diminished the prevalence of anemia in patients receiving chronic hemodialysis. Currently, residing at higher altitudes is associated with higher levels of endogenous erythropoietin. Objective: This study aims to analyze how residing at higher altitudes influences the requirements of exogenous erythropoietin in patients receiving hemodialysis as renal replacement therapy. Methodology: Descriptive observational cross-section, including adult patients from three Ecuadorian centers, receiving chronic hemodialysis, between January and June 2020. Patients were classified into two groups regarding the altitude of residence: those living at low-lying regions (2000 masl, Quito). Results: We included 580 patients, 45.5% in the high-altitude group and 54.5% at low-lying regions. Median exogenous erythropoietin dose was higher in low-lying regions (22000 international units) versus high altitude (17333.3 international units) (P=0.00003) and the proportion of patients without erythropoietin requirement was higher in high altitude (21.6%), compared to low regions (1.0%) (P

Introducción: la contaminación resultante de la industrialización ha propiciado el aumento de la concentración de metales en diversos ambientes y su incorporación a materias primas y productos terminados, lo que repercute directamente en la salud humana. Objetivo: cuantificar metales en la materia prima empleada en la fabricación de la tableta masticable LECISAN® y en la tableta, para establecer niveles de referencia de: aluminio, calcio, cadmio, cromo, cobre, hierro, magnesio, plomo, silicio, vanadio y zinc. Método: se utilizó la espectrometría atómica de emisión óptica con plasma inductivamente acoplado (ICP OES) y se establecieron mediante métodos estadísticos los intervalos de confianza para la media de los valores cuantificados con una probabilidad del 95 %. Resultados: existen diferencias significativas entre las dos formas de presentación en cuanto a la cantidad de todos los metales, excepto aluminio (p

Introduction: Soy lecithin is a highly demanded dietary supplement, with supposed benefits as antioxidants based on its high fatty acid content. Objective: To determine the preclinical effect of soy lecithin on the oxidative status of Wistar rats and on human erythrocytes as an in vitro pharmacological biomodel. Material and Methods: An experimental non-clinical pharmacology study was carried out to determine the oxidative profile in Wistar rats after the administration of soy lecithin in maximum and minimum doses, and to compare the effects with the non-supplemented control group. Subsequently, a prospective, experimental and non-clinical pharmacological study was carried out in human erythrocytes as a pharmacological biomodel according to the hemolysis test, with three experimental groups at different concentrations of the test product, a positive control and a negative control. The differences between the experimental groups were evidenced by the Kruskal Wallis ANOVA test and Dunn's post hoc test with a significance level of less than 5%. Results: In vivo oxidative stress markers were reduced in the administration groups, becoming more evident at higher doses, with a tendency towards stability in catalase values. The soy lecithin used showed signs of hemolysis, and the optical microscopy study showed severe morphological damage in the erythrocytes additionally treated with the tested product and H2O2. Conclusions: The results obtained suggest the existence of a pro-oxidant effect by inducing oxidative stress in vivo and erythrocyte hemolysis in vitro.

Wide Bandgap (WBG) semiconductor materials present promising electrical and thermal characteristics for Power Electronics applications. These WBG devices make it possible the development of more efficient converters with higher power densities. In contrast to Silicon Carbide (SiC) devices, Gallium Nitride (GaN) devices are several steps behind in terms of development, standardization and achievable power levels. This makes the use and integration of these devices in real power applications more challenging. Commercially available current Power GaN devices are based on lateral normally ON HEMT transistors. In order to get normally OFF power transistors, two transistor structures have been proposed: enhancement mode (e-mode) and hybrid transistors. Current E-mode transistors present a low gate threshold voltage which could lead to crosstalk problems. In contrast, hybrid transistors have higher gate threshold voltages, however, the use of a Silicon MOSFET in their structure limits their performance. The lack of a standard power GaN device makes it difficult the adoption of these promising devices by the industry. Thus, in order to facilitate the adoption of these power GaN devices, this paper presents a State of the Art of power Gallium Nitride devices focusing on their structures, basics and gate terminal requirements.

Even with the advent of 5G wireless communications and the millimeter wave spectrum, there will always be crowded frequency bands where multiple uncoordinated networks will have to contend (or collaborate) to squeeze as much throughput as possible while avoiding interference. This work proposes a branch and bound algorithm for maximizing the overall sum rate over multiple interfering networks with a pre-fixed set of offered flows, as well as a heuristic algorithm that individual networks can follow to collaboratively share the available bandwidth with that same objective. The latter algorithm finds a greedy solution by independently optimizing the links and routes for each network, and then refines that solution by discarding inefficient and potentially harmful links. It does not require any direct communication between the networks, relying instead on location estimates which could be inferred from interference powers. Simulation results show that, when the networks have different traffic loads, the proposed algorithm outperforms the original greedy solution as well as those based on partitioning the resources among the networks for their exclusive use.

Falls in older people are a major health concern as the leading cause of disability and the second most common cause of accidental death. We developed a rapid fall risk assessment based on a combination of physical performance measurements made with an inertial sensor embedded in a smartphone. This study aimed to evaluate and validate the reliability and accuracy of an easy-to-use smartphone fall risk assessment by comparing it with the Physiological Profile Assessment (PPA) results. Sixty-five participants older than 55 performed a variation of the Timed Up and Go test using smartphone sensors. Balance and gait parameters were calculated, and their reliability was assessed by the (ICC) and compared with the PPAs. Since the PPA allows classification into six levels of fall risk, the data obtained from the smartphone assessment were categorised into six equivalent levels using different parametric and nonparametric classifier models with neural networks. The F1 score and geometric mean of each model were also calculated. All selected parameters showed ICCs around 0.9. The best classifier, in terms of accuracy, was the nonparametric mixed input data model with a 100% success rate in the classification category. In conclusion, fall risk can be reliably assessed using a simple, fast smartphone protocol that allows accurate fall risk classification among older people and can be a useful screening tool in clinical settings.

Background: Multiple myeloma is a disease of the elderly. However, 40% of patients are diagnosed before 65 years old. Outcomes regarding age as a prognostic factor in MM are heterogeneous. Method: We retrospectively analyzed clinical characteristics, response to treatment and survival of 282 patients with active newly-diagnosed multiple myeloma, comparing results between patients younger and older than 65 years. Main results: The frequency of multiple myeloma in those younger than 66 years was 53.2%. Younger patients presented with a more aggressive disease, more advanced Durie-Salmon stage (85.3% vs 73.5%; p = 0.013), extramedullary disease (12.7% vs 0%; p

Este trabajo realizamos un análisis descriptivo del desarrollo histórico conceptual del paisaje sonoro. El objetivo es identificar la manera en que se ha construido un campo de estudio alrededor de dicha propuesta. Se desarrolló una búsqueda selectiva de literatura que tuvo como punto de partida textos clave de Murray Schafer y del World Soundscape Project, a partir de los cuales se rastreó su influencia en distintas partes del mundo. Se identificó un periodo de expansión durante la década de 1980, en el cual se conformaron sus dos enfoques principales: el ecológico y el perceptual-cultural. Así mismo, se hizo énfasis en la manera en que fue abordado dicho término desde enfoques culturalistas en geografía y se identificó que a partir de las discusiones hechas surgieron como propuesta las geografías auditivas y del sonido. Finalmente, se realizó una revisión sistemática en índices y buscadores de literatura académica y se encontró un interés latente, durante los últimos tres lustros, por incorporar el sonido como objetivo de estudio a partir de alguna de las posturas mencionadas (paisaje sonoro, geografías auditivas y geografías del sonido), sin embargo, es un tema que continúa en proceso de consolidación.

In this study, we analyse the proximity between professional players during a soccer match. Specifically, we are concerned about the time a player remains at a distance to a rival that is closer than 2 m, which has a series of consequences, from the risk of contagion during a soccer match to the understanding of the tactical performance of players during the attacking/defensive phases. Departing from a dataset containing the Euclidean positions of all players during 60 matches of the Spanish national league (30 from LaLiga Santander and 30 from LaLiga Smartbank, respectively, the first and second divisions), we analysed 1,670 participations of elite soccer players. Our results show a high heterogeneity of both the player-player interaction time (from 0 to 14 min) and the aggregated time with all opponents (from

Durante los últimos veinte años, el Centro de Arqueología Subacuática (CAS-IAPH) ha desarrollado un amplio programa de documentación y recopilación de información sobre naufragios históricos en aguas andaluzas a través de los fondos de archivos públicos y privados. En la actualidad, cuenta con cerca de 2.000 referencias que van a permitir la mejora del conocimiento, protección y preservación de ese patrimonio tan amenazado por el expolio. Con el fin de mejorar la eficacia de este proceso, entre 2018 y 2019, ha desarrollado, junto con el Centro PRHLT de la Universidad Politécnica de Valencia, un proyecto innovador (el proyecto Carabela) que confirma la eficacia de las técnicas de reconocimiento de texto manuscrito (HTR) para localizar y caracterizar documentos digitales en grandes fondos de archivos sin apenas intervención humana, con el consecuente ahorro de tiempo y recursos en la investigación y/o gestión de estos fondos.

El autor, luego de leer el artículo titulado “Leucemia promielocítica aguda M3. Reporte de un caso clínico”,(1) publicado en la Revista Eugenio Espejo, tuvo la motivación por dirigirse al equipo editorial y el público en general para referir sus consideraciones al respecto.

Background: Urinary tract infections (UTI) are among the most common infections in pediatric patients. The main etiopathogenic agent is Escherichia coli. The purpose of this study was to determine the antimicrobial resistance pattern of E. coli in pediatric patients and to understand their main clinical and laboratory manifestations. Methods: Fifty-nine patients were included in the study and classified into two groups: hospitalization (H) and external consultation (EC). Every patient presented urine cultures with the isolation of E. coli that included an antibiogram. Clinical signs and symptoms, urinalysis, complete blood count (CBC) and serum inflammatory markers were analyzed. Results: The most common clinical manifestations were fever (H: 76.5%; EC: 88%), vomiting (H: 32.4%; EC: 32%), hyporexia (H: 20.6%; EC: 16%), abdominal pain (H: 20.6%: EC: 28%), and dysuria (H: 14.7%; EC: 32%). Ten patients (16.95%) presented UTI for extended spectrum beta-lactamase (ESBL) E. coli. Ampicillin, nalidixic acid, and trimethoprim-sulfamethoxazole showed a higher resistance rate, being ampicillin the most significant (H: 88.2%; EC: 92%). Leukocyturia, bacteriuria and urine nitrites were frequent alterations in urinalysis (H: 52.9%; EC: 92%). In ESBL E. coli patients, a positive correlation was found between leukocytes in CBC and C-reactive protein (r = 0.9, p < 0.01). Diarrhea and foul-smelling urine were associated with E. coli resistance. Conclusions: The presence of leukocytes, bacteria, nitrites and the Gram stain are the most common indicators. Nitrofurantoin and phosphomycin are good therapeutic options. However, an antibiogram must be conducted to determine the best therapeutic agent.

We investigate the relation between the number of passes made by a football team and the number of goals. We analyze the 380 matches of a complete season of the Spanish national league “LaLiga" (2018/2019). We observe how the number of scored goals is positively correlated with the number of passes made by a team. In this way, teams on the top (bottom) of the ranking at the end of the season make more (less) passes than the rest of the teams. However, we observe a strong asymmetry when the analysis is made depending on the part of the match. Interestingly, fewer passes are made in the second half of a match, while, at the same time, more goals are scored. This paradox appears in the majority of teams, and it is independent of the number of passes made. These results confirm that goals in the first half of matches are more “costly” in terms of passes than those scored in second halves.

We quantified the spatial and temporal entropy related to football teams and their players by means of a pass-based interaction. First, we calculated the spatial entropy associated to the positions of all passes made by a football team during a match, obtaining a spatial entropy ranking of Spanish teams during the 2017/2018 season. Second, we investigated how the player’s average location in the field is related to the amount of entropy of his passes. Next, we constructed the temporal passing networks of each team and computed the deviation of their network parameters along the match. For each network parameter, we obtained the permutation entropy and the statistical complexity of its temporal fluctuations. Finally, we investigated how the permutation entropy (and statistical complexity) of the network parameters was related to the total number of passes made by a football team. Our results show that (i) spatial entropy changes according to the position of players in the field, and (ii) the organization of passing networks change during a match and its evolution can be captured measuring the permutation entropy and statistical complexity of the network parameters, allowing to identify what parameters evolve more randomly.

Objetivo: medir la asociación entre el nivel de conocimientos sobre la resolución de problemas en la utilización de los métodos anticonceptivos y la presencia de embarazo no planeado en mujeres que usan métodos anticonceptivos de corta acción. Establecer la prevalencia del embarazo no planeado y describir actitudes, percepciones y características de la atención en las actividades de planificación familiar. Materiales y métodos: estudio analítico de corte transversal. Se incluyeron mujeres entre 14 y 49 años de edad, que acudieron a realizarse una prueba de embarazo a una institución de salud del sector público, de bajo nivel de complejidad, que atiende población del régimen de aseguramiento subsidiado por el Estado en la ciudad Medellín (Colombia). Antes de obtener el resultado de la prueba de embarazo se les realizó una encuesta estructurada y un test acerca de su conocimiento para resolver situaciones que pueden afectar la efectividad de los métodos de anticoncepción dependientes de la mujer. Resultados: se realizaron 471 encuestas, el 75,2 % de las mujeres no planeaban embarazarse y el 57 % tuvieron un embarazo no planeado. La mediana del nivel de conocimientos fue del 50 % (p25: 37,5 %, p75: 62,5 %). La razón de prevalencias de embarazo no planeado con nivel medio y alto de conocimientos fue 0,56 (IC 95 %: 0,34-0,92). Conclusión: el conocimiento sobre la resolución de los problemas que afectan la efectividad de los métodos anticonceptivos que dependen del buen uso de la mujer para garantizar esa efectividad se asocia a menor frecuencia de embarazo no planeado.