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Contribution: This study explores industry members' perceptions about the ABET-based accreditation in a developing country, using the case study of a program in a publicly funded polytechnic university in Ecuador. Background: Engineering programs often seek international accreditations to enhance the education quality, align with the global standards or gain academic reputation. ABET-based accreditation originates in United States, and thus presents some challenges for institutions in developing countries. Intended Outcomes: This study aimed to investigate the significance of international academic accreditation, as seen through the perspective of industry members. It focused on identifying fundamental competencies valued by employers and aimed to provide insights for institutions in similar contexts. Application Design: The research employed an approach informed by a qualitative methodology, involving in-depth interviews with five industry members who had served on the advisory committee board of an engineering program from a higher education institution in Ecuador. Findings: The findings identified three main areas of competencies that the industry members value: communication skills for teamwork, a problem-solving orientation, and an ability for effective task planning. The study also showed that these industry members value international accreditation as a means for enhancing education quality and ensuring graduates develop the necessary skills and competencies, yet the overall awareness with their peers remains relatively low.

This paper presents a systematic literature review of professional development programs in computational thinking (CT). CT has emerged as an essential set of skills that everyone should develop to participate in a global society. However, there were no pre-service or in-service teacher programs to integrate CT into the K-12 classrooms until very recently. Thus, it is important to identify how educators and researchers address the challenges to prepare the next generation of students and what gaps persist in the current literature. We review existing work in this field from two perspectives: First, we analyze the learning outcomes, assessment methods, pedagogical approaches, and pedagogical tools used in the professional development programs in CT. Second, we examine how these programs assess the teachers' knowledge and skills as outcomes. We used the technological pedagogical and content knowledge (TPACK) framework to characterize existing literature and identify possible gaps in the preparation of pre-service and in-service teachers in CT. Our results suggest that (1) existing evidence is limited to developed countries; (2) many studies are only focusing on teachers understanding the concepts but do not explore how the participants evaluate or create learning activities; (3) no studies look into classroom observations as part of the program, which limits our understanding to how these programs work; and (4) most programs use block-based programming languages as the tool to develop student CT. While block-based programming languages are used for introductory training programs, students are often expected to transfer their learning to more professional programming languages.

Understanding spoken words requires listeners to integrate large amounts of linguistic information over time. There has been considerable debate about how semantic context preceding or following a target word affects its recognition, with preceding semantic context often viewed as a constraint on possible future words, and following semantic context as a mechanism for disambiguating previous ambiguous input. Surprisingly, no studies have directly compared whether the timing of semantic context influences spoken word recognition. The current study manipulates the acoustic-perceptual features of a target word, a semantic cue elsewhere in the sentence biasing toward one interpretation, and the location of the semantic context. We find that the two cues are additively integrated in participants' word identification responses, and that semantic context affects categorization the same regardless of where it appears relative to the target word. This suggests that listeners can optimally integrate acoustic-perceptual and semantic information across time.

Rural schools and communities in Peru are rich in cultural diversity in Indigenous languages and traditions, but rural areas remain the most disadvantaged regions. Peru's educational policies are neoliberal and have hindered opportunities for the rural population to receive a high quality education with a critical reappraisal of their cultural backgrounds. Within this scenario, critical perspectives in education have emerged from the voices of historically marginalised educational actors: rural teachers. Two rural teachers from small towns in Cusco and Ayacucho (in the southern highlands of Peru) participated in narrative research to explore their practices of social justice in education. The aim of this paper is to examine their practices through critical pedagogies. The findings reveal that a crucial role of the Indigenous language, Quechua, is in making an inclusive reappraisal of the local culture. The teachers sought to empower their pupils by applying Freirean concepts of critical consciousness and dialogue through creative activities. They acknowledged the role of parents and the community who value diversity and local culture and support their critical pedagogical practices in schools. In this case, social justice in education was addressed by valuing Indigenous culture and placing it in dialogue with Western knowledge.

Abstract Background The selection of adequate indicators of tissue hypoxia for guiding the resuscitation process of septic patients is a highly relevant issue. Current guidelines advocate for the use of lactate as sole metabolic marker, which may be markedly limited, and the integration of different variables seems more adequate. In this study, we explored the metabolic profile and its implications in the response to the administration of a fluid challenge in early septic shock patients. Methods Observational study including septic shock patients within 24 h of ICU admission, monitored with a cardiac output estimation system, with ongoing resuscitation. Hemodynamic and metabolic variables were measured before and after a fluid challenge (FC). A two-step cluster analysis was used to define the baseline metabolic profile, including lactate, central venous oxygen saturation (ScvO2), central venous-to-arterial carbon dioxide difference (PcvaCO2), and PcvaCO2 corrected by the difference in arterial-to-venous oxygen content (PcvaCO2/CavO2). Results Seventy-seven fluid challenges were analyzed. Cluster analysis revealed two distinct metabolic profiles at baseline. Cluster A exhibited lower ScvO2, higher PcvaCO2, and lower PcvaCO2/CavO2. Increases in cardiac output (CO) were associated with increases in VO2 exclusively in cluster A. Baseline isolated metabolic variables did not correlate with VO2 response, and changes in ScvO2 and PcvaCO2 were associated to VO2 increase only in cluster A. Conclusions In a population of early septic shock patients, two distinct metabolic profiles were identified, suggesting tissue hypoxia or dysoxia. Integrating metabolic variables enhances the ability to detect those patients whose VO2 might increase as results of fluid administration.

The Transvolcanic Belt (TVB) of Mexico is a biogeographic province of significant biodiversity, acting as a transition zone between eastern and western Mexico. Using available literature, we collected species lists for amphibians and reptiles in Mexican states within the TVB biogeographic province, updating them with additional literature. The TVB is home to 427 native species of amphibians and reptiles, 154 amphibians and 273 reptiles, which represent 30.5% of the species of amphibians and reptiles in Mexico. The TVB also houses 50 endemic species, with 84 species listed by the IUCN. Threats include habitat destruction and pollution. The TVB shares a significant portion of its amphibian and reptile species with neighboring provinces, particularly the Sierra Madre Oriental and the Sierra Madre del Sur, suggesting a mixture of species from both eastern and western Mexico. Cluster analyses based on species composition reveal distinct groupings of provinces, with the TVB forming a cluster with the Sierra Madre Oriental, Veracruzan, and Sierra Madre del Sur for both amphibians and reptiles. Conservation assessments indicate that a significant proportion of the amphibian and reptile species in the TVB are at risk, primarily due to habitat loss from urbanization, agriculture, and pollution. Urgent conservation actions are needed to protect the unique herpetofauna of the TVB from further decline.

Objectives. To evaluate the structure and operation of national immunization technical advisory groups (NITAGs) in Latin America and the Caribbean and to make recommendations for improvement. Methods. A convenience sample of six current and eight former NITAG members representing 12 countries in the region were invited in 2022 to answer a web-based questionnaire on NITAG structure, organization, and procedures. The questionnaire used indicators similar to those in the Joint Reporting Form on Immunization. Participants were also asked about the role their NITAGs played in coronavirus disease 2019 (COVID-19) immunization policies. Results. Brazil, Dominican Republic, and Venezuela (Bolivarian Republic of) reported not having an active NITAG. The nine active NITAGs are structured and organized according to World Health Organization and Pan American Health Organization recommendations, with variations between countries. Most NITAGs include representatives of the five recommended medical specialties with the participation of additional members possible. Only Bolivia (Plurinational State of) and Mexico have no explicit policy for managing members' potential conflicts of interest. All NITAGs have an exclusively technical advisory role and generally meet once a quarter. Usually, NITAGs are asked by health ministries to analyze issues and make recommendations. All NITAGs, except for Perus, actively participated in supporting decision-making for immunization policy on COVID-19. Conclusions. NITAGs have successfully supported vaccine policy-making through evidence-based recommendations. However, improvement in their structure, operation, and transparency is needed to help them keep up with the rapidly evolving field of immunization. Research on the impact of NITAGs is important to support the development of recommendations for improvement.

Abstract Background Metformin, a widely prescribed antidiabetic drug, has shown several promising effects for cancer treatment. These effects have been shown to be mediated by dual modulation of the AMPK-mTORC1 axis, where AMPK acts upstream of mTORC1 to decrease its activity. Nevertheless, alternative pathways have been recently discovered suggesting that metformin can act through of different targets regulation. Methods We performed a transcriptome screening analysis using HeLa xenograft tumors generated in NOD-SCID mice treated with or without metformin to examine genes regulated by metformin. Western Blot analysis, Immunohistochemical staining, and RT-qPCR were used to confirm alterations in gene expression. The TNMplot and GEPIA2 platform were used for in silico analysis of genes found up-regulated by metformin, in cervical cancer patients. We performed an AMPK knock-down using AMPK-targeted siRNAs and mTOR inhibition with rapamycin to investigate the molecular mechanisms underlying the effect of metformin in cervical cancer cell lines. Results We shown that metformin decreases tumor growth and increased the expression of a group of antitumoral genes involved in DNA-binding transcription activator activity, hormonal response, and Dcp1-Dcp2 mRNA-decapping complex. We demonstrated that ZFP36 could act as a new molecular target increased by metformin. mTORC1 inhibition using rapamycin induces ZFP36 expression, which could suggest that metformin increases ZFP36 expression and requires mTORC1 inhibition for such effect. Surprisingly, in HeLa cells AMPK inhibition did not affect ZFP36 expression, suggesting that additional signal transducers related to suppressing mTORC1 activity, could be involved. Conclusions These results highlight the importance of ZFP36 activation in response to metformin treatment involving mTORC1 inhibition. Graphical Abstract

Se analiza el Modelo Mexicano de Formación Dual (MMFD) para la adquisición de habilidades laborales y sus efectos en la transición escuela-trabajo en Guanajuato. Los resultados muestran que los aprendices duales obtienen competencias técnicas y experimentan transiciones coherentes entre su formación escolar y su destino ocupacional, lo que se debe al vínculo institucional empresa-escuela construido por los tomadores de decisiones y por quienes han sido favorecidos por un contexto económico en crecimiento. Para recolectar la información se aplicaron entrevistas en profundidad a los jóvenes y a los actores involucrados en las compañías e instituciones educativas. También se llevó a cabo una encuesta a egresados y estudiantes duales activos, así como a sus pares con una formación escolar tradicional.

Abstract Seismic tomography observations show a low‐velocity feature in the upper mantle beneath eastern North America known as the Northern Appalachian Anomaly (NAA). Proposed models for the formation of the NAA include a remnant high‐temperature feature resulting from the passage of the Great Meteor Hotspot, edge‐driven convection, and ongoing asthenospheric upwelling. We investigate the structure of the lithosphere above the central portion of the NAA using data from the New England Seismic Transects (NEST) experiment. Ps receiver functions reveal two consistent interfaces beneath the dense northern line of NEST: the Moho (the base of the crust) and a deeper negative velocity gradient (NVG) feature located at depths between 60 and 110 km. We consider several potential explanations for this NVG feature; based on comparisons with previous results, we propose that it likely corresponds to the lithosphere‐asthenosphere boundary. Our results indicate that the lithosphere beneath New England is nonuniform and has likely been thinned.

Objetivo: evaluar los efectos del uso de plasma rico en plaquetas (PRP), ácido hialurónico (AH), o su combinación, en la analgesia y funcionalidad en pacientes femeninas operadas por artroscopía por lesiones condrales en la rodilla. Materiales y métodos: estudio de cohorte prospectivo, participaron dieciséis pacientes femeninas con una edad promedio de 52.7 años (DE = 2.84). Las exposiciones evaluadas fueron inyección intraarticular de plasma rico en plaquetas (12.5%), ácido hialurónico (37.5%) y su combinación (50.0%). Todas las pacientes fueron seguidas durante cuatro semanas postquirúrgicas. Se evaluaron el dolor, la funcionalidad en términos de distancia caminada y capacidad para subir y bajar escaleras, y los resultados de maniobras clínicas (Appley, McMurray, cajón anterior y posterior). Resultados: se observó que el dolor promedio disminuyó significativamente de 3 (DE = 1) a 2 (DE = 1) (p = 0.015). En la escala funcional de subir y bajar escaleras, se constató una mejoría clínica significativa (p = 0.004), con un aumento del 12.5% al 62.5% en las pacientes que realizaban esta actividad sin asistencia. Las maniobras de Appley y McMurray positivas al dolor mostraron disminución, siendo significativa la segunda (p = 0.072 y p = 0.023). Conclusiones: a la fecha, la evidencia que apoya o rechaza la inyección de ortobiológicos es escasa y controversial. Los resultados de este estudio sugieren que estas intervenciones pueden ser efectivas para la rehabilitación postquirúrgica en pacientes con lesiones condrales en la rodilla, aunque se necesitan trabajos con mayores muestras y seguimiento a largo plazo para reforzar estos hallazgos.

Aging is a universal and progressive process involving the deterioration of physiological functions and the accumulation of cellular damage. Gene regulation programs influence how phenotypes respond to environmental and intrinsic changes during aging. Although several factors, including sex, are known to impact this process, the underlying mechanisms remain incompletely understood. Here, we investigate the functional organization patterns of skeletal muscle genes across different sexes and ages using gene co-expression networks (GCNs) to explore their influence on aging. We constructed GCNs for three different age groups for male and female samples, analyzed topological similarities and differences, inferred significant associated processes for each network, and constructed null models to provide statistically robust results. We found that each network is topologically and functionally distinct, with young women having the most associated processes, likely due to reproductive tasks. The functional organization and modularity of genes decline with age, starting from middle age, potentially leading to age-related deterioration. Women maintain better gene functional organization throughout life compared to men, especially in processes like macroautophagy and sarcomere organization. The study suggests that the loss of gene co-expression could be a universal aging marker. This research offers insights into how gene organization changes with age and sex, providing a complementary method to analyze aging.

OBJECTIVES:. Anemia has been associated with an increased risk of both cardiac arrest and stroke, frequent complications of COVID-19. The effect of hemoglobin level at ICU admission on a composite outcome of cardiac arrest or stroke in an international cohort of COVID-19 patients was investigated. DESIGN:. Retrospective analysis of prospectively collected database. SETTING:. A registry of COVID-19 patients admitted to ICUs at over 370 international sites was reviewed for patients diagnosed with cardiac arrest or stroke up to 30 days after ICU admission. Anemia was defined as: normal (hemoglobin ≥ 12.0 g/dL for women, ≥ 13.5 g/dL for men), mild (hemoglobin 10.0–11.9 g/dL for women, 10.0–13.4 g/dL for men), moderate (hemoglobin ≥ 8.0 and < 10.0 g/dL for women and men), and severe (hemoglobin < 8.0 g/dL for women and men). PATIENTS:. Patients older than 18 years with acute COVID-19 infection in the ICU. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. Of 6926 patients (median age = 59 yr, male = 65%), 760 patients (11.0%) experienced stroke (2.0%) and/or cardiac arrest (9.4%). Cardiac arrest or stroke was more common in patients with low hemoglobin, occurring in 12.8% of patients with normal hemoglobin, 13.3% of patients with mild anemia, and 16.7% of patients with moderate/severe anemia. Time to stroke or cardiac arrest by anemia status was analyzed using Cox proportional hazards regression with death as a competing risk. Covariates selected through clinical knowledge were age, sex, comorbidities (diabetes, hypertension, obesity, and cardiac or neurologic conditions), pandemic era, country income, mechanical ventilation, and extracorporeal membrane oxygenation. Moderate/severe anemia was associated with a higher risk of cardiac arrest or stroke (hazard ratio, 1.32; 95% CI, 1.05–1.67). CONCLUSIONS:. In an international registry of ICU patients with COVID-19, moderate/severe anemia was associated with increased hazard of cardiac arrest or stroke.

Irrigation systems significantly enhance agricultural productivity but are also substantial consumers of water, energy, and natural resources. The need to optimize their design encouraged agronomic engineering to develop various methods for improving the design and management of these irrigation networks. This development focuses on creating a tool to define the optimal flow distribution according to the system's irrigation or consumption needs, thereby determining the design flows. The aim is to optimize the design of pipe diameters to improve sustainability (i.e., reducing CO2 emissions, minimizing service pressure, and maximizing recoverable energy within the system). These principles ensure a better evaluation of sustainable development goals within agricultural production. The proposed procedure develops a strategy to define the best-fitting distribution using a multicriteria solution. As novel, the research develops a tool, which characterizes flow distributions deviating from the classic Clement's formulation used in irrigation systems. The proposed method was applied in a Mediterranean irrigation system in Spain, achieving a correlation coefficient above 0.9 in the model. This methodology addresses design criteria in terms of sustainability and reduces energy consumption in networks. It achieved material savings of 6.01 % compared to the observed network, reducing CO2 emissions between 5.61 and 5.72 TnCO2/ha over its lifecycle.

This work presents the employing of LoRaWAN (Long Range Wide Area Network) for location applications through a network simulation to determine a mobile node position. We rely on FLoRa (Framework for LoRa) and OMNeT++ (Objective Modular Network Testbed in C++) simulator, which uses Python feature tools, following the calculation of node placement using the trilateration technique. Our method differs from others in that we calculate the FLoRa power loss and determine different simulation settings using the shadowing feature of the log-distance path loss model. We approached RSSI (Received Signal Strength Indicator) to measure the distance between the LoRa gateways and the nodes, establishing a link between these parameters. Our work aims to promote the integration of open-source tools for verifying signal intensity values based on node distance from gateways. We consider it useful for engineers in predicting signal behaviors according to topology and settings variations. During the experimentation, the network underwent different performances according to the transmission parameters considered during the simulation. This was critical when increasing the number of mobile nodes, leading to consuming computer capacity and resources. Through repetition of tests, we confirmed the lower intensity of the received signal as the node moves to farther positions, reaching consistent power indicators and positioning accuracy. Overall, the results show that LoRaWAN integrated with trilateration techniques can be practical in providing adequate performance for node positioning accuracy and long-distance communication with low power consumption.

Objective. To provide an overview of the status of the childhood vaccination schedule in the Americas, outline program structures, and identify updated implementation strategies to improve vaccination coverage following the COVID-19 pandemic. Methods. A group of experts in pediatrics, epidemiology, vaccines, and global and public health discussed the current status of the childhood vaccination schedule in the Americas, describing the program structure and identifying new implementation strategies that have the potential to improve vaccination coverage in the post-pandemic context, after the challenges COVID-19 presented for more than two years. Results. The Americas currently face a high risk of resurgence of diseases that were previously controlled or eliminated. Therefore, it is important to find new strategies to educate citizens on the risks associated with lower vaccination rates, especially in children. Conclusions. New strategies along with strong mobilization of the population and advocacy by citizens are necessary to prevent antivaccination groups from gaining a stronger presence in the region and jeopardizing the credibility of the Expanded Program on Immunization.

The clitic pronoun ne and the functional element de introducing nominal constituents have many nominal and prepositional functions across Romance languages. In this article, we focus on the nominal functions, singling out three different bundles of semantic features that characterize both ne and de. They can denote properties of individual entities, properties of kinds, or predicate properties. The article shows that Catalan ne and de display the three types of denotation, while Italian ne and de only display the first one. This article further supports the hypothesis that the indefinite determiner de can be overt or silent, thereby unifying de-phrases (and the Italian partitive article) with bare nouns. The analysis of de as an indefinite determiner is then extended to adjectival de, which is claimed to mark concord features on adjectives in both Catalan and Italian.

Researchers have made headway against challenges of increasing cement infrastructure and low plastic recycling rates by using waste plastic in cementitious materials. Past studies indicate that microbially induced calcium carbonate precipitation (MICP) to coat plastic in calcium carbonate may improve the strength. The objective of this study was to increase the amount of clean and contaminated waste plastic that can be added to mortar and to assess whether MICP treatment enhances the strength. The performance of plastic-filled mortar was investigated at 5%, 10%, and 20% volume replacement for cement. Untreated, clean plastics at a 20% cement replacement produced compressive strengths acceptable for several applications. However, a coating of MICP on clean waste plastic did not improve the strengths. At 10% replacement, both MICP treatment and washing of contaminated plastics recovered compressive strengths by approximately 28%, relative to mortar containing oil-coated plastics. By incorporating greater volumes of waste plastics into mortar, the sustainability of cementitious composites has the potential of being improved by the dual mechanisms of reduced cement production and repurposing plastic waste.

FMR1 premutation cytosine-guanine-guanine repeat expansion alleles are relatively common mutations in the general population that are associated with a neurodegenerative disease (fragile X-associated tremor/ataxia syndrome), reproductive health problems and potentially a wide range of additional mental and general health conditions that are not yet well-characterised. The International Fragile X Premutation Registry (IFXPR) was developed to facilitate and encourage research to better understand the FMR1 premutation and its impact on human health, to facilitate clinical trial readiness by identifying and characterising diverse cohorts of individuals interested in study participation, and to build community and collaboration among carriers, family members, researchers and clinicians around the world. Here, we describe the development and content of the IFXPR, characterise its first 747 registrants from 32 countries and invite investigators to apply for recruitment support for their project(s). With larger numbers, increased diversity and potentially the future clinical characterisation of registrants, the IFXPR will contribute to a more comprehensive and accurate understanding of the fragile X premutation in human health and support treatment studies.

Advanced manufacturing research for sustainable battery life cycles is of utmost importance to reach net zero carbon emissions (European Commission, 2023a) as well as several of the United Nations Sustainable Development Goals (UNSDGs), for example: 30% reduction of CO2 emission, 10 million job opportunities and access to electricity for 600 million people (World Economic Forum, 2019). This editorial paper highlights international motivations for pursuing more sustainable manufacturing practices and discusses key research topics in battery manufacturing. Batteries will be central to our sustainable future as generation and storage become key components to on-demand energy supply. Four underlying themes are identified to address industrial needs in this field: 1. Digitalizing and automating production capabilities: data-driven solutions for production quality, smart maintenance, automation, and human factors, 2. Human-centric production: extended reality for operator support and skills development, 3. Circular battery life cycles: circular battery systems supported by service-based and other novel business models, 4. Future topics for battery value chains: increased industrial resilience and transparency with digital product passports, and next-generation battery chemistries. Challenges and opportunities along these themes are highlighted for transforming battery value chains through circularity and more sustainable production, with a particular emphasis on lithium-ion batteries (LIB). The paper concludes with directions for further research to advance a circular and sustainable battery value chain through utilizing the full potential of digitalization realising a cleaner, more energy-efficient society.

El presente estudio experimental aborda el impacto del tipo de emisor de información en la percepción de credibilidad de las noticias tecnológicas. La investigación involucró a 150 estudiantes universitarios, quienes, mediante un diseño entre sujetos 3 x 1, observaron un video sobre un innovador invento médico. La variable principal fue el emisor de la noticia: un presentador humano, un avatar con alto grado de realismo humano y un avatar de apariencia ficticia. La evaluación se centró en la credibilidad de la información. A través de análisis de la varianza (Anovas) y pruebas post-hoc se descubrió una jerarquía clara en la percepción de credibilidad. Los datos revelaron que existen diferencias estadísticamente significativas en la credibilidad otorgada a la condición humana y a la del avatar realista, a favor del humano. Sin embargo, no se hallaron diferencias significativas entre el humano y el avatar ficticio. Esto sugiere que la apariencia no humana de un avatar no necesariamente disminuye la credibilidad frente a una persona real, aunque los avatares muy realistas pueden generar cierto rechazo que se puede traducir en una menor credibilidad percibida.

The set of singular values of a digraph with respect to a vertex-degree based topological index is the set of all singular values of its general adjacency matrix. The spectral norm is the largest singular value and the energy the sum of the singular values. In this paper we characterize the digraphs which have exactly one singular value different from zero and the digraphs for which all singular values are equal. As a consequence, we deduce sharp upper and lower bounds for the spectral norm and energy of digraphs. In addition to being a natural generalization, proving the results in the general setting of digraphs allows us to deduce new results on graph energy.

The objective of this study was to understand the maize production chain in the Republic of Honduras, and to identify potential obstacles hindering grain end-quality. Seventy-one municipalities across six departments of Western Honduras were surveyed: Copán, Intibucá, La Paz, Lempira, Ocotepeque, and Santa Bárbara. A total of 871 surveys were collected, out of which 725 were from rural areas and 146 from urban areas. The sampling design reflected population density and population-based indicators from USAID's Feed the Future initiative, such as poverty level and prevalence of underweight non-pregnant females between the ages of 15 and 49. Further, indicators associated with underdevelopment in children were also considered. Survey instruments designed for either maize farmers or maize marketers were used to collect data including seed source, type planted, intercropping, time of harvest, drying and storage practices, quality control, and consumption patterns. Farmers preferred to plant criolla (native) maize (81–96%), although non-native varieties were also grown and consumed (3–13%). Following harvest, sun drying is the most used method (14–40%) for moisture control. Farmers reported maize spoilage resulting primarily from inadequate drying and pest damage (56–82%). Although aware of this, up to 28% of the producers reported not performing preventive grain inspections in the course of storage. Maize marketers typically sourced their grain within the department (33–71%), with a smaller fraction (0–8%) also obtaining maize from other departments or neighboring countries. Mirroring farmers, visual quality checks by marketers occurred primarily at initial storage (36–69%) and decreased in frequency as storage time lengthened. Given that both studied groups of farmers and marketers continue to rely on traditional practices, and corrective rather than preventive measures, the likelihood of low-quality product and risk for mycotoxin contamination is exacerbated. Based on these findings, achieving food security for the region of study will require a transformation in pre- and post-harvest handling practices.

Premutation alleles with 55-200 CGG repeats in FMR1 can lead to fragile X-associated tremor/ataxia syndrome (FXTAS). In this case study, we report uncontrolled gout in a 68-year-old male with FXTAS with multiple sites of involvement including a rare gouty tophus in the nasal region.

BACKGROUND: BCG vaccines are given to more than 100 million children every year, but there is considerable debate regarding the effectiveness of BCG vaccination in preventing tuberculosis and death, particularly among older children and adults. We therefore aimed to investigate the age-specific impact of infant BCG vaccination on tuberculosis (pulmonary and extrapulmonary) development and mortality. METHODS: In this systematic review and individual participant data meta-analysis, we searched MEDLINE, Web of Science, BIOSIS, and Embase without language restrictions for case-contact cohort studies of tuberculosis contacts published between Jan 1, 1998, and April 7, 2018. Search terms included mycobacterium tuberculosis, TB, tuberculosis, and contact. We excluded cohort studies that did not provide information on BCG vaccination or were done in countries that did not recommend BCG vaccination at birth. Individual-level participant data for a prespecified list of variables, including the characteristics of the exposed participant (contact), the index case, and the environment, were requested from authors of all eligible studies. Our primary outcome was a composite of prevalent (diagnosed at or within 90 days of baseline) and incident (diagnosed more than 90 days after baseline) tuberculosis in contacts exposed to tuberculosis. Secondary outcomes were pulmonary tuberculosis, extrapulmonary tuberculosis, and mortality. We derived adjusted odds ratios (aORs) using mixed-effects, binary, multivariable logistic regression analyses with study-level random effects, adjusting for the variable of interest, baseline age, sex, previous tuberculosis, and whether data were collected prospectively or retrospectively. We stratified our results by contact age and Mycobacterium tuberculosis infection status. This study is registered with PROSPERO, CRD42020180512. FINDINGS: We identified 14 927 original records from our database searches. We included participant-level data from 26 cohort studies done in 17 countries in our meta-analysis. Among 68 552 participants, 1782 (2·6%) developed tuberculosis (1309 [2·6%] of 49 686 BCG-vaccinated participants vs 473 [2·5%] of 18 866 unvaccinated participants). The overall effectiveness of BCG vaccination against all tuberculosis was 18% (aOR 0·82, 95% CI 0·74-0·91). When stratified by age, BCG vaccination only significantly protected against all tuberculosis in children younger than 5 years (aOR 0·63, 95% CI 0·49-0·81). Among contacts with a positive tuberculin skin test or IFNγ release assay, BCG vaccination significantly protected against tuberculosis among all participants (aOR 0·81, 95% CI 0·69-0·96), participants younger than 5 years (0·68, 0·47-0·97), and participants aged 5-9 years (0·62, 0·38-0·99). There was no protective effect among those with negative tests, unless they were younger than 5 years (0·54, 0·32-0·90). 14 cohorts reported on whether tuberculosis was pulmonary or extrapulmonary (n=57 421). BCG vaccination significantly protected against pulmonary tuberculosis among all participants (916 [2·2%] in 41 119 vaccinated participants vs 334 [2·1%] in 16 161 unvaccinated participants; aOR 0·81, 0·70-0·94) but not against extrapulmonary tuberculosis (106 [0·3%] in 40 318 vaccinated participants vs 38 [0·2%] in 15 865 unvaccinated participants; 0·96, 0·65-1·41). In the four studies with mortality data, BCG vaccination was significantly protective against death (0·25, 0·13-0·49). INTERPRETATION: Our results suggest that BCG vaccination at birth is effective at preventing tuberculosis in young children but is ineffective in adolescents and adults. Immunoprotection therefore needs to be boosted in older populations. FUNDING: National Institutes of Health.

Purpose: Slotting is one of the main operations in warehouse management. It is based on the efficient allocation of slots for stock-keeping units (SKUs). Order picking and slotting represent a high percentage of total logistics costs; therefore, improving these activities leads to significant savings in the overall performance. This paper aims to develop an allocation model integrating SKUs physical variables, warehousing design, and operation (dimensions, layout, material handling equipment), and heterogeneous product demand. Design/methodology/approach: The modeling methodology considers two phases. First, an integer linear programming model for warehousing spaces assignment for SKUs considering priority and required orders is developed. Then, the total operation times using different strategies are calculated. Findings: The effectiveness of the model was verified through simulation using historical data. The results showed that the best performance in the total time of the slotting operation is achieved by using the ABC as a criterion for the classification of the SKUs and by sequentially assigning the row, level, column, and the section. Practical implications: This approach can be adapted to different industrial sectors and serves as a basis for more robust models regarding the number of constraints or the incorporation of additional warehouse operating parameters. Originality/value: The most important contribution of this work is the development of a flexible and adaptable methodology to changes in the operation to improve the efficiency of storage management through slotting. Future work includes other objective functions of sustainable operations and uncertainty treatment techniques.

Herein, we present an updated list of the species of amphibians and reptiles that inhabit Nayarit, Mexico. In the years since the publication of a previous list in 2016, threats to amphibians and reptiles in Nayarit have continued unabated and efforts to more fully catalogue the richness of Nayarit’s herpetofauna have continued. Nayarit harbours 162 native species of amphibians and reptiles, representing 35 families and 85 genera. These include 37 species of amphibians (35 anurans and two salamanders) and 125 species of reptiles (one crocodile, 44 lizards, 69 snakes and 11 turtles). Of the amphibian and reptile species in Nayarit, 102 are endemic to Mexico and two endemic to Nayarit. The ecoregion with the highest richness of amphibians and reptiles in Nayarit is the Trans-Mexican Volcanic Belt followed closely by the Sierra Madre Occidental and then the Sierra Madre del Sur, the Pacific Lowlands and the Nayarit Islands. Just 5.8% of the species of amphibians and reptiles in Nayarit is IUCN-listed as Vulnerable, Endangered or Critically Endangered, 11.1% are placed in a protected category by SEMARNAT and nearly a third are categorised as high risk by the Environmental Vulnerability Score. The herpetofauna of Nayarit overlaps the most with Jalisco (88.9%). One of the main conclusions of our updated list of the amphibian and reptile species of Nayarit is that our understanding of the full complement of species is not complete, especially the reptiles.

Background: One of the most frequent etiologies for spinal surgery is unstable lumbar spondylolisthesis (ULS). To decompress affected structures while maintaining or restoring stability through fusion, surgeons utilize a variety of procedures. When paired with interbody fusion, posterior fusion is most applied, resulting in greater fusion rates. The two most popular techniques for implementing spinal fusion are posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF). As a result, these two procedures have been assessed formally. Methodology: A retrospective analysis of patients who underwent interbody fusion for lumbar stenosis through PLIF and minimally invasive (MI)-TLIF was performed. The patients were followed up for 24 months and fusion rates, Visual Analog Score (VAS), and Oswestry Disability Index (ODI) alongside the MacNab clinical outcome score, were assessed. The Bridwell interbody fusion grading system was used to evaluate fusion rates in computed tomography (CT). Results: Operations were performed in 60 cases where patients suffered from ULS. PLIF was performed on 33 patients (55%) (14 males and 19 females) and 27 patients (45%) (11 males and 16 females) who underwent MI-TLIF. In 87% of our respective cohort, either the L4–5 or the L5–S1 level was operated on. Overall fusion rates were comparable between the two groups; however, the TLIF group improved more in terms of VAS, ODI, and MacNab scores. On average, MI-TLIF surgery was longer and resulted in reduced blood loss. MI-TLIF patients were more mobile than PLIF patients postoperatively. Conclusion: With well-established adequate results in the literature, TLIF offers benefits over other methods used for interbody lumbar fusion in ULS or other diseases of the spine. However, MI-TLIF may procure more advantageous for patients if MI methods are implemented. In this instance, TLIF outperformed PLIF due to shorter operating times, less blood loss, faster ODI recovery, better MacNab scores, and a greater decline in VAS pain ratings.

Los lahares son flujos compuestos por sedimentos y agua originados en la parte externa de los volcanes; son altamente destructivos debido a la gran velocidad que toman y a su alta densidad. Esta investigación sugiere umbrales de precipitaciones para ser integrados a un Sistema de Alerta Temprana en el volcán Concepción, en la isla de Ometepe, Rivas, Nicaragua, ante la ocurrencia de fenómenos laháricos. Inicialmente se realizó un inventario de lahares ocurridos entre el periodo del 2005 al 2016, a partir de esta base de datos se hizo una selección de eventos y se realizó un análisis estadístico de precipitaciones registradas el día de cada evento lahárico o precipitaciones detonantes del lahar (según disponibilidad de información) y las lluvias acumuladas antecedentes en un período de 30 días. Posterior con el programa LanslideSim2016® se realizó una modelación de lahares para diferentes intensidades de precipitaciones; para disminuir la incertidumbre del programa, en campo se hicieron ensayos de penetración estándar y mediciones de cohesión; el ángulo de fricción interna se estimó a partir de los resultados de los ensayos de penetración estándar, la conductividad y densidad aparente se obtuvieron a partir de la correlación con las diferentes clases texturales según lo observado en campo. Finalmente, considerando lo establecido por la ley No. 337 “Ley Creadora del Sistema Nacional para la Prevención, Mitigación y Atención de Desastres” con su reforma Ley No. 863, se estimaron umbrales de precipitaciones para la activación de un Sistema de Alerta Temprana. Basado en los resultados obtenidos, se proponen cinco intervalos de umbrales de precipitaciones para su integración a un Sistema de Alerta Temprana bajo el riesgo de ocurrencia de lahares entre 15 mm y 25 mm, de 25 mm a 50 mm, entre 50 mm y 80 mm, de 80 mm a 100 mm y mayor 100 mm; el tipo de alerta a emitir es verde, amarilla o roja y estará ligado a la lluvia acumulada antecedente de un día, tres días o diez días.

El presente estudio tiene como objetivo analizar el contexto social y económico actual de las mipymes que forman parte de la cadena turística, en función de su capacidad de desarrollo y sostenibilidad en el mercado a partir de cuatro dimensiones: gestión contable, gestión de proyectos y de cooperación, gestión de marketing digital y gestión de talento humano y habilidades blandas emprendedoras, como parte de un estudio para el diseño de un modelo de formación base para los emprendedores turísticos. Este se aplicó en municipios de Sabana Centro y del Sumapaz, cuyos resultados se obtuvieron a partir de una muestra intencionada de 64 mipymes de la cadena turística, localizadas en dichas provincias del departamento de Cundinamarca. Se aplicó una metodología tipo exploratoria, con enfoque descriptivo, apoyada en la investigación acción participativa de los actores de la cadena. En los resultados obtenidos, se evidenció la persistente brecha digital en el sector productivo, así como la falta de una sólida cultura organizacional que contribuya de manera efectiva al rendimiento empresarial. Se destaca especialmente la desconexión existente entre los empresarios y el manejo de los acontecimientos económicos a través de la contabilidad, revelando una carencia en la toma de decisiones basada en la realidad económica debido a la ausencia de instrumentos contables como guías para la planificación y gestión de riesgos económicos. Este distanciamiento se traduce en una limitada gestión para la distribución del riesgo de inversión por parte de los propietarios, quienes enfrentan dificultades significativas en la formulación de proyectos. Esta dificultad, a su vez, repercute en la falta de acceso a financiamiento mixto o a alianzas público-privadas, lo que representa una oportunidad desaprovechada para fortalecer y potenciar los negocios empresariales

Background and context: Transfer is a process where students apply their learning to different contexts. This process includes using their knowledge to solve problems with similar complexity, and in new contexts. In the context of programming, transfer also includes being able to understand and use different programming languages. Objective: This study explores: (a) student ability to transfer from a block-based programming language into another block-based programming language; (b) student ability to transfer from a block-based programming language to a text-based programming language; (c) student ability to transfer their learning within the same programming language; and (d) the difficulties students had to transfer in these contexts. Method: A group of students participating in a program called Coding For Kids explained three different programs in different programming languages during an interview protocol. The students used the programming language MakeCode, and worked on transfer activities in Scratch and Python. Findings: The results suggest that while most students are able to transfer between block-based programming languages, most of them struggle to explain a program in a text-based programming language, and to solve a new coding challenge. Implications: Instructional designers should consider different strategies to facilitate student transfer into professional programming languages, which is particularly difficult for non-English speakers.

The importance of dedicating time for teacher's professional learning is known, but dedicating adequate time for principals' learning and development is often neglected. The author recommends that superintendents take the following steps to guide their efforts to support principals' learning: (1) get to know principals as individual learners, (2) ground the work in adult developmental theory, and (3) be intentional and strategic about allocating time and resources to principals' professional learning. In this article, the author discusses these strategies and how they are based on their research and experience as superintendent of Community School District 12 in the Bronx, New York City.