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Our paper introduces a new theoretical framework called the Fractional Einstein–Gauss–Bonnet scalar field cosmology, which has important physical implications. Using fractional calculus to modify the gravitational action integral, we derived a modified Friedmann equation and a modified Klein–Gordon equation. Our research reveals non-trivial solutions associated with exponential potential, exponential couplings to the Gauss–Bonnet term, and a logarithmic scalar field, which are dependent on two cosmological parameters, m and α0=t0H0 and the fractional derivative order μ. By employing linear stability theory, we reveal the phase space structure and analyze the dynamic effects of the Gauss–Bonnet couplings. The scaling behavior at some equilibrium points reveals that the geometric corrections in the coupling to the Gauss–Bonnet scalar can mimic the behavior of the dark sector in modified gravity. Using data from cosmic chronometers, type Ia supernovae, supermassive Black Hole Shadows, and strong gravitational lensing, we estimated the values of m and α0, indicating that the solution is consistent with an accelerated expansion at late times with the values α0=1.38±0.05, m=1.44±0.05, and μ=1.48±0.17 (consistent with Ωm,0=0.311±0.016 and h=0.712±0.007), resulting in an age of the Universe t0=19.0±0.7 [Gyr] at 1σ CL. Ultimately, we obtained late-time accelerating power-law solutions supported by the most recent cosmological data, and we proposed an alternative explanation for the origin of cosmic acceleration other than ΛCDM. Our results generalize and significantly improve previous achievements in the literature, highlighting the practical implications of fractional calculus in cosmology.

Atrial fibrillation (AF), the most common arrhythmia, is associated with increased morbidity, mortality, and healthcare costs. Evidence indicates that rhythm control offers superior cardiovascular outcomes compared to rate control, especially when initiated early after the diagnosis of AF. Catheter ablation remains the single best therapy for AF; however, it is not free from severe complications and only a small percentage of AF patients in the Western world ultimately receive ablation. Ensuring that AF ablation is safe, effective, and efficient is essential to make it accessible to all patients. With the limitations of traditional thermal ablative energies, pulsed field ablation (PFA) has emerged as a novel non-thermal energy source. PFA targets irreversible electroporation of cardiomyocytes to achieve cell death without damaging adjacent structures. Through its capability to create rapid, selective lesions in myocytes, PFA presents a promising alternative, offering enhanced safety, reduced procedural times, and comparable, if not superior, efficacy to thermal energies. The surge of new evidence makes it challenging to stay updated and understand the possibilities and challenges of PFA. This review aims to summarize the most significant advantages of PFA and how this has translated to the clinical arena, where four different catheters have received CE-market approval for AF ablation. Further research is needed to explore whether adding new ablation targets, previously avoided due to risks associated with thermal energies, to pulmonary vein isolation can improve the efficacy of AF ablation. It also remains to see whether a class effect exists or if different PFA technologies can yield distinct clinical outcomes given that the optimization of PFA parameters has largely been empirical.

In this work, we test the ability of an exact solution, found in the framework of a nonlinear extension of the Israel–Stewart theory, to fit the supernovae Ia, gravitational lensing, and black hole shadow data. This exact solution is a generalization of one previously found for a dissipative unified dark matter model in the context of the near-equilibrium description of dissipative processes, where we do not have the full regime of the nonlinear picture. This generalized solution is restricted to the case where a positive entropy production is guaranteed and is tested under the condition that ensures its causality, local existence, and uniqueness. From the observational constraints, we found that this generalized solution is a good candidate in the description of the observational late-time data used in this work, with best-fit values of H0=73.2−0.9+0.8km/sMpc, q0=−0.41−0.03+0.03, ξ^0=0.88−0.17+0.09, ϵ=0.34−0.04+0.03, and k=0.27−0.20+0.37, at a 1σ(68.3%) of confidence level. We show that the nonlinear regime of the Israel–Stewart theory consistently describes the recent accelerated expansion of the universe without the inclusion of some kind of dark energy component and also provides a more realistic description of the fluids that make up the late universe.

El sistema de bibliotecas de la Universidad de Costa Rica es un apoyo a la formación académica y a la generación de conocimientos; objetivos prioritarios para una institución de educación superior. Como parte de los procesos de autoevaluación de las carreras que se acreditan bajo el Sistema Nacional de Acreditación de la Educación Superior (SINAES), se utilizan indicadores que valoran la asistencia brindada por el centro de información a estudiantes y docentes. Sin embargo, al considerarse limitados para conocer la contribución de la biblioteca universitaria a los fines académicos de la Escuela de Bibliotecología y Ciencias de la Información, este artículo tiene como objetivo aplicar indicadores de evaluación de bibliotecas universitarias desde el punto de vista de su cuerpo docente. Se elaboró un cuestionario para dilucidar las prácticas de uso de los servicios, los recursos de información y las instalaciones de las bibliotecas por parte de 22 docentes encuestados. Los resultados indican que la Biblioteca Carlos Monge Alfaro es la más utilizada debido a su amplia colección impresa en el área de Bibliotecología y su servicio de préstamo uno de los más solicitados (60 %). El portal web se aprovecha para acceder a las bases de datos a texto completo (91 %) y los servicios de apoyo más recurridos son la atención de consultas y la coordinación de actividades como giras, charlas y prácticas. Se concluye que el personal docente está altamente satisfecho con los servicios de las bibliotecas y las consideran como un recurso importante (77 %) que promueven activamente entre sus estudiantes (90 %).

Monkeypox (Mpox) is a zoonotic viral infection endemic to Africa, which has caused a global outbreak since April 2022. The global Mpox outbreak is related to Clade IIb. The disease has primarily affected men who have sex with men. Skin lesions are concentrated in the genital area, with lymphadenopathy as well as concurrent sexually transmitted infections (STIs). This is an observational study of adult patients with a recent development of skin lesions and systemic symptoms, which could not be explained by other diseases present. Fifty-nine PCR-positive patients with prominent skin lesions in the genital area (77.9%), inguinal lymphadenopathy (49.1%), and fever (83.0%) were included. Twenty-five (42.3%) were known to be living with human immunodeficiency virus (HIV), and 14 of the HIV-naïve subjects (51.9%) were found to be positive during workup, totaling 39 (66.1%) patients with HIV. Eighteen patients (30.5%) had concurrent syphilis infections. It is worrisome that Mpox is present in large metropolitan areas of Mexico, but the underlying growth of cases of HIV infection and other STIs has not been well studied and should be evaluated in all at-risk adults and their contacts.

El objetivo de este trabajo es abordar las respuestas institucionales a partir de la fuga de la Penitenciaría Nacional de Buenos Aires, sucedida en agosto de 1923, una de las más representativas de la historia del penal. El suceso, de amplia cobertura mediática, implicó importantes consecuencias con respecto a la administración del castigo en la prisión modelo del conjunto penitenciario del estado argentino: evidenció algunas de las problemáticas coyunturales del penal porteño como dificultades intrínsecas en la dirección, deficiencias en el orden de la vigilancia y tensiones con la población recluida. El análisis de la fuga a través de la prensa masiva demuestra los límites de las intenciones regeneradoras de la Penitenciaría Nacional en los momentos de crisis. En este sentido, el artículo se estructura en tres partes. En el primer apartado se desarrolla el contexto en el cual tiene lugar el escape, relacionado principalmente con los cuestionamientos en torno al emplazamiento del penal, que se había proyectado para funcionar en las afueras de una ciudad que se urbanizó a un ritmo mucho más acelerado que lo esperado. Además de la metropolización de los alrededores de la penitenciaría, otros antecedentes de insurrecciones influyen de manera directa en la interpretación de la fuga de 1923, desarrollada en el apartado siguiente a partir de documentación institucional y prensa de época, que sigue de cerca el suceso durante varias semanas. Por último, se abordan las decisiones y propuestas institucionales por parte del Ministerio de Justicia e Instrucción Pública sobre dicha problemática.

Introducción al dosier: Insurrecciones carcelarias: fugas, motines y conflictos penitenciarios en perspectiva histórica, 1870-1960

Abstract Arterial hypertension is considered a public health problem with severe consequences at an individual and public health levels. However, there is a lack of information regarding its characterization in Mexico. The objective of this study is to estimate the proportion of undiagnosed arterial hypertension (UAH) and the overall prevalence and clinical management of arterial hypertension within the Eastern Zone of Mexico. Additionally, we explore associated factors related with both UAH and uncontrolled arterial hypertension. We obtained information from the May Measure Month (MMM) 2019 study. People were asked for cardiovascular risk factors and blood pressure was measured according to the protocols of the European Society of Hypertension (ESH). Data from 5901 subjects were extracted: 76.04% from the Eastern Zone of the State of Mexico. The overall prevalence of hypertension was 32.4% (95% CI 31.2‐33.6). From all subjects living with hypertension, 28.3% had UAH, 22.1% had previous diagnosis but were untreated; 29.3% were treated but had uncontrolled hypertension. Younger men adults living in the State of Michoacán had increased proportion of UAH and untreated hypertension. We observed that male sex, age, obesity, living at Michoacán were risk factors for UAH. Finally, male sex, diabetes, and living at Michoacán were related risk conditions for having uncontrolled arterial hypertension. In summary, there is a high proportion of UAH in Easter Zone of Mexico. Younger adults had higher proportion of UAH and untreated hypertension profiles. Efficient actions are required to make a timely diagnosis in the young adult population to prevent long‐term complications.

Introduction and Objectives: In Argentina, it is estimated that around 50% of patients infected with hepatitis C virus (HCV) have been diagnosed and only 5% of those have accessed treatment after several months; this reality got worse with the pandemic. World Health Organization proposed a global health sector strategy to eliminate HCV as a public health threat by 2030. Key elements of the elimination plan include increased diagnosis and treatment access. This study aimed to describe the implementation of “Relinkage and simplified care pathway program” as a strategy for micro-elimination of HCV. Materials and Methods: : Hospital outpatients aged over 18 years, with a confirmed or suspected diagnosis of HCV infection and without follow-up during the last year, were included. Patient selection was made by collecting data from medical records. Selected patients were contacted by telephone and scheduled for a clinic visit with a simplified care pathway. “Reflex Testing,” which is an HCV antibody test, was used; if the result was positive, an HCV RNA and genotype test on the same specimen was performed. Untreated and non-responder patients were treated. Results: : A total of 938 patients were included, and 409 (44%) could be reached. Out Of these, 16.3% (67) died, 1.7% (7) developed hepatocellular carcinoma, and 6.75% (15) progressed to cirrhosis. We found that 21.7% were candidates for treatment, and the treatment was delivered in two clinic visits with an average time of 29 days (7-69). However, 41% (34) of patients with cirrhosis could not be contacted. Conclusions: : Program implementation improved the diagnosis and treatment access. Furthermore, it reduces the number of clinical visits and may increase adherence to follow-up. On the other hand, we are concerned that half of the patients were lost on the follow-up and about their progression to cirrhosis rate. If we are looking for different results, we should take different measures.

Abstract In this paper, we study a cosmological model inspired in the axionic matter with two canonical scalar fields $$\phi _1$$ ϕ 1 and $$\phi _2$$ ϕ 2 interacting through a term added to its potential. Introducing novel dynamical variables, and a dimensionless time variable, the resulting dynamical system is studied. The main difficulties arising in the standard dynamical systems approach, where expansion normalized dynamical variables are usually adopted, are due to the oscillations entering the nonlinear system through the Klein–Gordon (KG) equations. This motivates the analysis of the oscillations using methods from the theory of averaging nonlinear dynamical systems. We prove that time-dependent systems, and their corresponding time-averaged versions, have the same late-time dynamics. Then, we study the time-averaged system using standard techniques of dynamical systems. We present numerical simulations as evidence of such behavior.

Abstract Scalar-field cosmologies with a generalized harmonic potential and matter with energy density $$\rho _m$$ ρ m , pressure $$p_m$$ p m , and barotropic equation of state (EoS) $$p_m=(\gamma -1)\rho _m, \; \gamma \in [0,2]$$ p m = ( γ - 1 ) ρ m , γ ∈ [ 0 , 2 ] in Kantowski–Sachs (KS) and closed Friedmann–Lemaître–Robertson–Walker (FLRW) metrics are investigated. We use methods from non-linear dynamical systems theory and averaging theory considering a time-dependent perturbation function D. We define a regular dynamical system over a compact phase space, obtaining global results. That is, for KS metric the global late-time attractors of full and time-averaged systems are two anisotropic contracting solutions, which are non-flat locally rotationally symmetric (LRS) Kasner and Taub (flat LRS Kasner) for $$0\le \gamma \le 2$$ 0 ≤ γ ≤ 2 , and flat FLRW matter-dominated universe if $$0\le \gamma \le \frac{2}{3}$$ 0 ≤ γ ≤ 2 3 . For closed FLRW metric late-time attractors of full and averaged systems are a flat matter-dominated FLRW universe for $$0\le \gamma \le \frac{2}{3}$$ 0 ≤ γ ≤ 2 3 as in KS and Einstein–de Sitter solution for $$0\le \gamma

El diagnóstico de pacientes con dispepsia representa un desafío ya que en la mayoría de los casos se requieren observaciones endoscópicas complejas y costosas. En este estudio, evaluamos el rol del diagnóstico de la calprotectina fecal en pacientes con dispepsia. Para ello, en el año 2019 se realizó un estudio observacional en 149 pacientes con dispepsia registrados en el Centro de Especialistas en Gastroenterología de la entidad privada Cuenca, Ecuador. Los datos disponibles abarcaron edad, sexo, signos de alarma, valores de calprotectina fecal (CF) y hallazgos endoscópicos. Los pacientes en el grupo de edad >65 años fueron los más representados, el 56.4% de la población eran del sexo femenino, el 48.57% eran CF positivos de los cuales el 86.8% poseían valores significativos de CF. CF+ se asoció significativamente con los hallazgos por EDA/colonoscopia (p

We analyzed the antimicrobial resistance (AMR) data of 6519 clinical isolates of Escherichia coli (n = 3985), Klebsiella pneumoniae (n = 775), Acinetobacter baumannii (n = 163), Pseudomonas aeruginosa (n = 781), Enterococcus faecium (n = 124), and Staphylococcus aureus (n = 691) from 43 centers in Mexico. AMR assays were performed using commercial microdilution systems (37/43) and the disk diffusion susceptibility method (6/43). The presence of carbapenemase-encoding genes was assessed using PCR. Data from centers regarding site of care, patient age, and clinical specimen were collected. According to the site of care, the highest AMR was observed in E. coli, K. pneumoniae, and P. aeruginosa isolates from ICU patients. In contrast, in A. baumannii, higher AMR was observed in isolates from hospitalized non-ICU patients. According to age group, the highest AMR was observed in the ≥60 years age group for E. coli, E. faecium, and S. aureus, and in the 19–59 years age group for A. baumannii and P. aeruginosa. According to clinical specimen type, a higher AMR was observed in E. coli, K. pneumoniae, and P. aeruginosa isolates from blood specimens. The most frequently detected carbapenemase-encoding gene in E. coli was blaNDM (84%).

IntroductionInfections caused by antimicrobial-resistant bacteria are a significant cause of death worldwide, and carbapenemase-producing bacteria are the principal agents. New Delhi metallo-beta-lactamase-1 producing Klebsiella pneumoniae (KP-NDM-1) is an extensively drug-resistant bacterium that has been previously reported in Mexico. Our aim was to conduct a case–control study to describe the risk factors associated with nosocomial infections caused by K. pneumoniae producing NDM-1 in a tertiary-care hospital in Mexico.MethodsA retrospective case–control study with patients hospitalized from January 2012 to February 2018 at the Hospital Civil de Guadalajara “Fray Antonio Alcalde” was designed. During this period, 139 patients with a culture that was positive for K. pneumoniae NDM-1 (cases) and 486 patients hospitalized in the same department and on the same date as the cases (controls) were included. Data were analyzed using SPSS v. 24, and logistic regression analysis was conducted to calculate the risk factors for KP-NDM-1 infection.ResultsOne hundred and thirty-nine case patients with a KP-NDM-1 isolate and 486 control patients were analyzed. In the case group, acute renal failure was a significant comorbidity, hospitalization days were extended, and significantly more deaths occurred. In a multivariate analysis of risk factors, the independent variables included the previous use of antibiotics (odds ratio, OR = 12.252), the use of a urinary catheter (OR = 5.985), the use of a central venous catheter (OR = 5.518), the use of mechanical ventilation (OR = 3.459), and the length of intensive care unit (ICU) stay (OR = 2.334) as predictors of infection with NDM-1 K. pneumoniae.ConclusionIn this study, the previous use of antibiotics, the use of a urinary catheter, the use of a central venous catheter, the use of mechanical ventilation, and ICU stay were shown to be predictors of infection with NDM-1 K. pneumoniae and were independent risk factors for infection with NDM-1 K. pneumoniae.

Abstract Scalar field cosmologies with a generalized harmonic potential and a matter fluid with a barotropic equation of state (EoS) with barotropic index $$\gamma $$ γ for the locally rotationally symmetric (LRS) Bianchi I and flat Friedmann–Lemaître–Robertson–Walker (FLRW) metrics are investigated. Methods from the theory of averaging of nonlinear dynamical systems are used to prove that time-dependent systems and their corresponding time-averaged versions have the same late-time dynamics. Therefore, the simplest time-averaged system determines the future asymptotic behavior. Depending on the values of $$\gamma $$ γ , the late-time attractors of physical interests are flat quintessence dominated FLRW universe and Einstein-de Sitter solution. With this approach, the oscillations entering the system through the Klein–Gordon (KG) equation can be controlled and smoothed out as the Hubble parameter H – acting as time-dependent perturbation parameter – tends monotonically to zero. Numerical simulations are presented as evidence of such behavior.

Abstract Scalar field cosmologies with a generalized harmonic potential and a matter fluid with a barotropic Equation of State (EoS) with barotropic index $$\gamma $$ γ for locally rotationally symmetric (LRS) Bianchi III metric and open Friedmann–Lemaître–Robertson–Walker (FLRW) metric are investigated. Methods from the theory of averaging of nonlinear dynamical systems are used to prove that time-dependent systems and their corresponding time-averaged versions have the same late-time dynamics. Therefore, simple time-averaged systems determine the future asymptotic behavior. Depending on values of barotropic index $$\gamma $$ γ late-time attractors of physical interests for LRS Bianchi III metric are Bianchi III flat spacetime, matter dominated FLRW universe (mimicking de Sitter, quintessence or zero acceleration solutions) and matter-curvature scaling solution. For open FLRW metric late-time attractors are a matter dominated FLRW universe and Milne solution. With this approach, oscillations entering nonlinear system through Klein–Gordon (KG) equation can be controlled and smoothed out as the Hubble factor H – acting as a time-dependent perturbation parameter – tends monotonically to zero. Numerical simulations are presented as evidence of such behaviour.

Citizen science (CS) is a way to open up the scientific process, to make it more accessible and inclusive, and to bring professional scientists and the public together in shared endeavours to advance knowledge. Many initiatives engage citizens in the collection or curation of data, but do not state what happens with such data. Making data open is increasingly common and compulsory in professional science. To conduct transparent, open science with citizens, citizens need to be able to understand what happens with the data they contribute. Data management documentation (DMD) can increase understanding of and trust in citizen science data, improve data quality and accessibility, and increase the reproducibility of experiments. However, such documentation is often designed for specialists rather than amateurs. This paper analyses the use of DMD in CS projects. We present analysis of a qualitative survey and assessment of projects’ DMD, and four vignettes of data management practices. Since most projects in our sample did not have DMD, we further analyse their reasons for not doing so. We discuss the benefits and challenges of different forms of DMD, and barriers to having it, which include a lack of resources, a lack of awareness of tools to support DMD development, and the inaccessibility of existing tools to citizen scientists without formal scientific education. We conclude that, to maximise the inclusivity of citizen science, tools and templates need to be made more accessible for non-experts in data management.

This paper investigates exact solutions of cosmological interest in fractional cosmology. Given μ, the order of Caputo’s fractional derivative, and w, the matter equation of state, we present specific exact power-law solutions. We discuss the exact general solution of the Riccati Equation, where the solution for the scale factor is a combination of power laws. Using cosmological data, we estimate the free parameters. An analysis of type Ia supernovae (SNe Ia) data and the observational Hubble parameter data (OHD), also known as cosmic chronometers, and a joint analysis with data from SNe Ia + OHD leads to best-fit values for the free parameters calculated at 1σ, 2σ and 3σ confidence levels (CLs). On the other hand, these best-fit values are used to calculate the age of the Universe, the current deceleration parameter (both at 3σ CL) and the current matter density parameter at 1σ CL. Finding a Universe roughly twice as old as the one of ΛCDM is a distinction of fractional cosmology. Focusing our analysis on these results, we can conclude that the region in which μ>2 is not ruled out by observations. This parameter region is relevant because fractional cosmology gives a power-law solution without matter, which is accelerated for μ>2. We present a fractional origin model that leads to an accelerated state without appealing to Λ or dark energy.

Abstract Background This study aimed to determine the epidemiological, microbiological, and molecular characteristics of an outbreak of carbapenem-resistant Leclercia adecarboxylata in three hospitals associated with the unintended use of contaminated total parental nutrition (TPN). Methods For 10 days, 25 patients who received intravenous TPN from the same batch of a formula developed sepsis and had blood cultures positive for L. adecarboxylata. Antimicrobial susceptibility and carbapenemase production were performed in 31 isolates, including one from an unopened bottle of TPN. Carbapenemase-encoding genes, extended-spectrum β-lactamase–encoding genes were screened by PCR, and plasmid profiles were determined. Horizontal transfer of carbapenem resistance was performed by solid mating. Clonal diversity was performed by pulsed-field gel electrophoresis. The resistome was explored by whole-genome sequencing on two selected strains, and comparative genomics was performed using Roary. Results All 31 isolates were resistant to aztreonam, cephalosporins, carbapenems, trimethoprim/sulfamethoxazole, and susceptible to gentamicin, tetracycline, and colistin. Lower susceptibility to levofloxacin (51.6%) and ciprofloxacin (22.6%) was observed. All the isolates were carbapenemase producers and positive for bla NDM-1, bla TEM-1B, and bla SHV-12 genes. One main lineage was detected (clone A, 83.9%; A1, 12.9%; A2, 3.2%). The bla NDM-1 gene is embedded in a Tn125-like element. Genome analysis showed genes encoding resistance for aminoglycosides, quinolones, trimethoprim, colistin, phenicols, and sulphonamides and the presence of IncFII (Yp), IncHI2, and IncHI2A incompatibility groups. Comparative genomics showed a major phylogenetic relationship among L. adecarboxylata I1 and USDA-ARS-USMARC-60222 genomes, followed by our two selected strains. Conclusion We present epidemiological, microbiological, and molecular evidence of an outbreak of carbapenem-resistant L. adecarboxylata in three hospitals in western Mexico associated with the use of contaminated TPN.

Abstract Background In type I diabetes mellitus (T1DM) pancreatic β cells are destroyed. Treatment entails exogenous insulin administration and strict diet control, yet optimal glycemic control is hardly attainable. Islet transplant could be an alternative in patients with poor glycemic control, but inefficient islet purification and autoimmune response of patients is still a challenge. For these reasons, it is necessary to explore new cellular sources and immunological isolation methods oriented to develop T1DM cell-based therapies. Aims We postulate human adipose-derived stem cell (hASC) as an adequate source to generate pancreatic islet cells in vitro, and to produce islet-like structures. Furthermore, we propose microencapsulation of these aggregates as an immunological isolation strategy. Methods hASC obtained from lipoaspirated fat tissue from human donors were differentiated in vitro to insulin (Ins) and glucagon (Gcg) producing cells. Then, insulin producing cells (IPC) and glucagon producing cells (GPC) were cocultured in low adhesion conditions to form cellular aggregates, and later encapsulated in a sodium alginate polymer. Expression of pancreatic lineage markers and secretion of insulin or glucagon in vitro were analyzed. Results The results show that multipotent hASC efficiently differentiate to IPC and GPC, and express pancreatic markers, including insulin or glucagon hormones which they secrete upon stimulation (fivefold for insulin in IPC, and fourfold for glucagon, compared to undifferentiated cells). In turn, calculation of the Feret diameter and area of cellular aggregates revealed mean diameters of ~ 80 µm, and 65% of the aggregates reached 4000 µm2 at 72 h of formation. IPC/GPC aggregates were then microencapsulated in sodium-alginate polymer microgels, which were found to be more stable when stabilized with Ba2+, yielding average diameters of ~ 300 µm. Interestingly, Ba2+-microencapsulated aggregates respond to high external glucose with insulin secretion. Conclusions The IPC/GPC differentiation process from hASC, followed by the generation of cellular aggregates that are later microencapsulated, could represent a possible treatment for T1DM.

Objectives: Linezolid is a synthetic oxazolidinone antibiotic frequently used to treat vancomycin-resistant enterococcal infections. Vancomycin-susceptible Enterococcus faecalis can develop resistance to linezolid in environments with excessive linezolid use. The aim of this study was to define risk factors and outcome associated with the acquisition of linezolid-resistant E. faecalis (LREfs). Methods: A retrospective case–control study was designed including patients hospitalised from January 2014 to October 2017 at Hospital Civil de Guadalajara ‘Fray Antonio Alcalde’ in Guadalajara, Mexico. A total of 50 patients culture-positive for LREfs and 100 control patients hospitalised in the same room and time as the cases were included. Clinical and demographic data were collected and analysed. Results: Risk factors for the presence of LREfs included prior linezolid use [odds ratio (OR) = 6.74], prior clindamycin use (OR = 6.72) and previous surgery (OR = 5.79). The mortality rate was 18% for LREfs cases versus 9% for controls. Conclusion: LREfs has emerged and spread in our hospital, an environment in which linezolid use is considerable. Risk factors for LREfs are prior antibiotic use, including linezolid, and previous surgery.

BackgroundStructural and post-ablation gender differences are reported in atrial fibrillation (AF). We analyzed the gender differences in structural remodeling and AF mechanisms in patients with persistent/long-lasting AF who underwent wide area circumferential pulmonary vein isolation (WACPVI).Materials and MethodsUltra-high-density mapping was used to study atrial remodeling and AF drivers in 85 consecutive patients. Focal and rotational activity (RAc) were identified with the CartoFinder system and activation sequence analysis. The impact of RAc location on post-ablation outcomes was analyzed.ResultsThis study included 64 men and 21 women. RAc was detected in 73.4% of men and 38.1% of women (p = 0.003). RAc patients had higher left atrium (LA) voltage (0.64 ± 0.3 vs. 0.50 ± 0.2 mV; p = 0.01), RAc sites had higher voltage than non-RAc sites 0.77 ± 0.46 vs. 0.53 ± 0.37 mV (p < 0.001). Women had lower LA voltage than men (0.42 vs. 0.64 mV; p < 0.001), including pulmonary vein (PV) antra (0.16 vs. 0.30 mV; p < 0.001) and posterior wall (0.34 vs. 0.51 mV; p < 0.001). RAc in the posterior atrium was recorded in few women (23.8 vs. 54.7% in men; p = 0.014). AF recurrence rate was higher in patients with RAc outside WACPVI than those with all RAc inside WACPVI or no RAc (63.4 vs. 11.1 and 31.0%; p = 0.008 and p = 0.01). Comparison of selected patients using propensity score matching confirmed lower atrial voltage (0.4 ± 0.2 vs. 0.7 ± 0.3 mV; p = 0.007) and less RAc (38 vs. 75%; p = 0.02) in women.ConclusionWomen have shown more advanced structural remodeling at ablation, which is associated with a lower incidence of RAc (usually located outside the WACPVI). These findings could explain post-ablation gender differences.

La alteración en la microarquitectura del hueso generada con la osteoporosis predispone a fracturas por fragilidad que impactan la calidad y el pronóstico de vida de millones de adultos mayores. Uno de los tratamientos actuales de la osteoporosis son los antiresortivos como los bifosfonatos. Con el auge del uso de bifosfonatos actualmente existe un incremento en la incidencia de los efectos adversos. Aunque su fisiopatología aún es debatida, existe una asociación entre el uso crónico de estos medicamentos y fracturas atípicas del fémur. Se reporta el caso de una paciente con uso crónico de alendronato por 10 años, quien presenta una fractura atípica subtrocantérica de fémur, con estudios de imágenes previos por presentar síntomas prodrómicos.

Extensions to a ΛDM model have been explored in order to face current tensions that occur within its framework, which encompasses broadening the nature of the dark matter (DM) component to include warmness and a non-perfect fluid description. In this paper, we investigated the late-time cosmological evolution of an exact solution recently found in the literature, which describes a viscous warm ΛDM model (ΛWDM) with a DM component that obeys a polytropic equation of state (EoS), which experiences dissipative effects with a bulk viscosity proportional to its energy density, with proportionality constant ξ0. This solution has the particularity of having a very similar behavior to the ΛCDM model for small values of ξ0, evolving also to a de Sitter type expansion in the very far future. We explore firstly the thermodynamic consistences of this solution in the framework of Eckart’s theory of non-perfect fluids, focusing on the fulfillment of the two following conditions: (i) the near-equilibrium condition and (ii) the positiveness of the entropy production. We explore the range of parameters of the model that allow to fulfill these two conditions at the same time, finding that a viscous WDM component is compatible with both ones, being in this sense, a viable model from the thermodynamic point of view. Furthermore, we constrained the free parameters of the model with the observational data coming from supernovae Ia (SNe Ia) and the observational Hubble parameter data (OHD), using these thermodynamics analyses to define the best priors for the cosmological parameters related to the warmness and the dissipation of the DM, showing that this viscous ΛWDM model can describe the combined SNe Ia+OHD data in the same way as the ΛCDM model. The cosmological constraint at 3σ CL gives us an upper limit on the bulk viscous constant of order ξ0∼106 Pa·s, which is in agreement with some previous investigations. Our results support that the inclusion of a dissipative WDM, as an extension of the standard cosmological model, leads to a both thermodynamically consistent and properly fitted cosmological evolution.

The novel coronavirus SARS-CoV-2, which has similarities to the 2002–2003 severe acute respiratory syndrome coronavirus known as SARS-CoV-1, causes the infectious disease designated COVID-19 by the World Health Organization (Coronavirus Disease 2019). Although the first reports indicated that activity of the virus is centered in the lungs, it was soon acknowledged that SARS-CoV-2 causes a multisystem disease. Indeed, this new pathogen causes a variety of syndromes, including asymptomatic disease; mild disease; moderate disease; a severe form that requires hospitalization, intensive care, and mechanical ventilation; multisystem inflammatory disease; and a condition called long COVID or postacute sequelae of SARS-CoV-2 infection. Some of these syndromes resemble previously described disorders, including those with no confirmed etiology, such as Kawasaki disease. After recognition of a distinct multisystem inflammatory syndrome in children, followed by a similar syndrome in adults, various multisystem syndromes occurring during the pandemic associated or related to SARS-CoV-2 began to be identified. A typical pattern of cytokine and chemokine dysregulation occurs in these complex syndromes; however, the disorders have distinct immunological determinants that may help to differentiate them. This review discusses the origins of the different trajectories of the inflammatory syndromes related to SARS-CoV-2 infection.

Hispanic/Latino children have the highest risk of acute lymphoblastic leukemia (ALL) in the US compared to other racial/ethnic groups, yet the basis of this remains incompletely understood. Through genetic fine-mapping analyses, we identified a new independent childhood ALL risk signal near IKZF1 in self-reported Hispanic/Latino individuals, but not in non-Hispanic White individuals, with an effect size of ∼1.44 (95% confidence interval = 1.33-1.55) and a risk allele frequency of ∼18% in Hispanic/Latino populations and

Current clinical guidelines establish Pulmonary Vein (PV) isolation as the indicated treatment for Atrial Fibrillation (AF). However, AF can also be triggered or sustained due to atrial drivers located elsewhere in the atria. We designed a new simulation workflow based on personalized computer simulations to characterize AF complexity of patients undergoing PV ablation, validated with non-invasive electrocardiographic imaging and evaluated at one year after ablation. We included 30 patients using atrial anatomies segmented from MRI and simulated an automata model for the electrical modelling, consisting of three states (resting, excited and refractory). In total, 100 different scenarios were simulated per anatomy varying rotor number and location. The 3 states were calibrated with Koivumaki action potential, entropy maps were obtained from the electrograms and compared with ECGi for each patient to analyze PV isolation outcome. The completion of the workflow indicated that successful AF ablation occurred in patients with rotors mainly located at the PV antrum, while unsuccessful procedures presented greater number of driving sites outside the PV area. The number of rotors attached to the PV was significantly higher in patients with favorable long-term ablation outcome (1-year freedom from AF: 1.61 ± 0.21 vs. AF recurrence: 1.40 ± 0.20; p-value = 0.018). The presented workflow could improve patient stratification for PV ablation by screening the complexity of the atria.

An amendment to this paper has been published and can be accessed via the original article.

Some doctors and nurses played a key role in Nazism. They were responsible for the sterilization and murder of people with disabilities. Nazi doctors used concentration camp inmates as guinea pigs in medical experiments that had military or racial objectives. What we have learnt about the behaviour of doctors and nurses during the Nazi period enables us to reflect on several issues in present-day medicine (research limitations, decision making at the beginning and the end of a life and the relationship between physicians and the State). In some authors' opinions, the teaching of the medical aspects of the Holocaust could be a new model for education relating to professionalism, Human Rights, Bioethics and the respect of diversity. Teaching Medicine and the Holocaust could be a way of informing doctors and nurses of violations of Ethics in the past. Moreover, a Study Trip to Holocaust and Medicine related sites has a strong pedagogical value. Visiting Holocaust related sites, T4 centres and the places where medical experiments were carried out, has a special meaning for medical students. Additionally, tolerance, anti-discrimination, and the value of human life can be both taught and learned through this curriculum. The following article recounts our experiences of organizing and supervising a study trip with a group of medical students to some Holocaust and medicine-related sites in Berlin and Hadamar (Germany). The study tour included lectures at universities in Düsseldorf and Berlin.

Drug-resistant tuberculosis (DR-TB) remains a major global health problem. Early treatment of TB is critical; in the absence of rapid- susceptibility testing, the empiric selection of drugs should be guided by clinical data. This study aimed to determine the clinical predictors of DR-TB. From September 2010 to August 2017, sociodemographic and clinical characteristics were collected from 144 patients with tuberculosis at the Hospital Civil de Guadalajara, Mexico. Isolates were subjected to drug-susceptibility testing. Clinical predictors of DR-TB were determined using univariate and multivariate analysis. Any drug, isoniazid, and rifampin resistance rates were 47.7, 23.0, and 11.6%, respectively. The visualization of cavities and nodules through either chest radiography or computed tomography were independent predictors of DR-TB. In conclusion, early detection of DR-TB in this population could be based on multiple cavities being observed using chest imaging. This study's results can be applied to future patients with TB in our community to optimize the DR-TB diagnostic process.

El artículo expone cómo se desarrolló un proceso de arquitectura de información para el sitio Web del Centro Centroamericano de Población (CCP) de la Universidad de Costa Rica (UCR), como parte de un estudio dentro del campo de la Bibliotecología. Explica, ampliamente, cómo se realizó el análisis del sitio, la identificación de los requerimientos, la estructura y los sistemas de etiquetado y navegación requeridos por el CCP para mejorar su sitio Web. Durante este proceso se diseñaron, también, todas las visualizaciones (wireframes) de las páginas que conforman la versión de escritorio de este sitio, además, se elaboraron visualizaciones para la versión responsive requerida por los dispositivos móviles. Se concluye que la arquitectura de información es un proceso que demanda de planificación y análisis del problema a tratar, al mismo tiempo, es un campo laboral importante para profesionales en Bibliotecología con interés en incorporar la tecnología a su práctica profesional.

Este ensayo propone una base teórica y algunos lineamientos para implementar el estudio de casos en la formación del estudiantado de las carreras que oferta la Escuela de Bibliotecología y Ciencias de la Información de la Universidad de Costa Rica. Esta estrategia didáctica puede ser exitosa en situaciones en que se requiere la aplicación de la teoría y la práctica para el estudio de distintos temas, ya que se desprenden de situaciones o problemas reales relacionados con la actividad laboral y fomentan la búsqueda de soluciones, la creatividad, la negociación, el trabajo en equipo, el liderazgo, entre muchas otras actitudes y habilidades. Se parte desde una perspectiva constructivista que favorece el aprendizaje significativo y permite al docente y al estudiantado asumir distintos roles en la construcción de nuevo conocimiento.

Este ensayo propone una base teórica y algunos lineamientos para implementar el estudio de casos en la formación del estudiantado de las carreras que oferta la Escuela de Bibliotecología y Ciencias de la Información de la Universidad de Costa Rica. Esta estrategia didáctica puede ser exitosa en situaciones en que se requiere la aplicación de la teoría y la práctica para el estudio de distintos temas, ya que se desprenden de situaciones o problemas reales relacionados con la actividad laboral y fomentan la búsqueda de soluciones, la creatividad, la negociación, el trabajo en equipo, el liderazgo, entre muchas otras actitudes y habilidades. Se parte desde una perspectiva constructivista que favorece el aprendizaje significativo y permite al docente y al estudiantado asumir distintos roles en la construcción de nuevo conocimiento.

Introducción. La resistencia bacteriana a los antibióticos es un problema de salud mundial. Las investigaciones relacionadas con este problema emergente son indispensables para reconocer y desarrollar programas para su vigilancia y control. Objetivo. Revisar y comentar las contribuciones de los investigadores mexicanos en el área de la resistencia bacteriana a los antibióticos. Materiales y métodos. Se realizó una búsqueda de la literatura científica relacionada con la resistencia bacteriana a los antibióticos producida por investigadores mexicanos y registrada en Medline-PubMed entre 1973 y julio de 2013. Resultados. En 66 publicaciones, las contribuciones de investigadores mexicanos incluyeron datos sobre la resistencia de agentes patógenos entéricos como Salmonella Typhi, múltiples contribuciones sobre la producción de betalactamasas de espectro extendido, de metalobetalactamasas y de carbapenemasas, los mecanismos de resistencia en Pseudomonas aeruginosa y la evolución de la resistencia en cocos Gram positivos como Streptococcus pneumoniae, Staphylococcus aureus y Enterococcus spp., entre otros. Conclusiones. Los datos publicados en los últimos 40 años son fuente adecuada para entender la evolución de la resistencia bacteriana a los antibióticos y desarrollar programas para su control.