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Hermansky-Pudlak syndrome (HPS) types 1 and 4 are caused by defective vesicle trafficking. The mechanism for Crohn's disease-like inflammation, lung fibrosis, and macrophage lipid accumulation in these patients remains enigmatic. The aim of this study is to understand the cellular basis of inflammation in HPS-1. We performed mass cytometry, proteomic and transcriptomic analyses to investigate peripheral blood cells and serum of HPS-1 patients. Using spatial transcriptomics, granuloma-associated signatures in the tissue of an HPS-1 patient with granulomatous colitis were dissected. In vitro studies were conducted to investigate anti-microbial responses of HPS-1 patient macrophages and cell lines. Monocytes of HPS-1 patients exhibit an inflammatory phenotype associated with dysregulated TNF, IL-1α, OSM in serum, and monocyte-derived macrophages. Inflammatory macrophages accumulate in the intestine and granuloma-associated macrophages in HPS-1 show transcriptional signatures suggestive of a lipid storage and metabolic defect. We show that HPS1 deficiency leads to an altered metabolic program and Rab32-dependent amplified mTOR signaling, facilitated by the accumulation of mTOR on lysosomes. This pathogenic mechanism translates into aberrant bacterial clearance, which can be rescued with mTORC1 inhibition. Rab32-mediated mTOR signaling acts as an immuno-metabolic checkpoint, adding to the evidence that defective bioenergetics can drive hampered anti-microbial activity and contribute to inflammation.

La utilización de escape rooms en los ámbitos educativos, y de forma específica, en la formación inicial del profesorado, puede ofrecer nuevas oportunidades para trabajar en disciplinas como las que conforman las Ciencias Sociales. Esta investigación detalla el diseño e implementación de un escape room educativo centrado en la enseñanza de la Historia, que fue aplicado a un total de 261 docentes en formación matriculados en diversas titulaciones (Máster en Profesor de Educación Secundaria, Grado en Educación Primaria, Grado en Educación Infantil y Titulación Conjunta en Educación Infantil y Primaria). El estudio examina, utilizando un enfoque metodológico de carácter mixto, las concepciones, valoraciones y perspectivas de los participantes sobre su experiencia en la implementación y sobre el potencial educativo de este tipo de recursos. Los resultados muestran una valoración muy positiva de los aspectos relacionados con el diseño implementado, incluyendo la ambientación, las pruebas, el tiempo, y las fuentes históricas utilizadas. Asimismo, es posible detectar que los futuros docentes destacan el potencial motivador y para generar aprendizajes de los escape rooms, mostrándose receptivos a incorporarlos en su futura práctica como profesores. En muchas de sus valoraciones se vislumbra la adopción, normalmente espontánea, de una perspectiva docente que les lleva a ponerse en la piel del profesor que diseña y desarrolla esta actividad en un aula, aunque se encuentran diferencias entre titulaciones. Se debate acerca de la utilidad de estos recursos desde la formación inicial del profesorado, y sobre la manera en la que la integración de elementos basados en metodologías activas puede ayudar a mejorar la formación de los futuros docentes en disciplinas como la Historia.

Inflammatory bowel diseases (IBDs) are chronic conditions of unknown cause or cure. Treatment seeks to reduce symptoms and induce and maintain remission. Many patients have turned to alternatives, such as cannabis, to alleviate living with IBD. This study reports the demographics, prevalence, and perception on cannabis use of patients attending an IBD clinic. Patients agreed to participate and completed an anonymous survey during their visit or online. Descriptive analysis, Fisher’s exact test, and Wilcoxon-Mann-Whitney rank-sum test were used. One hundred and sixty-two adults (85 males, 77 with CD) completed the survey. Sixty (37%) reported use of cannabis, of which 38 (63%) used it to relieve their IBD. A value of 77% reported low to moderate knowledge about cannabis, and 15% reported little to no knowledge. Among cannabis users, 48% had discussed use with their physician, but 88% said they would feel comfortable discussing medical cannabis for IBD. Most saw improvement of their symptoms (85.7%). A considerable number of patients with IBD use medical cannabis for their disease, unknown to their physician. The study reinforces the importance that physicians understand the role of cannabis in the treatment of IBD in order to appropriately counsel patients.

El presente trabajo de investigación es resultado de un rastreo contante de la variable inflación tanto en México como en Zacatecas por parte de cinco docentes-investigadores de dos unidades académicas de la Universidad Autónoma de Zacatecas, México durante el periodo 2012-2017. Los datos que se manejan fueron obtenidos de fuentes directas e indirectas que al contrastarlas con las oficiales (tanto federales como estatales), nos indican que la inflación ha tenido repercusiones directas en las compras de bienes y servicios que realizan de manera periódica la clase trabajadora de México y Zacatecas. En el sistema económico mexicano, la inflación en el período 2012-2017 se mantuvo bajo control por parte de las autoridades encargadas de ello. Es uno de los mayores logros obtenidos en materia económica del actual sexenio, una inflación por debajo del 10%. Ese indicador económico en México es resultado de una férrea contención del salario de la mayoría de los trabajadores, los cuales sufren el embate empresarial y gubernamental, lo mismo que de sus mismos sindicatos al no propiciar acciones tendientes a subir el bajo salario que tienen desde hace tiempo. Esta tendencia de bajas salariales en el sistema mexicano es resultado de negociaciones anuales sostenidas por la llamada comisión tripartita: trabajadores representados por sus sindicatos, empresarios que se agrupan en varias organizaciones y el sector gubernamental encabezado por la Secretaria de Trabajo y Previsión Social. Al mismo tiempo se escuchaban voces del mismo sector empresarial que proponían de inmediato un aumento a los salarios mínimos en México, argumentando que debe ser por arriba de los 150 pesos al día. También era noticia la posición de sectores económicos canadienses que establecen una posición de crítica contante hacia el bajo nivel salarial de la mayoría de los trabajadores en México.

Resumen: Introducción: La enfermedad inflamatoria intestinal (EII) es una entidad crónica e incurable. La Pan American Crohn's and Colitis Organisation (PANCCO) tiene como objetivo generar concientización sobre la EII, con especial énfasis en Latinoamérica, y el Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa (GETECCU) tiene por objetivo primordial procurar la homologación de criterios clínico-terapéuticos para el diagnóstico y tratamiento de la EII. Objetivo: Realizar un consenso para la evaluación de los criterios de aprobación que debe cumplir una Clínica de Atención Integral de pacientes con EII a nivel latinoamericano para ser considerada un centro de excelencia. Material y métodos: Se contó con la participación de 14 expertos clínicos especialistas en gastroenterología, con amplia experiencia clínica de varios años en el manejo de la atención a numerosos pacientes con EII, así como también aquellos que tuvieran la formación de alta especialidad en EII. Todos pertenecientes a 11 países latinoamericanos: Argentina, Brasil, Colombia, Ecuador, Guatemala, México, Perú, Puerto Rico, República Dominicana, Uruguay y Venezuela, en donde tienen clínicas de EII; así mismo, también participó un experto de España como apoyo metodológico, representante de GETECCU.El consenso consistió de 52 enunciados divididos en tres secciones: 1) Indicadores de estructura; 2) Indicadores de proceso y 3) Indicadores de resultados. Se aplicó el método de panel Delphi. Resultados: El consenso latinoamericano muestra los indicadores de calidad que debe cumplir una Clínica de Atención Integral de pacientes con EII para ser considerada un centro de excelencia teniendo en cuenta las necesidades de nuestra región. Conclusiones: Es el primer consenso latinoamericano realizado de manera conjunta por la PANCCO y GETECCU para presentar los estándares para aprobar centros de excelencia en la atención de pacientes con EII. Abstract: Introduction: Inflammatory bowel disease (IBD) is a chronic and incurable entity. The aim of the Pan American Crohn's and Colitis Organisation (PANCCO) is to create awareness of IBD, with special emphasis on Latin America, and the primary objective of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU, the Spanish acronym) is to obtain the accreditation of the clinical and therapeutic criteria for the diagnosis and treatment of IBD. Aim: To carry out a consensus for evaluating the approval criteria that a Comprehensive Care Clinic for Latin American IBD patients must meet, to be considered a center of excellence. Materials and methods: Fourteen clinical experts participated in the consensus. They were made up of specialists in gastroenterology, with broad clinical experience, spanning several years, in managing the care of a large number of patients with IBD, as well as advanced specialists in IBD. Thirteen of the participants came from 11 Latin American countries (Argentina, Brazil, Colombia, Dominican Republic, Ecuador, Guatemala, Mexico, Peru, Puerto Rico, Uruguay, and Venezuela) that have IBD clinics. An expert from Spain, representing the GETECCU, provided the methodologic support.The consensus consisted of 52 statements divided into three sections: 1) Structure indicators, 2) Process indicators, and 3) Result indicators. The Delphi panel method was applied. Results: The present Latin American consensus describes the quality indicators that a Comprehensive Care Clinic for IBD patients must meet, to be considered a center of excellence, taking into account the needs of our region. Conclusions: This is the first Latin American consensus, jointly carried out by the PANCCO and GETECCU, to present accreditation standards for centers of excellence in the care of patients with IBD.

Objectives. To analyse and compare 30-day mortality prognostic power of several biomarkers (C-reactive protein, procalcitonin, lactate and suPAR) in patients seen in emergency departments (ED) due to infections. Secondly, if these could improve the accuracy of systemic inflammatory response syndrome (SIRS) and quick Sepsis-related Organ Failure Assessment (qSOFA). Methods. A prospective, observational and analytical study was carried out on patients who were treated in an ED of one of the eight participating hospitals. An assessment was made of 32 independent variables that could influence mortality at 30 days. They covered epidemiological, comorbidity, functional, clinical and analytical factors. Results. The study included 347 consecutive patients, 54 (15.6%) of whom died within 30 days of visiting the ED. SUPAR has got the best biomarker area under the curve (AUC)-ROC to predict mortality at 30 days of 0.836 (95% CI: 0.765-0.907; P 10 ng/mL who had a sensitivity of 70% and a specificity of 86%. The score qSOFA ≥ 2 had AUC-ROC of 0.707 (95% CI: 0.621-0.793; P < .001) with sensitivity of 53% and a specificity of 89%. The mixed model (suPAR > 10 ng/mL plus qSOFA ≥ 2) has improved the AUC-ROC to 0.853 [95% CI: 0.790-0.916; P < .001] with the best prognostic performance: sensitivity of 39% and a specificity of 97% with a negative predictive value of 90%. Conclusions. suPAR showed better performance for 30-day mortality prognostic power from several biomarkers in the patients seen in ED due to infections. Score qSOFA has better performance that SRIS and the mixed model (qSOFA ≥ 2 plus suPAR > 10 ng/mL) increased the ability of qSOFA.

Supporting women to disclose gender-based violence (GBV) is a central feature of how healthcare and other welfare services address this problem. In this paper we take a discursive approach to analyse the process of disclosing GBV from the perspectives of young women who have been subjected to GBV and professionals working in the welfare system. Through a reflective thematic analysis of 13 interviews with young women who have been subjected to GBV and 17 with professionals working in different sectors of the welfare system, we developed four themes about how disclosure is perceived: (i) as a conversation between acquaintances; (ii) as 'no solution'; (iii) as a possible prerequisite for action; and (iv) as difficult because GBV is normalised. Even if disclosure is not the solution per se, it makes it possible to respond institutionally to GBV on an individual basis through the figure of the expert professional who is alert to signs, knows how to support disclosure, and has the power to legitimate women's claims of GBV. We acknowledge the possibilities that supporting disclosure brings for women subjected to GBV, but at the same time, problematise that it can re-centre expertise in the professional and place the responsibility on women. This study was funded by the Health Institute Carlos III (Ref. PI17CIII/00022). Sí

Management of inflammatory bowel disease (IBD) often relies on biological and immunomodulatory agents for remission through immunosuppression, raising concerns regarding the SARS-CoV-2 vaccine's effectiveness. The emergent variants have hindered the vaccine neutralization capacity, and whether the third vaccine dose has the capacity to neutralize SARS-CoV-2 variants in this population remains unknown. This study aims to evaluate the humoral response of SARS-CoV-2 variants in patients with IBD 60 days after the third vaccine dose [BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna)].56 su bjects with IBD and 12 healthy subjects were recruited. 90% of patients with IBD (49/56) were receiving biologics and/or immunomodulatory therapy. 24 subjects with IBD did not develop effective neutralizing capability against the Omicron variant. 70% (17/24) of those subjects were receiving anti-Tumor Necrosis Factor therapy [10= adalimumab, 7= infliximab], two of them had a history of COVID-19 infection, and one subject did not develop immune neutralization against three other variants: Gamma, Epsilon, and Kappa. All subjects in the control group developed detectable antibodies and effective neutralization against all seven SARS-CoV-2 variants. Our study shows that patients with IBD might not be protected against SARS-CoV-2 variants, and larger studies are needed to evaluate optimal immunity.

Objetivo: Evaluar la eficacia de una intervención a cuidadores no profesionales (CNP). Diseño: Estudio cuasiexperimental de tipo antes/después, sin grupo control. Emplazamiento: Atención primaria; 5 Zonas Básicas de Salud (ZBS) en Castelló. Período: Entre el mes de enero de 2018 y el mes de enero de 2019. Participantes: 72 CNP participantes en una intervención específica de reciente implementación en el Departament de Salut de Castelló. Intervención: Formación a CNP buscando mejorar el conocimiento del cuidado de personas dependientes y facilitando apoyo. Diez sesiones grupales de 120 min. Mediciones principales: Descriptivo sociodemográfico. Comparación de las variables sobrecarga, dolor lumbar (DL), apoyo social y calidad de vida relacionada con la salud (CVRS) antes-después de la intervención. Variable respuesta: sobrecarga del cuidador. Análisis descriptivo y bivariante. Resultados: Todos los CNP presentaban sobrecarga basal (59,93 ± 14,71); el 73,3% manifestaban DL, con un nivel medio de 5,13 ± 2,56 e incapacidad moderada (41,7%). El 50% percibían escaso apoyo social y gran afectación de la CVRS, sobre todo en términos de dolor y ansiedad. Tras la intervención se encontró una mejora significativa (p = 0,004) en el apoyo social, así como cambios positivos de carácter descriptivo en la incapacidad por DL y dimensiones de la CVRS. No se hallaron progresos (p > 0,05) para la presencia y en el nivel de DL, así como en los niveles de sobrecarga. Conclusiones: La intervención resulta efectiva para mejorar el apoyo social percibido. Sin embargo, el escaso impacto sobre otras variables aconseja reconsiderar sus contenidos, así como animar a nuevos estudios prospectivos que puedan ofrecer resultados más alentadores. Objective: Evaluate the effectiveness of an intervention to family caregivers. Design: Quasi-experimental study of type before/after, without control group. Setting: Primary care; 5 primary care centers of Castelló city. Period: Between the month of January 2018 and the month of January 2019. Participants: 72 family caregivers, participants in a specific intervention recently implemented in the Department de Salut de Castelló. Intervention: Training to family caregivers, seeking to improve knowledge of dependent care, and provide support. Ten group sessions of 120 minutes. Principal measurements: Descriptive of sociodemographic data. Comparison of the variables overload, low back pain, social support and health-related quality of life before-after the intervention. Variable response: caregiver overload. Bivariate and multivariate analysis. Results: All family caregivers had baseline overload (59.93 ± 14.71); 73.3% showed low back pain, with an average level of 5.13 ± 2.56 and moderate disability (41.7%). 50% received little social support and a great impact on health-related quality of life, especially in terms of pain and anxiety. After the intervention, there was a significant improvement (P = .004) in social support, as well as positive descriptive changes in disability due to low back pain and health-related quality of life dimensions. No progress was found (P > .05) for the presence and level of low back pain, as well as overload levels. Conclusions: The resulting effective intervention to improve perceived social support. However, the low impact on other variables suggests reconsidering its contents, as well as encouraging new prospective studies that may offer more encouraging results.

Castellanos-Torres, E. y Caballero, I. (2020). “La violencia contra las mujeres con discapacidad en tiempos de COVID-19 y experiencias grupales de sororidad online”. Revista Española de Discapacidad, 8(2).

Introduction: Women experiencing intimate partner violence (IPV) do not tend to go very frequently to formal support services. The objective of this study is to identify barriers related to the accessibility, acceptability, equity, appropriateness and effectiveness of IPV services from the perspective of the professionals working in the IPV public services. Methods: A qualitative study was carried out in the Madrid region based on 13 semi‐structured interviews of young women who had survived IPV as well as 17 interviews with professionals. A thematic content analysis was performed, guided by the dimensions proposed by the World Health Organization (WHO) for friendly services for young people. Results: From the perspective of the young women and professionals, barriers were identified for all the dimensions of the WHO's friendly services for young people: accessibility: lack of information and support from the social setting, scarce dissemination of the services, economic cost, non‐adapted schedules, inadequate locations or lack of services in settings close to young people; acceptability: lack of protocols to guarantee confidentiality, lack of speed in the provision of services or their referral, unwelcoming environments or unsympathetic professional malpractice; equity: discriminatory professional attitudes towards groups with different social status and lack of protocols to ensure the care of these groups; appropriateness: unmet needs and lack of multidisciplinary teams; and effectiveness: shortage of time, resources, competent professionals, protocols and coordination. Conclusions: Strategies are needed to make the necessary changes to promote friendly services for the care of young people exposed to IPV. Additionally, it must be emphasized that resources are needed to raise awareness and disseminate IPV services, as well as to train professionals in this area. Patient or Public Contribution: This paper is based on professionals' perspectives of public IPV‐related services of different areas such as Psychology, Social Work, Nursing, Psychiatry, Social Education and young women exposed to IPV. They either work in the public administration at the local, regional or state level or in NGOs in Spain. The authors thank all the participants for their valuable contributions to this study. This study was funded by the Health Institute Carlos III (Ref. PI17CIII/00022). Sí

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research has been partially funded by the research grants ECO2016-75909-P (Spanish Ministry of Science, Education, and Universities), ECO2017-88222-P and PID2019-106725GB-I00/SRA (Spanish Research Agency/10.13039/501100011033)., This empirical article examines how the institutional development of the home country and host countries in which multinational enterprises (MNEs) are embedded can drive MNEs’ research and development (R&D) intensity. In doing so, this study analyzes 967 firm-year observations of 234 pharmaceutical firms from 30 developed and less developed countries in the period from 2010 to 2017. We find empirical support for internationalization toward developed countries as a driver of R&D intensity at the firm level. Furthermore, we find that this positive effect is stronger for MNEs from less institutionally developed home countries. The results can help managers, researchers, and policymakers to better understand the innovation process in R&D-intensive industries., Spanish Government ECO2016-75909-P ECO2017-88222-P PID2019-106725GB-I00/SRA

Producción Científica, The use of social media is now as prevalent as ever, and its educational ramifications still need to be fully explored, especially in initial teacher training. The aim of this study is to analyze social studies prospective teachers’ perceptions regarding the usefulness of social media for teacher professional development, and to generate communication, learning and engagement. This research also has the objective of exploring the effects of an intervention during an academic semester with three different groups of university students, applying a didactic strategy based on the use of Twitter, monitoring the interventions of 122 participants. A quantitative analysis was used to process the information obtained using questionnaires as well as the data obtained using MSocial, a tool for Social Network Analysis (SNA). Results indicate that, while pre-service teachers are not necessarily skeptical of the potential of social media for educational purposes, systematic interventions that promote interaction can positively affect their perception of the usefulness of social media. Results also show that the group where prospective educators interacted among themselves the most using Twitter during the interventions was the one that showed a significant increase in prospective teachers’ perception of the educational potential of social media., Universidad de Valladolid - (grant PID 025. COV. 2019-20. PID)

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[Background & Aims]: Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent, yet largely underappreciated liver condition which is closely associated with obesity and metabolic disease. Despite affecting an estimated 1 in 4 adults globally, NAFLD is largely absent on national and global health agendas., [Methods]: We collected data from 102 countries, accounting for 86% of the world population, on NAFLD policies, guidelines, civil society engagement, clinical management, and epidemiologic data. A preparedness index was developed by coding questions into 6 domains (policies, guidelines, civil awareness, epidemiology and data, NAFLD detection, and NAFLD care management) and categorising the responses as high, medium, and low; a multiple correspondence analysis was then applied., [Results]: The highest scoring countries were India (42.7) and the United Kingdom (40.0), with 32 countries (31%) scoring zero out of 100. For 5 of the domains a minority of countries were categorised as high-level while the majority were categorised as low-level. No country had a national or sub-national strategy for NAFLD and, [Conclusions]: Although NAFLD is a pressing public health problem, no country was found to be well prepared to address it. There is a pressing need for strategies to address NAFLD at national and global levels., The data collection and analysis were funded by the EASL International Liver Foundation with support from, Intercept, Bristol-Myers-Squibb Company, Genfit, and MSD. Data collection for the original European data was funded by the EASL International Liver Foundation supported by Gilead Sciences Europe Ltd., Allergan Pharmaceutical International Ltd., Bristol-Myers-Squibb Company, Pfizer Inc., and Resoundant Inc.

La economía de Andalucía ha encontrado su base tradicionalmente en torno a la explotación de los ricos recursos naturales de los que dispone, así como el cultivo y cría de especies autóctonas de gran calidad, convirtiéndose en referente internacional en estos aspectos y asociando el nombre de la región a la calidad innata de las materias primas que se producen en ella. Un 13% del PIB total de la región andaluza en 2019 se corresponde a actividades económicas relacionadas con la agricultura, ganadería y pesca, así como las manufacturas de dichas materias primas, según datos del Instituto Nacional de Estadística (INE) ., This publication has been funded by the project PID2019-107767GA-I00, PID2019-106725GB-I00, PDC2021.120953.I00 to MCIN/ AEI/10.13039/501100011033 and FEDER/Junta de Andalucía-Consejería de Economía y Conocimiento/ Proyecto A-SEJ-291-UGR18.

The purpose of this report, firstly, is to deepen our understanding of the European food manufacturing firms, identifying what their main characteristics are in terms of size, profitability, sales volume, geographical distribution and their evolution in the last ten years. Secondly, this report aims to assess the environmental sustainability of European food manufacturing firms, and thirdly, to understand the scope of their international operations. Industries in the food manufacturing subsector transform livestock and agricultural products into products for intermediate or final consumption. The industry groups are distinguished by the raw materials (generally of animal or vegetable origin) processed into food products. The food products manufactured in these establishments are typically sold to wholesalers or retailers for distribution to consumers. As classified under North American Industry Classification System (NAICS 311), the Food Manufacturing sector, consists of nine subsectors., This publication has been funded by the project ECO2016-75909-P, PID2019-106725GB-I00, PID2019-107767GA-I00 to MCIN/ AEI/10.13039/501100011033 and FEDER/Junta de Andalucía-Consejería de Economía y Conocimiento/ Proyecto A-SEJ-291-UGR18.

Inflammatory Bowel Disease has increased in Hispanics. This study estimates its prevalence in Puerto Rico for 2013 and compares it with prior reports.The database of commercial and government insurance claims of the Department of Health for 2013 was used. A case was defined as having at least two medical claims of outpatient services or one or more hospitalizations and emergency department visits with an ICD-9 code for Crohn's disease or ulcerative colitis. Cases with codes for both were classified as undetermined inflammatory bowel disease. Prevalence was calculated for inflammatory bowel disease, Crohn's disease, and ulcerative colitis overall and by age, sex, and health insurance.5,378 persons were classified as having inflammatory bowel disease, for an overall prevalence of 181.54/100,000. Of these, 2,154 had Crohn's disease and 2,689 had ulcerative colitis, with prevalences of 72.71 and 90.77/100,000 respectively. Crohn's disease was more prevalent in males and ulcerative colitis in females. Both types were more prevalent in the government insured population. 719 children had inflammatory bowel disease, for a prevalence of 89.8/100,000. Of these, 480 were classified as Crohn´s disease and 169 as ulcerative colitis. Prevalences for pediatric Crohn's disease and ulcerative colitis were 60.0 and 21.2/100,000 respectively.When compared with a report for 2005, the prevalence for inflammatory bowel disease in Puerto Rico for 2013 showed a 4-fold increase overall and a 3-fold increase in children. Inflammatory bowel disease was more prevalent in government-insured as opposed to commercially insured persons, in contrast with previous findings.

In 2017, the government of Puerto Rico legalized medical cannabis for several conditions including Crohn's disease (CD). There is little information about cannabis use in this population. This study aimed to develop a demographic characterization and evaluate patient perception on cannabis use for Inflammatory Bowel Disease (IBD) at the University of Puerto Rico Center for Inflammatory Bowel Diseases.One hundred patients of ages 21 or older with a confirmed diagnosis of IBD were recruited to complete a voluntary anonymous questionnaire.27% of the surveyed participants reported use of cannabis. Of these, 39% reported moderate knowledge and 53% reported little to no knowledge of medical cannabis. The majority did not discuss cannabis use with their physician (78%), and most saw improvement of their symptoms (68%).Cannabis is frequently considered by patients as a treatment option for IBD but most have limited knowledge about its use. The low number of patients that discuss cannabis use with their physician suggests the need for physician awareness of unreported use. It should also lead to the development of strategies for patient orientation regarding the uses, properties, and expectations of cannabis as a therapy.

Formar una ciudadanía crítica ante los problemas de nuestro tiempo constituye una finalidad esencial de la enseñanza de las Ciencias Sociales en todas las etapas educativas. Para alcanzarla, el Aprendizaje Servicio (ApS) y el recurso a las fuentes orales pueden resultar especialmente útiles en Educación Infantil. Este estudio profundiza en las posibilidades que ofrece en esta etapa fusionar ambas prácticas metodológicas para facilitar la comprensión de problemáticas sociales y el desarrollo de habilidades de pensamiento histórico y compromiso social. Esta investigación cualitativa adopta un enfoque metodológico hermenéutico basado en el análisis de los aprendizajes generados en una muestra de 25 escolares de entre 4 y 5 años que, a partir de entrevistas a sus abuelos, desarrollan un proyecto de ApS centrado en la España vaciada. Los resultados confirman el potencial educativo que tiene en Educación Infantil la utilización de fuentes orales para acercarse desde el ApS a problemas sociales actuales, promoviendo aprendizajes cognitivo-académicos, cívicos y sociales.

RESUMEN Objetivo: Evaluar la actividad antioxidante y antiinflamatoria en extractos hidroalcohólicos de las partes aéreas de Kalanchoe daigremontiana Raym. -Hamet & H. Perrier. Materiales y métodos: Se obtuvieron extractos hidroalcohólicos utilizando como solventes etanol (EtOH) y metanol (MeOH) en diferentes concentraciones. Los fenoles totales y los flavonoides se cuantificaron con el método de Folin Ciocalteu y el de complejación de aluminio respectivamente. Metodología: Para determinar la actividad antioxidante en los extractos se utilizó la técnica de decoloración del radical libre DPPH» (2,2-difenil-1-picrilhidracilo) y para la actividad antiinflamatoria se evaluó la capacidad inhibitoria de la enzima lipoxigenasa (LOX). Resultados: El extracto etanólico al 70% presentó mayor capacidad antioxidante frente a los radicales DPPH» y mayor inhibición sobre la enzima lipooxigenasa como respuesta antiinflamatoria, lo cual estaría relacionado con el contenido de fenoles y flavonoides. Conclusiones: Esto sugiere que el K. daigremontiana posee propiedades antioxidantes y antiinflamatorias. SUMMARY Aim: To evaluate the antioxidant and anti-inflammatory activity in hydroalcoholic extracts of the aerial parts of Kalanchoe daigremontiana Raym. -Hamet & H. Perrier. Materials and methods: Extracts were obtained using ethanol (EtOH) and methanol (MeOH) as solvents at different concentrations. Total phenols and flavonoids were quantified using the Folin-Ciocalteu method and the aluminum complexation reaction, respectively. Methodology: The antioxidant activity of the extracts was determined using the DPPH» (2,2-diphenyl-1-picrylhydracil) free radical discoloration technique, while lipoxygenase (LOX) inhibition assays were used to measure the anti-inflammatory activity. Results: The 70% ethanolic extract showed a greater antioxidant capacity against DPPH» and a greater inhibition of the lipoxygenase enzyme, which should be related to the overall phenols and flavonoids content, suggesting that K. daigremontiana exhibits antioxidant and anti-inflammatory properties. RESUMO Objetivo: Avaliar a atividade antioxidante e anti-inflamatória em extratos hidroalcoólicos da parte aérea de Kalanchoe daigremontiana Raym. -Hamet & H. Perrier. Materiais e métodos: Os extratos foram obtidos usando etanol (EtOH) e metanol (MeOH) como solventes em diferentes concentrações. Fenóis e flavonóides totais foram quantificados pelo método de Folin-Ciocalteu e pela reação de complexação com alumínio, respectivamente. Metodologia: A atividade antioxidante dos extratos foi determinada pela técnica de descoloração do radical livre DPPH» (2,2-difenil-1-picrilidracila), enquanto ensaios de inibição da lipoxigenase (LOX) foram utilizados para medir a atividade anti-inflamatória. Resultados: O extrato etanólico 70% apresentou maior capacidade antioxidante contra DPPH» e maior inibição da enzima lipoxigenase, que deve estar relacionada ao teor geral de fenóis e flavonoides, sugerindo que K. daigremontiana apresenta propriedades antioxidantes e anti-inflamatórias.

Este estudio se realizó con el objetivo de potenciar el pensamiento creativo mediante el cuento corto, en 44 estudiantes de tercero de primaria en la Institución Educativa Luis Carlos Galán Sarmiento sede Juan Ramón en la Jagua de Ibirico - Cesar. Para ello, se llevó a cabo un diseño metodológico desde el enfoque cualitativo de corte descriptivo, aplicando las técnicas e instrumentos de la observación directa y participante, partiendo de una prueba diagnóstica; posteriormente, se desarrolló los talleres mediante un programa didáctico, utilizando el cuento corto como estrategia didáctica. Como resultado, se pudo determinar que el cuento corto es un potenciador de la creatividad; su implementación aumentó la imaginación significativamente en los 44 estudiantes. A medida que fueron construyendo nuevos cuentos, pudieron expresar mayor originalidad y creatividad, incrementando así, su pensamiento creativo. Por tanto, se concluye que escribir cuentos cortos es una herramienta que contribuye a la estimulación del pensamiento creativo.

Patients with immune conditions and immune-modifying therapies were excluded from the Covid-19 vaccine trials. Studies have shown conflicting response to different vaccines in persons receiving immune suppressors or biologics. The aim of this study is to evaluate humoral and cellular response to Covid-19 vaccines in patients with Inflammatory Bowel Disease (IBD) using biologic and/or immunomodulatory (IMM) therapies.MethodsParticipants are adults with IBD receiving biologics or IMM planning to receive a Covid 19 vaccine. Cellular immunity (CD4+ and CD8+ T cell levels) with flow cytometry are measured at baseline and 2 weeks after each vaccine dose. Humoral immunity (antibody titers and neutralizing capacity,VNT%) is analyzed by ELISA at baseline, 2 weeks after each dose, and 6 and 12 months after vaccine. We present the early results of the first 19 subjects. The study is approved by the IRB.Results19 subjects (18 in biologics and 1 in IMM) who received 2 doses of the Pfizer-BioNTech vaccine are included. Total IgG antibodies increased 21.13 times after the first dose and 90 times after the second dose. VTN% increased 11.92 times after the first dose and 53.79 times after the second dose. When compared with a healthy control cohort, total IgG antibodies and VTN% were lower in the subjects after the first dose. After the second dose, IgG antibodies increased but remained lower than controls, but VTN% were similar to controls. CD4 and CD8 mean levels had an upward trend after vaccination.ConclusionsNeutralizing capacity response to the vaccine in subjects was similar to a healthy cohort in spite of lower increases in total IgG antibodies. The CD4 and CD8 results observed may support the capacity to mount an effective cellular response in patients on biologics. Larger studies are needed to determine vaccine efficacy in these patients.

Coagulopathy is a key feature of COVID-19 and D-dimer has been reported as a predictor of severity. However, because D-dimer test results vary considerably among assays, resolving harmonization issues is fundamental to translate findings into clinical practice. In this retrospective multicenter study (BIOCOVID study), we aimed to analyze the value of harmonized D-dimer levels upon admission for the prediction of in-hospital mortality in COVID-19 patients. All-cause in-hospital mortality was defined as endpoint. For harmonization of D-dimer levels, we designed a model based on the transformation of method-specific regression lines to a reference regression line. The ability of D-dimer for prediction of death was explored by receiver operating characteristic curves analysis and the association with the endpoint by Cox regression analysis. Study population included 2663 patients. In-hospital mortality rate was 14.3%. Harmonized D-dimer upon admission yielded an area under the curve of 0.66, with an optimal cut-off value of 0.945 mg/L FEU. Patients with harmonized D-dimer >= 0.945 mg/L FEU had a higher mortality rate (22.4% vs. 9.2%; p < 0.001). D-dimer was an independent predictor of in-hospital mortality, with an adjusted hazard ratio of 1.709. This is the first study in which a harmonization approach was performed to assure comparability of D-dimer levels measured by different assays. Elevated D-dimer levels upon admission were associated with a greater risk of in-hospital mortality among COVID-19 patients, but had limited performance as prognostic test.

A correction to this paper has been published: https://doi.org/10.1007/s41061-021-00340-y

El presente artículo se materializó con el objetivo de ofrecer una guía que oriente el proceder a seguir para favorecer la integración de conocimiento en la Práctica Laboral Investigativa de Deporte, a partir del propio trabajo metodológico. Considerando, que este es la labor que se realiza en el proceso docente educativo, apoyados en la didáctica, con el propósito de alcanzar óptimos resultados, partiendo en primer lugar de la labor educativa en la instrucción, para lograr el propósito que se plantea en el plan de estudio, el cual se propone mediante un conjunto de influencias en el proceso de formación lograr la transformación de la personalidad del estudiante para alcanzar con ello niveles cualitativamente superiores en su desempeño profesional pedagógico integral. Al respecto, el trabajo metodológico del 5to año, se concreta en su plan, en la aplicación y profundización de las diferentes herramientas didácticas que materialicen la calidad del proceso docente educativo, en aras de lograr la adecuada integración de la docencia con la actividad investigativa y laboral, así como con las tareas de alto impacto social y demás tareas de carácter extracurricular que cumplen los estudiantes. En este sentido, en la Práctica laboral Investigativa se diseñan dos actividades fundamentales con sus respectivas bases orientadoras que responden a una de las deficiencias declaradas en el plan metodológico del año. Abstract The present article was materialized with the objective of offering a guide that guides the procedure to advance in the integration of knowledge in the Labor Investigative Practice of Sport, from the own methodological work. Considering that this is the work that is done in the educational process, supported in the didactic, with the purpose of the optimal results, which starts in the first place of the labor instruction in the instruction, for the purpose that arises in the study plan, which is proposed through a set of influences in the training process for the transformation of the student's personality to achieve qualitatively higher levels in their integral pedagogical professional performance. In this regard, the methodological work of year 5, is specified in its plan, in the application and deepening of the different teaching tools that materialize the quality of the educational process, in order to achieve the proper integration of research with research activity and work, as well as tasks of high social impact and other tasks of an extracurricular nature that students meet. In this sense, in the Investigative Work Practice the fundamental activities are designed with their respective oriented bases that respond to one of the deficiencies declared in the methodological plan of the year.

2636 Background: The HER2DX prognostic assay in early-stage HER2-positive breast cancer integrates clinical variables and 4 gene expression signatures (GES) tracking IGG, tumor proliferation, luminal cell differentiation, and the expression of the HER2 amplicon. Here, we assessed the prognostic value across cancer-types of each of these four individual GES and a research-based version of the HER2DX risk-score. Methods: RSEM batch normalized RNA-sequencing gene expression data from The Cancer Genome Atlas (TCGA) project were downloaded from cBioPortal. The association between a research-based version of the HER2DX risk-score, and each GES, with overall survival (OS) was assessed as continuous variables using univariate Cox regression model. The research-based version of the HER2DX risk-score tested did not include clinical variables. The Cox model was applied to estimate hazard ratios (HR) with 95% confidence intervals. The threshold for statistical significance was set at p< 0.05. Results: Gene expression data from 9,852 patients representing 30 different cancer-types were evaluated. The proliferation, IGG, luminal and HER2 amplicon GES were significantly associated with OS in 40.0%, 33.3%, 23.0% and 6.7% of the cancer-types tested, respectively. The IGG GES was found significantly associated with a favorable OS in breast cancer (HR: 0.73, p < 0.001), cervical and head & neck squamous cell carcinomas (HR: 0.75, p = 0.021 and HR: 0.78, p < 0.001), lung adenocarcinoma (HR: 0.84, p = 0.020), skin melanoma (HR: 0.73, p < 0.001) and sarcomas (HR: 0.78, p = 0.029). Conversely, association of IGG GES with unfavorable OS was observed in uveal melanoma (HR: 1.74, p = 0.008), kidney clear cell and papillary cell carcinomas (HR: 1.29, p < 0.001 and HR: 1.44, p = 0.017, respectively), as well as brain low-grade gliomas (LGG) (HR: 1.56, p < 0.001). Finally, the research-based HER2DX risk-score was found significantly associated with OS in 11 of 30 (36.7%) cancer-types, including breast (HR: 1.42, p < 0.001) cervical and head & neck squamous cells cancers (HR: 1.36, p = 0.018 and HR: 1.30, p < 0.001), lung adenocarcinoma (HR: 1.34, p < 0.001), skin melanoma (HR: 1.34, p < 0.001), sarcomas (HR: 1.41, p = 0.003), adrenocortical carcinoma (HR: 2.31, p < 0.001), endometrial carcinoma (HR: 1.36, p = 0.005), hepatocarcinoma (HR: 1.26, p = 0.012), LGG (HR: 1.37, p = 0.001) and mesothelioma (HR: 1.48, p = 0.005). Conclusions: The 14-gene IGG and proliferation signatures are strong prognostic biomarkers across cancer-types. The opposite association of IGG with OS depending on the cancer-type warrants further investigation.