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Abstract Background The convergence of pulmonary hemorrhage, pulmonary amyloidosis, and multiple myeloma is uncommon. Amyloidosis can affect the pulmonary parenchyma in a diffuse, tracheobronchial, or parenchymal pattern and may rarely be associated with pulmonary hemorrhage. Additionally, pulmonary amyloidosis is not a frequent manifestation of multiple myeloma. We present a case of a male patient with pulmonary hemorrhage as the initial manifestation of AL pulmonary amyloidosis, and ultimately, confirmation of multiple myeloma through bone marrow biopsy. Case presentation The clinical case involves a 60-year-old male with no significant medical history, who was admitted presenting a clinical picture evolving over 6 months characterized by hemoptoic cough, accompanied by dyspnea, a decrease in functional capacity, and constitutional symptoms. Thoracic CT images revealed multilobar ground-glass opacities with suspected alveolar hemorrhage. In response to this clinical presentation, bronchoalveolar lavage with cytology was performed, revealing the presence of hemosiderin-laden macrophages. Given the complexity of the case, further investigation included a wedge biopsy of the lung. The pathological report indicated an atypical lymphoplasmacytoid proliferation with deposits of eosinophilic amorphous material, suggestive of amyloidosis. Congo red staining confirmed the presence of amyloid material. Elevated Kappa light chains were detected in both serum and urine, with an increased K/L ratio. Immunoglobulins G and M were found to be decreased. As part of the comprehensive assessment, a bone marrow biopsy was conducted, confirming the diagnosis of multiple myeloma with 10% atypical plasma cells. In light of this diagnosis, appropriate treatment has been initiated to address this intricate medical condition effectively. Conclusion The present case report provides an illustrative perspective on an uncommon presentation of pulmonary amyloidosis secondary to multiple myeloma, with the initial manifestation being pulmonary hemorrhage. The findings from both the physical examination and laboratory tests were consistent with pulmonary amyloidosis, and definitive confirmation of the multiple myeloma diagnosis was achieved through bone marrow biopsy. This case highlights the significance of considering pulmonary amyloidosis as a potential cause of hemoptysis, especially in patients with associated risk factors for multiple myeloma. Early recognition of this clinical association is pivotal for precise diagnosis and prompt therapeutic intervention. The complexity of this case underscores the importance of a comprehensive diagnostic approach in unraveling intricate medical conditions.

En el marco de las necesidades de integrar la bioética a las organizaciones, se realiza un análisis cienciométrico, con el objetivo de describir los indicadores bibliométricos del desarrollo científico de este campo, desde los primeros registros de la base de datos en línea Web of Science correspondiente al año 1975, hasta el año 2022, identificando autores, países, publicaciones, citaciones, revistas e instituciones, en una investigación concluyente descriptiva. Los resultados permitieron evidenciar un desarrollo lineal creciente de las publicaciones relacionados con los ámbitos de la gobernanza, la ética, la investigación científica, las variables culturales relacionadas con la bioética, la relación entre médico y paciente, el consentimiento informado y las prácticas clínicas. La principal contribución de esta investigación es sintetizar el conocimiento y ofrecer una discusión actualizada sobre la investigación en bioética.

The great advances that derive from the technological revolution 4.0 have permeated higher education institutions, which have been forced to initiate extensive transformation processes that consider the integration of digital technologies to guarantee student satisfaction, maintain their social validity and ensure their sustainability. In this article, focused on the case of the Autonomous University of Chile, the existence of causal relationships between the Digital Transformation model of that University and the Student Satisfaction Index model proposed by Turkyilmaz, Temizer and Oztekin (2018) is demonstrated. The objective of the research was to determine the impact of the digital transformation on the student’s satisfaction of that University. The structural equation modeling technique was applied, using the data obtained from a questionnaire applied to 313 students at that University in the month of May 2023. The analyzes carried out empirically validated the proposed theoretical model, demonstrating that perceived quality is the variable that has the greatest effect on student satisfaction, and finding that the expectations created regarding the results of the digital transformation of the University have a negative influence on the satisfaction; In other words, the higher the expectations about digital transformation, the more difficult it will be to satisfy students and achieve their loyalty to the institution.

AbstractThis work seeks to analyze the scientific evidence of the last five years and investigate the behavioral trends of virtual platforms and simulations for learning and skills development. By conducting a systematic literature review, utilizing the SciVal tool, and assessing statistical findings, we aim to establish a framework for the current status of the subject and identify the primary trends and applications of the strategies employed. Among the most relevant findings were the increase in registered users worldwide in 2021 due to the pandemic and the growth of courses available on virtual platforms such as Coursera and edEx. The most significant themes, both in indexed scholarly publications and in recent citations, were in computer science and education, showing how applications of educational technology have broken the paradigm of traditional education. Statistical studies also provide information regarding projections for new users in the next five years, owing to the popularity and effectiveness of these tools. This article summarizes the most significant information from sources such as Scopus, Web of Science, SciVal, and Statistical Sources. It presents a clear overview of the experimentation and use of virtual platforms and simulations for learning and competency development in higher education, highlighting key concepts and providing guidelines for future applications.

Technological tools in education open new learning possibilities. This proposal describes integrating augmented reality and different educational elements to develop engineering competencies, specifically using specialized machinery in the manufacturing laboratory. It is necessary to encourage self-management of learning, where users interact with the devices employing an application that contains significant information about procedures to perform and essential elements to consider when manipulating the machinery. The machines involved include industrial robots, CNC (Computer Numerical Control) lathes and milling machines, and PLCs (Programmable Logic Controls). In a traditional training model, an instructor guides the users in learning how to manipulate the equipment. This proposal intends that the participants use their mobile devices to receive each machine's instruction and the necessary documentation. The participants' learning pace varies. So, the research aimed to reduce the deficit in the disciplinary competencies since, in the traditional methodology, there is no heterogeneity in understanding the contents. We designed a competency development strategy with six laboratory practices, integrating multimedia elements to address the significant learning content of each manufacturing cell device. Each lesson contained information about each device and a practice activity and self-evaluation to ensure learning the content.

Abstract The tick Amblyomma tigrinum inhabits areas with diverse climatic conditions, with adult stages parasitizing wild canids, such as chilla (Lycalopex griseus) and culpeo (Lycalopex culpaeus) foxes. We described the infestation loads in wild foxes captured at three sites (periurban, rural and wild) through an anthropization gradient in north-central Chile. We tested whether local-scale environmental and/or individual host factors can predict tick abundance by using negative binomial models. During 2018-2020 (spring and summer), we captured 116 foxes (44 chillas and 72 culpeos), and 102 of them were infested with ticks (87.9%, CI=80.6-93.2%). We collected 996 A. tigrinum adult ticks, estimating a total mean abundance of 8.6±0.8 ticks/host. Periurban and rural foxes harbored greater tick loads than foxes from the wild site (2.34 and 1.71 greater, respectively) while tick abundance in summer decreased by up to 57% compared to spring. Tempered, more humid climate conditions of the periurban site could favor the development and survival of adults A. tigrinum; and ticks may have adopted a quiescent stage or similar survival mechanisms to cope with summer temperature increases related to the ongoing megadrought. Further studies are warranted to understand the underlying factors determining the life cycle of A. tigrinum at larger spatiotemporal scales.

En la isla de Cozumel, México, se encuentran especies endémicas y ferales, mismas que se encuentran amenazadas por sus reducidos tamaños poblacionales y por enfermedades. Para el manejo de una problemática que se pudiera presentar y toma de decisiones, se propone un prototipo de sistema de alerta temprana epidemiológica animal, construida sobre una plataforma Web bajo el modelo cliente-servidor. Se siguió la metodología del ciclo de vida del software junto con el modelo incremental. Para la definición de los requerimientos se utilizó el Lenguaje Unificado de Modelado (Unified Model Languaje) integrando el desarrollo guiado por pruebas (Test Driven Development). Para la codificación se utilizó el lenguaje de programación JavaScript y MySQL como motor de base de datos. La implementación de la interfaz de usuario se realizó con el apoyo de las librerías Vue.js y Vuetify.js. Los módulos del sistema comprenden el catálogo de especies, captura de casos que incluyen datos de georeferencia y consultas de través de un mapeo de casos y un módulo de alertas automáticas based en el uso de semáforos similar al del SARS-COV 19.

Las organizaciones empresariales necesitan integrar los principios y métodos de la bioética. Sin embargo, la investigación en este campo es incipiente. Dado esto, se realiza un análisis cienciométrico de los artículos publicados entre 1975 y 2021, con el objetivo de caracterizar el campo de investigación sobre bioética, como ética aplicada a todos los campos de la vida, en este caso en la empresa, mediante indicadores bibliométricos de la producción científica indexada en la base de datos en línea Web of Science, identificando publicaciones, autores, instituciones, citaciones y regiones. Los resultados evidencian un desarrollo débil y heterogéneo de las publicaciones científicas, asociado con líneas de investigación sobre los tópicos de principios bioéticos y comportamiento ético. Por tanto, la contribución de este estudio es caracterizar la investigación asociada a la bioética en la empresa.

Mujer de 74 años tratada con 2 stents solapados en tronco y descendente anterior proximal-media por enfermedad grave sintomática. Se recruzó una guía Sion (Asahi Intecc, Japón) a la circunfleja para finalizar con posdilatación de la zona de solapamiento en la descendente anterior proximal y el tronco. Al retirar la guía recruzada, el bucle distal se enredó en el stent a nivel ostial de la circunfleja, sin poder extraerla (figura 1A, flecha amarilla). Se avanzó sobre ella un balón de bajo perfil y se consiguió retirar la guía, aunque un pequeño fragmento distal radiopaco quedó atrapado en el stent del tronco (figura 1B) (Clearstent, Siemens Healthcare, Alemania), sospechoso de material residual en el seno coronario, no visible en fluoroscopia convencional. Se evaluó el resultado con tomografía de coherencia óptica, que mostró fragmentos de guía en el tronco. Se repitió la posdilatación en el interior del stent con balón no distensible a altas presiones (vídeo 1 del material adicional). La tomografía de coherencia óptica confirmó el aplastamiento del fragmento de guía sobre los struts del stent (figura 2A, flecha blanca) y un finísimo fragmento de guía que se introducía en el catéter guía (figura 2B, flechas blancas y vídeos 2-4 del...

This is the case of a 74-year-old woman treated with 2 overlapping stents in the proximal-to-middle segment of the left anterior descending coronary artery due to severe symptomatic disease. A Sion guidewire (Asahi Intecc, Japan) was recrossed towards the left circumflex artery to finish with postdilatation of the overlapping zone between the proximal left anterior descending coronary artery and left main coronary artery. While the recrossed guidewire was being removed, the distal loop tangled up with the stent at left circumflex artery ostial level and it couldn’t be removed (figure 1A, yellow arrow). A low-profile balloon was advanced over the guidewire that was eventually removed. Still, a small radiopaque distal fragment got trapped in the stent of the left main coronary artery (figure 1B) (Clearstent, Siemens Healthcare, Germany) suspicious of residual material in the coronary sinus not visible through conventional fluoroscopy. The result was assessed on an optical coherence tomography that revealed the presence of guidewire fragments in the left main coronary artery. In-stent postdilatation was repeated with a noncompliant balloon at high pressures (video 1 of the supplementary data). The optical coherence tomography confirmed the crushing of the guidewire fragment on the stent struts (figure 2A, white arrow), and...

The purpose of this study is to conduct a bibliometric analysis of socioemotional wealth research from the perspective of the family business. This analysis describes the current research trends and shows the future lines of research to guide future research in this field. A detailed and systematic analysis of the scientific production of 1026 articles on socioemotional wealth published in the Web of Science (WoS) between 1975 and 2012 has been carried out. This work shows the consolidation of socioemotional wealth as an area of research in family business, whose development has occurred since 2007. On the other hand, the most important articles, authors, countries and institutions in research on socioemotional wealth are pointed out. Finally, this paper concludes that the theoretical foundation of socioemotional wealth as an area of research is due to its connection with Family Business Theory.

γδT intraepithelial lymphocyte represents up to 60% of the small intestine intraepithelial compartment. They are highly migrating cells and constantly interact with the epithelial cell layer and lamina propria cells. This migratory phenotype is related to the homeostasis of the small intestine, the control of bacterial and parasitic infections, and the epithelial shedding induced by LPS. Here, we demonstrate that Myo1f participates in the adhesion and migration of intraepithelial lymphocytes. Using long-tailed class I myosins KO mice, we identified the requirement of Myo1f for their migration to the small intestine intraepithelial compartment. The absence of Myo1f affects intraepithelial lymphocytes’ homing due to reduced CCR9 and α4β7 surface expression. In vitro, we confirm that adhesion to integrin ligands and CCL25-dependent and independent migration of intraepithelial lymphocytes are Myo1f-dependent. Mechanistically, Myo1f deficiency prevents correct chemokine receptor and integrin polarization, leading to reduced tyrosine phosphorylation which could impact in signal transduction. Overall, we demonstrate that Myo1f has an essential role in the adhesion and migration in γδT intraepithelial lymphocytes.

RESUMEN Introducción y objetivos: Los pacientes con estenosis en el tronco coronario izquierdo (TCI) han sido excluidos de los ensayos que apoyan la no inferioridad del cociente de presiones en el índice diastólico instantáneo sin ondas (iFR) respecto a la reserva fraccional de flujo (RFF) en la toma de decisiones sobre revascularización coronaria. El presente estudio propone valorar de manera prospectiva la concordancia entre los dos índices en lesiones del TCI y validar el valor de corte del iFR de 0,89 para su uso clínico. Métodos: Registro multicéntrico nacional, prospectivo, observacional, con la inclusión de 300 pacientes consecutivos con lesiones intermedias (estenosis angiográfica 25-60%) en el TCI. Se realizará un estudio con guía de presión y determinación de RFF e iFR. En caso de resultado concordante negativo (RFF > 0,80 / iFR > 0,89), no se realizará tratamiento; en caso de resultado concordante positivo (RFF ≤ 0,80 / iFR ≤ 0,89), se realizará revascularización; en caso de resultado discordante (RFF > 0,80 / iFR ≤ 0,89 o RFF ≤ 0,80 / iFR > 0,89), se realizará estudio con ecocardiografía intravascular y se considerará diferir la revascularización si el área luminal mínima es > 6 mm2. El criterio de valoración clínico primario será la incidencia del combinado de muerte cardiovascular, infarto no mortal relacionado con la lesión del TCI o necesidad de revascularización de la lesión del TCI a los 12 meses. Conclusiones: La demostración de la seguridad clínica en la toma de decisiones del iFR en pacientes con lesiones intermedias en el TCI tendría un impacto clínico importante y justificaría su uso sistemático para la decisión del tratamiento en estos pacientes de potencial alto riesgo. Registrado en ClinicalTrials.gov (identificador: NCT03767621).

ABSTRACT Introduction and objectives: Patients with left main coronary artery (LMCA) stenosis have been excluded from the trials that support the non-inferiority of the instantaneous wave-free ratio (iFR) compared to the fractional flow reserve (FFR) in the decision-making process of coronary revascularization. This study proposes to prospectively assess the concordance between the two indices in LMCA lesions and to validate the iFR cut-off value of 0.89 for clinical use. Methods: National, prospective, and observational multicenter registry of 300 consecutive patients with intermediate lesions in the LMCA (angiographic stenosis, 25% to 60%. A pressure gudiewire study and determination of the RFF and the iFR will be performed: in the event of a negative concordant result (FFR > 0.80/iFR > 0.89), no treatment will be performed; in case of a positive concordant result (FFR ≤ 0.80/iFR ≤ 0.89), revascularization will be performed; In the event of a discordant result (FFR> 0.80/iFR ≤ 0.89 or FFR ≤ 0.80/iFR> 0.89), an intravascular echocardiography will be performed and revascularization will be delayed if the minimum lumen area is > 6 mm2. The primary clinical endpoint will be a composite of cardiovascular death, LMCA lesion-related non-fatal infarction or need for revascularization of the LMCA lesion at 12 months. Conclusions: Confirm that an iFR-guided decision-making process in patients with intermediate LMCA stenosis is clinically safe and would have a significant clinical impact. Also, justify its systematic use when prescribing treatment in these potentially high-risk patients. Registered at ClinicalTrials.gov ( Identifier: NCT03767621).

The vesicular nucleotide transporter (VNUT) is critical for sympathetic co-transmission and purinergic transmission maintenance. To examine this proposal, we assessed whether the bisphosphonate clodronate, claimed as a potent in vitro VNUT blocker, modified spontaneous and/or the electrically evoked overflow of ATP/metabolites and NA from mesentery sympathetic perivascular nerve terminals. Additionally, in primary endothelial cell cultures derived from this tissue, we also evaluated whether clodronate interfered with ATP/metabolite cell outflow and metabolism of N6-etheno adenosine 5′-triphosphate (eATP), N6-etheno adenosine (eADO), and adenosine deaminase enzyme activity. Rat mesenteries were perfused in the absence or presence of .01–1,000 nM clodronate, 1–1,000 nM Evans blue (EB), and 1–10 µM DIDS; tissue perfusates were collected to determine ATP/metabolites and NA before, during, and after perivascular electrical nerve terminal depolarization. An amount of 1–1,000 nM clodronate did not modify the time course of ATP or NA overflow elicited by nerve terminal depolarization, and only 10 nM clodronate significantly augmented perfusate adenosine. Electrical nerve terminal stimulation increased tissue perfusion pressure that was significantly reduced only by 10 nM clodronate [90.0 ± 18.6 (n = 8) to 35.0 ± 10.4 (n = 7), p = .0277]. As controls, EB, DIDS, or reserpine treatment reduced the overflow of ATP/metabolites and NA in a concentration-dependent manner elicited by nerve terminal depolarization. Moreover, mechanical stimulation of primary endothelial cell cultures from the rat mesentery added with 10 or 100 nM clodronate increased adenosine in the cell media. eATP was metabolized by endothelial cells to the same extent with and without 1–1,000 nM clodronate, suggesting the bisphosphonate did not interfere with nucleotide ectoenzyme metabolism. In contrast, extracellular eADO remained intact, indicating that this nucleoside is neither metabolized nor transported intracellularly. Furthermore, only 10 nM clodronate inhibited (15.5%) adenosine metabolism to inosine in endothelial cells as well as in a commercial crude adenosine deaminase enzyme preparation (12.7%), and both effects proved the significance (p < .05). Altogether, present data allow inferring that clodronate inhibits adenosine deaminase activity in isolated endothelial cells as in a crude extract preparation, a finding that may account for adenosine accumulation following clodronate mesentery perfusion.

IntroductionThe COVID-19 pandemic is still in force, causing global public health challenges and threats. Although vaccination and herd immunity have proven to be the most efficient way to control the pandemic, massive and early testing of patients using the RT-qPCR technique is crucial for constant genomic surveillance. The appearance of variants of SARS-CoV-2 with new mutations can reduce the efficiency of diagnostic detection. In this sense, several commercial RT-qPCR kits have been the target of extensive analysis because low assay performance could lead to false-negative diagnoses.MethodsIn this study, we evaluated the performance of three commercial RT-qPCR kits; Thermo Fisher (TaqMan 2019-nCoV Assay Kit v1), BGI and Roche (LightCycler® Multiplex RNA Virus Master) used for the diagnosis of COVID-19 throughout the pandemic in Santiago de Chile.ResultsUnder our best assay conditions, we found significant differences in Cq amplification values for control and viral probes, against the same nasopharyngeal swab samples (NPSs). In addition, in some cases, the sensitivity of the RT-qPCR kits decreased against viral variants.ConclusionOur study suggests evaluating the RT-qPCR kits used to detect SARS-CoV-2 because variants such as Omicron, which has several mutations, can compromise their detection and underestimate viral circulation.

El implante previo de un stent en el tracto de salida del ventrículo derecho (TSVD) suele preceder al implante percutáneo de válvula pulmonar para garantizar una zona de anclaje estable. Una indicación fuera de ficha técnica habitual suele ser la presencia de un TSVD nativo y grande que requiera del anclaje de un stent extragrande. Se presenta el caso de una mujer de 17 años con tetralogía de Fallot reparada hospitalizada para valoración de un cuadro de insuficiencia pulmonar grave con dilatación del VD (vídeo 1 del material adicional). Se clasificó como paciente en clase funcional III según la NYHA. Las imágenes por resonancia magnética cardiaca revelaron la presencia de un TSVD grande con diámetros de 27 x 26 mm (vídeo 2 del material adicional). Para implantar la válvula SAPIEN XT (Edwards Lifesciences, Estados Unidos) y evitar la migración del stent, se empleó la técnica de doble stent. Se procedió al premontado de un stent AndraStent XXL (Andramed, Alemania) de 57 mm sobre un balón de 26 mm para su implante de distal a proximal desde la arteria pulmonar derecha hasta el tronco pulmonar. Después, se procedió al premontado de un segundo stent AndraStent XXL de 48 mm sobre un balón de...

HOW WOULD I APPROACH IT? Authors present here an incidental finding of an unusual yet interesting case of a partial anomalous pulmonary venous connection (PAPVC) in a 56-year-old man after a study of moderate exertional dyspnea and angina. PAPVC is a congenital malformation that can be associated with interatrial septum defects (it has been reported in 10% to 15% of the cases) or happen in isolation. It can be unilateral or bilateral. If found on the right side, the PAPVC often drains into the superior vena cava (sometimes directly into the right atrium or the inferior vena cava), and its association with sinus venosus interatrial communication is a common finding. If on the left side, the left upper pulmonary vein (LUPV) often drains directly into the left innominate vein through an anomalous vertical vein (VV). The presence of 1 bilateral PAPVC is a rarer finding. In many patients the diagnosis of this entity is merely incidental since patients are often asymptomatic especially for the lack of other congenital cardiac defects. Based on the degree of left-right shunt, the right cavities can be dilated and even in some cases, pulmonary hypertension due to vascular pulmonary vascular bed remodeling can occur. Traditionally, the management of...

CÓMO LO HARÍA Los autores presentan un interesante e inusual caso de drenaje venoso pulmonar anómalo parcial (DVPAP) descubierto de manera incidental en un paciente de 56 años a raíz de un estudio por disnea y angina de moderados esfuerzos. El DVPAP es una malformación congénita que puede aparecer asociada a defectos del tabique interauricular (en un 10-15% de los casos) o de forma aislada. Puede ser unilateral o bilateral. Si se localiza en el lado derecho, el DVPAP suele desembocar en la vena cava superior (a veces directamente en la aurícula derecha o en la vena cava inferior) y es frecuente su asociación con una comunicación interauricular de tipo seno venoso. Cuando el DVPAP se encuentra en el lado izquierdo, lo más habitual es el drenaje de una vena pulmonar superior izquierda (VPSI) directamente en la vena innominada izquierda a través de una vena vertical (VV) anómala. Más raro es encontrar un DVPAP bilateral. En muchos pacientes el diagnóstico se realiza de forma casual, pues suelen estar asintomáticos, sobre todo si no hay otros defectos cardiacos congénitos asociados. En función del grado de cortocircuito izquierda-derecha se puede producir dilatación de las cavidades derechas, y en algunos casos incluso desarrollo de hipertensión pulmonar...

The use of biological immunotherapeutic drugs is one of the options currently being evaluated and employed to manage COVID-19, specifically monoclonal antibodies, which have shown benefit by regulating the excessive immune response seen in patients with severe infection, known as a cytokine storm. Tocilizumab has received particular importance for this clinical application, as has sarilumab. Both drugs share a substantial similarity in terms of pharmacodynamics, being inhibitors of the interleukin six receptor (IL-6Rα). Furthermore, sotrovimab, a neutralizing anti-SARS CoV-2 antibody, has gained the attention of the scientific community since it has recently been authorized under certain circumstances, positioning itself as a new therapeutic alternative in development. However, despite their clinical benefit, biological immunotherapies have the potential to generate life-threatening immune-related adverse events. Therefore it is essential to review their incidence, mechanism, and risk factors. This review aims to provide a comprehensive understanding of the safety of the biological immunotherapeutic drugs currently recommended for the treatment of COVID-19, provide a review of the known immune-mediated adverse events and explore the potential immune-related mechanisms of other adverse reactions.

This article problematizes the uncritical fascination zwith modern architecture, approached here through the notion of the fetish. Uncritical fascination with modern architecture has caused many architects to disengage from the socio-political realities of Colombia in order to design buildings that look like twentieth-century European precedents. Such an endogamous approach forecloses the possibility for architectural innovation, keeping architects in a vicious circle of repetition. The concept of coloniality is introduced as a vehicle to overcome the limitations of the modernist project, and the reproduction of colonising principles that give priority to European discourses and ideas. Finally, the article further discusses the concept of coloniality through recent debates on African cities and the emergence of ‘postcolonial urban theory’. The aim is to demonstrate that architectural scholarship in Colombia would benefit greatly from an engagement with southern theory, as well as from a greater emphasis on the contemporary urban condition, and the complex history that has lead us to where we are currently.

Editors Felipe Hernández and Fernando Lara interviewed Brazilian scholar Carlos Eduardo Dias Comas about his encounters with Colombian architecture, from the Seminarios de Arquitectura Latinoamericana in the 1980s and 90s all the way to his role in the construction of a critical assessment of modern architecture in our continent.

Pre-stenting of the right ventricular outflow tract (RVOT) is often performed before percutaneous pulmonary valve implantation to guarantee a stable landing zone. One common off-label indication is the presence of a large native RVOT, which requires the anchoring of an extra-large stent. This is the case of a 17-year-old woman with a repaired Fallot´s tetralogy admitted for the assessment of severe pulmonary regurgitation with RV dilatation (video 1 of the supplementary data). The patient was ranked as NYHA functional class III. The cardiac magnetic resonance imaging revealed the presence of a large RVOT with diameters of 27 mm x 26 mm (video 2 of the supplementary data). For SAPIEN XT valve implantation (Edwards Lifesciences, United States) and to prevent stent migration, the “double-stent” technique was used. A 57 mm AndraStent XXL stent (Andramed, Germany) was pre-mounted on a 26 mm balloon followed by distal-to-proximal implantation from right pulmonary artery to pulmonary trunk. Afterwards, a second 48 mm AndraStent XXL stent was pre-mounted on a 30 mm balloon and partially implanted overlapping the former stent (figure 1A). A stent that remained in the left pulmonary branch that...

The cell potential of the cell containing two ion-selective electrodes (ISE), Na-ISE | NaClO4 (m), PEG 4000 (Y), H2O (100-Y) | ClO4-ISE has been measured at temperatures of (288.15, 298.15, and 308.15) K as a function of the weight percentage Y of PEG 4000 in a mixed solvent at a 1 Mpa and the standard state for measured activity coefficients will be a solution of the salt in pure water. Y was varied between (0 and 25) wt.% in five-unit steps and the molality of the electrolyte (m) was between 0.05 mol kg-1 and almost saturation. The values of the standard cell potential were calculated using routine methods of extrapolation together with extended Debye-Hückel and Pitzer equations. The results obtained produced good internal consistency for all the temperatures studied. Once the standard electromotive force was determined, the mean ionic activity coefficients for NaClO4, the Gibbs energy of transfer from the water to the PEG 4000-water mixture, and the primary NaCl hydration number were calculated.

Timely detection of severe acute respiratory syndrome due to coronavirus 2 (SARS-CoV-2) by reverse transcription quantitative polymerase chain reaction (RT-qPCR) has been the gold- strategy for identifying positive cases during the current pandemic. However, faster and less expensive methodologies are also applied for the massive diagnosis of COVID-19. In this way, the rapid antigen test (RAT) is widely used. However, it is necessary to evaluate its detection efficiency considering the current pandemic context with the circulation of new viral variants. In this study, we evaluated the sensitivity and specificity of RAT (SD BIOSENSOR, South Korea), widely used for testing and SARS-CoV-2 diagnosis in Santiago of Chile. The RAT showed a 90% (amplification range of 20 ≤ Cq 30. In SARS-CoV-2 variant detection, RAT had a 42.8% detection sensitivity in samples with RT-qPCR amplification range 20 ≤ Cq

The early detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using the real-time quantitative polymerase chain reaction (RT-qPCR) as a gold-standard molecular tool has allowed to test and trace the viral spread and the isolation of COVID-19-infected patients. The detection capacity of viral and internal genes is an essential parameter to consider and analyze during the assay. In this study, we analyze the performance of the two commercial RT-qPCR kits used in Chile, TaqMan™ 2019-nCoV Control Kit v1 (Thermo Fisher) and MaxCov19 (TAAG Genetics), for the COVID-19 diagnosis from nasopharyngeal swab samples (NPSs). Our results show a lower sensitivity of the TAAG kit compared to the Thermo Fisher kit, even in the detection of SARS-CoV-2 mutations associated with its variants. This study reinforces the relevance of evaluating the performance of RT-qPCR kits before being used massively since those with lower sensitivity can generate false negatives and produce outbreaks of local infections.

Quantum chaos in many-body systems provides a bridge between statistical and quantum physics with strong predictive power. This framework is valuable for analyzing properties of complex quantum systems such as energy spectra and the dynamics of thermalization. While contemporary methods in quantum chaos often rely on random ensembles of quantum states and Hamiltonians, this is not reflective of most real-world systems. In this paper, we introduce a new perspective: across a wide range of examples, a single nonrandom quantum state is shown to encode universal and highly random quantum state ensembles. We characterize these ensembles using the notion of quantum state k-designs from quantum information theory and investigate their universality using a combination of analytic and numerical techniques. In particular, we establish that k-designs emerge naturally from generic states in a Hilbert space as well as physical states associated with strongly interacting Hamiltonian dynamics. Our results offer a new approach for studying quantum chaos and provide a practical method for sampling approximately uniformly random states; the latter has wide-ranging applications in quantum information science from tomography to benchmarking.

The aim of this paper is to understand how absorptive capacity and innovativeness influence business performance. Most previous studies have not considered the different dimensions of absorptive capacity and innovativeness. As a consequence, they have not analyzed the relationships between these dimensions, such as potential and realized absorptive capacity (RACAP) and product and process innovation. In our study, we analyzed the relationships between each of these dimensions and their effect on organizational performance. To achieve this, in addition to the theoretical foundation provided by the working hypotheses, a questionnaire was sent to 800 CEOs of Spanish companies in different sectors, obtaining a response rate of 38.25%. Structural equation modeling was applied to test the hypotheses. This study confirms the positive effect of absorptive capacity on innovation capacity, which in turn has a positive effect on business performance. Moreover, different dimensions of absorptive capacity and innovativeness play an important role in these relationships. This study contributes to a better understanding of how potential and RACAP influence the innovativeness of firms, both in their ability to innovate products and to improve business processes. In addition, it explores how these different innovations impact business performance and provide firms with knowledge on how to invest resources to increase profits. Future research should further study the inner workings of each of the dimensions analyzed to determine the importance of each dimension for business performance.

A questionnaire is a basic tool for collecting information in survey research. Often, these questions are measured using a Likert scale. With multiple items on the same broad object, these codes could be summed or averaged to give an indication of each respondent’s overall positive or negative orientation towards that object. This is the basis for Likert scales. Aggregation methods have been widely used in different research areas. Most of them are mathematical methods, such as the arithmetic mean, the weighted arithmetic mean, or the OWA (Ordered Weighted Averaging) operator. The usual presentation of Likert scale derived data are Mean. This paper presents a new approach to compute an aggregate value that represents Likert scale responses as a histogram adequate to treat better than Mean with asymmetric distributions. This method generates a set of partitions using an approach based on successive division. After every division, each partition is evaluated using a consensus measure and the one with the best value is then selected. Once the process of division has finished, the aggregate value is computed using the resulting partitions. Promising results have been obtained. Experiments show that our method is appropriate for distributions with large asymmetry and is not far from the behavior of the arithmetic mean for symmetric distributions. Overall, the article sheds light on the need to consider other presentations of Likert scale derived data beyond Mean more suitable for asymmetric distributions.

Varón de 80 años con fibrilación auricular permanente (consentimiento informado obtenido) tratado con una intervención percutánea de cierre de la orejuela izquierda (OI). Había ingresado repetidas veces con un cuadro de anemia grave y hemorragias gastrointestinales crónicas mientras estaba en tratamiento con diferentes regímenes antitrombóticos (ácido acetilsalicílico, clopidogrel, apixabán). Tenía una puntuación de 6 en la escala CHADS-VASC2 y de 4 en la escala HAS-BLED. La ecocardiografía transesofágica (ETE) confirmó la presencia de morfología en manga de viento con ausencia de trombo en la OI. Los diámetros de la zona de aterrizaje eran entre 23 y 25 mm (figura 1).

An 80-year-old male with permanent atrial fibrillation (informed consent obtained) underwent a percutaneous procedure to close the left atrial appendage (LAA). He had required repeated admissions for severe anemia and chronic gastrointestinal bleedings while on different antithrombotic regimens (aspirin alone, clopidogrel alone, apixaban). He had a CHADS-VASC2 score of 6 and a HAS-BLED score of 4. A transesophageal echocardiography (TEE) performed revealed the presence of Windsock morphology and no thrombus in the LAA. The diameters of the landing zone were between 23 mm and 25 mm (figure 1).

ABSTRACT Introduction and objectives: The PSP (pre-dilation, sizing and post-dilation) score, derived from the GHOST-EU registry, has evaluated the relationship between the implantation technique of bioresorbable scaffolds and the clinical outcomes. The objective was to perform an external validation of the PSP technique and to determine its effect on adverse cardiac events in various clinical and anatomical scenarios. Methods: Data from the REPARA registry (2230 patients) were used for external validation, whereas a common database combining REPARA and GHOST-EU (3250 patients) data was used to evaluate the effect of PSP technique in various clinical and anatomical scenarios. PSP-1 and PSP-3 were used to score the appropriateness of pre-dilation, scaffold sizing, and post-dilation. The primary endpoint was 1-year device-oriented composite endpoint of cardiac death, target-vessel myocardial infarction, and target-lesion revascularization. The definite/probable scaffold thrombosis according to the Academic Research Consortium criteria was also evaluated. Results: A total of 303 (18.2%) patients were treated with an optimal PSP-1, and 182 (8.2%) with an optimal PSP-3. The external validation showed that PSP has a very high negative predictive value for device-oriented composite endpoint and scaffold thrombosis (91.8% and 89.1% for PSP-1; 98.4% and 97.3% for PSP-3, respectively). Patients with an optimal PSP-3 had a numerically lower rate of device-oriented composite endpoint and scaffold thrombosis compared to those without it (0.5% vs 2.9%; P = .085 and 0.5% vs 1.8%; P = .248, respectively). In the merged database, PSP benefits were seen on many scenarios, except in the ST-segment elevation myocardial infarction where a trend towards no benefit of an optimal PSP technique was present (Pinteraction = .100). Conclusions: In the REPARA registry, at 1-year follow-up, an optimal PSP technique was not associated with a lower rate of device-oriented composite endpoint. Further research is necessary to assess the impact of the PSP technique in longer follow-ups.

RESUMEN Introducción y objetivos: La escala de puntuación PSP (pre-dilation, sizing and post-dilation), derivada del registro GHOST-EU, evalúa la relación entre la técnica de implante de los armazones bioabsorbibles y los resultados clínicos. El objetivo fue realizar una validación externa de la escala PSP y determinar su efecto en eventos adversos cardiacos en diversos escenarios clínicos y anatómicos. Métodos: Para la validación externa se emplearon los datos del registro REPARA (2.230 pacientes), mientras que se utilizó una base de datos común que combina datos de REPARA y GHOST-EU (3.250 pacientes) para evaluar el efecto de la técnica PSP en varios escenarios clínicos y anatómicos. Se usó PSP-1 y PSP-3 para calificar la calidad de la predilatación, el dimensionamiento de los armazones y la posdilatación. El objetivo primario fue la variable compuesta orientada al dispositivo (muerte cardiaca, infarto de miocardio del vaso diana y revascularización de la lesión diana) a 1 año. También se evaluó la trombosis definitiva o probable del armazón según los criterios del Academic Research Consortium. Resultados: Se trató a 303 (18,2%) pacientes con una PSP-1 óptima y a 182 (8,2%) con una PSP-3 óptima. La validación externa mostró que la escala PSP tiene un valor predictivo negativo muy alto para el objetivo primario compuesto orientado al dispositivo y la trombosis del armazón (91,8 y 89,1% para PSP-1; 98,4 y 97,3% para PSP-3, respectivamente). En pacientes con PSP-3 óptimo, el objetivo primario compuesto orientado al dispositivo y la trombosis del armazón fueron numéricamente inferiores en comparación con los pacientes sin PSP-3 óptimo (0,5 frente a 2,9%; p = 0,085; y 0,5 frente a 1,8%; p = 0,248, respectivamente). En la base de datos combinada, los beneficios de la escala PSP se observaron en diversos escenarios, excepto en el de infarto de miocardio con elevación del segmento ST, en el que se observó una tendencia hacia laausencia de beneficios de una técnica de PSP óptima (pinteracción = 0,100). Conclusiones: Una técnica de PSP óptima no se asoció con una tasa más baja del objetivo primario compuesto orientado al dispositivo. Se necesitan nuevos estudios para evaluar el impacto de la técnica de PSP con un seguimiento más prolongado.

El satisfactorio desempeño de las organizaciones puede deberse a varios factores, entre los que se encuentra el capital intelectual, que ha cobrado especial relevancia debido a que los bienes intangibles generan más valor que incluso los tangibles. La literatura al respecto señala que el incremento del valor en las pequeñas y medianas empresas recae en gran medida en el mantenimiento de un capital intelectual próspero y en constante evolución. El presente artículo tiene como objetivo establecer la influencia del capital intelectual en el desempeño de las pequeñas y medianas empresas del sector manufacturero de la región mexicana de Baja California. Para ello, se diseñó un cuestionario aplicado a 149 empresas de la región. Los resultados obtenidos recibieron un tratamiento estadístico basado primeramente en un análisis factorial de tipo exploratorio, seguido de uno confirmatorio; posteriormente, mediante el uso de regresiones lineales, se pudo dar comprobación a las hipótesis planteadas en el estudio. Los resultados mostraron que efectivamente existe una fuerte influencia del capital intelectual sobre el desempeño de las organizaciones. Asimismo, de manera específica se demostró que el capital organizativo es el que mayor influencia presenta en relación con el capital social y del cliente; en contraste, el capital tecnológico y humano no presentaron asociación alguna con el desempeño de las organizaciones. Los resultados permiten detectar áreas de oportunidad e implementar estrategias que revaloricen sus intangibles y, con ello, generen mayor valor para sus organizaciones.

The concept of the Internet of Things (IoT) is not exactly a novelty, even if it has not burst out yet with all the force that the market expected. The 5th generation of mobile telephony (5G) is rushing to deploy in the midst of a real trade war, and intends to get one’s own way on this and others fronts. This paper analyses how to overcome the challenges of an IoT deployment, which can be too complex to fulfil its promise of massification and ubiquity. This analysis is primarily intended to identify whether 5G will be the key to a current IoT deployment in all contexts, or whether it is wise to pursue other development paths first.

Dengue is a worldwide expanding threat caused by dengue virus (DENV) infection. To date, no specific treatment or effective vaccine is available. Antibodies produced by plasma cells (PCs) might be involved concomitantly in protection and severe dengue immunopathology. Although a massive appearance of PCs has been reported during acute DENV infection in humans, this response has been poorly characterized. Here, we show the dynamic of PC generation in immune-competent mice cutaneously inoculated with DENV compared with two control experimental groups: mice inoculated with inactivated DENV or with PBS. We found that PC numbers increased significantly in the skin-draining lymph node (DLN), peaking at day 10 and abruptly decreasing by day 14 after DENV inoculation. Class-switched IgG+ PCs appeared from day 7 and dominated the response, while in contrast, the frequency of IgM+ PCs decreased from day 7 onwards. Even though the kinetic of the response was similar between DENV- and iDENV-inoculated mice, the intensity of the response was significantly different. Interestingly, we demonstrated a similar PC response to virus antigens (E and prM) by ELISPOT. In situ characterization showed that PCs were distributed in the medullary cords and in close proximity to germinal centers (GCs), suggesting both an extrafollicular and a GC origin. Proliferating PCs (Ki-67+) were found as early as 3-day postinoculation, and in-depth analysis showed that these PCs were in active phases of cell cycle during the kinetic. Finally, we found a progressive appearance of high-affinity neutralizing DENV-specific IgG further supporting GC involvement. Of note, these antibodies seem to be highly cross-reactive, as a large proportion recognizes Zika virus (ZIKV). The strong PC response to skin-inoculated DENV in this work resembles the findings already described in humans. We consider that this study contributes to the understanding of the in vivo biology of the humoral immune response to DENV in an immunocompetent murine model.

Agaves resist extreme heat and drought. In A. tequilana var. azul, the central spike of the rosette -containing the shoot apical meristem and folded leaves in early stages of development- is remarkably heat tolerant. We found that the most abundant protein in this organ is a 27 kDa protein. This protein was named mayahuelin to honor Mayáhuel, the agave goddess in the Aztec pantheon. LC-MS/MS analyses identified mayahuelin as a type I RIP (Ribosome Inactivating Protein). In addition to the spike, mayahuelin was expressed in the peduncle and in seeds, whereas in mature leaves, anthers, filaments, pistils, and tepals was absent. Anti-mayahuelin antibody raised against the A. tequilana var. azul protein revealed strong signals in spike leaves of A. angustifolia, A. bracteosa, A. rhodacantha, and A. vilmoriniana, and moderate signals in A. isthmensis, A. kerchovei, A. striata ssp. falcata, and A. titanota, indicating conservation at the protein level throughout the Agave genus. As in charybdin, a type I RIP characterized in Drimia maritima, mayahuelin from A. tequilana var. azul contains a natural aa substitution (Y76D) in one out of four aa comprising the active site. The RIP gene family in A. tequilana var. azul consists of at least 12 genes and Mayahuelin is the only member encoding active site substitutions. Unlike canonical plant RIPs, expression of Mayahuelin gene in S. cerevisiae did not compromise growth. The inhibitory activity of the purified protein on a wheat germ in vitro translation system was moderate. Mayahuelin orthologs from other Agave species displayed one of six alleles at Y76: (Y/Y, D/D, S/S, Y/D, Y/S, D/S) and proved to be useful markers for phylogenetic analysis. Homozygous alleles were more frequent in wild accessions whereas heterozygous alleles were more frequent in cultivars. Mayahuelin sequences from different wild populations of A. angustifolia and A. rhodacantha allowed the identification of accessions closely related to azul, manso, sigüín, mano larga, and bermejo varieties of A. tequilana and var. espadín of A. angustifolia. Four A. rhodacantha accessions and A. angustifolia var. espadín were closer relatives of A. tequilana var. azul than A. angustifolia wild accessions or other A. tequilana varieties.

En la actualidad la industria ornamental en Veracruz atraviesa un proceso de transición, de empresas familiares a negocios inteligentes para enfrentar el mercado nacional. El objetivo del presente trabajo es determinar los aspectos que se requieren para poder implementar una microempresa ornamental, la metodología consta de ocho fases, hechas para emprendedores. Los resultados del trabajo son el establecimiento de una microempresa productora y comercializadora de plantas dracenas miniatura, la cual contribuirá a satisfacer la demanda existente en el mercado ornamental.

This paper analyses the relationship between servant leadership, innovative capacity and performance in Third Sector entities and proposes a mediation model. This research is based on a two-fold theoretical approach: the servant leadership approach and the resource-based approach. The data have been obtained through a survey sent to territorial and functional managers of Third Sector entities. The fieldwork ran from June to September 2019. At the end of the entire process, 85 valid questionnaires were obtained. For the analysis of the results, a double methodology has been used: (1) a method of second order structural equations (PLS-SEM) and, (2) qualitative comparative analysis (QCA). The main contributions of this work are: 1) a double theoretical approach has been applied in this work, which has allowed to adequately define the relationships between servant leadership, innovation capacity and performance in Third Sector entities; (2) the application of a double data analysis methodology has allowed us to obtain robust and reliable results; (3) the measures of the three composites used (servant leadership, innovative capacity and performance) have adequate reliability and validity values; (4) the servant leadership positively influences the performance of Third Sector entities being able to explain the 35.6% of the variation of the performance of these entities and besides, it is a necessary condition for this performance to take place, (5) the average innovative capacity in the influence of the servant leadership in the performance of the entities of the Third Sector, being a necessary condition. Mediation is total, eliminating the direct effect of servant leadership on the performance of third Sector entities and increasing the capacity to explain the variation in the performance of Third Sector entities up to 44.7%.

The purpose of this study was to understand how proactivity can affect the relationship between absorptive capacity and organisational performance. Most previous studies have ignored the role of proactivity in this relationship and have not considered the multidimensional nature of absorptive capacity. A questionnaire was sent to 800 CEOs of Spanish companies from different sectors, procuring a response rate of 38.25%. A structural equation model was applied to test the hypothesis. This study confirms the positive effect that absorptive capacity has on business performance and the moderating role of proactivity in this relationship. Companies that develop their capacity to absorb information from the environment achieve better results. Furthermore, if they engage in proactive behaviour within their company, this relationship is stronger. Future research should include more capacities that are related to knowledge and business performance (i.e., learning capability, innovation capacity, etc.). This study contributes to the understanding of how to manage a company’s knowledge in an appropriate way. It sheds new light on how knowledge management should be conducted, emphasising not only the gathering of information but also the promotion of a proactive attitude on the part of employees to achieve the goal of better performance.

PREGUNTA: ¿Cuál sería el resumen del estado actual de la evidencia para el cierre del foramen oval permeable (FOP)? RESPUESTA: Durante años, el cierre del FOP para la prevención de eventos embólicos ha sido motivo de controversia entre cardiólogos y neurólogos al tomar decisiones terapéuticas. La principal razón era la falta de estudios clínicos aleatorizados que demostraran la eficacia (o la ineficacia) de realizar esta intervención de forma percutánea en determinados pacientes que habían recibido el diagnóstico de ictus criptogénico. Tras la publicación en 2017 de 3 estudios aleatorizados en una de las revistas médicas de mayor impacto, y algún metanálisis posterior, los resultados sugieren un beneficio clínico a largo plazo en pacientes con ciertas características clínicas, anatómicas y ecocardiográficas que han sufrido un ictus (o un evento neurológico de perfil embólico) sin poder determinar una causa evidente1.

QUESTION: What would you say is the current state of the evidence available on the closure of patent foramen ovale (PFO)? ANSWER: The closure of PFO to prevent embolic events has been a matter of discussion for cardiologists and neurologists in the therapeutic decision-making process for years. The main reason was the lack of randomized clinical trials showing the efficacy (or inefficacy) of performing this percutaneous procedure in certain patients diagnosed with cryptogenic stroke. After the publication of 3 randomized clinical trials in 2017 in one of the highest-impact medical journals and posterior meta-analysis, the results suggest long-term clinical benefits in patients with certain anatomical, echocardiographic, and clinical characteristics who have suffered a stroke (or neurological event of embolic profile) without apparent reason.1

A 51 year-old-male, with a diagnosis of severe pulmonary stenosis treated with surgical commissurotomy at the age of 4, was admitted due to severe right heart failure. The echocardiography showed severe pulmonary regurgitation, severe right ventricular dilatation with moderate systolic dysfunction, severe tricuspid regurgitation with mild pulmonary hypertension. The magnetic resonance angiography showed pulmonary trunk dilatation. Surgery was ruled out due to high risk (morbid obesity, chronic dialysis). A staged percutaneous procedure was planned, including pre-stenting with one XXL AndraStent premounted on a 30 mm balloon. After placing the stent embolized to the right pulmonary artery. Recovery was unsuccessful and a second stent had to be deployed (premounted on a 35 mm balloon). The pulmonary annulus size was 31 mm, so the direct implantation of a conventional valve (SAPIEN XT or Melody) was not recommended. Several weeks later, a 22 mm Melody valve and a 37 mm long covered BeGraft stent premounted on a 12 mm balloon were simultaneously placed in parallel inside the stent and sequentially inflated (figure 1). Then a 16 mm AVP-2 device was placed inside the stent to occlude the lumen (figure 2 and figure 3). The final result was good, with mild pulmonary regurgitation (video 1 of the...