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Como la experiencia nos ha demostrado, la situación de la educación superior ha cambiado mucho durante los últimos años y ello hace que se exija una apertura sin precedentes a nuevas formas de enseñanza-aprendizaje. Como se apreciará, la elaboración del concepto de mapas conceptuales supera las actuaciones tradicionales de alumnado y profesorado. Con la utilización de este medio, los conceptos atinentes a los Objetivos de Desarrollo Sostenible son descubiertos autónomamente y el alumnado adquiere los significados que hay que aprender. Para ello, el empleo de las comparaciones es muy útil llegando a obtener resultados muy valiosos.

Es objeto de la investigación exponer las diversas políticas que se han enfocado en la educación superior en México, a través de la revisión de la reforma educativa, la influencia de los distintos actores de la sociedad y los resultados en materia de equidad, financiamiento y cobertura, los cuales fungen como plataforma para alcanzar el desarrollo educativo en Puebla.Tomando en cuenta que la educación es una condición necesaria, más no suficiente, para asegurar una mejor calidad de vida, resulta fundamental generan políticas que cumplan con la siguiente hipótesis: incidir positivamente en el desarrollo socioeconómico y territorial, analizando el financiamiento, cobertura y la equidad.Desde el plano supranacional, se analizarán las políticas regulatorias y normativas en cada Institución de Educación Superior (IES). Respecto al ámbito regional, se revisarán las políticas de territorialización y distribución; y, por último, en el plano local, las políticas que atienden la organización de las universidades públicas preservando su autonomía, así como aquellas que fortalecen a los institutos tecnológicos y las escuelas normales.

La presente investigación realiza un análisis de las desigualdades de género que se presentan entre mujeres y hombres al egresar de los distintos campos de formación de la educación superior y su conexión con las brechas de género presentes en los mercados laborales en México. Para ello se presentan datos de las dos esferas analizadas en el período 2020-2021, haciendo énfasis en que los roles de género se trasladan a la educación y la economía de manera transversal, tendiendo a perpetuar y reproducir las desigualdades entre mujeres y hombres de manera estructural. Concluyendo que los datos visibilizan la necesidad de romper paradigmas sobre las brechas de género en los campos de estudio, así como fortalecer los esquemas de vinculación entre institución y mercado laboral para no precarizar el trabajo del egreso.

Fifteen aroma compounds have been determined in their free and glycosylated forms in grapes using dispersive liquid-liquid microextraction with gas chromatography-mass spectrometry. The sample treatment includes a previous solid-liquid extraction stage and subsequent parallel microextraction approaches to preconcentrate total aroma content and the free fraction. Thus, the extraction of the total content of analytes requires previous enzymatic hydrolysis of the bound forms. For preconcentration, chloroform (250 μl) and acetonitrile (1.5 ml) were added to 10 ml of the sample extract in the presence of 0.5 g sodium chloride. The absence of matrix effect in the samples allowed quantification against aqueous external standards. Limits of detection ranged between 5 and 30 ng/g, depending on the compound. Method accuracy was studied through recovery assays, with recoveries in the 82-115% range being obtained. Relative standard deviations for repeatability studies were lower than 12%. Four different samples of grapes were analyzed, being quantified linalool in its free form at concentrations in the 359-470 ng/g range, and benzyl alcohol, 2-phenylethanol, and linalool oxide I and II in their bound forms between 52 and 464 ng/g.

Between 2009 and 2010, in response to the global financial crisis, the International Monetary Fund created a number of lending tools to pre-empt and insure against crises. These pre-emptive facilities were intended for countries with sound economic fundamentals and policies, but with exposure to financial contagion risks. The use of these instruments (in terms of number of countries) was limited during the first ten years of their existence, but with the outbreak of the pandemic three Latin American countries applied to use them. An assessment of these lines suggests they have performed the insurance function for which they were conceived. In anticipation of the forthcoming review of these credit lines, and in the light of recent experience, possible reasons for the limited demand are analysed and relevant factors are suggested for the design of “exit strategies”, the aspect of their use that has attracted most attention.

Infection with hepatitis C virus (HCV) is a major public health problem. In fact, chronic HCV is a leading cause of cirrhosis, hepatocellular carcinoma, and death from liver disease in most countries. The advent of highly effective oral direct-acting antiviral therapy is the most significant advance in the treatment of HCV in decades and now allows us to cure chronic HCV. However, a large number of infected patients have not been diagnosed since hepatitis C is a largely asymptomatic disease. Thus, it is fundamental to improve the screening system in order to identify individuals who are currently infected and to treat them. Risk-based hepatitis C testing and birth cohort screening have had limited success and many patients living with the infection are not aware of their status. Universal screening for HCV is a tremendous improvement compared with the previous strategies. Indeed, global screening leads to the appropriate identification and treatment of all individuals chronically infected with HCV and prevents the progression of liver disease and the associated morbidity and mortality. In addition, universal HCV testing appears to be cost-effective. In this article, we review the current barriers to HCV eradication and the different strategies for HCV infection screening.

Introduction: Trastuzumab emtansine (T-DM1) is a novel antibody-drug conjugate targeting the human epidermal growth factor receptor 2, used in some recurrent metastatic cancers. It was linked to modest increases in serum aminotransferase elevations and bilirubin. More recently, some cases of noncirrhotic portal hypertension have been described in patients on long-term T-DM1. The underlying liver condition is usually nodular regenerative hyperplasia (NRH) with elements of sinusoidal obstruction. Case Report: We report the case of a 52-year-old woman who started T-DM1 therapy for recurrent metastatic lung adenocarcinoma. Although a progressive reduction in lung nodules was noticed, there was a new-onset cytocholestasis and elevation in bilirubin. A reduction in platelet count was also apparent over several months during the T-DM1 therapy. Liver biopsy revealed NRH and so the dose of T-DM1 was reduced. Thereafter, the patient had normalization of liver tests and platelet count. T-DM1 was continued for more than 9 months with no signs of portal hypertension or cancer progression. Conclusions: We presented a rare case of NRH induced by T-DM1 in a patient with lung adenocarcinoma. A high index of suspicion for liver injury and NRH must be maintained for patients who develop liver test abnormalities and/or signs of portal hypertension during treatment with T-DM1. This is the first report of a successful dose reduction in a patient with NRH induced by T-DM1, suggesting that it is possible to maintain the drug while it is being effective for lung cancer treatment.

Entre 2009 y 2010, el Fondo Monetario Internacional creó, en respuesta a la crisis financiera global, una serie de líneas de préstamo destinadas a la prevención y al aseguramiento frente a crisis. Estas líneas preventivas fueron dirigidas a países con fundamentos y políticas económicas sólidos, pero expuestos a riesgos de contagio financiero. La utilización de estos instrumentos —medida en número de países— fue reducida durante sus diez primeros años de existencia, y con la irrupción de la pandemia tres nuevos países de Latinoamérica solicitaron acogerse a ellos. La valoración de estas líneas sugiere que han cumplido la función de aseguramiento para la que fueron concebidas. De cara a la próxima revisión de estas líneas, y a la luz de la experiencia reciente, se analizan las posibles causas de su limitada demanda y se aportan elementos relevantes en el diseño de las «estrategias de salida», uno de los aspectos que más atención han suscitado en su utilización.

Mesalazine is a widely prescribed drug, used for the treatment of ulcerative colitis to both induce and maintain remissions in disease. Mesalazine therapy has been associated with a low rate of serum enzyme elevations and a with rare instances of clinically apparent acute liver injury.A 51-year-old Caucasian woman with ulcerative colitis was treated with mesalazine. Two weeks later, the patient presented severe liver cholestatic injury. No symptoms of generalized hypersensitivity were seen. She had no history of liver disease and was known to have normal routine liver tests before starting treatment. The liver biopsy revealed mild periportal necroinflammatory lesions with no fibrosis, suggestive of drug-induced liver injury. The patient's symptoms were resolved by discontinuing the mesalazine treatment; within 6 months, all her liver panels returned to normal. After extensively excluding other potential causes of liver injury and with clinical and lab resolution after discontinuing the drug, we assumed mesalazine as the cause of hepatic toxicity.We describe a patient with ulcerative colitis who developed severe but fully reversible liver cholestatic injury following the prescription of mesalazine. This case reinforces the possibility of a causal relationship between mesalazine therapy and toxic hepatic injury without systemic hypersensitivity. Although it is a usually well-tolerated drug, clinicians should be alert and discontinue therapy when liver dysfunction occurs to avoid the development of chronic hepatitis and liver fibrosis.

Background Primary biliary cholangitis (PBC) is a chronic autoimmune disease characterized by symptoms with a major impact on the quality of life. The aim of this study was to identify patients with undiagnosed PBC who are not under hepatology follow-up and to assess the clinical impact of lack of adequate treatment and surveillance. Methods Adult patients with a positive antimitochondrial antibodies (AMA) titer were identified from local biochemistry records. Patients with probable PBC who were not known by the hepatology services were invited to accurately stage their disease and optimize medical management. Results A total of 214 AMA-positive patients were identified, 148 of whom had diagnostic criteria for PBC. Twenty-three patients were not known by the hepatology services, most of them followed by specialties other than gastroenterology. These patients had significantly higher liver stiffness compared to those followed by the hepatology services (14.3 kPa vs. 6.2 kPa; P = 0.009). A large percentage of untreated individuals reported fatigue (72.7%) and pruritus (27.3%). Conclusions A substantial number of patients with PBC are not known to have hepatology services with a significant long-term impact from a lack of follow-up and therapy. Strategies must be established to identify these patients and reduce the disease's progressive nature.

Celiac disease has been associated with abnormal liver function tests at diagnosis that usually resolve with a gluten-free diet (GFD). The aim of this study was to assess the evolution of liver involvement and possible long-term complications in patients on a GFD.Retrospective and single-center study, which included all individuals with Celiac disease followed in specialized consultation in a tertiary referral hospital.A total of 162 patients were included, most of them female (77.8%) with a median age of 24 years (IQR, 7-39). Seventy-four (45.7%) patients had abnormal liver function tests at diagnosis. These individuals had higher anti-tissue transglutaminase IgA (tTG-IgA) antibody titers (126 vs. 29 IU/L; P = 0.003). There were no significant differences in the Marsh classification ( P = 0.599). During follow-up, most celiac hepatitis patients had normalization of liver function tests and tTG-IgA antibodies. At the last follow-up, all the patients had fibrosis-4 indexlt;2.4 and an aspartate aminotransferase-to-platelet ratio index scorelt;0.6. Vibration-controlled transient elastography showed valueslt;6.4 kPa in all cases. On the other hand, it was found that 42.9% of the individuals had a controlled attenuation parametergt;206.5 db/m.In our cohort, liver function tests normalized in the vast majority of celiac hepatitis patients on a GFD, with no progression to chronic liver disease. It should be noted the high number of individuals who present hepatic steatosis during follow-up, which may be related to a diet that tends to be hyperlipidemic and hypercaloric.

Crohn disease (CD) and ulcerative colitis (UC) are considered chronic disorders of the gastrointestinal tract, lifelong medication often being necessary. Furthermore, they have significant implications on the quality of life. In the past few years, major advances have been achieved concerning the treatment of inflammatory bowel disease. These advances are expanding the possibilities for managing these patients. Janus kinase (JAK) inhibitors represent the most auspicious treatment to date because they consist of drugs that are orally administered, with a short half-life and low antigenicity. In addition, they seem to concurrently lessen various proinflammatory routes. In fact, tofacitinib has already been approved in patients with UC, both naïve and with prior exposure to tumor necrosis factor inhibitors. In CD, the results with tofacitinib have been less impressive. Several other JAK inhibitors are currently being investigated. However, given the wide spectrum of immunosuppressive effects, special attention has been given to the safety profile of these drugs, namely with regard to the occurrence of thromboembolic events, opportunistic infections, and malignancy. In this article, we review key evidence on the efficacy and safety of JAK inhibitors concerning both UC and CD.

This article underlines the centrality of justice when understanding it as an overarching value that globalizes and systematizes all the others. In particular, it analyzes what happens with legal security as a formal enshrinement of justice, and freedom and equality as its material manifestations. From this point of view, it becomes clear that the resulting systematization depends on the type of State currently in force. This is joined the diverse ways of understanding justice and the evaluation of the validity-justice relationship depending on the different ways of understanding it. Likewise, the ways of understanding the justice-law connection are linked to the concept of the Law that we uphold. Finally, it is concluded that legal operators are called to administer justice in a complementary regime, with legal security serving to reinforce freedom, as is the case with regard to equality.

In this study, the photocatalytic degradation of four fungicides, myclobutanil, penconazole and difenoconazole (triazole compounds) and boscalid (carboxamide), has been examined in different aqueous matrices (tap water, irrigation water and two WWPT effluents). Experiments were conducted at laboratory scale with different reagents—zinc oxide (ZnO), titanium dioxide (TiO2), sodium persulphate (Na2S2O8) and the combined systems ZnO/Na2S2O8 and TiO2/Na2S2O8—in water exposed to UV-LED irradiation. Previously, the effect of catalyst and oxidant loading on the disappearance kinetics of the different fungicides was assessed to know maximum degradation efficiency. The influence of water matrices and pesticide loading in removal effectiveness has been evaluated. It was observed a greater efficiency in processes conducted using the tandems ZnO/Na2S2O8 and TiO2/Na2S2O8 in irrigation and tap waters. Results showed that UV-LED are a suitable alternative for tackling the removal of organic pollutants in water.

Background: There are few studies that have investigated the response to the prone position in mechanically ventilated COVID-19 patients with acute respiratory distress syndrome (ARDS). We describe the characteristics and outcomes of those patients in a tertiary hospital in Spain. Methods: This is an observational study in consecutive, mechanically ventilated COVID-19 patients. The primary endpoint was to describe the respiratory pathophysiology and clinical outcomes of COVID-19 patients treated by mechanical ventilation in the prone position. Results: Of 84 patients mechanically ventilated in the prone position, 19 (22%) were successfully extubated and 43 (51%) were discharged from the ICU. The duration of mechanical ventilation and ICU length of stay were 11 days (IQR 8-16) and 15 days (IQR 9-25), respectively. On admission to ICU, 61% patients had a moderate ARDS according to the Berlin criteria. 76% had 4 lung quadrants affected. After intubation, the median PaO2/FiO(2) was 105 (IQR 76-138), ventilatory ratio was 1.48 (IQR 1.16-1.88), and compliance was 33 mL cm H2O-1 (IQR 25-4] ).The median number of cycles in the prone position was 2 (1-3), with a median of total hours in the prone position of 76 (IQR 64-111). 72 h after the first prone position cycle the median PaO2/FiO(2) increase was up to 193 (IQR 152-251), but the compliance was similar to the basal level (34 mL cm H2O-1 [IQR 26-43]). However, the percentage of patients with normal compliance (> 50 mL cm H2O-1) increased with the prone position from 15% (n = 13) to 32% (n = 27) after 72 h. Conclusions: In our study, the COVID-19 patients with respiratory failure presented respiratory mechanics, gas exchange parameters, and a response to prone ventilation similar to those observed in other causes of ARDS.

This article seeks to lay the foundations to overcome the rigorous normativism that has frequently been attached to the theory of law, both in theoretical studies and in the teaching of law, mainly by following Kelsen and Hart’s more open-minded models. Thus, the work is based on appreciating the new demands made by a reconstructed theory of law, highlighting its pragmatic functionality. The relevance of sociology of law in relation to the theory of law is analysed for these purposes, drawing the conclusion that the challenge lies in placing the concepts arising from modernity within a novel context guided by the dialogue and interrelationship which are already in place. Therefore, the author believes that law must be understood by starting from the very culture to which it belongs without forgetting the en-dured changes, while at the same time urging for the reconstruction of the theory of law through a socio-legal approach.

One of the consequences of phytosanitary treatments applied to crops is the generation of a great volume of agro-wastewater having pesticide residues. These pollutants can be considered a serious threat to the environment and human health due to their capacity to affect distant areas remaining for a long time after their application. We have assessed the degradation of five pesticides in agro-waste water produced in two farms by the cleaning pesticide containers and phytosanitary treatment equipment used in the farms. For this purpose, a pilot facility was installed in both farms and advanced oxidation treatments were conducted using natural sunlight by means of Na2S2O8 and heterogeneous photocatalysis (TiO2/Na2S2O8). The remaining percentages obtained at the end of the experiments ranged from 5 to 90.1% for chlorantraniliprole, 5 to 82.3% for difenoconazole, 0.02 to 19.1% for metalaxyl, 1.4 to 74.4% for myclobutanil, and 0.3 to 61% for triadimenol. We observed a correlation between the higher remaining percentages and the total initial concentration of pollutant because of other commercial formulations applied in the farms. The results showed that this equipment could be used to eliminate or reduce the presence of pesticide residues in agro-waste water using an innovative facility installed in the farms and a renewable and economical source of energy (sunlight).