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En el artículo Jorge L. Rodríguez introduce la discusión alrededor del texto de Cristina Redondo y el problema de la relación entre reglas y normas. Además de resumir algunas de las posturas centrales de la discusión, propone su propio punto de vista sobre uno de los múltiples aspectos discutidos. Según el autor el tema central es el de la relevancia práctica de las normas generales. Esto como mínimo da lugar a diversas concepciones: la universalista y la particularista.

Background: People Who Inject Drugs (PWID) are at a higher risk of acquiring bloodborne infections. This study aimed to estimate the prevalence of Hepatitis C Virus (HCV) in People Who Inject Drugs (PWID) and identify correlates and risk factors using data from the Puerto Rico National HIV Behavioral System, PWID cycle 5 conducted in 2018.Methods: A total of 502 San Juan Metropolitan Statistical Area participants were recruited through Respondent Driven Sampling method. Sociodemographic, health-related, and behavioral characteristics were assessed. Detection of HCV antibodies was completed after the face-to-face survey. Descriptive and logistic regression analyses were performed using STATA 17™. Results: The prevalence of HCV was 76.5% (95%CI: 70.8%-81.4%). Adjusted multivariate logistic regression models showed that frequent speedball injectors and knowing the HCV serostatus of the last sharing partner were significantly more associated with HCV infection (ORa = 4.17; 95% CI: 1.40-12.42; ORa = 4.49; 95% CI: 1.43-14.09, respectively).Conclusions: A high prevalence of HCV infection in PWID was observed in this sample, validating the continuing call for local action for public health and prevention strategies.

El análisis de los comentarios y críticas presente en este número nos ha permitido repensar algunos puntos sobre el tema, y el presente trabajo es el fruto de tales reflexiones. En él no se pretende ofrecer una respuesta a todas las cuestiones en discusión, sino sólo avanzar algunas ideas adicionales, básicamente respecto de la distinción entre la inconstitucionalidad de una norma jurídica y su declaración por un órgano de control, el nexo que media entre tal distinción y la concepción que se adopte respecto de la interpretación de las normas y ciertos aspectos vinculados con la dinámica de los sistemas constitucionales.

Se explorará el tradicional problema de la existencia de las normas inconstitucionales con el propósito de disolverlo, mostrando la dependencia que media entre el modo en que las normas pueden existir y el concepto de “norma” que se asuma. Se analizarán centralmente dos nociones de norma: la que las identifica con formulaciones normativas no interpretadas y la que las identifica con formulaciones normativas interpretadas. Aprovechando la distinción entre sistema y orden jurídico se examinarán dos modelos de reconstrucción del resultado que producen los actos de promulgación y derogación de normas. Sobre tales bases, se intentará demostrar la independencia conceptual entre la inconstitucionalidad de una norma y su derogación. A continuación se evaluarán los diferentes sistemas de control de constitucionalidad. El análisis se cerrará con el estudio crítico de un fallo reciente de los tribunales argentinos.

Although they come from different traditions, Hans Kelsen and W. N. Hohfeld have offered two essential contributions to the clarification of fundamental legal concepts. After a brief review of their proposals, certain problematic aspects of their reconstructions will be analyzed in the light of categories developed by Eugenio Bulygin, in particular his criticism of the reductionist conceptions of norms, the non-prescriptive character of power-conferring rules, and the distinction between norms and norm-propositions. On this basis, and starting from the concept of legal obligation, an outline of an alternative reconstruction of the theory of fundamental legal concepts will be presented. | The Spanish original of this article was published in Revus (2018) 36.

In mice, the host response to malaria weakens colonization resistance to an enteric pathogen by suppressing gastric acidity., Malaria parasite infection weakens colonization resistance against Salmonella enterica serovar (S.) Typhimurium. S. Typhimurium is a member of the Enterobacterales, a taxon that increases in abundance when the colonic microbiota is disrupted or when the colonic mucosa is inflamed. However, here, we show that infection of mice with Plasmodium yoelii enhances S. Typhimurium colonization by weakening host control in the upper GI tract. P. yoelii–infected mice had elevated gastric pH. Stimulation of gastric acid secretion during P. yoelii infection restored stomach acidity and colonization resistance, demonstrating that parasite-induced hypochlorhydria increases gastric survival of S. Typhimurium. Furthermore, blockade of P. yoelii–induced TNF-α signaling was sufficient to prevent elevation of gastric pH and enhance S. Typhimurium colonization during concurrent infection. Collectively, these data suggest that abundance in the fecal microbiota of facultative anaerobes, such as S. Typhimurium, can be increased by suppressing antibacterial defenses in the upper GI tract, such as gastric acid.

En su último libro Cristina Redondo efectúa una excelente defensa de la postura a la que califica como positivismo jurídico interno, de acuerdo con la cual sería posible formular enunciados referidos al contenido del derecho, concebido este como una entidad normativa, que sean puramente descriptivos y expresados desde un punto de vista que no presupone su aceptación. En este trabajo me limitaré a tres observaciones más bien marginales, desarrollando algunas dudas, en primer lugar, sobre la estrategia de impugnación de la denominada tesis de la imposibilidad; en segundo lugar, sobre un punto vinculado a los dos sentidos de la distinción entre punto de vista interno y externo que Redondo propone diferenciar y, en tercer lugar, respecto de una consecuencia que se derivaría de ello para la evaluación crítica de teorías interpretativistas como la de Ronald Dworkin, para luego formular algunas conclusiones de ese análisis. Redondo's last book excellently defends what she calls the 'internal legal positivism', i.e. a position according to which it is possible to formulate statements relating to the content of the law conceived as a normative entity, which are purely descriptive and are expressed from a point of view that does not presuppose its acceptance. In this essay I will limit myself to developing three rather marginal observations that raise some doubts: first, about the strategy of questioning the so-called impossibility thesis; second, about a point related to Redondo's disambiguation of the distinction between internal and external points of view; and third, about a consequence derived from this for the critical evaluation of interpretativist theories such as Dworkin's.

From 2010-2014, colorectal cancer (CRC) was the second highest incident cancer and leading cause of cancer-related deaths in Puerto Rico (PR). Although preventable through screening and treatment, colorectal cancer screening (CRCS) using fecal occult blood test (FOBT) or colonoscopy remains low for adults in PR. Data from the 2016 Behavioral Risk Factor Surveillance System indicated that 18.0% of the PR population aged 50 to 75 had undergone an FOBT within the past year compared to 8.0% in the United States (US). Additionally, 50.1% of age-eligible Puerto Ricans report ever having a colonoscopy in the past 10 years compared to 63.5% in the US. Given the higher burden of CRC and the low CRCS rates in PR, we developed ¡Salud!, por la Vida (SPLV), an educational program which aims to increase CRCS in non-adherent men and women aged 50 and 75 who attend Federally Qualified Health Clinics (FQHCs) in PR. We used Intervention Mapping (IM) as framework to develop an educational intervention that is theoretically sound and grounded in evidence. For the development of SPLV, steps 1 to 4 of IM were completed. Step 1: a needs assessment conducted through focus groups and key informant interviews to gather quantitative and qualitative data for the development of the logic model and the program; step 2: development of a logic model of change and matrices of change objectives; step 3: selection of theory and evidence-based methods and strategies; and step 4: program production, components, and materials. Step 1 revealed 5 main themes: (1) lack of knowledge about CRC and CRCS practices; (2) patient’s fear of the CRC test results; (3) low risk perception of CRC; (4) lack of provider CRCS recommendation; and (5) the importance of social support. Interviews revealed that the majority of clinics offer FOBT as part of their CRCS protocol; where 74.0% of these had a clinical laboratory on-site. Over half (53.0%) had implemented electronic medical records and 82.0% had health educators on staff. A logic model was developed by combining personal behaviors with behavioral determinants and identifying beliefs targeted by the intervention (step 2). Tailored interactive multimedia intervention (TIMI) and small media were selected as the practical application to deliver the intervention (step 3). Development of the program included 5 components: script development; testimonials; animations; written materials; and newsletter. Pre-testing was conducted to evaluate the usability of the program. Our educational program, SPLV, is completed and currently being implemented, using a randomized trial. Trial is being conducted in 10 FQHCs and will recruit 710 participants aged 50 to 75 who have no prior history of CRC and are not adherent to CRCS guidelines. Clinics are randomized to either the intervention group (TIMI) or the control group (usual care). We aim that this intervention will significantly increase CRCS rates and provide evidence to disseminate this educational effort to FQHCs in PR. Citation Format: Vivian Colón-López, Camille Vélez-Alamo, Adrianna Acevedo-Fontanez, Marievelisse Soto-Salgado, Jorge L Rodríguez-Lebrón, Josheili Y Llavona-Ortiz, Yolanda Serra-Martínez, Ileska Valencia-Torres, María Fernández. ¡Salud!, por la Vida, an educational intervention to increase colorectal cancer screening in Puerto Ricans [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B009.

Hans Kelsen y W. N. Hohfeld, desde diferentes tradiciones, han ofrecido dos contribuciones imprescindibles para el esclarecimiento de los conceptos jurídicos básicos. Tras un breve repaso de sus propuestas, se analizarán algunos aspectos deficitarios de sus reconstrucciones a la luz de categorías desarrolladas por Eugenio Bulygin en diversos trabajos, en particular sus críticas al reduccionismo normativo, la imposibilidad de identificar las reglas que confieren potestades con prescripciones y la distinción entre normas y proposiciones normativas. Sobre tales bases, y tomando como punto de partida al concepto de deber jurídico, se ofrecerá finalmente un bosquejo de reconstrucción alternativa de la teoría de los conceptos jurídicos básicos. Hans Kelsen and W. N. Hohfeld, from different traditions, have offered two essential contributions for the clarification of the fundamental legal concepts. After a brief review of their proposals, certain problematic aspects of their reconstructions will be analyzed in the light of categories developed by Eugenio Bulygin in several papers, in particular his criticism of normative reductionism, the impossibility of identifying power-conferring rules with prescriptions, and the distinction between norms and norm-propositions. On this basis, and taking as a starting point the concept of legal obligation, an outline of an alternative reconstruction of the theory of fundamental legal concepts will be presented.

In his contribution, Jorge L. Rodriguez criticizes the position that Marmor has defended in previous works. Basically the criticism is that, according to Rodriguez, it cannot be the case that a convention is constitutive, and therefore the rule of recognition cannot be of this type. According to this author, the concept of convention employed by Marmor is too weak: it leads to consider a rule as conventional even though all the members of a community follow it because they consider that it is correct, and a rule may not be considered as conventional even though everyone is following it just because others follow it. Moreover, it seems to be pointless to speak of constitutional conventions inasmuch as, according to Rodriguez, the arbitrary character of conventions is incompatible with the constitutive character of a rule. As a consequence, Marmor’s view would be affected by an internal inconsistency because, following his own definitions, the constitutive character of the rule of recognition is incompatible with its conventional character.

We analyze the economic returns to post-secondary degrees in Chile. We posit a schooling decision model with unobserved ability, degree-specific tuition costs, and earnings. We use administrative records to carry out our empirical analysis. Our results show positive average returns to post-secondary education, especially for five-year degrees. However, we also uncover significant heterogeneity. We document how unobserved characteristics (ability) determine the economic benefits of first- and second-best choices, even leading to negative returns to post-secondary degrees. Our findings illustrate the importance of allowing for heterogeneous treatment effects and individuals’ choices when examining the returns to education.

Obesity is prevalent in PR and has been associated with prostate cancer (PCa) mortality and aggressiveness. Polymorphisms (SNPs)The study population consisted of 513 Puerto Rican men age ranging from 40-79 years old who underwent radical prostatectomy (RP) as the first treatment for PCa and 128 healthy Puerto Rican men age ranging from 40-79 years old. Genomic DNA (gDNA) was extracted and SNPs were determined by Real-Time PCR. PCa severity was defined based on RP stage and Gleason Score. The relationship of FTO SNPs with demographic, clinical characteristics, PCa status and PCa severity were assessed. Logistic regression models with a 95% confidence interval (CI) determined SNPs interaction with PCa risk and severity odds ratio (ORs).BMI, age and PSA were considered as confounders. Hardy-Weinberg equilibrium was present for both SNPs. The heterozygous forms (Results offer a research line to be followed with an expanded number of subjects that may provide a better statistical significance, to unravel the high mortality rate in this population.

Background: Obesity is prevalent in PR and has been associated with prostate cancer (PCa) mortality and aggressiveness. Polymorphisms (SNPs) rs9930506 and rs9939609 in the FTO gene have been associated with both obesity and PCa. The aim of this work was to ascertain whether the presence of these SNPs is associated with PCa risk and severity in a cohort of Puerto Rican men. Methods and findings: The study population consisted of 513 Puerto Rican men age ranging from 40-79 years old who underwent radical prostatectomy (RP) as the first treatment for PCa and 128 healthy Puerto Rican men age ranging from 40-79 years old. Genomic DNA (gDNA) was extracted and SNPs were determined by Real-Time PCR. PCa severity was defined based on RP stage and Gleason Score. The relationship of FTO SNPs with demographic, clinical characteristics, PCa status and PCa severity were assessed. Logistic regression models with a 95% confidence interval (CI) determined SNPs interaction with PCa risk and severity odds ratio (ORs). Results and discussion: BMI, age and PSA were considered as confounders. Hardy-Weinberg equilibrium was present for both SNPs. The heterozygous forms (A/G; T/A) were the most prevalent genotypes and the frequency of alleles and genotypes for both SNPs agreed with those published in 1000 genomes. Results suggest an inverse association between the mutated rs9939609 and the risk of having PCa (OR: 0.53, 95% CI: 0.31-0.92) and a positive association with overweight (OR: 1.05, 95% CI: 0.68-1.62). Importantly, among the cases that were overweight, those with mutated rs9939609 had a greater chance of high severity PCa (OR: 1.39, 95% CI: 0.84-2.32) although these results were not statistical significant upon adjustment. Limitations of the study were the relatively small cohort and lack of access to the weight history of all our subjects. Conclusion: Results offer a research line to be followed with an expanded number of subjects that may provide a better statistical significance, to unravel the high mortality rate in this population..

The paper deals with the notions of consistency, completeness, and coherence within the normative domain. It investigates their mutual relations by singling out relative (to negation) and absolute consistency, weak, strong and trivial completeness, and three different functions of coherence (simplification, integration, and defeasance). The main upshot of the inquiry is that coherence may be regarded as a complex combination of weak completeness and possible absence of consistency and strong completeness of a system of rules regarding a non-trivially complete/non-absolutely inconsistent system of underlying principles.

Limited data are available on the added value of exercise echocardiography (ExEcho) over exercise electrocardiography (ExECG) in patients with suspected acute coronary syndromes (ACS) referred to a chest pain unit. We aimed to assess the incremental value of ExEcho over ExECG in this setting.ExECG and ExEcho were performed in parallel in 1052 patients with suspected ACS, nondiagnostic but interpretable electrocardiograms, and negative serial troponin results. The primary outcome was a composite of coronary death, nonfatal myocardial infarction or unstable angina with angiographic documentation of significant coronary artery disease within 6 months.The primary outcome occurred in 2/614 patients (0.3%) with both negative ExECG and ExEcho, 3/60 (5%) with positive ExECG and negative ExEcho, 73/135 (54.1%) with negative ExECG and positive ExEcho, 106/136 (77.9%) with both positive ExECG and ExEcho, and 8/107 (7.5%) with inconclusive results. The addition of ExEcho data to a model based on clinical and ExECG data significantly increased the c statistic from 0.898 to 0.968 (change +0.070, 95% confidence interval 0.052-0.092), with a continuous net reclassification improvement of 1.56 and an integrated discrimination improvement of 22% (p0.001). Decision curve analysis showed that a strategy of referral to coronary angiography based on ExEcho was associated with the highest net benefit and with the largest reduction in unnecessary coronary angiographies.ExEcho provides significant incremental prognostic information and higher net clinical benefit than a strategy based on ExECG in patients referred to a chest pain unit for suspected ACS and negative troponin levels.

It is a basic intuition about the law that organs of adjudication ought to justify their decisions by recourse to the appropriate applicable norms. Nevertheless, a sound reconstruction of the applicability of legal norms has been largely ignored in contemporary legal theory. Different connections between applicable norms and cases are explored in this paper, and a distinction is suggested between internal and external applicability. A legal norm is internally applicable to the cases regulated by its scope of validity (i.e. by its terms the norm fits the facts of the case), and is externally applicable when it has to be used in a certain case as a justification of an institutional decision (i.e. the presiding judge has a legal duty to apply it to the case). A usual claim holds that all and only valid norms which, by their terms, apply to the case at hand must be applied in determining the outcome of the case. However, we try to demonstrate that a valid legal norm that exists as a member in a legal system may be internally applicable to a case and yet not be externally applicable to it. It also may occur that judges sometimes have the legal duty to apply norms that are not part of their own legal system. Consequently, the relations between internal and external applicability and between external applicability and validity deserve a careful examination. In these pages we hold that, though validity plus internal applicability is neither a necessary nor a sufficient condition of the duty to apply a legal norm, there is a complex conceptual link between external applicability and the systematic reconstruction of the law.

The validity within legal systems of entailed norms, that is, those norms that are logically derivable from explicitly issued rules, has been called into question with different arguments. To take two examples from distinguished figures, Joseph Raz has claimed that what he calls the “incorporation thesis” cannot account for law’s claim of authority, and Andrei Marmor believes that the admission of entailed norms in a legal system would imply the mistaken view that it is necessarily coherent. In this paper we show that these two arguments are, at the very least, highly controversial; that the positivist social sources thesis, though not committed to it, is compatible with the validity of entailed norms, and that taking into account the whole set of logical consequences of explicitly issued norms is an unavoidable step in explaining the dynamic character of legal systems .

A considerable number of books and papers have analyzed normative concepts using new techniques developed by logicians; however, few have bridged the gap between the English legal culture and the Continental (i.e. European and Latin American) tradition in legal philosophy. This book addresses this issue by offering an introductory study on the many possibilities that logical analysis offers the study of legal systems. The volume is divided into two sections: the first covers the basic aspects of classical and deontic logic and its connections, advancing an explanation of the most important topics of the discipline by comparing different systems of deontic logic and exploring some of the most important paradoxes in its domain. The second section deals with the role of logic in the analysis of legal systems by discussing in what sense deontic logic and the logic of norm-propositions are useful tools for a proper understanding of the systematic structure of law.

A series of platinum(II) complexes of the type [NEt4][PtLBr3] where L is a 2-styrylbenzothiazole or 2-styrlbenzole was prepared. The complexes were characterized by their melting points, elemental analyses, UV-Vis and far-infrared spectra, and 1H and 195Pt NMR spectroscopy. The NMR data are consistent with coordination of the benzoheterazole ligands to the Pt ion through the nitrogen atom. The ligands and the complexes were assayed for cytotoxicity against U937 human histiocytic lymphoma cells. It was observed that the ligands displayed very poor cytotoxicity, while the Pt(II) complexes demonstrated marked cytotoxicities and a structure-activity correlation was established. Pt(II) complexes containing S as the heteroatom in the benzoheterazole ring were generally more active than their O-containing counterpart. The position and type of substituents in the styryl moeity were also important for biological activity. Our data indicate that adjacent methoxy functionalities were present in the most potent drugs tested. Further development of active Pt(II) complexes with improved solubilities is warranted.

The proposed mechanism of action of the antineoplastic drug 3-nitrobenzothiazolo[3,2-& agr;]quinolinium chloride (NBQ-2) involves its interaction with DNA by intercalation and inhibition of topoisomerase II activity by arresting the enzyme in a covalent cleavage complex. In an attempt to identify some structural determinants for activity and develop a molecular structure/cytotoxicity correlation, four new structural analogs of the antitumor NBQ-2 were prepared and their cytotoxic activity and DNA binding properties were investigated. The cytotoxic activity was evaluated against six different human tumor cell lines: U937, K-562, HL-60, HT-29, HeLa, and A431. The results showed that these new drugs elicit pronounced cytotoxic effects against U937, K-562, HL-60 and A431 while HeLa and HT-29 were less sensitive to the new drugs. This apparent selectivity was different to that of m-AMSA, a drug currently used for cancer treatment. Since the interaction of NBQ-2 to DNA by intercalation has been proposed as the initial step leading to its antineoplastic activity, DNA binding and changes in DNA contour length induced by the new NBQ-2 structural analogs were also investigated using calf thymus and human DNA. The drug, 7-(1-propenyl)-3-nitrobenzimidazolo[3,2-& agr;]quinolinium chloride (NBQ-59) was the most cytotoxic agent of the analog series (IC50 = 16 & mgr;M for HL-60 cells), however, it demonstrated the weakest binding to DNA (Kint = 0.9 × 105 M-1 for calf thymus DNA). NBQ-59 was also found to be a poor intercalator into the DNA double helix. Therefore, our results suggest that DNA binding is not the primary mechanism of drug action for this family of compounds. In addition structural determinants important for cytotoxicity of the benzazolo quinolinium chlorides were suggested by our results. In particular, the nitro group in the 3 position does not seem to be necessary for bioactivity, while substitutions in the benzazolo moiety have striking effects on the biological activity of the drugs.