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La inteligencia artificial generativa (IAG), con aplicaciones como ChatGPT, se ha convertido en una interesante herramienta en el ámbito de la educación biomédica. Entre sus bondades destaca la simplificación y mejora del proceso enseñanza-aprendizaje, favoreciendo la búsqueda de información, la creación y actualización de contenido, la simulación de escenarios clínicos, la atención personalizada o la evaluación inmediata. Sin embargo, son muchos los riesgos que comporta una herramienta tan novedosa y disruptiva. Debido a ello, con el objetivo de evaluar estas amenazas, utilizamos los Principios Éticos de la UNESCO y el Reglamento de la Unión Europea sobre Inteligencia Artificial, concluyendo que el principal riesgo de estas aplicaciones deriva de su potencial capacidad discriminatoria, especialmente en referencia a la evaluación y categorización de los estudiantes; también, de la aparición de diferentes sesgos técnicos, de la falta de equidad, de control, de transparencia y de privacidad, o del plagio y la falsa autoría.

Entre 1940 y 1965, el poder adquisitivo de las familias obreras en el sur de Madrid era extremadamente bajo, por lo que buena parte de sus miembros en edad laboral buscaban una ocupación: situación ésta que aceleró la transición laboral de las mujeres, a pesar de que ciertas pautas culturales coadyuvaban por entonces a que abandonasen su ocupación cuando se casaban. Con todo, según información cualitativa obtenida en trabajo de campo, la actividad laboral femenina fue mayor que la registrada oficialmente, ocupada en trabajos sumergidos que no recogieron las estadísticas socio-demográficas pero que contribuían a mejorar las economías familiares. A este trabajo asalariado se añadían las arduas labores de la casa.

Antecedentes: En México, en 2020 se implementó el etiquetado frontal de advertencia (EFA) como parte de una estrategia para incrementar el consumo consciente de alimentos. Sin embargo, la limitada cobertura mediática, la falta de conocimiento entre los profesionales de la salud y el uso de terminología técnica parecen ser impedimentos que afectan a algunos grupos de la población, particularmente a las personas mayores. Objetivo: Analizar el perfil del uso y comprensión del etiquetado nutricional entre las personas mayores, según diferentes factores que podrían influir en ello. Material y métodos: El uso y comprensión del EFA se evaluó en una muestra representativa de 1884 personas mayores de la Encuesta Nacional de Salud y Nutrición (ENSANUT) 2021. Se realizó regresión logística para determinar la asociación de conocer o usar el EFA, ajustando por edad, género, capacidad de lectura, nivel educativo, vivir con diabetes, hipertensión y estatus de seguridad social. Resultados: La probabilidad de leer y usar el EFA estuvo influida por una menor edad, ser mujer, un nivel educativo más alto y tener seguridad social. No existió un efecto significativo de vivir con diabetes o hipertensión. Conclusiones: Es oportuna una educación nutricional adaptada a las circunstancias de las personas mayores en México.

Background/Aims Abexol is a mixture of primary aliphatic alcohols purified from beeswax (Apis mellifera), that produces anti-inflammatory, antioxidant and gastroprotective effects, as well as it is safe and well tolerated. To investigate and compare the efficacy and safety of Abexol (suspension versus tablets) in patients with gastrointestinal symptoms. Methods Monocentric study, open-label, randomized design, with two parallel groups receiving Abexol tablets (150 mg/d) or Abexol suspension (75 mg/d) for 8 weeks. Primary efficacy variable (significant improvement in the total score of Gastrointestinal Symptom Rating Scale [GSRS]). Significant reduction in the intensity of the gastrointestinal-symptoms and the reduction in the consumption of antacids are considered secondary efficacy variable. Short form-36 (SF-36) quality of life questionnaire was evaluated as collateral variable. Data were analyzed as per intention to treat. Results A significantly decrease in the overall score of the survey was observed with respect to the baseline level (p < 0.001) of 81.4% in the Abexol suspension group and 77.9% in the Abexol tablets group. At the end of the trial, most gastrointestinal-symptoms disappeared or reduced significantly. The frequency of consumption of neutralizing antacids was low. The significantly improvement in the perception of the state of health obtained in the Abexol is in correspondence with the improvement achieved in some of the components evaluate in the SF-36 questionnaire. Both treatments were safe and well tolerated. Conclusions Abexol suspension showed efficacy and safety similar to Abexol tablets in patients with gastrointestinal symptoms, but using half the dose.

Oxidative stress is one of the primary instigators of the onset of various human ailments, including cancers, cardiovascular diseases, and dementia. Particularly, oxidative stress severely affects low-density lipid & protein (LDL) oxidation, leading to several detrimental health effects. Therefore, in this study, the effect of beeswax alcohol (BWA) was evaluated in the prevention of LDL oxidation, enhancement of paraoxonase 1 (PON-1) activity of high-density lipid & protein (HDL), and zebrafish embryo survivability. Furthermore, the implication of BWA consumption on the oxidative plasma variables was assessed by a preliminary clinical study on middle-aged and older human subjects (n = 50). Results support BWA augmentation of PON-1 activity in a dose-dependent manner (10–30 μM), which was significantly better than the effect exerted by coenzyme Q10 (CoQ10). Moreover, BWA significantly curtails LDL/apo-B oxidation evoked by CuSO4 (final 0.5 μM) and a causes a marked reduction in lipid peroxidation in LDL. The transmission electron microscopy (TEM) analysis revealed a healing effect of BWA towards the restoration of LDL morphology and size impaired by the exposure of Cu2+ ions (final 0.5 μM). Additionally, BWA counters the toxicity induced by carboxymethyllysine (CML, 500 ng) and rescues zebrafish embryos from development deformities and apoptotic cell death. A completely randomized, double-blinded, placebo-controlled preliminary clinical study on middle- and older-aged human subjects (n = 50) showed that 12 weeks of BWA (100 mg/day) supplementation efficiently diminished serum malondialdehyde (MDA) and total hydroperoxides and enhanced total antioxidant status by 25%, 27%, and 22%, respectively, compared to the placebo-control and baseline values. Furthermore, the consumption of BWA did not exhibit any noteworthy changes in physical variables, lipid profile, glucose levels, and biomarkers pertinent to kidney and liver function, thus confirming the safety of BWA for consumption. Conclusively, in vitro, BWA prevents LDL oxidation, enhances PON-1 activity in HDL, and positively influences oxidative variables in human subjects.

Renewable energy, particularly geothermal energy, is on the rise globally. It has been demonstrated that recovering heat lost during geothermal cycles is essential due to the inefficiency of these cycles. This paper pproposes a combined power generation cycle using EES software to model a single-flash geothermal cycle, and a trans-critical carbon dioxide cycle. The study compares the system's performance during its "Without Economizer" and "With Economizer" operational stages. The impact of the economizer on the system's output metrics, including the net power output, energy efficiency, and exergy efficiency, was examined. The results show that the "With Economizer" system's net power output increased from 451.3 kW to 454 kW. The energy efficiency difference between the two systems is based on the first law of thermodynamics, where the value ofthe "Without Economizer" system is 6.036%, and the "With Economizer" system is 6.075%. The system without an economizer had an exergy efficiency value of 26.26%, whereas the system with an economizer reached 26.43%, based on the second law of thermodynamics. Installing the economizer increased the total economic cost rate of the system from 0.225M$/Year to 0.2294M$/Year, which increased the product cost rate from 15.82$/GJ to 16.02$/GJ.

En este artículo reflexionamos sobre la potencialidad terapéutica de los nuevos desarrollos de la Inteligencia Artificial en el ámbito de la salud mental, en particular en la prevención de conductas suicidas. En primer lugar, analizamos los aspectos tecno-científicos más relevantes del Machine Learning en el entorno de las Redes Sociales, las aplicaciones móviles y los chatbots, así como las ventajas e inconvenientes de esta nueva Psiquiatría Computacional. A continuación, consideramos los límites y dificultades en el uso de estas tecnologías desde una perspectiva ética, además del marco legal para que estas aplicaciones preventivas sean garantistas en lo que a eficacia, seguridad, privacidad, transparencia, responsabilidad y equidad se refiere. Si bien las amenazas son considerables, concluimos que con una correcta identificación y gestión de las mismas el alcance terapéutico de estas herramientas se antoja alentador.

Factors such as fossilisation, diversification of energy resources, sustainable development, and energy security are attracting global attention for the development and expansion of renewable energy sources. Environmental issues arising from fossil fuel consumption are being addressed, but concerns remain about the renewability and availability of new energy sources. Mexico is one of the ten countries in the exploitation of geothermal energy, with a history of approximately five decades. This study examines Mexico's five major geothermal fields: Cerro Prieto, Los Azufres, Los Humeros, Las Tres Vírgenes, and Domo San Pedro. Currently, Mexico is working with international geothermal companies. However, there are more power plants and substantial cooperation to obtain this energy for industry and homes. This study is focused on the potential of geothermal exploitation in Mexico and its position worldwide after the introduction of geothermal energy in Mexico. Next, five geothermal fields are introduced in Mexico, and the potential and capacities of each are discussed. Finally, the future energy scenarios in Mexico are reviewed, with an emphasis on geothermal energy .

Life Cycle Assessment (LCA) is normally used independently of the physical and temporal location of the product, process or service under analysis. This makes LCA results more easily comparable and globally accepted. At the same time, it has drawbacks though, e.g. land use will have the same impact regardless of location. However, the use of certain terrains in high erosion risk areas as compared to others in low erosion risk areas will have a different impact on the ecosystem. The availability of airborne Light Detection and Ranging (LiDAR) data (ALS) allows a quick and accurate morphogeometric analysis of any terrain. For this reason, this article offers a methodology, based on Revised Universal Soil Loss Equation (RUSLE) method and airborne LiDAR data, for the straightforward detection of zones with high vulnerability to erosion problems. Based on these local erosion risk data, a method is developed to assess the environmental impact of land use, based on its location. In this way, the LCA methodology is incorporated to gather local data, dependent on the specific location of the activity under analysis. The methodology developed has been applied, as a case study, to a specific municipality in the high mountains of the Autonomous Community of La Rioja (Spain).

Hospitals have demonstrated their enormous capacity to adapt to the rapidly changing situation imposed by the pandemic: increasing the number of intensive care units and intermediate and inpatient beds, with the corresponding human resources, services and facilities required. Internationally, the enormous demand to manage the COVID-19 pandemic has challenged hospitals in terms of staffing, supplies and equipment. This article analyses the effect of the COVID-19 pandemic on hospital activities, from the perspective of its environmental impact. It compares a year of normal hospital activities, 2019, with data on hospital activities from 2020. The aim of this research is to analyse the changes produced by the pandemic in the regular activities of the hospital and to determine the environmental impact, which allows reflecting on the exceptional situation generated. The results show that the hospital’s environmental impact increased significantly in 2020 compared to 2019, with a 17.2% increase in overall environmental efficiency indices. The main contributors to this increase were waste generation and medical gas consumption, which are critical aspects of hospital activities during the pandemic.

En este artículo se hace una lectura comparada de dos relatos del siglo xx por medio del pacto diabólico y la codificación fantástica: “Enoch Soames”, de Beerbohm, y “Un pacto con el diablo”, de Arreola. Esta lectura comparada se hace desde una perspectiva literaria y se comentan algunas cuestiones estilísticas y las técnicas narrativas, particularmente la ironía, el humor y la metaficción para observar cómo cada autor reescribe un motivo tradicional como el pacto diabólico.

Fundamento: la β2microglobulina está reconocida como marcador tumoral para diferentes propósitos en hematopatías malignas de estirpe linfoide; sin embargo, no hay antecedentes de su utilización en la provincia de Cienfuegos.Objetivo: describir las características sociodemográficas, clínicas y la distribución de los niveles séricos de β2microglobulina en pacientes con síndrome linfoproliferativo crónico y su relación con los estadios clínicos y la respuesta al tratamiento de primera línea.Métodos: estudio observacional descriptivo transversal. La serie se conformó con todos los pacientes adultos con diagnóstico reciente (sin comenzar terapia antitumoral específica) de mieloma múltiple, leucemia linfoide crónica, linfoma no Hodgkin y linfoma Hodgkin, ingresados en el Servicio de Hematología del Hospital General Universitario Dr. Gustavo Aldereguìa Lima, durante el año 2020. La información se obtuvo mediante revisión documental de historias clínicas y ensayos de laboratorio. Se analizaron las variables: sexo, edad, color de la piel, niveles de β2microglobulina, tipo de enfermedad, estadios clínicos y respuesta al tratamiento.Resultados: el 84 % de la serie presentó niveles elevados del analito, más acentuado en el mieloma. Se constató relación entre los niveles estratificados de β2microglobulina con los estadios clínicos y la respuesta al tratamiento de primera línea. Conclusiones: las características sociodemográficas y las variables clínicas observadas no difieren de forma sustantiva con lo reportado. La distribución de los niveles de la β2microglobulina es sugerente de una relación directa entre los estadios clínicos e inversa con la respuesta al tratamiento.

This study investigated the wind energy potential of Ciudad Juárez (Chihuahua, México) for a whole year. The viability of employing three small-scale wind turbine models, including the S-343, Bergey BWC Excel, and AOC 15/50, in Ciudad Juarez, located in the northern Mexican state of Chihuahua in Mexico, is studied in the first stage using RETScreen software. The performance of these three turbine models was subjected to sensitivity analysis in the following study stage using the three defined economic scenarios, assuming a 7% inflation rate, a 9% discount rate, a 7% fuel cost escalation rate, and a 20-year project duration. Finally, the circumstances under which these turbines operate in Ciudad Juarez are discussed economically. Findings indicate that the study site is not economically appropriate, not even for the installation of specific small wind turbines. Finally, it was suggested that the viability of adopting alternative renewable energy systems, such as solar and hybrid systems (photovoltaic wind), be examined in the upcoming study in Ciudad Juárez.

IntroductionThe antinociceptive and pharmacological activities of C-Phycocyanin (C-PC) and Phycocyanobilin (PCB) in the context of inflammatory arthritis remain unexplored so far. In the present study, we aimed to assess the protective actions of these compounds in an experimental mice model that replicates key aspects of human rheumatoid arthritis.MethodsAntigen-induced arthritis (AIA) was established by intradermal injection of methylated bovine serum albumin in C57BL/6 mice, and one hour before the antigen challenge, either C-PC (2, 4, or 8 mg/kg) or PCB (0.1 or 1 mg/kg) were administered intraperitoneally. Proteome profiling was also conducted on glutamate-exposed SH-SY5Y neuronal cells to evaluate the PCB impact on this key signaling pathway associated with nociceptive neuronal sensitization.Results and discussionC-PC and PCB notably ameliorated hypernociception, synovial neutrophil infiltration, myeloperoxidase activity, and the periarticular cytokine concentration of IFN-γ, TNF-α, IL-17A, and IL-4 dose-dependently in AIA mice. In addition, 1 mg/kg PCB downregulated the gene expression for T-bet, RORγ, and IFN-γ in the popliteal lymph nodes, accompanied by a significant reduction in the pathological arthritic index of AIA mice. Noteworthy, neuronal proteome analysis revealed that PCB modulated biological processes such as pain, inflammation, and glutamatergic transmission, all of which are involved in arthritic pathology.ConclusionsThese findings demonstrate the remarkable efficacy of PCB in alleviating the nociception and inflammation in the AIA mice model and shed new light on mechanisms underlying the PCB modulation of the neuronal proteome. This research work opens a new avenue to explore the translational potential of PCB in developing a therapeutic strategy for inflammation and pain in rheumatoid arthritis.

The LIFE SALINAS project, co-financed by the European Union, aims for the conservation and improvement of the protected area named the Regional Park of Las Salinas and Arenales de San Pedro del Pinatar (Region of Murcia, Spain). The main objectives are, among others, to stop the erosion of the dunes in front of a 500 m long beach and to expand the breeding habitat of aquatic birds. Between the dune and the beach, a barrier was placed to protect the dune from the effects of storms. The dunes were fenced, placed with sand traps and revegetation was carried out with native species in the most degraded areas. Within the salt pans, 1800 m of new sandy dikes were built to separate the salt ponds. The results have been the recovery of the dune ecosystem and the increase in the population of nesting aquatic birds and other species, as well as an increase in the quality and production of salt.

En este artículo se examina de manera íntegra Manual de flora fantástica del poeta mexicano Eduardo Lizalde por medio de la filogenia perversa y la alteridad floral. Esta flora fantástica es perversa y pervierte al romper con las normas establecidas y fundar un nuevo orden en que las plantas son la especie dominante. Rico en intertextualidad, humor, ironía, simbolismo y otros recursos literarios, este libro despliega múltiples connotaciones sobre el ejercicio estético a partir de la rosa, la flor que, al igual que el tigre lo es en la obra global de Lizalde, tiene innegable importancia aquí.

IntroductionElevated pulse pressure (ePP) is an independent marker of cardiovascular risk (CVR) in people older than 60, and a functional marker of subclinical target organ damage (sTOD) which can predict cardiovascular events in patients with hypertension (HTN), regardless of sTOD.ObjectiveTo evaluate the prevalence of ePP in adult population seen in primary care and its association with other vascular risk factors, sTOD and with cardiovascular disease (CVD).Materials and methodsObservational multicentre study conducted in Spain (8,066 patients, 54.5% women) from the prospective cohort study IBERICAN recruited in Primary Care. Pulse pressure (PP) was defined as the difference between the systolic blood pressure (SBP) and the diastolic blood pressure (DBP) ≥60 mmHg. Adjusted (for age and sex) ePP prevalence were determined. Bivariate and multivariate analyses of the possible variables associated with ePP were carried out.ResultsThe mean of PP was 52.35 mmHg, and was significantly higher (p

El Síndrome de Linburg-Comstock se caracteriza por la incapacidad para flexionar activamente la articulación interfalángica del pulgar, sin, involuntariamente, flexionar también las articulaciones interfalángicas proximal y distal del índice, debido a conexiones tendinosas entre el tendón flexor largo del pulgar, o su vientre muscular, y los tendones flexores profundos de los dedos. Presentamos el caso de una policía con esta anomalía, a la que se le indicó baja laboral, y, posteriormente, fue reubicada, por su incapacidad para empuñar el arma reglamentaria, sin que la disparase involuntariamente. Hasta la fecha, no hemos encontrado ninguna publicación en el que el uso de la técnica de cirugía mediante anestesia local sin isquemia (WALANT) se haya utilizado como método quirúrgico en el Síndrome de Linburg-Comstock.

Background: there is an established relationship between cancer and the appearance and development of thromboembolic disease. It is necessary to identify patients with an increased risk of venous thromboembolism using predictive scales to individualize the risk. Objective: to identify the risk of thrombosis in patients with suffering cancer conditions undergoing chemotherapy. Method: a series of cases descriptive cross-sectional study, treated at the Clinical Oncology Service of the Dr. Gustavo Aldereguía Lima University General Hospital, Cienfuegos, from June the 1st, 2020 to April 30th, 2021. The information was obtained from the clinical record and a data collection model. The variables analyzed were: age, sex, site of the primary tumor, platelet count prior to chemotherapy, serum hemoglobin levels, erythropoietin use, leukocyte count prior to chemotherapy, and body mass index. The data obtained were processed using the SPSS version 21 statistical program and the results are presented in tables using absolute numbers and percentages. Results: the most frequent age group was 60 years old and over with 77 patients (51.3 %), 45 (30 %) male. The application of the Khorana score marked a relevant percentage (26 %) of patients with intermediate and high risk of thrombosis. Conclusions: the research shows a mostly aged adult population, with risk factors for thrombosis related to the patient, oncological disease and systemic treatments.

Fundamento: existe una relación establecida entre el cáncer y la aparición y desarrollo de enfermedad tromboembólica. Se hace necesario identificar a los pacientes con un riesgo aumentado de tromboembolismo venoso utilizando escalas predictivas para individualizar el riesgo. Objetivo: identificar el riesgo de trombosis en el paciente con padecimientos oncológicos ambulatorios en quimioterapia. Método: se realizó un estudio descriptivo de corte transversal, en una serie de casos, atendidos en el Servicio de Oncología Clínica del Hospital General Universitario Dr. Gustavo Aldereguía Lima, de Cienfuegos, en el período comprendido entre el primero de junio de 2020 hasta el treinta de abril de 2021. La información se obtuvo del expediente clínico y un modelo recolector de datos. Las variables analizadas fueron: edad, sexo, sitio del tumor primario, conteo de plaquetas previo a la quimioterapia, niveles de hemoglobina sérica, uso de eritropoyetina, conteo leucocitario previo a la quimioterapia e índice de masa corporal. Los datos obtenidos se procesaron mediante el programa estadístico SPSS versión 21 y los resultados se presentan en tablas mediante números absolutos y porcientos. Resultados: el grupo de edad más frecuente fue el de 60 años y más con 77 pacientes (51,3 %), del sexo masculino 45 (30 %). La aplicación del modelo de predicción de Khorana marcó un porcentaje relevante (26 %) de pacientes con riesgo intermedio y alto de trombosis. Conclusiones: la investigación muestra una población adulta mayoritariamente envejecida, con factores de riesgo de trombosis relacionados con el paciente, la enfermedad oncológica y los tratamientos sistémicos.

Fundamento: los profesionales de la salud deben estar adecuadamente calificados para desempeñar sus funciones como investigadores. En Cienfuegos se han impartido varios cursos para capacitar al personal en ensayos clínicos, lo cual permite elevar la calidad de este tipo de investigación.Objetivo: describir el comportamiento de la capacitación del personal de salud en la temática de ensayos clínicos durante el periodo desde 2004 hasta 2018 en la provincia Cienfuegos.Métodos: estudio descriptivo sobre los cursos impartidos en Cienfuegos en el periodo comprendido desde 2004 hasta 2018. Se consultó la documentación legislada por secretaria docente de postgrado para la impartición de cursos. Se analizaron las variables: cursos impartidos, años en que se impartieron, investigadores capacitados, lugar de procedencia y profesión. Resultados: se impartieron 46 cursos, de ellos 19 para la capacitación de investigadores clínicos. Se capacitaron 366 investigadores, de los cuales 283 (77,3 %) pertenecen a la atención secundaria y 83 (22,7 %) a la atención primaria de salud. Entre los años 2013 y 2017 se alcanzaron las mayores cifras: 30 cursos y 163 investigadores capacitados para un el 46, 2 %. Según su profesión, el 52, 5 % son médicos y el 21,9 % son enfermeros.Conclusiones: en Cienfuegos se capacitó al personal que participó en la ejecución de ensayos clínicos; con mayor representación en el personal médico y de enfermería de la atención secundaria en relación al número de ensayos clínicos que se ejecutan en este nivel del sistema de salud.

Renal hyperfiltration (RHF) is a prevalent phenomenon in critically ill patients characterized by augmented renal clearance (ARC) and increased of elimination of renally eliminated medications. Multiple risk factors had been described and potential mechanisms may contribute to the occurrence of this condition. RHF and ARC are associated with the risk of suboptimal exposure to antibiotics increasing the risk of treatment failure and unfavorable patient outcomes. The current review discusses the available evidence related to the RHF phenomenon, including definition, epidemiology, risk factors, pathophysiology, pharmacokinetic variability, and considerations for optimizing the dosage of antibiotics in critically ill patients.

Cytokines, demyelination and neuroaxonal degeneration in the central nervous system are pivotal elements implicated in the pathogenesis of multiple sclerosis (MS) and its nonclinical model of experimental autoimmune encephalomyelitis (EAE). Phycocyanobilin (PCB), a chromophore of the biliprotein C-Phycocyanin (C-PC) from Spirulina platensis, has antioxidant, immunoregulatory and anti-inflammatory effects in this disease, and it could complement the effect of other Disease Modifying Treatments (DMT), such as Interferon-β (IFN-β). Here, our main goal was to evaluate the potential PCB benefits and its mechanisms of action to counteract the chronic EAE in mice. MOG35-55-induced EAE was implemented in C57BL/6 female mice. Clinical signs, pro-inflammatory cytokines levels by ELISA, qPCR in the brain and immunohistochemistry using precursor/mature oligodendrocytes cells antibodies in the spinal cord, were assessed. PCB enhanced the neurological condition, and waned the brain concentrations of IL-17A and IL-6, pro-inflammatory cytokines, in a dose-dependent manner. A down- or up-regulating activity of PCB at 1 mg/kg was identified in the brain on three (LINGO1, NOTCH1, and TNF-α), and five genes (MAL, CXCL12, MOG, OLIG1, and NKX2-2), respectively. Interestingly, a reduction of demyelination, active microglia/macrophages density, and axonal damage was detected along with an increase in oligodendrocyte precursor cells and mature oligodendrocytes, when assessed the spinal cords of EAE mice that took up PCB. The studies in vitro in rodent encephalitogenic T cells and in vivo in the EAE mouse model with the PCB/IFN-β combination, showed an enhanced positive effect of this combined therapy. Overall, these results demonstrate the anti-inflammatory activity and the protective properties of PCB on the myelin and support its use with IFN-β as an improved DMT combination for MS.

COVID-19, a disease considered by the World Health Organization as a global pandemic, has so far lacked effective and specific therapy. Among the therapeutic alternatives used to decrease the severity of the process and shorten its duration, passive immunization with plasma transfusions obtained from recovered patients is of great interest. The efficacy and safety results of published research are reviewed. In these articles, there is no complete coincidence in the plasma volumes administered, in the antibody title required, time of initiation of treatment, and in the variables selected to evaluate the response. Most studies have few cases and lack a control group. However, an improvement in the clinical and laboratory parameters of the transfused patients is generally reported, with an adequate safety profile. There are more than 100 registered clinical trials, which are currently trying to demonstrate the efficacy and safety of the use of convalescent plasma in patients afflicted by COVID-19.

Foundation: in patients with sickle cell disease, lung function abnormalities are frequent and can be detected by spirometry. Objective: to describe the disturbances of the respiratory functions in patients with sickle cell disease followed in a provincial consultation of hemoglobinopathies. Methods: observational, descriptive, cross-sectional study. Seventy six patients, selected by accidental non-probabilistic sampling, of 88 adults followed at the Dr. Gustavo Aldereguía Lima Hospital were included. The variables studied were: age, sex, type of hemoglobinopathy, respiratory symptoms, history of acute thoracic syndrome, (clinical forms and number of events), comorbidities and ventilatory pattern. Functional ventilatory tests were performed with Hellige digital Microspiro. Results: the age group between 20-29 years was the most frequent (34.2%). There was a discrete female predominance (56.1%) and the SS genotype (67.1%). The most frequent of the respiratory symptoms was dyspnea and among the comorbidities heart failure in 9.2% of the patients. In 42.1% there was a history of acute chest syndrome, pneumonia in most cases. Nine patients (11.8%) presented obstructive disorders and 43 patients (56.6%) a restrictive pattern. In the SS genotype the risk of having spirometry alterations was three times higher than the rest [OR = 3.2 IC (1.7-5.9)] Conclusion: the finding of altered respiratory functional test with a predominance of the restrictive pattern was common. These modifications were observed more frequently in patients with the SS genotype.

Resumen: Algunas personas, también las menores de edad, tienen una identidad de género que no se corresponde con el sexo asignado al nacer. Se les conoce como personas trans*, que es el término paraguas que engloba transgénero, transexual y otras identidades no conformes con el género asignado. Las unidades de asistencia sanitaria a menores trans* requieren un trabajo multidisciplinario, realizado por personal experto en identidad de género, que permita, cuando así lo soliciten, intervenciones para el menor y su entorno sociofamiliar, de forma individualizada y flexible durante el camino de afirmación de género. Este modelo de servicio también incluye tratamientos hormonales adaptados en la medida de lo posible a las necesidades del individuo, más allá de los objetivos dicotómicos de un modelo binario tradicional. Esta guía aborda los aspectos generales de la atención profesional de menores trans* y presenta el protocolo actual basado en evidencia de tratamientos hormonales para adolescentes trans* y no binarios. Además, detalla aspectos clave relacionados con los cambios corporales esperados y sus posibles efectos secundarios, así como el asesoramiento previo sobre preservación de la fertilidad. Abstract: Some people, including minors, have a gender identity that does not correspond to the sex assigned at birth. They are known as trans* people, which is an umbrella term that encompasses transgender, transsexual, and other identities not conforming to the assigned gender. Healthcare units for trans* minors require multidisciplinary working, undertaken by personnel expert in gender identity, enabling, when requested, interventions for the minor and their social–familial environment, in an individualized and flexible way during the gender affirmation path. This service model also includes hormonal treatments tailored as much as possible to the individual's needs, beyond the dichotomic goals of a traditional binary model. This guide addresses the general aspects of professional care of trans* minors and presents the current evidence-based protocol of hormonal treatments for trans* and non-binary adolescents. In addition, it details key aspects related to expected body changes and their possible side effects, as well as prior counselling about fertility preservation.

Some people, including minors, have a gender identity that does not correspond to the sex assigned at birth. They are known as trans* people, which is an umbrella term that encompasses transgender, transsexual, and other identities not conforming to the assigned gender. Healthcare units for trans* minors require multidisciplinary working, undertaken by personnel expert in gender identity, enabling, when requested, interventions for the minor and their social–familial environment, in an individualized and flexible way during the gender affirmation path. This service model also includes hormonal treatments tailored as much as possible to the individual's needs, beyond the dichotomic goals of a traditional binary model. This guide addresses the general aspects of professional care of trans* minors and presents the current evidence-based protocol of hormonal treatments for trans* and non-binary adolescents. In addition, it details key aspects related to expected body changes and their possible side effects, as well as prior counselling about fertility preservation. Resumen: Algunas personas, también las menores de edad, tienen una identidad de género que no se corresponde con el sexo asignado al nacer. Se les conoce como personas trans*, que es el término paraguas que engloba transgénero, transexual y otras identidades no conformes con el género asignado. Las unidades de asistencia sanitaria a menores trans* requieren un trabajo multidisciplinario, realizado por personal experto en identidad de género, que permita, cuando así lo soliciten, intervenciones para el menor y su entorno sociofamiliar, de forma individualizada y flexible durante el camino de afirmación de género. Este modelo de servicio también incluye tratamientos hormonales adaptados en la medida de lo posible a las necesidades del individuo, más allá de los objetivos dicotómicos de un modelo binario tradicional. Esta guía aborda los aspectos generales de la atención profesional de menores trans* y presenta el protocolo actual basado en evidencia de tratamientos hormonales para adolescentes trans* y no binarios. Además, detalla aspectos clave relacionados con los cambios corporales esperados y sus posibles efectos secundarios, así como el asesoramiento previo sobre preservación de la fertilidad.

Introduction: The detection of SARS-CoV-2 genetic material from nasopharyngeal swab samples by RT-PCR is the most specific and sensitive way to test suspected cases. However, factors such as the sampling process, the type of hyssop used, and the anatomical area from which the sample is collected can distort the result and cause false negatives. Objective: To evaluate the reliability of CNUERO hyssops for sample collection for the SARS-CoV-2 diagnosis versus IMPROSWAB hyssops. Material and Methods: To study the reliability of hyssops developed in Cuba for swabbing for the COVID-19 diagnosis by comparing them to other hyssops successfully used for this task, 2 swabbing samples were obtained from each patient (136). One of these two samples was taken using the hyssops made in Cuba, while the other was taken using another hyssop imported from Germany. The positive detections obtained with the use of both hyssops were compared using the Fisher’ s exact test. The result of the detection of each hyssop was evaluated and compared using the ROC curve. Results: The use of CNEURO hyssops allowed the detection of 45 out of 59 positive cases, while IMPROSAWAB hyssops detected 52 out of 59 true positive cases. There were no significant differences between positive cases detected with the use of each hyssop. The sensitivity of sample detection using CNEURO hyssops was 76,3 % while the one using IMPROSWAB hyssops was 88,1 %. Hence, there are no significant differences in the detection of cases using these two hyssops. Conclusion: CNEURO hyssops are safe and reliable to be used to take nasopharyngeal samples from COVID-19 patients.

Sotol is a distilled spirit made in the north of Mexico produced from the wild plant Dasylirion wheeleri. Although sotol was awarded the Designation of Origin (DO) in 2002 and has an economic influence on the DO region, its environmental profile has not been determined. For that reason, this paper reports a Life Cycle Analysis (LCA) of the industrial sotol production process in the Mexican state of Chihuahua to determine any significant environmental impacts caused by sotol production from raw material acquisition to the packaging stage. The LCA was modeled using SimaPro 8.5.2 software (PRé Sustainability, Amersfoort, The Netherlands) and the environmental impacts were calculated using the CML-IA baseline v3.03/EU25 impact assessment technique. The findings reveal that sotol beverage manufacturing considerably affects three of the eleven impact categories selected and that the harvesting and bottling stages have the greatest negative environmental impact of all the sotol production stages. According to empirical data, one bottle (750 mL) of sotol results in a higher carbon dioxide value than any other spirit evaluated in earlier LCA studies, with white, rested, and aged sotol generating 5.07, 5.12, and 5.13 kg CO2 eq, respectively. Other drinks, such as mescal, classic gin, and whisky generate only 1.7, 0.91, and 2.25 kg CO2 eq, respectively. In conclusion, sotol distillery companies should start to decrease road transport of raw materials used in the packaging stage and begin to cultivate sotol instead of extracting it from the wild as strategies to achieve cleaner production.

In the transition towards a sustainable world with a “green horizon” (something that is also of great importance to the policy of energy self-sufficiency in housing and self-consumption), geothermal energy is seen as quite a feasible alternative for single-family homes. This article focuses on a comparison between the environmental impact and life cycle analysis of three alternatives and provides a base case for the replacement of a conventional type of boiler with a geothermal one for a typical house located in a Mediterranean climate. The first alternative (A) consists of a horizontal catchment system through a field of geothermal probes. The second alternative (B) is a shallow water catchment system, open type, with the return of water to a nearby river. The third option studied (C) is also a shallow water catchment system but with the water, return injected into a well downstream to the underground water flow. The study shows that alternatives A and B have the least environmental impact in most of the categories studied. The total amortization periods for the three alternatives and the base case differ by almost two years, with alternative A taking 6.99 years and alternative C costing 8.82 years.

Lymphomas are malignant diseases that originate in the immune system cells and are predominantly manifested by lymphadenopathy; sometimes the presentation is in extranodal places. The eye and its annexes may be affected by a heterogeneous group of primary lymphomas or, secondarily, by the extension of lymphomas originated in lymph nodes or other extranodal sites. The case of a patient who went to the consultation due to left palpebral ptosis is reported and physical examination showed bilateral involvement, with tumors in the lower right eye bulbar conjunctiva and in the left eye upper bulbar conjunctiva. A small B cell lymphocytic non-Hodgkin lymphoma was diagnosed by conjunctiva biopsy. The patient was considered a stage IIIAE of Ann Arbor and treated with six cycles of cyclophosphamide, vincristine, doxorubicin and prednisone, plus the Cuban monoclonal antibody anti-CD20 CIMABior®. The complete response was reached, state in which the disease remains so far.

In the past decades, the use of indices and indicators to report on the environmental performance of organisations has increased exponentially. However, the available studies did not address the topic of obtaining indicators that show the environmental behaviour of the health sector. The main objective of this research, therefore, was aimed at the calculation of environmental efficiency indices in the hospital sector, taking a regional hospital as a case study and considering the environmental aspects identified during the development of its healthcare activity in 2019. The results obtained provided information on the potential environmental impacts triggered by every aspect of the operation of a hospital in the course of its activities that focus on patient care. The results demonstrated that the aspects related to transportation of patients, workers, and materials had the greatest impact on the global environmental indices we calculated. For the environmental efficiency indices of hospital activities, the most significant environmental aspects were materials consumption and waste generation.

Introduction: The SARS-CoV-2 virus is a positive-strand RNA virus. The virus can also be detected in many different specimens as throat swabs, nasal swabs, sputum, saliva, blood, etc. Objective: The aim of this paper is to compare the reliability of different types of specimen collection, saliva and swabs samples for the detection of SARS-CoV-2. Material and Methods: A sample of 22 COVID-19 positive patients was selected. Paired samples from saliva, nasopharyngeal, oropharyngeal and nasopharyngeal + oropharyngeal swabs were collected on the 7th day after diagnosis. The hyssops and medium employed was IMPROSWAB and IMPROVIRAL NAT Medium, Germany. The sample evaluation was conducted through RT-PCR. The results were compared using Fisher’s exact test and ROC curve. The gold standard proposed in this paper was the nasopharyngeal + oropharyngeal swabs specimen. Results: The gold standard method detected 10 true positive cases, of which oropharyngeal swabs, nasopharyngeal swabs and saliva only detected three positive cases. Significant differences (Fisher’s exact test p = 0.003) were detected in the comparison between saliva and the gold standart proposed. The ROC curve analysis showed that saliva had an area under the curve of 0.650, with a 30% of sensibility. However, the nasopharyngeal and nasopharyngeal + oropharyngeal samples had an area under curve of 0.950 and 1.000, respectively, with a sensibility of 90% and 100%, respectively. Conclusion: Saliva samples are not a reliable specimen for SARS-CoV-2 RNA detection. In turn, the most reliable specimens are nasopharyngeal and nasopharyngeal + oropharyngeal samples collected by swabbing.