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En Uruguay existe una desigual distribución de médicos entre la capital y el resto del país, determinando que los pacientes deban ser referidos a centros asistenciales fuera del área en la que residen. El Proyecto ECHO (del inglés: Extension for Community Healthcare Outcomes) busca mejorar el acceso a atención especializada para poblaciones rurales mediante la utilización de tecnologías de la comunicación, democratizando el conocimiento. Objetivo: evaluar los resultados en lo referente a competencias y habilidades profesionales en los participantes de las teleclínicas ECHO sobre cáncer ginecológico en Uruguay. Método: evaluación retrospectiva de impacto con línea de base y línea de impacto mediante un censo vía web. Período: setiembre 2020- mayo/2021. Se relevaron 22 variables, 14 indicadores dependientes que miden autopercepciones sobre incremento de capacidades en forma retrospectiva a partir de una escala Likert de 5 valores y, 8 independientes que abordan aspectos generales de la población. Teniendo en cuenta que no hay una distribución normal se aplica el test no paramétrico de Wilkoxon. Resultados: se obtuvieron 36 respuestas. Los resultados, muestran que todos los pares tienen una significación bilateral, pudiendo afirmar que existe una diferencia significativa entre las capacidades previas y posteriores a la participación en el programa ECHO. Conclusiones: se objetiva una mejora en la autopercepción de las capacidades de los participantes luego de la implementación de las teleclínicas ECHO.

This work provides significant insight into the molecular structure of alizarin lake pigments used by artists in the past. To characterize two red powders, lakes 1 and 2, obtained by complexation of 1,2-dihydroxy anthraquinone (alizarin) with Al3+, a multi-analytical approach was designed based on solid and liquid state Nuclear Magnetic Resonance Spectroscopy (NMR), Fourier-Transform Infrared Spectroscopy (FTIR), Mass Spectrometry (MS) and Density Functional Theory (DFT) calculations. Lake 1 was synthesized according to literature and compared with lake 2, a reproduction of an artist’s pigment. FTIR showed Al3+ coordinated to oxygens in C1 and C9, and that in lake 2 the -OH groups in C2 are protonated, being responsible for its low solubility. 1H-NMR proved that lake 2 is formed by two tautomers [Al(Aliz-2-H-)2(OH)(H2O)] and [Al(Aliz-10-H-)2(OH)(H2O)], the latter being the major species. SS-NMR was the only technique that got insight into the Al3+ coordination, octahedral for both lakes. It confirmed the existence of two species in lake 2, in a 5:1 ratio. Both are amorphous “open structures”, resulting in fewer constraints for the ligands and in a large variety of geometries. SS-NMR allowed the analysis of the red pigments without preparation, which is a unique advantage for their study in artworks.

Objectives: Knowledge on mental health consultations in immigration detention and characteristics of people receiving consultations is scarce. Based on a sample of 230 adult men in immigration detention in Switzerland, we aimed to: (1) Quantify the proportion of persons receiving mental health consultations during detention; and (2) Identify socio-demographic and clinical characteristics associated with mental health consultations.Methods: Retrospective observational study with a cross-sectional design. Prevalence estimates, logistic regressions, and contingency tables were used to analyse the data.Results: A total of 30% of the sample received mental health consultations during detention. Time spent in immigration detention, mental health problems during detention, use of psychotropic medication, and self-harm were associated with mental health consultations. Although mental health consultations are provided to people with more severe mental health problems, 41% of persons with assessed mental health needs during the initial screening and 26% of those who self-harmed during detention did not receive mental health consultations.Conclusion: Mental health resources and screening procedures could be improved to ensure that mental health consultations are matched to clinical need in immigration detention settings.

This study investigated correlates of domestic homicide (DH) and other violent crimes. Data were collected retrospectively from criminal justice files on 617 persons in Switzerland (DH = 47). Multinomial logistic regressions revealed that, overall, DH perpetrators were more likely to be older, female, married, to have a psychiatric hospitalization history, and to be under the influence of delusions when they committed the crime. In addition, they were less likely to have prior convictions. Furthermore, the characteristics associated to DH perpetrators were more similar to domestic violence perpetrators than those of persons who committed non-domestic offenses. Based on the current sample, data, and methods, DH appears to be better explained by specialist theories than generalist views of crime, suggesting that DH and the homicide of non-family members are different phenomena. Therefore, domestic offenders may require specific assessment and intervention methods. However, replications of this study are necessary to generalize the current findings.

The burden of mental health problems in detained persons is high. At the same time, mental health problems are discussed as possible predictors of criminal recidivism. During detention, mental health tends to improve. The aims of the study were twofold: First, to identify group-based trajectories of mental health problems over the course of detention; second, to test the association between trajectories and criminal recidivism. A prospective cohort of 1,904 adult males detained in Dutch pre-trial detention facilities was assessed at three time points after imprisonment (week 3, month 3, and month 9). Mental health problems were measured using the Brief Symptom Inventory. Recidivism was defined as reconviction and re-incarceration up to 18 months post-release. We used group-based trajectory modeling and logistic regressions for the analyses. On average, self-reported mental health improved during incarceration. Two distinct groups of mental health trajectories were identified: The majority (81%) reported relatively low levels of mental health problems, remaining stable over time. A small group (19%) reported high distress after prison entry with improvements over time. Older age, pre-existing functional impairment due to alcohol or drug use, diagnosis of psychiatric disorders, debts, use of psychiatric care during detention, and a more severe experience of detention were associated with membership in the second group. Group membership did not predict reoffending. The study confirms prior findings illustrating a generally positive change in mental health symptoms during detention. The course of mental health was associated with pre-existing socio-demographic and psychological characteristics that seem worthy to be considered in correctional treatment plans. Changes in mental health did not result in better legal outcomes. An interesting avenue for future research would be to examine changes in specific mental health symptoms or disorders in relation to recidivism risk.

Concentrations of heavy metals (HMs) were assessed in Tilapia spp. from selected communities in Calapan City, Philippines. Eleven (11) inland farmed tilapia samples were collected and analyzed for HMs concentration using X-ray fluorescence (XRF). The 11 fish samples were cut into seven pieces, according to the fish body parts, constituting a total of 77 samples. These fish samples were then labeled as bone, fins, head, meat, skin, and viscera. Results showed that the mean concentration of Cd in all parts of tilapia exceeded the Food and Agriculture Organization/World Health Organization (FAO/WHO) limits. The highest concentration was recorded in the fins, which was sevenfold higher than the limit. The trend of the mean concentration of Cd in different parts of tilapia was fins > viscera > skin > tail > head > meat > bone. The target hazard quotient (THQ) recorded a value less than 1. This means that the population exposed to tilapia, within the area where fish samples originated, were not at risk to non-carcinogens. The concentrations of Cu, Pb, Mn, Hg, and Zn in different parts, particularly in skin, fins, and viscera, also exceeded the FAO/WHO limits. The calculated cancer risk (CR) in consuming the fish skin, meat, fins, bone, viscera, and head was higher than the USEPA limit. This indicated a possible carcinogenic risk when consumed regularly. Most of the correlations observed between HMs in various parts of the tilapia had positive (direct) relationships, which were attributed to the HM toxicity target organ characteristics. Results of the principal component analysis (PCA) showed that most of the dominating HMs recorded in tilapia were attributable to anthropogenic activities and natural weathering within the watershed of agricultural areas. The agriculture area comprises about 86.83% of the overall land area of Calapan City. The identified carcinogenic risks were associated with Cd. Therefore, regular monitoring of HMs in inland fishes, their habitat, and surface water quality shall be carried out. This information is useful in creating strategies in metals concentration monitoring, health risks reduction program, and relevant guidelines that would reduce the accumulation of HM in fish.

AIMS OF THE STUDY Although many studies have investigated the influence of personal characteristics on recidivism, knowledge about the impact of correctional policies remains limited. The present study adds to this debate by investigating the effect of the dualistic system of custodial sanctions in Switzerland over time. Specifically, we: (1) tested the influence that different types of custodial sanctions – sentences (offering regular prison treatment) and measures (offering crime-related rehabilitation programmes) – have on reconviction rates; and (2) forecasted future reconviction rates to estimate their value in the year 2020. METHODS National level data from the Swiss Federal Statistical Office were collected, including 3-year reconviction rates after release from custody and the number of persons serving custodial sentences and measures. A time series framework was used for the analyses, which included data available from 1988 to 2013 (n = 26 years). RESULTS The number of persons serving custodial sentences had no effect on recidivism (p = 0.582); however, a higher number of persons serving custodial measures was significantly associated with a decrease in recidivism (p = 0.003). For the year 2020, a reconviction rate of 28% (range 23–33%) was predicted. CONCLUSIONS Custodial measures seem to be associated with a reduction in recidivism. However, owing to the indeterminate time associated with some custodial measures, often at the cost of the prisoners’ rights and the criminal justice system, future studies are needed to determine the optimal serving time for custodial measures.

OBJECTIVES To develop and validate a screening tool designed to identify detained people at increased risk for COVID-19 mortality, the COVID-19 Inmate Risk Appraisal (CIRA). DESIGN Cross-sectional study with a representative sample (development) and a case-control sample (validation). SETTING The two largest Swiss prisons. PARTICIPANTS (1) Development sample: all male persons detained in Pöschwies, Zurich (n = 365); (2) Validation sample: case-control sample of male persons detained in Champ-Dollon, Geneva (n = 192, matching 1:3 for participants at risk for severe course of COVID-19 and participants without risk factors). MAIN OUTCOME MEASURES The CIRA combined seven risk factors identified by the World Health Organization and the Swiss Federal Office of Public Health as predictive of severe COVID-19 to derive an absolute risk increase in mortality rate: Age ≥60 years, cardiovascular disease, diabetes, hypertension, chronic respiratory disease, immunodeficiency and cancer. RESULTS Based on the development sample, we proposed a three-level classification: average (5.7) risk. In the validation sample, the CIRA identified all individuals identified as vulnerable by national recommendations (having at least one risk factor). The category “elevated risk” maximised sensitivity (1) and specificity (0.97). The CIRA had even higher capacity in discriminating individuals vulnerable according to clinical evaluation (a four-level risk categorisation based on a consensus of medical staff). The category “elevated risk” maximised sensitivity and specificity (both 1). When considering the individuals classified as extremely high risk by medical staff, the category “high risk” had a high discriminatory capacity (sensitivity =0.89, specificity =0.97). CONCLUSIONS The CIRA scores have a high discriminative ability and will be important in custodial settings to support decisions and prioritise actions using a standardised valid assessment method. However, as knowledge on risk factors for COVID-19 mortality is still limited, the CIRA may be considered preliminary. Underlying data will be updated regularly on the website (http://www.prison-research.com), where the CIRA algorithm is freely available.

This article discusses the assessment of groundwater quality using a hybrid technique that would aid in the convenience of groundwater (GW) quality monitoring. Twenty eight (28) GW samples representing 62 barangays in Calapan City, Oriental Mindoro, Philippines were analyzed for their physicochemical characteristics and heavy metal (HM) concentrations. The 28 GW samples were collected at suburban sites identified by the coordinates produced by Global Positioning System Montana 680. The analysis of heavy metal concentrations was conducted onsite using portable handheld X-Ray Fluorescence (pXRF) Spectrometry. Hybrid machine learning—geostatistical interpolation (MLGI) method, specific to neural network particle swarm optimization with Empirical Bayesian Kriging (NN-PSO+EBK), was employed for data integration, GW quality spatial assessment and monitoring. Spatial map of metals concentration was produced using the NN-PSO-EBK. Another, spot map was created for observed metals concentration and was compared to the spatial maps. Results showed that the created maps recorded significant results based on its MSEs with values such as 1.404 × 10−4, 5.42 × 10−5, 6.26 × 10−4, 3.7 × 10−6, 4.141 × 10−4 for Ba, Cu, Fe, Mn, Zn, respectively. Also, cross-validation of the observed and predicted values resulted to R values range within 0.934–0.994 which means almost accurate. Based on these results, it can be stated that the technique is efficient for groundwater quality monitoring. Utilization of this technique could be useful in regular and efficient GW quality monitoring.

Combination chemotherapy has been a mainstay in cancer treatment for the last 60 years. Although the mechanisms of action and signaling pathways affected by most treatments with single antineoplastic agents might be relatively well understood, most combinations remain poorly understood. This review presents the most common alterations of signaling pathways in response to cytotoxic and targeted anticancer drug treatments, with a discussion of how the knowledge of signaling pathways might support and orient the development of innovative strategies for anticancer combination therapy. The ultimate goal is to highlight possible strategies of chemotherapy combinations based on the signaling pathways associated with the resistance mechanisms against anticancer drugs to maximize the selective induction of cancer cell death. We consider this review an extensive compilation of updated known information on chemotherapy resistance mechanisms to promote new combination therapies to be to discussed and tested.

En el ámbito de las investigaciones clínico-epidemiológicas, los profesionales de la salud asiduamente se proyectan en sus investigaciones; se definen las relaciones entre las características de un fenómeno, el grado de esa relación o probar la confiabilidad de sus observaciones, planteándose como hipótesis si estas son o no la causa de una determinada entidad. En la práctica, generalmente, acontece que el investigador entre las disímiles pruebas estadísticas de las que dispone, no selecciona adecuadamente la que con mayor cientificidad le aportará una lectura fácil de dicha relaciones. Se realiza una revisión bibliográfica con el objetivo de caracterizar el método de correlación de rangos de Spearman, utilizado para valorar la asociación entre variables cuantitativas, aplicándose el método de análisis documental .Los resultados son declarados al resumir la historia del surgimiento de la teoría de la correlación y la regresión, explicación de conceptos asociados, su presentación gráfica, los rasgos esenciales del algoritmo de solución tradicional y con asesor estadístico, así como una compilación sobre escalas de interpretación de la prueba estadística. Se proyecta que el trabajo realizado sirva de bibliografía a consultar por investigadores y estudiantes de las Ciencias Médicas. Palabras clave: Correlación, Spearman, Pearson, Correlación de Spearman, estadística, regresión, correlación lineal, coeficiente de correlación, rangos, psicología diferencial, historia

Abstract Background In Cameroon, the COVID-19 disease has demonstrated shortcomings in preventing nosocomial infections at both collective and individual levels. This study aimed to identify practice changes in ENT outpatient consultations in Cameroon inducted by the COVID-19 pandemic. Methods This was a descriptive cross-sectional study that took place in March 2024. A Google Form was submitted to ENT practitioners online across Cameroon. It consisted of 20 questions grouped into socio-professional and clinical data. Results Sixty-four practitioners responded to the questionnaire. The average age of respondents was 36, with extremes of 31 and 70. The sex ratio was 0.35 in favor of women. In terms of experience, 47.7% had been practicing for less than 10 years. A total of 91.3% practiced in public health facilities. Before the COVID-19 outbreak, attitudes towards respiratory diseases were as follows: wearing of masks by suspected patients (4.3%), information posters in waiting rooms (13%), constant use of disinfectant gel (26.1%), wearing of masks by practitioners (0%), wearing of gloves (54.5%), wearing of gowns (87%), constant hand hygiene after each consultation (26.1%), and regular surface hygiene (30.4%). All precautions were improved after 4 years of the pandemic except wearing eye protection. Conclusion ENT practice has been strongly impacted by the COVID-19 pandemic, and many measures still need to be taken to improve infection control in hospitals in Cameroon.

Hosting capacity (HC) describes the electricity network’s ability to accommodate distributed generation (DG) without deteriorating electrical performance indicators. Distribution system operators typically express their networks’ HC as a single threshold, called static hosting capacity (SHC). SHC is determined via conservative regulatory criteria, increasing connection costs and time. This paper explores the potential for additional energy injection into the network via dynamic hosting capacity (DHC). A network node’s DHC is derived from the hourly operation of the network, accounting for the time variability of existing distributed generation (DG) output and demand. The methodology considers the network assets’ N-1 contingencies and their probabilities, defining the security-aware DHC (SDHC). The SDHC definition is technologically neutral. Through a case study of a radial medium voltage distribution network, the paper highlights the significant limitations of SHC due to conservative calculation criteria mandated by regulators. Annual injectable energy is increased by 62% to 76% when comparing DHC to SHC. Variations between average DHC and SDHC are below 0.01% due to low N-1 probabilities. This finding points out the potential of dynamic hosting capacity definitions, allowing more efficient use of the existing network and facilitating the integration of new DG capacity with reduced connection costs and time.

En la escritura de Mario Bellatin la imagen de autor se presenta como cierto vacío constitutivo. Sin embargo, su ficción ha insistido en establecerse muchas veces en relación con otros creadores. Es el caso de Marcel Duchamp (“Duchamp post mortem”), Frida Kahlo (Demerol), Yukio Mishima (Biografía ilustrada) y Daniel Link (“Antiprólogo”), entre otros. Al abordar cada caso hay un procedimiento que se repite: la imagen del creador que ha sido incorporado a la ficción es reproducida por un pequeño dispositivo pedagógico. Por consiguiente, el presente trabajo propone un recorrido por esta figura con el fin de interrogar la imagen de autor producida por el sistema creativo de Mario Bellatin junto al procedimiento de la repetición como experiencia estética y ética.

Resumo A proposta de adoção de uma alíquota uniforme para a tributação sobre o consumo tem sido criticada porque, supostamente, alíquotas diferenciadas favoreceriam os mais pobres. A partir da análise da literatura internacional, o artigo conclui de forma contrária: alíquotas diferenciadas não são o melhor meio de se proteger os mais pobres por quatro razões: (i) as alíquotas menores atingem tanto os mais pobres quanto os mais ricos, que normalmente consomem mais que os mais pobres, em termos absolutos, os bens com alíquota reduzida ou isentos; (ii) alíquotas reduzidas geram complexidade, o que cria um contencioso que prejudica o funcionamento do sistema como um todo; (iii) alíquotas menores favorecem a atuação dos grupos de pressão; e (iv) as reduções de alíquota não são em geral ou integralmente repassadas aos preços dos produtos.

Abstract The purpose is to identify and analyze some innovations in public services, PSI, between 2019 and 2022 to evaluate their attempts to deter corruption in a context where the current government’s Mexican public sector has been improving its capacity to fight corruption as the most critical problem. The research is designed to describe 12 PSI selected from the national level. Their innovativeness is measured through an INDICO index adapted from technology firms, which mainly has added a perception of its public value besides their use value. Corruption is measured based on the neo-institutional approach on three axes: public–private relations, its organization, and the agents’ behavior. The question is to measure the impact of the innovations in deterring corruption, which is estimated by the difference in magnitude between the current and the previous one. The findings are: 1. The neo-institutional theory highlights corruption-related aspects rooted in public–private relations, however, complemented with social and management approaches. 2. The INDICO index measures, based on a pre-established 10-point quantitative maximum scale distributed between components on capacity -knowledge of the service, training, design, peer evaluation through external links- and on innovation results in public services—its legitimization through public value, and its possible replication (diffusion), which an expert in the field of innovation qualitatively evaluates. 3. The impact of the selected Public Service Innovations shows that there is a positive effect in reducing the level of corruption. The more systemic or institutionalized corruption is, the more difficult it is to develop effective strategies proving their long-term value. The PSIs have been managed by the government’s leadership founded on legitimate authority, secured from the victory in the 2018 elections in Mexico, enabling it to put forward its top-to-bottom anti-corruption program. A more extended period, a group of experts, and more cases are desirable to assess PSI sustainability. However, the methodology could be extended to other contexts for policymakers or practitioners in public services and corruption.

Portugal made a climate commitment when it ratified the Paris Climate Agreement in 2015. As a result, Portugal, along with other EU members, has created a national roadmap for the deployment of hydrogen as a crucial component of Portugal's energy transition towards carbon neutrality, creating synergies between the electric and gas systems.The increased variability of generation from variable renewable power sources will create challenges regarding the security of supply, requiring investment in storage solutions to minimize renewable energy curtailment and to provide dispatchability to the electric power system. Hydrogen can be a renewable energy carrier capable of ensuring not only the desired transformation of the infrastructures of the gas system but also an integrator of the Electric System, such as in Power-to-Power (P2P) systems. Hydrogen can be produced with a surplus of renewable electricity from wind and solar, allowing a long-term energy seasonal storage strategy, namely by using underground salt caverns, to be subsequently transformed into electricity when demand cannot be supplied due to a shortage of renewable generation from solar or wind.P2P investments are capital intensive and require the development of transitional regulation mechanisms to both create opportunities to market agents while fostering the energy surplus valuation and decreasing the energy dependency. In order to maintain the electric system's security of supply, the suggested methodology innovatively manages the importance of seasonal storage of renewable energy surplus using hydrogen in power systems. It suggests a novel set of regulatory strategies to foster the creation of a P2P solution that maintains generation adequacy while assisting in decarbonising the electric power industry. Such methodology combines long-term adequacy assessment with regulatory framework evaluation to evaluate the cost of the proposed solutions to the energy system.A case study based on the Portuguese power system outlook between 2030 and 2040 demonstrates that the considerable renewable energy surplus can be stored as hydrogen and converted back into electricity to assure adequate security of supply levels throughout the year with economic feasibility under distinct public policy models.

Featured Application: In-Situ and Hybrid Machine Learning—Geostatistical Interpolation method for groundwater quality monitoring applications. This article discusses the assessment of groundwater quality using a hybrid technique that would aid in the convenience of groundwater (GW) quality monitoring. Twenty eight (28) GW samples representing 62 barangays in Calapan City, Oriental Mindoro, Philippines were analyzed for their physicochemical characteristics and heavy metal (HM) concentrations. The 28 GW samples were collected at suburban sites identified by the coordinates produced by Global Positioning System Montana 680. The analysis of heavy metal concentrations was conducted onsite using portable handheld X-Ray Fluorescence (pXRF) Spectrometry. Hybrid machine learning—geostatistical interpolation (MLGI) method, specific to neural network particle swarm optimization with Empirical Bayesian Kriging (NN-PSO+EBK), was employed for data integration, GW quality spatial assessment and monitoring. Spatial map of metals concentration was produced using the NN-PSO-EBK. Another, spot map was created for observed metals concentration and was compared to the spatial maps. Results showed that the created maps recorded significant results based on its MSEs with values such as 1.404 × 10−4, 5.42 × 10−5, 6.26 × 10−4, 3.7 × 10−6, 4.141 × 10−4 for Ba, Cu, Fe, Mn, Zn, respectively. Also, cross-validation of the observed and predicted values resulted to R values range within 0.934–0.994 which means almost accurate. Based on these results, it can be stated that the technique is efficient for groundwater quality monitoring. Utilization of this technique could be useful in regular and efficient GW quality monitoring. [ABSTRACT FROM AUTHOR]

Este estudio tiene como objetivo comparar el aporte estructural de la capa base granular estabilizada con cemento Portland tipo I versus emulsión asfáltica catiónica CSS-1H en vías del conjunto habitacional Micaela Bastidas, cuya área corresponde a Enlace I, II, III, IV Etapa y en la UPIS Villa Hermosa, distrito Veintiséis de Octubre del departamento de Piura, provincia de Piura. Como parte del análisis se realizaron ensayos de laboratorio al material granular extraídos de la cantera Bastian, con el fin de obtener las características del material base. De tal manera, que para la evaluación comparativa del aporte estructural de la base granular se ejecutó el cálculo del diseño para pavimentos flexibles de acuerdo con el método AASHTO 93; según el manual de carreteras sección suelos y pavimentos, estabilizados con cemento Portland tipo I, emulsión asfáltica catiónica de rotura lenta CSS-1H y sin estabilizar. Los resultados obtenidos indicaron que según las dosificaciones estimadas al 3%, 5% y 7% de adición de cemento y la emulsión asfáltica mejora las condiciones del material base granular. En conclusión, la evaluación del aporte estructural el cemento Portland tipo I es el agente estabilizador de mejor comportamiento, incluso en dosificaciones muy bajas, lo cual se traduce en pavimentos de espesores competentes en la práctica constructiva

This longitudinal study investigated the self-reported adjustment of 75 young adults (aged 17–22 years) newly admitted to a Portuguese prison, and examines changes, correlates, and outcomes of their prison adjustment. The prisoners were assessed at the first, third, and sixth month after their entry in prison. Regression analyses revealed that, overall, adjustment problems remained relatively stable during the first six months of incarceration. Having more prison visits, a lower educational level, and being White were associated with more adjustment problems in general. Adjustment problems were, in turn, associated with subsequent mental health symptoms and severe disciplinary infractions. The current study shows that self-report measures may be useful in assessing the adjustment of young adult offenders' over time in prison. [ABSTRACT FROM AUTHOR]