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Coastal areas face significant challenges due to natural and anthropogenic changes, such as sea level rise, extreme events and coastal erosion. The coastal management requires the consideration of socioeconomic and environmental factors to address these variables. The selection of an appropriate Decision Support Tool (DST) based on decision matrix method plays a crucial role in implementing coastal management strategies to tackle climate change-related issues. This has posed considerable challenges for decision-makers, aligning with the Sustainable Development Goals (SDG). This review provides an overview of the practical experience in the application of DSTs for coastal erosion and flood risk, emphasizing the use of Multi-Criteria Decision Analysis (MCDA). DST choice depends on the coastal archetype, including its geographical features and sociocultural context. The purpose is to clarify how the integration of DSTs maximizes flexibility and supports the implementation of future Decision Support System (DSS) tailored to the needs of coastal cities with development pathways (DP). This review assesses different MCDA methods, highlighting their applicability, utility, and integration in coastal management, while evaluating each method's strengths, weaknesses, and specific applications, with a focus on sustainability and resilience. The review highlights the necessity of expert knowledge in accurately defining criteria and weighting factors to ensure that the chosen MCDA method reflects the complexities of the coastal environment. Depending on the scenario, methods like PROMETHEE and ELECTRE are recommended for their flexibility and robustness in handling complex decision-making processes, especially in data-rich and well-structured environments. In contrast, TOPSIS and AHP are suitable for scenarios with limited information or requiring minimal interaction with decision-makers. For more challenging contexts, where computational resources and expertise are constrained, methods like MAUT, VIKOR, and TODAIM emerge as viable alternatives due to their adaptability and reduced reliance on extensive datasets., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Andres M Enriquez reports a relationship with Fundación WWB para la investigación that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier Ltd. All rights reserved.)

Aortic dissection (AD) is the most prevalent aortic pathology, with an incidence of 2.6-3.5 cases per 100,000 inhabitants per year with mortality rates as high as 90% at 3 months without proper management. Despite the presence of typical symptoms, it has been reported that up to 38% of cases go unnoticed in the initial evaluation, either due to additional symptomatology or the absence of classic symptoms. In 28% of cases the diagnosis is made post-mortem, highlighting the severity and importance of timely diagnosis. The main goals of this study were to identify the primary neurological manifestations of acute AD and the frequency of these manifestations in type A and B AD according to the Stanford classification. A total of 2,734 records were retrieved from two databases, of which 2,611 were excluded. Therefore, 123 articles were obtained and 88 were evaluated for eligibility. Consequently, 79 articles were included in the review. The abstracts identified in the search were screened by seven blinded independent authors and excluded those who lacked relevance. The authors read the full texts independently to determine inclusion. A third reviewer adjudicated discrepancies when opinions were at odds. There were 169 patients diagnosed with Stanford type A, of which 43.8% displayed quantitative impairment of consciousness. Within this group, transient loss of consciousness was observed in 34.3% of cases. Motor syndrome was present in 54.5%, with 23.7% of patients presenting with hemiparesis or hemiplegia. 3.6% had facial paresis or paralysis and less frequently monoparesis, paraparesis, hyperreflexia, spasticity, and muscle spasms. 7.6% presented with language impairments including Broca's aphasia and dysarthria. Seizures were present in 3.6%. Neuro-ophthalmological symptoms were 2.9%, cortical or cognitive symptoms and headache were 2.3%, cerebellar syndrome was 1.8%, and sensory syndrome was 1.2%. Of 86 patients diagnosed with Stanford type B, 57.0% displayed motor syndrome, with 50.0% being paraparesis or paraplegia, 4.7% monoplegia, and 2.3% hemiplegia or hemiparesis. Additionally, impairment of consciousness was present in 26.7%, sensory syndrome in 12.8%, and language impairments in 3.5%. In the emergency department, understanding the neurological manifestations in both Stanford type A and B dissections emerges as a pivotal cornerstone for conducting precise assessments and efficient patient management. Given the wide spectrum of manifestations, we emphasize the importance of suspecting AD when neurological disorders are associated with the classic symptoms. In these cases, we encourage a complete neurological examination to be performed and a multidisciplinary group assembled to tackle this entity.

Aim: In pregnant women with Type 1 Diabetes (T1D), achieving a lower recommended time in range (TIRp,63-140 mg/dl) could have an impact on fetal outcomes. To determine the TIRp and mean glucose cut-off point associated with better fetal outcomes in pregnant women using automated insulin delivery (AID) systems., Methods: A prospective cohort of pregnant women with T1D, using AID systems and followed-up in Latin America was analyzed. Optimal TIRp and mean glucose cut-off points for predicting large for gestational age (LGA) were determined using the Liu method. Fetal outcomes were evaluated for the identified cut-off point and the one recommended by guidelines (TIRp > 70 %)., Results: Sixty-two patients were included (mean age 31.9 ± 5.9 years, HbA1c 7.57 %±1.29 %, TIRp 59.8 %±14.6 %). 27.5 % on advanced hybrid closed loop systems (AHCL). LGA (50 vs 17.9 %,p = 0.010) and hyperbilirubinemia (45 % vs 11.8 %,p = 0.016) were more common in patients with TIRp < 59.1 %. Optimal cut-off of TIRp in the second trimester for predicting LGA was < 59.1 % (sensitivity 75 %, specificity 61 %) with an AUC of 0.68(CI 0.48-0.88). Optimal cut-off for mean glucose was 133 mg/dL (sensitivity 69 %, specificity 70 %) with an AUC of 0.70(CI 0.51-0.88) in the same trimester. Better metabolic control during the third trimester was seen in the AHCL users compared to other devices., Conclusions: TIRp > 59.1 % and mean glucose < 133 mg/dl in the second trimester, is associated with lower fetal outcomes of large for gestational age. One of the strategies that would improve TIRp is the early use of AHCL systems. Further studies are needed before a strong recommendation can be made., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Ana María Gómez received speaker’s fees from Novo Nordisk, Elli Lilly, Boehringer Ingelheim, Abbott, and Medtronic. Diana Henao received speaker’s fees from Novo Nordisk, Sanofi and Abbott. Bruno Grassi received speaker’s fees from Novo Nordisk, Sanofi, and Medtronic. Alejandro Cob received speaker’s fees from Abbott and Astra Zeneca]., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

In the present work, we addressed the relationship between parental leave policies and social norms. Using a pre-registered, cross-national approach, we examined the relationship between parental leave policies and the perception of social norms for the gender division of childcare. In this study, 19,259 students (11,924 women) from 48 countries indicated the degree to which they believe childcare is (descriptive norm) and should be (prescriptive norm) equally divided among mothers and fathers. Policies were primarily operationalized as the existence of parental leave options in the respective country. The descriptive and prescriptive norms of equal division of childcare were stronger when parental leave was available in a country - also when controlling for potential confounding variables. Moreover, analyses of time since policy change suggested that policy change may initially affect prescriptive norms and then descriptive norms at a later point. However, due to the cross-sectional nature of the data, drawing causal inferences is difficult., (© 2024 British Psychological Society.)

Introduction: Regulatory T cells (Treg cells) in a tumor environment and the expression of forkhead box P3 (FOXP3) in tumor cells have been associated with a poor prognosis. There are few studies evaluating Treg cells and FOXP3 in B-cell acute lymphoblastic leukemia (B-cell ALL). This study aimed to evaluate the frequencies of Treg cells in bone marrow (BM) and peripheral blood (PB) of patients with B-cell ALL and to determine their associations with the circulating cytokine profile and the expression of CXCR1 (IL-8 receptor) in Treg cells, as well as to compare FOXP3 expression in blasts of patients with B-cell ALL and normal lymphoid precursors., Methods: Samples of BM and PB from patients with B-cell ALL and healthy controls were studied. Treg cells, cytokines, FOXP3 and CXCR1 were evaluated using flow cytometry and analyzed., Results: A total of 20 patients with B-cell ALL and 10 healthy controls were included. In B-cell ALL patients, Treg cell frequencies increased significantly, with higher percentages in the PB. Absolute Treg cell counts were associated with absolute blast counts in the BM and PB and with an IL-8 concentration. The IL-8 and IL-6 levels were associated with the CXCR1 expression in PB Treg cells. In addition, a greater expression of FOXP3 was observed in leukemic blasts than in normal lymphoid precursors., Conclusions: These results suggest that the presence of Treg cells and cytokines in the tumor environment may correspond to mechanisms to evade the immune response. For that reason, it would be important to monitor these parameters in B-cell ALL to establish their effect on the disease prognosis., Competing Interests: Conflicts of interest None., (Copyright © 2023 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier España, S.L.U. All rights reserved.)

Transport intoxication in the form of body stuffing, a dangerous practice involving the ingestion or insertion of psychoactive substances into the body to evade detection during drug trafficking, represents a major medical problem that requires immediate attention in the emergency department. Unlike body packing, where substances are encapsulated and swallowed for later extraction, body stuffing involves direct ingestion without wrapping, which greatly increases the risk of serious intoxication and even death. Benzodiazepines, due to their high demand on the black market, are among the most common drugs used in body stuffing. The management of this type of poisoning in the emergency department presents a significant clinical challenge due to the variability in clinical presentation, which can range from drowsiness and confusion to respiratory depression and coma.Rapid and accurate assessment is critical for effective management.The initial focus is on patient stabilization and life support as needed, which may include administration of naloxone to reverse opioid effects, mechanical ventilation for respiratory depression, and management of seizures if they occur.An appropriate approach in the emergency department is crucial to improve the prognosis and quality of life of patients affected by this type of poisoning. Timely intervention and expert management can prevent serious complications and even death. We present the case of a patient with benzodiazepine intoxication with an atypical presentation due to clonazepam transport with bradycardia and its management in an institution in Bogotá-Colombia., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Objective: To determine the predictive value of Cognitive Assessment, Symptom Severity, Personal Control and Self-Efficacy on decision making in the experience of Acute Coronary Syndrome symptoms., Method: Quantitative study of cross-sectional analytical design, a probabilistic sampling was carried out for 256 participants diagnosed with coronary syndrome in three health institutions. The effects between the independent variables Cognitive Assessment, Symptom Severity, Personal Control, Self-Efficacy and the dependent Decision-Making were analyzed. Using inferential statistics, a Generalized Linear Regression Model was carried out, which allowed establishing the causal relationships between the variables., Results: Two predictive models were obtained between decision making and cognitive evaluation, in which personal control, severity of symptoms, sex and context were significant. Self-efficacy was not reported as a predictor variable. The values ​​of the independent variables showed a behavior directly proportional to the Decision Making score., Conclusion: A verification of the conceptual model for the management of symptoms was carried out., (Copyright © 2023 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Published by Elsevier España S.L.U. All rights reserved.)

Background: Cardiovascular disease (CVD) represents the primary cause of death and disability globally, with elevated cholesterol as one of the leading risk factors for CVD. We describe the clinical characteristics, treatment patterns, and effectiveness of evolocumab in treating hyperlipidemia., Methods: Observational study conducted through a chart review of patients with hyperlipidemia receiving evolocumab as part of clinical management in Colombia., Results: This study included 115 patients treated with evolocumab. A total of 101 patients (87.8%) had a history of CVD, 13 (11.3%) familial hypercholesterolemia (FH), and 23 (20%) type 2 diabetes. Thirty-nine patients reported intolerance to any statin (33.9%). The median value of LDL-C before initiation of evolocumab was 147mg/dL (IQR: 122.5-183.7mg/dL). Within the first 3 months of treatment, LDL-C value dropped to a median value of 53mg/dL (IQR: 34.0-95.5mg/dL), showing a reduction of 63.9%. The median LDL-C values remained below 45mg/dL until the end of follow-up. Among the patients with available data, up to 61% achieved an LDL-C level below 55mg/dL at the 10-12-month follow-up. A total of 72% of patients were persistent with treatment. Safety results showed a low frequency of hospitalizations (≤2%) and treatment-emergent adverse drug reactions (5.2%). No serious adverse events were reported., Conclusions: Evolocumab was associated with reductions in LDL-C levels, with a relative decrease of 63.9% within the first 3 months of treatment. Low rates of interruptions due to adverse events and adequate medication persistence was reported., (Copyright © 2023 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Duchenne Muscular Dystrophy (DMD) is characterized by an initial increase in motor function followed by a plateau phase and then entering a phase of steady decline. However, motor evolution of DMD have not been evaluated in developing countries. Therefore, this study aims to evaluate the trajectory of motor function in a sample of Colombian children with DMD. We included 119 children with DMD aged 4.8-19.3 years (mean follow-up = 1.7 years). A linear mixed model was used with age as the time scale and adjusted for covariates using a stepwise regression. Participants showed a progressive decline in motor skills from the age of 5 years with a decrease in speed around the age of 11 years (p < 0.001). After age 11, the decline in motor function was observed to continue until age 20 but at a slower rate (βAge = -9.64. and βAge2 = 0.18, p < 0.001 for both). Educational inclusion, glucocorticoid treatment and the number of mutated exons were shown to be associated with the motor performance. These findings may indicate that the evolution of DMD maintains similar patterns between high income countries and the Colombian population. They allow us to adapt and develop treatments that impact the population with DMD in Colombia, based in international evidence., (© 2023 Published by Elsevier Ltd on behalf of European Paediatric Neurology Society.)

Purposes: To describe the clinical characteristics and factors associated with keratitis in patients with corneal foreign bodies in Colombia., Methods: This cross-sectional study was based on a clinical records review of patients who had corneal foreign bodies and were admitted to the emergency department between June 2018 and June 2019 in Cali, Colombia. The primary outcome was the presence of keratitis diagnosed based on clinical criteria. Univariate and multivariate logistic regression models were used to identify associated factors., Results: A total of 381 corneal foreign bodies in 372 patients were analyzed (median age, 40.0; interquartile range, 29.0-53.0 years; male, 94.7% (n=352). Ninety-five patients developed keratitis (24.9%, 95% confidence interval [CI] 20.8%-29.5%). In the multivariate analysis, age 30 years (odds ratio [OR] 2.15, 95% CI 1.06-4.36), finding of aqueous flare (OR 2.81, 95% CI 1.39-5.66]), and a foreign body in the peripheral cornea (OR 2.05, 95% CI 1.19-3.50] were associated with an increased risk for keratitis. Sex, time between injury and admission, and corneal edema were not related to keratitis (p>0.05)., Conclusion: In Cali, Colombia, a high proportion of keratitis was reported in patients with corneal foreign body. Age, an aqueous flare, and a foreign body in the peripheral cornea were the factors associated with keratitis.

This paper introduces a novel benchmark to study the impact and relationship of built environment elements on pedestrian collision prediction, intending to enhance environmental awareness in autonomous driving systems to prevent pedestrian injuries actively. We introduce a built environment detection task in large-scale panoramic images and a detection-based pedestrian collision frequency prediction task. We propose a baseline method that incorporates a collision prediction module into a state-of-the-art detection model to tackle both tasks simultaneously. Our experiments demonstrate a significant correlation between object detection of built environment elements and pedestrian collision frequency prediction. Our results are a stepping stone towards understanding the interdependencies between built environment conditions and pedestrian safety.

Background: Reamputation as a complication of diabetic foot ulcers presents a high economic burden and represents a therapeutic failure. It is paramount to identify as early as possible patients in whom a minor amputation may not be the best option. The purpose of this investigation was to do a case-controlled study to determine risk factors associated with re-amputation in patients with DFU (diabetic foot ulcers) at two University Hospitals., Methods: Multicentric, observational, retrospective, case-control study from clinical records of 2 university hospitals. Our study included 420 patients, with 171 cases (re-amputations), and 249 controls. We performed a multivariate logistic regression analysis and time-to-event survival analysis to identify re-amputation risk factors., Results: Statistically significant risk factors were artery history of tobacco use (p = 0.001); male sex (p = 0.048); arterial occlusion in Doppler ultrasound (p = 0.001); percentage of stenosis in arterial ultrasound >50 % (p = 0.053); requirement of vascular intervention (p = 0.01); and microvascular involvement in photoplethysmography (p = 0.033). The most parsimonious regression model suggests that history of tobacco use, male sex, arterial occlusion in ultrasound, and percentage of stenosis in arterial ultrasound >50 % remained statistically significant. The survival analysis identified earlier amputations in patients with larger occlusion in arterial ultrasound, high leukocyte count, and elevated ESR., Conclusion: Direct and surrogate outcomes in patients with diabetic foot ulcers identify vascular involvement as an important risk factor for reamputation., Level of Evidence: III., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Aims: To determine the correlation between %TIR and HbA1c in pregnant women with type 1 diabetes mellitus (DM1)., Methods: Diagnostic test study in a prospective cohort of pregnant patients with DM1 using automated insulin delivery system (AID)in Colombia and Chile., Results: Fifty-two patients were included [mean age 31.8 ± 6.2 years, pregestational HbA1c 7.2% [interquartile range (IQR), 6.5-8.2]. During follow-up, we found a better metabolic control during the second (HbA1c 6.40%, IQR 5.9,7.1) and third trimesters (HbA1c 6.25%;IQR 5.9,6.8). A weak and negative correlation between %TIR and HbA1c was found for all the gestation (Spearman's rank correlation coefficient:-0.22, p:0.0329), and in the second (r:-0.13, p: 0.38) and third trimesters (r:-0.26, p = 0.08). %TIR had poor discriminating capacity for predicting HbA1c < 6% (area under the curve [AUC], 0.59; 95% confidence interval [CI],0.46-0.72) and for predicting HbA1c < 6.5% (AUC, 0.57;95% CI,0.44-0.70). The optimal cutoff points for %TIR were > 66.1% for predicting HbA1c < 6% (65% sensitivity, 62% specificity) and %TIR > 61.1% for HbA1c < 6.5% (59% sensitivity, 54% specificity)., Conclusion: The correlation between HbA1c and %TIR during pregnancy was weak. The optimal cutoff points for identifying patients with HbA1c < 6.0% and < 6.5% were %TIR > 66.1% and > 61.1%, respectively, with moderate sensitivity and specificity., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Interactions in the tumor microenvironment (TME) between tumor cells and stromal cells such as cancer-associated fibroblasts (CAF) favor increased survival, progression, and transformation of cancer cells by activating mechanisms of invasion and metastasis. The design of new therapies to modulate or eliminate the CAF phenotype or functionality has been the subject of recent research including natural product-based therapies. We have previously described the generation of a standardized extract rich in polyphenols obtained from the Caesalpinia spinosa plant (P2Et), which present antitumor activities in breast cancer and melanoma models through activities that modulate the metabolism of tumor cells or induce the development of the immune response. In this work, a model of CAF generation was initially developed from the exposure of 3T3 fibroblasts to the cytokine TGFβ1. CAF-like cells generated in this way exhibited changes in the expression of Caveolin-1 and α-SMA, and alterations in glucose metabolism and redox status, typical of CAFs isolated from tumor tissues. Then, P2Et was shown to counteract in vitro-induced CAF-like cell generation, preventing caveolin-1 loss and attenuating changes in glucose uptake and redox profile. This protective effect of P2Et translates into a decrease in the functional ability of CAFs to support colony formation and migration of 4T1 murine breast cancer tumor cells. In addition to the functional interference, the P2Et extract also decreased the expression of genes associated with the epithelial-mesenchymal transition (EMT) and functional activities related to the modulation of the cancer stem cells (CSC) population. This work is an in vitro approach to evaluate natural extracts' effect on the interaction between CAF and tumor cells in the tumor microenvironment; thus, these results open the chance to design a more profound and mechanistic analysis to explore the molecular mechanisms of P2Et multimolecular activity and extent this analysis to an in vivo perspective. In summary, we present here a standardized polymolecular natural extract that has the potential to act in the TME by interfering with CAF generation and functionality., Competing Interests: S.F. is the inventor of a granted patent related to P2Et. The rest of the authors declare no competing interests., (© 2023 The Authors.)

Objective: To evaluate the healing response of critical defects in rat calvaria with recombinant cementum protein 1 (hrCEMP-1) combined with human dental pulp stem cells (hDPSC) and polylactide-co-glycolide/hydroxyapatite (PLGA/HA) scaffold., Methods: The effect of hrCEMP-1 on proliferation and differentiation of human dental stem cells (hDPSCs) toward a mineralizing-like phenotype was evaluated in monolayer and PLGA/HA scaffold by qPCR. 5 mm calvarial defects were created in Wistar rats and filled with: 1) PLGA/HA scaffold; 2) hDPSCs-PLGA/HA scaffold; 3) hrCEMP-1-hDPSc-PLGA/HA scaffold; 4) control (without scaffold). Bone formation was evaluated by histological-histomorphometric analysis, scanning electron microscopy (SEM) and radiographic evaluation. Comparisons between groups were made with a one-way analysis of variance ANOVA and Bonferroni post-hoc test., Results: In vitro results showed that the PLGA/HA scaffold loaded with hrCEMP-1 improved the proliferation and differentiation of hDPSCs towards a mineralization phenotype by inducing mRNA expression of ALP, OSX, RUNX2, OP, and COL-I genes. The hrCEMP-1/hDPSCs/-PLGA/HA scaffold resulted only in connective tissue formed after ten weeks of healing, larger central radiolucency, and a low peripheral density. We showed superior bone growth and repair with a PLGA/HA matrix scaffold alone and containing hDPSCs compared to the hrCEMP/cells group., Conclusions: PLGA/HA scaffold with hrCEMP-1 induces hDPSC commitment to mineralizing phenotype in vitro, but does not promote critical size osseous defect repair in vivo when it is included in a substitute biomaterial with hDPSc-PLGA/HA scaffold., (Copyright © 2022. Published by Elsevier Ltd.)

CEO social capital has shown a positive association with dynamic capabilities, although correlations have considerable heterogeneity among them. This meta-analysis estimates the correlation between CEO social capital and dynamic capabilities, and analyses moderator variables in explaining the heterogeneity in the results. Moderators are classified across four levels from macro to micro variables: country variables, firm environment, firm characteristics, and CEO variables. We apply a systematic search for studies in the Web of Science, Scopus, EBSCO, ProQuest, and Google Scholar databases. Additionally, we used a three-level random-effect meta-analysis on 89 correlations published between 2008 and 2021 from 9,272 CEOs. Findings indicate a positive correlation between CEO social capital and dynamic capabilities. Furthermore, we identified a moderator effect in the country and firm environment level. We found that the country of the study, the perception of transparency and legality in the country, and the environmental dynamism in the market moderate the size of the correlations. We also reject other moderators, including the individualism-collectivism national culture, firm size, the sources of social capital (business or political ties), and the dimension of the social capital (structural, relational or cognitive). This study contributes to the exploration of the sources of dynamic capabilities from the micro-foundation, identifies moderator variables that explain the heterogeneity in the results, and highlights the social nature of management activities which always evolve in a social context.

Background: Optic neuritis (ON) is the most common manifestation of myelin oligodendrocyte glycoprotein antibody associated disorder (MOGAD) and multiple sclerosis (MS). Acute ON in MOGAD is thought to be associated with more severe optic disk edema than in other demyelinating diseases, but this has not been quantitatively confirmed. The goal of this study was to determine whether optical coherence tomography (OCT) can distinguish acute ON in MOGAD from MS, and establish the sensitivity of OCT as a confirmatory biomarker of ON in these entities., Methods: This was a multicenter cross-sectional study of MOGAD and MS patients with peripapillary retinal nerve fiber layer (pRNFL) thickness measured with OCT within two weeks of acute ON symptom. Cirrus HD-OCT (Carl Zeiss Meditec, Inc. Dublin, CA, USA) was used to measure the pRNFL during acute ON. Eyes with prior ON or disk pallor were excluded. A receiver operating characteristic (ROC) curve analysis was performed to assess the ability of pRNFL thickness to distinguish MOGAD from MS., Results: Sixty-four MOGAD and 50 MS patients met study inclusion criteria. Median age was 46.5 years (interquartile range [IQR]: 34.3-57.0) for the MOGAD group and 30.4 years (IQR: 25.7-38.4) for the MS group (p<0.001). Thirty-nine (61%) of MOGAD patients were female compared to 42 (84%) for MS (p = 0.007). The median pRNFL thickness was 164 µm (IQR: 116-212) in 96 acute MOGAD ON eyes compared to 103 µm (IQR: 93-113) in 51 acute MS ON eyes (p<0.001). The ROC area under the curve for pRNFL thickness was 0.81 (95% confidence interval 0.74-0.88) to discriminate MOGAD from MS. The pRNFL cutoff that maximized Youden's index was 118 µm, which provided a sensitivity of 74% and specificity of 82% for MOGAD. Among 31 MOGAD and 48 MS eyes with an unaffected contralateral eye or a prior baseline, the symptomatic eye had a median estimated pRNFL thickening of 45 µm (IQR: 17-105) and 7.5 µm (IQR: 1-18), respectively (p<0.001). All MOGAD affected eyes had a ≥ 5 µm pRNFL thickening, whereas 26 (54%) MS affected eyes had a ≥ 5 µm thickening., Conclusion: OCT-derived pRNFL thickness in acute ON can help differentiate MOGAD from MS. This can aid with early diagnosis and guide disease-specific therapy in the acute setting before antibody testing returns, and help differentiate borderline cases. In addition, pRNFL thickening is a sensitive biomarker for confirming acute ON in MOGAD, which is clinically helpful and could be used for adjudication of attacks in future MOGAD clinical trials., (Copyright © 2022. Published by Elsevier B.V.)

Background: The implementation of new technologies in medical research, such as novel big storage systems, has recently gained importance. Electronic data capture is a perfect example as it powerfully facilitates medical research. However, its implementation in resource-limited settings, where basic clinical resources, internet access, and human resources may be reduced might be a problem., Methods: In this paper we described our approach for building a network architecture for data collection to achieve our objectives using a REDCap® tool in Colombia and provide guidance for data collection in similar settings., Conclusions: REDCap is a feasible and efficient electronic data capture software to use in similar contexts to Colombia. The software facilitated the whole data management process and is a way to build research capacities in resourced-limited settings., (Copyright © 2021. Published by Elsevier España, S.L.U.)

Context: Colombia passed Law 100 in 1993 with the goal of providing universal health care coverage, and by 2013, over 96% of the Colombian population had health insurance coverage. However, little is known about how health-related quality of life (HRQoL) and health literacy are related among those with the two most common types of health insurance coverage: subsidized (those with lower incomes) and contributory (those with higher incomes) coverage., Objectives and Methods: In the current exploratory investigation, data from adults visiting six primary care clinics in Colombia were analysed to examine the relationship between HRQoL (assessed as problems with mobility, self-care, completing usual activities, pain/discomfort, and anxiety/depression), demographics, the two health insurance types, and health literacy. Analyses also assessed whether, within insurance types, health literacy was related to HRQoL., Results: Results showed that those with contributory health insurance coverage had greater health literacy than those with subsidized coverage, and this was accounted for by differences in education and socioeconomic status. HRQoL did not differ by insurance type. Although lower health literacy was related to worse HRQoL in the overall sample, in subgroup analyses lower health literacy significantly related to worse HRQoL only among those with subsidized health insurance coverage., Conclusion: Targeting skills which contribute to health literacy, such as interpreting medical information or filling out forms, may improve HRQoL, particularly in those with subsidized insurance coverage., (Copyright © 2021. Published by Elsevier España, S.L.U.)

Objective: Assess the prevalence and types of digital technology use, as well as the extent to which patients use the internet and mobile devises. Evaluate the socioeconomic characteristics of patients and the possible relation to patterns of technology use in Colombia. Understand the nature of patient technology use in primary care for finding medical information., Methods: A survey was applied to adult patients who attended primary health care centers systems in 6 Colombian cities. The survey inquired about demographic characteristics, insurance, access to services, cell phone use, internet access, and the use of such technology to access health-related services and information. Data was collected and managed using REDCap. Summary statistics on each survey item were calculated and the differences between discrete variables were analyzed using chi-square. Multivariate analyses were performed using logistic regression analysis for binary dependent variables., Results: A total of 1580 patients were surveyed across the six study sites. 93% of the patients reported they have a cell phone. Patients from urban healthcare centers showed a higher use of the Internet on their phone than less urban settings. Around half of the surveyed patients reported Internet use (49.7%). Among Internet users, 65% of participants use the Internet looking for health care information. Around one-third of patients use cellphones to arrange clinic visits. Around 24% of participants answered positively for both Whooley's questions. Of those who screened positive on the Whooley questions, 43% reported being moderately anxious, 47% reported being very anxious. 51% reported having moderate pain; 52% reported having severe pain., Conclusions: The patterns of technology use identified in this study are essential for developing future health interventions based on ICT. The design of ICT clinical interventions must take into account the cellphone payment plans, availability of internet connection, advantages, and disadvantages of messenger services, including SMS as a possible alternative to people who do not have smartphones., (Copyright © 2021. Published by Elsevier España, S.L.U.)

Aims and Method: This systematic review examines the effectiveness and cost-effectiveness of behavioural health integration into primary healthcare in the management of depression and unhealthy alcohol use in low- and middle-income countries. Following PRISMA guidelines, this review included research that studied patients aged ≥18 years with unhealthy alcohol use and/or depression of any clinical severity. An exploration of the models of integration was used to characterise a typology of behavioural health integration specific for low- and middle-income countries., Results: Fifty-eight articles met inclusion criteria. Studies evidenced increased effectiveness of integrated care over treatment as usual for both conditions. The economic evaluations found increased direct health costs but cost-effective estimates. The included studies used six distinct behavioural health integration models., Clinical Implications: Behavioural health integration may yield improved health outcomes, although it may require additional resources. The proposed typology can assist decision-makers to advance the implementation of integrated models.

The zoonotic virus now named SARS-CoV-2 first infected humans in China, and COVID-19 has rapidly become pandemic. To mitigate its impact on societies, health systems and economies, countries have adopted non-pharmacological preventive practices such as 'spatial' or 'social' distancing, the use of protective masks, and handwashing; these have been widely implemented. However, measures aimed at protecting physical health and healthcare systems have side-effects that might have a big impact on individuals' wellbeing. As the pandemic reaches low- and middle-income countries, weaker health systems, limited resources and the lower socioeconomic status of their populations make halting the pandemic more challenging. In this article, we explore the impact of COVID-19 and its prevention measures on the wellbeing of vulnerable populations. Special attention must be given to homeless, indigenous, migrant and imprisoned populations, as well as people living with disabilities and the elderly. More than just resolute governmental action will be required to overcome the pandemic. Links between science and political actions have to be strengthened. Fighting COVID-19 is a collective endeavour and community action, on a global scale, is of paramount importance., (Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.)

New international enterprises that are referred to as Born Globals have become the subject of research due to the success of their global operations, despite their early internationalization and limited resources. Given the importance of analyzing the characteristics that contribute to the success of Born Globals, our study examines the influence of international orientation on export performance. Additionally, we consider internal and external drivers for early and accelerated internationalization such as the Born Global's innovative capacity, the dynamism of the market and the favorability of the environment. By estimating a structural equation model, the results show that international orientation is a strong driver of the export performance of Born Globals. However, this relationship is moderated by innovative capacity and the dynamism and favorability of the environment, thus achieving a greater effect on export performance when international orientation is complemented by these variables., (© 2019 The Authors.)

Although speaking a foreign language is undoubtedly an asset, foreign-accented speakers are usually perceived negatively. It is unknown, however, to what extent this bias impacts cognitive processes. Here, we used ERPs and pupillometry to investigate whether the negative bias generated by a short exposure to a foreign accent influences the overall perception of a speaker, even when the person is not speaking. We compared responses to written sentence comprehension, memory and visual perception, associated with native speakers (high and low social status) and a foreign-accented speaker (high social status). The foreign-accented speaker consistently fell in-between the high-status native speaker and the low-status native speaker. This is the first physiological demonstration that short exposure to a foreign accent impacts subsequent cognitive processes, and that foreign-accented speakers seem to be considered less reliable than native speakers, even with equally high social status. Awareness of this bias is essential to avoid discriminations in our multilingual society., (Copyright © 2019 Elsevier Ltd. All rights reserved.)