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On December 14, 2021, an earthquake with a magnitude of 7.4 originated from the Flores Sea, impacting Kalaotoa Island in Indonesia, resulting in significant structural damage. Macroseismic observations at the site classified that there were 120 buildings slightly damaged, 108 buildings moderately damaged, and 201 buildings heavily damaged. The shakemap shows that Kalaotoa Island experienced VI-VII MMI shaking. The results of the field survey showed many indications of subsidence as many fractures were found in Kalaotoa Island. This study employed Differential Interferometry Synthetic Aperture Radar (DInSAR) to quantify land subsidence and uplift in Kalaotoa Island before and after the earthquake. Sentinel-1A satellite radar data from December 2 and December 14, 2021, were analyzed. The results revealed subsidence of up to 12 cm in Garaupa Raya Village and uplift of up to ±10 cm in Lembang Mate’ne Village. Approximately 50.50% of Kalaotoa Island experienced subsidence (39.4 km²), primarily in Garaupa Village (18.85 km²), while 49.02% of the island experienced uplift (38.2 km²), mostly in Lembang Mate’ne Village (19.03 km²). This spatial analysis underscores the efficacy of DInSAR in detecting and mapping surface deformation, offering critical insights for earthquake preparedness, mitigation efforts for impacted landscape topography, stability soils, structure of ecosystems, and infrastructure resilience.

Abstract Background Early childhood caries (ECC) is a global public health challenge that requires innovation, infrastructure, and health system influences to bolster initiatives for its management and control. The aim of this scoping review was to investigate the published evidence on the association between ECC and the targets of the Sustainable Development Goal 9 (SDG9) concerned with industry, innovation, and infrastructure development. Methods The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. A search was conducted in PubMed, Web of Science, and Scopus between July and August 2023 using a search strategy related to the promotion of resilient infrastructure, sustainable industries, scientific research and innovation, access to the internet and ECC. Only English language publications were included. Studies that solely examined ECC without reference to the SDG9 targets were excluded. Results The search yielded 933 studies for review. After screening for the eligibility and removing duplicates, 916 unique articles remained for further screening. However, none of the identified studies provided data on the association between resilient infrastructure, sustainable industries, scientific research and innovation, access to the internet and ECC. Conclusion There were no primary studies that assessed the association between ECC and SDG9, even though the plausibility of a potential relationship exists. Future studies are needed to generate evidence on the link between ECC and SDG9 as this link may contribute to the reduction in the proportion of children with untreated ECC.

BackgroundPPARα and cyclooxygenase (COX)-2 are overexpressed in certain types of cancer. Thus, developing a dual inhibitor that targets both could be more effective as an anticancer agent than single inhibitors. We have previously shown that an analog of the bezafibrate named AA520 is a PPARα antagonist. Herein, we report the identification of AA520 as a potent COX-2 inhibitor using in silico approaches. In addition, we performed a thorough pharmacological characterization of AA520 towards COX-1 and COX-2 in different in vitro models.MethodsAA520 was characterized for inhibiting platelet COX-1 and monocyte COX-2 activity in human whole blood (HWB) and for effects on lipidomics of eicosanoids using LC-MS/MS. The kinetics of the interaction of AA520 with COX-2 was assessed in the human colon cancer cell line, HCA-7, expressing only COX-2, by testing the COX-2 activity after extensive washing of the cells. The impact of AA520 on cancer cell viability, metabolic activity, and cytotoxicity was tested using the MTT reagent.ResultsIn HWB, AA520 inhibited in a concentration-dependent fashion LPS-stimulated leukocyte prostaglandin (PG) E2 generation with an IC50 of 0.10 (95% CI: 0.05–0.263) μM while platelet COX-1 was not affected up to 300 μM. AA520 did not affect LPS-induced monocyte COX-2 expression, and other eicosanoids generated by enzymatic and nonenzymatic pathways. AA520 inhibited COX-2-dependent PGE2 generation in the colon cancer cell line HCA7. Comparison of the inhibition of COX-2 and its reversibility by AA520, indomethacin (a time-dependent inhibitor), acetylsalicylic acid (ASA) (an irreversible inhibitor), and ibuprofen (a reversible inhibitor) showed that the compound is acting by forming a tightly bound COX-2 interaction. This was confirmed by docking and molecular dynamics studies. Moreover, AA520 (1 μM) significantly reduced MTT in HCA7 cells.ConclusionWe have identified a highly selective COX-2 inhibitor with a unique scaffold. This inhibitor retains PPARα antagonism at the same concentration range. It has the potential to be effective in treating certain types of cancer, such as hepatocellular carcinoma (HCC) and renal cell carcinoma (RCC), where COX-2 and PPARα are overexpressed.

Antecedentes: La selva alta perennifolia (SAP) se ha transformado por el cambio del uso de suelo. Los cafetales rústicos son parte del paisaje y su abandono puede favorecer la regeneración de la vegetación original. Hipótesis: La protección de cafetales abandonados en SAP, favorece la regeneración natural permitiendo el desarrollo de bosques secundarios en distintas fases de sucesión. Sitio de estudio: Colipa, Veracruz, México. Dos cafetales abandonados y un fragmento de SAP. Métodos: En 24 transectos (50 × 2 m), se registraron y midieron diámetros y alturas de especies leñosas (DAP ≥ 5 cm). En cada transecto se marcaron cuadrantes (2 × 2 m) para registro de especies del estrato arbustivo y plántulas. Se evaluó el estatus de regeneración mediante densidades de plántulas, juveniles y adultos. Resultados: Se registraron 60 especies. El mayor número de especies se presentó en la SAP y el cafetal colindante, fueron los sitios con más especies compartidas. El otro cafetal (alejado 3 km) tuvo la mayor densidad de árboles mientras que la SAP presentó mayor densidad de arbustos y plántulas. El 50 % de las especies características de la SAP en el área se están regenerando en los cafetales, mientras que las especies cultivadas presentaron regeneración pobre o nula. Conclusiones: Después de más de 25 años de abandono, la estructura y composición de especies es similar a la SAP. Los cafetales de sombra abandonados contribuyen a la regeneración natural y funcionan como reservorios de germoplasma nativo para la región.

Objectives: The World Health Organization recommends three drug anti-malarial combinations: cloroquine+primaquine, artesiminin+primaquine, and cloroquine+tafenoquine. These combinations aim to eradicate Plasmodium by disrupting its life cycle within the human body. We evaluated the effect of these medications on the vectorial competence of two main vectors in the New World. Methods: We recruited patients diagnosed with malaria vivax from a primary care in Manaus, Amazonas. To determine how different treatments affected vectors, we collected blood samples prior to treatment at the hospital and at six intervals over the next 68 hours at the patient's homes. These samples were used to infect Anopheles darlingi and Anopheles aquasalis. To assess the potential for Plasmodium transmission by bite to a new human host, we analyzed the infection intensity, infection rate, and presence of parasites in the salivary gland of the mosquitoes. Results: The results show the infection of the mosquitoes fed with the patient's blood during the first days of treatment with all three drug combinations. However, the cloroquine+tafenoquine combination was the least effective while artesiminin+primaquine was the most effective. Conclusions: In the first few days of treatment, two main vectors continue to spread malaria vivax from patients, potentially contributing to the ongoing transmission in malaria-endemic regions.

ABSTRACT Background: Pathophysiological mechanisms of rheumatoid arthritis arise because of a proinflammatory environment, generated by the interaction of autoreactive lymphocytes and proinflammatory mediators. Current strategies to mitigate the progression of the disease produce adverse effects, so there is a need for new therapeutic strategies and molecular targets to treat this disease. In this context, evidence suggests that scorpion venoms could modulate the immune response and some important cellular mechanisms of pharmacological interest. To evaluate the immunomodulatory effect of the venom of Tityus sp. (a possible new species close to Tityus metuendus) peripheral blood mononuclear cells of women diagnosed with RA were compared to cells of a control group. Methods: A case-control study was conducted with a sample of 10 women with a confirmed diagnosis of RA and controls matched by sex and age. The cytotoxicity of the venom was evaluated to find sublethal concentrations of the venom, and subsequently, their immunomodulatory capacity in terms of percentage of proliferation, cell activation, and cytokines production. Results: the venom of Tityus sp. produced a decrease in the percentage of proliferation in the CD3+, CD3+CD4+, and CD3+CD8+ cell subpopulations of RA patients and healthy controls, at concentrations of 252 and 126 µg/mL. However, the venom did not induce significant differences in the percentage of cell activation markers. The venom caused a decrease in IL-10 at a concentration of 252 µg/mL compared to untreated cells from patients and controls. The remaining cytokines did not show significant differences. Conclusion: the venom of Tityus sp. is a potential source of molecules with immunomodulatory ability in CD4 and CD8 T lymphocytes. This result directs venom characterization studies to identify pharmacological targets with immunomodulatory capacity in T lymphocytes to enhance research in the treatment of autoimmune disorders such as RA.

In this research, several SO2 removal alternatives were evaluated for the treatment of gaseous effluents generated by the "Carlos Manuel de Céspedes" power plant in Cienfuegos to be use in gaseous stream to Ulva lettuce intensive culture. A low-cost sensor was used to monitor the gas concentration during the proposed methods. The sensor was previously calibrated and a linear regression model with a coefficient of determination of 0,9926 was obtained. The alternatives evaluated were adsorption with activated carbon, absorption with calcium hydroxide and absorption with seawater. The removal was evaluated at three levels SO2 concentration. In addition, the parameters pH, salinity and alkalinity were determined to a seawater sample from the Bay of Cienfuegos and with which the experiments were carried out. The values obtained were 8,17±0,003; 26,50±0,10 ups and 171,67±1,03 mg/L respectively, which confirms its good performance for gas removal. The three methods studied showed satisfactory results for SO2 removal. The seawater absorption experiment was the most efficient alternative, achieving the lowest final concentrations in the shortest time.

Assessing air quality's impact on human health involves monitoring pollutant concentrations such as NO2, O3, CO, SO2, and particulate matter. While high-income countries rely on expensive reference instruments, low-income nations face technological limitations. This study explores the potential of low-cost scientific devices as a viable solution for these regions. The research focuses on evaluating the reliability of low-cost NO2 sensors and consistency across five identical sensors. Calibration tests in controlled settings reveal a linear model with high coefficients of determination, contrasting with lower coefficients observed during field tests. Variability in intercepts and slopes is evident across time and campaign contexts. Time series analysis using low-cost NO2 sensors showed that many of the tall peaks atop a fluctuating baseline correlates with peaks identified by reference instruments. Additionally, NO gas sensors are also able to identify pollution peaks in monitoring campaigns. Therefore, such affordable sensors provide valuable insights into pollutant concentration trends, offering indicative magnitude information. However, improving calibration and reliability of these sensors necessitates further research.

Abstract Background Early Childhood Caries (ECC) is a prevalent chronic non-communicable disease that affects millions of young children globally, with profound implications for their well-being and oral health. This paper explores the associations between ECC and the targets of the Sustainable Development Goal 8 (SDG 8). Methods The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. In July 2023, a search was conducted in PubMed, Web of Science, and Scopus using tailored search terms related to economic growth, decent work sustained economic growth, higher levels of productivity and technological innovation, entrepreneurship, job creation, and efforts to eradicate forced labor, slavery, and human trafficking and ECC all of which are the targets of the SDG8. Only English language publications, and publications that were analytical in design were included. Studies that solely examined ECC prevalence without reference to SDG8 goals were excluded. Results The initial search yielded 761 articles. After removing duplicates and ineligible manuscripts, 84 were screened. However, none of the identified studies provided data on the association between decent work, economic growth-related factors, and ECC. Conclusions This scoping review found no English publication on the associations between SDG8 and ECC despite the plausibility for this link. This data gap can hinder policymaking and resource allocation for oral health programs. Further research should explore the complex relationship between economic growth, decent work and ECC to provide additional evidence for better policy formulation and ECC control globally.

Abstract Background Reducing mosquito abundance or interfering with its ability to support the parasite cycle can help to interrupt malaria in areas of significant risk of malaria transmission. Fluralaner is a safe and effective drug for veterinary use indicated for the treatment against fleas and ticks which acts as an antagonist of chloride ion channels mediated by γ-aminobutyric acid (GABA), preventing the entry of these ions into the postsynaptic neuron, leading to hyperexcitability of the postsynaptic neuron of the central nervous system of arthropods. Fluralaner demonstrated insecticidal activity against different insect species. Methods The study aimed to evaluate the effects of fluralaner on the biology, survival, and reproductive fitness of Anopheles aquasalis. The following lethal concentrations (LC) were determined for An. aquasalis: LC5 = 0.511 µM; LC25 = 1.625 µM; LC50 = 3.237 µM. Results A significant decrease (P

Abstract Malaria is a severe public health problem in several developing tropical and subtropical countries. Anopheles aquasalis is the primary coastal malaria vector in Central and South America and the Caribbean Islands, and it has the peculiar feature of living in water with large changes in salinity. Recent research has recognised An. aquasalis as an important model for studying the interactions of murine and human Plasmodium parasites. This study presents the complete genome of An. aquasalis and offers insights into its evolution and physiology. The genome is similar in size and gene content to other Neotropical anophelines, with 162 Mb and 12,446 protein-coding genes. There are 1387 single-copy orthologs at the Diptera level (eg. An. gambiae, An. darlingi and Drosophila melanogaster). An. aquasalis diverged from An. darlingi, the primary malaria vector in inland South America, nearly 20 million years ago. Proteins related to ion transport and metabolism belong to the most abundant gene families with 660 genes. We identified gene families relevant to osmosis control (e.g., aquaporins, vacuolar-ATPases, Na+/K+-ATPases, and carbonic anhydrases). Evolutionary analysis suggests that all osmotic regulation genes are under strong purifying selection. We also observed low copy number variation in insecticide resistance and immunity-related genes for all known classical pathways. The data provided by this study offers candidate genes for further studies of parasite-vector interactions and for studies on how anophelines of brackish water deal with the high fluctuation in water salinity. We also established data and insights supporting An. aquasalis as an emerging Neotropical malaria vector model for genetic and molecular studies.

La evaluación sistemática de los cuadros permite conocer las potencialidades y capacidades de estos y, al igual que el diagnóstico de necesidades de aprendizaje, constituye un elemento imprescindible a tener en cuenta para la planificación de la preparación y superación de los cuadros y reservas. La atención directa a este proceso en el municipio Baraguá ha evidenciado la necesidad de solucionar las limitaciones de los directores, especialistas y funcionarios de cuadro en entidades de subordinación local. Para su solución se ha elaborado un sistema de acciones, concebidas de manera integral, contextualizadas y sistémicas, a partir del propio Sistema de preparación y superación de los cuadros y reservas del territorio, que contribuya a su capacitación. Para su desarrollo se emplearon los métodos del nivel teórico: analítico-sintético, análisis histórico-lógico, inductivo-deductivo y sistémico estructural; del nivel empírico: la observación, la entrevista, el cuestionario y el análisis documental. La evaluación científica demostró que las acciones propuestas fueron efectivas, debido a que se logró que los cuadros implicados con la tarea se apropiaran de conocimientos y habilidades para diseñar los planes de preparación y superación teniendo en cuenta los resultados de la evaluación y el diagnóstico de necesidades de aprendizaje, en correspondencia con las necesidades del territorio.

Food SMEs (Small and Medium Enterprises) were examples of labor-intensive industry, which involved laborers in pursuing production activities. Food SMEs require complex processes in production activities. Support to increase work productivity and reduce ergonomic risks of the activities was needed. The study was conducted at Tofu SMEs. The determination of the rest period could be developed to give some recovery times to laborers. WBGT (Wet Bulb Globe Temperature) was estimated to determine the rest period. The rest period was determined by the workstation environment and workload labor. ANN (Artificial Neural Networks) model was carried out due to a nonlinear relationship. ANN was used to process the information from the data set and predict the amount of rest period and WBGT. ANN was trained using backpropagation. The backpropagation algorithm used the error value to change the weight with forward and backward propagation. The result showed that dry bulb temperature, heart rate, wet bulb temperature, and gender significantly impacted the rest period and WBGT. A total of 180 data sets from tofu SMEs were divided into training data (80%) and validation data (20%). The optimal ANN structure was determined by four input, four hidden, and two output neurons. The activation function was sigmoid for both layers. SSE (Sum of Squared Errors) was used to obtain the best structure. The value of R2 was equal to above 0.900, which indicated that ANN could model the labor rest period based on environmental ergonomics.

Latar Belakang : Luka bakar merupakan masalah kesehatan yang sering dihadapi di Indonesia dengan tingkat kejadian yang tinggi. Salah satu pendekatan yang telah diambil dalam pengobatan luka bakar dengan penggunaan obat berbahan alam. Tanaman sirih merah (Piper crocatum) berpotensi sebagai antiinflamasi dan penyembuhan luka karena mengandung senyawa alkaloid, flavonoid, saponin, dan tanin. Sediaan obat topikal seperti patch transdermal menjadi alternatif bentuk sediaan obat dengan berbagai keuntungan. Tujuan : Penelitian ini bertujuan untuk mengevaluasi efektivitas sediaan patch ekstrak daun sirih merah dalam penyembuhan luka bakar, kelembaban luka, warna luka dan keropeng luka derajat II secara in vivo. Metode : Penelitian ini menggunakan desain eksperimental post-test only control group design pada tikus putih jantan (n=6/kelompok) dengan empat formulasi sediaan patch ekstrak daun sirih merah (F1-F4). Evaluasi dilakukan selama 14 hari terhadap kelembaban, warna, dan keropeng luka untuk menguji efektivitas penyembuhan luka bakar derajat II. Analisis data menggunakan Anova One-way dan uji posthoc LSD. Hasil : Hasil uji posthoc LSD menunjukkan perbedaan signifikan dalam kesembuhan luka bakar tikus antar kelompok perlakuan (p < 0,05). Variasi formulasi patch (F1-F4) menghasilkan perbedaan rata-rata yang signifikan dalam kelembaban, warna, dan pembentukan keropeng luka. Kelompok F4 (30%) menunjukkan tingkat penyembuhan tertinggi, mencapai 50,37%, sedangkan kelompok F2 (10%) juga menunjukkan konsentrasi efektif dengan rata-rata persentase penyembuhan 43,45%. Kesimpulan : Ekstrak daun sirih merah (Piper crocatum) efektif dalam mendukung penyembuhan luka bakar derajat II secara in vivo, yang tercermin dalam penurunan kelembaban luka, perubahan warna luka, dan pembentukan keropeng luka.

Bioactive plants such as P. aduncum, M. citrifolia, and A. altilis might improve intestinal health as an alternative to antibiotic growth promoters. The objective of this study was to determine the effect of the ethanolic extracts (EEs) of these plants on the intestinal health of broiler chickens. Cobb 500 chickens (n = 352) were distributed into eight treatments with four replicates and 11 chickens each. T1 received a base diet, and T2 received a base diet with 0.005% zinc bacitracin. T3, T5, and T7 were supplemented with 0.005% of P. aduncum, M. citrifolia, and A. altilis EE in the diet while T4, T6, and T8 with 0.01% of the extract. The EEs were supplemented with drinking water from 1 to 26 days of age. The following parameters were evaluated: hematological profiles at 28 days of age, blood metabolites profiles at 14, 21, and 28 days; Escherichia coli, Staphylococcus aureus, and Lactobacillus sp. abundance in the ileum mucosa and content at 21 and 28 days, and histomorphometry of the duodenum, jejunum, and ileum mucosa at 14, 21, and 28 d. Final weight (FW), weight gain (WG), feed intake (FI), and feed conversion rate (FCR) were evaluated at seven, 21, and 33 days of age. M. citrifolia and A. altilis EE at 0.01% increased blood glucose levels at 21 and 28 days of age, respectively, and P. aduncum and M. citrifolia EE at 0.01% increased triglycerides at 28 days of age; in addition, this EE did not have any effect on the AST and ALT profiles. The depths of the Lieberkühn crypts and the villi length to the crypt’s depth ratio increased with age on supplementation with 0.01% M. citrifolia and A. altilis EE at 21 days of age (p

O artigo tem por base o estudo bibliográfico realizado ao longo de pesquisa no mestrado em educação profissional e tecnológica – ProfEPT. Objetivou ampliar a compreensão conceitual da Integração que dá suporte ao projeto do Ensino Médio Integrado – EMI na educação profissional e tecnológica. Para tanto, baseou-se nos trabalhos da professora Marise Ramos em relação aos sentidos da Integração por ela apresentados. O estudo permitiu compreender aspectos importantes da Integração para o EMI, tais como a omnilateralidade, o Trabalho, a Ciência e a Cultura e suas relações com o tripé Ensino, Pesquisa e Extensão. Por fim, destacamos a importância de se compreender, no âmbito da Rede Federal de Ensino, a Integração para além da relação entre formação geral e formação técnica.

It is essential to manage waste in an integrated manner, beginning at the domestic and village levels. In fact, there are still a significant number of residents who throw trash carelessly. Jurangjero village, a village in Klaten Regency, Central Java, is an example of a village that does not adequately manage its waste. In addition, the village has agricultural waste issues that require optimal utilization, including rice straw. This community service program aims to increase public awareness of organic and inorganic domestic waste management and agricultural waste management so that they can be applied appropriately to the concept of the green village. The program’s methods included field observations, waste management outreach, and training. The training included the creation of organic fertilizers, eco-bricks, plastic waste containers, and straw paper. Farmer groups and farmer women’s groups have gained an understanding of the management of domestic organic waste into organic fertilizer and compost as a result of the outreach and training activities. Karangtaruna has also gained an understanding of inorganic waste management by applying the recycling concept, which entails transforming plastic refuse into plastic pots and ecobricks. They have also grasped the production of economically valuable art paper from rice stalks. The descriptive analysis revealed that the average pre-test and posttest scores were 55.58 and 76.67, respectively. Based on these findings, it can be concluded that this community service program has increased residents’ knowledge of managing domestic and agricultural waste to create valuable products. The support of the village administration is required for sustainable waste management and the continuation of empowerment initiatives.

Background: Tooth loss leads to decreased masticatory function, which affects nutritional intake. Tooth loss accompanied by poor nutritional status affects quality of life both physically and psychosocially. Purpose: This study was conducted to identify the relationship between number of teeth lost due to nutritional status and quality of life. Methods: A study conducted at Gulai Bancah Primary Health Care in Bukittinggi. Participants were recruited using a non-probability purposive sampling technique. 178 pre-elderlies aged between 45 and 59 years took part in this study. Tooth loss was reported in the dental examination format while nutritional status and quality of life pertaining to dental and oral health were determined using the Mini Nutritional Assessment (MNA) and the Geriatric Oral Health Assessment Index (GOHAI). Pearson correlation and path analysis were utilized to analyze the data. Results: The Pearson correlation test indicated a moderate correlation between tooth loss and nutritional status (r = -0.549) and a strong correlation between the number tooth lost and quality of life (r = -0.742). Pathway analysis confirmed that the direct effect value (beta coefficient = 0.552) was greater than the indirect effect value (beta coefficient = 0.189). The findings indicated that, indirectly, the amount of tooth loss mediated with nutritional status had no significant relationship to quality of life. Conclusion: An increase in tooth loss leads to pre-elderly poor nutritional status and quality of life. However, nutritional status is not an intermediate factor between the number of teeth lost and pre-elderly quality of life.

O artigo tem como objetivo compreender como a valorização da cultura popular local e/ou regional pode contribuir com a formação integral do sujeito. Além disso, visa definir os conceitos de cultura e de cultura popular, identificar traços da cultura popular no contexto da Escola Família Agrícola (EFAN) de Natalândia e perceber a visão do profissional da EFAN acerca da cultura popular local/regional. O estudo se caracteriza como uma pesquisa de campo, enquadrada na abordagem qualitativa. Quanto aos procedimentos, realizou-se uma entrevista semiestruturada, feita por meio da Plataforma Zoom. Realizou-se, também, uma revisão bibliográfica, por meio do levantamento de artigos e livros de renomados autores, como Santaella (2003), Santos (1983), Souza e Pereira (2014), Lopes e Macedo (2011), Pessoa (2018), Benjamin (1996), entre outros que discutem os conceitos de cultura e cultura popular. O conteúdo e os dados foram analisados de forma crítica. Os resultados revelaram que existem inúmeras estratégias pedagógicas para auxiliar os estudantes, em especial os da EFAN, na valorização e aproximação da cultura popular local/regional. Portanto, ao trabalhar com manifestações da cultura popular na escola, propicia-se ao indivíduo desenvolver consciência política, de classe, de pertencimento, de valorização do seu espaço de vivência e de fortalecimento da identidade camponesa.

Background: Kawasaki disease (KD) is a type of vasculitis in which giant coronary artery aneurysms (CAAs) can occur. There are no specific guidelines for managing giant CAAs that develop quickly and are at risk of rupture. Regarding cardiovascular drugs, only beta-blockers are formally recommended in the acute phase of KD. Case presentation: A 6-month-old male patient with multiresistant Kawasaki disease and giant CAAs that continued to enlarge after controlling systemic inflammation was examined. The patient required three doses of intravenous immunoglobulin, methylprednisolone pulses, and anakinra and infliximab to normalize systemic inflammation. Due to the rapid increment of aneurysms’ dimensions and the risk of rupture, we introduced anticoagulant therapy and propranolol plus captopril, and titration doses were introduced according to a tolerated decrease in heart rate and arterial pressure. CAAs increment stabilized and slowly reduced their dimensions. Conclusions: The authors describe an atypical case of multiresistant KD with giant rapidly increasing CAAs even after controlling systemic inflammation. The introduction of a beta-blocker and an angiotensin-converting enzyme (ACE) inhibitor was demonstrated to be useful for stabilizing giant CAAs growth and reducing the potential risk of rupture.

In recent years, therapeutic endoscopy has become a fundamental tool in the management of gallbladder diseases in light of its minimal invasiveness, high clinical efficacy, and good safety profile. Both endoscopic transpapillary gallbladder drainage (TGBD) and endoscopic ultrasound (EUS)-guided gallbladder drainage (EUS-GBD) provide effective internal drainage in patients with acute cholecystitis unfit for cholecystectomy, avoiding the drawbacks of external percutaneous gallbladder drainage (PGBD). The availability of dedicated lumen-apposing metal stents (LAMS) for EUS-guided transluminal interventions contributed to the expansion of endoscopic therapies for acute cholecystitis, making endoscopic gallbladder drainage easier, faster, and hence more widely available. Moreover, EUS-GBD with LAMS opened the possibility of several cholecystoscopy-guided interventions, such as gallstone lithotripsy and clearance. Finally, EUS-GBD has also been proposed as a rescue drainage modality in malignant biliary obstruction after failure of standard techniques, with encouraging results. In this review, we will describe the TBGD and EUS-GBD techniques, and we will discuss the available data on clinical efficacy in different settings in comparison with PGBD. Finally, we will comment on the future perspectives of EUS-GBD, discussing the areas of uncertainty in which new data are more strongly awaited.

BackgroundChild neglect is a public health, human rights, and social problem, with potentially devastating and costly consequences. The aim of this study was to: (1) summarize the oral health profile of children across the globe; (2) provide a brief overview of legal instruments that can offer children protection from dental neglect; and (3) discuss the effectiveness of these legal instruments.MethodsWe summarized and highlighted the caries profile and status of implementation of legislation on child dental neglect for 26 countries representing the World Health Organization regions: five countries in Africa (Nigeria, South Africa, Sudan, Tanzania, Zimbabwe), eight in the Americas (Argentina, Brazil, Canada, Chile, Mexico, Peru, Unites States of America, Uruguay), six in the Eastern Mediterranean (Egypt, Iran, Libya, Jordan, Qatar, Saudi Arabia), four in Europe (Italy, Latvia, Serbia, United Kingdom), two in South-East Asia (India and Indonesia) and one country (China) with its special administrative region (Hong Kong) in the Western Pacific.ResultsTwenty-five of the 26 countries have legal instruments to address child neglect. Only two (8.0%) of these 25 countries had specific legal instruments on child dental neglect. Although child neglect laws can be interpreted to establish a case of child dental neglect, the latter may be difficult to establish in countries where governments have not addressed barriers that limit children's access to oral healthcare. Where there are specific legal instruments to address child dental neglect, a supportive social ecosystem has also been built to facilitate children's access to oral healthcare. A supportive legal environment, however, does not seem to confer extra protection against risks for untreated dental caries.ConclusionsThe institution of specific country-level legislation on child dental neglect may not significantly reduce the national prevalence of untreated caries in children. It, however, increases the prospect for building a social ecosystem that may reduce the risk of untreated caries at the individual level. Social ecosystems to mitigate child dental neglect can be built when there is specific legislation against child dental neglect. It may be more effective to combine public health and human rights-based approaches, inclusive of an efficient criminal justice system to deal with child dental neglect.

This paper critically reviews the literature on technostress, the organizational culture of employee well-being, and the relationship between the concepts in the software industry workers. For this task, it is crucial to describe the characteristics of the software industry. After that, the definition and dimensions of technostress and organizational culture are explained. Finally, the relationship between technostress and organizational culture is presented.

El emprendimiento en la economía constituye en una herramienta natural de MiPyME, permite afianzar ideas de negocios con productividad y competitividad. En la actualidad postpandemia -COVID-19- la actividad empresarial se ha reactivado, así como las iniciativas familiares de emprendimiento. El objetivo de la investigación es analizar las debilidades existentes en el posicionamiento de emprendimientos del mercado artesanal de la asociación “Formando Hombres y Mujeres Artesanas” del cantón La Libertad. La metodología aplicada, fue con un enfoque cualitativo y cuantitativo, con técnicas de recolección de datos por medio de la encuesta y observación directa; se realizó el cálculo resultante de confiabilidad en lo referente al coeficiente Alfa de Cronbach con 0,7538322; ubicándose en un rango de magnitud alta, por lo que se identifica la incidencia de las estrategias y herramientas para la gestión de marcas en el posicionamiento de las artesanías de la provincia. Los resultados muestran falencias en la oferta de productos, por el desconocimiento sobre la gestión de marca.

Introducción: Las emisiones de gases contaminantes a la atmósfera de los sistemas de generación de vapor están determinadas por el tipo y la composición del combustible. El fuel oíl con alto contenido de azufre es el responsable de las emisiones de dióxido de azufre. Es necesario conocer la incidencia en la calidad del aire de este contaminante desde una fuente fija, como una industria de recape, en el radio higiénico sanitario. Objetivo: Cuantificar el dióxido de azufre generado en una recapadora de neumáticos mediante medidas de emisión e inmisión en la zona higiénico sanitaria de la misma. Materiales y Métodos: Se desarrolló una metodología que incluye el inventario de emisiones de SO2 en función del consumo de combustible para la generación de vapor, la modelación de la dispersión y la evaluación de la inmisión mediante monitoreo con sensor de bajo costo. Resultados y Discusión: Los resultados evidencian que el SO2 en el aire ambiental determinados por modelación de la emisión y monitoreados con sensores de bajo costo son similares y no superan el valor límite establecido. Conclusiones: Los resultados de la concentración de SO2 evaluada con medidas de emisión e inmisión, demuestran que es la industria de recape la fuente principal que tributa a la calidad del aire por el efecto de este contaminante y en este estudio es aceptable. Además, la similitud de los valores de inmisión y la modelación de la emisión justifican la factibilidad del uso de sensores de bajo costo para medir la calidad del aire.

Anophelines are vectors of malaria, the deadliest disease worldwide transmitted by mosquitoes. The availability of genomic data from various Anopheles species allowed evolutionary comparisons of the immune response genes in search of alternative vector control of the malarial parasites. Now, with the Anopheles aquasalis genome, it was possible to obtain more information about the evolution of the immune response genes. Anopheles aquasalis has 278 immune genes in 24 families or groups. Comparatively, the American anophelines possess fewer genes than Anopheles gambiae s. s., the most dangerous African vector. The most remarkable differences were found in the pathogen recognition and modulation families like FREPs, CLIP and C-type lectins. Even so, genes related to the modulation of the expression of effectors in response to pathogens and gene families that control the production of reactive oxygen species were more conserved. Overall, the results show a variable pattern of evolution in the immune response genes in the anopheline species. Environmental factors, such as exposure to different pathogens and differences in the microbiota composition, could shape the expression of this group of genes. The results presented here will contribute to a better knowledge of the Neotropical vector and open opportunities for malaria control in the endemic-affected areas of the New World.

Necrotizing pancreatitis is a complex clinical condition burdened with significant morbidity and mortality. In recent years, the huge progress of interventional endoscopic ultrasound (EUS) has allowed a shift in the management of pancreatic necrotic collections from surgical/percutaneous approaches to mini-invasive endoscopic internal drainage and debridement procedures. The development of lumen-apposing metal stents (LAMSs), devices specifically dedicated to transmural EUS interventions, further prompted the diffusion of such techniques. Several studies have reported excellent outcomes of endoscopic interventions, in terms of technical success, clinical efficacy and safety compared to surgical interventions, and thus endoscopic drainage of walled-off necrosis (WON) has become a fundamental tool for the management of such conditions. Despite these advancements, some critical unresolved issues remain. Endoscopic therapeutic approaches to WON are still heterogeneous among different centers and experts. A standardized protocol on indication, timing and technique of endoscopic necrosectomy is still lacking, and experts often adopt a strategy based on personal experience more than robust data from well-conducted studies. In this review, we will summarize the available evidence on endoscopic management of WON and will discuss some unanswered questions in this rapidly evolving field.

El uso indiscriminado de antibióticos ha generado un grave problema en la salud pública debido al aumento en la resistencia bacteriana. La producción por algunos gérmenes de betalactamasas tipo AmpC forma parte de los mecanismos de resistencia bacteriana; estas enzimas se caracterizan por ser activas frente a penicilinas, cefalosporinas y algunas combinaciones de antibióticos B-lactámicos más inhibidores. La primera línea de tratamiento de estos microorganismos han sido los carbapenémicos y en la actualidad se estudia la utilización de agentes alternativos como cefepime, piperacilina-tazobactam, entre otros. El objetivo de esta revisión narrativa es comentar los aspectos básicos relacionados a los gérmenes productores de betalactamasas tipo AmpC. Mediante una búsqueda bibliográfica amplia utilizando palabras claves, se realizó una descripción narrativa de los principales hallazgos. Este problema de salud continua en expansión y se constituye en una amenaza continua a la salud pública mundial.

Abstract Data on convalescent plasma (CP) treatment in COVID-19 outpatients are scarce. We aimed to assess whether CP administered during the first week of symptoms reduced the disease progression or risk of hospitalization of outpatients. Two multicenter, double-blind randomized trials (NCT04621123, NCT04589949) were merged with data pooling starting when

Abstract Background The close link between human resources for health and the performance of health systems calls for a comprehensive study of the labor market. This paper proposes a performance metric for the nursing labor market, measures its magnitude and analyzes its predictors over the last 15 years. Design and methods A repeated cross-sectional analysis using data from the quarterly population-based National Survey of Occupation and Employment 2005–2019 (ENOE in Spanish). An aggregate total of 19,311 Mexican nurses (population N = 4,816,930) was analyzed. Nursing labor market performance was defined as the level of non-precarious employment of nurses in the health sector. After describing the sociodemographic, labor and contextual characteristics of the nurses surveyed, we identified the key correlates of market performance using repeated cross-sectional multiple logistic regression analysis. We then estimated the adjusted prevalence of market performance according to the survey period and socioeconomic region of residence. Results The exogenous indicators analyzed shed light on various aspects of the market structure. Unemployment remained stable at 5% during the period examined, but underemployment rose by 26% and precarious employment, our endogenous indicator, also grew significantly. On the whole, our indicators revealed a notable deterioration in the structure of the nursing labor market; they varied by age and sex as well as between public and private institutions. Although the steepest deterioration occurred in the private sector, we observed an increase in precarious jobs among public institutions formerly protective of employment conditions. Conclusions The deterioration of the labor market jeopardizes the ability of nursing professionals to participate in the market as well as to obtain secure jobs once they do enter. The Mexican Health System suffers from a chronic dearth of nurses, reducing its capacity to achieve its core objectives including enhanced coverage and increased effectiveness. Nursing workforce planning requires a context where the conditions in which the market currently operates, and its potential deterioration are considered.

En la literatura académica existe la postura de que las regiones rurales e indígenas que expulsan mano de obra a regiones urbanas de mayor tamaño, tienden a generar procesos de desigualdad en el ingreso. A partir de esa premisa se han analizado las zonas rurales de Quintana Roo, México, si es que típicamente expulsan mano de obra a regiones como la Riviera Maya y la Costa Maya, se han comenzado a generar las brechas que se señalan en la teoría. Para ello, se analizaron los módulos de condiciones sociales de la Encuesta Nacional de Ingreso y Gasto 2000-2018 de los Hogares de México (ENIGH). Con dichos datos se estimó el coeficiente de Gini en hogares rurales y se trazó la curva de Lorenz para ilustrar los niveles de desigualdad y acumulación. Entre los resultados más importantes está el hecho de que los hogares rurales de Quintana Roo escapan a los postulados teóricos, puesto que en el período de estudio mostraron disminución leve de la desigualdad

Objetivo: evaluar el efecto preliminar del Aprendizaje Basado en Problemas en habilidades de Gestión del Cuidado. Método: cuasiexperimental pretest-postest, con alumnos de la carrera de Licenciatura en Enfermería de una institución educativa. Muestra de 29 alumnos (Grupo Experimental) y 74 (Grupo Control). El Grupo Experimental solucionó cuatro escenarios bajo el método de Aprendizaje Basado en Problemas con los 7 pasos propuestos por la Universidad de McMaster, en un programa de Gestión del Cuidado en modalidad a distancia. El instrumento autoinformado evaluó las habilidades de Gestión del Cuidado pretesty postesten ambos grupos. Se obtuvieron valores medios y se realizó estadística descriptiva e inferencial (t de Student, t pareada, regresión lineal). Resultados: el Grupo Experimental obtuvo puntuaciones más elevadas en habilidades analíticas, de acción y globales que el Grupo Control (p

Summary: Current COVID-19 vaccines have been associated with a decline in infection rates, prevention of severe disease, and a decrease in mortality rates. However, SARS-CoV-2 variants are continuously evolving, and development of new accessible COVID-19 vaccines is essential to mitigate the pandemic. Here, we present data on preclinical studies in mice of a receptor-binding domain (RBD)-based recombinant protein vaccine (PHH-1V) consisting of an RBD fusion heterodimer comprising the B.1.351 and B.1.1.7 SARS-CoV-2 variants formulated in SQBA adjuvant, an oil-in-water emulsion. A prime-boost immunisation with PHH-1V in BALB/c and K18-hACE2 mice induced a CD4+ and CD8+ T cell response and RBD-binding antibodies with neutralizing activity against several variants, and also showed a good tolerability profile. Significantly, RBD fusion heterodimer vaccination conferred 100% efficacy, preventing mortality in SARS-CoV-2 infected K18-hACE2 mice, but also reducing Beta, Delta and Omicron infection in lower respiratory airways. These findings demonstrate the feasibility of this recombinant vaccine strategy.

Plasmodium vivax is a public health problem and the most common type of malaria outside sub-Saharan Africa. The capacity of cytoadhesion, rosetting, and liver latent phase development could impact treatment and disease control. Although the ability to P. vivax gametocyte develop rosetting is known, it is not yet clear which role it plays during the infection and transmission process to the mosquito. Here, we used ex vivo approaches for evaluate the rosetting P. vivax gametocytes capacity and we have investigated the effect of this adhesive phenotype on the infection process in the vector Anopheles aquasalis mosquito. Rosette assays were performed in 107 isolates, and we have observed an elevated frequency of cytoadhesive phenomena (77,6%). The isolates with more than 10% of rosettes have presented a higher infection rate in Anopheles aquasalis (p=0.0252). Moreover, we found a positive correlation between the frequency of parasites in rosetting with the infection rate (p=0.0017) and intensity (p=0.0387) in the mosquito. The disruption of P. vivax rosette formation through mechanical rupture assay confirmed the previously findings, since the paired comparison showed that isolates with disrupted rosettes have a lower infection rate (p

Chile is amidst an unprecedented legal and institutional change since the restoration of democracy at the end of the 80’s, which is expected to affect fisheries governance. A global lead in marine resource landings, Chile implemented significant fisheries management reforms in the past decade. Yet, Chilean fisheries still face sustainability challenges. In this paper we reflect on the results of a survey carried out in 2019-2020 with key informants aimed to identify fisheries policy reform priorities in country. Addressing Illegal, unreported, and unregulated fishing; Developing a priority national research agenda to improve fisheries management in Chile; Addressing the lack of legitimacy of the fisheries law; Developing a new national fisheries policy; and Update the Artisanal Fisheries Registry were identified as priority topics by respondents.

Este estudo tem a finalidade de apontar algumas contribuições do Currículo Integrado e da Pedagogia da Alternância para a formação integral do sujeito na EFAN –Escola Família Agrícola de Natalândia – MG. Possibilita compreender as concepções de currículo, discorrer sobre o conceito de Currículo Integrado, caracterizar a Pedagogia da Alternância (PA) e analisar a relação do Currículo Integrado com a Pedagogia da Alternância. Refere-se a uma pesquisa descritiva, enquadrada na abordagem qualitativa. Quanto aos procedimentos, trata-se de uma revisão bibliográfica, através do levantamento de artigos e livros de renomados autores que discutem o currículo, o Currículo Integrado e a Pedagogia da Alternância. Além disso, analisam-se, também, as informações expressas no Projeto Político Pedagógico – PPP da EFAN acerca da temática ora pesquisada. Nesse sentido, é possível inferir que com a PA, utilizando-se de instrumentos pedagógicos que se têm à disposição,é possível realizar um trabalho com práticas do Currículo Integrado. É uma experiência bastante inovadora, na qual o estudante tem a possibilidade de integrar os estudos à vida social. Além disso, permite que o educando seja o protagonista do processo ensino-aprendizagem e busca a organização da educação, sobretudo a do campo, com o propósito da formação dos sujeitos de modo integral.