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OBJECTIVETo characterize in sera anti-myenteric autoantibody profiles and in tissues MMP-9 proteoforms towards the identification of possible autoantigenic proteins in the muscle of the lower esophageal sphincter (LES) of achalasia patients.METHODSBiopsies of the LES muscle from 36 achalasia patients, 6 esophagogastric junction outflow obstruction (EGJOO) patients, and 16 transplant donors (TD) were compared in a blind cross-sectional study. Histological characteristics such as inflammation, fibrosis, presence of ganglion cells, cells of Cajal, GAD65, PNMA2, S100, P substance, and MMP-9 proteforms in tissue were assessed by H&E and Picro-Sirius Red stainings, and immunohistochemistry analysis. Antineuronal antibodies (amphiphysin, CV2, and PNMA2 (Ma2/Ta)), onconeural antigens (Ri, Yo, and Hu), recoverin, SOX-1, titin, zic4, GAD65, and Tr (DNER) were evaluated by immunoblot/line assay.RESULTSTissue of achalasia patients had heterogeneous inflammatory infiltrates with fibrosis and contrasting higher levels of activated MMP-9 compared with EGJOO and TD. Moreover, lower ganglion cell percentages and cell of Cajal percentages were determined in esophageal tissues of achalasia patients vs. TD. In addition, tissue of achalasia patients had higher GAD65 and PNMA2 protein expression vs. EGJOO. Unexpectedly, these proteins were absent in TD tissue. S100 and P substance had similar expression levels in tissues of achalasia patients vs.TD and EGJOO. Most of the achalasia sera had anti-GAD65 (83%) and anti-PNMA2 (90%) autoantibodies vs. EGJOO (17% and 33%, respectively) and healthy volunteers (10% and 0%, respectively).CONCLUSIONTissue-specific ectopic expression of GAD65 and PNMA/Ta2 and active MMP-9, associated with the presence of specific autoantibodies directed against these proteins, might participate in the pathophysiology of achalasia triggering and/or perpetuating autoimmune disease.WHAT YOU NEED TO KNOW?BACKGROUND AND CONTEXTAchalasia is a primary esophageal motility disorder associated with a selective loss of inhibitory neurons in the myenteric esophageal plexus.An inflammatory/autoimmune response seems involved in pathophysiology.NEW FINDINGSMost of the achalasia sera have anti-GAD65 and anti-PNMA2 autoantibodies vs. EGJOO and healthy volunteers.Esophageal tissues of achalasia patients have higher ectopic GAD65 and PNMA2 protein expression vs. EGJOO. These proteins are absent in healthy donors with non-inflamed muscle of the LES.Activated MMP-9 is detected in situ together with GAD65 and PNMA2 substrates.LIMITATIONSBy its design, our study does not shed light on the mechanisms that induce the ectopic expression of the GAD65 and PNMA/Ta2 proteins in LES muscle tissue. It remains impossible to firmly state the sequence of events, e.g. whether the expression of ectopic antigens is due to tissue destruction or the presence of autoantibodies. Whether serum autoantibodies react with autoantigens of the LES muscle tissue of the patients with achalasia also remains unknown.IMPACTThis information yields new insights into pathophysiological mechanisms of achalasia for better disease understanding and possible design of novel therapeutic strategies.LAY SUMMARYMost of the achalasia sera have anti-GAD65 and anti-PNMA2. Esophageal tissues of achalasia patients have ectopic GAD65 and PNMA2. This information yields new insights into pathophysiological mechanisms of achalasia for better disease understanding.

BACKGROUNDCurrently, therapeutic options for ambulatory COVID-19 patients are limited.OBJECTIVETo evaluate the safety, efficacy and effect of the intramuscular administration of polymerized type I collagen (PTIC) on hyperinflammation, oxygen saturation and symptom improvement in adult outpatients with symptomatic COVID-19.DESIGNDouble-blind, randomised, placebo-controlled clinical trial of PTIC vs placebo.SETTINGSingle Third-level hospital in Mexico City (Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán)PARTICIPANTSEighty-nine adult participants with a confirmed COVID-19 diagnosis and symptom onset within the 7 days preceding recruitment were included from August 31, 2020 to November 7, 2020 and followed for 12 weeks. Final date of follow-up was February 4, 2021.INTERVENTIONSPatients were randomly assigned to receive either 1.5 ml of PTIC intramuscularly every 12 h for 3 days and then every 24 h for 4 days (n=45), or matching placebo (n=44).MAIN OUTCOMES AND MEASURESThe primary outcome was a mean reduction of at least 50% in the level of IP-10 compared to baseline. The secondary outcomes were mean oxygen saturation ≥92% while breathing ambient air and duration of symptoms.RESULTSOf 89 patients who were randomised, 87 (97.8%) were included in an intention-to-treat analysis; 37 (41.6%) were male and mean age was 48.5±14.0 years. The IP-10 levels decreased 75% in the PTIC group and 40% in the placebo group vs baseline. The comparison between treatment vs placebo was also statistically significant (P=0.0047). The IL-8 (44%, P=0.045), M-CSF (25%, P=0.041) and IL-1Ra (36%, P=0.05) levels were also decreased in the PTIC group vs baseline. Mean oxygen saturation ≥92% was achieved by 40/44 (90%), 41/42 (98%) and 40/40 (100%) of participants that received PTIC at 8, 15 and 97 days of follow-up vs 29/43 (67%), 31/39 (80%) and 33/37 (89%) of patients treated with placebo (P=0.001). The unadjusted accelerated failure time model showed that patients treated with PTIC achieved the primary outcome 2.70-fold faster (PPCONCLUSIONSIn this study, treatment with PTIC down-regulated IP-10, IL-8, M-CSF and IL-Ra levels, which could explain the PTIC effect on the higher proportion of patients with mean oxygen saturation readings ≥92% and a shorter duration of symptoms as compared to patients treated with placebo. Although results are encouraging, larger randomised trials are needed.TRIAL REGISTRATIONClinicalTrials.gov Identifier: NCT04517162

Laparoscopic Adjustable Gastric Banding (LAGB) is a common surgery method used to help obese patients to lose weight. However, even if LAGB is able to produce a durable and relevant weight loss, it is less effective in improving body image: as demonstrated by a recent study, obese patients with a body image disorder in the pre-operative stage continue to show this even 13 months after the operation. In this presentation we will discuss the possible role of virtual reality (VR) in addressing this problem within an integrated cognitive behavioral approach. To test this approach, a case series of three LAGB patient who experienced body dissatisfaction even after a >30/40% excess body weight loss, is presented and discussed. At the end of the 6-week protocol the patients experienced a 15%-20% further reduction of their weight. This reduction was also matched by a general improvement of the psychological state. Both the weight loss and the level of well-being were further improved after a three-month follow-up. © 2014 The authors and IOS Press. All rights reserved.

Thin films of Er3+-doped gallium lanthanum sulfide (GLS) glass were prepared by RF magnetron sputtering onto fused silica and BK7 glass substrates. The films were characterized by use of SEM imaging, X-ray diffractometry, and energy dispersive spectroscopy. They are shown to be glassy, uniform in composition, and to exhibit an RMS surface roughness of 4I11/2 to 4I13/2 and 4I13/2 to 4I15/2 transitions of Er3+ were measured at each processing stage.

La formación de los periodistas del siglo XXI en la era digital se concibe como un reto y el mayor desafío. Los medios digitales demandan especialización y dominio de las nuevas tecnologías. Las universidades, principales gestores de este cambio, en la sociedad del conocimiento, requieren trabajar en la reformulación de nuevos pensum y en tres terrenos fundamentales: el perfil del egresado, el estilo pedagógico y el nuevo modo de relacionarse con el mundo exterior. Se necesita de una oferta académica referida al ciberperiodismo y a la cibercomunicación. La profesión periodística, y específicamente la formación de los comunicadores registra cambios importantes debido a las nuevas tecnologías, ahora el aula es el mundo globalizado e interconectado por la gran autopista de la información, por ello, la formación del comunicador social, demanda renovadas prácticas educativas. Las universidades deben repensar el papel que están obligadas a desempeñar, reformular los pensum académicos y ofertar la cibercomunicación y el ciberperiodismo para estar al día de las grandes transformaciones.

El nuevo siglo ha traído aparejadas una serie de realidades e innovaciones que conmueven día a día a toda la sociedad. Usos y costumbres, por igual, están sujetos a revisión e, indudablemente, ha dejado de ser un lugar común aquella afirmación de que si nuestras abuelos volverían a la vida, inmediatamente dejarían de existir ante la magnitud del cambio que se opera a cada momento.

ÍNDICE Presentación Presentation. Rengifo, Diana Economía/Economy: La agenda y condiciones para el desarrollo local. Un caso de estudio: Asentamiento San Benito. The agenda and conditions for local development, a case study: Establishment San Benito. García Lobo, Ligia; Dugarte de Viloria, Alba E. La empresa contemporánea emergente y el desarrollo local. The emergent contemporary enterprise and the sustainable local development. Araujo Lobo, Alice Educación/Education: Lo tengo a pata de mingo (El burro de San Pablo). It is just right there (San Pablo’s donkey). Portillo Parody, Jairo Una explicación histórica sobre la influencia de la concepción descriptiva en la enseñanza geográfica. A historical explicacion on the descriptive concepcion's influence in the geographical teaching. Santiago Rivera, José Armando Filosofía/Philosophy: Racionalidad y ecología en la modernidad. Rationality and ecology in the modernity. Sánchez Pirela, Beatriz Wagensberg, el azar y la complejidad: Implicaciones y aplicaciones en el ámbito educativo. Wagensberg, the chance and the complexity: Implications and applications in the educational environment. Delmastro, Ana Lucía; Vílchez, Mayela; Villalobos G., Fernando Sociohistoria/Sociohistory: Centros poblados, sistemas de transporte y adscrición político-territorial de la planicie del motatán - Lago de Maracaibo a través del análisis cartográfico - histórico, 1810-1997. Human settlements, transport systems and political territorial of the motatan lowland-Maracaibo’s Lake, through a cartograhical -historical analysis 1810-1997. Roa, José Gregorio Ensayos/Essays: ¿Cuál tierra es mi tierra? Construcción de identidades en tiempos de globalización. Which earth is my earth? Construction of dentities in times of globalization. Crespo, Francisco Reseña de libros y revistas/Review of books and magazines: Valles, Miguel: Técnicas cualitativas de investigación social. Reflexión metodológica y práctica profesional (2003). Reseñado por: Delgado de Colmenares, Flor Utopia y praxis latinoamericana. Año 9, Nº 25. Abril-junio 2004. Revista geográfica venezolana. Vol 45(1) 2004. Cuestiones políticas. Nº 32, enero-junio 2004. Revista de pedagogía. Vol XXIV, Nº 69, enero-abril 2003. Gaceta laboral. Vol 10, Nº 1, enero-abril 2004. FERMENTUM, Año 13, Nº 38, septiembre-diciembre 2004. Información Institucional. Institutional Information. 103-122 aldelmastro@yahoo.com mayelavilchez@cantv.net fvillalo@cantv.net semestral Nivel analítico