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Endoscopic retrograde cholangiopancreatography (ERCP) is the treatment of choice for symptomatic choledocholithiasis during pregnancy. In pregnant patients, aside from the risks inherent in the procedure and sedation, there is the added concern of the potentially damaging effects of ionizing radiation on the fetus.

La colangiopancreatografía retrógrada endoscópica (CPRE) es el tratamiento de elección para la coledocolitiasis sintomática durante el embarazo. Además de los riesgos inherentes al procedimiento y a la sedación, en pacientes embarazadas se agrega la preocupación por los potenciales efectos dañinos que la radiación ionizante pudiera tener sobre el feto.

So far, available evidence suggests that patients with inflammatory bowel disease (IBD) are not at greater risk for developing COVID-19 infection. In regard to patients with IBD remission: 5-aminosalycylates (5-ASAs) do not increase the risk for infection and should be continued. There is no need to suspend them or lower the dose. Immunomodulating drugs, such as thiopurines and methotrexate, should be continued, without modifying doses (even in patients with positive SARS-CoV-2 infection). No type of biologic therapy should be suspended, unless there are signs of COVID-19. Regarding patients with IBD activity: the oral and/or topical 5-ASA dose should be optimized in cases of disease relapse. Budesonide MMX should be considered in cases of mild-to-moderate activity, to avoid systemic steroid use. Systemic steroids should be avoided whenever possible because doses above 20 mg per day have an immunosuppressive effect, which could increase susceptibility to any type of infection, including COVID-19. The combined use of thiopurines with steroids and/or tumor necrosis factor (TNF) monoclonal antibodies should also be avoided because those combinations can increase the risk for infections, including COVID-19. Finally, biologic treatment with anti-TNF-alpha agents or any other mechanism of action, such as anti-integrins or anti-interleukins, should be suspended if patients become infected with SARS-CoV-2. The drugs can be restarted once the infectious process is resolved.

Hasta este momento, la evidencia disponible sugiere que los pacientes con enfermedad inflamatoria intestinal (EII) no tienen un mayor riesgo de desarrollar COVID-19. En pacientes con remisión de la EII: los 5-aminosalicilatos (5-ASA) no incrementan el riesgo de infección y se deben continuar sin necesidad de suspenderlos o disminuir la dosis; los fármacos inmunomoduladores como las tiopurinas y metotrexato deben continuarse sin modificar las dosis (a considerar en el paciente con infección por SARS-CoV-2 positiva); y en relación con cualquier tipo de terapia biológica, no deberá suspenderse a menos que existan datos de COVID-19. En aquellos pacientes con actividad de la EII: se deberá optimizar la dosis de 5-ASA en administración oral y/o tópica en caso de recaída de la enfermedad; considerar el uso de budesonida MMX en casos de actividad leve a moderada con el fin de evitar el uso de esteroides sistémicos; los esteroides sistémicos deben evitarse en la medida de lo posible, ya que dosis mayores de 20mg al día ejercen un efecto inmunosupresor el cual pudiera aumentar la susceptibilidad a cualquier tipo de infección, incluyendo COVID-19; evitar el uso combinado de tiopurinas con esteroides y/o agentes anti-TNF ya que puede incrementar el riesgo de infecciones, incluyendo COVID-19; y finalmente, el tratamiento biológico con agentes en contra del factor de necrosis tumoral alfa (anti-TNF alfa) o de cualquier otro mecanismo de acción como antiintegrinas o antiinterleucinas deberán suspenderse en caso de documentarse infección por SARS-CoV-2 y podrán reiniciarse en cuanto haya cedido el proceso infeccioso.

A fundamental experimental study was conducted to understand the physical phenomena resulting from the dynamic instability of carbon/epoxy composite tubes in an underwater pressurized tubular confining environment. The confining nature of the environment limits the potential energy available to drive instability, resulting in a decrease in hydrostatic pressure with the onset of instability and allowing the carbon/epoxy composite tubes to recover. Unsupported tube length and tube diameter were varied in order to determine the effect of tube geometry on the failure mechanisms of the tube and pressure waves emitted throughout the confining chamber during the instability event. High-speed photography coupled with Digital Image Correlation techniques were employed alongside the acquisition of pressure-history data from each experiment to relate specimen displacement behavior to resulting pressure pulses. Tubes of 55 mm diameter experienced partial implosion, in which the walls of the specimen oscillated radially with no wall contact. This resulted in pressure oscillations of the same frequency throughout the confining chamber, with oscillations increasing in amplitude with distance from the axial center. Amplitude of pressure and radial structural oscillations were found to be dependent on pressure just prior to instability. Tubes of 35 mm diameter experienced full implosion, which resulted in water-hammer pressure spikes at the ends of the confining chamber due to the formation and subsequent collapse of large cavitation bubbles. Longer tubes were observed to undergo significantly more damage during full implosion, reducing their ability to recover radially and thus effectively reducing the strength of hammer pulses.

Phenotypic changes in plants can be observed along many environmental gradients and are determined by both environmental and genetic factors. The identification of alleles associated with phenotypic variations is a rapidly developing area of research. We studied the genetic basis of phenotypic variations in 11 populations of wild pearl millet (Pennisetum glaucum) on two North-South aridity gradients, one in Niger and one in Mali. Most of the 11 phenotypic traits assessed in a common garden experiment varied between the populations studied. Moreover, the size of the inflorescence, the number of flowers and aboveground dry mass co-varied positively with a decrease in rainfall. To decipher the genetic basis of these phenotypes, we used an association mapping strategy with a mixed model. We found two SNPs on the same myosin XI contig significantly associated with variations in the average number of flowers. Both the allele frequency of the two SNPs and the average number of flowers co-varied with the rainfall gradient on the two gradients. Interestingly, this gene was also a target of selection during domestication. The Myosin XI gene is thus a good candidate for fitness-related adaptation in wild populations.

Se describe el caso de un paciente masculino de 32 años de edad, quien consulta al servicio de urgencias con historia clínica del síndrome de la vena cava superior, en el estudio de la angiotomografía pulmonar, se demuestra embolismo pulmonar izquierdo, trombosis de la vena yugular interna derecha y confluente yugulo subclavio. No hay evidencia de asociación con neoplasia, infecciones o enfermedades del tejido conectivo, siendo el único factor de riesgo asociado para la trombosis, hiperviscocidad (tríada de virchow) por poliglobulia.

•Venezuelan women and girls face HIV risks of infection and threats of violence before, during and after migration.•There is a lack of evidence on barriers and facilitators to HIV prevention and care amidst a growing epidemic in Colombia.•Main barriers to HIV services relate to discrimination, GBV, rigid gender norms, lack of information and system fragmentation.•Policies ought to integrate community-based networks and support intersectoral work to adequately address HIV risks for women.•To decrease barriers related to GBV, programs ought to include social support resources (housing, education, childcare, jobs).

The Poem "Four Snakes Makes Our Flag" by C. T. Salazar is presented. First Line: + sparrows spring sometimes the resurrection; Last Line: they don't wake the frigate birds gliding in their sleep.

The Poem "Four Snakes Makes Our Flag" by C. T. Salazar is presented. First Line: cast iron and lo cast your sunlight low; Last Line: -first I've crawled in under overcast.

The poem "FOUR SNAKES MAKES OUR FLAG" by C.T. Salazar is presented. First Line: Your father sleeping. The beautiful bull; Last Line: the deer that was watching you darted away.

Comparar el efecto de 2 métodos de electroestimulación en las siguientes variables: fuerza y antropometría.

The existence of seasonal variability in patients with acute pulmonary embolism (PE) has been debated for years, with contradictory results. The aim of this study was to identify the trend and possible existence of a seasonal pattern in hospitalizations for PE in Spain.

The poem "FOUR SNAKES MAKES OUR FLAG" by C. T. Salazar is presented. First Line: the floorboards creak and I love; Last Line: something about time and the God who thought it was a gift.

The poem "FOUR SNAKES MAKES OUR FLAG" by C. T. Salazar is presented. First Line: Embellish this if you must; Last Line: broken like shards of terracotta.

The poem "FOUR SNAKES MAKES OUR FLAG" by C. T. Salazar is presented. First Line: I'm still learning this language forgive me; Last Line: rocket chased by the flame of the lord.

The mechanical and dielectric relaxation phenomena in PEN‐films have been studied using fractional models. A mechanical fractional model for the description of dynamic modulus, E* = E′ + iE″, and a dielectric fractional model for the dynamic relative permittivity, ɛr* = ɛr′ − iɛr″. These models takes into account three relaxation phenomena and the corresponding differential equations have derivatives of fractional order between 0 and 1. In applying the Fourier transform to fractional differential equations and in considering that each relaxation mode is associated to cooperative or noncooperative molecular movements, we calculated E*(iω,T) and ɛr*(iω,T). The isochronal diagrams of the real and imaginary parts of either E* and εr* obtained from fractional models have been used to study the three relaxation phenomena (α, β*, and β) of poly(ethylene‐2,6‐napthalene dicarboxylate). An agreement between experiments and fractional models has been achieved for both mechanical and dielectric relaxation phenomena, and the effect of morphology samples on the fractional order parameters of the Fractional Models are related to molecular motions associated to α, β*, and β relaxations. © 2006 Wiley Periodicals, Inc. J Appl Polym Sci 102:3354–3368, 2006

OBJECTIVE: The purpose of this work is to present our endoscopic neuroanatomical findings of a series of myelomeningocele and hydrocephalus patients, treated with endoscopic third ventricular cisternostomy (ETVC), in order to describe ventricular configuration abnormalities in this group of patients, in which this neurosurgical procedure has limited performance. METHOD: We checked the videos of 10 endoscopic third ventricular cisternostomies of myelomeningocele patients taken during 24 months as from December 1998. A previous guideline is designed to record anatomic variables in the lateral ventricles, IIIrd ventricle, and basal cisterns. The topic is analyzed in view of the necropsy and imaging background data. RESULTS: The ETVC of lateral ventricles showed: absence of septum (9/10); absence of anteroseptal vein (8/10); absence of choroid plexus and thalamostriate vein (0/10); absence of fornix (1/10): small foramen of Monro (4/10). The ETVC of the IIIrd ventricle showed: impossibility of recognizing any mammillary bodies (4/10); presence of septations (5/10); presence of atypical veins in the floor (6/10); translucent floor (5/10); floor umbilications (5/10); absence of infundibulum (4/10); arachnoid adherences (7/10); and visual contact of basilar artery (4/10). CONCLUSION: There are categorical structural alterations in the ventricular system of myelomeningocele patients that are well correlated with previous necropsy and imaging reports. The ventricular system of dysraphic children presents severe anatomic alterations, which alter the reference points of the classical endoscopic third ventricular cisternostomy.

A model based on the concept of fractional calculus is proposed for the description of the relative complex permittivity (ɛ*r = ɛ′r − iɛ′r, where ɛ′r and ɛ″r are the real and imaginary parts of ɛ*r) in polymeric materials. This model takes into account three dielectric relaxation phenomena. The differential equations obtained for this model have derivatives of fractional order between 0 and 1. Applying the Fourier transform to fractional differential equations and considering that each relaxation mode is associated with cooperative or noncooperative movements, we have calculated ɛ*r(iω,T) (where ω is the angular frequency and T is the temperature). The isothermal and isochronal diagrams obtained from the proposed model of ɛ′r and ɛ″r clearly show three dielectric relaxation phenomena; in the isochronal case, each relaxation mode manifests by an increase in ɛ′r with increasing temperature, and this behavior is associated with a peak of ɛ″r(T) in each case. The model is matched with the experimental data on poly(ethylene naphthalene 2,6‐dicarboxylate) (PEN) to justify its validity. Poly(ethylene 2, 6–naphthalene dicarboxylate) (PEN) is a semicrystalline polymer that displays three dielectric relaxation processes: β, β*, and α. © 2005 Wiley Periodicals, Inc. J Appl Polym Sci 98: 923–935, 2005

No Heading The effect of flux-line cutting upon the magnetic behavior of hard superconductors subjected to a dc bias magnetic field Hz and a transverse field Hy undergoing half-wave oscillations of large amplitude is investigated theoretically. We have applied both the generalized double critical-state model and the elliptic flux-line-cutting one to interpret available experimental results for VTi ribbons. The predictions of these models are compared and discussed.

The effect of flux-line cutting upon the magnetic behavior of hard superconductors subjected to a dc bias magnetic field Hzand a transverse field Hyundergoing half-wave oscillations of large amplitude is investigated theoretically. We have applied both the generalized double critical-state model and the elliptic flux-line-cutting one to interpret available experimental results for VTi ribbons. The predictions of these models are compared and discussed.

A model based on the concept of fractional calculus is proposed for the description of the dynamic elastic modulus, E* = E′ + iE″, of polymer materials. This model takes into account three relaxation phenomena (α, β, and γ) under isochronal conditions. The differential equations obtained for this model have derivatives of fractional order between 0 and 1. Applying the Fourier transform to the fractional differential equations and associating each relaxation mode to cooperative or noncooperative movements, E*(iω,T) was evaluated. The isochronal diagrams of E′ and E″ clearly show three relaxation phenomena, each of them is manifested by a decrease of E′ when temperature increases. This decrease is associated with a maximum in E″(T) diagram for each relaxation mode. The shape of the three peaks (three maxima in E″(T) diagrams) depends of the fractional orders of this new fractional model. The mathematical description obtained of E* corresponds to a nonexponential relaxation behavior often encountered in the dynamics of polymer systems having three relaxation phenomena. This model will enable us to analyze the viscoelastic behavior of polymers. © 2004 Wiley Periodicals, Inc. J Appl Polym Sci 94: 657–670, 2004

In assisted reproduction, hepatitis C virus (HCV) transmission may pose a risk for the baby, technicians, and gametes or embryos from non-contaminated parents. This study aimed at determining the prevalence and risk factors for HCV infection in a group of infertile couples.

Arbutus unedo L. communities in the southern part of the Iberian Peninsula (Spain and Portugal) were studied, highlighting the differences regarding their floristic composition, biological diversity and plant dynamics according to the dominant geological substratum. Firstly, this type of formation on the little-known decarbonated calcareous substrata was analysed using classification techniques. Later, they were compared to the remaining phytocoenoses in the southern part of the Iberian Peninsula using an ordination analysis. As a result, a new suballiance is proposed together with two plant associations, which will enable us to characterize the strawberry tree groves growing on carbonated substrata and those already proposed for siliceous substrata are confirmed.

A study of south-eastern Iberian plant communities where Lygeum spartumL. appears has been carried out, considering the chorological units Castellano-Maestrazgo-Manchega province (Manchego sector), Baetic province and Murciano-Almeriense province. This kind of vegetation develops in areas where thermotypes range from thermomediterranean to mesomediterranean while ombrotypes oscillate from semi-arid to dry. In the south-eastern Iberian Peninsula, 12 phytosociological associations include L. spartumto a greater or lesser extent. The new association Limonio quesadensis–Lygeetum spartiGarcı́a-Fuentes novafor the Hispalense sector (Baetic province) and the subassociation Limonio delicatuli-Gypsophiletum tomentosae limonietosum majiSalazar novaendemic to the Guadiciano-Bastetano district (Guadiciano-Bacense sector, Baetic province) are also proposed.