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Immunoglobulin G4-related disease (IgG4-RD) is a rare fibroinflammatory immune-mediated condition which can affect multiple organ systems and form mass-like lesions. Initial presentation can mimic other diseases such as pancreatic malignancy when there is pancreatic involvement or tuberculosis (TB) when there are pulmonary lesions or hypertrophic pachymeningitis (HP). Here, we report a novel case of IgG4-RD presenting as bilateral subdural haematomas with additional findings. Our patient is a male who presented with headaches and blurred vision. Physical examination showed disconjugate gaze with a fixed pupil. Trauma survey radiologic imaging revealed a pancreatic mass concerning for malignancy. Subsequent workup found hypophysitis with optic chiasm compression and hypopituitarism, mediastinal lymphadenopathy and HP. Laboratory values showed an elevated serum IgG4 level and latent TB. Our case adds to the existing IgG4-RD literature by highlighting a unique presentation. It is important to maintain it on the differential diagnosis especially in multisystemic presentations with competing diagnoses.

The gastrointestinal tract provides the biological environment for nutrient digestion and absorption. Its physical and chemical barriers are crucial to protect from invading pathogens and toxic substances. On this basis, the intactness of the gastrointestinal tract, with its multiple functions and impacts, is one of the key prerequisites for human and animal health. Undoubtedly, the functions of a healthy gut system also largely benefit the welfare and performance of animals in farming systems such as poultry industries. Broiler chickens grow rapidly, as a result of rigorous genetic programs, due to the high absorption capacity of intestinal epithelia for nutrients, the quick transport of nutrients to the muscle, and their efficient conversion into energy and biomass. Due to oxygen metabolism or enteric commensal bacteria, intestinal epithelial cells create reactive oxygen and nitrogen species physiologically. However, increased generation of these oxidants goes along with the formation of free radicals resulting in oxidative stress causing lipid peroxidation and dramatic molecular changes in the structure and function of the cell and mitochondrial membranes. These effects contribute to chronic oxidative stress and inflammation of the gastrointestinal tract and generally affect all chicken organs, tissues, and cells. Hence, all forms of chronic stress, regardless of the origin, negatively impact the chicken's overall performance, health, and welfare. This review article highlights some enteric inflammation models and biomarkers to evaluate gut integrity in chickens and discusses the repercussions that chronic stress and intestinal inflammation have on the health and performance of commercial poultry

Entrepreneurship in small towns presents both opportunities and challenges that are unique to rural areas. Small towns have their own character and offer a distinct market that can be leveraged for business ventures. The benefits of entrepreneurship in small towns include the potential for job creation, increased economic activity, and enhanced local identity. However, the challenges of entrepreneurship in small towns can be significant, including limited access to resources, a small customer base, and a lack of infrastructure and networking opportunities. One significant challenge for entrepreneurs in small towns is access to resources, such as financing, business services, and skilled labor. Many small towns have limited access to capital, and entrepreneurs may need to rely on personal savings or creative funding sources to launch and grow their businesses. Another challenge is the limited customer base, which may require creative marketing strategies to reach a wider audience. Infrastructure challenges, such as limited access to high-speed internet, can also pose barriers to entrepreneurship. Despite these challenges, entrepreneurship in small towns can be successful with the right support and strategies. Government support, including tax incentives and funding for small business development, can help entrepreneurs overcome some of the challenges of operating in rural areas. Building social capital through networking and community involvement can also help entrepreneurs access resources and gain support. Finally, a focus on innovation and adapting to changing markets can help entrepreneurs capitalize on new opportunities and sustain growth in small towns.

Background: Fibrinogen plays an essential role in blood coagulation and inflammation. Circulating fibrinogen levels may be determined based on interindividual differences in DNA methylation at cytosine-phosphate-guanine (CpG) sites and vice versa. Objectives: To perform an EWAS to examine an association between blood DNA methylation levels and circulating fibrinogen levels to better understand its biological and pathophysiological actions. Methods: We performed an epigenome-wide association study of circulating fibrinogen levels in 18 037 White, Black, American Indian, and Hispanic participants, representing 14 studies from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium. Circulating leukocyte DNA methylation was measured using the Illumina 450K array in 12 904 participants and using the EPIC array in 5133 participants. In each study, an epigenome-wide association study of fibrinogen was performed using linear mixed models adjusted for potential confounders. Study-specific results were combined using array-specific meta-analysis, followed by cross-replication of epigenome-wide significant associations. We compared models with and without CRP adjustment to examine the role of inflammation. Results: We identified 208 and 87 significant CpG sites associated with fibrinogen levels from the 450K (p < 1.03 × 10−7) and EPIC arrays (p < 5.78 × 10−8), respectively. There were 78 associations from the 450K array that replicated in the EPIC array and 26 vice versa. After accounting for overlapping sites, there were 83 replicated CpG sites located in 61 loci, of which only 4 have been previously reported for fibrinogen. The examples of genes located near these CpG sites were SOCS3 and AIM2, which are involved in inflammatory pathways. The associations of all 83 replicated CpG sites were attenuated after CRP adjustment, although many remained significant. Conclusion: We identified 83 CpG sites associated with circulating fibrinogen levels. These associations are partially driven by inflammatory pathways shared by both fibrinogen and CRP.

Background: Perioperative atrial fibrillation (AF) and myocardial injury after noncardiac surgery (MINS) are common complications after noncardiac surgery. Inflammation has been implicated in the pathogenesis of both disorders. The COP-AF trial tests the hypothesis that colchicine reduces the incidence of perioperative AF and MINS in patients undergoing major noncardiac thoracic surgery. Design: The 'COlchicine for the Prevention of Perioperative Atrial Fibrillation' (COP-AF) trial is an international, blinded, randomized trial that compares colchicine to placebo in patients aged at least 55 years and undergoing major noncardiac thoracic surgery with general anesthesia. Exclusion criteria include a history of AF and a contraindication to colchicine (e.g., severe renal dysfunction). Oral colchicine at a dose of 0.5 mg or matching placebo is given within 4 hours before surgery. Thereafter, patients receive colchicine 0.5 mg or placebo twice daily for a total of 10 days. The two independent co-primary outcomes are clinically important perioperative AF (including atrial flutter) and MINS during 14 days of follow-up. The main safety outcomes are sepsis or infection and non-infectious diarrhea. We aim to enroll 3,200 patients from approximately 40 sites across 11 countries to have at least 80% power for the independent evaluation of the two co-primary outcomes. Summary: COP-AF is a large randomized and blinded trial designed to determine whether colchicine reduces the risk of perioperative AF or MINS in patients who have major noncardiac thoracic surgery. Population Health Research Institute

Introducción: La resistencia bacteriana es una problemática multifactorial, donde otros escenarios diferentes al hospitalario han cobrado gran importancia. Objetivo: Determinar la presencia de bacilos Gram negativos resistentes a betalactámicos de importancia clínica en aguas residuales de un hospital de alta complejidad de la ciudad de Medellín, Antioquia. Materiales y métodos: Estudio descriptivo de corte transversal. Entre noviembre y diciembre de 2018 se realizaron dos muestreos en dos efluentes de agua residual de un hospital de alta complejidad. Las bacterias fueron aisladas empleando medios cromogénicos y posteriormente se realizó caracterización molecular de betalactamasas empleando PCR. La identificación bacteriana y la susceptibilidad se llevaron a cabo por métodos automatizados. Resultados: Noventa aislados fueron obtenidos, de los cuales el 78,90% (n=71) portaban al menos un gen que codificaba para BLEE ó penicilinasas; y el 78,90% (n=71) al menos un gen para carbapenemasas. Citrobacter freundii fue la bacteria predominante (30% n=12), seguida de Klebsiella pneumoniae (25% n=10). En todos los aislados seleccionados se encontró Multidrogorresistencia (MDR) (100% n=40). Conclusión: La alta presencia de bacterias resistentes a betalactámicos en aguas residuales hospitalarias evidencia la necesidad de implementar estrategias de manejo de estos desechos, dado el riesgo potencial para la transmisión y diseminación de bacterias resistentes.

The Sycamore Formation at the Sho-Vel-Tum Field primarily consists of clay-rich mudstones (Mdst) and quartz-rich siltstones. The clay-rich Mdst are mainly composed of clays, quartz grains, some allochems, and detrital organic matter. The siltstones are structureless and are divided into two petrofacies: high porosity and permeability massive calcareous siltstones and low porosity and permeability massive calcite-cemented siltstones. Core and well-log data provide mineralogical, lithologic, and porosity information that is useful to define petrophysical facies (petrofacies) and to create facies logs within the Sycamore Formation. We used the data to establish the Sycamore Formation stratigraphic architecture and to map its spatial variability and reservoir properties. To classify the Sycamore Formation petrofacies in noncored wells, we developed a machine learning-based workflow that compares more than 1800 classification models and selects the best combination of well logs, algorithms, and hyperparameters to predict defined petrofacies. The process includes combinations of well logs that were optimized in four classification algorithms: artificial neural network, K-nearest neighbor, support vector machine, and random forest. To adjust each classifier, we used a grid search and a fivefold cross validation to find the best combination of three hyperparameters to improve results of each algorithm. This workflow allows for the efficient extraction of information from cores at a low cost. After we generated the petrofacies logs in noncored wells, we combined them with multiple constraints to create a 3D petrofacies model for the Sycamore Formation at the Sho-Vel-Tum Field and analyze the stratigraphic and diagenetic controls on petrofacies and its impact in reservoir quality.

El proceso educativo en el mundo sufrió un cambio vertiginoso debido a la pandemia provocada por el Virus SARS-COV2 que produce la enfermedad COVID 19. Ante la emergencia sanitaria, México implementó específicamente la educación a distancia como una alternativa para atender a estudiantes de todos los niveles educativos. Este estudio se realizó con una población de 28 estudiantes de una escuela secundaria pública en Puebla, México. La investigación demostró que la gamificación mediante Quizizz es una herramienta que puede ser utilizada como recurso didáctico asíncrono con el objetivo de verificar la comprensión de los temas estudiados con los estudiantes. Por lo tanto, el enfoque de este estudio es un método mixto que utiliza dos formularios en los formularios de Google Doc como instrumentos. En consecuencia, el estudio se realizó durante un mes (febrero a marzo de 2021) se implementó el uso de gráficos, videos y páginas de internet para la comprensión y verificación de la comprensión de las terminaciones en inglés. de los verbos (ied, ed y d). Por lo tanto, se concluye que la gamificación, el uso de Quizizz asincrónico y el uso de gráficos pueden ser recursos didácticos y digitales para los profesores de inglés.

Introduction: The purpose of this study is to assess the evolution of motor coordination deficits in upper limbs in children with cerebral palsy (CP). Methods: This is a narrative review of studies monitoring the PRISMA guidelines that were followed during the design, research, and reporting. Results: The articles were screened by reading the titles and abstracts or full articles. This process resulted in a total of 11 studies that met the selection criteria and were therefore included in the narrative review and considered eligible for quality assessment through the MINORS scale, NIH quality assessment tool for Observational Cohort and Cross-Sectional Studies and CASP checklist. Conclusion: Factors that include body structures and functions, time and age of the child, the relationship between factors, and assessment tools can influence the assessment and presentation of upper limb coordination in children with CP. High level research that focuses on interventions that address the factors found in this review are warranted. Keywords: cerebral palsy, children, upper extremity.

Cabe destacar que hubo una revolución completa en la educación y un cambio de paradigmas como la enseñanza remota de emergencia. A nivel mundial, las escuelas cerraron las puertas e implementaron la enseñanza remota de emergencia. Sin embargo, las barreras y la adaptación en la educación se han hecho evidentes en varios países, incluido México. Este estudio de investigación de métodos mixtos fue una forma de analizar el uso de Braille en el aula de inglés. Por lo tanto, el presente estudio es una investigación de métodos mixtos que utiliza dos formularios de Google Doc para recopilar datos cuantitativos y narraciones escritas, los datos cualitativos, como instrumentos de investigación. Específicamente, debido a la pandemia de Covid-19, el estudio se realizó de manera virtual durante los meses de noviembre-diciembre (2020), febrero y marzo (2021). Los hallazgos de este estudio mostraron una aceptación del uso de Braille en el aula de inglés. El objetivo de este estudio es comprender cómo los estudiantes de secundaria perciben el uso de un convertidor Braille como técnica didáctica para mejorar su aprendizaje de idiomas en un entorno de aprendizaje virtual.

Despite the importance of simulation-based training for robotic surgery, there is no consensus about its training curricula. Recently, a virtual reality (VR) platform (SimNow, Intuitive, Inc) was introduced with 33 VR drills but without evidence of their validity. As part of our creating a new robotic VR curriculum, we assessed the drills' validity through content mapping and the alignment between learning goals and drill content.Three robotically trained surgeons content-mapped all 33 drills for how well the drills incorporated 15 surgery skills and also rated the drills' difficulty, usefulness, relevance, and uniqueness. Drills were added to the new curriculum based on consensus about ratings and historic learner data. The drills were grouped according to similar skill sets and arranged in order of complexity.The 33 drills were judged to have 12/15 surgery skills as primary goals and 13/15 as secondary goals. Twenty of the 33 drills were selected for inclusion in the new curriculum; these had 11/15 skills as primary goals and 11/15 as secondary goals. However, skills regarding energy sources, atraumatic handling, blunt dissection, fine dissection, and running suturing were poorly represented in the drills. Three previously validated inanimate drills were added to the curriculum to address lacking skill domains.We identified 20 of the 33 SimNow drills as a foundation for a robotic surgery curriculum based on content-oriented evidence. We added 3 other drills to address identified gaps in drill content.

Background: Aromatase inhibitors (AIs) are highly effective at reducing recurrences and mortality in postmenopausal patients with estrogen receptor positive breast cancer (ER+ BC). Poor anti-proliferative (Ki67) response or ER+ BCs to AIs after 2 weeks is associated with worse long-term outcomes. Factors that relate to the degree of the response may identify markers and/or mechansims of resistance. Methods: The PeriOperative Endocrine Therapy for Individualizing Care (POETIC) trial randomized 4,480 with ER+ BC to 2 weeks’ AI before surgery or no presurgical treatment. All patients within the bottom 15% of Ki67 responders to AI (poor responders [PRs]; n=177 with RNA extracted) were selected from and matched to good responders (GRs) within the 50% showing the best response (n=190). Matching was based on baseline Ki67 levels as measured by immunohistochemistry (IHC). Response to AI was measured by the percentage change in Ki67 after 2 weeks’ treatment. PRs were further divided into groups expressing high ESR1 (PRs ESR1HIGH; n=119) and low ESR1 (PRs ESR1LOW; n=58) levels since there were very few GRs with low ESR1. RNAseq, targeted exome DNA sequencing of 87 BC/resistance related genes and measurement of plasma estradiol levels by mass spectrometry were performed to understand mechanisms of de novo resistance. Intrinsic subtypes were estimated from RNAseq data. Results: More than 90% of PRs ESR1LOW were non-luminal subtypes with low expression of estrogen-responsive genes. In contrast, 11% of PRs ESR1HIGH were non-luminal compared to 4% of GRs but only HER2-enriched subtypes were significantly higher in PR ESR1HIGH (p=0.05, Fisher exact). While AI treatment had limited impact on Ki67 IHC values in PRs ESR1HIGH, PGR expression was more than 2-fold lower after 2 weeks of AI. Gene-set enrichment analysis showed significantly lower expression of estrogen-response genes in PRs ESR1HIGH compared to GRs (FDR< 10-9) at baseline despite similar percentage of Luminal subtypes in PRs ESR1HIGH and GRs. Plasma estradiol levels were correlated with expression of estrogen-response genes (FDR=0.01) and levels were significantly lower in PRs ESR1HIGH compared to GRs (p=0.003, Mann Whitney). PRs ESR1HIGH had significantly more mutations in RB1, TP53, ARID1B and DNAH11 genes (p< 0.05, Fisher exact). TP53 mutations were significantly enriched in Luminal-A PRs ESR1HIGH compared to GRs (22% and 3% respectively; p=0.003, Fisher exact), but not in Luminal-B tumors (23% and 15% mutated respectively). Discussion and conclusions: In approximately 33% of PRs, de novo AI resistance was associated with and most likely due to low expression of ER/ESR1 and estrogen-responsive genes in non-luminal tumors. In the remaining tumors, AI treatment still impacted some estrogen responsive genes but had limited downstream impact on suppressing proliferation. This might be due to mutations including in TP53 that limit suppression of proliferation downstream of estrogen signaling. The proportion of Luminal tumors in GRs and PRs ESR1HIGH was similar, suggesting better outcome of Luminal-A tumors on AI is likely due to their better intrinsic prognosis rather than better response to endocrine therapy. Citation Format: Eugene F. Schuster, Elena López-Knowles, Anastasia Alataki, Lila Zabaglo, Elizabeth Folkerd, David Evans, Kally Sidhu, Holly Tovey, Perry Maxwell, Nicholas Turner, Stephen Johnston, Manuel Salto-Tellez, Maggie Chon U Cheang, John Robertson, Ian Smith, Judith Bliss, Mitch Dowsett. PD10-07 Low plasma estradiol, low expression of estrogen responsive genes and TP53 mutations are associated with poor anti-proliferative response to aromatase inhibitors [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr PD10-07.

Background: Aromatase inhibitors (AIs) are one of the main treatment strategies for the clinical management of estrogen receptor-positive (ER+) breast cancer (BC). Despite prolonged time to recurrence and initial clinical responses, >20% of patients eventually relapse, and previous studies have shown an association of poor anti-proliferative response to AIs and worse outcome. High immune activity in ER+ tumors may be associated with worse outcome, in contrast to ER-negative BC where immune infiltration is a feature associated with better outcome. Our work focused on understanding the correlations between immune cell infiltration and response to AI. Methods: All patients with ER+ HER2- tumors within the bottom 15% of Ki67 anti-proliferative responders to AIs (poor responders [PRs]; n=177) were selected from the PeriOperative Endocrine Therapy for Individualizing Care (POETIC) trial and matched on baseline Ki67 levels to good responders (GRs) within the 50% showing the best response (n=190). Response to AI was measured by the Ki67 percentage change after 2 weeks of treatment. PRs were further divided into groups expressing high ESR1 (PRs ESR1HIGH; n=119) and low ESR1 (PRs ESR1LOW; n=58) levels to represent PR subgroups that showed partial or no response to AIs. The percentage of stromal tumor-infiltrating lymphocytes (TILs) was assessed. Multiple immunofluorescence was performed for ER, CD3, CD20, CD68, FOXP3, and CD3/FOXP3 in 15 baseline samples from each of the GR, PR ESR1HIGH, and PR ESR1LOW populations and immune cell density in stromal or tumor compartments was estimated. Spearman correlations of TILs with Consensus tumor microenvironment (TME) deconvolution and Molecular Signatures Database hallmark gene sets were conducted. The relationship between the immune markers’ density and genes, hallmark gene sets and Consensus TME was assessed. Results: The percentage of TILs was significantly higher in the PR ESR1HIGH and PR ESR1LOW compared to the GRs (adjusted p< 0.05). As expected, TILs were highly correlated with T cells (particularly T-regulatory cells) and immune hallmark gene sets. There was a tendency for higher density of each of the immune markers in PRs compared to GRs, with significant differences being observed in stromal B-cell marker CD20 density (p< 0.05). Analysis showed a significant correlation between TILs and stromal FOXP3 marker density (FDR< 0.05), and stromal biomarker density was highly correlated to the gene expression of the encoding genes of the same tumors (CD3/CD3D, FOXP3/FOXP3, and CD20/MS4A1) (FDRs< 0.05). There was also a strong and significant correlation between the stromal expression of CD20, CD3, FOXP3, and CD3/FOXP3 with the immune hallmark gene sets (FDRs< 0.05). Finally, the immune phenotyping showed the expected correlations with TME deconvolution, with particularly strong correlations of CD20 and CD3 with B- and T-cell gene signatures, respectively (FDRs< 0.05). Conclusions: Different immune features indicated a broad involvement of several immune cell types in PRs to AIs, suggesting that the immune system might be associated with resistance of ER+ breast tumors to AI treatment. Spatial gene expression profiling is ongoing to characterize these tumors further and investigate potential mechanisms of AI resistance. Citation Format: Anastasia Alataki, Gene Schuster, Lila Zabaglo, Perry Maxwell, Elena López-Knowles, Elizabeth Folkerd, David Evans, Kally Sidhu, Holly Tovey, Nicholas Turner, Stephen Johnston, Maggie Chon U Cheang, John Robertson, Manuel Salto-Tellez, Ian Smith, Judith Bliss, Mitch Dowsett. PD10-08 Immune cell infiltration associated with poor anti-proliferative response to aromatase inhibitors in postmenopausal women with primary ER-positive HER2-negative breast cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr PD10-08.

Background: We aim to assess whether time of day modified the treatment effect in the RACECAT trial (Direct Transfer to an Endovascular Center Compared to Transfer to the Closest Stroke Center in Acute Stroke Patients With Suspected Large Vessel Occlusion Trial), a cluster-randomized trial that did not demonstrate the benefit of direct transportation to a thrombectomy-capable center versus nearest local stroke center for patients with a suspected large vessel stroke triaged in nonurban Catalonia between March 2017 and June 2020. Methods: We performed a post hoc analysis of RACECAT to evaluate if the association between initial transport routing and functional outcome differed according to trial enrollment time: daytime (8:00 am –8:59 pm ) and nighttime (9:00 pm –7:59 am ). Primary outcome was disability at 90 days, as assessed by the shift analysis on the modified Rankin Scale score, in patients with ischemic stroke. Subgroup analyses according to stroke subtype were evaluated. Results: We included 949 patients with an ischemic stroke, of whom 258 patients(27%) were enrolled during nighttime. Among patients enrolled during nighttime, direct transport to a thrombectomy-capable center was associated with lower degrees of disability at 90 days (adjusted common odds ratio [acOR], 1.620 [95% CI, 1.020–2.551]); no significant difference between trial groups was present during daytime (acOR, 0.890 [95% CI, 0.680–1.163]; P interaction =0.014). Influence of nighttime on the treatment effect was only evident in patients with large vessel occlusion(daytime, acOR 0.766 [95% CI, 0.548–1.072]; nighttime, acOR, 1.785 [95% CI, 1.024–3.112] ; P interaction P interaction >0.1 for all comparisons). We observed longer delays in alteplase administration, interhospital transfers, and mechanical thrombectomy initiation during nighttime in patients allocated to local stroke centers. Conclusions: Among patients evaluated during nighttime for a suspected acute severe stroke in non-urban areas of Catalonia, direct transport to a thrombectomy-capable center was associated with lower degrees of disability at 90 days. This association was only evident in patients with confirmed large vessel occlusion on vascular imaging. Time delays in alteplase administration and interhospital transfers might mediate the observed differences in clinical outcome. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02795962.

En este artículo analizamos el fenómeno de la migración interna y cómo estos grupos indígenas con una identidad étnica se han incorporado a las grandes ciudades, viviendo procesos de segregación, racismo y discriminación, así como la posibilidad de ser reconocidos como sujetos de derechos con retos frente a una ciudad pluricultural. A partir de la observación participante en el estudio de caso de los migrantes otomíes de la colonia Roma en la Ciudad de México se observó la transformación identitaria sobre la forma de relacionarse con la ciudad y con respecto a la comunidad de origen, en cuanto a las relaciones etáreas, así como la incorporación de nuevas actividades laborales y sociales que los llevaron a la demanda por un espacio de vivienda, por su reivindicación y derecho a estar en la ciudad desde su forma de vida y sus identidades particulares.

Objetivo. Comparar aspectos cuantitativos y cualitativos de la ejecución del test de fluidez verbal (TFV) semántica (animales) y fonológica (F, A, S y M), en pacientes con Trastorno Neurocognitivo Leve (TNL) y un grupo control. Método. La muestra se compuso de 70 participantes: 35 con diagnóstico de TNL con una media de 71.5 (± 8) años de edad y escolaridad de 13.1 (± 3.6) y 35 individuos como grupo control con edad media de 72.1 (± 7.1) con 13.2 (± 3.7) años de escolaridad. Se realizó un análisis de la ejecución del TFV en términos de: número de aciertos y errores, número y tamaño de agrupaciones, número de saltos. Resultados. No se observaron diferencias significativas entre grupos en número de aciertos y errores. No obstante, se encontraron diferencias respecto a las estrategias empleadas, el grupo control mostró mayor número de agrupaciones que el grupo con TNL en los TFV semántica y fonológica. Asimismo, el tamaño de las agrupaciones en el TFV fonológica fue mayor en el grupo control que en los pacientes con TNL. No se encontraron diferencias entre grupos en el número de saltos. Conclusiones. El análisis cualitativo del TFV aporta mayor información sobre el procesamiento cognitivo, y puede ser una herramienta de utilidad para diferenciar el funcionamiento ejecutivo del envejecimiento normal y del TNL, en un breve periodo de tiempo.

This paper provides the theoretical foundation for the approximation of the regions of attraction in hyperbolic and polynomial systems based on the eigenfunctions deduced from the data-driven approximation of the Koopman operator. In addition, it shows that the same method is suitable for analyzing higher-dimensional systems in which the state space dimension is greater than three. The approximation of the Koopman operator is based on extended dynamic mode decomposition, and the method relies solely on this approximation to find and analyze the system’s fixed points. In other words, knowledge of the model differential equations or their linearization is not necessary for this analysis. The reliability of this approach is demonstrated through two examples of dynamical systems, e.g., a population model in which the theoretical boundary is known, and a higher-dimensional chemical reaction system constituting an original result.

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with COVID-19, but uncertainty remains about the determinants of in-hospital mortality and data on post-discharge outcomes are scarce. The aims of this study were to investigate the variables associated with in-hospital outcomes in patients who received ECMO during the first wave of COVID-19 and to describe the status of patients 6 months after ECMO initiation.METHODS: EuroECMO-COVID is a prospective, multicentre, observational study developed by the European Extracorporeal Life Support Organization. This study was based on data from patients aged 16 years or older who received ECMO support for refractory COVID-19 during the first wave of the pandemic-from March 1 to Sept 13, 2020-at 133 centres in 21 countries. In-hospital mortality and mortality 6 months after ECMO initiation were the primary outcomes. Mixed-Cox proportional hazards models were used to investigate associations between patient and management-related variables (eg, patient demographics, comorbidities, pre-ECMO status, and ECMO characteristics and complications) and in-hospital deaths. Survival status at 6 months was established through patient contact or institutional charts review. This study is registered with ClinicalTrials.gov, NCT04366921, and is ongoing.FINDINGS: Between March 1 and Sept 13, 2020, 1215 patients (942 [78%] men and 267 [22%] women; median age 53 years [IQR 46-60]) were included in the study. Median ECMO duration was 15 days (IQR 8-27). 602 (50%) of 1215 patients died in hospital, and 852 (74%) patients had at least one complication. Multiorgan failure was the leading cause of death (192 [36%] of 528 patients who died with available data). In mixed-Cox analyses, age of 60 years or older, use of inotropes and vasopressors before ECMO initiation, chronic renal failure, and time from intubation to ECMO initiation of 4 days or more were associated with higher in-hospital mortality. 613 patients did not die in hospital, and 547 (95%) of 577 patients for whom data were available were alive at 6 months. 102 (24%) of 431 patients had returned to full-time work at 6 months, and 57 (13%) of 428 patients had returned to part-time work. At 6 months, respiratory rehabilitation was required in 88 (17%) of 522 patients with available data, and the most common residual symptoms included dyspnoea (185 [35%] of 523 patients) and cardiac (52 [10%] of 514 patients) or neurocognitive (66 [13%] of 512 patients) symptoms.INTERPRETATION: Patient's age, timing of cannulation (FUNDING: None.

The COVID pandemic led to the closure of educational institutions worldwide. In Mexico, the education system went into lockdown on March 16, 2021. With people unable to interact in the physical world, virtual spaces provided alternatives where emojis and other graphical representations were used to convey emotions. This research aimed to investigate the Facebook reactions of four generations (Baby boomers, Generation X, Millennials, and Post-millennials) over three months: April, May, and June 2020. A mixed-method approach focused on a survey following an exploratory design was used to collect data. The data showed that participants had several reasons to click on emojis on Facebook during the COVID- 19 lockdown. Baby boomers used emojis the most and relied on Facebook to share information about the pandemic. While more work is necessary to understand the emoji phenomenon deeply, data revealed that the cave paintings we left on Facebook walls at the beginning of the year 2020 reflect the impact of COVID- 19 had on our lives.

Interrogation of immune response in autopsy material from patients with SARS-CoV-2 is potentially significant. We aim to describe a validated protocol for the exploration of the molecular physiopathology of SARS-CoV-2 pulmonary disease using multiplex immunofluorescence (mIF).The application of validated assays for the detection of SARS-CoV-2 in tissues, originally developed in our laboratory in the context of oncology, was used to map the topography and complexity of the adaptive immune response at protein and mRNA levels.SARS-CoV-2 is detectable in situ by protein or mRNA, with a sensitivity that could be in part related to disease stage. In formalin-fixed, paraffin-embedded pneumonia material, multiplex immunofluorescent panels are robust, reliable and quantifiable and can detect topographic variations in inflammation related to pathological processes.Clinical autopsies have relevance in understanding diseases of unknown/complex pathophysiology. In particular, autopsy materials are suitable for the detection of SARS-CoV-2 and for the topographic description of the complex tissue-based immune response using mIF.

Vector Auto regression model (VAR) a time -varying parameter is applied to study the effect of oil price shocks on the returns of stocks in the LATAM (Latin American) markets. Coherent Wavelet analysis highlights possibilities of connectedness of the oil price and LATAM stock markets through the presence of different patterns in a time series. The structural demand shocks standard deviations during the COVID-19 era remain high and the pass-through effects on stock returns due to oil prices differ for different time frames. The fundamental linkages are demonstrated due to oil market specific demand. The main motive of the research work is to identify the influence of oil price on stocks and identify the fundamental source of contagion. A random effects model is applied to the panel data of LATAM markets with the Global stock market index, MSCI (Morgan Stanley Capital International World Index), domestic money market rates and currency exchange rates during the period of study, 15 March 2019 to 31 July 2021 with 684 observations of controlled non-observed characteristics from individual country. The findings of this research recommend the pass-through effect of the oil prices on the stock market returns are based on time frequency. The contribution of this paper helps the policy makers to restore the confidence amongst the investors in the stock markets and strategies to be adopted by the investors to mitigate the risk by ideal portfolio management.

El objetivo del presente artículo fue determinar el impacto del compromiso organizacional (CO) y satisfacción laboral (SL) en el desempeño laboral (DL) de los trabajadores, a través de la revisión bibliográfica, analizando, comprendiendo e interpretando la información obtenida de distintos artículos de investigación, realizadas en diversos sectores laborales, ocupacionales y profesionales. El estudio se alineó al paradigma interpretativo-hermenéutico, donde se describió, analizó, comprendió e interpretó las interrelaciones de los constructos (CO, SL y DL). La investigación tiende al enfoque mixto (cuantitativo y cualitativo), pues, se realizó la descripción, comprensión e interpretación de la revisión bibliográfica sobre las variables en estudio, mediante el uso de la bibliometría. Respecto a la metodología, se utilizó el método de la investigación documental. Para la búsqueda y selección de la literatura científica se utilizó el Scopus como gestor bibliográfico y la bibliometría para el estudio de las publicaciones científicas y cuya unidad de análisis es el artículo científico. Los resultados, basados en una muestra de 92 artículos, durante los últimos 19 años, que la cantidad de estudios divulgados y de citas se ha incrementado de manera progresiva. Adicionalmente, los resultados revelan el impacto positivo de las variables CO y SL sobre el DL, del mismo modo, la mediación de los componentes del compromiso y satisfacción de los empleados para la mejora continua del desempeño de estos en el trabajo; esto implica logro de reputación positiva, prestigio e imagen organizacional o empresarial, en síntesis, el comportamiento organizacional con desarrollo sostenible.

El texto es una reseña sobre el libro "El clown existencial. Historia de una poética sobre la condición humana", de Carlos Gutiérrez Bracho.

Esta investigación abordó la preferencia de los bachilleres en Colombia en virtud de las decisiones que toman dentro de un conjunto de oportunidades y, que rodean la elección del programa de formación y de la institución de educación superior, aspecto que surge por la tensión entre calidad docente y calidad educativa. El objetivo de este trabajo es comprender la configuración de la preferencia académica de los bachilleres para su ingreso a la educación superior, con énfasis en carreras de educación, tomando como referente elementos de la Teoría de la Elección Racional, a partir del análisis estadístico descriptivo de clústeres, extraídos de la base de datos del ICFES (Instituto Colombiano para la Evaluación de la Educación), evidenciando que la configuración de la preferencia confluyen tres elementos: a) deseos y creencias de quien decide; b) restricciones; y c) opciones disponibles o conjunto de oportunidad que permite la acción. Luego se contrastan las similitudes y diferencias de los elementos circundantes a la elección de este tipo de programas, concluyendo que hay semejanzas en sus deseos y oportunidades, no obstante, los filtros y las restricciones marcan diferencias entre los bachilleres que eligen carreras de educación y los que no.

The objective of the work was to evaluate the production of lignocllulolytic enzymes produced by Trametes polyzona HHM001 during its growth on corn leaf residues. Two particle sizes (PS) (PS8 and PS12), two levels of aeration (1 vvm and 0 vvm), as well as the height of the substrate in the production of lignocellulolytic enzymes were tested. The enzymatic activities of Laccase (Lcc), Lignin peroxidase (LiP), and Manganese peroxidase (MnP) were favored under aerated conditions (1 vvm). The enzymatic activity of Lcc was the most favored, with 80 Activity Units (AU)/mL, compared to the culture without aeration, in which 40 AU/mL was obtained. The production of xylanases (Xyl) and cellulases (Cel) were not influenced by aeration under the tested conditions. The results indicated that the particle size has more effect on enzyme production than the presence or absence of air, with a particle size of 8 where the best levels of enzymatic activity were observed. It was observed that the height of the substrate in the fermentation column strongly affects the activity of ligninolytic enzymes and not of the hydrolytic; at 5 cm, the highest ligninolytic activity was detected, where aeration favors oxidative conditions.

The success of a functional coating is intrinsically linked to the improvement of its surface properties, as it is the surface that will be in direct contact with the environment and mechanical stresses when the material is used in severe wear, fatigue, or corrosion applications. It has been shown, for example, by increasing mechanical properties, that factors such as surface hardness increase the durability of the coating/substrate system. Consequently, current research on the design and development of multifunctional coatings for surface engineering within mechanical systems must address surface treatment and modification techniques. This article is a bibliographic review of coatings with industrial applications regarding transition metal nitrides deposited with physical vapor deposition (PVD) techniques such as sputtering and cathodic arc.

Nació en la Ciudad de México el 19 de agosto de 1960, es hijo de la señora Beatriz Bernal Fernández y el señor Rodolfo Ibáñez Gámiz, y nieto del reconocido Manuel Carlos Bernal Mejía (El Declamador de América, Tío Polito).

Chile implementó en el 2006 una política público-privada denominada: Chile Potencia Alimentaria. La política tuvo como objetivo posicionar a Chile como una potencia exportadora en alimentos a nivel mundial. El presente trabajo es una investigación exploratoria, descriptiva y de análisis longitudinal. La información se recopiló a través de una ficha de contenido que incluyó: autor, año, área de investigación, frase o párrafo, número de página, título, lugar, edición, editorial, fuente, web. La información se obtuvo de: bases de datos académicas, internet y medios de comunicación social, los cuales fueron validados con información oficial del gobierno de Chile y organismos internacionales. El trabajo concluye que las exportaciones de alimentos de Chile en montos FOB: frutas y hortalizas, pescados y mariscos y bebidas alcohólicas han tenido un crecimiento económico lineal de un 275% entre el período 2002 al 2018 y continúan creciendo. Finalmente, podemos decir que la Política Chile Potencia Alimentaria fue un éxito en las exportaciones de alimentos con valor agregado, a pesar de lo competitivo que son los mercados mundiales de alimentos y lo difícil que es acceder a ellos.

Clinical guidelines do not recommend long-term anticoagulation in non-cirrhotic splanchnic vein thrombosis (NC-SVT) without underlying thrombophilia because it is assumed that there is a very low risk of recurrent thrombosis (RT). Our first aim was to describe the incidence of RT in people with NC-SVT without an indication for long-term anticoagulation. The second aim was to identify RT risk factors and afterwards verify them in a validation cohort.This is a multicentre, retrospective observational study evaluating risk factors for RT in 64 people with NC-SVT of idiopathic/local factor aetiology. In a subgroup of 48 individuals, the potential value of additional thrombophilic parameters to predict RT was analysed. Findings were validated in 70 individuals with idiopathic/local factor NC-SVT.Of the 64 participants in the training cohort, 17 (26%) presented splanchnic and/or extrasplanchnic RT (overall-RT) during follow-up (cumulative incidence: 2, 10, 19, and 34% at 1, 2, 5, and 10 years, respectively). In addition, 53% of people with splanchnic RT were asymptomatic. No clinical or biochemical parameters predicted overall-RT. However, in the 48 people with an additional comprehensive thrombophilic study, factor VIII ≥150% was the only independent factor predicting overall-RT (hazard ratio 7.10, 95% CI 2.17-23.17, p0.01). In the validation cohort, 19 individuals (27%) presented overall-RT, and it was also independently predicted by factor VIII150% (hazard ratio 3.71, 95% CI 1.31-10.5, p0.01). The predictive value of factor VIII was confirmed in both people with idiopathic/local factor aetiology associated NC-SVT.People with idiopathic/local factor NC-SVT are at risk of overall-RT. Splanchnic RT can be asymptomatic and requires screening for its detection. Values of factor VIII ≥150% may help identify individuals at high risk of overall-RT who could benefit from long-term anticoagulation.People with idiopathic/isolated local factor non-cirrhotic portal vein thrombosis were previously thought to be at minimal risk of re-thrombosis and therefore did not receive scheduled follow-up. The results of this study are of special interest for hepatologists treating people with non-cirrhotic splanchnic thrombosis, as they show a 25% incidence of re-thrombosis and support the close follow-up of people with factor VIII150% to ensure the early identification of new thrombotic events.

Background: A well-recognized therapy to improve the symptoms of patients with malignant pleural effusion (MPE), indwelling pleural catheters (IPCs) can also achieve spontaneous pleurodesis. Chemical pleurodesis is associated with a significant pro-coagulation and fibrinolytic environment. Hence, anticoagulation could theoretically interfere with this process. Objective: The aim of this study was to evaluate if anticoagulation can interfere with successful spontaneous pleurodesis in patients treated with IPC. Methods: This was a cohort study of all patients with MPE treated with IPC. The primary objective was to determine if anticoagulant use after IPC placement decreased the rate of spontaneous pleurodesis. The secondary objective was to identify other factors associated with spontaneous pleurodesis. We used a Fine-Gray subdistribution hazard model and a direct acyclic graph to identify variables associated with time to spontaneous pleurodesis. Results: Of the included 410 patients, 210 patients (51.2%) achieved pleurodesis and had their IPC removed. We found no association between anticoagulation and likelihood of pleurodesis. Multivariate analyses revealed that prior chemotherapy, ECOG score of 2–4 were associated with unsuccessful pleurodesis, while chemotherapy or radiotherapy after IPC placement remained associated with increased likelihood of spontaneous pleurodesis. Conclusions: We failed to demonstrate an association between anticoagulation and pleurodesis. We found that better performance status and chemotherapy or radiotherapy after IPC placement can increase the rate of pleurodesis and catheter removal.

One of the major environmental challenges of our time is plastic pollution. Motivated by this global environmental challenge, the authors launched a research program to investigate the development and application of natural fiber composites (NFCs) as potential substitutes for foamed plastics (e.g Styrofoam). In parallel, the authors also established a new research group and a capstone course in their industrial design program to engage undergraduate students in this research initiative. Between 2018 and 2021, the authors led a research program intended to explore the use of wastes from corn crops (Zea mays) and fibers from fique plants (Furcraea andina) for developing new NFCs and their applications. Throughout this program, the authors mentored five cohorts of undergraduate students in industrial design, who proposed and conducted their capstone projects in alignment with the program’s research agenda. This program was funded by internal grants and the investment of a private company interested in producing and commercializing some of the applications developed by the researchers. As results of this research initiative supported by undergraduate students, the research team developed a family of six new Natural Fiber Composites and a collection of near a dozen products that applied the new materials. These new products were aimed at the three industries that consume the most foamed plastics, that is, construction, packaging, and automotive. At an experimental level, these new materials have shown beneficial properties for these industries since they are highly resistant to impact, have low thermal conduction, have high acoustic insulation capacity, and have low weight. The preliminary findings from material testing and market validation show great promise for continuing developing and scaling up the production of these new NFCs and their applications with the ultimate goal of making significant contributions to the social, environmental, and economic welfare of rural communities that produce corn and fique in Colombia and other developing countries.

Time Series Forecasting (TSF) is essential to key domains, and the transformer neural network has advanced the state-of-the-art on global, multi-horizon TSF benchmarks. The quadratic time and memory complexity of the vanilla transformer (VT) hinders its application to big data environments; therefore, multiple efficient variants of the VT that lower complexity via sparse self-attention have been proposed. However, less complex algorithms do not directly produce faster executions, and machine learning models for big data are typically trained on accelerators designed for dense-matrix computation that render slower performance with sparse matrices. To better compare the accuracy-speed trade-off of the VT and its variants, it is essential to test them on such accelerators. We implemented a cloud-based VT on Tensor Processing Units to address this task. Experiments on large-scale datasets show that our transformer outperforms two reference models on accuracy while reducing training times from hours to under two minutes.

Background: We aim to compare the outcome of patients from urban areas, where the referral center is able to perform thrombectomy, with patients from nonurban areas enrolled in the RACECAT trial (Direct Transfer to an Endovascular Center Compared to Transfer to the Closest Stroke Center in Acute Stroke Patients With Suspected Large Vessel Occlusion). Methods: Patients with suspected large vessel occlusion stroke, as evaluated by a Rapid Arterial Occlusion Evaluation score of ≥5, from urban catchment areas of thrombectomy-capable centers during RACECAT trial enrollment period were included in the Stroke Code Registry of Catalonia. Primary outcome was disability at 90 days, as assessed by the shift analysis on the modified Rankin Scale score, in patients with an ischemic stroke. Secondary outcomes included mortality at 90 days, rate of thrombolysis and thrombectomy, time from onset to thrombolysis, and thrombectomy initiation. Propensity score matching was used to assemble a cohort of patients with similar characteristics. Results: The analysis included 1369 patients from nonurban areas and 2502 patients from urban areas. We matched 920 patients with an ischemic stroke from urban areas and nonurban areas based on their propensity scores. Patients with ischemic stroke from nonurban areas had higher degrees of disability at 90 days (median [interquartle range] modified Rankin Scale score, 3 [2–5] versus 3 [1–5], common odds ratio, 1.25 [95% CI, 1.06–1.48]); the observed average effect was only significant in patients with large vessel stroke (common odds ratio, 1.36 [95% CI, 1.08–1.65]). Mortality rate was similar between groups(odds ratio, 1.02 [95% CI, 0.81–1.28]). Patients from nonurban areas had higher odds of receiving thrombolysis (odds ratio, 1.36 [95% CI, 1.16–1.67]), lower odds of receiving thrombectomy(odds ratio, 0.61 [95% CI, 0.51–0.75]), and longer time from stroke onset to thrombolysis (mean difference 38 minutes [95% CI, 25–52]) and thrombectomy(mean difference 66 minutes [95% CI, 37–95]). Conclusions: In Catalonia, Spain, patients with large vessel occlusion stroke triaged in nonurban areas had worse neurological outcomes than patients from urban areas, where the referral center was able to perform thrombectomy. Interventions aimed at improving organizational practices and the development of thrombectomy capabilities in centers located in remote areas should be pursued. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02795962.

This chapter recounts negative experienc­es at academic conferences by one junior faculty member at a Southern California university. Discussion topics include her worries about the realities of conference attendance; care or lack thereof; public and private exclusion; and issues surrounding accessibility. In each section, the author of­fers recommendations for changes made by conference organizers and attendees toward making conference attendance more welcoming. Citing feminist rhetorical resilience (Flynn, Sotirin, and Brady) as a response to the adversity experienced by many attending academic conferences, the author also sees aspects of feminist resilience as reasons she is attracted to conferences and believes they are im­portant to her growth as a feminist scholar and to the growth of other scholars. While this chapter makes recommendations for academic conference organizers and at­tendees, it also serves a broader audience who can also benefit from considerations of ways BIPOC are excluded in public and private spaces, as well as ways those in attendance, or organizing large gatherings can be more considerate of issues sur­rounding access.

Major advances in pathogen identification, treatment, vaccine development, and avian immunology have enabled the enormous expansion in global poultry production over the last 50 years. Looking forward, climate change, reduced feed, reduced water access, new avian pathogens and restrictions on the use of antimicrobials threaten to hamper further gains in poultry productivity and health. The development of novel in vitro cell culture systems, coupled with new genetic tools to investigate gene function, will aid in developing novel interventions for existing and newly emerging poultry pathogens. Our growing capacity to cryopreserve and generate genome-edited chicken lines will also be useful for developing improved chicken breeds for poultry farmers and conserving chicken genetic resources.

In the scientific literature, it has been documented that electrochemical genosensors are novel analytical tools with proven clinical diagnostic potential for the identification of carcinogenic processes due to genetic and epigenetic alterations, as well as infectious diseases due to viruses or bacteria. In the present work, we describe the construction of an electrochemical genosensor for the identification of the k12p.1 mutation; it was based on use of Screen-Printed Gold Electrode (SPGE), Cyclic Voltammetry (CV), and Atomic Force Microscopy (AFM), for the monitoring the electron transfer trough the functionalized nanostructured surface and corresponding morphological changes. The sensitivity of the genosensor showed a linear response for the identification of the k12p.1 mutation of the K-ras gene in the concentration range of 10 fM to 1 μM with a detection limit of 7.96 fM in the presence of doxorubicin (Dox) as DNA intercalating agent and indicator of the hybridization reaction. Thus, the electrochemical genosensor developed could be useful for the identification of diseases related with the K-ras oncogene.

Extracorporeal membrane oxygenation (ECMO) carries a high morbidity of acute brain injury (ABI) with resultant mortality increase. Transcranial Doppler (TCD) allows real-time characterization of regional cerebral hemodynamics, but limited data exist on the interpretation of microembolic signals (MES) in ECMO.This prospective cohort study was conducted at a single tertiary care center, November 2017 through February 2022, and included all adult patients receiving venoarterial (VA) and venovenous (VV) ECMO undergoing TCD examinations, which all included MES monitoring.Of 145 patients on ECMO who underwent at least 1 TCD examination, 100 (68.9%) patients on VA-ECMO received 187 examinations whereas 45 (31.1%) patients on VV-ECMO received 65 examinations (TCD analysis in a large cohort of patients on ECMO demonstrates a significant number of MES, especially in patients on VA-ECMO with intra-aortic balloon pump, and/or left ventricular assist device. However, clinical associations and significance of TCD MES remain unresolved and warrant further correlation with systematic imaging and long-term neurologic follow-up.

To evaluate the association of a history of infertility with long-term weight, body composition, and blood pressure.We studied 1581 women from the prospective cohort Project Viva. History of infertility was based on self-reported time to pregnancy ≥12 months or use of medical treatment to conceive for the index or any prior pregnancy; a diagnosis of infertility; claims for infertility treatments/prescriptions abstracted from medical records. The outcomes were weight, waist circumference, and body fat assessed through 12 years postpartum; and blood pressure assessed through 3 years postpartum. We used linear mixed-effect models adjusted for age, race/ethnicity, income, education, marital status, parity, and age at menarche.Three hundred forty-two women (21.6%) had a history of infertility. In adjusted models, women with versus without infertility, had higher average weight (3.29 kg, 95% confidence interval [CI]: 1.35-5.24), waist circumference (2.46 cm, 95% CI: 0.78-4.13) and body fat (1.76 kg, 95% CI: 0.09-3.43). Among younger (18-29 years), but not older (≥30 years) women, infertility was associated with higher systolic (4.08 mmHg, 95% CI: 0.93, 7.23) and diastolic blood pressure (2.16 mmHg, 95% CI: 0.11-4.20).A history of infertility may serve as a marker to identify women at higher cardiometabolic risk.