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Respiratory diseases and cardiovascular diseases (CVDs) have high prevalence and share common risk factors. In some respiratory diseases such as sleep apnoea and COPD, the evidence of their negative impact on the prognosis of CVDs seems clear. However, in other diseases it is less evident whether there is any direct relationship. With this in mind, our objective was to provide information that may be helpful to better understand the relationship between respiratory pathology and CVDs.There are different reasons for this relationship, such as shared risk factors, common pathophysiological mechanisms, side effects of treatment and the direct effect in the heart and great vessels of respiratory diseases.Indeed, aging and smoking are risk factors for CVDs and also for respiratory diseases such as obstructive sleep apnea (OSA), COPD and interstitial lung diseases (ILD).Furthermore, there are common pathophysiological mechanisms that affect both respiratory diseases and CVDs, such as accelerated atherosclerosis, microvascular dysfunction, endothelial dysfunction, inflammation, hypoxemia and oxidative stress.Besides that, it is well known that lung cancer, sarcoidosis and amyloidosis may directly affect the heart and great vessels.Finally, side effects of drugs for respiratory diseases and the discontinuation of treatments that are necessary for CVDs, such as β-blockers and aspirin, may have a deleterious impact on the cardiovascular system.In conclusion, the coexistence of respiratory diseases and CVDs is very common. It makes modifying diagnostic and therapeutic management necessary and is also a relevant prognostic factor. Resumen: Las enfermedades respiratorias y cardiovasculares (ECVs) tienen una alta prevalencia y comparten factores de riesgo comunes. En algunas enfermedades respiratorias como la apnea del sueño y la EPOC, la evidencia de su impacto negativo en el pronóstico de las ECVs parece clara. Sin embargo, en otras enfermedades es menos evidente si existe alguna relación directa. Considerando esto, nuestro objetivo fue aportar información que pueda ser útil para comprender mejor la relación entre la patología respiratoria y las ECVs.Existen diferentes razones para esta relación, como factores de riesgo compartidos, mecanismos fisiopatológicos comunes, efectos secundarios del tratamiento y el efecto directo en el corazón y los grandes vasos de las enfermedades respiratorias.De hecho, el envejecimiento y el tabaquismo son factores de riesgo para las ECVs y también para las enfermedades respiratorias como la apnea obstructiva del sueño (AOS), la EPOC y las enfermedades pulmonares intersticiales (EPID).Además, existen mecanismos fisiopatológicos comunes que afectan tanto a las enfermedades respiratorias como a las ECVs, como la aterosclerosis acelerada, la disfunción microvascular, la disfunción endotelial, la inflamación, la hipoxemia y el estrés oxidativo. Además, es bien conocido que el cáncer de pulmón, la sarcoidosis y la amiloidosis pueden afectar directamente al corazón y a los grandes vasos.Finalmente, los efectos secundarios de los fármacos para enfermedades respiratorias y la suspensión de tratamientos necesarios para las ECVs, como los β-bloqueantes y la aspirina, pueden tener un impacto deletéreo sobre el sistema cardiovascular.En conclusión, la coexistencia de enfermedades respiratorias y ECVs es muy frecuente, lo que obliga a modificar el manejo diagnóstico y terapéutico y es, además, un factor pronóstico relevante.

Abstract Improved phenotyping in pneumonia is necessary to strengthen risk assessment. Via a feasible and multidimensional approach with basic parameters, we aimed to evaluate the effect of host response at admission on severity stratification in COVID-19 and community-acquired pneumonia (CAP). Three COVID-19 and one CAP multicenter cohorts including hospitalized patients were recruited. Three easily available variables reflecting different pathophysiologic mechanisms—immune, inflammation, and respiratory—were selected (absolute lymphocyte count [ALC], C-reactive protein [CRP] and, SpO2/FiO2). In-hospital mortality and intensive care unit (ICU) admission were analyzed as outcomes. A multivariable, penalized maximum likelihood logistic regression was performed with ALC ( 60 mg/L), and, SpO2/FiO2 (

Abstract Introduction The impact of remdesivir on mortality in patients with COVID-19 is still controversial. We aimed to identify clinical phenotype clusters of COVID-19 hospitalized patients with highest benefit from remdesivir use and validate these findings in an external cohort. Methods We included consecutive patients hospitalized between February 2020 and February 2021 for COVID-19. The derivation cohort comprised subjects admitted to Hospital Clinic of Barcelona. The validation cohort included patients from Hospital Universitari Mutua de Terrassa (Terrassa) and Hospital Universitari La Fe (Valencia), all tertiary centers in Spain. We employed K-means clustering to group patients according to reverse transcription polymerase chain reaction (rRT-PCR) cycle threshold (Ct) values and lymphocyte counts at diagnosis, and pre-test symptom duration. The impact of remdesivir on 60-day mortality in each cluster was assessed. Results A total of 1160 patients (median age 66, interquartile range (IQR) 55–78) were included. We identified five clusters, with mortality rates ranging from 0 to 36.7%. Highest mortality rate was observed in the cluster including patients with shorter pre-test symptom duration, lower lymphocyte counts, and lower Ct values at diagnosis. The absence of remdesivir administration was associated with worse outcome in the high-mortality cluster (10.5% vs. 36.7%; p

Background: Complications in community-acquired pneumonia (CAP), including cardiovascular events (CVE), can occur during an acute episode and in the long term. We aimed to analyse the role of endothelial damage biomarkers (C-terminal endothelin-1 precursor fragment [CT-proET-1] and mid-regional pro-adrenomedullin [MR-proADM]), in contrast to classic inflammation markers (C Reactive Protein [CRP] and procalcitonin [PCT]) in patients admitted for CAP and their relationship with ICU admission, CVE and mortality in the short and long term; Methods: Biomarkers were analysed in 515 patients with CAP at day 1, 285 at day 5 and 280 at day 30. Traditional inflammatory biomarkers and endothelial damage biomarkers were measured. ICU admission, CVE and mortality (in-hospital and 1-year follow-up) were assessed using receiver operating characteristic (ROC) curve analysis and univariate logistic regression. Results: A statistically significant association was observed between initial, raised CT-proET-1 and MR-proADM levels, the need for ICU admission and the development of in-hospital CVE or in-hospital mortality. Both endothelial markers maintained a strong association at day 30 with 1-year follow-up CVE. At day 1, CRP and PCT were only associated with ICU admission. On day 30, there was no association between inflammatory markers and long-term CVE or death. The odds ratio (OR) and area under the curve (AUC) of endothelial biomarkers were superior to those of classic biomarkers for all outcomes considered. Conclusions: Endothelial biomarkers are better indicators than classic ones in predicting worse outcomes in both the short and long term, especially CVE. MR-proADM is the best biomarker for predicting complications in CAP.

Abstract Pancreatic acinar cells rely on PTF1 and other transcription factors to deploy their transcriptional program. We identify NFIC as a NR5A2 interactor and regulator of acinar differentiation. NFIC binding sites are enriched in NR5A2 ChIP-Sequencing peaks. Nfic knockout mice have a smaller, histologically normal, pancreas with reduced acinar gene expression. NFIC binds and regulates the promoters of acinar genes and those involved in RNA/protein metabolism, and Nfic knockout pancreata show defective ribosomal RNA maturation. NFIC dampens the endoplasmic reticulum stress program through binding to gene promoters and is required for resolution of Tunicamycin-mediated stress. NFIC is down-regulated during caerulein pancreatitis and is required for recovery after damage. Normal human pancreata with low levels of NFIC transcripts display reduced expression of genes down-regulated in Nfic knockout mice. NFIC expression is down-regulated in mouse and human pancreatic ductal adenocarcinoma. Consistently, Nfic knockout mice develop a higher number of mutant Kras-driven pre-neoplastic lesions.

IntroductionThere are no data on the association of type of pneumonia and long-term mortality by the type of pneumonia (COVID-19 or community-acquired pneumonia [CAP]) on long-term mortality after an adjustment for potential confounding variables. We aimed to assess the type of pneumonia and risk factors for long-term mortality in patients who were hospitalized in conventional ward and later discharged.MethodsRetrospective analysis of two prospective and multicentre cohorts of hospitalized patients with COVID-19 and CAP. The main outcome under study was 1-year mortality in hospitalized patients in conventional ward and later discharged. We adjusted a Bayesian logistic regression model to assess associations between the type of pneumonia and 1-year mortality controlling for confounders.ResultsThe study included a total of 1,693 and 2,374 discharged patients in the COVID-19 and CAP cohorts, respectively. Of these, 1,525 (90.1%) and 2,249 (95%) patients underwent analysis. Until 1-year follow-up, 69 (4.5%) and 148 (6.6%) patients from the COVID-19 and CAP cohorts, respectively, died (p = 0.008). However, the Bayesian model showed a low probability of effect (PE) of finding relevant differences in long-term mortality between CAP and COVID-19 (odds ratio 1.127, 95% credibility interval 0.862–1.591; PE = 0.774).ConclusionCOVID-19 and CAP have similar long-term mortality after adjusting for potential confounders.

Newer higher valency pneumococcal conjugate vaccines (PCVs) have the potential to reduce the adult community-acquired pneumonia (CAP) burden. We describe the evolution and distribution of adult community-acquired pneumonia (CAP) serotypes in Spain, focusing on serotypes contained in the 20-valent PCV (PCV20). This was a prospective, observational study of chest X-ray (CXR)-confirmed CAP in immunocompetent adults hospitalized in one of four Spanish hospitals between November 2016 and November 2020. Pneumococci were isolated from cultures and detected in urine using BinaxNow® and Pfizer serotype-specific urinary antigen tests UAD1 and UAD2. We included 1948 adults hospitalized with CXR-CAP. The median age was 69.0 years (IQR: 24 years). At least one comorbidity was present in 84.8% (n = 1653) of patients. At admission, 76.1% of patients had complicated pneumonia. Pneumococcus was identified in 34.9% (n = 680) of study participants. The PCV20 vaccine-type CAP occurred in 23.9% (n = 465) of all patients, 68.4% (n = 465) of patients with pneumococcal CAP, and 82.2% (83/101) of patients who had pneumococcus identified by culture. Serotypes 8 (n = 153; 7.9% of all CAP) and 3 (n = 152; 7.8% of all CAP) were the most frequently identified. Pneumococcus is a common cause of hospitalized CAP among Spanish adults and serotypes contained in PCV20 caused the majority of pneumococcal CAP.

ABSTRACT: Objective: To analyse differences in clinical presentation and outcome between bacteraemic pneumococcal community-acquired pneumonia (B-PCAP) and sSvere Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pneumonia. Methods: This observational multi-centre study was conducted on patients hospitalized with B-PCAP between 2000 and 2020 and SARS-CoV-2 pneumonia in 2020. Thirty-day survival, predictors of mortality, and intensive care unit (ICU) admission were compared. Results: In total, 663 patients with B-PCAP and 1561 patients with SARS-CoV-2 pneumonia were included in this study. Patients with B-PCAP had more severe disease, a higher ICU admission rate and more complications. Patients with SARS-CoV-2 pneumonia had higher in-hospital mortality (10.8% vs 6.8%; P=0.004). Among patients admitted to the ICU, the need for invasive mechanical ventilation (69.7% vs 36.2%; P

El sistema educativo sufre un proceso de transición constante que implica innovación en metodologías de aprendizaje y aunque la educación tradicional ha venido incluyendo a la tecnología en sus prácticas diarias, no han sido suficiente ya que la misma se ha convertido en el instrumento principal de la educación en línea. Esta modalidad de educación, la virtual, se vuelve un reto no solo para docentes sino también para los estudiantes, acostumbrados al sistema tradicional, frente a los contextos familiares, situaciones personales que se deben afrontar y ha repercutido en el campo emocional en donde, la motivación y la satisfacción son el eslabón principal para conseguir un adecuado rendimiento académico. La metodología planteada en esta investigación, es de tipo cualitativa con enfoque descriptivo basado en un proceso de revisión bibliográfico documental con el apoyo de la técnica de la encuesta aleatoria a una muestra de estudio de 1113 estudiantes universitarios cuyo objetivo permitió determinar la influencia de las variables psicológicas motivación y satisfacción en el rendimiento virtual, consiguiendo como resultado el análisis del nivel de incidencia de las variables motivación y satisfacción; planteando propuestas que permitan incluirlas en el currículo vigente e incorporar constructos y modelos tecnopedagógicos para la mejora del rendimiento en el aprendizaje virtual.

Abstract Background COVID-19 can course with respiratory and extrapulmonary disease. SARS-CoV-2 RNA is detected in respiratory samples but also in blood, stool and urine. Severe COVID-19 is characterized by a dysregulated host response to this virus. We studied whether viral RNAemia or viral RNA load in plasma is associated with severe COVID-19 and also to this dysregulated response. Methods A total of 250 patients with COVID-19 were recruited (50 outpatients, 100 hospitalized ward patients and 100 critically ill). Viral RNA detection and quantification in plasma was performed using droplet digital PCR, targeting the N1 and N2 regions of the SARS-CoV-2 nucleoprotein gene. The association between SARS-CoV-2 RNAemia and viral RNA load in plasma with severity was evaluated by multivariate logistic regression. Correlations between viral RNA load and biomarkers evidencing dysregulation of host response were evaluated by calculating the Spearman correlation coefficients. Results The frequency of viral RNAemia was higher in the critically ill patients (78%) compared to ward patients (27%) and outpatients (2%) (p

Chronic inflammation is a major cause of disease. Inflammation resolution is in part directed by the differential stability of mRNAs encoding pro-inflammatory and anti-inflammatory factors. In particular, tristetraprolin (TTP)-directed mRNA deadenylation destabilizes AU-rich element (ARE)-containing mRNAs. However, this mechanism alone cannot explain the variety of mRNA expression kinetics that are required to uncouple degradation of pro-inflammatory mRNAs from the sustained expression of anti-inflammatory mRNAs. Here, we show that the RNA-binding protein CPEB4 acts in an opposing manner to TTP in macrophages: it helps to stabilize anti-inflammatory transcripts harboring cytoplasmic polyadenylation elements (CPEs) and AREs in their 3′-UTRs, and it is required for the resolution of the lipopolysaccharide (LPS)-triggered inflammatory response. Coordination of CPEB4 and TTP activities is sequentially regulated through MAPK signaling. Accordingly, CPEB4 depletion in macrophages impairs inflammation resolution in an LPS-induced sepsis model. We propose that the counterbalancing actions of CPEB4 and TTP, as well as the distribution of CPEs and AREs in their target mRNAs, define transcript-specific decay patterns required for inflammation resolution. Thus, these two opposing mechanisms provide a fine-tuning control of inflammatory transcript destabilization while maintaining the expression of the negative feedback loops required for efficient inflammation resolution; disruption of this balance can lead to disease.

Summary: Upon tissue injury, cytokine expression reprogramming transiently remodels the inflammatory immune microenvironment to activate repair processes and subsequently return to homeostasis. However, chronic inflammation induces permanent changes in cytokine production which exacerbate tissue damage and may even favor tumor development. Here, we address the contribution of post-transcriptional regulation, by the RNA-binding protein CPEB4, to intestinal immune homeostasis and its role in inflammatory bowel diseases (IBD) and colorectal cancer (CRC) development. We found that intestinal damage induces CPEB4 expression in adaptive and innate immune cells, which is required for the translation of cytokine mRNA(s) such as the one encoding interleukin-22. Accordingly, CPEB4 is required for the development of gut-associated lymphoid tissues and to maintain intestinal immune homeostasis, mediating repair and remodeling after acute inflammatory tissue damage and promoting the resolution of intestinal inflammation. CPEB4 is chronically overexpressed in inflammatory cells in patients with IBD and in CRC, favoring tumor development.

La tecno educación o llamada también pedagogía digital, se centra en desarrollar colaborativamente conceptos, prácticas e ideas asociadas a la innovación académica con apoyo tecnológico centrado en el desarrollo de metodologías activas. Es importante distinguir la cooperación con la colaboración que es un término que suele utilizarse sinonímicamente; según Soto y Torres (2016), en referencia a ello señala: Un aspecto importante que distingue el trabajo colaborativo del cooperativo es que el rol del profesor es más protagónico, conduce al equipo o grupo de trabajo con mayor liderazgo y se asegura de que los alumnos realicen su parte correspondiente para lograr un objetivo compartido. En cambio, en el enfoque colaborativo el docente solamente funge como un facilitador y el grupo asume la responsabilidad de llevar a cabo las actividades de manera colectiva y así cumplir sus metas y objetivos (págs. 2-3). En relación con lo que se menciona, la gestión colaborativa del docente debe estar inmersa en las pedagogías activas que persiguen un aprendizaje basado en la práctica y en los entornos de aprendizaje liderados por los modelos constructivista, conectivista, socioconstructivista; los cuales son concretados por las metodologías activas que delimitan las formas precisas de facilitar el aprendizaje en los estudiantes.

La educación en los últimos tiempos, ha dado un giro exponencial y especialmente sus consecuencias han incidido en la gestión docente, quienes han tenido que adaptarse al cambio de manera fragosa en función de su experiencia y formación pedagógica o profesional aprobada. El objetivo de esta investigación, considera verificar si los modelos tecnopedagógicos actuales son aplicados en la planificación meso y micro curricular, en consideración con el uso de las metodologías activas de aprendizaje y su integración a través de herramientas digitales en la educación híbrida actual. El método aplicado es de tipo descriptivo, basado en un enfoque cualitativo consiguiendo resultados con el apoyo de técnicas tales como la encuesta estructurada aplicada a docentes universitarios de diferentes carreras y el análisis documental en fuentes de información científica. Los resultados permitieron afirmar que no se aplican funcionalmente todos los modelos tecnopedagógicos actuales, sino que, en su mayoría, son tradicionales sin considerar las metodologías activas aprovechadas por el uso de herramientas digitales de acuerdo con los procesos cognitivos de los estudiantes. Además, se concluye que es imperante proponer una mejora que permita el reconocimiento y capacitación del personal docente en la integración de modelos tecnopedagógicos, metodologías activas y herramientas digitales.

Las empresas de diferente nicho de mercado, desarrollan la prestación de servicios y/o productos con miras a la internacionalización a través del comercio exterior, varias modelan sistemas de gestión por procesos considerando prácticas de eficacia y eficiencia propendiendo la seguridad de la carga como son las normas Basic Alliance for Secure Commerce (BASC). Este estudio, pretende analizar la integración de características y preceptos teóricos del manejo de información para una efectiva comunicación en las empresas de comercio exterior que aplican estas normas, y proponer su innovación normativa. Se desarrolló una metodología de enfoque cualitativo de tipo descriptivo apoyado en la revisión bibliográfica y se obtuvo como principal resultado que, en las organizaciones, se tratan de manera aislada a la gestión de información y la comunicación, por lo que se consiguen estudios parciales y al no estar integrados todos los elementos informacionales, la comunicación no es efectiva; lo que presume, la materialización de riesgos y el cometimiento de actividades ilícitas por parte de personas o grupos inescrupulosos externos al negocio, problema que puede ser mitigado con la actualización normativa en los datos de entrada y elementos de la salida de la revisión por parte de la dirección empresarial.

Most patients with bronchiectasis have a predominantly neutrophilic inflammatory profile, although other cells such as lymphocytes (as controllers of bronchial inflammation) and eosinophils also play a significant pathophysiological role. Easy-to-interpret blood biomarkers with a discriminative capacity for severity or prognosis are needed. The objective of this study was to assess whether the peripheral neutrophil-to-lymphocyte ratio (NLR) is associated with different outcomes of severity in bronchiectasis. A total of 1369 patients with bronchiectasis from the Spanish Registry of Bronchiectasis were included. To compare groups, the sample was divided into increasing quartiles of NLR ratio. Correlations between quantitative variables were established using Pearson’s P test. A simple linear regression (with the value of exacerbations as a quantitative variable) was used to determine the independent relationship between the number and severity of exacerbations and the NLR ratio. The area under the curve (AUC)-ROC was used to determine the predictive capacity of the NLR for severe bronchiectasis, according to the different multidimensional scores. Mean age: 69 (15) years (66.3% of women). The mean NLR was 2.92 (2.03). A higher NLR was associated with more severe bronchiectasis (with an especially significant discriminative power for severe forms) according to the commonly used scores (FACED, E-FACED and BSI), as well as with poorer quality of life (SGRQ), more comorbidities (Charlson index), infection by pathogenic microorganisms, and greater application of treatment. Furthermore, the NLR correlated better with severity scores than other parameters of systemic inflammation. Finally, it was an independent predictor of the incident number and severity of exacerbations. In conclusion, the NLR is an inexpensive and easy-to-measure marker of systemic inflammation for determining severity and predicting exacerbations (especially the most severe) in patients with bronchiectasis.

Introduction: Postsurgical Lumbar facet joint syndrome (PLFJS) is a clinical entity characterized by acute or chronic lumbar pain which can irradiate to the lower extremities but never with a dermatomal pattern in postsurgical patients of lumbar surgery. The diagnosis and treatment are with a Diagnostic Facet Block (DFB). This study describes the outcome of patients undergoing DFB after lumbar surgery and compares the results with patients without surgery. Methods: An analytic and longitudinal study with patients over 18 years old between January 2018 and January 2020. For the comparative analysis, we performed two groups: non-surgical lumbar facet joint syndrome (NSLFJS) and PLFJS. Results: The general prevalence of PLFJS in our population was 12.5%. The results after DBF showed a significant decrease in the Oswestry percentage and pain according to the Visual Analog Scale(VAS) for the NSLFJS and PLFJS groups between the 3 surgical stages (pre-DFB, post-DFB at 6 weeks and post-DFB at 6 months), but no significant differences between the 2 groups. Discussion: The VAS and Oswestry reported a significant improvement in both groups of patients. The innervation of the lumbar facet joints causes pain, this is secondary to the pathological neural activity of facet arthritis that arises because of chronic postsurgical inflammation or chronic degenerative changes. Conclusion: The origin of the LFJS is the arthrosis of the facet, originated by postsurgical or degenerative changes. DFB is effectivefor decreasing pain of facet joint origin in patients with previous lumbar surgery.

La incidencia de la pandemia en el mundo ha dado un giro exponencial a los procesos sociales y, por ende, a la modalidad de formación en los procedimientos académicos de todas las instituciones educativas. Con ello y en concordancia con el análisis de la procrastinación y su incidencia en el incremento del estrés tanto en estudiantes como en docentes universitarios, que han tenido que adaptarse a la enseñanza online que, se ha propuesto como objetivo, la necesidad de observar estas conductas mediante la aplicación metodológica que consideró el enfoque mixto cuali-cuantitativo, apoyado en un análisis descriptivo. Ha sido necesario, revisar y priorizar presupuestos teóricos de varios documentos publicados; además, se aplicó un cuestionario estructurado a una muestra intencional lo que ha permitido obtener como resultados, el análisis de conductas de procrastinación y características propias del estrés que se han visto incrementadas en la muestra estudiada tales como: emociones, pensamientos, conductas y cambios físicos los cuales coadyuvan a proponer el uso adecuado del tiempo en todas las actividades académicas y sociales, para facilitar la consecución de las tareas cotidianas, plantear alternativas de solución minimizando el impacto y desarrollando actitudes de apoyo a la gestión docente y discente de los universitarios.

El objetivo de la presente investigación, pretende indagar sobre la dinámica de las familias de estudiantes de nivel medio, la situación académica actual en casa y su eventual retorno a la educación con la modalidad presencial y uso de instalaciones en instituciones con financiamiento particular o fiscomisional. La investigación adoptó el enfoque cualitativo de carácter descriptivo en el que participaron una muestra de 971 padres de familia y/o representantes estudiantiles con características similares de educación particular en la zona urbana de Cuenca, Ecuador. Luego de obtener los resultados producto de instrumentos cualitativos como encuestas estructuradas y análisis de información documental, se obtuvieron datos que permitieron describir criterios de adaptación social a los procesos académicos de los estudiantes en sus hogares durante la actual pandemia, la realidad de la salud familiar y el posible contacto con personas contagiadas o con vulnerabilidad de contagio en el sector de influencia. Así mismo el estudio, facilitó el planteamiento de algunas consecuencias respecto al retorno progresivo o futuro a las aulas físicas, resaltando los criterios expresados por la muestra estudiada que servirán de preámbulo para la toma de decisiones por parte de las autoridades educativas zonales y distritales en este campo académico para el nivel medio.

Las empresas vinculadas al comercio exterior en Ecuador enfrentan retos importantes para mejorar sus flujos de comunicación y, de esta manera lograr ser más eficaces y seguros en el desarrollo de sus actividades cotidianas. Actualmente, los costos de estas empresas se ven afectados por falencias en dichos flujos, lo que desencadena en ineficiente rotación de inventarios, pérdidas de producción, robos, pérdidas de tiempo y esfuerzo del personal, actividades ilícitas; situaciones que pudieran evitarse con el manejo de una trazabilidad eficiente de la comunicación en el manejo de la carga, de modo que se tomen acciones inmediatas ante situaciones imprevistas. El proceso investigativo desarrollado, pretende analizar la Gestión de la comunicación organizacional en este tipo de empresas vinculadas a las normas BASC “Business Alliance for Secure Commerce” para un comercio seguro en la República del Ecuador. Se aplicó el enfoque cualitativo de tipo descriptivo apoyado en investigación documental y en encuestas estructuradas para validar los elementos de la comunicación organizacional. Se pudo verificar que no todos los elementos de la gestión de la comunicación están integrados en las normas de seguridad mencionadas, ante lo cual se propone la reestructuración del capítulo específico a ser considerado en la publicación de versiones futuras.

La situación actual en el mundo ha desarrollado nuevas formas de ver la vida y de valorar hechos que han tomado relevancia en los últimos meses, específicamente desde marzo del año 2020 en que la pandemia del Covid-19 tomó fuerza en el Ecuador y el resto del planeta. Ha desatado una crisis cultural que impacta de forma creciente en todos los campos de acción y se destaca en la función docente y el cambio en el proceso académico. La investigación pretende analizar el impacto que ha tenido el paso emergente de la modalidad de estudios presenciales a la modalidad virtual en la tarea diaria del docente y su repercusión en la ejecución de su gestión; así mismo centrar la atención en el aislamiento social y los procesos de educación alternativa que denotan su estudio. Se considera un enfoque mixto basado en el método de revisión bibliográfica apoyado en la aplicación de encuestas estructuradas al personal docente que ha vivenciado el cambio. Se pudo notar que tanto el personal docente como los estudiantes, no estuvieron preparados para adoptar de manera urgente e inmediata la realidad presente lo que ocasionó cambios estructurales en su forma de impartir y recibir información, así como afecciones en el proceso académico resultante.

Neutrophil extracellular traps (NETs) induce a procoagulant response linking inflammation and thrombosis. Low levels of miR-146a, a brake of inflammatory response, are involved in higher risk for cardiovascular events, but the mechanisms explaining how miR-146a exerts its function remain largely undefined. The aim of this study was to explore the impact of miR-146a deficiency in NETosis both, in sterile and non-sterile models in vivo, and to inquire into the underlying mechanism. Two models of inflammation were performed: 1) Ldlr-/- mice transplanted with bone marrow from miR-146a-/- or wild type (WT) were fed high-fat diet, generating an atherosclerosis model; and 2) an acute inflammation model was generated by injecting lipopolysaccharide (LPS) (1 mg/Kg) into miR-146a-/- and WT mice. miR-146a deficiency increased NETosis in both models. Accordingly, miR-146a-/- mice showed significant reduced carotid occlusion time and elevated levels of NETs in thrombi following FeCl3-induced thrombosis. Infusion of DNAse I abolished arterial thrombosis in WT and miR-146a-/- mice. Interestingly, miR-146a deficient mice have aged, hyperreactive and pro-inflammatory neutrophils in circulation that are more prone to form NETs independently of the stimulus. Furthermore, we demonstrated that community acquired pneumonia (CAP) patients with reduced miR-146a levels associated with the T variant of the functional rs2431697, presented an increased risk for cardiovascular events due in part to an increased generation of NETs.

Las empresas que forman parte de la cadena de suministros en el comercio exterior en Ecuador, mantienen su desarrollo organizacional basado en procesos regulados por normas de seguridad en la carga entre las que se encuentran las Basic Alliance for Secure Commerce (BASC) que, utilizan de forma transversal al tratamiento de la información y la comunicación, pero no las declaran de manera explícita. El objetivo de esta investigación fue sistematizar presupuestos teóricos acerca de los componentes de la Gestión de Información (GI); y la Gestión de la Comunicación (GC), que permitan plantear un modelo para su integración en procesos regulados por normas BASC como un recurso coadyuvante. La investigación desarrollada tiene un enfoque cualitativo y el método aplicado es el fenomenográfico apoyado de entrevistas semiestructuradas a expertos a fin de analizar sus procedimientos para tratar la información y la comunicación interna y externa de las empresas. Se encontró que las organizaciones no gestionan adecuadamente la información y la comunicación, pues no aplican principios infocomunicacionales, sino que se enfocan en tratamientos aislados, normativas y en muchos casos únicamente guiados por medios tecnológicos. En consecuencia, se plantea un primer modelo genérico infocomunicacional que permite integrar los componentes de información y la comunicación en beneficio de la gestión organizacional.

Reseña del libro, El Levítico Como Literatura. Una Investigación Antropológica Y Literaria De Los Ritos En El Antiguo Testamento, trad. Javier Arrambide y Marta Pino Moreno, Gedisa, Barcelona, 2006, 310 pp., ISBN 84-9784-080-1.

Abstract Background Non-cystic fibrosis bronchiectasis is a chronic structural lung condition that courses with recurrent infectious exacerbations that lead to frequent antibiotic treatment making this population more susceptible to acquire pathogens with antibiotic resistance. We aimed to investigate risk factors associated with isolation of multidrug-resistant pathogens in bronchiectasis exacerbations. Methods A prospective observational study was conducted in two tertiary-care hospitals, enrolling patients when first exacerbation appeared. Multidrug-resistance was determined according to European Centre of Diseases Prevention and Control classification. Results Two hundred thirty three exacerbations were included and microorganisms were isolated in 159 episodes. Multidrug-resistant pathogens were found in 20.1% episodes: Pseudomonas aeruginosa (48.5%), methicillin-resistant Staphylococcus aureus (18.2%) and Extended spectrum betalactamase + Enterobacteriaceae (6.1%), and they were more frequent in exacerbations requiring hospitalization (24.5% vs. 10.2%, p: 0.016). Three independent multidrug-resistant risk factors were found: chronic renal disease (Odds ratio (OR), 7.60, 95% CI 1.92–30.09), hospitalization in the previous year (OR, 3.88 95% CI 1.37–11.02) and prior multidrug-resistant isolation (OR, 5.58, 95% CI 2.02–15.46). The proportion of multidrug-resistant in the 233 exacerbations was as follows: 3.9% in patients without risk factors, 12.6% in those with 1 factor and 53.6% if ≥2 risk factors. Conclusions Hospitalization in the previous year, chronic renal disease, and prior multidrug-resistant isolation are risk factors for identification multidrug-resistant pathogens in exacerbations. This information may assist clinicians in choosing empirical antibiotics in daily clinical practice.

Abstract Background Bronchiectasis (BE) is a chronic structural lung disease with frequent exacerbations, some of which require hospital admission though no clear associated factors have been identified. We aimed to evaluate factors associated with hospitalization due to exacerbations during a 1-year follow-up period. Methods A prospective observational study was performed in patients recruited from specialized BE clinics. We considered all exacerbations diagnosed and treated with antibiotics during a follow-up period of 1 year. The protocol recorded baseline variables, usual treatments, Bronchiectasis Severity Index (BSI) and FACED scores, comorbid conditions and prior hospitalizations. Results Two hundred and 65 patients were recruited, of whom 162 required hospital admission during the follow-up period. Independent risk factors for hospital admission were age, previous hospitalization due to BE, use of proton pump inhibitors, heart failure, FACED and BSI, whereas pneumococcal vaccination was a protective factor. The area under the receiver operator characteristic curve (AUC) was 0.799 for BSI model was 0.799, and 0.813 for FACED model. Conclusions Previous hospitalization, use of proton pump inhibitors, heart failure along with BSI or FACED scores is associated factors for developing exacerbations that require hospitalization. Pneumococcal vaccination was protective. This information may be useful for the design of preventive strategies and more intensive follow-up plans.

Este trabajo busca mostrar el delay o discontinuidad que la teología misional evangélica exhibe frente a las actualizaciones socio-espaciales de la cultura urbana en la ciudad de México y su zona metropolitana. En este amplio sector urbano coexisten la mayoría de los grupos religiosos representativos de México. Se repara en la evangelización protestante metropolitana y sus dinámicas de apropiación de los espacios, interacción de géneros y experiencias urbanas, entendiendo tal dinámica de comunicación como la ejecución de una cultura del creer de carácter sobresituado, la cual sería una derivación de la cultura del habitar urbano en contextos glocales. Ante esta cultura la teoría misiológica se encuentra desfasada, aunque la praxis evangélica ha buscado actualizaciones no oficiales.

mRNA translational control by CPEBs is reactivated in cancer. Here, the authors show that the insertion of CPE regulatory sequences in the 3′ UTR of the E1A viral gene induces oncoselectivity, with oncolytic potency in cancer cells but attenuated toxicity in normal tissues.

Background: DNA methylation (DNAm) may contribute to processes that underlie associations between air pollution and poor health. Therefore, our objective was to evaluate associations between DNAm and ambient concentrations of particulate matter (PM) ≤2.5, ≤10, and 2.5–10 μm in diameter (PM2.5; PM10; PM2.5–10). Methods: We conducted a methylome-wide association study among twelve cohort- and race/ethnicity-stratified subpopulations from the Women's Health Initiative and the Atherosclerosis Risk in Communities study (n = 8397; mean age: 61.5 years; 83% female; 45% African American; 9% Hispanic/Latino American). We averaged geocoded address-specific estimates of daily and monthly mean PM concentrations over 2, 7, 28, and 365 days and 1 and 12 months before exams at which we measured leukocyte DNAm in whole blood. We estimated subpopulation-specific, DNAm-PM associations at approximately 485,000 Cytosine-phosphate-Guanine (CpG) sites in multi-level, linear, mixed-effects models. We combined subpopulation- and site-specific estimates in fixed-effects, inverse variance-weighted meta-analyses, then for associations that exceeded methylome-wide significance and were not heterogeneous across subpopulations (P 0.10), we characterized associations using publicly accessible genomic databases and attempted replication in the Cooperative Health Research in the Region of Augsburg (KORA) study. Results: Analyses identified significant DNAm-PM associations at three CpG sites. Twenty-eight-day mean PM10 was positively associated with DNAm at cg19004594 (chromosome 20; MATN4; P = 3.33 × 10−8). One-month mean PM10 and PM2.5–10 were positively associated with DNAm at cg24102420 (chromosome 10; ARPP21; P = 5.84 × 10−8) and inversely associated with DNAm at cg12124767 (chromosome 7; CFTR; P = 9.86 × 10−8). The PM-sensitive CpG sites mapped to neurological, pulmonary, endocrine, and cardiovascular disease-related genes, but DNAm at those sites was not associated with gene expression in blood cells and did not replicate in KORA. Conclusions: Ambient PM concentrations were associated with DNAm at genomic regions potentially related to poor health among racially, ethnically and environmentally diverse populations of U.S. women and men. Further investigation is warranted to uncover mechanisms through which PM-induced epigenomic changes may cause disease. Keywords: Particulate matter, DNA methylation, Epigenetics, Air pollution, Epigenome-wide association study

Cytoplasmic polyadenylated transcripts have been poorly characterized, particularly in cancer. Here the authors identify a lineage-specific requirement of the cytoplasmic polyadenylation binding protein 4 (CPEB4) in malignant melanoma and show that it controls melanoma drivers MITF and RAB27A.

La cuestión de las relaciones entre la filosofía y la fe es una novedad en la historia a partir de la aparición del cristianismo. Sus razones son de tipo histórico, pero también estructural. Por su misma identidad, el cristianismo generó un ámbito donde este asunto debe resolverse. Desde el comienzo, el proceso no ha sido unidireccional ni pacífico; se generaron diversas posiciones. Las consecuencias son una nueva mirada sobre la filosofía y el desarrollo de una comprensión de la fe que excede su simple profesión.

BackgroundThe electrocardiographically quantified QRS duration measures ventricular depolarization and conduction. QRS prolongation has been associated with poor heart failure prognosis and cardiovascular mortality, including sudden death. While previous genome-wide association studies (GWAS) have identified 32 QRS SNPs across 26 loci among European, African, and Asian-descent populations, the genetics of QRS among Hispanics/Latinos has not been previously explored.MethodsWe performed a GWAS of QRS duration among Hispanic/Latino ancestry populations (n = 15,124) from four studies using 1000 Genomes imputed genotype data (adjusted for age, sex, global ancestry, clinical and study-specific covariates). Study-specific results were combined using fixed-effects, inverse variance-weighted meta-analysis.ResultsWe identified six loci associated with QRS (PConclusionsOur QRS duration GWAS, the first in Hispanic/Latino populations, identified two new loci, underscoring the utility of extending large scale genomic studies to currently under-examined populations.

La cuestión que nos planteamos se centra principalmente en conocer si las colectividades árabe y judía de Argentina cumplirían un rol en la determinación de la política exterior gubernamental con los países de Medio Oriente, con la posición argentina respecto del conflicto en dicha región y también si esta influencia se manifestaría en la política interior del Estado hacia ambas colectividades. Nos serviremos del análisis de ciertos hitos históricos como eje ordenador del tratamiento. Rastreando las acciones de ambas colectividades en relación con el conflicto del Medio Oriente y las políticas de Estado respecto del mismo tema, verificaremos la verosimilitud de ese rol supuestamente cumplido.

Introduction The Spanish Society of Pulmonology and Thoracic Surgery created a registry for hospitalised patients with COVID-19 and the different types of respiratory support used (RECOVID). Objectives. To describe the profile of hospitalised patients with COVID-19, comorbidities, respiratory support treatments and setting. In addition, we aimed to identify varying profiles of patients according to outcomes and the complexity of respiratory support needed.Methods Multicentre, observational study in 49 Spanish hospitals. A protocol collected demographic data, comorbidities, respiratory support, treatment setting and 1-year follow-up. Patients were described using either frequency and percentages or median and interquartile range, as appropriate. A cluster analysis made it possible to identify different types of profile among the patients.Results In total, 2148 of 2454 hospitalised patients (87.5%) received care in the conventional ward, whilst 126 in IRCU and 180 in ICU. In IRCU, 30% required high-flow nasal oxygen whilst 25%, non-invasive mechanical ventilation and 17%, mechanical ventilation. Four clusters of patients were identified. Two clusters were more likely to require IRCU/ICU admission, although primarily Cluster 2: Cluster (C) 1 consisted of patients without comorbidities and C2, those with comorbidities. Both presented higher inflammatory levels and lower lymphocyte count and SpO2/FiO2; however, C2 showed worse values. Two different clusters identified patients requiring less complex respiratory support. C3 presented higher comorbidities and elevated lymphocyte count, SpO2/FiO2 and low C-reactive protein (CRP). C4 included those without comorbidities except for arterial hypertension, lymphopenia and an intermediate CRP. In-hospital mortality and subsequent 1-year mortality were greater for C2 (28.6% and 7.1%) and C1 (11.1%, 8.3%) than for C4 (3.3%, 1.8%) and C3 (0%, 0%).Conclusions The cluster analysis identified four clinical phenotypes requiring distinct types of respiratory support, with great differences present per characteristics and outcomes.

Rationale The baseline value of eosinophils in peripheral blood (BEC) has been associated with different degrees of severity, prognosis and response to treatment in patients with bronchiectasis. It is not known, however, if this basal value remains constant over time. Objectives The aim of this study was to assess whether the BEC remains stable in the long term in patients with bronchiectasis. Methods and measurements Patients from the RIBRON registry of bronchiectasis diagnosed by computed tomography with at least 2 BEC measurements one year apart were included in the study. Patients with asthma and those taking anti-eosinophilic drugs were excluded. Reliability was assessed using the intra-class correlation coefficient (ICC). A patient with a BEC of at least 300 cells/uL or less than 100 cells/uL was considered eosinophilic or eosinopenic, respectively. Group changes over time were also calculated. Main results Seven hundred and thirteen patients were finally included, with a mean age of 66.5 (13.2) years (65.8 % women). A total of 2701 BEC measurements were performed, with a median number of measurements per patient of 4 (IQR: 2–5) separated by a median of 12.1 (IQR: 10.5–14.3) months between two consecutive measurements. The ICC was good (>0.75) when calculated between two consecutive measurements (approximately one year apart) but had dropped significantly by the time of the next annual measurements. Similarly, the change from an eosinophilic or eosinopenic patient to a non-eosinophilic or non-eosinopenic patient, respectively, was less than 30 % during the first year with respect to the baseline value but was close to 50 % in later measurements. Conclusions Given the significant changes observed in the baseline value of the BEC over time, its monitoring is necessary in patients with bronchiectasis in order to more reliably assess its usefulness.

The four members of the vertebrate CPEB family of RNA-binding proteins share similar RNA-binding domains by which they regulate the translation of CPE-containing mRNAs, thereby controlling cell cycle and differentiation or synaptic plasticity. However, the N-terminal domains of CPEBs are distinct and contain specific regulatory post-translational modifications that presumably differentially integrate extracellular signals. Here we show that CPEB4 activity is regulated by ERK2- and Cdk1-mediated hyperphosphorylation. These phosphorylation events additively activate CPEB4 in M-phase by maintaining it in its monomeric state. In contrast, unphosphorylated CPEB4 phase separates into inactive, liquid-like droplets through its intrinsically disordered regions in the N-terminal domain. This dynamic and reversible regulation of CPEB4 is coordinated with that of CPEB1 through Cdk1, which inactivates CPEB1 while activating CPEB4, thereby integrating phase-specific signal transduction pathways to regulate cell cycle progression.