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Canopy-forming kelps are essential foundation species, supporting biodiversity and providing ecosystem services valued at more than USD$500 billion annually. The global decline of giant kelp forests due to climate-driven ecological stressors underscores the need for innovative restoration strategies. An emerging restoration technique known as 'green gravel' aims to seed young kelps over large areas without extensive underwater labor and represents a promising restoration tool due to cost-effectiveness and scalability. This video article illustrates a protocol and tools for culturing giant kelp, Macrocystis pyrifera. It also provides a resource for further studies to address the successes and limitations of this method in field settings. We outline field and laboratory-based methods for collecting reproductive tissue, sporulating, inoculating, rearing, maintaining, and monitoring substrates seeded with early life stages using the 'green gravel' technique. The protocol simplifies and centralizes current restoration practices in this field to support researchers, managers, and stakeholders in meeting kelp conservation objectives.

Abstract Background In Latin America, interventions aimed at adolescents’ health suffer from a shortfall of investment and lack of sustainability. Nurses, as an integral part of health services and systems, can lead the implementation and development of public health policies to improve adolescent health. Objective To identify and analyze the role of nurses in the development and implementation of public policies and in the provision of health care to adolescents in Colombia, Ecuador, and Peru. Methods The research was carried out in three phases: a documentary analysis, an online survey, and semi-structured focus groups. A total of 48 documents were analyzed, 288 nurses participated in the survey, and 29 nurses participated in the focus groups. Results State policies aim to guarantee rights, with special protection for children and adolescents. It is an incremental process, with greater involvement of civil society and governments. Participants reported a lack of synergy between law and practice, as well as differences in regulatory compliance in rural areas and in populations of different ethnicities and cultures. Their perception was that the protection of adolescents is not specifically enshrined in the legal bases and regulatory structures of the countries, meaning that there are both protective factors and tensions in the regulatory framework. While nurses are highly committed to different actions aimed at adolescents, their participation in policy development and implementation is low, with barriers related to a lack of specialized training and working conditions. Conclusions Given nurses’ involvement in different actions aimed at adolescents, they could play a fundamental role in the development of policies for adolescents and ensure their effective implementation. Policymakers should consider revising the budget to make compliance viable, incorporating and using monitoring indicators, and increasing the involvement of educational institutions and the community.

Purpose: Extranodal NK/T-cell lymphoma (ENKTCL) is rare in the Western Hemisphere and is commonly treated with combined modality therapy (CMT). Methods and Materials: We retrospectively reviewed 35 patients treated with Ann Arbor stage I/II ENKTCL between 1994 and 2015 at a large academic cancer center in the United States. Results: With 11.6 years median follow-up, median overall survival and progression-free survival were 13.5 and 7.5 years, respectively. Eighteen (51%) patients experienced disease relapse, with 5 regional nodal relapses, of which 2 experienced combined regional and distant relapses. All 5 regional nodal relapses occurred exclusively among patients not treated with elective nodal irradiation (ENI). ENI was associated with improved progression-free survival (hazard ratio [HR], 0.21; 95% CI, 0.09-0.52; P = .018) without significant association with OS (HR, 0.33; 95% CI, 0.11-0.94; P = .11). There was a trend toward improved local control with radiation dose to the primary tumor ≥50 Gy (HR, 0.29; 95% CI, 0.08-1.08; P = .098). Conclusions: In this Western Hemisphere cohort of early-stage ENKTCL patients treated with CMT, ENI may have a potential clinical benefit, particularly in patients who are treated with non–asparaginase-containing CMT, such as in patients treated with radiation alone, patients treated with less intensive chemotherapy concurrently, or patients who are unable to tolerate intensive chemotherapy.

Purpose: Definitive intent radiation therapy (RT) for early-stage mucosa-associated lymphoid tissue (MALT) lymphoma typically includes a dose of 24 to 30 Gy. While modest, these doses may have associated toxicity. For patients with indolent B-cell lymphoma, there is increasing support for the use of ultra–low-dose RT (ULDRT) using 4 Gy in 2 fractions as part of a response-adapted approach, as high rates of complete response have been documented. This paradigm has been prospectively evaluated in the management of orbital and gastric indolent B-cell lymphomas; however, there is limited data guiding the use of ULDRT for lung MALT. Methods: We conducted a retrospective review of 20 patients at our institution with lung MALT treated with ULDRT as part of a response-adapted approach. Clinical variables including prior systemic therapy and symptoms were abstracted from the electronic health record. Responses were assessed using the revised Lugano criteria. Results: At a median follow up of 17 months following 4 Gy (IQR, 8-37 months), we observed 100% local control. Nineteen patients (95%) experienced a complete response. No patients with stage IE disease at RT (17/20; 85%) experienced distant progression. Nine patients (45%) were symptomatic prior to RT, with improvement or resolution of symptoms in 7 (7/9; 78%). One patient developed grade 2 pleuritic pain following RT, which resolved with a brief course of steroids. No other toxicities were noted. Conclusions: ULDRT, given in a response-adapted approach, is effective and well tolerated by patients with lung MALT.

Objetivo. El objetivo de esta investigación fue determinar las propiedades métricas del Test de Rendimiento Motor Infantil (TIMP) adaptado al español de Colombia. Métodos. Este estudio evaluó una prueba diagnóstica mediante análisis de propiedades métricas, es decir, consistencia interna, confiabilidad interevaluadores y validez concurrente. La unidad de análisis fue el Test de Rendimiento Motor Infantil. Se evaluó una muestra de 112 niños de entre 36 semanas de edad postmenstrual y 4 meses de edad. Participaron dos evaluadores expertos en el área de la neurorrehabilitación infantil, con experiencia y formación en la aplicación del instrumento. El análisis de consistencia interna se realizó mediante el coeficiente alfa de Cronbach. La evaluación de la fiabilidad entre evaluadores se realizó mediante el cálculo de los coeficientes de correlación intraclase. Para determinar la validez concurrente se utilizó el coeficiente de correlación de Pearson. Los análisis de los datos obtenidos se realizaron con el programa SPSS versión 27.0. Resultados. El α de Cronbach se situó entre 0,61 y 0,84. En cuanto a la fiabilidad, el instrumento arrojó un coeficiente de correlación intraclase entre 0,54 y 0,93. La validez concurrente arrojó un coeficiente de correlación de Pearson de 0,82. Conclusiones. El TIMP adaptado al español colombiano es un instrumento válido y confiable que puede ser utilizado para la evaluación del desempeño motor en niños.

Introduction: Adult T-cell leukemia/lymphoma (ATLL) is a mature, peripheral T-cell neoplasm caused by HTLV-1 and its lifetime risk is estimated as 4-7% among HTLV-1 carriers. Acute and lymphoma subtypes are highly aggressive diseases, characterized by shorter survival rates and a high risk of central nervous system involvement (iCNS) compared to other peripheral T-cell lymphomas. Currently, the treatment of ATLL remains a challenging. Our recent study on PTCL epidemiology and outcomes in Latin America (Thais et al. 2023 ASH Meeting) highlighted ATLL (18%) as the second most frequent subtype of PTCL, likely influenced by our distinct viral epidemiology. Objective: It is to assess the prevalence, clinical features, risk factors, and outcomes of iCNS in ATLL in Latin America. Methodology: Patients (pts) aged ≥18 years with newly diagnosed ATLL from GELL (n = 208, 2000-2023, retrospective) and TCBP (n = 83, 2015-2022, ambispective). Overall survival (OS) and progression free survival (PFS) were our endpoints. REDcap Platform (by Vanderbilt) was used to collect and store data, whereas for statistical analysis IBM-SPSS v.24. This trial is registered at Clinical trials (NCT03207789). Results: It was enrolled 291 pts, the prevalence of iCNS in ATLL was 7.9% (23/291), considering only aggressive forms (acute 40% and 60% lymphomatous). Pts'characteristics were similar between those without and with iCNS. There was a high frequency of advanced stage (90% vs 82%); ECOG ≥ 2 (45% vs 43%); B symptoms (74% vs 56%); elevated LDH (84% vs 78%); and IPI ≥3 (82% vs 65%) in the iCNS group. Treatment was heterogeneous including: IFN+AZT (74%) for acute subtypes, and CHOP (52%), CHOEP (26%) and EPOCH (2%), for lymphoma subtypes. Less than 30% of both groups achieved complete response at end of first treatment. Two clinical features were identified as possibly associated to iCNS: median age at diagnosis (55 [20-95] vs 44 [23-65]; p < 0.0001) and extra nodal involvement ≥ 2 (32% vs 65%, p = 0.005). The entire cohort of ATLL had 60- month OS and PFS of 16% [95% CI: 12-20%] and 9% [95% CI: 5-13%]; with median time of OS and PFS of 7 months (6-9) and 5 months (4-6). iCNS did not have an impact on survival outcomes (60 months OS 14% iCNS (n = 23) vs 16% no iCNS (n = 254), p = 0.91; PFS 12% vs 9% no iCNS, p = 0.61;) despite being a devastating complication. Outcomes in pts with lymphoma subtypes were slightly better than acute (60 months OS 19% vs 10%, p < 0.0001; PFS 12% vs 5%, p < 0.0001, respectively). Conclusion: Unlike other lymphoma subtypes, iCNS in ATLL does not appear to significantly impact outcomes. This paradoxical finding underscores the complexity of ATLL and may reflect the limitations of existing treatment options and the absence of standardized therapeutic protocols for this aggressive malignancy. The lack of significant survival difference, despite the severity of iCNS, points to an urgent need for innovative therapies and more effective treatment strategies. Our analysis identified median age at diagnosis and extranodal involvement as potential risk factors for iCNS, suggesting avenues for future prospective studies to further elucidate their role in disease progression. Given the high prevalence of ATLL in Latin America, there is a unique opportunity to advance our understanding of this disease through region-specific research. Collaborative efforts in this region could pave the way for breakthroughs in the management of ATLL and potentially offer insights applicable on a global scale.

Introduction: PTCL accounts for 10-15% of all NHL. As previously demonstrated, Latin America has its own epidemiological distribution, with a high frequency of ATLL and ENKT, likely influenced by distinct genetic profiles and viral epidemiology. 3-year OS is about 40%. Treatment advances have also been limited, except for BV-CHP in some countries. The IPI, which includes extranodal (EN) site as a variable, has been validated for PTCL. However, the specific impact of EN involvement on nodal PTCL (such as PTCL-NOS, AIT, ALCL ALK+/ALK-) and its biological implications remain unclear. Simplification could improve the reproducibility and applicability of these models, especially in low-income countries. Objective: To evaluate number of EN sites in nodal PTCL lymphomas as a risk factors or surrogate for outcomes, as OS and PFS in Latin America cohort. Methodology: Patients (pts) aged ≥18 years with newly diagnosed nodal PTCL-NOS, AITL and ALCL ALK+/ALK-) from GELL (n = 339, 2000-2023, retrospective), TCBP (n = 427, 2015-2022, ambispective). Treatment outcome was determined by OS and PFS. REDcap Platform (by Vanderbilt) was used to collect and store data, whereas statistical analysis the IBM-SPSS v.24. This trial is registered at Clinical trials (NCT03207789). Results: 766 pts [427pts - TCBP and 339 - GELL] diagnosed with nodal PTCL were grouped according to the number of EN: no EN involvement (No EN - 383); one EN involvement (EN1 -168); and 32 (EN2 - 215). Considering all, 61% male; median age 56 y/o; 74% were staged III/IV; 69% IPI 32; 60% was PTCL-NOS, 19% ALCL ALK- and 12% AITL. 61% had B symptoms and 55% elevated LDH. CHOEP was used in 47% and 34% CHOP, and 47% achieved CR after first line; 16% used transplant as consolidation. No EN, EN1 and EN2 were similar regarding clinical characteristics, except, for stage III/IV (58% vs. 79% vs 96%; p < .0001); IPI 32 (58% vs. 59% vs. 99%; p < .0001); ECOG>1 (58% vs. 92% vs. 99%; p < .0001); BMO involvement (16% vs. 24% vs. 63%%; p

Amazonia is believed to harbour the world’s most extensive tropical peatlands, storing significant amounts of carbon and having high value for biodiversity conservation, climate regulation and human welfare. However, a comprehensive assessment is hampered by fragmentary knowledge of the locations of peat-covered areas and this, in turn, prevents their protection and restoration in the face of ongoing anthropogenic destruction. The study reported here reviewed research activities on peatlands in Amazonia, which started with ecological studies in the 1950s. We found a broad and significant thematic increase since 2009, with growing focus first on carbon accumulation and greenhouse gas fluxes then, after 2017, on degradation and conservation, along with a spatial imbalance in favour of the Peruvian lowlands. Hitherto, very little scientific attention has been directed towards the peatlands of western Brazil, the Bolivian lowlands and the Guianas. Most research in Amazonia has been conducted by international institutions with, in recent times, increasing contributions from local institutes and research groups. Nevertheless, research on Amazonian peatlands is still in its early stages, and several scientific questions remain unanswered. Advancing the knowledge base with respect to various scientific disciplines (e.g., ecology, biology, geography, social sciences and economics) is, therefore, essential for understanding how and where peatlands developed, how they are used, which ecosystem services they provide, how climate change will affect them and, finally, what would be the most appropriate conservation, restoration and sustainable use strategies for safeguarding the wellbeing of both peatlands and people.

BackgroundDiffuse large B-cell lymphoma (DLBCL) involving the gastrointestinal (GI) organs is rare, and real-world outcomes after combined modality therapy (CMT) with systemic therapy (ST) and radiotherapy (RT) are not well-characterized, particularly in the contemporary era. We characterized outcomes in a large cohort of GI-DLBCL patients treated with ST alone or CMT.MethodsPatients with GI-DLBCL treated at a single institution were retrospectively reviewed. Kaplan-Meier and Cox regression models estimated survival. Multivariable analyses were conducted using the Cox proportional hazards model.ResultsOf 204 patients, gastric involvement was most common (63%). Most presented with early-stage disease (61%). All patients received ST and 65 patients (32%) received RT, 88% as part of first-line CMT. Median dose was 36 Gy (IQR 30.6–39.6) in 18 fractions (IQR 17–22). Median follow-up was 46 months. Five-year overall survival (OS) and progression-free survival (PFS) was 88% and 84%, respectively; complete response (CR) rate was 82%. Improved OS associated with low IPI (p=0.001), fewer chemotherapy lines (p0.25). Only early stage and CR correlated with improved OS on multivariable analysis. Stomach-directed RT vs. RT to other sites correlated with improved PFS and OS (p

Adult T-cell leukemia-lymphoma (ATLL) is an aggressive Human T-cell Leukemia Virus Type 1 (HTLV-1)-driven malignancy. Although Western hemisphere (Afro-Caribbean and South American) patients face worse prognoses, our understanding of ATLL molecular drivers derives mostly from Japanese studies. We performed multi-omic analyses to elucidate the genomic landscape of ATLL in Western cohorts. Recurrent deletion and/or damaging mutations involving FOXO3, ANKRD11, DGKZ, and PTPN6 implicate these genes as potential tumor suppressors. RNA-seq, published functional data and in vitro assays support the roles of ANKRD11 and FOXO3 as regulators of T-cell proliferation and apoptosis in ATLL, respectively. Survival data suggest ANKRD11 mutation may confer a worse prognosis. Japanese and Western cohorts, in addition to acute and lymphomatous subtypes, demonstrated distinct molecular patterns. GATA3 deletion was associated with unfavorable chronic cases. IRF4 and CARD11 mutations frequently emerged in relapses after interferon therapy. Our findings reveal novel putative ATLL driver genes and clinically relevant differences between Japanese and Western ATLL patients.

Abstract Marine reserves (MRs) are implemented worldwide to protect, restore, and manage marine ecosystems and species. However, it is important to document the positive effects those marine reserves have on slow-growth, temperate invertebrates such as abalone. Abalone, Haliotis spp., are marine gastropods of high economic value extracted worldwide for decades, which has led to fisheries-driven population decreases. In this work, we focused on a case study and assessed the short-term (1–2 years) effects of marine reserves established and managed by a local fishing cooperative at Guadalupe Island, Mexico. We evaluated the population status of green abalone, H. fulgens, by conducting (1) an assessment of the green abalone population around Guadalupe Island through subtidal monitoring and (2) an evaluation of the effect of two recently established marine reserves on population parameters such as the increase in density (individuals·m2), biomass, number of aggregated abalone, egg production, and proportion of individuals bigger than 150 mm (minimum harvest size) compared to fished areas. To assess the population around Guadalupe Island, we surveyed 11,160 m2 during 2020 and 2021. We recorded 2327 green abalones with a mean ± SE shell length of 135.978 ± 0.83 mm and a mean density of 0.21 ± 0.02 individuals·m2. All variables were statistically higher at the MRs except for shell length in 2021. In this work, we report for the first time the green abalone population status at Guadalupe Island and a positive short-term biological response to community-based marine reserves. This study suggests that a network of MRs combined with good management could help abalone populations in the short term in Guadalupe Island, potentially leading to more sustainable fishing practices and social-ecological resilience.

Understanding how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in 2019 is critical to preventing future zoonotic outbreaks before they become the next pandemic. The Huanan Seafood Wholesale Market in Wuhan, China, was identified as a likely source of cases in early reports, but later this conclusion became controversial. We show here that the earliest known COVID-19 cases from December 2019, including those without reported direct links, were geographically centered on this market. We report that live SARS-CoV-2-susceptible mammals were sold at the market in late 2019 and that within the market, SARS-CoV-2-positive environmental samples were spatially associated with vendors selling live mammals. Although there is insufficient evidence to define upstream events, and exact circumstances remain obscure, our analyses indicate that the emergence of SARS-CoV-2 occurred through the live wildlife trade in China and show that the Huanan market was the epicenter of the COVID-19 pandemic.

Understanding the circumstances that lead to pandemics is important for their prevention. We analyzed the genomic diversity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) early in the coronavirus disease 2019 (COVID-19) pandemic. We show that SARS-CoV-2 genomic diversity before February 2020 likely comprised only two distinct viral lineages, denoted "A" and "B." Phylodynamic rooting methods, coupled with epidemic simulations, reveal that these lineages were the result of at least two separate cross-species transmission events into humans. The first zoonotic transmission likely involved lineage B viruses around 18 November 2019 (23 October to 8 December), and the separate introduction of lineage A likely occurred within weeks of this event. These findings indicate that it is unlikely that SARS-CoV-2 circulated widely in humans before November 2019 and define the narrow window between when SARS-CoV-2 first jumped into humans and when the first cases of COVID-19 were reported. As with other coronaviruses, SARS-CoV-2 emergence likely resulted from multiple zoonotic events.

Introduction Paediatric cancer survivors have a risk for neuropsychological impairment due to the disease and the treatment received. These affections have been neglected in the follow-up of these patients. It is important to identify the most valid outcomes in the evaluation of neurocognitive sequelae in childhood cancer survivors. Objectives This work aims to compare the results obtained between subjective perception of caregivers and objective cognitive performance based on validated attention tests. Methods In a randomized controlled and unblinded trial to demonstrate the benefit of video games on different neurocognitive areas in cancer survivors, we studied attention functioning before and after the intervention program. The attention deficit subscale from the Behavior Assessment System for Children 3rd edition (BASC-3), self- and parent-reported versions, and the Continuous Performance Test, 3rd edition (CPT 3) will be used as outcomes (z scores: mean = 0, S.D. = 1). Results We observed an improvement in attention after intervention using the CPT-3 (omissions z = 1.2; hit reaction time z = 3.4; hit reaction time block change z = 1.2 versus hit reaction time z = 3.6 without other atipycal z scores after intervention), changing the attentional pattern from “ADHD” to “slowed”. However, in the parent-reported version of the BASC-3, a worsening in the attention subscale is observed (z = 0.3 pre-intervention vs z = 1.0 post-intervention) while the self-reported version of the patient didn’t show any significant changes (z = 1.4 pre-intervention vs z = 1.1 post-intervention). Conclusions It is essential to use objective tests to measure neurocognitive sequelae in these patients. Subjective surveys can provide additional information, but not substitute the above. Disclosure of Interest None Declared

Introduction Children who have undergone an oncological process and have received treatment with chemotherapy or radiotherapy on the central nervous system may have significant neurocognitive sequelae. Some video games have shown neurocognitive benefits in people with impairments in different areas, such as attention or memory. Objectives This work aims to demonstrate the benefit of a video game-based training program to improve the neurocognitive profile in a child survivor of cancer. Methods The patient is a 9-year-old female who was diagnosed with acute lymphoblastic leukemia at the age of 4 years. She received routine treatment of this disease by chemotherapy, including high-dose chemotherapy (with blood-brain barrier crossing) and intrathecal chemotherapy. She is currently 3 years after the end of treatment. The Continuous Performance Test 3 (CPT-3) (sustained attention/vigilance) was administered before and after a multifaceted training program consisting of playing 3 video games for 12 weeks, as follows: a brain-training game (4 days per week, 7-12 minutes per day), a skill-training game (2 days per week, 10 minutes per day) and an exergaming game (2 days per week, 10 minutes per day). Results Prior to intervention, the patient had 3 atypical z-scores on the CPT-3 (z scores: mean = 0, S.D. = 1), with a pattern compatible with ADHD (omissions z = 1.2; hit reaction time z = 3.4; hit reaction time block change z = 1.2). After intervention, she had only an atypical z-score (hit reaction time z = 3.6), with a pattern compatible with slowing, without ADHD. Conclusions The neuropsychological evaluation of this patient showed an improvement in his attentional pattern on the CPT-3 after the video game-based training. Disclosure of Interest None Declared

Introduction Childhood cancer survivors have neurocognitive sequelae that in most survivor follow-up programs are underdiagnosed and for which there is usually no treatment plan. Video games have demonstrated various psychological and neurocognitive benefits in different subpopulations, such as patients with organic neurological deficits or children with ADHD. However, few studies have been carried out using video games-based interventions in the paediatric oncology population. Objectives The aim of this work is to present the WINNERS study protocol, the objectives of which are to diagnose the neurological and cognitive sequelae in child cancer survivors, and to demonstrate the benefit in these areas of a training program based on video games. Methods A randomized controlled and unblinded trial is presented. Fifty-six patients aged 8 to 17 years stratified into two age groups (8-12 and 13-17) who had received any of the following treatments 1 to 6 years before the enrolment will be selected: high-dose chemotherapy with blood-brain barrier crossing, intrathecal or intraventricular chemotherapy, CNS radiotherapy or hematopoietic stem cell transplantation. A neuropsychological evaluation will be performed consisting of a battery of neuropsychological tests to assess parameters such as attention, memory, visuospatial ability or speed of response, as well as a neuroimaging evaluation by structural and functional magnetic resonance imaging. The evaluation will be repeated 3 months and 6 months after the enrolment. Patients will be randomized to a treatment group or to a recycled waiting group. Intervention will consist on a 12-week training at home using 3 video games: a brain training game, an exergaming game and a skill training game. Results According to the hypotheses of this study, it is expected that the proposed program of videogame-based interventions will improve neurocognitive and other wellbeing parameters in the intervention group. Conclusions This study aims to improve the quality of care for patients who have survived a cancer disease by detecting sequelae that have so far been poorly attended, and by proposing a gamification-based intervention program that is effective and attractive for this population. Disclosure of Interest None Declared

El cultivo de Oreochromis niloticus se ve afectado por la reproducción excesiva en los sistemas de cultivo, lo que provoca un retraso en el crecimiento y tamaños pequeños en el momento de la cosecha, volviéndose no comercializables, creando la necesidad de invertir el sexo de las hembras, siendo posible con técnicas hormonales de reversión del sexo como es la 17 α metiltestosterona (MT). El objetivo de esta investigación fue determinar la proporción sexual y obtener los parámetros de producción en ejemplares de O. niloticus a los que se suministró la hormona MT en el alimento al 45% de proteína, con una dosis de 24 mg de MT/kg de alimento, durante 28 días. La determinación del sexo se realizó mediante la técnica del squash y observación al microscopio. La información se analizó mediante la estadística descriptiva e inferencial al 95% de confianza en el programa Excel. Se trabajó con un 10% de la población total, alcanzando un 95,2 % de machos. Las gónadas de las hembras mostraron los oocitos, mientras que en las gónadas de machos se observaron espermatocitos, presentaron una supervivencia de 96,33%, un incremento de peso de 13,46 g y de longitud de 7,82 cm.

Foundation: the relevance in health is related to the existing coherence in an intervention project according to the needs of its beneficiaries; In this it is very important that the professional has the faculties to combine his capacities in the achievement of a certain purpose.Objective: to determine employability indicators according to the competencies in graduates of the Guayaquil University nursing career.Methods: descriptive/explanatory study with a representative sample of 136 graduates of the last five years, to whom an instrument validated by expert judgment (0.89: Cronbach's alpha) was applied. 17 indicators of internal employability and six of external employability were measured.Results: Nursing graduates perceive employability as attributes and competencies of being, with problem-solving skills, being reflective, critical thinking, ethical behaviors, and effective leadership. In relation to external employability, graduates were considered to have attribute competencies that make them competitive in the nursing work environment.Conclusions: Nursing graduates from the Guayaquil University have the attributes and competencies of internal and external employability in accordance with the expectations of the objectives and the nursing professional’s profiles.

Globally, we are failing to meet numerous nutritional, health, and environmental targets linked to food. Defining food composition in its full chemical and quantitative diversity is central to data-driven decision making for supporting nutrition and sustainable diets. "Foodomics"-the application of omics-technology to characterize and quantify biomolecules to improve wellbeing-has the potential to comprehensively elucidate what is in food, how this composition varies across the food system, and how diet composition as an ensemble of foods guides outcomes for nutrition, health, and sustainability. Here, we outline: (i) challenges of evaluating food composition; (ii) state-of-the-art omics technology and innovations for the analysis of food; and (iii) application of foodomics as a complementary data-driven approach to revolutionize nutrition and sustainable diets. Featuring efforts of the Periodic Table of Food Initiative, a participatory effort to create a globally shared foodomics platform, we conclude with recommendations to accelerate foodomics in ways that strengthen the capacity of scientists and benefit all people.

Tuberculosis (TB) is an important infectious disease in relation to global public health and is caused species of the Mycobacterium tuberculosis complex (MTBC). In this study, we used whole-genome sequencing (WGS) and comparative genomics to investigate the genetic diversity of M. tuberculosis (Mtb) isolates circulating in North Santander (NS), Colombia. WGS was used for the phylogenetic and lineage characterization of 18 isolates of Mtb typed with orphan genotypes from 11 municipalities of NS between 2015 and 2018. The isolates studied were included in six sublineages from L4; the most frequent were 4.1.2.1, 4.3.3, and 4.3.4.2, corresponding to a proportion of 22.2%. The genome analysis conducted allowed the identification of a set of genetic variants mainly associated with determinants of virulence and evasion of the immune system (PPE34 and PE_PGRS2); adaptation and survival (PGL/p-HBAD); stress response (sigJ and sigM); geographic variability (PPE34); and carbohydrate and lipid metabolism (aldA, rocA, and cyp144). This is the first description of the molecular epidemiology of Mtb isolates circulating in NS achieved through WGS. It was possible to perform comparative genomics analyses between Mtb isolates against the universal reference H37Rv and Colombian UT205 genome, which can help us to understand the local genetic diversity and is relevant for epidemiological studies, providing insight into TB transmission dynamics in NS.

Foundation: according to the World Health Organization, diabetes causes 300,000 deaths a year in Latin America and the Caribbean and in the Cienfuegos province since 2020 it ranks as the seventh cause of death. Objective: to characterize mortality from diabetes mellitus in the Cienfuegos province in the first nine months of 2020. Methods: a descriptive investigation was carried out on health systems and services based on a series of cases to characterize mortality from diabetes mellitus in Cienfuegos in the first nine months of 2020. The deceased were compiled taking into account: sex, age, skin color, educational level, place of residence, territorial stratum, disease, associated risk factors and direct causes of death. The arithmetic mean and standard deviation were used. The results are presented in the form of tables and graphs. Results: the greatest affectation was in the last decades of life for the female gender, as well as residence in an urban territory, among the first direct causes of death are pulmonary thromboembolism, as well as acute chronic renal failure; hydroelectrolytic imbalance stands out in a considerable number of deaths. Conclusions: the last decades of life were the most affected and the female sex, the main causes of death were: pulmonary thromboembolism and acute chronic renal failure. The hydroelectrolytic imbalance stands out in a considerable number of the deceased.

Objective: We present the evolution of medical imaging software and its impact on the medical imaging community through the study of four open-source image analysis software platforms: 3D Slicer, FreeSurfer, FSL, and SPM. Materials and methods: We have studied the impact of these software tools over time, measured by the number of scientific citations. Additionally, we have also studied the source code evolution by measuring the lines of code and the tarball size of the stable releases and the changes in programming languages. Results and discussion: The rising number of related scientific publications confirms the popularity of these software tools in the research community, albeit some differences can be observed in the popularity of the tools. Moreover, we demonstrate that source code has evolved to modernize and optimize, at least partially thanks to the collaboration and code sharing with the user community. Furthermore, this evolution reveals an increased use of higher-level programming languages and meta-languages. Conclusions: The study of four open-source packages has revealed certain patterns in the evolution of medical imaging software and their impact on the medical image community. Further analyses and complementary metrics are suggested.

La insuficiencia cardiaca crónica sigue siendo unas de las principales causas de afectación en el funcionamiento y en la calidad de vida de las personas que la presentan, así como una de las primeras causas de mortalidad en nuestro país y en todo el mundo. México tiene una alta prevalencia de factores de riesgo para desarrollar insuficiencia cardiaca, tales como hipertensión arterial, diabetes y obesidad, lo que hace imprescindible contar con un documento basado en la evidencia que brinde recomendaciones a los profesionales de la salud involucrados en el diagnóstico y el tratamiento de estos pacientes. Este documento establece la guía de práctica clínica (GPC) elaborada por iniciativa de la Sociedad Mexicana de Cardiología (SMC) en colaboración con la Agencia Iberoamericana de Desarrollo y Evaluación de Tecnologías en Salud, con la finalidad de establecer recomendaciones basadas en la mejor evidencia disponible y consensuadas por un grupo interdisciplinario y multicolaborativo de expertos. Cumple con estándares internacionales de calidad, como los descritos por el Institute of Medicine de los Estados Unidos de América (IOM), el National Institute of Clinical Excellence (NICE) del Reino Unido, la Intercollegiate Network for Scottish Guideline Development (SIGN) de Escocia y la Guidelines International Network (G-I-N). El grupo de desarrollo de la guía se integró de manera interdisciplinaria con el apoyo de metodólogos con experiencia en revisiones sistemáticas de la literatura y en el desarrollo de GPC. Se llevó a cabo y se condujo metodología de panel Delphi modificado para lograr un nivel de consenso adecuado en cada una de las recomendaciones contenidas en esta GPC. Esperamos que este documento contribuya para la mejor toma de decisiones clínicas y se convierta en un punto de referencia para los clínicos que manejan pacientes con insuficiencia cardiaca crónica en todas sus etapas clínicas, y de esta manera logremos mejorar la calidad en la atención clínica, aumentar la calidad de vida de los pacientes y disminuir las complicaciones de la enfermedad.

Las subestaciones son instalaciones clave dentro de un sistema eléctrico; las fallas intempestivas tienden a causar baja calidad y efectos negativos del suministro eléctrico. Un indicador temprano de posibles fallas en los equipos eléctricos es la aparición de puntos calientes; por lo que su detección y posterior corrección programada evita incurrir en fallas mayores y paradas de operación innecesarias. En esta investigación se realizaron 64 experimentos del algoritmo YOLOv5, con la finalidad de proponer un mecanismo automatizado de visión por computadora para la detección de puntos calientes en imágenes térmicas de subestaciones eléctricas. Los mejores resultados muestran un valor mAP de 81,99 %, los cuales se obtuvieron con el algoritmo YOLOv5m y la aplicación de transfer learning. Estos resultados dejan una base para profundizar y mejorar el desempeño del algoritmo, variando otros hiperparámetros a los considerados en el presente estudio.

A data-based reduced-order model (ROM) is developed to accelerate the time integration of stiff chemically reacting systems by effectively removing the stiffness arising from a wide spectrum of chemical time scales. Specifically, the objective of this work is to develop a ROM that acts as a non-stiff surrogate model for the time evolution of the thermochemical state vector (temperature and species mass fractions) during an otherwise highly stiff and nonlinear ignition process. The model follows an encode-forecast-decode strategy that combines a nonlinear autoencoder (AE) for dimensionality reduction (encode and decode steps) with a neural ordinary differential equation (NODE) for modeling the dynamical system in the AE-provided latent space (forecasting step). By means of detailed timescale analysis by leveraging the dynamical system Jacobians, this work shows how data-based projection operators provided by autoencoders can inherently construct the latent spaces by removing unnecessary fast timescales, even more effectively than physics-based counterparts based on an eigenvalue analysis. A key finding is that the most significant degree of stiffness reduction is achieved through an end-to-end training strategy, where both AE and neural ODE parameters are optimized simultaneously, allowing the discovered latent space to be dynamics-informed. In addition to end-to-end training, this work highlights the vital contribution of AE nonlinearity in the stiffness reduction task. For the prediction of homogeneous ignition phenomena for H2-air and C2H4-air mixtures, the proposed ROM achieves several orders-of-magnitude increase in the integration time step size when compared to (a) a baseline CVODE solver for the full-chemical system, (b) statistical technique – principal component analysis (PCA), and (c) computational singular perturbation (CSP), a vetted physics-based stiffness-reducing modeling framework.

Abstract Background Cervical intraepithelial neoplasia (CIN) grades 2 and 3 are usually grouped and treated in the same way as "high grade", in spite of their different risk to cancer progression and spontaneous regression rates. CIN2-3 is usually diagnosed in formaldehyde-fixed paraffin embedded (FFPE) punch biopsies. This procedure virtually eliminates the availability of water-soluble proteins which could have diagnostic and prognostic value. Aim To investigate whether a water-soluble protein-saving biopsy processing method followed by a proteomic analysis of supernatant samples using LC-MS/MS (LTQ Orbitrap) can be used to distinguish between CIN2 and CIN3. Methods Fresh cervical punch biopsies from 20 women were incubated in RPMI1640 medium for 24 hours at 4°C for protein extraction and subsequently subjected to standard FFPE processing. P16 and Ki67-supported histologic consensus review CIN grade (CIN2, n = 10, CIN3, n = 10) was assessed by independent gynecological pathologists. The biopsy supernatants were depleted of 7 high abundance proteins prior to uni-dimensional LC-MS/MS analysis for protein identifications. Results The age of the patients ranged from 25-40 years (median 29.7), and mean protein concentration was 0.81 mg/ml (range 0.55 - 1.14). After application of multistep identification criteria, 114 proteins were identified, including proteins like vimentin, actin, transthyretin, apolipoprotein A-1, Heat Shock protein beta 1, vitamin D binding protein and different cytokeratins. The identified proteins are annotated to metabolic processes (36%), signal transduction (27%), cell cycle processes (15%) and trafficking/transport (9%). Using binary logistic regression, Cytokeratin 2 was found to have the strongest independent discriminatory power resulting in 90% overall correct classification. Conclusions 114 proteins were identified in supernatants from fresh cervical biopsies and many differed between CIN2 and 3. Cytokeratin 2 is the strongest discriminator with 90% overall correct classifications.

Abstract The presence of a long-wavelength sensitive (LWS) opsin gene was demonstrated in the stygobitic crustacean Creaseria morleyi (Creaser, 1936) by PCR readings from genomic DNA. In order to find the expression of this gene in extraocular tissue, shrimps were collected and placed in a tank to expose them to light/dark conditions for a period of 72 hours, and immediately after, sacrificed and sampled for RNA in the eyes, cephalothorax, abdomen, and sixth abdominal segment plus uropods. The transcripts of the LWS opsin gene were found in the eyes and abdomen of individuals exposed to light. The expression of these opsins could be involved in extravisual functions such as synchronization of their biological processes with environmental cycles related to diurnal vertical migration.

Purpose: Purpose: Radiation therapy (RT) and the antibody-drug conjugate brentuximab vedotin (BV) are standard-of-care treatment options for patients with certain B and T-cell lymphomas; however, there are limited data exploring the safety of concurrent BV and RT (BVRT). Methods and Materials: We performed a single institutional retrospective review of 44 patients who received BVRT. Results: Twenty percent of patients (9/44) developed new grade 2 or higher (G2+) hematologic toxicity (HT) after BVRT, which was associated with radiation dose (median dose of 35 Gy in those with new G2+ HT compared with 15 Gy in those without; P < .001). Acute G2+ elevation in aspartate transaminase or alanine transaminase level was associated with administration of concurrent chemotherapy with BVRT (57% vs 21%; P = .047) but was not associated with any RT factors. Local control (LC) was achieved in 24 of 42 patients (57%) with available follow-up. Ten patients (23%) proceeded to stem cell transplant or cellular therapy after BVRT at a median of 48 days (interquartile range, 27-188 days). At last follow-up, 10 patients (23%) remained without evidence of disease. Conclusions: Our analysis demonstrates that the combination of BV and RT is well tolerated, though care should be taken during RT planning to reduce the risk of HT. This combination can be considered for patients in need of both local and systemic disease control.