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Targeted alpha therapy is an oncological treatment, where cytotoxic doses of alpha radiation are locally delivered to tumor cells, while the surrounding healthy tissue is minimally affected. This therapeutic strategy relies on radiopharmaceuticals made of medically relevant radionuclides chelated by ligands, and conjugated to targeting vectors, which promote the drug accumulation in tumor sites. This review discusses the state-of-the-art in the development of radiopharmaceuticals for targeted alpha therapy, breaking down their key structural components, such as radioisotope, targeting vector, and delivery formulation, and analyzing their pros and cons. Moreover, we discuss current drawbacks that are holding back targeted alpha therapy in the clinic, and identify ongoing strategies in field to overcome those issues, including radioisotope encapsulation in nanoformulations to prevent the release of the daughters. Lastly, we critically discuss potential opportunities the field holds, which may contribute to targeted alpha therapy becoming a gold standard treatment in oncology in the future.

Background: Thrombophilia due to protein C deficiency is an unusual condition, present in 0.2% of general population. Cerebral venous thrombosis has an incidence of 3-4 cases per million in adults. A combination of both is very uncommon. Patients with these conditions are prone to acquiring life-threatening superinfections. Case: A 51-year-old woman presented to the Emergency Department with bilateral pressing frontal headache accompanied with nausea and vomiting. Laboratory findings, medical history and physical examination were unremarkable. Computed tomography demonstrated sphenoidal rhinosinusitis. Migraine diagnosis was established and treated with analgesics. No treatment for sphenoidal rhinosinusitis was prescribed. Over the next 2 weeks, headaches worsened, and the patient returned to the Emergency Department showing left periorbital edema, fever, diplopia, and disorientation. Laboratory exams showed low protein C levels, elevated procalcitonin and neutrophilia. Magnetic Resonance Venography revealed cavernous sinus thrombosis. The patient was treated with empiric antibiotic treatment (vancomycin, ceftriaxone, and metronidazole) and long-term direct oral anticoagulants (Dabigatran). After one year of the diagnosis, the patient fully recovered and showed no recurrence of thrombotic events. Conclusion: This case report emphasizes the importance of early diagnosis and appropriate management of patients with protein C deficiency complicated by septic cavernous sinus thrombosis.

El acceso abierto es un pilar fundamental para entender la comunicación científica de las últimas tres décadas, tanto a nivel mundial, pero especialmente desde América Latina. Su crecimiento, fundamentalmente a partir de la ruta dorada, ha generado cambios importantes en los modelos de negocio de la industria editorial científica. Uno de ellos ha venido con la aparición de los cobros por publicación (APC), lo cual se ha ido posicionando por el auge del acceso abierto y las políticas universitarias y gubernamentales para la evaluación de la investigación y los sistemas de recompensas. En este sentido, se ha hecho necesario reconocer las dinámicas asociadas a este fenómeno y atacar la falta de datos y la transparencia de los costos que implica el APC. Por ello, este artículo propone una metodología de seis pasos para analizar estos cobros en cualquier universidad, y presenta el panorama para el caso de las instituciones de educación superior colombianas. Se puede evidenciar el aumento de la producción científica en abierto a partir de la ruta dorada pero también el aumento de los gastos de las instituciones en los últimos años.

ObjectivesIdentify molecular mechanisms responsible for the in vitro non-susceptibility to ceftolozane/tazobactam (TOL) in a group of 158 clinical isolates of Pseudomonas aeruginosa from five Latin American countries collected before the introduction of TOL into the clinical practice.MethodsClinical isolates of P. aeruginosa (n = 504) were collected between January 2016 and October 2017 from 20 hospitals located in Argentina, Brazil, Chile, Colombia, and Mexico. Minimum inhibitory concentrations (MICs) to TOL were determined by standard broth microdilution and interpreted according to CLSI breakpoints. Initially, production of carbapenemases in TOL non-susceptible isolates was assessed by Rapidec® followed by qPCR to detect blaKPC, blaNDM-1, blaVIM, and blaIMP. Illumina® WGS was performed for isolates in which non-susceptibility to TOL was not mediated by carbapenemases.ResultsA total of 158 (31.3%) isolates were non-susceptible to TOL. In 74 (46.8%) of these isolates, non-susceptibility to TOL was explained by the production of at least one carbapenemase. WGS revealed that some isolates carried ESBLs, mutated blaPDC and ampD, associated with decreased susceptibility to TOL.ConclusionSubstitutions found in PDC and carbapenemase production were the most common presumed mechanisms of resistance to TOL detected in this study. This study shows that epidemiological surveillance is warranted to monitor the emergence of novel mechanisms of resistance to TOL that might compromise its clinical utility.

In this work 99mTc-MIBI cardiac scintigraphs are quantitively analyzed with the aim to determine the radiopharmaceutical uptake in the heart (organ of interest) and in the liver. The impact of the radioactivity distribution in the diagnostic quality of the images is discussed.

Reactive oxygen species (ROS) carried or induced by particulate matter (PM) are suspected of inducing oxidative stress in vivo, leading to adverse health impacts such as respiratory or cardiovascular diseases. The oxidative potential (OP) of PM, displaying the ability of PM to oxidize the lung environment, is gaining strong interest in examining health risks associated with PM exposure. In this study, OP was measured by two different acellular assays (dithiothreitol, DTT, and ascorbic acid, AA) on PM10 filter samples from 15 yearly time series of filters collected at 14 different locations in France between 2013 and 2018, including urban, traffic and Alpine valley site typologies. A detailed chemical speciation was also performed on the same samples, allowing the source apportionment of PM using positive matrix factorization (PMF) for each series, for a total number of more than 1700 samples. This study then provides a large-scale synthesis of the source apportionment of OP using coupled PMF and multiple linear regression (MLR) models. The primary road traffic, biomass burning, dust, MSA-rich, and primary biogenic sources had distinct positive redox activity towards the OPDTT assay, whereas biomass burning and road traffic sources only display significant activity for the OPAA assay. The daily median source contribution to the total OPDTT highlighted the dominant influence of the primary road traffic source. Both the biomass burning and the road traffic sources contributed evenly to the observed OPAA. Therefore, it appears clear that residential wood burning and road traffic are the two main target sources to be prioritized in order to decrease significantly the OP in western Europe and, if the OP is a good proxy of human health impact, to lower the health risks from PM exposure.

Basado en el formato del trabajo de Andrew Barry y Mark Maslin, este artículo tiene como objetivo reflejar las discusiones sobre la capacidad de la economía social y las economías alternativas para generar impactos colectivos sobre el territorio en la segunda década del siglo XXI. La reflexión analítica se apoya en varias teorías sobre la aparición de nuevas formas de actividad económica y su relación con el territorio, y asume que las condiciones territoriales son siempre desiguales, como ha constatado la geografía económica. Por tanto, a partir de la path dependence o dependencia de la trayectoria y de la teoría de la transición sociotécnica, principalmente, se discuten y se formulan nuevas preguntas, que en este artículo se dejan abiertas, sobre los fuertes componentes sociales y territoriales de ambos conceptos. La idea de que las decisiones pasadas condicionan las decisiones que podemos adoptar en la actualidad y de que los estados, acciones o decisiones actuales o futuros dependen de la ruta que hayan tomado eventos previos se postula como una explicación crítica de la formación de distintas soluciones y espacios económicos. La transición sociotécnica como herramienta conceptual se propone para la comprensión del proceso de transición (ecológica, energética, alimentaria, entre otras) hacia un modelo económico y social sostenible.

Introduction: At present, few studies conducted in Latin America have addressed the demographic, clinical, and laboratory characteristics of patients with COVID-19 and intensive care unit (ICU) admission requirement. Objective: To compare the sociodemographic, clinical, imaging, and laboratory characteristics of patients diagnosed with COVID-19 and treated in the emergency department of a hospital in Cali, Colombia, based on ICU admission requirement. Materials and methods: Retrospective and descriptive single cohort study conducted in 49 adults with COVID-19 treated in the emergency department of a quaternary care hospital in Cali (Colombia) between March and April 2020. Patients were divided into two groups: ICU admission requirement (n=24) and non-ICU admission requirement (n=25). Bivariate analyses were performed to determine differences between groups (chi-square, Fisher's exact, Student's t, and Mann-Whitney U tests), with a significance level of p

El sector de la comunicación, concretamente el periodístico sufrió duramente las consecuencias de la crisis económica iniciada en 2008 y está asistiendo, otra vez, a la complicada situación derivada de la Covid-19. Malas decisiones estratégicas; el descenso de la inversión publicitaria; la excesiva dependencia del sector financiero, o la cultura del gratis total propias de la idiosincrasia nacional son algunas de las causas de la situación de emergencia que arrastra el periodismo escrito en España. A través de entrevistas en profundidad, se analizan acciones innovadoras vinculadas a la organización, financiación y producto en el sector periodístico de los nativos digitales El Salto, CTXT y La Marea a modo de case studies. Los resultados se presentan divididos en seis variables de estudio: perspectiva histórica; financiación y participación; diversificación de ingresos; estructura organizativa; valor de marca, y competencia. Aunque los ejemplos analizados divergen en aspectos como la personalidad jurídica, todos coinciden en apelar a un periodismo tradicional, reflexivo y con garantías procedimentales, apuestan por estructuras organizativas horizontales y basan su modelo de ingresos en la suscripción. Son iniciativas que buscan diferenciarse a través de estrategias y marcas cuyas cuotas económicas, financieras y de lectores están indisolublemente ligadas al concepto de nicho.

El objetivo fue fortalecer la participación de los padres de familia en el proceso de enseñanza y aprendizaje de los estudiantes de cuarto grado en la Institución Educativa Rosa Jaimes Barrera Sede 27 de Marzo. Se inscribió en el paradigma postpositivista, en el enfoque sociocrítico, con el método de la investigación acción participativa que se dio a través de la detección y diagnóstico del problema, elaboración del plan para introducir el cambio, evaluación de resultados y realimentación. La unidad de trabajo fue de 20 padres y 20 estudiantes. Los instrumentos aplicados fueron un cuestionario, una bitácora y una rúbrica. Se logró que los padres participaran y descubrieran la importancia de cooperar en el proceso de enseñanza y aprendizaje. Se concluye que los padres concienciaron que su participación y responsabilidad son esenciales para lograr que sus hijos aprendan significativamente.

Plutonium is a radioactive element widely used as an energy source and further employed in military applications. Although global stockpiles of plutonium have increased with time, the toxicological profile of this metal has only been partially characterized. The vast majority of studies have focused on either the biodistribution of plutonium following internal contamination, or the identification of important proteins involved in plutonium uptake within the body. Thus, an enhanced knowledge of the metal biology may improve future therapeutic approaches to mitigate uncontrolled releases of plutonium. Herein, we have employed genome-wide toxicogenomics to assess the biological functions and response mechanisms disrupted by plutonium in vivo. Microarray gene expression was used to identify the differentially expressed genes in liver, kidneys and lungs after internal contamination of Swiss-Webster mice with plutonium. Functional analysis revealed that plutonium altered immune and inflammatory responses and lipid homeostasis, likely as a consequence of radiation-induced damage and the disruption of metal-regulated processes. Moreover, protein-protein interaction network analysis identified several key proteins associated with cellular responses to plutonium-induced damage, including ribosome biosynthesis, cell proliferation inhibition, DNA repair and glycolysis upregulation. Lastly, real-time quantitative polymerase chain reaction was used to corroborate microarray results and analyze the effects of plutonium dosing and time of exposure. This study provides substantial context for the further development of novel therapeutics and prophylactics targeting the effects of Pu isotopes by identifying the key genes and proteins that are important to specific biological functions and cellular mechanisms.

This paper is focused on the use of radio frequency identification (RFID) technology operating at 125 kHz in a communication layer for a network of mobile and static nodes in marine environments, with a specific focus on the Underwater Internet of Things (UIoT). The analysis is divided into two main sections: characterizing the penetration depth at different frequencies and evaluating the probabilities of data reception between antennas of static nodes and a terrestrial antenna considering the line of sight (LoS) between antennas. The results indicate that the use of RFID technology at 125 kHz allows for data reception with a penetration depth of 0.6116 dB/m, demonstrating its suitability for data communication in marine environments. In the second part of the analysis, we examine the probabilities of data reception between static-node antennas at different heights and a terrestrial antenna at a specific height. Wave samples recorded in Playa Sisal, Yucatan, Mexico, are used for this analysis. The findings show a maximum reception probability of 94.5% between static nodes with an antenna at a height of 0 m and a 100% data reception probability between a static node and the terrestrial antenna when the static-node antennas are optimally positioned at a height of 1 m above sea level. Overall, this paper provides valuable insights into the application of RFID technology in marine environments for the UIoT, considering the minimization of impacts on marine fauna. The results suggest that by adjusting the characteristics of the RFID system, the proposed architecture can be effectively implemented to expand the monitoring area, considering variables both underwater and on the surface of the marine environment.

The OXA-10 class D β-lactamase has been reported to contribute to carbapenem resistance in non-fermenting Gram-negative bacilli; however, its contribution to carbapenem resistance in Enterobacterales is unknown. In this work, minimum inhibitory concentrations (MICs), whole genome sequencing (WGS), cloning experiments, kinetic assays, molecular modelling studies, and biochemical assays for carbapenemase detection were performed to determine the impact of OXA-10 production on carbapenem resistance in two XDR clinical isolates of Escherichia coli with the carbapenem resistance phenotype (ertapenem resistance). WGS identified the two clinical isolates as belonging to ST57 in close genomic proximity to each other. Additionally, the presence of the blaOXA-10 gene was identified in both isolates, as well as relevant mutations in the genes coding for the OmpC and OmpF porins. Cloning of blaOXA-10 in an E. coli HB4 (OmpC and OmpF-deficient) demonstrated the important contribution of OXA-10 to increased carbapenem MICs when associated with porin deficiency. Kinetic analysis showed that OXA-10 has low carbapenem-hydrolysing activity, but molecular models revealed interactions of this β-lactamase with the carbapenems. OXA-10 was not detected with biochemical tests used in clinical laboratories. In conclusion, the β-lactamase OXA-10 limits the activity of carbapenems in Enterobacterales when combined with low permeability and should be monitored in the future.

El estudio de la dieta de los murciélagos es importante para entender cómo se conforma su ensamble y cómo aportan a la dinámica de los bosques. Al ser pocos los estudios de dieta de murciélagos frugívoros en el bosque seco tropical, nuestro objetivo fue describir su dieta y analizar cuál es su efecto sobre la germinación de semillas. El trabajo se realizó en el Área Natural Única Los Estoraques, Norte de Santander, Colombia; una zona de vida de bosque seco premontano (bs-PM). Para la captura de murciélagos se utilizaron redes de niebla y se recolectaron sus excretas. Las semillas de Vismia bacci-fera y Piper sp4, obtenidas de las excretas, fueron seleccionadas para el experimento de germinación cuya respuesta se analizó mediante el índice de capacidad de germinación. Se hizo una curva de acu-mulación para describir la riqueza de semillas, se calculó el índice de mejor dispersor DII y el índice de Morisita para-gistro en la dieta de los murciélagos. En ninguna de las dos especies de plantas se encontraron diferen-estudiar solapamiento de dieta. Se registraron diez especies de murciélagos con siete registros nuevos para un total de 18 en la zona, trece de ellas fueron frugívoras. Carollia brevicauda fue la especie más abundante y la mejor dispersora, considerándola clave para la mayoría de las especies vegetales. Seidentificaron 18 morfoespecies de semillas, incluyendo Calycolpus moritzianus, nuevo recias en la germinación de semillas obtenidas de las excretas y aquellas extraídas del fruto directamente.

Abstract Background Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the four oral health-related quality of life (OHRQoL) dimensions (4D) or areas in which oral disorders impact pediatric patients. Using their dentists' assessment, the study aimed to evaluate whether pediatric dental patients' oral health concerns fit into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. Methods Dentists who treat children from 32 countries and all WHO regions were selected from a web-based survey of 1580 international dentists. Dentists were asked if their pediatric patients with current or future oral health concerns fit into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. Proportions of all pediatric patients’ oral health problems and prevention needs were computed. Findings Data from 101 dentists treating children only and 523 dentists treating children and adults were included. For 90% of pediatric patients, their current oral health problems fit well in the four OHRQoL dimensions. For 91% of oral health problems they intended to prevent in the future were related to these dimensions as well. Both numbers increased to at least 96% when experts analyzed dentists´ explanations of why some oral health problems would not fit these four categories. Conclusions The study revealed the four fundamental components of dental patients, i.e., the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact) are also applicable for pediatric patients, regardless of whether they have current or future oral health concerns, and should be considered when measuring OHRQoL in the pediatric dental patient population.

Resumen: Introducción: Existen vacíos de información respecto a la relación entre las tecnologías y el burnout en los médicos residentes. Objetivo: Evaluar el uso de dispositivos móviles y redes sociales, y su incidencia en el burnout. Material y métodos: Estudio transversal multicéntrico. La muestra integró 212 residentes de 15 especialidades médicas. Se aplicó un cuestionario, validado mediante juicio de expertos y análisis de consistencia interna, obteniéndose un α de Cronbach de 0,94. El instrumento integró 28 variables simples: 6 respecto al uso de dispositivos móviles y redes sociales, y 22 del burnout (agotamiento emocional, despersonalización y baja realización personal) obtenidas del Maslach Burnout Inventory. Se evaluaron con escala Likert 0-6. La información se analizó mediante 3 análisis estadísticos: descriptivo, correlacional y prueba T, utilizando SPSS v.22. Resultados: Los médicos residentes muy frecuentemente utilizan dispositivos móviles durante el horario laboral (5,04), y con frecuencia redes sociales (3,97). Respecto al burnout, los residentes presentan una puntuación de 23,51 en agotamiento emocional, 7,7 en despersonalización y 32,79 en realización personal. Asimismo, se observó correlación significativa (p ≤ 0,01) entre el uso de redes sociales, agotamiento emocional (22,2%) y despersonalización (20%). El uso de dispositivos móviles mostró una relación significativa con la realización personal (50%). La prueba T respecto a género mostró diferencias significativas (p ≤ 0,05) en endurecimiento emocional (despersonalización) (t = 1,99). Los hombres lo presentan más. Discusión: Existe una correlación significativa entre el uso de redes sociales y la presencia de sintomatología de burnout. También, entre el uso de dispositivos móviles y una alta realización personal, lo cual pudiera ser una paradoja. Abstract: Introduction: There are information gaps regarding the relationship between technologies and burnout in medical residents. Objective: To evaluate the use of mobile devices, social networks and their incidence in burnout. Material and methods: Multicentric cross-sectional study. The sample included 212 residents of 15 medical specialties. A questionnaire was applied and validated by: expert judgment and internal consistency analysis, obtaining a Cronbach's α of 0.94. The instrument integrated 28 simple variables: 6 regarding the use of mobile devices, social networks and 22 of burnout (emotional exhaustion, despersonalization and low personal accomplishment) obtained from Maslach Burnout Inventory. They were evaluated with Likert scale 0-6. The information was analyzed through 3 statistical analyzes: descriptive, correlational and T test; using SPSS v.22. Results: Medical residents frequently use mobile devices during working hours (5.04), and often use social networks (3.97). Regarding burnout, medical residents show a score of 23.51 in emotional exhaustion, 7.7 in despersonalization and 32.79 in personal accomplishment. There is significant correlation (P ≤ .01) between the use of social networks, emotional exhaustion (22.2%) and despersonalization (20%). The use of mobile devices showed a significant relationship with personal accomplishment (50%). The T test with respect to gender showed significant differences (P ≤ .05) in emotional hardening (despersonalization) (t = 1.99). Men present it more. Discussion: There is a significant correlation between the use of social networks and the presence of burnout symptomatology. Also, between the use of mobile devices and high personal accomplishment, which could be a paradox.

In 1973, in the midst of an economic downturn, New York City´s waterfront was envisioned as an enterprise for an urban renewal. This paper reflects on the interplay among a set of actors which was key in launching a more open, accessible, diverse and thrilling city´s edge. The intersecting condition among corporate capitalism, real estate, political interests and talented design illustrates the waterfront as particularly instrumental in the representation of a desire city to live in. However, the case study of two relevant built projects, Battery Park City and Gantry Plaza State Park, showcases different results in the challenge of the city´s waterfront strategy giving over its innovation, privileging instead the rapid commodification of the architecture and the unbalance between public and private interests.

Introducción: La American Optometric Association define el Síndrome Visual por Computadoras (SVC) como el conjunto de problemas oculares, visuales y musculoesqueléticos (especialmente del cuello y hombro), relacionados con el uso cercano y frecuente que se experimentan durante el trabajo con computadores o relacionados con estos, incluidos los dispositivos móviles inteligentes. Objetivo: Determinar la prevalencia del SVC en los estudiantes de medicina de la ciudad de Tunja durante las clases virtuales secundarias a la pandemia por COVID-19. Metodos: Estudio observacional descriptivo, donde se incluyeron a estudiantes del programa de medicina que estaban matriculados para el segundo semestre del año 2020. Se aplicó una encuesta virtual. Resultados: En el estudio se incluyeron 296 participantes, de los cuales 197 eran hombres. El 62.5% pertenecían a universidad pública. El 65% presentaban problema de alteración en la refracción. La prevalencia de síndrome visual por computadora fue del 84.4% de los participantes. Conclusiones: El síndrome visual por computadora es una patología poco estudiada, sin embargo muy frecuente, esto dado por los altos niveles de exposición a aparatos electrónicos a las que no vemos enfrentados en la actualidad. El presente estudio encontró un alto nivel de síndrome visual por computadora, dato que pudo estar relacionado con los cambios que se tuvieron en la forma de estudiar y laborar, donde las herramientas tecnológicas se convirtieron en un pilar fundamental, es por esto que es importante crear conciencia sobre el uso adecuado de los mismos y tener presente distintos métodos de prevención para disminuir al máximo esta patología.

Background and ObjectivesSubstantial evidence shows that diagnostic inertia leads to failure to achieve screening and diagnosis objectives for arterial hypertension (AHT). In addition, different studies suggest that the results may differ between men and women. This study aimed to evaluate the differences in diagnostic inertia in women and men attending public primary care centers, to identify potential gender biases in the clinical management of AHT.Study Design/Materials and MethodsCross-sectional descriptive and analytical estimates were obtained nested on an epidemiological ambispective cohort study of patients aged ≥30 years who attended public primary care centers in a Spanish region in the period 2008–2012, belonging to the ESCARVAL-RISK cohort. We applied a consistent operational definition of diagnostic inertia to a registry- reflected population group of 44,221 patients with diagnosed hypertension or meeting the criteria for diagnosis (51.2% women), with a mean age of 63.4 years (62.4 years in men and 64.4 years in women).ResultsOf the total population, 95.5% had a diagnosis of hypertension registered in their electronic health record. Another 1,968 patients met the inclusion criteria for diagnostic inertia of hypertension, representing 4.5% of the total population (5% of men and 3.9% of women). The factors significantly associated with inertia were younger age, normal body mass index, elevated total cholesterol, coexistence of diabetes and dyslipidemia, and treatment with oral antidiabetic drugs. Lower inertia was associated with age over 50 years, higher body mass index, normal total cholesterol, no diabetes or dyslipidemia, and treatment with lipid-lowering, antiplatelet, and anticoagulant drugs. The only gender difference in the association of factors with diagnostic inertia was found in waist circumference.ConclusionIn the ESCARVAL-RISK study population presenting registered AHT or meeting the functional diagnostic criteria for AHT, diagnostic inertia appears to be greater in men than in women.

Introduction: One of the challenges for teachers in the health area is competency assessment. The OSCE is designed to assess the performance of students in specific clinical situations. The objective of this study was to assess the level of achievement of the competencies proposed in the graduates' profile by applying the OSCE with socioformative rubrics and assessing their relationship with the written final exam and the general average of the degree. Method: A cross-sectional study was carried out with graduates of the career of medicine; in which an OSCE was applied as part of its degree exam. The rubrics were the instrument that was applied to assess competencies. Results: The significant differences between the students who applied the OSCE in the month of January compared to May, were also observed in the results of the written exam, which indicates that the students of the 4th. OSCE developed in better way their skills during their training process. The correlational analysis highlights a significant positive correlation between the average of the OSCE and the average of the written exam of the students, which makes it clear that an adequate performance in the written exam that assesses the theoretical knowledge is related to an adequate performance in the clinical skills demonstrated in the OSCE. Conclusion: The OSCE, is an objective and reliable test, suitable as part of the professional exam of the career of medicine; with the use of the rubric, it is possible to determine the level of achievement with which the student graduates. Resumen: Introducción: uno de los retos para los docentes en el área de la salud es la evaluación de las competencias. La ECOE se diseñó para evaluar el desempeño de los estudiantes en situaciones clínicas específicas. El objetivo de este estudio es evaluar el nivel de logro de las competencias propuestas en el perfil de egreso a través de la aplicación del ECOE con rubricas socioformativas y evaluar su relación con el examen final escrito y el promedio general de la carrera. Método: Se realizó un estudio transversal con egresados de la carrera de medicina. Se aplicó una ECOE como parte de su examen de grado. Las rúbricas socioformativas fueron el instrumento que se aplicó para evaluar las competencias. Resultados: Las diferencias significativas entre los estudiantes que realizaron la ECOE en el mes de enero respecto a mayo, también se observaron en los resultados del examen escrito, lo que indica que los estudiantes del 4to. ECOE desarrollaron mejor sus competencias durante su proceso formativo. El análisis correlacional destaca una correlación positiva significativa entre la media de la ECOE y la media del examen escrito de los estudiantes, lo que deja claro que un desempeño adecuado en el examen escrito que evalúa los conocimientos teóricos se relaciona con un desempeño adecuado en las habilidades clínicas demostradas en la ECOE. Conclusión: La ECOE, es una prueba objetiva y confiable, idónea como parte del examen profesional de la carrera de medicina. Con el uso de la rúbrica socioformativa se puede determinar el nivel de logro con el que egresa el estudiante.

Introducción: la poliangeítis microscópica (PAM) hace parte del grupo de vasculitis asociadas a anticuerpos anticitoplasmáticos de neutrófilos (ANCA), cuya presencia de anticuerpos contra mieloperoxidasa (MPO) se observa en la mayoría de los casos (70-95?%), asimismo, el compromiso renal presagia mayores tasas de morbilidad y mortalidad, sin embargo, la coexistencia con lupus eritematoso sistémico (LES) es poco frecuente y con mayor énfasis en la variante de LES del adulto mayor o de inicio tardío. Objetivo: dar a conocer un caso poco común de dos enfermedades autoinmunes, lo cual ha sido reportado como síndrome de superposición y brindar información útil que permita ampliar los diagnósticos diferenciales. Presentación del caso: se presenta el caso de un paciente masculino de 76 años con historia de poliartralgias progresivas en deterioro del estado general, con debut en síndrome confusional agudo, caída de filtrado glomerular, microhematuria y proteinuria casi nefrótica. A la evaluación inicial se encontró anemia y trombocitopenia severa, en perfil inmune ANA 1/320 y complemento consumido, cumpliendo criterios para LES, ANCA reactivo específicamente MPO ANCA (1/320) y sospecha de glomerulonefritis con patrón rápidamente progresivo (GNRP). Dado el contexto clínico, se decidió comenzar con pulsos de metilprednisolona consecutivos, seguidos de prednisolona oral y, como terapia de mantenimiento, se instauró ciclofosfamida. Finalmente, con una biopsia renal se confirmó el diagnóstico de vasculitis sistémica pauciinmune con formación de crescencia celular. La evolución clínica del paciente fue satisfactoria, logrando la estabilización de órganos y la normalización de la función renal, hematopoyética y el estado neurológico. Discusión y conclusión: dado que la presentación clínica de LES es heterogénea, se ha reportado su asociación con vasculitis, las cuales comparten un compromiso común de órganos como articulaciones, piel y riñones. Los hallazgos paraclínicos, como por biopsia, fueron consistentes tanto con PAM como con LES, por lo tanto, se diagnosticó como un caso de superposición. Este caso demuestra el enigma del diagnóstico y la complejidad en el manejo de entidades poco frecuentes, de etiologías inmunológicas superpuestas que ponen en peligro la vida de quien la(s) padece, de no tener un diagnóstico oportuno y un tratamiento temprano.

Abstract Background Autosomal dominant polycystic kidney disease (ADPKD) is the most frequent hereditary renal disease. There is an increased rate of cardiovascular disease (CVD) in ADPKD. In this study, we evaluate the prevalence of cardiovascular risk factors, the achievement rates for treatment goals and cardiovascular events (CVE) in ADPKD and their relations with asymptomatic CVD in CKD from other etiologies (CKDoe) and controls. Methods We evaluated 2445 CKD patients (2010–2012). The information collected was: clinical, anthropometric and analytical parameters, treatments and CVD evaluation (intima-media thickness (IMT), atheromatous plaque presence and ankle-brachial index (ABI)). Laboratory, vital status, CVE and hospitalizations were collected for 4 years. Results ADPKD patients had a worse renal function and worst achievement of blood pressure, higher parathormone levels but lower proteinuria compared to CKDoe. ADPKD patients presented lower IMT values than other groups, however, an intermediate rate of pathologic ABI and atheromatous plaque was present. More than half of the patients received statins, achieving LDL-c levels

La viabilidad del polen es un parámetro fundamental en la formación de la semilla, existen diferentes técnicas para su evaluación, de las cuales la germinación in vitro, presenta resultados confiables. El polen de maíz tiene dificultad para germinar en medios de cultivo debido a la morfología y fisiología. Este estudio, tuvo como objetivo evaluar cinco formulaciones de germinación in vitro sobre polen de maíz del híbrido Synko sembrada bajo las condiciones climáticas de la ciudad de Santa Marta-Colombia. El periodo de antesis se dio 50 días después de la siembra; los granos de polen recolectados fueron puestos de inmediato, sobre cinco medios de cultivo ya referenciados en maíz, los cuales están constituidos por diferentes formulaciones de agar - agar, sacarosa, nitrato de calcio y ácido bórico. El arreglo estadístico fue un diseño completo al azar, ocho repeticiones por tratamiento y dos replicas en el tiempo. El conteo de granos de polen viables se hizo sobre cuatro campos por caja de petri, sobre 50 granos por campo, para el conteo, se empleó un estéreo microscopio Leica M205, y en un microscopio compuesto de luz a 40X. Se utilizó como referencia de viabilidad la tinción con acetocarmin al 2 %, en 10 portaobjetos por réplica, 100 granos de polen por portaobjetos. El medio constituido por 0,6 % de agar-agar, 17 % de sacarosa, y 0,03 % de nitrato de calcio, registró los valores más alto de germinación de granos de polen; este fue de 70,13 %. La tinción del polen con acetocarmin superó los porcentajes de viabilidad in vitro.

The use of polymer solar cells (PSCs) for indoor dim-light energy harvesting has attracted significant interest for low power consumption electronics such as the Internet of Things. However, the photostability study and degradation mechanism under indoor artificial light is far behind than those under full sun illumination (standard AM 1.5G), which is crucial for the successful commercialization of indoor PSCs. Herein, the operational lifetime and photodegradation mechanism of PTB7-Th:PC70BM-based inverted PSCs degraded under standard AM 1.5G and 1000 lux LED 2700K light sources were compared. A high power conversion efficiency (PCE) of up to 16.19% and a long operational lifetime (T80) of 3060 min were achieved by LED-irradiated devices, higher and more stable than that of AM 1.5G-irradiated devices with PCE of 9.98% and T80 of only 260 min. Using impedance spectroscopy and three resistive-capacitive equivalent circuit model, we were able to identify the most suffered layer. Our results demonstrate that PSCs have potential practical applications as high performance and a high stable indoor power source.

The ability of the online marketing industry to track and profile users’ Web-browsing activity is what enables effective, tailored-made advertising services. The intrusiveness of these practices and the increasing invasiveness of digital advertising, however, have raised serious concerns regarding user privacy. Although the level of ubiquity of tracking and advertising has been investigated in top-world sites based in North America and Western Europe, the extent to which those practices are carried out in territories with less or no legal coverage —in terms of data protection— has not been studied so far. In this work, we present the first detailed measurement of online tracking and advertising conducted to date in one of those regions, namely, Ibero-America, by analyzing local websites (e.g., education and government sites). In doing so, our measurement study aims to find out how user location as well as the type of publisher may impact on tracking and advertising and thus user privacy. Lastly, our thorough, extensive analysis also explores whether differences are appreciated between Latin America and the EU with regard to the third-party tracking conducted from and towards the corresponding countries.

Zika virus (ZIKV) is a flavivirus transmitted by mosquitoes of the genus Aedes, but unlike other flaviviruses, ZIKV can be sexually transmitted by vaginal intercourse. The healthy vaginal pH ranges from 4.0 to 6.0, reaching values of 6.0–7.0 after semen deposition. Here, we report that low extracellular pH values (range 6.2–6.6) dramatically increase ZIKV infection on cell lines of different origin including some derived from the female genital tract and monocyte-derived macrophages. Furthermore, low pH significantly increased ZIKV infection of human ectocervix and endocervix cultured ex-vivo. Enhancement of infection by low pH was also observed using different ZIKV strains and distinct methods to evaluate viral infection, i.e. plaque assays, RT–PCR, flow cytometry, and fluorescence microscopy. Analysis of the mechanisms involved revealed that the enhancement of ZIKV infection induced by low pH was associated with increased binding of the viral particles to the heparan sulphate expressed on the target cell surface. Acidosis represents a critical but generally overlooked feature of the female genital tract, with major implications for sexual transmission diseases. Our results suggest that low vaginal pH might promote male-to-female transmission of ZIKV infection.

Age-related neurobiological changes significantly affect hippocampal structure and function, such that the main cognitive impairments associated with aging are related to the integrity of this brain structure, including the deterioration in spatial object recognition (SOR) memory. Previous studies have shown that intrinsic factors such as neuroinflammation, as well as lifestyle factors such as diet, can affect aging-associated brain functions and cognitive performance. In this regard, caloric restriction (CR) produces beneficial effects on health and life expectancy, although its ability to slow down age-dependent effects on cognitive decline and hippocampus (HPC) functioning remains unclear. Therefore, we set out to evaluate the effects of CR on SOR memory in aged male Wistar rats, as well as those on hippocampal neuron loss, neurogenesis and inflammation. The data show that CR in aged rats attenuates the decline in SOR memory, age-associated hippocampal neuron loss, and age-dependent microglial activation. Furthermore, we found a significant reduction in neurogenesis in the dentate gyrus of the old animals relative to adult rats. These findings support the positive effect of CR on SOR memory, suggesting that it dampens hippocampal neuronal loss and reduces proinflammatory activity.

We report the presence of the mcr-1 gene among 880 Escherichia coli clinical isolates collected in 13 hospitals from 12 Colombian cities between 2016 and 2019. Seven (0.8%) isolates were colistin resistant (MIC ≥ 4 µg/mL). These colistin-resistant isolates were screened for the presence of the mcr-1 gene; five carried the gene. These five isolates were subjected to whole genome sequencing (WGS) to identify additional resistomes and their ST. In addition, antimicrobial susceptibility testing revealed that all E. coli isolates carrying mcr-1 were susceptible to third generation-cephalosporin and carbapenems, except one, which carried an extended-spectrum β-lactamase (CTX-M-55), along with the fosfomycin resistance encoding gene, fosA. WGS indicated that these isolates belonged to four distinct sequence types (ST58, ST46, ST393, and a newly described ST14315) and to phylogroups B1, A, and D. In this geographic region, the spread of mcr-1 in E. coli is low and has not been inserted into high-risk clones such as ST131, which has been present in the country longer.

Background: We aimed to assess the incidence, etiology and outcomes of catheter-related bloodstream infection (CRBSI) in onco-hematological patients, to assess the differences between patients with hematological malignancies (HMs) and solid tumors (STs) and to identify the risk factors for Gram-negative (GN) CRBSI. Methods: All consecutive episodes of BSI in adult cancer patients were prospectively collected (2006–2020). The etiology of CRBSI was analyzed in three different 5-year periods. Risk factors for GN CRBSI were assessed in the whole cohort and separately in patients with HMs and STs. Results: Among 467 episodes of monomicrobial CRBSI, 407 were Gram-positive (GP) (87.1%), 49 GN (10.5%) and 11 fungal (2.4%). Hematological patients (369 episodes) were more frequently neutropenic and were more likely to carry central venous catheters and develop GP CRBSI. Patients with STs (98 episodes) had more comorbidities, more frequently carried port reservoirs and commonly presented more GN CRBSI. GN CRBSI significantly increased over the study period, from 5.2% to 23% (p < 0.001), whereas GP CRBSI decreased from 93.4% to 73.3% (p < 0.001). CRBSI episodes involving port reservoirs and peripherally-inserted central catheters were significantly increased (p < 0.001). The most frequent GPs were coagulase-negative staphylococci (CoNS) (57.8%) and Pseudomonas aeruginosa was the most common GN (3%). Multidrug-resistant (MDR) GN represented 32.7% of all GN CRBSIs and increased over time (p = 0.008). The independent risk factors for GN CRBSI in the whole cohort were solid tumor, chronic kidney disease and carrying a port reservoir. Carrying a port reservoir was also a risk factor in patients with STs. Health-care acquisition was identified as a risk factor for GN CRBSI in the whole cohort, as well as in patients with STs and HMs. Inadequate empirical antibiotic treatment (IEAT) occurred regardless of the etiology: 49% for GNs and 48.6% for GPs (p = 0.96). In GP CRBSI, IEAT was mainly due to inadequate coverage against CoNS (87%), whereas in GN CRBSI, IEAT was associated with multidrug resistance (54.2%). Early (48 h and 7-day) and 30-day case-fatality rates were similar when analyzed according to the type of underlying disease and etiology, except for the 30-day case-fatality rate, which was higher in the group of patients with STs compared to those with HMs (21.5% vs. 12.5%, p = 0.027). The 48 h case-fatality rate was significantly higher in patients in whom the catheter had not been removed (5.6% vs. 1%; p = 0.011), and it remained significant for GP CRBSI (6% vs. 1.3%, p = 0.023). Conclusions: GNs are an increasing cause of CRBSI in cancer patients, particularly in solid tumor patients carrying port reservoirs. Multidrug resistance among GNs is also increasing and is associated with higher rates of IEAT. Decreased 48 h survival was associated with the non-removal of the catheter. These findings should be considered when deciding on early therapeutic management for cancer patients with suspected CRBSI.

El presente artículo es el resultado de la revisión bibliográfica realizada respecto de los temas; responsabilidad legislativa, principio de seguridad de los productos y la aplicación territorial del estatuto del consumidor. El abordaje de estas temáticas se realizó con el fin de obtener criterios que permitieran conocer su alcance, dar luces en cuanto al tratamiento que a nivel de fuentes de derecho han tenido y verificar si a través de la investigación se ha dado respuesta a la pregunta ¿Existe responsabilidad legislativa en el estatuto del consumidor colombiano? Una vez realizado el análisis de estas variables a partir del enfoque cualitativo y con apoyo de la hermenéutica jurídica, se concluyó que los estudios realizados no tratan de manera particular la problemática planteada. Por lo anterior, en el desarrollo del artículo se presentan argumentos que ponen al descubierto la necesidad y pertinencia del estudio a partir de un análisis jurídico.

Background: Acute kidney injury (AKI) is a common complication among older adults with hip fracture. Factors such as baseline renal function, comorbidities, the use of nephrotoxic drugs, and age increase the incidence of this complication. Objectives: To find factors related to higher creatinine levels among older adults with hip fracture upon admission, discharge, and during hospitalization in a hospital setting in Mexico. Methods: This was an observational, comparative, longitudinal, and retrospective study. Setting and participants: Data from patients aged 60 and over with hip fracture presenting to the ER from January 2020 to August 2021 with at least one creatinine determination on admission and one at discharge were analyzed (n = 99). Using longitudinal linear regressions, factors associated to higher creatinine levels on admission and at discharge, AKI, and higher increase in creatinine levels during hospitalization were analyzed. Results: Higher creatinine levels on discharge were seen in older patients (p < 0.003), among those with higher creatinine levels on admission (p < 0.000) and those with higher body mass index (BMI) (p < 0.014). Individuals with higher BMI showed significantly higher increase in creatinine levels (p < 0.05). Conclusions: Our study found that individuals with previous risk factors for AKI showed higher creatinine levels on discharge, but none of these factors predicted AKI significantly.

Summary: Overlapping clinical phenotypes and an expanding breadth and complexity of genomic associations are a growing challenge in the diagnosis and clinical management of Mendelian disorders. The functional consequences and clinical impacts of genomic variation may involve unique, disorder-specific, genomic DNA methylation episignatures. In this study, we describe 19 novel episignature disorders and compare the findings alongside 38 previously established episignatures for a total of 57 episignatures associated with 65 genetic syndromes. We demonstrate increasing resolution and specificity ranging from protein complex, gene, sub-gene, protein domain, and even single nucleotide-level Mendelian episignatures. We show the power of multiclass modeling to develop highly accurate and disease-specific diagnostic classifiers. This study significantly expands the number and spectrum of disorders with detectable DNA methylation episignatures, improves the clinical diagnostic capabilities through the resolution of unsolved cases and the reclassification of variants of unknown clinical significance, and provides further insight into the molecular etiology of Mendelian conditions.

La esclerosis sistémica (ES) es una enfermedad inmunomediada, caracterizada por la presenciade fibrosis e inflamación tisular, que conlleva a cambios degenerativos vasculares de la piel yórganos internos tales como pulmón, corazón, tracto gastrointestinal y riñón. Tiene formas depresentación localizadas y sistémicas. La crisis renal esclerodérmica (CRE) es la manifestacióngrave en el riñón que se caracteriza por: a) hipertensión maligna, de inicio súbito asociado a aumento de actividad de renina plasmática. Hay una variante clínica que cursa con normotensión,la cual es de peor pronóstico; b) insuficiencia renal aguda (IRA); c) microangiopatía trombótica. A continuación, se relata la presentación de un caso de CRE en un paciente de sexo femeninode 60 años, que ingresó a la Institución con un cuadro caracterizado por crisis hipertensiva tipoemergencia, caída de filtrado glomerular severa, microhematuria y proteinuria; la cual recibiótratamiento médico, pero por persistencia de signos y síntomas, se decidió realizar una punciónbiopsia renal, la cual confirmo el diagnóstico.

The vertebrate cranium is a prime example of the high evolvability of complex traits. While evidence of genes and developmental pathways underlying craniofacial shape determination is accumulating, we are still far from understanding how such variation at the genetic level is translated into craniofacial shape variation. Here we used 3D geometric morphometrics to map genes involved in shape determination in a population of outbred mice (Carworth Farms White, or CFW). We defined shape traits via principal component analysis of 3D skull and mandible measurements. We mapped genetic loci associated with shape traits at ~80,000 candidate single nucleotide polymorphisms in ~700 male mice. We found that craniofacial shape and size are highly heritable, polygenic traits. Despite the polygenic nature of the traits, we identified 17 loci that explain variation in skull shape, and 8 loci associated with variation in mandible shape. Together, the associated variants account for 11.4% of skull and 4.4% of mandible shape variation, however, the total additive genetic variance associated with phenotypic variation was estimated in ~45%. Candidate genes within the associated loci have known roles in craniofacial development; this includes 6 transcription factors and several regulators of bone developmental pathways. One gene, Mn1, has an unusually large effect on shape variation in our study. A knockout of this gene was previously shown to affect negatively the development of membranous bones of the cranial skeleton, and evolutionary analysis shows that the gene has arisen at the base of the bony vertebrates (Eutelostomi), where the ossified head first appeared. Therefore, Mn1 emerges as a key gene for both skull formation and within-population shape variation. Our study shows that it is possible to identify important developmental genes through genome-wide mapping of high-dimensional shape features in an outbred population.

La medición y control de la actividad universitaria es cada vez más relevante y condiciona la imagen institucional. La proliferación de rankings internacionales así lo evidencia. El objetivo de esta investigación es analizar las acciones de apoyo que las universidades en España ofrecen a la comunidad científica para alcanzar la excelencia investigadora, categorizarlas y comparar, después, si existe una correlación entre estos servicios internos y la posición de las universidades españolas en el ranking SIR, con base en resultados externos. La metodología se fundamenta en el análisis de contenido. Los resultados obtenidos evidencian cierta similitud, aunque hay casos discordantes que permiten inferir que la actividad investigadora responde a iniciativas individuales y encuentra sinergias a partir del trabajo colaborativo entre diferentes instituciones. Además, se perciben niveles más elevados de fomento de la investigación en el caso de las universidades públicas.