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Alternative materials with added-value functions, such as phytopathogen suppression and biostimulant and/or biofertilising activity, have been proposed as peat substitutes in growing media. The aim of this work was to evaluate the effect of 23 agro-industrial composts as components of growing media for baby-leaf lettuce transplant production and their activity against the plant pathogen Pythium irregulare. The composts were produced by mixing different starting feedstocks—tomato waste, leek waste, olive mill cake and vineyard pruning waste—with different additives (coffee, thyme, lavender and rockrose waste), which were incorporated at the beginning of the maturation phase. The results obtained indicated that the composts were mature enough to be used as growing media. The fresh weight of the lettuce plants grown with the different composts was significantly higher than in plants obtained with peat. Composts with the coffee additive produced higher lettuce fresh weight, while those with thyme yielded a lower fresh weight. Moreover, composts as components of growing media showed significantly higher P. irregulare suppressiveness than peat. The composts with additives produced lower lettuce fresh weight than composts without additives, but showed higher suppressiveness. Composts with additives showed opposite results depending on whether they were exposed to pathogens or not. Composts with additives showed opposite results according to pathogen pressure or not. Out of all the composts studied, the compost with tomato waste and leek waste as the initial feedstock, and lavender as an additive, showed the highest suppressive capacity. After lettuce harvesting, the growing media with composts showed significantly lower concentrations of P. irregulare than peat. Principal Component Analysis (PCA) revealed that the growing media with compost can be grouped together according to the additive type, This work has been supported by the Spanish Ministry of Economy and Competitiveness and by European Regional Development Funds (ERDF, ‘‘Una manera de hacer Europa”) in the framework of the project ‘‘Compost as biofertilizer, resistance inductor against plant pathogens and healthy property promoter under a crop intensive sustainable production. Compoleaf” (Project AGL2017- 84085-C3-1-R, C3-2-R and C3-3-R)

Objective To determine whether the extraperitoneal approach for paraaortic staging lymphadenectomy results in a lower rate of surgical complications compared to the transperitoneal approach, without compromising oncological outcomes. Methods Prospective randomized multicenter study of patients with early endometrial or ovarian cancer undergoing paraaortic lymphadenectomy in 2010–2019. Patients were randomized to minimally invasive surgery (laparoscopy or robotic-assisted) using an extraperitoneal or a transperitoneal approach. The primary end point measure was a composite outcome that included developing one or more of the following surgical complications: bleeding during paraaortic lymphadenectomy ≥500 mL, any intraoperative complication related to paraaortic lymphadenectomy, severe postoperative complication (Dindo ≥ IIIA), impossibility to complete the procedure, or conversion to laparotomy. Results There were 103 patients in the extraperitoneal group and 100 in the transperitoneal group. Differences in the composite outcome (transperitoneal 26.0% vs, extraperitoneal 18.4%; P = 0.195) were not found. Differences in the operative time, conversion to laparotomy, intraoperative bleeding, or survival were not observed. A higher number of lymph nodes were retrieved through the extraperitoneal approached (median, interquartile range [IQR] 12 [7–17] vs, 14 [10–19]: P = 0.026). Older age and greater body mass index (BMI) or waist-to-hip ratio (WHR) increased the risk for surgical complications independently of the laparoscopic approach. Conclusions The extraperitoneal approach did not show differences regarding surgical and oncological parameters compared with the transperitoneal approach, although the number of aortic nodes retrieved was higher. The decision to use one or another laparoscopic route is a matter of the surgeon preference. Trial registration ClinicalTrials.gov .identifier: NCT02676726

Este artículo de investigación describe, desde la teoría actor-red, las prácticas de educación ambiental desarrolladas alrededor del agua en distintos escenarios formativos de Bogotá, como los programas de educación de la Secretaría de Ambiente, las instituciones escolares y el trabajo de organizaciones sociales. La descripción onto-epistémica que se propone involucra tres nodos: concepto de agua, estrategias de enseñanza y sentidos pedagógicos; los cuales funcionan para señalar las particularidades que adquiere la enseñanza del agua en espacios formales, informales y no-formales, así, como sus conexiones y colaboraciones.

Introduction: The use of probiotics has been broadly popularized due to positive effects in the attenuation of aberrant immune responses such as asthma. Allergic asthma is a chronic respiratory disease characterized by airway inflammation and remodelling. Objective: This study was aimed to evaluate the effect of oral administration of Lactococcus lactis NZ9000 on asthmatic airway inflammation and lung tissue remodelling in rats and its relation to the maintenance of an adequate intestinal barrier. Methods: Wistar rats were ovalbumin (OVA) sensitized and challenged and orally treated with L. lactis. Lung inflammatory infiltrates and cytokines were measured, and remodelling was evaluated. Serum OVA-specific immunoglobulin (Ig) E levels were assessed. We also evaluated changes on intestinal environment and on systemic immune response. Results: L. lactis diminished the infiltration of proinflammatory leucocytes, mainly eosinophils, in the bronchoalveolar compartment, decreased lung IL-4 and IL-5 expression, and reduced the level of serum allergen-specific IgE. Furthermore, L. lactis prevented eosinophil influx, collagen deposition, and goblet cell hyperplasia in lung tissue. In the intestine, L. lactis-treated asthmatic rats increased Peyer’s patch and goblet cell quantity and mRNA expression of IgA, MUC-2, and claudin. Additionally, intestinal morphological alterations were normalized by L. lactis administration. Splenocyte proliferative response to OVA was abolished, and serum levels of transforming growth factor (TGF)-β were increased by L. lactis treatment. Conclusions: These findings suggest that L. lactis is a potential candidate for asthma prevention, and the effect is mediated by the improvement of intestinal barrier function and systemic TGF-β production.

Objective Paraaortic lymph node involvement is an important prognostic factor in locally advanced cervical cancer (LACC), but the anatomic limit of aortic lymphadenectomy is controversial. We assessed the impact of extraperitoneal paraaortic lymphadenectomy up to the left renal vein in patients with LACC undergoing pretherapeutic staging. Methods A retrospective, multicenter study of patients with LACC stages FIGO 2009 IB2 and IIA2-IVA treated in 10 Spanish reference hospitals in gynecological oncology between 2000 and 2016. Sites of metastatic paraaortic lymph nodes above or below the inferior mesenteric artery were evaluated. Procedural-related intraoperative and early and late complications were assessed. Results We included 634 patients undergoing paraaortic lymphadenectomy, in 616 (97.2%) of which the left renal vein was the upper limit of dissection (laparoscopy 592, robotic-assisted 24). The median surgical time was 150 min (interquartile range (IQR) 120–180), blood loss was 50 mL (range 20–80), and the length of stay was 2 days (range 2–3). Metastatic paraaortic involvement was found in 114 patients (18.5%), with infrarenal metastases in 73 (64%) of them. There were 11 patients (9.6%) with infrarenal metastases only, whereas in the remaining 62 (54.4%) patients concomitant infrarenal and inframesenteric metastases were observed. Intraoperative, early, and late postoperative complications occurred in 3.6%, 7.0%, and 4.5% of patients, respectively. Conclusions In this study of patients with LACC undergoing surgical staging, paraaortic lymphadenectomy up to the left renal vein detected skip or isolated infrarenal metastasis in 9.6% of patients, with an acceptable surgical morbidity.

Treatment of recurrent ovarian carcinoma is a challenge, particularly for the clear cell (CCC) subtype. However, there is a preclinical rationale that these patients could achieve a benefit from antiangiogenic therapy. To assess this hypothesis, we used the growth modulation index (GMI), which represents an intrapatient comparison of two successive progression-free survival (PFS). We conducted a retrospective real-world study performed on 34 patients with recurrent ovarian cancer, treated with bevacizumab-containing regimens from January 2009 to December 2017. The primary endpoint was GMI. An established cut-off > 1.33 was defined as a sign of drug activity. 73.5% of patients had high-grade serous ovarian carcinoma (HGSOC), and 17.7% had CCC; 70.6% of patients received carboplatin/gemcitabine/bevacizumab, and 29.4% received weekly paclitaxel/bevacizumab. According to histological subtype, the overall response rate and median PFS were 52% and 14 months for HGSOC and 83.3% and 20 months for CCC, respectively. The overall population median GMI was 0.99; it was 0.95 and 2.36 for HGSOC and CCC, respectively. CCC subtype was significantly correlated with GMI > 1.33 (odds ratio 41.67; 95% confidence interval 3.6–486.94; p = .03). Adding bevacizumab to chemotherapy in recurrent CCC is associated with a remarkable benefit in this cohort. The efficacy of antiangiogenic drugs in CCC warrants further prospective evaluation.

Objective This study aimed to evaluate the psychological impacts of COVID-19 prevention measures, such as social isolation, on a Mexican sample. Methods We conducted an online sociodemographic and Impact of Event Scale-Revised (IES-R) survey during the second phase of the COVID-19 outbreak in Mexico to evaluate the presence of psychological distress, signs of post-traumatic stress, and to identify the groups at highest risk in the sample. Results Prevalence of psychological distress at moderate or severe levels in the sample were as follows: 943 (22%) intrusive thoughts, 933 (22.3%) avoidance, and 515 (12.2%) hyperarousal. Furthermore, we found the symptoms of clinically significant post-traumatic stress in 1160 (27.7%) of the participants. The variables positively correlated with higher psychological distress were as follows: age (younger), sex (female), employment (employed), relationship status (single), in social isolation, number of days in isolation, the number of people in the household (3-5), and a perception of a high risk of contracting COVID-19, change in routine, engaging in less activity, and loss of income. Conclusion During phase 2 of the COVID-19 outbreak in Mexico, we observed the presence of psychological distress and post-traumatic stress symptoms in over a quarter of the population. This investigation may guide mental health interventions and policies towards the groups that are most vulnerable to the impacts of the social and lifestyle changes taking place in Mexico due to COVID-19.

In this work, we compare and evaluate the efficiency of fosfatriclaben with three commercial fasciolicides in experimentally infected sheep. Fosfatriclaben is a novel prodrug derived from triclabendazole; it is highly water-soluble with excellent aqueous stability at pH 7, properties that make it ideal for developing intramuscular pharmaceutical compositions in the form of solutions. In order to compare, 30 mixed breed sheep, previously diagnosed negative to fluke eggs, were infected with 200 metacercariae of Fasciola hepatica, twice. Five groups of six animals/each were formed for treatments. Group 1 (G1) was treated with closantel 5% injectable at 5 mg/kg subcutaneously, G2 with clorsulon at 2 mg/kg subcutaneously, G3 with triclabendazole at 12 mg/kg per os, G4 with fosfatriclaben at 6 mg/kg intramuscularly (dose equivalent to triclabendazole content), and G5 remained as the non-treated control. On day 110, fecal samples were examined to determine the percentage of egg reduction after treatment, and sheep were humanely euthanized. The livers were collected, the flukes were extracted, measured, and counted. Efficiency in egg reduction was of 86.8, 90.5, 98.4, and 97.3% for closantel, clorsulon, triclabendazole, and fosfatriclaben, respectively, and efficiency against flukes was of 96.2, 91.9, 99.4, and 95.7%, respectively. No statistical differences were found between treatments. It is concluded that fosfatriclaben at 6 mg/kg intramuscularly presented a high fasciolicide efficiency, similar to the best commercial fasciolicides, having advantage over its predecessor since it uses half of the dose required by triclabendazole to remove flukes in sheep under study.

Resumen Objetivo Validar la version espanola de Sintomas y Calidad de Vida en los Miomas Uterinos (SCdV-MU) en mujeres con miomatosis uterina para evaluar la gravedad de los sintomas y su impacto en la calidad de vida relacionada con la salud. Materiales y metodos Las participantes fueron reclutadas en consultas de ginecologia. El cuestionario SCdV-MU consta de 37 items, 8 de los cuales evaluan la gravedad de los sintomas, mientras que los 29 restantes evaluan la calidad de vida relacionada con la salud en 6 subescalas. Se determinaron la consistencia interna, la validez concurrente y discriminante, la fiabilidad test-retest y la sensibilidad al cambio de la escala. Resultados Un total de 619 pacientes con miomatosis uterina y 57 mujeres sin miomatosis participaron en el estudio. El coeficiente alfa de Cronbach fue de 0,97 y la fiabilidad test-retest de 0,90 para la escala global. El cuestionario SCdV-MU no solo discrimino entre pacientes y controles normales sino tambien entre pacientes con distintos grados de miomatosis uterina. La escala respondio a los cambios tras el tratamiento, con un tamano de efecto de 1,2. Conclusiones La version espanola del cuestionario SCdV-MU, administrada en una muestra de la poblacion espanola, ha demostrado ser una herramienta valida y fiable para diferenciar las pacientes con miomatosis uterina con diferentes grados de sintomas y valorar el impacto de la gravedad de estos sintomas en la calidad de vida relacionada con la salud. Ademas, el SCdV-MU ha demostrado ser sensible a los cambios generados por el tratamiento de la miomatosis.

ETV6::RUNX1 is a genetic rearrangement of good prognosis in children with acute lymphoblastic leukemia (ALL). In Mexico, its prevalence is low in comparison with Caucasian populations. We developed a novel TaqMan one-step RT-qPCR approach to assess the prevalence of four genetic rearrangements in a cohort of Hispanic children with ALL from Mexico City. The prevalence of common fusion gene transcripts was as follows: TCF3::PBX1 7.7%; BCR::ABL1p190 3.3%; and KMT2A::AFF1 2.8%, and ETV6::RUNX1was observed with low prevalence (10.5%) in comparison to that reported for developed countries. This is consistent with previous findings on Mexican children with ALL and similar to those reported on children from Hispanic populations. The confirmation of a low prevalence of ETV6::RUNX1 in children of a Hispanic origin represents an advancement in the description of genetic factors of ALL in these populations.

Acute respiratory distress syndrome, due to SARS-CoV-2, is a worldwide health problem. The neutrophil-lymphocyte index allows risk stratification in patients with severe and poor prognostic data, since it reflects the inflammatory state.To determine whether the Neutrophil-Lymphocyte Index delta predicts mortality in patients with COVID-19.We conducted a longitudinal, comparative study in patients with COVID-19, older than 18 years, admitted to the ICU. We evaluated HAS, DM, obesity, COPD, asthma, PaO2/FiO2, tomographic severity. On admission and on days 3 and 7 we measured Neutrophil-Lymphocyte Index, SOFA and APACHE score. For statistical analysis, we performed ROC and Kaplan-Meyer curves.We included 180 patients with COVID-19, 63 died (35%). Delta INL1(Day1-day3)4.11 was associated with mortality (AUC:0.633); sensitivity 55.56% and specificity 77.78%, CI95 0.55-0.70, for delta INL2 (Day1-day7)8.95 (AUC:0.623); sensitivity 44.44% and specificity 84.62%, CI95 0.54-0.69. Difference in survival was observed for Delta1. SOFA scale6, was associated with more days of mechanical ventilation and lower PaO2/FiO2 (p0.001).INL delta between the day of ICU admission and the 3rd day of evolution is a predictor of mortality in critically ill patients.El síndrome de dificultad respiratoria aguda, por SARS-CoV-2, es un problema mundial de salud. El índice neutrófilo-linfocito, permite estratificar el riesgo en pacientes con datos de severidad y mal pronóstico, ya que refleja el estado inflamatorio.Determinar si el delta del Índice Neutrófilo-Linfocito predice mortalidad en pacientes con COVID-19.Se realizó un estudio longitudinal, comparativo en pacientes con COVID-19, mayores de 18 años, ingresados a UCI. Evaluamos HAS, DM, Obesidad, EPOC, asma, PaO2/FiO2, severidad tomográfica., A su ingreso y los días 3 y 7 medimos Índice Neutrófilo-Linfocito, puntaje SOFA y APACHE. En el análisis estadístico, realizamos curvas ROC y Kaplan-Meyer.Incluimos 180 pacientes con COVID-19, 63 fallecieron (35%). Se asoció delta INL1(Día1-día3)4.11 con mortalidad (AUC:0.633); sensibilidad 55.56% y especificidad 77.78%, IC95 0.55-0.70, para delta INL2 (Día1-día7)8.95 (AUC:0.623); sensibilidad 44.44% y especificidad 84.62%, IC95 0.54-0.69. Se observó diferencia en la sobrevida para delta1. La escala SOFA6, se asoció a más días de ventilación mecánica y PaO2/FiO2 menor (p0.001).El delta de INL entre el día de ingreso a UCI y el 3er día de evolución es predictor de mortalidad en pacientes críticamente enfermos.

Serum lactate dehydrogenase (LHD) concentration has been described as a biomarker to predict severe lung injury and severe hypoxemia in patients with ARDS. The aim of the study was to correlate lactate dehydrogenase concentrations with the tomographic severity index in SARS-CoV-2 pneumonia cases, considering lung CT as the gold standard for severity diagnosis in this population based on the presence of ground glass pattern and the score given in the segmental assessment. A total of 110 patients were included in the study, in the period from April to September 2020. From the results, a moderate correlation was obtained between serum LHD levels and severity score by pulmonary tomography, with an r=0.474 andpp< 0.001, sensitivity 86.02%, specificity 75%, AUC 0.806). Serum DHL levels may be useful for predicting severity in patients with COVID pneumonia 19t.

The Major Temporal Arcade (MTA) is a critical component of the retinal structure that facilitates clinical diagnosis and monitoring of various ocular pathologies. Although recent works have addressed the quantitative analysis of the MTA through parametric modeling, their efforts are strongly based on an assumption of symmetry in the MTA shape. This work presents a robust method for the detection and piecewise parametric modeling of the MTA in fundus images. The model consists of a piecewise parametric curve with the ability to consider both symmetric and asymmetric scenarios. In an initial stage, multiple models are built from random blood vessel points taken from the blood-vessel segmented retinal image, following a weighted-RANSAC strategy. To choose the final model, the algorithm extracts blood-vessel width and grayscale-intensity features and merges them to obtain a coarse MTA probability function, which is used to weight the percentage of inlier points for each model. This procedure promotes selecting a model based on points with high MTA probability. Experimental results in the public benchmark dataset Digital Retinal Images for Vessel Extraction (DRIVE), for which manual MTA delineations have been prepared, indicate that the proposed method outperforms existing approaches with a balanced Accuracy of 0.7067, Mean Distance to Closest Point of 7.40 pixels, and Hausdorff Distance of 27.96 pixels, while demonstrating competitive results in terms of execution time (9.93 s per image).

B-cell precursor acute lymphoblastic leukemia (BCP-ALL) is the most frequent pediatric cancer worldwide. Despite improvements in treatment regimens, approximately 20% of the cases cannot be cured, highlighting the necessity for identifying new biomarkers to improve the current clinical and molecular risk stratification schemes. We aimed to investigate whetherA nested case-control study including Mexican children with BCP-ALL was conducted.A lower expression ofOur findings suggest that

El desarrollo de la informática aceleró los tiempos y momentos del escenario y dinámica de los negocios, los grandes cambios comenzaron a forjarse en periodos de tiempo relativamente cortos y las organizaciones se vieron inmersas en constantes cambios. De esta manera la dinámica interactiva y digital empresa, basada en un soporte digital, demandó la necesidad de desarrollar, transformar y emplear nuevos métodos, instrumentos y herramientas para el desarrollo de la función de marketing en las organizaciones, logrando que el marketing digital abriera múltiples ámbitos en cómo desarrollar estructuras de negocios y transformar el campo comercial, dando la oportunidad a que las empresas con capacidad digital e infraestructura tecnológica asumieran con mayor facilidad el cambio de paradigma y comenzaran a migrar sus portafolios y relaciones con sus clientes a los escenarios digitales. La presente investigación surge del interés en la búsqueda de alternativas de desarrollo y aplicación de un plan de marketing digital para las Pymes afiliadas a la caja de compensación familiar Cafam ubicadas en Bogotá en los últimos dos años, con el fin de mejorar la estructura financiera y el posicionamiento de dichas entidades a nivel local y nacional, siendo una investigación de carácter mixto, un diseño explicativo secuencial, enmarcado en 3 fases o etapas de desarrollo, que identifican características de impactos positivos y negativos en entornos digitales sociales, comerciales, administrativos ambientales, a través de sus ejes de análisis a saber: población, sociedad, espacio y recurso, lo que permite triangular información cualitativa y cuantitativa en diferentes contextos empresariales, con el fin de determinar estrategias de marketing digital apropiadas a las Pymes objeto de estudio.

Human epidermal growth factor receptor 2 (HER2)-enriched breast cancers (BC) present the highest rates of pathological response to primary systemic therapy (PST), but they are also the ones that tend to be larger at diagnosis, with microcalcifications and, often, with axillary involvement. If we do not have a reliable method to predict the degree of response, we may not be able to transfer the benefits of PST to surgery. The post-PST surgery planning is guided by the findings in the magnetic resonance imaging (MRI), whose predictive capacity, although high, is far from optimal. Thus, it seems interesting to find other variables to improve it. A retrospective observational study including women with HER2 BC treated with PST and further surgery was conducted. Information regarding clinical, radiological, and histopathological variables was gathered from a total of 132 patients included. Radiological complete response (rCR) was achieved in 65.9% of the sample, and pathological complete response (pCR), according to Miller and Payne criteria, in 58.3% of cases. A higher Ki67 value, the absence of Hormonal Receptors expression, and an rCR was significantly related to a pCR finding. This information impacts directly in surgery planning, as it permits adjustment of the breast resection volume.

Introducción: La alta prevalencia de Diabetes Mellitus tipo 2 en México ha posicionado a la retinopatía diabética como la principal causa de ceguera en adultos en edad productiva en México. Por ello, la detección oportuna de este padecimiento es una tarea prioritaria para el sistema público de salud. En el presente artículo se estudia el desempeño de un nuevo algoritmo para la determinación de la forma de la arcada temporal mayor de la retina, mediante el uso de técnicas de segmentación de imágenes y modelado numérico de curvas. Método: La metodología propuesta emplea Filtros Gaussianos de Correspondencia que realzan la geometría de los vasos sanguíneos. Posteriormente, la estructura vascular es segmentada mediante la umbralización global de la imagen realzada. Dicha segmentación es utilizada como entrada para construir un modelo numérico de las arcadas temporales superior en inferior, utilizando funciones Spline. Resultados: La evaluación de desempeño se realizó utilizando 136 imágenes de pixeles. El algoritmo de segmentación automática de venas de la retina mediante el método GMF obtuvo un valor de Accuracy de 0.9852; el algoritmo de modelado numérico dio un resultado de 6.01 pixeles en la métrica de la distancia media al punto más cercano (MDCP). Otro estudio previo reportó 12.33 pixeles. Con respecto al tiempo, se reportó un tiempo promedio de 10.65 segundos por imagen. Discusión: El método propuesto fue capaz de realizar eficientemente el modelado numérico de las arcadas temporales en imágenes de fondo de ojo. Los resultados demuestran que este método es una herramienta computacional útil para el diagnóstico de alteraciones en la anatomía del ojo.

The production of estradiol within the brain, that is, neuroestradiol (nE2), is widely documented. nE2 deeply impacts adult brain physiology and synaptic plasticity. In the hippocampus, a region of the brain essential for cognitive function, multiple cellular sources, and targets of nE2 have been identified. The impact of estradiol in excitatory and inhibitory neurotransmission suggests a role for regulated nE2 synthesis in the coordination of the activity of different cellular elements of hippocampal network. Here, we review the role of nE2 in the physiology of the hippocampal circuits taking into account the cellular heterogeneity of the hippocampus. We aspire at expanding the consideration of neuron-derived estradiol as a neuromodulator of hippocampal network activities underlying cognition., This work was supported by grants PID2020-112824GB-100 (to PM) funded by MCIN/AEI/ 10.13039/501100011033. N C-A is supported by the PhD fellowship PRE2018-084857 funded by MCIN/AEI/ 10.13039/501100011033 by “ESF Investing in your future” and Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (to IA).

There are three prognostic stratification tools used for endometrial cancer: ESMO-ESGO-ESTRO 2016, ProMisE, and ESGO-ESTRO-ESP 2020. However, these methods are not sufficiently accurate to address prognosis. The aim of this study was to investigate whether the integration of molecular classification and other biomarkers could be used to improve the prognosis stratification in early-stage endometrial cancer. Relapse-free and overall survival of each classifier were analyzed, and the c-index was employed to assess accuracy. Other biomarkers were explored to improve the precision of risk classifiers. We analyzed 293 patients. A comparison between the three classifiers showed an improved accuracy in ESGO-ESTRO-ESP 2020 when RFS was evaluated (c-index = 0.78), although we did not find broad differences between intermediate prognostic groups. Prognosis of these patients was better stratified with the incorporation of CTNNB1 status to the 2020 classifier (c-index 0.81), with statistically significant and clinically relevant differences in 5-year RFS: 93.9% for low risk, 79.1% for intermediate merged group/CTNNB1 wild type, and 42.7% for high risk (includ-ing patients with CTNNB1 mutation). The incorporation of molecular classification in risk stratification resulted in better discriminatory capability, which could be improved even further with the addition of CTNNB1 mutational evaluation, This research was funded by the Instituto de Salud Carlos III (ISCIII), cofinanced by the European Development Regional Fund ‘A way to achieve Europe’ (FEDER, PI17/01723 to D.H.), and by Academy of Finland grant (No. 317680 to J.T.). B.Z. is supported by the faculty funded PhD position in the Integrative Life Science Doctoral Programme, University of Helsinki

[Importance] The consumption of broad-spectrum drugs has increased as a consequence of the spread of multidrug-resistant (MDR) Escherichia coli. Finding alternatives for these infections is critical, for which some neglected drugs may be an option., [Objective] To determine whether fosfomycin is noninferior to ceftriaxone or meropenem in the targeted treatment of bacteremic urinary tract infections (bUTIs) due to MDR E coli., [Design, Setting, and Participants] This multicenter, randomized, pragmatic, open clinical trial was conducted at 22 Spanish hospitals from June 2014 to December 2018. Eligible participants were adult patients with bacteremic urinary tract infections due to MDR E coli; 161 of 1578 screened patients were randomized and followed up for 60 days. Data were analyzed in May 2021., [Interventions] Patients were randomized 1 to 1 to receive intravenous fosfomycin disodium at 4 g every 6 hours (70 participants) or a comparator (ceftriaxone or meropenem if resistant; 73 participants) with the option to switch to oral fosfomycin trometamol for the fosfomycin group or an active oral drug or parenteral ertapenem for the comparator group after 4 days., [Main Outcomes and Measures] The primary outcome was clinical and microbiological cure (CMC) 5 to 7 days after finalization of treatment; a noninferiority margin of 7% was considered., [Results] Among 143 patients in the modified intention-to-treat population (median [IQR] age, 72 [62-81] years; 73 [51.0%] women), 48 of 70 patients (68.6%) treated with fosfomycin and 57 of 73 patients (78.1%) treated with comparators reached CMC (risk difference, −9.4 percentage points; 1-sided 95% CI, −21.5 to ∞ percentage points; P = .10). While clinical or microbiological failure occurred among 10 patients (14.3%) treated with fosfomycin and 14 patients (19.7%) treated with comparators (risk difference, −5.4 percentage points; 1-sided 95% CI, −∞ to 4.9; percentage points; P = .19), an increased rate of adverse event–related discontinuations occurred with fosfomycin vs comparators (6 discontinuations [8.5%] vs 0 discontinuations; P = .006). In an exploratory analysis among a subset of 38 patients who underwent rectal colonization studies, patients treated with fosfomycin acquired a new ceftriaxone-resistant or meropenem-resistant gram-negative bacteria at a decreased rate compared with patients treated with comparators (0 of 21 patients vs 4 of 17 patients [23.5%]; 1-sided P = .01)., [Conclusions and Relevance] This study found that fosfomycin did not demonstrate noninferiority to comparators as targeted treatment of bUTI from MDR E coli; this was due to an increased rate of adverse event–related discontinuations. This finding suggests that fosfomycin may be considered for selected patients with these infections., The study was funded by grants RD16/0016/0001, 0002, 0003, 0005, 0007, 0008, 0009, 0011, 0012, and 0015 from Plan Nacional de Investigación, Desarrollo e Innovación (I+D+i) 2013 to 2016 and the Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, Spanish Network for Research in Infectious Diseases (REIPI); PT13/0002/0010 and PT17/0017/0012 from the Spanish Clinical Research and Clinical Trials Platform (SCReN); and PI 13/01282 co-financed by the European Development Regional Fund “A Way to Achieve Europe” and Operative Program Intelligence Growth 2014 to 2020.

El aprendizaje significativo y social es una tarea que hoy en día los docentes deben de cumplir y más a raíz de la pandemia Covid-19. El objetivo del presente trabajo se expresa a través de la siguiente pregunta de investigación: ¿Cuál es la experiencia y satisfacción en el uso de la herramienta Flipgrid en estudiantes de la carrera de Licenciatura en Tecnologías de Información en una universidad pública del Noreste de México, como recurso en su formación académica y medio de interacción en un ambiente virtual derivado de la pandemia? La metodología que se siguió fue con alcance del tipo exploratorio descriptivo con un enfoque del tipo mixto. Para el enfoque cuantitativo se diseñó y aplicó una encuesta compuesta por 8 preguntas cerradas categorizadas en una escala de Likert del 1 al 5. En el enfoque cualitativo se aplicó una metodología sistémica la cual consistió en cinco etapas: Planeación, desarrollo, obtención de los datos, análisis de los datos y evaluación. Los resultados indican un porcentaje promedio de satisfacción del 68% en el uso de la herramienta Flipgrid, para el desarrollo de las actividades solicitadas a los estudiantes que participaron en este estudio. Sólo un 3% refiere haber realizado alguna actividad académica de este tipo, sólo que con un software diferente. Considerando lo anterior se hace necesario que el docente trate de ser creativo e innovador en el aula y buscando el generar en el estudiante el conocimiento y habilidades que los estudiantes requieren en su ámbito académico y profesional.

Los cambios tecnológicos han originado que las personas se capaciten y realicen de forma diferente su trabajo adoptando las nuevas tecnologías, sin embargo, la capacitación no solo concierne al trabajador sino también a los empleadores e instituciones educativas o quienes se encargan de capacitar, todos ellos tienen la obligación de cubrir los perfiles profesionales que demande el mercado laboral. El estudio tuvo como objetivo determinar si los estudiantes de maestría de una universidad pública del noreste de México se están capacitando o no en herramientas digitales. La metodología se definió como alcance de tipo exploratorio descriptivo, se creó y aplicó una encuesta integrada por 16 preguntas cerradas y 3 abiertas. La muestra fue no probabilística integrada por 550 estudiantes. Los resultados muestran una disminución de capacitación del 24.2% durante el año 2020 respecto al 2019 y esto no es debido a un problema de desempleo originado por la pandemia Covid-19, además se identifica que el 41.5% presentan una capacitación o ninguna al año. El porcentaje más alto de capacitación se da en las herramientas básicas de Microsoft Office con un 30% (Word, Excel y PowerPoint), seguida de los paquetes especializados con un 28.2%, tales como, SPSS, Contpaqi, Aspel SAE, ERP SAP, Photoshop, entre otros. Es importante que universidades, corporaciones y gobiernos generen una alianza a fin de aumentar significativamente el porcentaje de capacitación a fin de satisfacer las necesidades del mercado laboral, así como analizar el costo-beneficio que se puede dar de una capacitación presencial a una en línea.

Simple Summary Lymph node metastasis is an important prognostic factor in locally advanced cervical cancer (LACC), which makes correct staging crucial. In contrast to existing studies evaluating pelvic lymphadenectomy after aortic lymphadenectomy, this study focuses on the pelvic node (PLN) debulking technique which has the dual objective of staging and cytoreduction. This is a multicenter retrospective study of patients with LACC and positive pelvic nodes on imaging tests. Feasibility, morbidity and delay in the initiation of chemoradiotherapy (CRT) were evaluated for the PLN debulking by comparing it with a control group of aortic lymphadenectomy alone. Excision of the bulky nodes was possible in 99.4% of patients. There were no differences in complications between the groups and a shorter time from diagnosis and from surgery to the start of CRT was observed in the study group. Background: Few studies have evaluated laparoscopic pelvic lymph node (PLN) debulking during staging aortic lymphadenectomy in locally advanced cervical cancer (LACC). It allows us to know the lymph node status and facilitates the action of chemoradiotherapy (CRT) by reducing tumor burden. We evaluated its feasibility and compared the perioperative morbidity and the time to CRT with a control group. Methods: This was a multicenter retrospective study of patients with LACC FIGO stage IIIC1r who were recipients of CRT. We compared two cohorts: group 1, which consisted of 164 patients with surgical staging by laparoscopic aortic lymphadenectomy and PLN debulking, and group 2, which consisted of 111 patients with aortic lymphadenectomy alone. Results: Excision of the bulky nodes was possible in all patients in group 1 except for one. Surgery lasted a median of 82 min longer in group 1 but there was no greater intraoperative bleeding or increased hospital stay. There were no significant differences in intraoperative or postoperative complications between the groups. A significantly shorter time from surgery to the start of RT was observed in group 1. Conclusions: It is feasible to perform laparoscopic PLN debulking in the same procedure as the staging aortic lymphadenectomy in LACC without increasing surgical or postoperative complications and without delaying the start of CRT compared to single aortic lymphadenectomy.