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This dissertation analyzes how the Salvadoran state, civil war veterans, and gang members share a common understanding of peace that enables them to occupy the paradoxical position of being both purveyors of violence and “peacemakers.” I conducted this work in a violent, distrustful and hyper-masculine context with the help of civil war veterans who were mentoring relatives in youth gangs to support their efforts to make peace with other gangs and the government. Throughout my 2011 - 2015 ethnographic research in San Salvador, I found that many women, relatives of civil war veterans and gang member interlocutors, characterized the 1992 Peace Accords as una paz masculinista (a masculinist peace). While la paz maculinista denotes the absence of violence between men in conflict, for women living with social and gender violence and struggling with poverty reinforced by neoliberal economic policies, life was anything but peaceful. I build on Johan Galtung’s concept of “negative” and “positive” peace by using an intersectional theory perspective. I argue that the postwar experience is shaped by a negative notion of peace that is highly gendered. I further complicate the state’s notion of postwar peacemaking through an analysis of the rise of gang and femicidal violence, and the state’s punitive responses to both as a measure to attain peace. I discovered that gangs use their own peacemaking efforts to question the state’s racialized violence and human rights violations against its members. However, neither top-down (state-led) nor bottom-up (gang-led) peacemaking efforts have seriously grappled with violence against women or with the harsh realities of living under neoliberalism. My dissertation contends that to build a lasting peace, peacemaking in El Salvador must address not just ending war, but transforming economic inequality, class-based political exclusion, and racialized and gendered violence

Background and objectives Telomerase is an enzyme involved in maintaining the length of telomeres and cell senescence. Numerous studies have shown that in more than 90% of malignant tumors telomerase activity is detected. Material and methods Retrospective observational study in a series of 85 cases of primary melanomas, 12 metastatic melanomas, and 22 melanocytic nevi. We used the monoclonal antibody hTERT (human telomerase reverse transcriptase, Rockland) to assess telomerase activity. The SPSS software package was used to analyze data. Results Telomerase expression was present in all the melanocytic neoplasms analyzed. Expression was heterogenous and moderate or high in the melanomas. In contrast, expression was homogeneous and lower in the nevi. Heterogeneous expression was associated with rapid melanoma growth (P = .028), a Breslow thickness of more than 4 mm (P = .004), mitosis (P = .032), and mutations in the TERT gene (P = .002). Activity was less intense in intradermal nevi, and more intense in compound and dysplastic nevi (P = .054). Conclusions Telomerase expression is found in all melanocytic neoplasms but is higher in melanomas than in nevi. A heterogeneous pattern of expression in melanomas is associated with more aggressive tumors.

Recent publication of the results of clinical trials in which lymph node dissection was not associated with any survival benefit in patients with sentinel node metastasis makes it necessary to reconsider the treatment of patients with melanoma. This article provides an update on the available evidence on the diverse factors (routes of metastatic spread, predictors, adjuvant therapy, etc.) that must be considered when treating patients with sentinel node-positive melanoma. The authors propose a decision-making algorithm for use in this clinical setting. The current evidence no longer supports lymph node dissection in patients with Low-risk sentinel node metastasis (sentinel node tumor load

Breast cancer (BC) is widely studied due to its importance in the world public health. Currently, there are multiple standardized methods for its diagnosis including physical and molecular ones. The strategies for BC treatment are diverse; despite the availability of different therapeutic options, BC still remains one of the leading causes of cancer death in women. There is a need for novel diagnostic and therapeutic tools, and metabolomics approach could help us to develop them and to improve the already existing ones, which leads us to the possibility of a personalized treatment with reduced adverse effects and a better clinical outcome. Herein, we describe the targets that are currently being used in the diagnosis and treatment of BC and review the development of new ones based on metabolic alterations on BC. We conclude that a recent metabolomics approach can be a novel tool to improve the diagnosis of BC as well as constitute the basis for identification of new therapeutic targets.

Biting midges (Diptera, Ceratopogonidae) of the genus Culicoides are important vectors of pathogens causing diseases in free living and production animals and can lead to large economic losses in many European countries. In Europe, Culicoides imicola and the Obsoletus group are considered to be the main vectors of bluetongue virus that mostly affects ruminants such as cattle and sheep. Spatio-temporal modelling of vector distribution and abundance allows us to identify high risk areas for virus transmission and can aid in applying effective surveillance and control measures. We used presence-absence and monthly abundance data of Culicoides from 1005 sites across 9 countries (Spain, France, Denmark, Poland, Switzerland, Austria, Poland, Sweden, Norway) collected between the years 2007 and 2013. The dataset included information on the vector species abundance (number of specimens caught per night), GPS coordinates of each trap, start and end dates of trapping. We used 120 environmental predictor variables together with Random Forest machine learning algorithms to predict the overall species distribution (probability of occurrence) and monthly abundance in Europe. We generated maps for every month of the year, to visualize the abundance of C. imicola and Obsoletus group in Europe as well as distribution maps showing the probability of occurrence. We were able to create predictive maps of both Culicoides sp. occurrence and abundance using Random Forest models, and although the variance was large, the predicted abundance values for each site had a positive correlation with the observed abundance. We found relatively large spatial variations in probability of occurrence and abundance for both C. imicola and the Obsoletus group. For C. imicola probability of occurrence and abundance was higher in southern Spain, where as the Obsoletus group had higher probability of occurrence and abundance in central and northern Europe such as France and Germany. Temporal variation was also observed with higher abundance occurring during summer months and low or no abundance during winter months for both C. imicula and the Obsoletus group, although abundance was generally higher for a longer period of time for C. imicula than for the Obsoletus group.Using machine learning techniques, we were able to model the spatial distribution in Europe for C. imicola and the Obsoletus group in terms of abundance and suitability (probability of occurrence). Our maps corresponded well with the previously reported distribution for C. imicola and the Obsoletus group. The observed seasonal variation was also consistent with reported population dynamics for Culicoides, as it depends on environmental factors such as temperature and rainfall. Longer seasonal abundance for C. imicula compared to the Obsoletus group can be explained by the species distribution, as C. imicula is limited to the southern parts of Europe where the warm season lasts longer, whereas the Obsoletus group is found further north. The outputs obtained here will be used as input for epidemiological models and can be helpful for determining high risk areas for disease transmission.

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Introduction: In numerous clinical practice guidelines, emphasis is placed on the need for coordinated care of psoriatic arthritis (PsA) between rheumatologists and the objective was to develop experience-based points to consider facilitating the implementation of multidisciplinary units (Dermatology/Rheumatology) for the management of patients with PsA. Methods: A scientific committee of rheumatology and dermatology experts in the management of PsA, and with experience in joint care, discussed the critical aspects of multidisciplinary PsA Units. The discussion became the basis for a Delphi survey in two rounds submitted to a panel of 24 specialists in rheumatology and dermatology not involved in PsA units. The statements and practices that reached a consensus were summarized and further elaborated. Results: After two Delphi rounds, agreement was reached for 49 of the 50 proposed statements. These included a justification of the units, objectives, and utilities, as well as operational aspects of the units, such as the minimal and ideal premises, referral criteria, and necessary resources. The statements were compiled in 11 points to consider. Conclusions: This consensus offers some points to consider, including premises and recommendations, for the development of specialized Units in the management of PsA based on expert opinion. We trust these guidelines may facilitate their implementation in the future.