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Background: Lifestyle interventions (LIs) are the cornerstone for obesity management. The Mayo Clinic Diet (MCD) offers two approaches for LIs: the In-Person LI (IPLI) and the Digital Enhanced LI (DELI). The IPLI includes a 2-day in-person program with monthly follow-ups, whereas the DELI provides on-demand digital tools. The comparative efficacy of these approaches is currently unknown. Methods: This retrospective study included two cohorts of adults with a body mass index (BMI) of ≥25 kg/m2 and weight metrics at least 3 months after starting either the IPLI or DELI program. The primary endpoint was the total body weight loss percentage (TBWL%) at 6 months. Results: The study included 133 participants in the IPLI cohort (mean age 46.3 years, 65.4 % female, BMI 36.4) and 9603 in the DELI cohort (mean age 60.1 years, 85.0 % female, BMI 33.1). The DELI group achieved superior TBWL% at 1, 3, and 6 months compared to the IPLI group (3.4 % vs. 1.5 %, 4.7 % vs. 2.4 %, 5.3 % vs. 2.9 %, respectively; p 5 % TBWL at 6 months (OR 1.66; 95 % CI [1.08, 2.55], p

Background. The noninvasive detection of subclinical graft injury including subclinical T cell–mediated rejection (subTCMR) is one of the unresolved challenges after liver transplantation. Recently, serum C-X-C motif chemokine ligand 8 (CXCL8) was proposed as a highly accurate marker of subTCMR in pediatric liver transplant recipients. We aimed to evaluate the accuracy of the quantification of this chemokine for predicting subTCMR in adult liver transplant recipients, as well as its capacity to classify patients who could benefit from immunosuppression reduction. Methods. Plasma CXCL8 concentrations were measured retrospectively in a prospectively collected cohort of adult liver transplant recipients with well-characterized histologic phenotypes. Results. In total, 78 patients were included. Median plasma CXCL8 concentrations did not differ (P = 0.24) between patients without histological evidence of rejection (3.6 [0.4–22.0] pg/mL), subTCMR (11.5 [0.4–41.0] pg/mL), clinical TCMR (9.4 [0.4–40.5] pg/mL), and other etiologies of graft injury (8.7 [0.4–31.2] pg/mL). Likewise, plasma CXCL8 concentrations did not discriminate between patients within and outside histologic criteria for immunosuppression reduction that were proposed by the 2016 Banff Working Group on Liver Allograft Pathology (cutoff: 10.9 pg/mL, sensitivity: 0.48, and specificity: 0.79). Furthermore, weak correlation was found between plasma CXCL8 and alanine aminotransferase and aspartate aminotransferase (Spearman ρ = 0.18 and 0.25). Patients with significant fibrosis (17.8 [0.4–40.5] pg/mL) showed higher plasma CXCL8 concentrations than patients without fibrosis (8.2 [0.4–41.0] pg/mL; P = 0.05). Conclusions. Plasma CXCL8 concentrations are not predictive of subclinical graft injury or of histological criteria for the minimization of immunosuppression in adult liver transplant recipients.

La economía de las personas se ve inmersa todos los días en una problemática que cada vez resulta más difícil de resolver no solo en el ámbito local, sino también en el na-cional e internacional. Las entidades económicas, por su parte, buscan obtener utilidades, principal objetivo para las que fueron creadas, pero hoy en día, es un reto no solo generar dichas utilidades, sino, subsistir, y en el ámbito fis-cal, el cumplimiento se convierte en algo difícil y tortuoso.Es precisamente en el año 2022 cuando la Secretaría de Hacienda y Crédito Público emitió cambios en el régimen tributario para que las personas contribuyan ya sea indivi-dual o colectivamente a través de una sociedad y puedan hacerlo de una manera simplificada. El Servicio de Adminis-tración Tributaria (sat), se dio a la tarea de crear el Régi-men Simplificado de Confianza (resico), donde el principal agente de cambio consiste en la motivación y en facilitar el cumplimiento de obligaciones y con impuestos justos para que el contribuyente pague.La presente investigación tiene como objetivo, eviden-ciar, bajo un enfoque cualitativo descriptivo, que al inscri-birse en el padrón fiscal y promover la formalidad, se favo-rece una cultura contributiva en la población y se logran importantes beneficios tanto para el contribuyente como para la autoridad. Además, dejar de manifiesto que no solo se trata de cumplir con la presentación de declaraciones sino de crear conciencia al implementar una administración en la empresa donde la contabilidad financiera prevalezca también como un elemento clave para su crecimiento

Abstract Autoantibodies are the diagnostic hallmark of autoimmune liver diseases. Indirect immunofluorescence (IFT) is the reference method for the detection of anti-mitochondrial antibodies (AMA) and anti-liver kidney microsomal type-1 (anti-LKM1) antibodies, and inhibition ELISA (iELISA) for anti-soluble liver antigen (anti-SLA) antibodies. Given the complexity of these techniques, commercial ELISAs have emerged as a practical alternative, but without head-to-head validations. This study evaluated the agreement between three commercial ELISAs and the reference techniques and the impact of polyreactive immunoglobulin G (pIgG), a recently described phenomenon in autoimmune hepatitis, on commercial ELISAs. Inter-rater reliability was assessed using Cohen-Kappa coefficient (κ). Forty-eight, 46, and 66 samples were analyzed for AMA, anti-LKM1, and anti-SLA, respectively. For AMA, one commercial assay showed high agreement (κ = 0.91 (0.78–1.00)) with the reference method, while the other two showed weak or moderate agreement. For anti-LKM1, only one commercial assay showed high agreement (κ = 0.86 (0.71–1.0)). For anti-SLA antibodies only moderate agreement was achieved (κ up to 0.71 (0.52–0.89)). There was a trend towards higher pIgG levels in false-positives in the commercial ELISAs. Patients with high suspicion of autoimmune liver diseases should be referred to reference laboratories with the capacity of performing gold standard methods if the initial ELISA-based screening was performed.

No Brasil, não há iniciativas estruturadas para a elaboração de indicadores de monitoramento do saneamento básico, as quais contemplem todos os componentes e princípios definidos pelas políticas nacionais. Os processos de construção dos indicadores têm se caracterizado pela arbitrariedade na escolha e ponderação dos indicadores. O objetivo desta pesquisa foi construir indicadores, no nível local, para subsidiar os processos de tomada de decisão na gestão municipal do saneamento básico, utilizando métodos validados pela literatura científica e considerando os princípios fundamentais estabelecidos pelas políticas brasileiras de saneamento básico. O processo de construção dos indicadores incluiu um estudo de caso que envolveu a participação dos gestores e gestoras do saneamento básico do município de Florianópolis. Foram construídos 36 indicadores, dos quais: treze corresponderam ao componente de abastecimento de água, sete corresponderam ao esgotamento sanitário, dez ao manejo de resíduos sólidos e seis ao manejo de águas pluviais. O grande diferencial metodológico desta pesquisa foi a adoção de um marco teórico – conceitual baseado nos princípios fundamentais da prestação dos serviços públicos para estruturar o conjunto de indicadores.

Background and Aims: Hunger, satiation, postprandial satiety, and hedonic eating constitute key food intake parameters. We aim to study whether these symptoms are associated with gastrointestinal symptoms (GIS) in patients with obesity. Methods: This is a cross-sectional study of patients with obesity. Patients completed the following validated biomarkers and questionnaires: hunger was measured via visual analog scale (100 mm) following a standard meal, satiation was measured via ad libitum meal (calories to fullness; kcal), postprandial satiety was measured via gastric emptying scintigraphy (T1/2; mins), and hedonic eating was measured via the Hospital Anxiety and Depression Scale questionnaire. Participants completed the abridged Bowel Disease Questionnaire to evaluate their GIS. We calculated the odds ratios (ORs) adjusted for sex, weight, and age between food intake parameters 75th percentile observed in a prior cohort of 450 participants with obesity and GIS. Results: A total of 274 participants (41 ± 10 [SD] years, 75% females, body mass index 39 ± 8 kg/m2) were included in the analysis. Increased hunger was associated with a lower prevalence of lumpy stools (OR = 0.18, P = .02). Satiation was associated with abdominal pain/discomfort (relieved by defecation [OR = 2.4, P = .02] or associated with change in stool consistency [OR = 2.92, P < .01]), loose/watery stools (OR = 2.09, P = .02), and bloating (OR = 2.49, P < .01). Abnormal postprandial satiety was associated with bloating (OR = 2.26, P < .01) and loose/watery stools (OR = 1.84, P = .04). Hedonic eating was associated with abdominal pain/discomfort with stool frequency change (OR = 2.4, P = .02), >3 bowel movements per day (OR = 1.93, P = .048), bloating (OR = 2.49, P = .01), abdominal pain after meals >1 per month (OR = 4.24, P < .01), and nausea >1 per week (OR = 4.51, P < .01). Conclusion: Alterations in hunger, satiation, postprandial satiety, and hedonic eating are associated with GIS in patients with obesity.

Background & Aims: Acute-on-chronic liver failure (ACLF) has been linked to different pathophysiological mechanisms, including systemic inflammation and mitochondrial dysfunction. Sarcopenia has also been proposed as a potential mechanism; myostatin is a key factor inducing sarcopenia. Therefore, this study aimed to evaluate the association of myostatin levels with the development of ACLF and mortality in patients with cirrhosis. Methods: We performed a prospective cohort study, including both outpatient and hospitalized patients with cirrhosis. Clinical, biochemical, and nutritional parameters were evaluated, and the development of acute decompensation (AD) or ACLF during follow-up was recorded. ACLF was defined according to the EASL-CLIF criteria. Receiver-operating characteristic, Kaplan-Meier and Cox regression analyses were performed. Results: A total of 186 patients with the whole spectrum of cirrhosis were included; mean age was 53.4 ± 14 years, mean Child-Pugh score was 8 ± 2.5 and mean MELD score was 15 ± 8. There was a stepwise decrease in myostatin levels from a compensated stage to AD and ACLF. Myostatin correlated positively with nutritional markers and negatively with severity scores. The prevalence of sarcopenia was 73.6%. During follow-up, 27.9% of patients developed AD and 25.8% developed ACLF. Most episodes were grade 2-3, mainly (62.5%) precipitated by infections. The most common organ failures observed were in the liver (63.3%) and the kidney (64.6%). Receiver-operating characteristic analysis yielded

IntroductionTorque teno virus (TTV) replication is controlled by immune status, mirroring a degree of immunosuppression after solid organ transplantation. TTV viraemia (TTVv) was associated with acute cellular rejection and infection within the first year after liver transplantation (LT). Long-term data on TTV after LT and correlation with graft injury from protocol biopsies are limited. MethodsOne hundred plasma samples paired with graft biopsies from a prospective single-center biorepository were analyzed.ResultsThe median time post-LT was 23 months (range, 2–298). TTVv was detectable in 97%. TTVv decreased over time after LT and showed a significant decline from year 1 to later time points. Hence, TTVv correlated negatively with histologic liver fibrosis (liver allograft fibrosis and Ishak scores) and positively with the overall immunosuppression degree quantified by an immunosuppression score in the first year after LT. There was no association with dosages or trough levels of single immunosuppressants. The pharmacodynamic marker TTVv did not correlate with pharmacokinetic assessments of immunosuppression degree [calcineurin inhibitor (CNI) trough levels or immunosuppressant dosages]—our clinical gold standards to guide immunosuppressive therapy. TTVv was independently associated with histologically proven liver fibrosis after LT in the first year after LT in multivariate analysisDiscussionThe independent association of histological graft fibrosis with lower TTVv in year 1 underscores that a pharmacodynamic marker would be preferable to individualize immunosuppression after LT. However, a high variability of TTVv at the low immunosuppression doses given after the first year precludes TTV as a clinically useful marker after LT in the long-term liver transplant recipients.

IntroductionThe combination of everolimus (EVR) and low-dose tacrolimus (lowTAC) prevents T cell-mediated rejection of liver grafts as sufficiently as high-dose tacrolimus (highTAC) and mycophenolate, but is associated with a preserved kidney function within the first years after orthotopic liver transplantation (OLT). However, none of the available studies assessed the histological pattern of graft injury or fibrosis in surveillance biopsies (svLbx).MethodsAll svLbx taken under at least one month of stable immunosuppression with either EVR (aim 3-8 ng/ml) combined with lowTAC (aim 3-5 ng/ml) or highTAC (aim 5-8 ng/ml) combined with mycophenolate (500-1500 mg/day) within the first three to four years after OLT at our center were included. Patients who were switched to EVR because of insufficient control of alloreactivity were excluded.ResultsReasons for switches to EVR were mainly malignancies before or after OLT, or chronic kidney injury. We were able to include 20 svLbx with EVR/lowTAC and 49 with highTAC/mycophenolate. Both groups had similar liver enzymes and similar kidney function. The EVR/lowTAC group exhibited lower TAC trough levels at svLbx (4.4 vs. 6.6 ng/ml; p

Summary: Background: Lifestyle interventions for weight loss are currently not individualised to underlying pathophysiology and behavioral traits in obesity. We aim to compare the outcome of a standard lifestyle intervention (SLI) to phenotype-tailored lifestyle interventions (PLI) on weight loss, cardiometabolic risk factors and physiologic variables contributing to obesity. Methods: This 12-week, single-centre non-randomised proof-of-concept clinical trial including men and women aged 18–65 years with a body mass index (BMI) greater than 30 without history of any bariatric procedure, and current use of any medication known to affect weight. Participants lived anywhere in the United States, and underwent in-person testing in Rochester, MN at a teaching hospital. All participants completed in-person phenotype testing at baseline and after 12 weeks. Participants were assigned to their intervention based on their period of enrollment. In the first phase, participants were assigned to SLI with a low-calorie diet (LCD), moderate physical activity, and weekly behavioral therapy sessions. In the second phase, other participants were assigned to PLI according to phenotype: abnormal satiation (time-restricted volumetric LCD); abnormal postprandial satiety (LCD with pre-meal protein supplementation); emotional eating (LCD with intensive behavioral therapy); and abnormal resting energy expenditure (LCD with post-workout protein supplementation and high-intensity interval training). The primary outcome was total body weight loss in kg at 12 weeks using multiple imputation for missing data. Linear models estimated the association of study group allocation and study endpoints adjusting for age, sex, and baseline weight. This study was registered with ClinicalTrials.gov, NCT04073394. Findings: Between July 2020 and August 2021, 211 participants were screened, and 165 were assigned to one of the two treatments in the two phases: 81 SLI (mean [SD] age 42.9 [12] years; 79% women; BMI 38.0 [6.0]) and 84 PLI (age 44.8 [12.2] years; 83% women; BMI 38.7 [6.9]); 146 completed the 12-week programs. The weight loss was −7.4 kg (95%CI, −8.8, −6.0) with PLI vs. −4.3 kg (95%CI, −5.8, −2.7) with SLI (difference, −3.1 kg [95%CI, −5.1 to −1.1]; P = 0.004). No adverse events were reported in any group. Interpretation: Phenotype-tailored lifestyle interventions may result in significant weight loss, but a randomised controlled trial is required to confirm causality. Funding: Mayo Clinic; NIH (K23-DK114460).

Considering entrepreneurship as a set of actions performed by a subject, and behavior one of the main predictors of actions, this work presents a study based on the Theory of Human Values, that aims to analyze the influence of personal values on entrepreneurial intention of university students; understanding as well the personal values as cognitive characteristics that explain the attitudes of a subject towards entrepreneurship, the hypotheses of this work establish a positive relation between values associated to individualism and the entrepreneurial intention as well as a negative relation between values associated to collectivism and the entrepreneurial intention of university students. For this, a sample of 488 undergraduate students from the University of Guadalajara in Mexico is used and statistical analysis is performed through the SPSS software. Using a quantitative methodology, an exploratory factorial analysis and a linear regression model are performed to calculate the predictive capacity of the different types of personal values on the entrepreneurial intention of students at the University previously mentioned. Personal values associated to individualism prove to be highly related to entrepreneurial intentions while those related to collectivism show low or null effect. Some exceptions are discussed and lead to future lines of research regarding different types of entrepreneurship.

Objective Describe the histological findings of minimally ultrasound-guided invasive autopsies in deceased patients with severe SARS-CoV-2 and compare the diagnostic yield with open autopsies. Design Observational post-mortem cohort study. Minimally invasive ultrasound-guided autopsies were performed in fourteen deceased patients with a confirmed diagnosis of SARS-CoV-2 pneumonia. Histological and clinical findings of lung, kidney, and liver tissue are described and contrasted with those previously reported in the literature. Setting Single-center COVID-19 reference center in Mexico City. Results Fourteen minimally invasive autopsies revealed a gross correlation with open autopsies reports: 1) Lung histology was characterized mainly by early diffuse alveolar damage (12/13). Despite low lung compliances and prolonged mechanical ventilation, the fibrotic phase was rarely observed (2/13). 2) Kidney histopathology demonstrated acute tubular injury (12/13), interstitial nephritis (11/13), and glomerulitis (11/13) as the predominant features 3) Liver histology was characterized by neutrophilic inflammation in all of the cases, as well as hepatic necrosis (8/14) despite minimal alterations in liver function testing. Hepatic steatosis was observed in most cases (12/14). SARS-CoV-2 positivity was widely observed throughout the immunohistochemical analysis. However, endothelitis and micro thrombosis, two of the hallmark features of the disease, were not observed. Conclusion Our data represents the largest minimally invasive, ultrasound-guided autopsy report. We demonstrate a gross histological correlation with large open autopsy cohorts. However, this approach might overlook major histologic features of the disease, such as endothelitis and micro-thrombosis. Whether this represents sampling bias is unclear.

La postura del sujeto corpóreo debe ser pensada dentro de un proceso de movimiento dinámico, facilitada por la infinidad de posiciones que existen para conseguir una armonía funcional dentro del esquema de movimiento humano. El ensayo tiene el objetivo de describir y analizar documentalmente el ser corpóreo en correlación a sus hábitos posturales, desarrolla las concepciones de corporeidad, conciencia pre-reflexiva, imagen corporal, postura corporal, hábitos corporales y la axiología praxiológica del docente universitario. Concluye, que el dinamismo en la praxiología del docente universitario permite apreciar la dignidad de todos los cuerpos humanos que interactúan con él en la acción pedagógica. Él es digno desde su valoración genética y autonomía de crecimiento como unidad humana completa hasta que, en el despliegue de su libertad, puede alcanzar la genialidad axiológica en su hacer docente. Valorar su cuerpo da sentido de pertinencia en su praxiología docente, es la responsabilidad humana del ser corpóreo

La enfermedad granulomatosa crónica (EGC) es un error innato de la inmunidad causado por un defecto en uno de los componentes del complejo NADPH oxidasa, responsable de generar especies reactivas de oxígeno (ERO) durante el estallido respiratorio en los fagocitos. La ausencia de ERO producidos por la NADPH oxidasa en los neutrófilos y en los macrófagos produce mayor susceptibilidad a infecciones bacterianas y fúngicas, además de manifestaciones inflamatorias por una respuesta inflamatoria desregulada, lo que sugiere que la capacidad para regular adecuadamente la señalización inflamatoria depende de las ERO derivadas de la NADPH oxidasa. Los pacientes con EGC ligada al cromosoma X tienen un curso de enfermedad más grave con infecciones invasivas recurrentes, a diferencia de los pacientes con EGC no clásica, quienes no presentan infecciones bacterianas o fúngicas invasivas, pero con manifestaciones inflamatorias más prominentes. Las manifestaciones gastrointestinales más frecuentes son estomatitis, gingivitis, diarrea crónica, abscesos hepáticos, similares a las de la enfermedad inflamatoria intestinal (EII) y granulomas, que pueden provocar obstrucción o estenosis en esófago, estómago o intestino. Se ha observado que la deficiencia de p40phox y EROS (EGC no clásica) se asocia a mayor susceptibilidad a colitis y al desarrollo de inflamación severa, por lo que se plantea que estas proteínas participan en la resolución de la inflamación. En general, los hallazgos inflamatorios en la EGC, incluyendo los gastrointestinales, han sido poco descritos. En las cohortes internacionales se reportan manifestaciones similares a EII hasta en 58 % de los pacientes con EGC; en cambio, en la única cohorte mexicana se describe su hallazgo solo en cuatro de 93 pacientes (4.3 %). En esta revisión resumimos los hallazgos clínicos gastrointestinales de la EGC, incluidas las manifestaciones infecciosas e inflamatorias, con énfasis en las últimas.

Abstract Introduction The role of insulin resistance in diabetic chronic complications among individuals with type 1 diabetes (T1D) has not been clearly defined. The aim of this study was to examine the performance of insulin resistance, evaluated using the estimated glucose disposal rate (eGDR) for the identification of metabolic syndrome (MS) and diabetic chronic complications. Methods Cross‐sectional study in a tertiary care centre. We included patients of 18 years and older, with at least 6 months of T1D duration. Anthropometric, clinical and biochemical data were collected. Results Seventy patients, 41 (58.6%) women, with a median age of 36.6 years (range 18–65). Mean age of onset and duration of diabetes was 13.5 ± 6.5 and 23.6 ± 12.2 years, respectively. Twenty‐one (30%) patients met the metabolic syndrome (MS) criteria. Patients with MS had lower eGDR compared to patients without (5.17 [3.10–8.65] vs. 8.86 [6.82–9.85] mg/kg/min, respectively, p = .003). Median eGDR in patients with nephropathy, retinopathy and neuropathy compared with those without was 6.75 (4.60–8.20) versus 9.53 (8.57–10.3); p

Introduction Diabetes and hyperglycemia are risk factors for critical COVID-19 outcomes; however, the impact of pre-diabetes and previously unidentified cases of diabetes remains undefined. Here, we profiled hospitalized patients with undiagnosed type 2 diabetes and pre-diabetes to evaluate its impact on adverse COVID-19 outcomes. We also explored the role of de novo and intrahospital hyperglycemia in mediating critical COVID-19 outcomes.Research design and methods Prospective cohort of 317 hospitalized COVID-19 cases from a Mexico City reference center. Type 2 diabetes was defined as previous diagnosis or treatment with diabetes medication, undiagnosed diabetes and pre-diabetes using glycosylated hemoglobin (HbA1c) American Diabetes Association (ADA) criteria and de novo or intrahospital hyperglycemia as fasting plasma glucose (FPG) ≥140 mg/dL. Logistic and Cox proportional regression models were used to model risk for COVID-19 outcomes.Results Overall, 159 cases (50.2%) had type 2 diabetes and 125 had pre-diabetes (39.4%), while 31.4% of patients with type 2 diabetes were previously undiagnosed. Among 20.0% of pre-diabetes cases and 6.1% of normal-range HbA1c had de novo hyperglycemia. FPG was the better predictor for critical COVID-19 compared with HbA1c. Undiagnosed type 2 diabetes (OR: 5.76, 95% CI 1.46 to 27.11) and pre-diabetes (OR: 4.15, 95% CI 1.29 to 16.75) conferred increased risk of severe COVID-19. De novo/intrahospital hyperglycemia predicted critical COVID-19 outcomes independent of diabetes status.Conclusions Undiagnosed type 2 diabetes, pre-diabetes and de novo hyperglycemia are risk factors for critical COVID-19. HbA1c must be measured early to adequately assess individual risk considering the large rates of undiagnosed type 2 diabetes in Mexico.

Aldo y Hannie van Eyck se trasladaron de Amsterdam a Loenen en 1964, reformando una antigua construcción junto al río Vecht que ha permanecido inédita hasta la actualidad. En su casa, habitada hasta 1999, Van Eyck desplegó las mismas estrategias arquitectónicas que en sus proyectos más conocidos, construyendo un interior que refleja su modo de comprender la profesión y su manera de habitar. Este breve ensayo se fija en los dibujos elaborados por el arquitecto en el proceso de proyecto, publicados por primera vez, recomponiendo la casa como montaje de fragmentos autónomos estudiados individualmente. Los dibujos, mezcla de bocetos y planimetrías a escala, presentan una casa hecha de cosas, un verdadero laberinto que exige la participación del que la recorre para ser comprensible. Al fin y al cabo, el dibujo no es tanto una herramienta de representación como un instrumento que facilita el pensamiento.

Food intake regulation in humans is a complex process controlled by the dynamic interaction of homeostatic and hedonic systems. Homeostatic regulation is controlled by appetitive signals from the gut, adipose tissue, and the vagus nerve, while conscious and unconscious reward processes orchestrate hedonic regulation. On the one hand, sight, smell, taste, and texture perception deliver potent food-related feedback to the central nervous system (CNS) and influence brain areas related to food reward. On the other hand, macronutrient composition stimulates the release of appetite signals from the gut, which are translated in the CNS into unconscious reward processes. This multi-level regulation process of food intake shapes and regulates human ingestive behavior. Identifying the interface between hormones, neurotransmitters, and brain areas is critical to advance our understanding of conditions like obesity and develop better therapeutical interventions. Neuroimaging studies allow us to take a glance into the central nervous system (CNS) while these processes take place. This review focuses on the available neuroimaging evidence to describe this interaction between the homeostatic and hedonic components in human food intake regulation.

This paper tries to explore the act of drawing as a tool for analysis and cultural dissemination, an instrument of memory which lives beyond the vanishing of what tries to represent. It applies this idea to the house of Aldo van Eyck in Loenen aan de Vecht, in order to understand the building of which handrawn sketches, blueprints and numerous pictures are conserved. The text is a result of a deeper research on Aldo van Eyck’s house, an unkwnown project shown here for the first time, outside the inner circle of his family and friends. The paper takes but five aspects of the house which have been represented in five drawings. “Superponer”: the house as a stop in a line of four houses inhabited by Van Eyck. “La casa, las cosas y los casos”: as a gathering of autonomous objetcs in a net of reciprocal relations. “Todo cambia”: as an overlap of two different ways of understanding and living space from two different times. “Entremuros”: as a space fully charged of potential, meaning. ”Abrir horizontes”: finally, the house as a place which holds inside the whole world. The objective of this essay is not to deduce final conclusions about the house but to present raw material, submitting it to a broad scientific discussion.

This study examines how entrepreneur’s values and knowledge can influence growth expectations in new technology-ventures. The study analyses six Spanish cases with different level of growth expectations in their first years and with different characteristics in the entrepreneurial team. Our research reveals that entrepreneur’s knowledge is not a factor that helps to differentiate the level of growth in this specific sector. However, we found certain values present in those new ventures with a higher growth expectations, mainly independence and wealth. The values that were not related are the need of exploitation and security. Finally, we draw a model to understand the relationship between entrepreneur’s values and knowledge and their impact on new technology venture growth expectations.

Purpose: The study aims to provide relevant information on the educational processes experienced by university students in Spain during the period of compulsory confinement. To this end, the key factors of the emergency educational model implemented by the country's universities have been analysed. Design/methodology/approach: The study investigated, through qualitative, exploratory research and 30 in-depth interviews, how university students have lived the process of change to alternative forms of education during the crisis, what training experiences stand out and what factors related to virtual education they identify as relevant keys. Findings: Participants usually focus on three main topics: (1) The impacts of changes in training development with regard to methodologies and forms of assessment; (2) The facilities and difficulties in this new modality of online training; and (3) The consequences of the crisis on higher education in the medium and long term. Originality/value: Students participating in the study offer relevant and critical information on the adaptations developed by Spanish universities during the Coronavirus crisis. This information can be fundamental for the conscious decision making of the institutions, so that they can develop educational processes more adequate to the needs and possibilities of the university students in times of crisis.

Introducción: El traumatismo cardíaco penetrante es poco frecuente, pero de extrema importancia porque conlleva gran morbimortalídad. Representa un desafío diagnóstico y terapéutico. La mayoría fallece antes de llegar al hospital y los que llegan vivos tienen alta sobrevida. Obietivos: Revisar las tendencias actuales en el manejo operatorio de las heridas cardiopericárdicas y analizar nuestra experiencia en el tratamiento de estos pacientes. Diseño: Análisis descriptivo, retrospectivo. Población: 33 pacientes con heridas cardiopericárdicas operados en el período 09/1995 - 09/2004. Método: Recolección de datos consignando variables demográficas; mecanismo y topografía

La fístula perianal es una enfermedad benigna de frecuente consulta en los Servicios de Cirugía. Los autores presentan un caso con múltiples fístulas anorrectales complicadas. Es muy poco frecuente y requiere consideraciones diagnósticas y terapéuticas particulares. Dadas las limitaciones en el diagnóstico clínico, varios procedimientos parac/ínicos se han sugerido para la evaluación preoperatoria. Se analizan elementos anatómicos, patológicos, de la paraclínica y el tratamiento quirúrgico