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Several aspects of diabetes pathophysiology and complications result from hyperglycemia-induced alterations in the structure and function of plasma proteins. Furthermore, insulin has a significant influence on protein metabolism by affecting both the synthesis and degradation of proteins in various tissues. To understand the role of progressive hyperglycemia on plasma proteins, in this study, we measured the turnover rates of high-density lipoprotein (HDL)-associated proteins in control (chow diet), prediabetic [a high-fat diet (HFD) for 8 wk] or diabetic [HFD for 8 wk with low-dose streptozotocin (HFD + STZ) in

Korsakoff’s syndrome (KS) is an insidious and progressive neuropsychiatric disorder that affects specific neurocognitive functioning, especially in tasks that require sustained attention, memory, executive functions, and visuospatial functioning. Usually, this disease generates neuropsychiatric complications that worsen the quality of life (QOL) of patients in the medium term. We present a case of a 63-year-old male who presented with a diagnosis of advanced Korsakoff’s syndrome and has a clinical history of recurrent memory loss and a history of alcohol abuse. The patient showed difficulty manipulating immediate information, associated with a possible frontal lobe dysfunction, and inability to remember material given through the auditory pathway. The patient showed a psychiatric clinical picture which is constantly worsening his and his immediate caregiver’s QOL. The data obtained demonstrate that the patient presents a progressive cognitive impairment, which in the short term is correlated with Korsakoff-type dementia. It is suggested to carry out functional neurorehabilitation plans aimed at improving the QOL of the patient, his immediate caregiver, and future people with this type of diagnosis.

La investigación pretende implementar una propuesta de intervención psicológica que fortalezca las estrategias de afrontamiento y habilidades sociales de las personas privadas de la libertad [PPL], internas en el complejo penitenciario y carcelario de Jamundí, que aporte al proceso de resocialización y prevención de conductas disruptivas y suicidas en el marco del programa institucional INPEC “Preservación de la vida”. La metodología cuenta con un enfoque mixto, diseño explicativo secuencial, alcance explicativo – exploratorio de corte transversal. La muestra: conformada por 80 PPL seleccionada por conveniencia. Resultados esperados: Fortalecimiento estrategias de afrontamiento y habilidades para la vida, disminución de conductas disruptivas.

Lysine acetylation of proteins has emerged as a key post-translational modification (PTM) that regulates mitochondrial metabolism. Acetylation may regulate energy metabolism by inhibiting and affecting the stability of metabolic enzymes and oxidative phosphorylation (OxPhos) subunits. While protein turnover can be easily measured, due to the low abundance of modified proteins, it has been difficult to evaluate the effect of acetylation on the stability of proteins in vivo. We applied 2H2O-metabolic labeling coupled with immunoaffinity and high-resolution mass spectrometry method to measure the stability of acetylated proteins in mouse liver based on their turnover rates. As a "proof-of-concept," we assessed the consequence of high-fat diet (HFD)-induced altered acetylation in protein turnover in LDL receptor-deficient (LDLR-/-) mice susceptible to diet-induced non-alcoholic fatty liver disease (NAFLD). HFD feeding for 12 weeks led to steatosis, the early stage of NAFLD. A significant reduction in acetylation of hepatic proteins was observed in NAFLD mice, based on immunoblot analysis and label-free quantification with mass spectrometry. Compared to control mice on a normal diet, NAFLD mice had overall increased turnover rates of hepatic proteins, including mitochondrial metabolic enzymes (0.159±0.079 vs. 0.132±0.068 day-1), suggesting their reduced stability. Also, acetylated proteins had slower turnover rates (increased stability) than native proteins in both groups (0.096±0.056 vs. 0.170±0.059 day-1 in control, and 0.111±0.050 vs. 0.208±0.074 day-1 in NAFLD). Furthermore, association analysis revealed a relationship between the HFD-induced decrease in acetylation and increased turnover rates for hepatic proteins in NAFLD mice. These changes were associated with increased expressions of the hepatic mitochondrial transcriptional factor (TFAM) and complex II subunit without any changes to other OxPhos proteins, suggesting that enhanced mitochondrial biogenesis prevented restricted acetylation-mediated depletion of mitochondrial proteins. We conclude that decreased acetylation of mitochondrial proteins may contribute to adaptive improved hepatic mitochondrial function in the early stages of NAFLD.

San Rafael de Alajuela Hospital outbreak, first SARS-Cov2 cases in Costa Rica Objective. Describe the SARS-Cov2 outbreak and the actions carried out for decreased it, it was occurred during the period from February 24th to April 28th, 2020, among health workers, patients, and caregivers in a peripheral hospital, in the city of Alajuela, Costa Rica. Material and methods. All health workers, patients and relatives who had contact with a positive index case by PCR for COVID-19, were included; in addition to those who presented symptoms compatible with COVID-19. The investigation form for a suspected and probable case of respiratory disease by 2019-nCov was applied to them. Two nasopharyngeal aspirate samples were taken. Results. 37 of the 828 people who underwent PCR were positive. The outbreak started in the Obstetrics and Gynecology Service. Conclusion. This outbreak was caused by index case as SARS-Cov2 virus carried, the cause of the outbreak was the close contact of health workers and patients with COVID-19 positive staff Objetivo. Describir el brote de SARS-Cov2, y las acciones realizadas para mitigarlo, ocurrido en el periodo del 24 de febrero al 28 de abril del 2020, entre los funcionarios, pacientes y cuidadores en un hospital periférico, en la ciudad de Alajuela, Costa Rica. Material y métodos. Se incluyó a todo funcionario, paciente y familiares que tuvieron contacto con caso índice positivo por PCR por COVID-19; además de los que presentaron síntomas compatibles con SARS-Cov2. Se les aplicó la ficha de investigación de caso sospechoso y probable de enfermedad respiratoria por 2019-nCov. Se tomaron dos muestras de aspirado nasofaríngeo. Resultados. De las 828 personas a quienes se les realizó la PCR, 37 fueron positivos. El brote inició en el Servicio de Ginecoobstetricia y Pediatría, todos en el II piso, todos contactos del caso índice. Conclusión. Este brote fue causado por caso índice como portados del virus SARS-Cov2, la causa del brote fue el contacto estrecho de los funcionarios y pacientes con personal positivo por COVID-19.

Resumen Objetivos La hipoplasia suprarrenal congénita ligada al cromosoma X es una enfermedad rara con base genética conocida, que se presenta con insuficiencia suprarrenal e hipogonadismo hipogonadotrófico y expresión clínica variable. Caso clínico Paciente varón, de 26 días, que ingresó con síntomas compatibles con insuficiencia suprarrenal, hiponatremia e hiperpotasemia, requiriendo sueroterapia con suplementos de NaCl y fludrocortisona, consiguiéndose estabilidad clínica. Se descartó la hiperplasia suprarrenal congénita tras la medición de 17-OH-progesterona. El resto de hormonas estaban dentro de los intervalos de referencia, salvo la hormona adrenocorticotrópica (ACTH), sensiblemente por encima, y la aldosterona, por debajo. En los siguientes análisis se estudiaron los ácidos grasos de cadena muy larga para descartar adrenoleucodistrofia, el gen CYP11B2 (aldosterona sintasa), y se realizó una RMN para descartar otras alteraciones morfológicas. Todas estas pruebas resultaron normales. Finalmente, tras detectar déficit de cortisol en una analítica, se realizó un estudio genético más amplio donde se describió una mutación en el gen NR0B1, estableciéndose el diagnóstico de hipoplasia suprarrenal congénita. Conclusiones La hipoplasia suprarrenal congénita es una enfermedad de diagnóstico complejo debido a la variabilidad en la expresión clínica y el grado de alteración de las pruebas de laboratorio, requiriéndose un seguimiento exhaustivo y la realización de pruebas genéticas para llegar al diagnóstico.

Objectives Congenital X-linked adrenal hypoplasia is a rare disease with a known genetic basis characterized by adrenal insufficiency, hypogonadotropic hypogonadism, and a wide variety of clinical manifestations. Case presentation We present the case of a 26-day old male newborn with symptoms consistent with adrenal insufficiency, hyponatremia, and hyperkalemia. Following NaCl and fludrocortisone supplementation, the patient remained clinically stable. 17-OH-progesterone testing excluded congenital adrenal hyperplasia. The rest of hormones were within normal limits, except for adrenocorticotropic hormone (ACTH), which was significantly elevated, and aldosterone, which was below the reference value. Further testing included very long chain fatty acids to exclude adrenoleukodystrophy, the CYP11B2 gene (aldosterone synthase), and an MRI to screen for other morphological abnormalities. All tests yielded normal results. Finally, after cortisol deficiency was detected, expanded genetic testing revealed a mutation in the NR0B1 gene, which led to a diagnosis of congenital adrenal hypoplasia. Conclusions Diagnosis of congenital adrenal hypoplasia is challenging due to the heterogeneity of both clinical manifestations and laboratory abnormalities. As a result, diagnosis requires close monitoring and genetic testing.

Pregnancy-associated breast cancer (PABC) is commonly defined as a breast cancer occurring during pregnancy, throughout 1 year postpartum, or during lactation. Despite being a rare circumstance, PABC is one of the most common types of malignancies occurring during pregnancy and lactation, with growing incidence in developed countries, due both to decreasing age at onset of breast cancer and to increasing maternal age. Diagnosis and management of malignancy in the prenatal and postnatal settings are challenging for practitioners, as the structural and functional changes that the breast undergoes may be misleading for both the radiologist and the clinician. Furthermore, safety concerns for the mother and child, as well as psychological aspects in this unique and delicate condition, need to be constantly considered. In this comprehensive review, clinical, diagnostic, and therapeutic aspects of PABC (including surgery, chemotherapy and other systemic treatments, and radiotherapy) are presented and fully discussed, based on medical literature, current international clinical guidelines, and systematic practice.

This paper reviews the requirements for future digital arrays in terms of power amplifier requirements for output power and efficiency and the device technologies that will realize future energy-efficient communication and sensing electronics for the upper millimeter-wave bands (100-300 GHz). Fundamental device technologies are reviewed to compare the needs for compound semiconductors and silicon processes. Power amplifier circuit design above 100 GHz is reviewed based on load line and matching element losses. We present recently presented class-A and class-B PAs based on a InP HBT process that have demonstrated record efficiency and power around 140 GHz while discussing circuit techniques that can be applied in a variety of integrated circuits.

Dada la lucha de reivindicación de derechos de los pueblos indígenas y sus procesos legislativos, las autoridades sanitarias deben articular la política pública en salud, según necesidades del contexto cultural para garantizar derechos como nutrición, atención con calidad y educación en salud según necesidades. El objetivo de este artículo es aportar es lineamientos metodológicos que contribuyan a adecuar y armonizar un Plan Territorial de Salud Pública con el Sistema Indígena de Salud Propio e Intercultural. Investigación crítico-propositiva, surge de la experiencia del trabajo de campo y análisis documental. Se obtuvo una ruta metodológica con siete etapas, cuya aplicación permite a la autoridad sanitaria un abordaje y gestión de la interculturalidad para el mejoramiento de la política pública en salud y el buen vivir de las comunidades indígenas. La implementación de esta ruta permite asumir las políticas que en materia de inclusión y gestión de interculturalidad en salud se vienen concretando en Colombia en los últimos años.

La Gestión del Riesgo es un factor muy importante que debe ser abordada desde el inicio de cualquier tipo de proyecto, este es uno de los aspectos fundamentales que permite ver desde diferentes puntos de vista diversas variables que pueden traer múltiples problemas en la ejecución del proyecto, en este artículo se hace un énfasis en la realización de proyectos de software debido a la importancia que han tenido en los últimos años y debido a los altos índices de fallas en la realización de los mismos. Esta investigación tiene en cuenta en su fase metodológica el uso de la Gestión de riesgos propuesta por el PMBOK, el ciclo PHVA y la metodología de Análisis y Gestión de Riesgos de los Sistemas de Información, el uso de estas metodologías permitirá usar y aplicar las mejores prácticas propuestas para definir las amenazas, riesgos, vulnerabilidades y a futuro sentará las bases para formular políticas de mejora continua y de esta forma evitar que estos proyectos fracasen.

Hypereosinophilic syndrome (HES) is characterized by persistent blood eosinophilia, organ damage, and the absence of an underlying cause. Heterogeneous presentations, etiologies, and prognosis are recognized. The landscape of targeted therapies has emphasized the importance of its etiology and pathogenesis. We present a boy with extreme, refractory eosinophilia and end-organ complications. The persistence, severity, and outcome suggested an aggressive myeloid neoplasm.A 6-year-old boy presented with fever and respiratory symptoms. A blood count revealed hyperleukocytosis of 200×10He was started on glucocorticoids and hydroxyurea as well as imatinib and a trial of antihelmintics. Signs of end-organ damage included 1) CNS hemiparesis, dysarthria, and MRI-documented small-vessel and white matter abnormalities; 2) myocarditis by cardiac ultrasound; and 3) respiratory distress with interstitial infiltrates. Covid PCR test was positive, so he was given Remdesivir, after which PCR became negative. Increased D-dimers led to enoxaparin, intravenous immunoglobulin, and support. Bone marrow evaluation ruled out an abnormal T-cell population and occult acute lymphoblastic leukemia by flow cytometry and immunohistochemistry. Marrow biopsy showed dysmorphic megakaryocytes, so a myeloid neoplasm could not be excluded. Cytogenetics on the marrow showed a normal karyotype, and myeloid-directed next generation sequencing on the blood was negative for mutations. A lung biopsy showed increased eosinophils within vessels and pleural fibrosis but no interstitial fibrosis or vasculitis. Subcutaneous interferon alfa was given 3 times weekly with no response. The 4 drugs were well tolerated. The boy was followed over 9 months, requiring antibiotics, anticoagulation, and oxygen support. Eosinophilia remained high at 40,000-150,000×10HES may be life-threatening in the pediatric population. Diagnosis and therapy can be challenging.

Resumen La infeccion puerperal es una de las causas principales de morbimortalidad de la mujer, contribuyendo con una decima parte de las muertes maternas a nivel global. La endometritis posparto es una de las infecciones mas comunes, con una incidencia del 1-3%, que incluso puede aumentar hasta el 20% bajo diferentes circunstancias. La definicion de endometritis, pese a no ser uniforme, cuenta con unos criterios globalmente reconocidos para su diagnostico y esquemas antibioticos ampliamente estudiados como tratamiento, entendiendo que en su mayoria, la etiologia es polimicrobiana. Sin embargo, existe poca literatura con respecto a casos de falla terapeutica o presentacion atipica. Presentamos aqui un reporte de caso de una paciente de 20 anos de edad, con antecedente de hipotiroidismo gestacional, sobrepeso y asma, quien ingreso al servicio de urgencias de nuestra institucion cursando con un cuadro clinico de endometritis posparto, para lo cual se inicio manejo antibiotico segun protocolos; pese a esto, la paciente presento deterioro clinico marcado, cursando con un sindrome de dificultad respiratoria aguda severo que incluso la llevo a requerir ventilacion mecanica. Dentro del desarrollo del cuadro, y en vista del empeoramiento del estado clinico, se decidio escalar manejo antibiotico y tomar cultivo endometrial, el cual finalmente evidencio que Morganella morganii era el agente causal. Este caso es un claro ejemplo de la importancia que toma la obtencion de muestras de tejido endometrial para cultivo cuando estamos ante un caso de endometritis con evolucion torpida o con pobre respuesta al tratamiento inicial.

Este artículo es el resultado del trabajo realizado durante un año como asistente editorial de una revista científica colombiana. Plantea una crítica al modelo de medición generado y utilizado hasta el año 2018 por las diferentes editoriales mediante los indicadores utilizados por Colciencias –hoy Minciencias–, a fin de clasificar y categorizar las investigaciones, donde el noble arte de investigar se ha tergiversado al pasar de ser una actividad de avance y progreso por la que se mejora la calidad del conocimiento, a convertirse en un banco de conocimiento por cantidad y competitividad. En el texto se presenta un esbozo crítico sobre el papel de la universidad y la ciencia en relación con la investigación y el impacto que la implementación de las mediciones trae para los articulistas e investigadores. También se dan a conocer las limitaciones y las falencias en el mecanismo que utilizan los indicadores de medición estandarizados para la clasificación de «calidad» investigativa. Y, finalmente, se identifican los componentes de un artículo científico para que este sea publicable y se señalan los pasos para escoger la revista científica que garantice la publicación del artículo, así como las mediciones a las que están sujetas tanto las revistas como los artículos científicos.

l presente estudio analiza la relación del proceso de enseñanza-aprendizaje de la historia del Perú con la construcción de identidad peruana, entendiendo que debe reforzarse en el hogar desde temprana edad más allá de lo que la escuela pueda fomentar. El proyecto wiñay.pe consiste en el diseño de un portal educativo que contiene una serie de elementos visuales que permiten el conocimiento de la historia del Perú y nace en consideración de las características del público al que va dirigido: niños del quinto grado de primaria en una escuela privada de la ciudad de Lima, quienes, al ser nativos digitales, requieren de innovaciones y del uso de recursos tecnológicos que permitan captar y mantener su atención en el mensaje. El artículo muestra el desarrollo alcanzado por este proyecto que consistió en el diseño y la ilustración de personajes emblemáticos de la historia peruana contando los hechos históricos del Perú en una animación 2D, así como en la presentación de material didáctico auxiliar, como un juego de mesa y unas láminas didácticas a manera de soporte y ayuda en las clases de historia.

International audience; CONTEXT: Coffee leaf rust (CLR) epidemics on Coffea arabica have led to severe socio-economic crises in Latin America starting in 2008. Until now, the scattered nature of scientific and empirical knowledge of the highly complex CLR-coffee pathosystem has been an obstacle to the development of CLR forecasting models. OBJECTIVE: To help prevent new severe epidemics, we built ExpeRoya, a qualitative model, based on a review of the scientific literature and expert opinion, to forecast the risk of a monthly increase in the incidence of CLR at plot and landscape levels. METHODS: We adopted the IPSIM (Injury Profile SIMulator) framework, a qualitative and aggregative modeling approach that describes the effects of the cropping system and the plot environment on injuries, thereby making it possible to incorporate scattered knowledge on the system and all its complexity in a simplified way. Involving experts makes this approach powerful and robust because it builds on empirical knowledge based on a very large number of field observations. We argue that broad expert knowledge provides more accurate information on the manifold interactions in the system than existing quantitative models can. The structure of ExpeRoya was discussed with coffee sector experts in 19 workshops and validated in an online survey with 17 CLR experts. RESULTS AND CONCLUSIONS: ExpeRoya successfully integrates in a simple way 229 multiple interactions that exist within the CLR-coffee pathosystem based on only 12 input variables easily acquired in the field: one incidence monitoring variable; two meteorological variables (temperature and rainfall), four crop management variables (management of shade cover, fungicide application, nutrition and pruning of coffee trees) and five coffee tree characteristics (dates of flowering, beginning and end of harvest, fruit load and cultivar genetic resistance). Coffee institutes in Honduras and Nicaragua now use ExpeRoya, hosted by the platform Pergamino (https://www.redpergamino.net/app-experoya), to assist them in preparing their monthly CLR warning bulletins for growers. ExpeRoya is an improved forecasting model of CLR by fully incorporating the main biophysical factors affecting CLR at the plot and landscape levels.SIGNIFICANCE: ExpeRoya is both a framework and a proof of concept that improves both forecasting and the comprehensive modeling of CLR. ExpeRoya is a powerful yet user-friendly model designed for all actors of the coffee sector, particularly smallholder farmers and extension agents. ExpeRoya is adaptable: users can modify the model according to advances in knowledge and/or their own expertise of the system. ExpeRoya can help prevent future socio-economic crises.

Wild boars (Sus scrofa) are a significant invasive species in Brazil. We evaluated the helminth diversity of 96 wild boars in São Paulo state. Helminth infection descriptors were calculated, the species were identified and their 18S, 28S rDNA and internal transcribed spacer (ITS) regions were amplified for phylogenetic analyses. Ascarops strongylina, Strongyloides ransomi, Globocephalus urosubulatus, Oesophagostomum dentatum, Trichuris suis, Metastrongylus salmi, Metastrongylus pudendotecus, Ascaris suum and Stephanurus dentatus and Macracanthorhynchus hirudinaceus were identified. Globocephalus urosubulatus had the highest prevalence and mean abundance, and most animals had mixed infections with three parasite species. There was no association between parasite intensity and prevalence and host sex and body condition index (p > 0.05). Novel DNA sequences were obtained from G. urosubulatus, A. strongylina, and S. dentatus. This is the first study on the helmint diversity of non-captive wild boars in Brazil, and the first report of the occurrence of M. hirudinaceus, G. urosubulatus and S. dentatus in Brazilian wild boars. Non-captive wild boars of São Paulo State did not act as capture hosts for native helminth species but maintained their typical parasites, common to domestic pigs. They may act as parasite dispersers for low-tech subsistence pig farming and for native Tayassuidae.