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RESUMEN El tratamiento de los pacientes con insuficiencia mitral aguda supone un reto terapéutico. Estos pacientes tienen una morbimortalidad muy elevada, que requiere un abordaje multidisciplinario. El presente documento recoge el posicionamiento de tres asociaciones implicadas en el tratamiento de estos pacientes: la Asociación de Cardiopatía Isquémica y Cuidados Agudos Cardiovasculares, la Asociación de Cardiología Intervencionista y la Asociación de Imagen Cardiaca. Incluye aspectos relacionados con la selección y los cuidados del paciente, los aspectos técnicos del tratamiento de borde a borde desde el punto de vista intervencionista y de la imagen cardiaca, y los resultados de este proceso. No se han incluido los resultados de la cirugía de reparación o sustitución mitral, que es la primera opción terapéutica a considerar en estos pacientes, por exceder los objetivos del documento.

ABSTRACT The approach to patients with acute mitral regurgitation poses a therapeutic challenge. These patients have a very high morbidity and mortality rate, thus requiring a multidisciplinary approach. This document presents the position of 3 associations involved in the management of these patients: the Ischemic Heart Disease and Acute Cardiovascular Care Association, the Interventional Cardiology Association, and the Cardiac Imaging Association. The document discusses aspects related to patient selection and care, technical features of the edge-to-edge procedure from both the interventional and imaging unit perspectives, and the outcomes of this process. The results of mitral repair and/or replacement surgery, which is the first-line treatment option to consider in these patients, have not been included as they exceed the scope of the aims of the document.

Digital transformation in the socio-educational sector is necessary for teachers, students, and families. That is why it is essential for them to develop their digital competences, so that they can access the educational services that are available to them. In this context, citizen digital literacy must be a priority and must promote technological, didactic, and techno-pedagogical knowledge, which serve to establish a digital culture that allows them to function in any environment. The objective of this article is to outline actions that contextualize the new teaching-learning trends that are aimed at improving classroom, institutional or territorial processes, for the digital literacy of teachers. Theoretical methods were used, such as the historical-logical, the analytical-synthetic, and the systemic-structural. In addition, empirical methods were included, such as interviews, surveys, and observation of teachers working at the General Directorate of Education in Havana. The actions were validated in two stages: first, diagnosis and awareness; second, practical intervention. From a socio-educational perspective, it is necessary to incorporate elements to contextualize educational institutions, because they are the place from which the literacy variants that nourish the development of digital competences of teachers, students, and the community are projected. These competences will be directly reflected in the digital culture of individuals and will enable their interaction with the different digital educational services.

RESUMEN Introducción y objetivos: La mayoría de los pacientes con embolia pulmonar (EP) aguda reciben únicamente anticoagulación. La reperfusión es necesaria en los pacientes con EP de alto riesgo y en una minoría de pacientes con EP de riesgo intermedio-alto. La trombólisis sistémica (TS) es el tratamiento de reperfusión de primera línea, pero debido a las contraindicaciones y a la preocupación por las hemorragias graves, las terapias dirigidas por catéter (TDC) están surgiendo como una alternativa adecuada. El objetivo del presente estudio fue detectar predictores del uso de TDC con respecto a otras terapias en pacientes con EP aguda. Métodos: Este registro incluyó pacientes consecutivos con EP de riesgo intermedio y alto en dos centros terciarios, con un equipo de respuesta a la EP, desde 2014 hasta 2022. Los pacientes se agruparon según la terapia inicial: solo anticoagulación, TDC o TS; y se evaluaron los predictores de selección de terapia y variables de seguridad. Resultados: Se incluyó a un total de 274 pacientes. De ellos, 112 recibieron solo anticoagulación, 96 recibieron TS como tratamiento primario y 66 fueron sometidos a TDC en un primer momento. Las comorbilidades fueron mayores en el grupo TDC que en los otros dos. Los pacientes sometidos a TS o TDC presentaban mayores parámetros de gravedad de la EP al ingreso hospitalario. Tras el análisis multivariable, el índice de comorbilidad de Charlson (OR = 1,29; IC95%, 1,05-1,59), la cirugía reciente (OR = 11,07; IC95%, 3,07-39,87) y la EP central bilateral (OR = 2,42; IC95%, 1,10-5,32) siguieron siendo predictores independientes del uso de TDC. En cuanto a los resultados precoces de seguridad, sólo se produjeron hemorragias intracraneales en el grupo TS (1,8% de los pacientes). Conclusiones: Este registro contemporáneo utilizó TDC como terapia inicial en el 24% de los pacientes de riesgo intermedio y alto, principalmente en pacientes comórbidos y posquirúrgicos. La TDC fue una alternativa segura y eficaz al tratamiento médico en pacientes seleccionados.

ABSTRACT Introduction and objectives: Most patients with acute pulmonary embolism (PE) receive anticoagulation only. Reperfusion is required in high-risk and a minority of intermediate-risk PE patients. Systemic thrombolysis (ST) is the first-line reperfusion therapy, but due to contraindications and major bleeding concerns, the use of catheter-directed therapies (CDT) is increasing as a suitable alternative. The objective of the present study was to detect predictors of the use of CDT compared with other therapies in patients with acute PE. Methods: This registry included consecutive intermediate- and high-risk PE patients in 2 tertiary centers with a 24/7 PE response team from 2014 to 2022. The patients were grouped according to the primary treatment: anticoagulation only, CDT, or ST. We evaluated predictors of treatment assignment and safety endpoints. Results: A total of 274 patients were included. Of them, 112 received anticoagulation only, 96 received ST as the primary treatment, and 66 underwent CDT first. Comorbidities were higher in the CDT group than in the other 2 groups. Patients undergoing ST/CDT had higher PE severity parameters at hospital admission. On multivariable analysis, independent predictors for the use of CDT were Charlson Comorbidity Index (OR, 1.29; 95%CI, 1.05-1.59), recent surgery (OR, 11.07; 95%CI, 3.07-39.87), and bilateral central PE (OR, 2.42; 95%CI, 1.10-5.32). Analysis of early safety outcomes showed that intracranial bleeding occurred only in the ST group (1.8% of patients). Conclusions: This contemporary registry used CDT as the primary treatment in 24% of intermediate- and high-risk patients, mainly in comorbid and postsurgical patients. CDT was a safe and effective alternative to medical therapy in selected patients.

Abstract Spatial proximity to important stimuli often induces impulsive behaviour. How we overcome impulsive tendencies is what determines behaviour to be adaptive. Here, we used virtual reality to investigate whether the spatial proximity of stimuli is causally related to the supplementary motor area (SMA) functions. In two experiments, we set out to investigate these processes using a virtual environment that recreates close and distant spaces to test the causal contributions of the SMA in spatial impulsivity. In an online first experiment (N = 93) we validated and measured the influence of distant stimuli using a go/no-go task with close (21 cm) or distant stimuli (360 cm). In experiment 2 (N = 28), we applied transcranial static magnetic stimulation (tSMS) over the SMA (double-blind, crossover, sham-controlled design) to test its computations in controlling impulsive tendencies towards close vs distant stimuli. Reaction times and error rates (omission and commission) were analysed. In addition, the EZ Model parameters (a, v, Ter and MDT) were computed. Close stimuli elicited faster responses compared to distant stimuli but also exhibited higher error rates, specifically in commission errors (experiment 1). Real stimulation over SMA slowed response latencies (experiment 2), an effect mediated by an increase in decision thresholds (a). Current findings suggest that impulsivity might be modulated by spatial proximity, resulting in accelerated actions that may lead to an increase of inaccurate responses to nearby objects. Our study also provides a first starting point on the role of the SMA in regulating spatial impulsivity.

Introduction: Diarrheal diseases constitute a significant public health problem in terms of mortality and morbidity. In Honduras and around the world, RVs have consistently emerged as the single most important etiologic agent in acute childhood diarrhea. However, other viruses, such as NoVs and HAstVs, have also been shown to be responsible for viral gastroenteritis. Unfortunately, the country has limited information concerning the etiologic role of these viral agents in acute gastroenteritis. This study investigated the frequency, genotypes, and epidemiological characteristics of RV-A, NoVs, and HAstVs among children under 5 years old in Distrito Central, Honduras. Methods: Stool samples and their corresponding epidemiological data were collected from children with acute gastroenteritis in three healthcare centers in Distrito Central. All samples were screened by immunoassays for RV-A and HAstVs. RV-A-positive samples were molecularly characterized by RT-PCR and genotyping assays. RT-PCR was also applied to confirm HAstVs positivity and to detect NoVs, followed by nucleotide sequencing to assign their genotypes. Results: Our results show that at least one viral agent was detected in 31% of the children. The frequency of RV-A, NoVs, and HAstVs was 14%, 13%, and 5%, respectively. The most frequent RV-A genotype was G2P[4], occurring in 93% of cases. 92.3% of NoVs-positive samples belonged to genogroup II, with GII.4 and GII.16 being the most common. HAstVs were clustered into three genotypes: HAstV-1, HAstV-2, and HAstV-8. Only one sample showed coinfection with NoVs and HAstVs. Conclusion: This comprehensive molecular and epidemiological characterization of enteric viruses demonstrates the vast diversity of these agents and describes for the first time NoVs and HAstVs as causative agents of acute childhood gastroenteritis in Distrito Central, Honduras. This suggests that further in-depth studies of the pediatric population are necessary to develop and implement effective preventive and control measures in the country.

Tunicate maize (Zea mays var. tunicata A. St. Hil) is a landrace that constitutes a fundamental aspect of the socio-cultural identity of Ixtenco, Tlaxcala (Mexico) and represents an exotic phenotype whose kernels are enclosed in leaflike glumes. Despite multiple studies conducted worldwide on plant growth-promoting-rhizobacteria (PGPR) in commercial maize varieties grown under monoculture systems, very little is known about bacteria inhabiting native maize landraces in agroecosystems, but for tunicate maize such knowledge is non-existent. This research described and profiled functional groups of culturable rhizobacteria from tunicate maize at two phenological stages (tasseling and maturity/senescence) in a polyculture system, highlighting potential PGPR for biotechnological purposes. Ninety-five rhizobacteria were isolated and molecularly identified, and their physiological activities such as plant growth promotion, production of exogenous lytic enzymes, and antagonism against fungal pathogens were determined. The culturable rhizobacterial community associated to tunicate maize comprised 42 genera, dominated by Bacillaceae, Comamonadaceae, Microbacteriaceae, Micrococcaceae, Oxalobacteraceae, Pseudomonadaceae, and Rhizobaceae families. At tasseling stage, the identified bacteria corresponded to Arthrobacter, Priestia, Herbaspirillum, Pseudomonas, and Rhizobium, and exhibited redundant capabilities for stimulating plant growth and nutrition, and inhibiting fungal phytopathogens. At maturity/senescence stage, the main genera Arthrobacter and Microbacterium displayed lytic capabilities to support mineralization process. We recorded potential novel rhizosphere functional bacteria such as Rhizobium, Sphingobium, and Arthrobacter which are not previously described associated to maize landraces, as well as their bioprospection as PGPR detected at plant phenological stages poorly explored (like maturity/senescence). This taxonomic and functional diversity was attributed to the application of agricultural practices as well as the rhizosphere effect during specific phenological stages. Results described the diversity and functionality of culturable rhizosphere bacteria from tunicate maize in polyculture systems that allowed us the detection of potential rhizobacteria for further developing of biofertilizers and biocontrollers directed as biotechnology for sustainable agriculture, and for generating strategies for conservation of native plants and their microbial genetic resources.

Abstract In this paper, we present an algorithm to construct the q T distribution at NLO accuracy to arbitrary power precision, including the assembly of suitable zero-bin subtrahends, in a mathematically well-defined way for a generic choice of rapidity-divergence regularisation prescription. In its derivation, we divide the phase space into two sectors, the interior of the integration domain as well as the integration boundary, which we include here for the first time. To demonstrate the applicability and usefulness of our algorithm, we calculate the N2LP corrections for Higgs hadroproduction for the first time. We observe that our approximate N2LP-accurate q T spectra replicate the asymptotic behaviour of the full QCD calculation to a much better degree than the previously available results, both within the q T → 0 limit and in the large-q T domain for all the involved partonic processes. While playing a minor role at larger transverse momenta, we show that the newly incorporated boundary contribution plays a vital role in the q T → 0 limit, where any subleading power accuracy would be lost without them. In particular, our N2LP-accurate q T expansion can approximate the exact q T distribution up to q T ≈ 30 GeV at the percent level for rapidities |Y H | ≲ 3.

Imaging is increasingly used to capture information on the marine environment thanks to the improvements in imaging equipment, devices for carrying cameras and data storage in recent years. In that context, biologists, geologists, computer specialists and end-users must gather to discuss the methods and procedures for optimising the quality and quantity of data collected from images. The 4th Marine Imaging Workshop was organised from 3-6 October 2022 in Brest (France) in a hybrid mode. More than a hundred participants were welcomed in person and about 80 people attended the online sessions. The workshop was organised in a single plenary session of presentations followed by discussion sessions. These were based on dynamic polls and open questions that allowed recording of the imaging community’s current and future ideas. In addition, a whole day was dedicated to practical sessions on image analysis, data standardisation and communication tools. The format of this edition allowed the participation of a wider community, including lower-income countries, early career scientists, all working on laboratory, benthic and pelagic imaging.This article summarises the topics addressed during the workshop, particularly the outcomes of the discussion sessions for future reference and to make the workshop results available to the open public.

AbstractUnderstanding queer language, which includes knowing its meaning and its applications, is essential not only for understanding sexuality and fostering language inclusivity but also for acknowledging the multifaceted uses of language across all societal groups. This study explored the semantic nuances and underlying patterns of Filipino queer language using Word Sense Disambiguation (WSD). Using content analysis on the data from publicly available posts and comments on Facebook and Twitter, the findings uncovered distinct characteristics of Filipino queer language, encompassing affixation, appropriation, clipping, association, mutation, neologism, recontextualization, and stylized reversal with affixation. The findings underscore the vibrancy and adaptability of Filipino queer language, reflecting the LGBTQIA + community’s ability to use language as a tool for self-expression and cultural relevance. Additionally, the findings highlight the significance of understanding queer language not only as an identity expression for LGBTQIA + individuals but also as a means to promote linguistic inclusivity for all groups in society. We discuss the implications, and we offer recommendations.

Introduction: Persistent Müllerian Duct Syndrome is a rare inherited disorder characterized by incomplete regression of Müllerian duct structures in an individual with male physical and genetic traits. Objective: To describe the presentation and surgical treatment in a patient with persistent Müllerian duct syndrome. Clinical Case: An 18-year-old male patient who attended the general surgery outpatient clinic due to left cryptorchidism, right hydrocele and a synechiae from the penis to the scrotum. During the surgical procedure, the presence of an ovary with a fallopian tube on the left side without the presence of the uterus was confirmed. An oophorectomy with salpingectomy was performed, in addition to a hydrocelectomy on the right side and the release of the penis, leaving it in a functional position. The diagnosis was made early in the patient's life, with no evidence of malignancy during follow-up. Conclusions: The knowledge of general surgeons about persistent Müllerian duct syndrome is limited due to the small number of cases and the variety of presentations. Surgeons should have a high level of suspicion for this syndrome when evaluating individuals with cryptorchidism.

Esse artigo analisa a desigualdade e a necessidade de movimento da população entre classes de renda e entre os municípios das Mesorregiões Diferenciadas do Sul do Brasil para se chegar à distribuição de renda esperada. Foram utilizados como indicadores de desigualdade o movimento virtual da população (m) e o movimento virtual relativo de população (índice de dissimilaridade - d), a partir de dados do Censo Demográfico. Os resultados mostram que a Mesorregião Grande Fronteira do Mercosul apresenta maior desigualdade e maior necessidade de movimento da população entre as classes de renda e entre os municípios. Além disso, essa desigualdade aumentou entre 2000 e 2010 em boa parte dos municípios dos estados do Rio Grande do Sul e Paraná e diminuiu nos municípios de Santa Catarina. Na Mesorregião Metade Sul do Rio Grande do Sul, a desigualdade é menor e apresenta índices menores para a necessidade de movimento da população entre classes de renda e entre os municípios dessa mesorregião, além de uma tendência de redução entre 2000 e 2010. Abstract: This paper analyzes inequality and the need for population movement between income classes and between municipalities in the differentiated regions of Southern Brazil to reach the expected income distribution. The virtual population movement (m) and the relative virtual population movement (dissimilarity index - d) were used as indicators of inequality, based on data from the Demographic Census. The results show that the Great Border Region of Mercosul presents greater inequality and a greater need for population movement between income classes and between municipalities. Furthermore, this inequality increased between 2000 and 2010 in most municipalities in the states of Rio Grande do Sul and Paraná Stats and decreased in the municipalities of Santa Catarina. In the Mid-South Region of Rio Grande do Sul, inequality is lower and presents lower rates for the need for population movement between income classes and between municipalities in this mesoregion, in addition to a reduction trend between 2000 and 2010.

Este artigo analisou o comportamento das disparidades econômicas regionais nas regiões mato-grossenses. Para isso, fez-se o uso do procedimento metodológico baseado na estimativa do Coeficiente de Williamson (Vw), empregando como parâmetro o Valor Adicionado Bruto (VAB) per capita por setor econômico e a população residente nos anos de 2002, 2010 e 2020. Os resultados evidenciaram que o setor de serviços apresentou a maior convergência regional no período compreendido entre 2002 a 2020. O setor industrial também avança em direção a maior homogeneidade regional, porém, com menor intensidade em algumas regiões quando observado o desempenho do Vw. As diferenças regionais foram detectadas no setor agropecuário, com destaque para a região imediata de Sorriso, que foi mais significativa em 2020. Além disso, as regiões imediatas de Cuiabá e Diamantino mostraram uma moderada variação em direção à maior divergência regional, ou seja, elas estão se distanciando das demais em termos de homogeneidade.

Objectives: The aim of this study was to investigate whether Epstein-Barr virus (EBV) acts as a cofactor with Human Papillomavirus (HPV) in the development of cervical abnormalities among women from Southern Morocco. Methods: A total of n = 308 sexually active women were enrolled in this study. EBV and HPV were detected using a nested PCR assay. HPV genotyping was carried out using direct Sanger sequencing assay. Statistical analyses were performed using R/RStudio software. Results: EBV DNA was detected in 11.04 % of participants. Among these women, 5.84 % were co-infected with HPV and EBV, representing 53 % of women who tested positive for EBV. High-risk HPV genotypes (HR-HPV) were the most common types of dual infections, accounting for 38 % of EBV-positive cases, whereas other genotypes were detected along with EBV in 15 % of cases. Interestingly, a statistically significant association between EBV/HR-HPV and cervical abnormalities was observed in this study (OR 4.58, 95 % CI 1.97–10.60, p = 0.030). In particular, EBV/HR-HPV dual infection was associated with a 7.86-fold increased risk of developing ASCUS-type cervical lesions (OR 7.86, 95 % CI 1.08–37.92, p = 0.017). Moreover, women with several sexual partners were 3.63-folds at a greater risk of contracting an EBV/HR-HPV coinfection (OR 3.63, 95 % CI 0.92–12.32, p = 0.045). Conclusion: Our findings suggest that EBV infection alone might not directly promote cervical oncogenesis. However, the possibility of its involvement in coinfection with HR-HPV genotypes remains an area of interest. Further investigations are required to provide firm evidence of the role of EBV in this context.

The high global production of Mangifera indica generates a considerable amount of waste, such as peels and seeds that are often discarded. The use of these by-products promotes a more sustainable approach, reducing environmental impacts and opening new perspectives in the phytocosmetics area. The peel presents secondary metabolites known mainly for their antioxidant properties, highlighting phenolic compounds. These antioxidants are capable of slowing down the rate of oxidation promoted by free radicals formed by external or pathophysiological factors. Thus, natural antioxidants extracted from plant species are increasingly being studied for application in the cosmetic and pharmaceutical industry. The phytocosmetic potential of the glycolic extract from the peel of M. indica L. var. Tommy Atkins in three galenic bases (Carbopol® gel, cream gel and Estagel® gel) was evaluated through antioxidant activity tests, the DPPH radical scavenging method, and stability studies. The formulations with the extract were stable and compatible for topical use, as there were no signs of instability such as changes in organoleptic characteristics and pH. Regarding antioxidant activity, formulations with the extract showed antioxidant potential, however the formulation with Carbopol® and gel-cream showed better performance compared to Estagel®. After 30 days of preliminary stability in different temperature conditions (40.0 ± 2

Un buon numero di apprendenti non ha maturato consapevolezza sul divario esistente tra la lingua di tutti i giorni, quella usata a casa o tra i pari, e la lingua della scuola e dei materiali scolastici e nemmeno ha consapevolezza del fatto che ciascuna materia scolastica prevede sia l’utilizzo di una lingua specifica che include più dimensioni (lessicale, morfosintattica, testuale, pragmatica…) sia lo svolgimento di operazioni cognitive particolari. Questa mancata percezione è spesso alla base dell’insuccesso scolastico degli apprendenti. Gli insegnanti hanno il compito di guidare la classe nell’acquisizione delle abilità linguistico-cognitive della lingua dello studio della disciplina di insegnamento progettando cicli glottodidattici inclusivi. Stimolare e supportare le fasi di acquisizione della lingua dello studio così come costruire l’accessibilità ai materiali di studio sono interventi didattici fondamentali per ridurre il tasso di insuccesso. In questo contributo si presenteranno le particolarità della lingua dello studio per la storia e verrà illustrato un ciclo glottodidattico inclusivo come modello operativo per l’acquisizione della microlingua storica. A GLOTTODIDACTIC INCLUSIVE CYCLE FOR ITALIAN AS THE LANGUAGE OF HISTORY STUDY A good number of learners have not become aware of the gap between everyday language, that used at home or among peers, and the language of school and school materials, nor are they aware of the fact that each school subject involves both the use of a specific language that includes several dimensions (lexical, morphosyntactic, textual, pragmatic...) and the performance of particular cognitive operations. This lack of perception is often at the root of learners’ academic failure. Teachers have the task of guiding the class in the acquisition of the linguistic-cognitive skills of the language of instruction by designing inclusive glottodidactic cycles. Stimulating and supporting the acquisition phases of the language of study as well as building accessibility to study materials are fundamental didactic interventions to reduce the failure rate. This contribution will present the particularities of the study language for history and illustrate an inclusive glottodidactic cycle as an operational model for the acquisition of the historical micro-language