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Abstract Background During the first nine months of the COVID-19 emergency, patients were encouraged to use virtual versus clinic visits if in-person care was not deemed necessary by clinical staff. This study examined the association of spoken language preference and ethnicity with use of video versus phone virtual visits by US Latino and Chinese adult patients who got care in the same healthcare system. Methods We analyzed electronic health record data for four groups of adults aged 26-85y who had ≥ 1 primary or specialty care outpatient clinician visits during April-December 2020: 80,869 Latino adults preferring Spanish (LEP Latino); 214,765 Latino adults preferring English (non-LEP Latino); 23,430 Chinese adults preferring a Chinese dialect (LEP Chinese); and 49,710 Chinese adults preferring English (non-LEP Chinese). Prevalence of the following utilization outcomes were compared by language preference (LEP/non-LEP) within ethnicity and by ethnicity within language preference for four age subgroups (26-39y, 40-64y, 65-75y, and 76-85y): ≥ 1 virtual (video or phone) visit, ≥ 1 video visit, ≥ 1 phone visit, ≥ 1 clinic visit, video visits only, and phone visits only. We also compared ethnicity x language group differences within age subgroups using absolute difference and adjusted prevalence ratios derived from modified log-Poisson regression models that controlled for age and sex. Results Among virtual users, LEP Latino and Chinese adults were significantly less likely to use video visits and more likely to use phone visits than non-LEP Latino and Chinese adults in the same age strata. The LEP/non-LEP difference in video visit use was significantly larger among Latino than Chinese patients, with no similar ethnic group difference observed for phone visits. Within the LEP and non-LEP language groups, Chinese adults were significantly more likely than Latino adults to use video visits and less likely to use phone visits. Conclusions During the first nine months of the COVID-19 pandemic, uptake of video and phone virtual visits by Latino and Chinese adults significantly differed by LEP/non-LEP status within ethnicity and by ethnicity within LEP/non-LEP language group. These findings underscore the importance of disaggregating data by ethnicity and language preference when attempting to understand and study patient use of different virtual visit modalities.

The role of Laboratory Medicine in patient care has evolved in the last decades. The same has occurred to the laboratory model, which has evolved from a traditional model where the laboratory is merely involved in clinical decision-making to a leading model where the laboratory is not only involved but also determines decision-making. The advent of new technologies and automation of processes have enabled laboratory professionals to focus on the first and last phase of the analytical process namely, test ordering and decision-making based on laboratory results. These phases are more error-prone than the analytical phase, and where action must be taken to improve the quality of patient care.

The coastal fishing of the snail Titanostrombus gakatus is carried out in some coastal countries of the Tropical Eastern Pacific. In this study, the individual growth of T. galeatus that are fished in the community at Punta Maldonado was estimated. The size structure was made using the shell length (SL), and the growth parameters were estimated through the five Schnute cases, where cases 1, 2, and 5 describe asymptotic growth and cases 3 and 4 describe nonasymptotic growth. The male population was more abundant than the females, with 398 and 322 specimens, respectively, but the females were larger (198 [+ or -] 9.66 mm). In general, the average SL during the two sampling cycles was 196 [+ or -] 9.44 mm; this size was not significantly different between the first and second cycles (P = 0.98). Females had a greater range of SL (170-267 mm) compared with males (170-240 mm). The lengths of both sexes showed significant differences between months (P < 0.05). The multinomial analysis showed a multimodal SL distribution, with one to three modal groups for females and males. In growth, cases 2 and 5 were the ones that best describe the growth in females, in males the best were cases 5 and 2. According to the best case (case 2) in females, the growth curve is sigmoidal. In males, the best case (case 5) describes growth according to an inverted exponential curve. In relation to the estimated growth parameters, females showed faster growth than males, analyzed using Kimura's test. The present investigation is the first that reports the growth for both sexes of T. galeatus using the five cases of the Schnute model. The information generated can be used for management purposes, as this species is not currently regulated in Mexico. KEY WORDS: Titanostrombus galeatus, Strombidae, growth parameters, shellfish fisheries, Mexican Pacific, INTRODUCTION In fisheries biology, growth estimation is one important objective in the assessment and management of fishery resources. The growth pattern of individuals can provide details on their age structure [...]

En las últimas décadas está evolucionando el posicionamiento de la Medicina de Laboratorio en el proceso médico asistencial de atención al paciente y también el modelo de laboratorio; de un modelo tradicional, con solo intervención, a un modelo líder, que además de intervenir condiciona la decisión clínica. La mejora en tecnología y automatización ha permitido también al profesional de laboratorio centrarse en la primera y última fase del ciclo de laboratorio, la solicitud de pruebas, y la acción tras su resultado, las etapas con más errores, y donde principalmente se debe actuar para conseguir una mejora en la calidad asistencial del paciente.

Las instituciones educacionales del área de las ciencias de la salud, desarrollan un perfeccionamiento continuo que las enriquece y las transforma con la propia dinámica de la sociedad. Los avances de la ciencia, la tecnología y el incesante flujo del progreso demandan adoptar una actitud renovadora perenne en aras de mejorar la calidad de la educación de pregrado y posgrado en las diferentes disciplinas de la carrera de Medicina. No obstante, se han identificado insuficiencias en la ausencia de algunos contenidos inherentes a la Especialidad de Gastroenterología que limitan un diagnóstico precoz y adecuado tratamiento oportuno, en pacientes que presentan enfermedades focalizadas en el tracto digestivo inferior. En consecuencia, el artículo se propone ofrecer una metodología del contenido diagnóstico-tratamiento a las enfermedades del tracto digestivo inferior desde el proceso pedagógico en la que se especifican sus procedimientos y pasos lógicos para perfeccionar el desempeño profesional del especialista, y a su vez, permitirá alcanzar los objetivos propuestos por el programa académico. Se emplearon como métodos teóricos: análisis-síntesis, inducción-deducción, revisión documental y modelación, y empíricos: observación, encuesta, entrevista y productos de la actividad pedagógica, así como el experimento formativo, que permitieron determinar las principales insuficiencias de estudiantes y docentes en el referido contenido y fundamentar la propuesta. En la investigación se describen los resultados a través del experimento pedagógico formativo, los cuales demostraron la factibilidad y viabilidad de la metodología implementada. El impacto logrado afloró las transformaciones que se manifiestan en el desempeño profesional médico del especialista en Gastroenterología.

La interacción turista-chatbot en destinos turísticos es crucial para la lealtad del turista. Este artículo de revisión sistemática evalúa cómo la calidad y frecuencia de esta interacción influyen en la percepción de utilidad, satisfacción y fidelidad del turista. Se destaca la relevancia de una comunicación eficaz como un factor fundamental para enriquecer la experiencia del turista. y fomentar la fidelidad. El objetivo fue analizar detalladamente esta influencia, centrándose en la percepción del turista. Se empleó un enfoque de revisión sistemática para analizar estudios relevantes en el campo. Se realizaron búsquedas en bases de datos relevantes, como Web of Science, Scopus y Scielo, siguiendo un protocolo exhaustivo y reproducible empleando la metodología PRISMA. Se identificaron limitaciones en la búsqueda y calidad de los estudios, sugiriendo futuras investigaciones con muestras más amplias, estudios longitudinales y consideración de factores contextuales. En conclusión, la calidad de la interacción entre turistas y chatbots es fundamental para potenciar la experiencia turística y la fidelización de los visitantes en destinos turísticos, destacando la importancia de mejorar estas interacciones para elevar tanto la percepción sobre el destino como la satisfacción del usuario.

This paper reviews and analyzes the process of the implementation of the circular economy in the European Union (EU) and Spain, and its links to the low-carbon transition. The EU implementation of the circular economy went through several stages. Since the adoption of the first action plan in 1993, the links between the circular economy and carbon transition goals have become intertwined. Recently, the EU approved the framework of new monitoring measures and indicators for the circular economy. The adopted actions have involved the adaptation of European legislation at the national level. Spain has participated in this process since 2017, when the Circular Economy Pact was signed. The subsequent approval of the Spanish Strategy for a Circular Economy in 2020 was developed, considering a close relationship between decarbonization and the circular economy. Lately, the circular economy implementation has been strengthened with the strategic project for economic recovery and transformation, linked to the recovery of COVID-19, and the roadmap for the sustainable management of mineral raw materials, with both documents including actions directly related to transforming the energy system. Data show that Spain has made significant improvements in the circular economy transition. However, Spain’s vulnerability to externalities is greater than that of the EU as a whole.

In Mexico, due to its high biological diversity, use of its resources, and a lack of knowledge about its biodiversity, Priority Marine Regions have been designated. The classification of these regions has served as an instrument for the large-scale conservation because the species composition is relatively homogeneous in these regions. This study reports some ecological attributes of bivalves from the Priority Marine Regions located in the Mexican Transitional Pacific ecoregion. Three samplings have been carried out in 2016–2018 in the rocky intertidal zone. In each sample per site, an area of 10 m2 was covered, and the sampling unit was 1 m2. A total of 4119 specimens were recorded, by identifying 53 species (35 genera, 18 families, and two specimens identified to genus). The richness of the species expected was calculated using non-parametric estimators, by showing acceptable completeness of the inventory. The highest species richness and diversity were recorded in the Copala-Punta Maldonado region (33 species), whereas the highest abundance and density were found in the Colola-Maruata region (30.9 individuals/m2). The best-represented species in abundance and distribution were Chama coralloides, Brachidontes adamsianus, Isognomon janus, and Choromytilus palliopunctatus. By considering their life form and degree of occurrence, studied bivalves attached to a hard substrate (epifaunal species) and restricted to habitats with particular characteristics (occasional species) were the most commonly found. The information provided here is directed to eight Marine Regions designated as a priority for conservation in Mexico, which is important for planning, decision-making, and formulating initiatives aimed at helping to co-ordinate management practice through outreach efforts to the conservation and sustainable use of bivalves as marine resources.

In this article, we are concerned with minimal-time optimal problems for the class of controllable linear control system on low-dimensional nonnilpotent solvable Lie groups and their homogeneous spaces.

Epilepsy is a disorder characterized by a predisposition to generate seizures. Levetiracetam (LEV) is an antiseizure drug that has demonstrated oxidant–antioxidant effects during the early stages of epilepsy in several animal models. However, the effect of LEV on oxidant–antioxidant activity during long-term epilepsy has not been studied. Therefore, the objective of the present study was to determine the effects of LEV on the concentrations of five antioxidant enzymes and on the levels of four oxidant stress markers in the hippocampus of rats with temporal lobe epilepsy at 5.7 months after status epilepticus (SE). The results revealed that superoxide dismutase (SOD) activity was significantly greater in the epileptic group (EPI) than in the control (CTRL), CTRL + LEV and EPI + LEV groups. No significant differences were found among the groups’ oxidant markers. However, the ratios of SOD/hydrogen peroxide (H2O2), SOD/glutathione peroxidase (GPx) and SOD/GPx + catalase (CAT) were greater in the EPI group than in the CTRL and EPI + LEV groups. Additionally, there was a positive correlation between SOD activity and GPx activity in the EPI + LEV group. LEV-mediated modulation of the antioxidant system appears to be time dependent; at 5.7 months after SE, the role of LEV may be as a stabilizer of the redox state.

In the pediatric population, epilepsy is one of the most common neurological disorders that often results in cognitive dysfunction. It affects patients’ life quality by limiting academic performance and self-esteem and increasing social rejection. There are several interventions for the neurohabilitation of cognitive impairment, including LEGO®-based therapy (LEGO® B-T), which promotes neuronal connectivity and cortical plasticity through the use of assembly sets and robotic programming. Therefore, the aim of this study was to analyze the effect of LEGO® B-T on cognitive processes in pediatric patients with epilepsy. Eligible patients were identified; in the treatment group, an initial evaluation was performed with the NEUROPSI and BANFE-2 neuropsychological tests. Then, the interventions were performed once a week, and a final test was performed. In the control group, after the initial evaluation, the final evaluation was performed. An overall improvement was observed in the LEGO® B-T patients, with a significant increase in BANFE-2 scores in the orbitomedial, anterior prefrontal, and dorsolateral areas. In addition, in the gain score analysis, the orbitomedial and memory scores were significantly different from the control group. LEGO® B-T neurohabilitation is a remarkable option for epilepsy patients, who are motivated when they observe improvements.

Pyrethroid resistance in Aedes aegypti has become widespread after almost two decades of frequent applications to reduce the transmission of mosquito-borne diseases. Because few insecticide classes are available for public health use, insecticide resistance management (IRM) is proposed as a strategy to retain their use. A key hypothesis of IRM assumes that negative fitness is associated with resistance, and when insecticides are removed from use, susceptibility is restored. In Tapachula, Mexico, pyrethroids (PYRs) were used exclusively by dengue control programs for 15 years, thereby contributing to selection for high PYR resistance in mosquitoes and failure in dengue control. In 2013, PYRs were replaced by organophosphates-insecticides from a class with a different mode of action. To test the hypothesis that PYR resistance is reversed in the absence of PYRs, we monitored Ae. aegypti's PYR resistance from 2016 to 2021 in Tapachula. We observed significant declining rates in the lethal concentration 50 (LC50), for permethrin and deltamethrin. For each month following the discontinuation of PYR use by vector control programs, we observed increases in the odds of mosquitoes dying by 1.5% and 8.4% for permethrin and deltamethrin, respectively. Also, knockdown-resistance mutations (kdr) in the voltage-gated sodium channel explained the variation in the permethrin LC50s, whereas variation in the deltamethrin LC50s was only explained by time. This trend was rapidly offset by application of a mixture of neonicotinoid and PYRs by vector control programs. Our results suggest that IRM strategies can be used to reverse PYR resistance in Ae. aegypti; however, long-term commitment by operational and community programs will be required for success.

El problema que aborda el proyecto es el servicio cultural a la comunidad, en el marco del proceso de extensión universitaria, como una de las prioridades del subsistema de educación superior de la República Popular de Angola. Es propósito de este trabajo que se coloque la institución al servicio de la comunidad mediante la transmisión de conocimientos y sabiduría positiva y la intervención, en correspondencia con el panorama international. En esta propuesta predominan criterios sobre el proceso universitario extensionista teniendo en cuenta la institución educativa, la familia, administraciones locales, autoridades tradicionales, iglesias y población

Using mRNA sequencing and de novo transcriptome assembly, we identified, cloned, and characterized 9 previously undiscovered fluorescent protein (FP) homologs from Aequorea victoria and a related Aequorea species, with most sequences highly divergent from A. victoria green fluorescent protein (avGFP). Among these FPs are the brightest green fluorescent protein (GFP) homolog yet characterized and a reversibly photochromic FP that responds to UV and blue light. Beyond green emitters, Aequorea species express purple- and blue-pigmented chromoproteins (CPs) with absorbances ranging from green to far-red, including 2 that are photoconvertible. X-ray crystallography revealed that Aequorea CPs contain a chemically novel chromophore with an unexpected crosslink to the main polypeptide chain. Because of the unique attributes of several of these newly discovered FPs, we expect that Aequorea will, once again, give rise to an entirely new generation of useful probes for bioimaging and biosensing.

Background: New tools for health information technology have been developed in recent times, such as Clinical Decision Support (CDS) systems, which are any digital solutions designed to help healthcare professionals when making clinical decisions. The study aimed to show how we have adopted a CDS system in the San Juan de Alicante Clinical Laboratory and facilitate the implementation of our protocol in other clinical laboratories. We have user experience and the motivation to improve healthcare tools. The improvement, measurement, and monitoring of interventions and laboratory tests has been our motto for years. Materials and methods: A descriptive research was conducted. All stages in the design of the project are as follows: 1. Set up a multidisciplinary workgroup. 2. Review patients’ data. 3. Identify relevant data from main sources. 4. Design the likely outcomes. 5. Define a complete integration scenario. 6. Monitor and track the impact. To set up this protocol, two new software systems were implemented in our laboratory: AlinIQ CDS v8.2 as Rule Engine, and AlinIQ AIP Integrated Platform v1.6 as Business Intelligence (BI) tool. Results: Our protocol shows the workflow and actions that can be done with a CDS system and also how it could be integrated with other monitoring systems, as well as some examples of KPIs and their outcomes. Conclusions: CDS could be a great strategic asset for clinical laboratories to improve the integration of care, optimize the use of laboratory tests, and add more clinical value to physicians in the interpretation of results.

The deployment of offshore platforms for the extraction of oil and gas from subsea reservoirs presents unique challenges, particularly when multiple platforms are connected by a subsea gas network. In the Santos basin, the aim is to maximize oil production while maintaining safe and sustainable levels of CO2 content and pressure in the gas stream. To address these challenges, a novel methodology has been proposed that uses boundary conditions to coordinate the use of shared resources among the platforms. This approach decouples the optimization of oil production in platforms from the coordination of shared resources, allowing for more efficient and effective operation of the offshore oilfield. In addition to this methodology, a fast and accurate proxy model has been developed for gas pipeline networks. This model allows for efficient optimization of the gas flow through the network, taking into account the physical and operational constraints of the system. In experiments, the use of the proposed proxy model in tandem with derivative-free optimization algorithms resulted in an average error of less than 5% in pressure calculations, and a processing time that was over up to 1000 times faster than the phenomenological simulator. These results demonstrate the effectiveness and efficiency of the proposed methodology in optimizing oil production in offshore platforms connected by a subsea gas network, while maintaining safe and sustainable levels of CO2 content and pressure in the gas stream.