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Background: In recent biomechanical studies, the importance of glenoid concavity and version for anterior shoulder stability has been highlighted. With this study, we aimed to assess their clinical relevance as stabilizing factors. We hypothesized that low glenoid concavity and low retroversion are associated with anterior glenohumeral instability. Methods: In this single-center, retrospective case-control study, computed tomography scans of n = 34 patients following acute anteroinferior glenohumeral dislocation between 2015 and 2021 were included. Patients with glenoid fractures and pre-existing glenohumeral pathologies were excluded. In the control group, n = 68 polytrauma patients referred to our level-I-trauma center were included, who showed neither acute nor chronic glenohumeral pathologies. Both groups were matched age- and gender-specifically in a 2:1 ratio. Glenoid concavity was measured according to the bony shoulder stability ratio (BSSR) in anterior-posterior (AP) and superior-inferior (SI) direction. Version was measured by the glenoid vault method. Results: The instability cohort presented with a lower BSSR (SI) compared to the control group (49.8% vs. 56.9%, P = .001). The BSSR (AP) did not differ significantly (30.2% vs. 33.7%, P = .163). A higher retroversion was seen in the instability cohort (−13.1° vs. −11.4°; P = .041). Subgroup analyses showed higher BSSR (SI) in ≥60-year-old patients compared to ≤30-year-old patients. BSSR (AP) and glenoid version did neither differ age- nor gender-specifically. Conclusion: Glenoid concavity is a relevant factor for anterior shoulder stability in the clinical setting. In contrast to recent biomechanical studies, glenoid version appears to have only limited clinical impact on anterior stability. Regarding the individual treatment of anterior glenohumeral instability, glenoid concavity should be focused on as an essential bony stabilizing factor.

BackgroundPatients with anti-aquaporin-4 antibody seropositive (AQP4-IgG+) neuromyelitis optica spectrum disorders (NMOSDs) frequently suffer from optic neuritis (ON) leading to severe retinal neuroaxonal damage. Further, the relationship of this retinal damage to a primary astrocytopathy in NMOSD is uncertain. Primary astrocytopathy has been suggested to cause ON-independent retinal damage and contribute to changes particularly in the outer plexiform layer (OPL) and outer nuclear layer (ONL), as reported in some earlier studies. However, these were limited in their sample size and contradictory as to the localisation. This study assesses outer retinal layer changes using optical coherence tomography (OCT) in a multicentre cross-sectional cohort.Method197 patients who were AQP4-IgG+ and 32 myelin-oligodendrocyte-glycoprotein antibody seropositive (MOG-IgG+) patients were enrolled in this study along with 75 healthy controls. Participants underwent neurological examination and OCT with central postprocessing conducted at a single site.ResultsNo significant thinning of OPL (25.02±2.03 µm) or ONL (61.63±7.04 µm) were observed in patients who were AQP4-IgG+ compared with patients who were MOG-IgG+ with comparable neuroaxonal damage (OPL: 25.10±2.00 µm; ONL: 64.71±7.87 µm) or healthy controls (OPL: 24.58±1.64 µm; ONL: 63.59±5.78 µm). Eyes of patients who were AQP4-IgG+ (19.84±5.09 µm, p=0.027) and MOG-IgG+ (19.82±4.78 µm, p=0.004) with a history of ON showed parafoveal OPL thinning compared with healthy controls (20.99±5.14 µm); this was not observed elsewhere.ConclusionThe results suggest that outer retinal layer loss is not a consistent component of retinal astrocytic damage in AQP4-IgG+ NMOSD. Longitudinal studies are necessary to determine if OPL and ONL are damaged in late disease due to retrograde trans-synaptic axonal degeneration and whether outer retinal dysfunction occurs despite any measurable structural correlates.

Las universidades desempeñan un papel fundamental en la dinamización de los ecosistemas de innovación al ser fuentes primordiales de conocimiento que fluye hacia los sectores público, privado y académico. Sin embargo, este flujo de conocimiento se ve obstaculizado por la carencia de canales de comunicación efectivos. Para abordar esta problemática, este estudio se enfocó en la concepción y desarrollo de un prototipo para dispositivos móviles y tabletas, utilizando metodologías Lean y herramientas de pensamiento de diseño. En las etapas de definición, investigación e ideación, se emplearon las metodologías de propuesta de valor y modelo Lean Canvas, con la participación de representantes de instituciones universitarias de España, Panamá, Guatemala, Perú, Ecuador, Argentina, Colombia y Chile. El desarrollo del prototipo, que incluye una aplicación para móviles y otra para tabletas, se llevó a cabo en Ecuador. Los prototipos desarrollados incluyen una interfaz con funcionalidades específicas, como la capacidad de búsqueda de inversionistas para sus proyectos y la posibilidad de establecer redes con distintas universidades. Además, permite a los usuarios crear y publicar noticias, ver el estatus de los proyectos y realizar preguntas a expertos. Estos prototipos fueron diseñados para crear un espacio dinámico donde investigadores, emprendedores, empresarios, inversionistas y mentores puedan interactuar de manera fluida. El impacto potencial de estas aplicaciones radica en su capacidad para fomentar, fortalecer y potencializar los vínculos y canales de comunicación entre todos los actores del ecosistema de innovación universitario.

BACKGROUND AND OBJECTIVES: To determine optic nerve and retinal damage in aquaporin-4 antibody (AQP4-IgG)-seropositive neuromyelitis optica spectrum disorders (NMOSD) in a large international cohort after previous studies have been limited by small and heterogeneous cohorts. METHODS: The cross-sectional Collaborative Retrospective Study on retinal optical coherence tomography (OCT) in neuromyelitis optica collected retrospective data from 22 centers. Of 653 screened participants, we included 283 AQP4-IgG-seropositive patients with NMOSD and 72 healthy controls (HCs). Participants underwent OCT with central reading including quality control and intraretinal segmentation. The primary outcome was thickness of combined ganglion cell and inner plexiform (GCIP) layer; secondary outcomes were thickness of peripapillary retinal nerve fiber layer (pRNFL) and visual acuity (VA). RESULTS: Eyes with ON (NMOSD-ON, N = 260) or without ON (NMOSD-NON, N = 241) were assessed compared with HCs (N = 136). In NMOSD-ON, GCIP layer (57.4 ± 12.2 μm) was reduced compared with HC (GCIP layer: 81.4 ± 5.7 μm, p < 0.001). GCIP layer loss (-22.7 μm) after the first ON was higher than after the next (-3.5 μm) and subsequent episodes. pRNFL observations were similar. NMOSD-NON exhibited reduced GCIP layer but not pRNFL compared with HC. VA was greatly reduced in NMOSD-ON compared with HC eyes, but did not differ between NMOSD-NON and HC. DISCUSSION: Our results emphasize that attack prevention is key to avoid severe neuroaxonal damage and vision loss caused by ON in NMOSD. Therapies ameliorating attack-related damage, especially during a first attack, are an unmet clinical need. Mild signs of neuroaxonal changes without apparent vision loss in ON-unaffected eyes might be solely due to contralateral ON attacks and do not suggest clinically relevant progression but need further investigation.

PurposeOptical coherence tomography (OCT) captures retinal damage in neuromyelitis optica spectrum disorders (NMOSD). Previous studies investigating OCT in NMOSD have been limited by the rareness and heterogeneity of the disease. The goal of this study was to establish an image repository platform, which will facilitate neuroimaging studies in NMOSD. Here we summarise the profile of the Collaborative OCT in NMOSD repository as the initial effort in establishing this platform. This repository should prove invaluable for studies using OCT to investigate NMOSD.ParticipantsThe current cohort includes data from 539 patients with NMOSD and 114 healthy controls. These were collected at 22 participating centres from North and South America, Asia and Europe. The dataset consists of demographic details, diagnosis, antibody status, clinical disability, visual function, history of optic neuritis and other NMOSD defining attacks, and OCT source data from three different OCT devices.Findings to dateThe cohort informs similar demographic and clinical characteristics as those of previously published NMOSD cohorts. The image repository platform and centre network continue to be available for future prospective neuroimaging studies in NMOSD. For the conduct of the study, we have refined OCT image quality criteria and developed a cross-device intraretinal segmentation pipeline.Future plansWe are pursuing several scientific projects based on the repository, such as analysing retinal layer thickness measurements, in this cohort in an attempt to identify differences between distinct disease phenotypes, demographics and ethnicities. The dataset will be available for further projects to interested, qualified parties, such as those using specialised image analysis or artificial intelligence applications.

En este artículo se presenta un análisis acerca de la aplicación de las competencias digitales para la transformación digital, con énfasis en el ámbito educativo y sobre la base de la literatura científica consultada. El artículo se enfoca en el estudio de algunos modelos internacionales de competencia digital que incorporan una propuesta de diferentes competencias digitales distribuidas en secciones con determinadas características y niveles de dominio de las tecnologías digitales, así como también instrumentos que facilitan al docente realizar una autoevaluación para medir el nivel de progresión en el desarrollo de las competencias digitales en su quehacer académico. Además, se realiza una revisión de la literatura científica que hace referencia al tema de la transformación digital, su definición y elementos que contribuyen a su logro. Como resultado de esta investigación se ha encontrado que la transformación digital y la innovación son competencias digitales, consideradas en los más altos niveles de dominio de las tecnologías digitales y que por tanto existe relación entre competencias digitales y transformación digital, en donde los apoyos institucionales son fundamentales para lograr con éxito disminuir la brecha digital y contribuir a la democratización de la educación desde una perspectiva de iguales oportunidades, al dotar de tecnologías pero también de las herramientas de apoyo en términos de formación continua y permanente así como también brindar un marco legal que respalde y fortalezca estos procesos en lo que las tecnologías juegan un papel esencial.

Izabela Matusz (Warsaw, 22 September 1974) is a Polish diplomat. She serves as Ambassador of the European Union and Head of the Delegation to Panama since 1 September 2022. She joined the Polish Foreign Service in 2002. Between 2013 and 2017, she served as Ambassador of Poland to Peru, concurrent for Bolivia and Ecuador. She also served at the Embassies of Poland in Argentina and Spain. While at Headquarters in Warsaw, she worked in the Department of the Americas, Department of Economic Cooperation and the Cabinet of the Minister. She holds a MA degree in Economics and International Relations from the SGH Warsaw School of Economics and a Postgraduate degree from the Center for Latin American Studies at the University of Warsaw.

En todos los sistemas educativos del mundo se plantean estrategias para minimizar los conflictos y la violencia en escuelas y colegios, tratando así de resolver graves confrontaciones entre educandos o estudiantes con docentes, siendo considerada esta una generación violenta. Estas prácticas basadas en valores tienen la finalidad de modelar los caracteres violentos de los alumnos mediante una práctica de mutua convivencia, diálogo y respeto, evitando discrepancias por conflictos raciales, religiosos, políticos, sociales, económicos o culturales. Esta conducta agresiva casi llega a la barbarie ante la incapacidad de convivir en paz, con valores de solidaridad, armonía, cooperación, equidad y no discriminación. Lamentablemente la sociedad se ha acostumbrado a la violencia en el mundo, por lo que hay que realizar cambios obligatorios. Si bien la conducta violenta del alumnado se genera inicialmente en la familia, generando estudiantes problemáticos y desadaptados, hay que realizar las debidas transformaciones en la formación de éstos que permita que se relacionen con la institución educativa mediante la participación e integración en ese ámbito. La esperanza y fe de que se verifiquen esos cambios en las futuras generaciones estudiantiles es deseo que toda la sociedad mundial espera para la consolidación de la paz de la humanidad.

Abstract This study mainly aimed to investigate how the relationships established at school affect the constitution of the self of autistic subjects. We carried out a multiple case study with children aged from seven to 14 years old enrolled in a public school that featured diverse profiles, with a total of 11 participants, such as teachers, coordinator, special education assistant (all of them women), as well as five autistic children (three boys and two girls) and two non-autistic girls. During the 6-month period, we conducted interviews with the adults, natural observations of school situations, and collaborative dynamics with the participating children. In light of theories from a dialogical-cultural perspective, it was possible to analyze our findings based on an I-positions framework, self positions, for each participant subject. From the convergence of each of the possible positions of all the subjects, we arrived at three axes of relationship: Playing, Helping, and Caring.

En el artículo se reflexiona sobre la gestión turística ecuatoriana en el contexto latinoamericano, teniendo en cuenta su latitud geográfica y cultura. De esta forma se toma en consideración la actividad turística que se desarrolla en el Ecuador concatenada con una cultura de paz debido al intercambio cultural, por cuanto el turismo lo desarrollan las naciones para los ciudadanos y ciudadanas que como personas constituyen los actores humanos. Sin dejar de considerar la Agenda 2030 y los Objetivos para el Desarrollo Sostenible.

Stroke remains the leading cause of disability and death in the Philippines. Evaluating the current state of stroke care, the needed resources, and the gaps in health policies and programs is crucial to decrease stroke-related mortality and morbidity effectively. This paper aims to characterize the Philippines' stroke system of care and network using the World Health Organization health system building blocks framework. To integrate existing national laws and policies governing stroke and its risk factors dispersed across many general policies, the Philippine Department of Health (DOH) institutionalized a national policy framework for preventing and managing stroke. Despite policy reforms, government financing coverage remains limited. In terms of access to medicines, the government launched its stroke medicine access program (MAP) in 2016, providing more than 1,000 vials of recombinant tissue plasminogen activator (rTPA) or alteplase subsidized to selected government hospitals across the country. However, DOH discontinued the program due to the lack of neuroimaging machines and organized system of care to support the provision of the said medicine. Despite limited resources, stroke diagnostics and treatment facilities are more concentrated in urban settings, mostly in private hospitals, where out-of-pocket expenditures prevail. These barriers to access are also reflective of the current state of human resource on stroke where medical specialists (e.g., neurologists) serve in the few tertiary and training hospitals situated in urban settings. Meanwhile, there is no established unified national stroke registry thus, determining the local burden of stroke remains a challenge. The lack of centralization and fragmentation of the stroke cases reporting system leads to reliance on data from hospital records or community-based stroke surveys, which may inaccurately depict the country's actual stroke incidence and prevalence. Based on these gaps, specific recommendations geared toward systems approach - governance, financing, information system, human resources for health, and medicines were identified.

Introducción: En el presente artículo se describe la estrategia metodológica implementada para el diagnóstico del estado inicial de la producción de recursos educativos digitales en la Facultad de Ciencias Naturales y Matemática de la Universidad de El Salvador, incluyendo la operacionalización de la variable objeto de investigación. Este estudio se deriva de un proyecto de tesis del programa de Doctorado en Educación de la Facultad Multidisciplinaria de la Universidad de El Salvador, que tiene por objeto de estudio la producción de recursos educativos digitales. Objetivo: estructurar el procedimiento para caracterizar la producción de recursos educativos digitales en la Facultad de Ciencias Naturales y Matemática de la Universidad de El Salvador. Metodología: se aplicaron los métodos teóricos analítico-sintético y sistémico-estructural y los métodos empíricos de tipo análisis documental, entrevista, grupo focal, encuesta y observación. Además, se utilizaron métodos estadísticos para la determinación de la población y muestra, y para el análisis de resultados se aplicó la triangulación de datos con una perspectiva predominantemente descriptiva e interpretativa. Resultados: mediante el análisis de las características de las dimensiones e indicadores de la variable objeto de investigación se determinó que esta se encuentra en un nivel de poco logrado, que corresponde con el estado más alejado de lo deseado. Discusión: los resultados confirman la necesidad de contar con un referente teórico-metodológico para dar cobertura a las necesidades pedagógicas, didácticas, metodológicas y organizativas que la variable en estudio demanda, además la estrategia metodológica aplicada tributó en determinar con mayor certeza y objetividad el diagnóstico realizado.

Purpose Optical coherence tomography (OCT) captures retinal damage in neuromyelitis optica spectrum disorders (NMOSD). Previous studies investigating OCT in NMOSD have been limited by the rareness and heterogeneity of the disease. The goal of this study was to establish an image repository platform, which will facilitate neuroimaging studies in NMOSD. Here we summarise the profile of the Collaborative OCT in NMOSD repository as the initial effort in establishing this platform. This repository should prove invaluable for studies using OCT to investigate NMOSD.Participants The current cohort includes data from 539 patients with NMOSD and 114 healthy controls. These were collected at 22 participating centres from North and South America, Asia and Europe. The dataset consists of demographic details, diagnosis, antibody status, clinical disability, visual function, history of optic neuritis and other NMOSD defining attacks, and OCT source data from three different OCT devices.Findings to date The cohort informs similar demographic and clinical characteristics as those of previously published NMOSD cohorts. The image repository platform and centre network continue to be available for future prospective neuroimaging studies in NMOSD. For the conduct of the study, we have refined OCT image quality criteria and developed a cross-device intraretinal segmentation pipeline.Future plans We are pursuing several scientific projects based on the repository, such as analysing retinal layer thickness measurements, in this cohort in an attempt to identify differences between distinct disease phenotypes, demographics and ethnicities. The dataset will be available for further projects to interested, qualified parties, such as those using specialised image analysis or artificial intelligence applications.

Neuromyelitis Optica Spectrum Disorder (NMOSD) is an inflammatory demyelinating disease of the central nervous system (CNS) primarily affecting the optic nerves and spinal cord, but also involving other regions of the CNS including the area postrema, periaqueductal gray matter, and hypothalamus. Knowledge related to pediatric manifestations of NMOSD has grown in recent years, particularly in light of newer information regarding the importance of not only antibodies to aquaporin 4 (AQP4-IgG) but also myelin oligodendrocyte glycoprotein (MOG-IgG) in children manifesting clinically with this syndrome. In this review, we describe the current state of the knowledge related to clinical manifestations, diagnosis, and chronic therapies for children with NMOSD, with emphasis on literature that has been published in the last 5 years. Following the review, we propose recommendations for the assessment/follow up clinical care, and treatment of this population.

The article highlights the relationbetween constitutionalism and democracyin progressive constitutional theories suchas law as integrity, judicial minimalism anddemocratic constitutionalism showing theirdifferences regarding the role Courts have insolving constitutional controversies as wellas the effects of their decisions (backlash).Finally, it discusses thevaquejada’scase (ADIn. 4.983) in order to show how such progressiveconstitutional theories and their answers to thebacklashcan help to enlighten some points thatare neglected in our constitutional practice yetwithout advocating in favor of importing suchtheories to Brazil.

El objetivo de la presente investigación es identificar cualitativa y cuantitativamente los sesgos cognitivos importantes para el desempeño laboral de las pequeñas y medianas industrias del municipio Valencia, del Estado Carabobo, Venezuela, con la finalidad de poder resolver y dar indicios de cuáles son los elementos que dichas empresas deben tomar en cuenta, para redefinir, alcanzar y buscar mejores resultados, representativos de un buen desempeño laboral, en sus aspectos racionales y no racionales. Metodológicamente, la investigación se ajusta al paradigma positivista cuantitativo; siendo un estudio exploratorio, de campo y descriptivo, ajustado al método deductivo, usando la observación directa y un cuestionario; procesando los datos con la estadística descriptiva, para una evidencia empírica. Los resultados han arrojado que los expertos seleccionaron 15 elementos, agrupados en 4 sesgos cognitivos: ilusión de control (sesgo clave), aversión a las pérdidas, percepción selectiva, y exceso de confianza. Se concluye que los sesgos cognitivos en orden de importancia, para el desempeño laboral de las PyMEs abordadas y su mejor productividad son: aversión las pérdidas, exceso de confianza y exceso de ilusión de control, considerando a estos sesgos en los aspectos no racionales.

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