Abstract Estimating the probability of occurrence of extreme hydrologic events is a fundamental input in the design of hydraulic infrastructure. The classical approach to this problem has been to fit parametric probability functions to annual maxima streamflow data and use them to calculate the risk of failure. An underlying assumption of this approach is the stationarity of the time series. However, the stationarity of streamflows may not hold due to the effect of land cover change and climate change on rainfall runoff processes on watersheds. This study assesses the effect of considering non-stationarity in the estimation of design peak flows at 33 gauging stations in the state of Antioquia, Colombia. Particularly, the effect of non-stationarity in the mean of Gumbel-distributed peak flows is evaluated. This study focuses on the 5-yr and 10-yr return period annual flood flows, which are customary in the design of type sewerage systems. The results show similar behaviours for both return periods. All gauge stations show an asymptotically tendency in the risk of failure to 100% as the project lifetime tends to 30 years. In general, 71.4% of gauging stations show that the estimated risk of failure is larger when non-stationary conditions are assumed, relative to assuming stationary conditions, and that the magnitude of the difference increases for larger return periods. The rest of gauging stations shows the opposite behaviour. Our results support the use of a probability model that includes non-stationary in the mean, and they suggest that a model that also includes non-stationary in the variance could be important.

Background: Most pharmacists have not received formal training or education in the provision of care for transgender patients. Nonetheless, pharmacists have the potential to be valuable partners in the care of transgender patients, and a continuing education course might be valuable in addressing this knowledge gap. Objective: The aim of this study was to examine the impact of a three-hour continuing education course in improving the knowledge of pharmacists to provide pharmaceutical care for transgender patients. Methods: A quasi-experimental, one-group pre-test/post-test study design was used to measure the impact of a three-hour continuing pharmacy education course on the knowledge of pharmacists on transgender care. The course was divided into three units: (1) Transgender Patient Care Introduction, (2) General Health Issues of Transgender Patients, and (3) Gender Affirming Hormone Therapy. A total of 68 pharmacists participated in the study, of which 54 completed both the pre- and post-test. An ANOVA was used to compare differences in knowledge in the group before and after the educational intervention. Results: The majority of the participating pharmacists were cisgender, heterosexual women who had not received any formal training related to transgender care. Participants demonstrated the largest increase in execution score in the third unit, with a percent improvement of 25.22% (pre-test 45.06%, post-test 70.28%; p<0.001). The average total execution score was 52.15% in the pre-test and 72.89% (p< 0.001) in the post-test. Conclusions: Pharmacists benefited from a three-hour continuing education course with an increase in knowledge regarding transgender patient care and hormone therapy for gender affirmation. As this study only evaluated the effect in short term memory, further studies are needed to assess long term impact of the continuing education course on transgender care knowledge.

Abstract Introduction Branchial cleft anomalies are the second most common congenital anomaly in children. However, some lesions may not develop clinically and are not diagnosed until adulthood. The recent literature of branchial cysts (BCs) in the adult population is really scanty. For this reason, we analyzed the clinical and surgical management of the adult population treated for a BC at a tertiary care general hospital. Methods A retrospective review of the clinical records of all the patients with histological diagnosis of BC who were surgically treated at the Social Security Hospital in Quito, Ecuador, was performed. Fifty-one patients (27 women) with congenital anomalies of the 2nd (43 patients with cysts) and 3rd (6 patients with cysts and 2 with fistula) branchial arches were diagnosed and treated. Diagnosis was made on clinical grounds and by computed tomography scan. Results The 43 patients with a 2nd branchial cleft cyst underwent complete surgical excision through a wide mid-neck transverse cervicotomy. The 6 cases of 3rd branchial cleft cyst underwent surgical resection through a lower-neck transverse incision, and the 2 patients with clinical fistula in the lower aspect of the neck were operated on via an elliptical incision around this external fistula opening. Postoperative evolution was uneventful in all patients. Conclusions Branchial cysts can occasionally be diagnosed in adult patients in the setting of a general hospital population. A correct clinical and imaging assessment was diagnostic in most patients. Complete surgical resection was curative in all our patients, and postoperative complications were exceptional.

Resumen. SIMBA-POP es un modelo desarrollado en Martinica (Francia), basado en los conceptos de cohortes y cadenas de cohortes de plantas, simula la dinámica poblacional de plantaciones de banano. El modelo original, modificado por Ochoa (2010), se programó en el software EVOLUCIÓN 4.0, desarrollado por el grupo SIMON de la Universidad Industrial de Santander y se calibró y validó para las condiciones de temperatura media habituales en el Urabá Antioqueño; la más importante zona productora de banano en Colombia. En el proceso de calibración se ajustan los ciclos de embolse y cosecha, así como los tiempos en que ocurren los máximos valores de embolse. Para controlar la calibración se usó la desviación media (DM), el error medio de predicción (EMP), el error cuadrático medio de predicción (ECMP), la raíz del error cuadrático medio (RECMP), curvas de masa y coeficiente de correlación lineal. Los resultados mostraron que SIMBA-POP es capaz de simular de forma verosímil la dinámica del ciclo anual de producción en Urabá; particularmente reproduce bien los tiempos de los picos y los valles de producción, aunque la magnitud de estos valles y picos es altamente sensible a los parámetros del modelo y condiciones climáticas no consideradas.

Abstract. SIMBA - POP is a model developed in Martinique (France), which uses the concepts of cohorts and cohort chains to simulate the population dynamics of a commercial plantation of bananas. The original model was slightly modified by Ochoa (2010) in order to correct for an error in the flowering rate curve. The model was programmed in EVOLUCION 4.0. SIMBA - POP was then calibrated and validated for the normal climatic pattern in Urabá (Antioquia). Care was taken that the model adequately represent bagging and harvesting cycles, and the time at which maximum values of bagging (flowering) were reached. To evaluate the calibration we used average deviation (DM), the average error of prediction (EMP), the error mean square of prediction (ECMP), the root of the error mean square (RECMP), mass curves and correlation coefficient. Results showed that SIMBA-POP is a suitable tool for simulating banana crops in Urabá; the model reproduced quite well the times of the peaks and the valleys of production, although the magnitude of these peaks and valleys is considerably sensitive to model parameters.

The objective of this article is to offer a new interpretation of the role of coercion in Hart's theory of rules. Firstly, it is discussed why an inaccurate interpretation of coercion makes impossible the important distinction between primary and secondary rules drawn by Hart. Secondly, it is analyzed the epistemological character of Hart's theory and the difference between coercion and social complains. Bases on these two clarifications, it is suggested that the role of coercion in secondary rules is to determine when we are in presence of a rule. Finally, some research lines and the solution to some controversies, following the main theses defended in this article, are suggested.

El objetivo del artículo es ofrecer una nueva interpretación sobre el papel de la coacción en la teoría de las reglas de H. L. A. Hart. En primer lugar, se explica por qué una inadecuada interpretación de la coerción rinde imposible la distinción entre reglas primarias secundarias y primarias, central en el pensamiento de Hart. En segundo lugar, se distingue entre coerción y reproche social, además se analiza el carácter epistemológico de El Concepto de derecho. Con base en estas dos precisiones, se sugiere que el papel de la coacción en las reglas secundarias es determinar cuándo estamos en presencia de una regla. Finalmente, se proponen posibles líneas de investigación y de solución de controversias en torno a la teoría de Hart, según las tesis defendidas en el artículo.

El objetivo del artículo es probar la irrelevancia del debate entre iusnaturalismo y positivismo para resolver problemas típicos del derecho. El artículo se fundamenta en las respuestas que positivistas y naturalistas podrían dar al problema de la existencia de normas de ius cogens, particularmente, al problema de la obligatoriedad y validez de dichas normas. Al probar que tanto el positivismo inclusivista y exclusivista, así como el iusnaturalismo responden a los problemas del ius cogens de la misma forma, el artículo concluye que no hay un verdadero debate entre estas dos teorías, excepto por la discusión que todavía continúa sobre si el derecho puede ser una ciencia descriptiva o tiene que ser una disciplina normativa. En este sentido, el debate entre positivistas y iusnaturalistas puede considerarse como un capítulo más en la larga discusión acerca de la naturaleza de las ciencias sociales.

The objective of the article is to establish the irrelevance of the positivism-natural law debate for problems lawyers typically face. The article is based on the answers that positivists and natural lawyers give to the problem of the existence of rules of ius cogens; particularly, the normativity and the criteria used to identify these rules. By showing that inclusive, exclusive positivist, and natural lawyers answer the problems of rules of ius cogens in the same fashion, the article concludes that there is not a real debate between these schools, except for explaining in what sense law can be considered as a normative or a descriptive discipline. In this sense, the debate between positivists and natural lawyers may be considered as a chapter in the longer debate on the nature of social sciences.