Chitosan (CS) blends with collagen (CL) and Aloe vera (AV) have gained significant attention in the biomedical field due to their biocompatibility, biodegradability, and potential for wound healing applications. In this study, we investigated the preparation and characterization of CS/CL and CS/AV blends using selective precipitation and co-precipitation techniques. The synthesis processes were analyzed for yield and 4-hydroxyproline content (in CS/CL blends). The materials were characterized using bromatological analyses, viscosity measurements, Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), and scanning electron microscopy (SEM). These eco-friendly methods effectively promoted interactions between the biopolymers, resulting in homogeneous blends with tunable properties. Besides, they are simple, fast, safe, and require minimal infrastructure. This study demonstrated that selective precipitation and co-precipitation are effective methods for producing chitosan/collagen and chitosan/Aloe vera blends. These methods foster interactions and miscibility between the biopolymers, as confirmed by FTIR, XRD, viscosity, and 4-Hy content analyses. They also align with green chemistry principles by avoiding organic solvents, reducing environmental risks, and minimizing waste. The high yields achieved, especially for CS/AV blends (exceeding 96%), make these materials compatible with lyophilization procedures. The absence of segregated phases after appropriate washing underscores their suitability for pharmaceutical formulations and other applications. CS (CS CL (CL AV (AV biocompatibility biodegradability applications CSCL CSAV coprecipitation co techniques 4hydroxyproline hydroxyproline 4 . blends) analyses measurements Fouriertransform Fourier transform FTIR , (FTIR) Xray X ray XRD (XRD) SEM. SEM (SEM) ecofriendly eco friendly biopolymers properties Besides simple fast safe infrastructure chitosancollagen chitosan chitosanAloe 4Hy Hy solvents risks waste achieved exceeding 96%, 96 96% 96%) procedures (FTIR (XRD (SEM 9

Abstract The essay critically presents two territorial scale projects prepared at different times but grouped under a common approach. The reasoning starts from the notion of restoration proposed by Franco Purini that captured the attention of the scientific community at the beginning of the nineties, according to which, the historically shaped landscape needs, after the damage caused by modernity, a restoration operation. renovatio, capable of pushing beyond conservation. A position that opens fertile and generative spaces for reflection, even in relation to the operational dimension of the project. The analytical, inclusive, transversal view of the disciplines that we have adopted in the preparation of the projects is informed by a single synthetic objective that unites everything. This refers to the possibility, based on the selective recapitulation of the phylogeny, of prefiguring through guidelines, corrections and actions (material and immaterial), different scenarios with respect to the present and the evolutionary projection of a given territory. By redefining materials, weights, measures and relationships between the parts, valuing hidden or frustrated levels of the palimpsest, it is possible to reconstruct a territorial framework capable of proposing future orders, compatible with the rules of the longue durée that have acted in the formation of territories, as a result contingent of the stratification and sedimentation of signs.

Resumen El ensayo presenta críticamente dos proyectos de escala territorial confeccionados en tiempos distintos pero agrupados bajo un enfoque común. El razonamiento parte de la noción de restauración propuesta por Franco Purini que capta la atención de la comunidad científica al inicio de los años noventa, según la cual, el paisaje históricamente conformado necesita, luego de los daños provocados por la modernidad, de una operación de renovatio, capaz de empujar más allá de la conservación. Una posición que abre espacios de reflexión fértiles y generativos, incluso en relación a la dimensión operativa del proyecto. La mirada analítica, inclusiva, transversal respecto de las disciplinas, que hemos adoptado en la confección de los proyectos, está informada por un único objetivo sintético que todo lo une. Esto hace referencia a la posibilidad, a partir de la recapitulación selectiva de la filogenia, de prefigurar mediante directrices, correcciones y acciones (materiales e inmateriales), escenarios distintos respecto del presente y de la proyección evolutiva de un territorio dado. Redefiniendo materiales, pesos, medidas y relaciones entre las partes, valorizando niveles ocultos o frustrados del palimpsesto, es posible reconstruir una armadura territorial capaz de proponer órdenes futuros, compatibles con las reglas de la longue durée que han actuado en la conformación de territorios, resultado contingente de la estratificación y de la sedimentación de los signos.

ABSTRACT Introduction: Social distancing measures due to the COVID-19 pandemic prevented many children with neurodevelopmental disorders from accessing face-to-face treatments. Tele-rehabilitation grew at this time as an alternative therapeutic tool. In this study we analyzed remote cognitive rehabilitation in neurodevelopmental disorders. Methods: This was a prospective, quasi-experimental (before-after) study that included 22 patients (mean age 9.41 years) with neurodevelopmental disorders who had telerehabilitation for over six months. Results: After six months of telerehabilitation, a statistically significant improvement was found with a large effect size in these areas: attention (sustained, selective and divided), executive functions (verbal and visual working memory, categorization, processing speed), visuospatial skills (spatial orientation, perceptual integration, perception, simultanagnosia) and language (comprehensive and expressive). On the Weiss Functional Impairment Scale, all areas (family, learning and school, self-concept, activities of daily living, risk activities) improved with statistical significance. We found a positive correlation between the number of sessions and the improvement observed in executive functions (visual working memory, processing speed), attention (sustained attention, divided attention) and visuospatial skills (spatial orientation, perceptual integration, perception, simultanagnosia). We did not find statistical significance between the family structure and the number of sessions carried out. A high degree of perception of improvement and satisfaction was observed in the parents. Conclusions: Telerehabilitation is a safe alternative tool which, although it does not replace face-to-face therapy, can achieve significant cognitive and functional improvements in children with neurodevelopmental disorders.

RESUMEN Introducción: Las medidas de distanciamiento social debidas a la pandemia por COVID-19 impidieron que muchos chicos con trastornos del neurodesarrollo pudieran acceder a tratamientos presenciales. La telerrehabilitación creció en este tiempo como una herramienta terapéutica alternativa. El objetivo es analizar la telerrehXbilitación cognitiva en trastornos del neurodesarrollo. Métodos: En este estudio prospectivo, cuasi-experimental (antes-después), se incluyó a 22 pacientes (media de edad, 9,41 arios) con trastornos del neurodesarrollo que realizaron telerrehabilitación con el programa Rehametrics por más de 6 meses. Resultados: Luego de 6 meses de telerrahabilitación, se constató una mejoría estadísticamente significativa con un gran tamaño del efecto en áreas de: atención (sostenida, selectiva y dividida), funciones ejecutivas (memoria de trabajo verbal y visual, categorización, velocidad de procesamiento), habilidades visuoespaciales (orientación espacial, integración perceptiva, percepción, simultagnosia) y lenguaje (comprensivo y expresivo). En la Escala de Impedimento Funcional de Weiss mejoraron con significancia estadística todas las áreas (familia, aprendizaje y escuela, autoconcepto, actividades de la vida diaria, actividades de riesgo). Se constata una correlación positiva entre la cantidad de sesiones y la mejoría observada en funciones ejecutivas (memoria de trabajo visual, velocidad de procesamiento), atencionales (atención sostenida, atención dividida) y habilidades visuoespaciales (orientación espacial, integración perceptiva, percepción, simultagnosia). No encontramos significancia estadística entre la estructura familiar y la cantidad de sesiones realizadas. Se observó un alto grado de percepción de mejora y satisfacción en los padres. Conclusiones: La telerrehabilitación puede ser una herramienta alternativa segura que, sin reemplazar la presencialidad, puede lograr mejoras cognitivas y funcionales significativas en niños con trastornos del neurodesarrollo.

ABSTRACT Introduction and objectives: Selective serotonin reuptake inhibitors (SSRIs) are medications used in child and adolescent psychiatry mainly for the treatment of depression, anxiety and obsessive-compulsive disorder. In general, these medications are safe and well tolerated. However, they can cause adverse effects such as activation syndrome, which if not identified can negatively affect adherence and response to treatment. Activation syndrome has received little attention and can be difficult to recognize due to the lack of a clear definition and objective diagnostic measures, and also because it can be confused with a worsening of the psychiatric disorder or mania triggered by the antidepressants. For all the above, it is important that professionals who prescribe antidepressants in the pediatric population are able to identify and manage activation syndrome when it occurs. Our aim was to carry out a narrative review of activation syndrome in children and adolescents treated with SSRIs in terms of definition, prevalence, pathophysiology, associated factors, relationship with suicide risk, management strategies and recommendations for reducing the risk of suicidal behaviors when using antidepressants in this population. Methods: We performed a non-systematic narrative review of activation syndrome in children and adolescents which involved finding information in PubMed, Ovid, EBSCO, Pro-Quest and Embase. Review articles, prospective and retrospective investigations, systematic reviews, meta-analyses and other articles related to activation syndrome in children and adolescents were selected. The search was limited to studies published in English and Spanish that involved children and adolescents and no limits were applied to the publication date or study design. Results: A total of 62 articles were included, 61 of them in English. The results were grouped into the following topics: definition; prevalence; pathophysiology; associated factors; relationship with suicide risk; management strategies; and recommendations for reducing the risk of suicidal behaviors when using antidepressants in this population. Activation syndrome refers to a set of symptoms consisting of impulsiveness, restlessness, increased activity, insomnia, irritability, disinhibition and agitation. This syndrome is poorly characterized in terms of its definition, prevalence, risk factors and pathophysiology, a situation that limits its recognition and evaluation. There are many factors that predispose the development of the syndrome such as age, differences in brain development in the pediatric population, the characteristics of the patient or the antidepressant, disorders of neurological development, and the doses and plasma levels of the medications. It has been thought that activation syndrome may be related to suicidal tendencies. However, the evidence in support of this link is inconsistent and further studies are therefore necessary. Conclusions: Activation syndrome with SSRI is a particularly important adverse effect in children and adolescents and, when it occurs, can cause lack of adherence to or discontinuation of treatment. Strict vigilance is therefore recommended during the use of these medications.

RESUMEN Introducción y objetivos: Los inhibidores selectivos de la recaptación de serotonina (ISRS) son medicamentos que se usan en psiquiatría de niños y adolescentes principalmente para el tratamiento de depresión, ansiedad y trastorno obsesivo compulsivo. En general, estos medicamentos son seguros y se toleran bien, pero pueden producir efectos adversos como el síndrome de activación, que si no se identifica puede afectar negativamente a la adherencia y la respuesta al tratamiento. El síndrome de activación ha recibido poca atención y existen dificultades en su reconocimiento por la falta de una definición clara y de medidas de diagnóstico objetivas y porque, además, puede confundirse con un empeoramiento del trastorno psiquiátrico de base o un viraje a manía con antidepresivos. Por todo lo anterior, es importante que los profesionales que prescriben antidepresivos a población pediátrica puedan identificar y tratar el síndrome de activación cuando se presente. El objetivo de este artículo es desarrollar una revisión narrativa del síndrome de activación en niños y adolescentes tratados con ISRS en cuanto a su definición, prevalencia, fisiopatología, factores asociados, relación con el riesgo de suicidio, las estrategias de tratamiento y las recomendaciones para la reducción del riesgo de conductas suicidas al usar antidepresivos en esta población. Métodos: Se realizó una revisión narrativa no sistemática del síndrome de activación en niños y adolescentes, la cual involucró la búsqueda de información en PubMed, Ovid, EBSCO, ProQuest y EMBASE. Se seleccionaron artículos de revisión, investigaciones prospectivas, retrospectivas, revisiones sistemáticas, metanálisis y demás artículos sobre el síndrome de activación en niños y adolescentes. La búsqueda se limitó a los estudios publicados en inglés y español que involucraran a niños y adolescentes y no se aplicaron límites en cuanto a la fecha de publicación o diseño del estudio. Resultados: Se incluyeron un total de 62 artículos, 61 de ellos en inglés. Los resultados se agruparon en los siguientes temas: definición, prevalencia, fisiopatología, factores asociados, su relación con el riesgo de suicidio, estrategias de tratamiento y recomendaciones para la reducción del riesgo de conductas suicidas al usar antidepresivos en esta población. Se encontró que el síndrome de activación hace referencia a un conjunto de síntomas consistentes en impulsividad, inquietud, aumento de la actividad, insomnio, irritabilidad, desinhibición y agitación. Hasta el momento, este síndrome está mal caracterizado en cuanto a definición, prevalencia, factores de riesgo y fisiopatología, situación que limita su reconocimiento y evaluación. Existen factores que pueden predisponer a la aparición del síndrome, como la edad, las diferencias de desarrollo cerebral en la población pediátrica, las características del paciente o del antidepresivo, los trastornos del desarrollo neurológico y las dosis y concentraciones plasmáticas de los medicamentos. Se ha considerado que el síndrome de activación puede estar relacionado con tendencias suicidas; no obstante, la evidencia que respalda dicho vínculo es contradictoria, por lo cual son necesarios más estudios. Conclusiones: El síndrome de activación con ISRS representa un efecto adverso particularmente importante en niños y adolescentes, y cuando se presenta puede causar la falta de adherencia o la suspensión del tratamiento, por lo cual se recomienda una vigilancia estricta durante el uso de estos medicamentos.

ABSTRACT What is the political agenda that animates, justifies, and legitimizes resource extractivism in the context of sustainability transformations and climate action enhanced? This is a question of growing relevance across geographies and sectors of activity that we aim to address from the Latin American countryside. To this end, we start with a discussion on the political economy and ecology of contemporary agrarian extractivism. Then, we turn to examine the role of diverse state and social actors in the rise of agroextractivism for climate stewardship in Bolivia, Guatemala, and Paraguay. In Bolivia, the alliance of Evo Morales with diverse classes of capital and reliance on the extractive economy ultimately led to his downfall as he lost support from his social bases and was unwilling to give up state power. The rise of the flex sugarcane and oil palm complexes in Guatemala since the mid-2000s relies on the new political agenda of ‘authoritarian corporate populism’. This involves political concessions to the underprivileged through public grants and multistakeholder governance, as in conventional populist political regimes. But additionally, authoritarian corporate populism involves concessions to working people and the environment in the private production realm. Violence, however, remains foundational to this political agenda, even if it is now cloaked in the rule of law. In Paraguay, the fierce rejection of Fernando Lugo’s tepid attempts to regulate the agribusiness sector culminated in a “parliamentary coup” orchestrated by the landlord class and preceded by spectacular acts of violence against peasants. The coup paved the way for the continuing expansion of an agroextractive export model characterized by the adoption of new genetically modified soy varieties, recurring state violence, and increasing campesino and indigenous dispossession and marginalization. Following the three country-analysis we discuss how the alliance among state actors, elites and agroextractivist capital, including through multistakeholder initiatives, have limited the transformative potential of progressive governments to improve the living conditions of the working people. In so doing, the triple alliance relies on the traditional strategies of influencing regulatory frameworks and legitimizing discourses. But it also relies on new political strategies that combine the manufacturing of popular consent to the agroextractivist order with violence and selective repression cloaked in the rule of law. We conclude stressing how the ´green´ ecomodernist turn of the agroextractivist agenda shifts attention away from the paradox of increasing the use of natural resources to cool down the planet. Rather, it privileges the sort of technical-administrative innovations that various flex crops complexes require to reproduce their necessary natural and social conditions of production of bioenergy and biomaterials for ‘the common good.’

RESUMEN ¿Cuál es la agenda política que anima, justifica y legitima el extractivismo de recursos en el marco de las transformaciones hacia la creciente sustentabilidad y la acción climática? Esta es una cuestión de creciente relevancia a nivel mundial y multisectorial a la que buscamos ofrecer respuestas desde el campo latinoamericano. Para ello comenzamos con un debate sobre la economía y la ecología política del extractivismo agrario contemporáneo. Después examinamos el papel de diversos actores estatales y sociales tras el auge del agroextractivismo en la acción climática en Bolivia, Guatemala y Paraguay. En Bolivia, las alianzas de Evo Morales con diversas clases de capital y su dependencia de la economía extractiva acabaron provocando su caída al perder el apoyo de sus bases y no estar dispuesto a renunciar al poder del Estado. El auge reciente de los complejos de cultivos comodín de la caña de azúcar y la palma aceitera en Guatemala se asienta sobre la nueva agenda del ‘populismo corporativo autoritario.’ Esta conlleva concesiones políticas a las personas más desfavorecidas a través de transferencias públicas y de sistemas de gobernanza multiparte, como en el caso de los regímenes políticos populistas convencionales. Pero además el populismo corporativo autoritario implica concesiones a las clases trabajadoras y al medio ambiente en el ámbito productivo privado. La violencia, sin embargo, sigue siendo clave en esta agenda política del poder, aun si ahora se legitima bajo la defensa del Estado de Derecho. En Paraguay, el feroz rechazo a los intentos de Fernando Lugo para regular el agronegocio culminó en un ‘golpe parlamentario’ orquestado por la clase terrateniente y precedido por violencia extrema contra el campesinado. El golpe facilitó la expansión de un modelo agroextractivo caracterizado por la adopción de nuevas variedades de soja genéticamente modificadas, la violencia estatal y el despojo y marginación de la población campesina e indígena. Tras este análisis por países planteamos una discusión mas general sobre cómo las alianzas entre actores estatales, elites y capital agroextractivo, incluyendo a través de iniciativas de gobernanza multiparte, han debilitado el potencial transformador de gobiernos progresistas para mejorar las condiciones de vida de las y los trabajadores. Con este fin, la triple alianza no sólo recurre a las tradicionales estrategias de influencia sobre marcos normativos y discursos legitimadores, sino también a nuevas estrategias políticas que combinan la generación de consentimiento popular al orden agroextractivista con la violencia y represión selectiva amparada en la defensa del Estado de Derecho. Concluimos subrayando cómo el giro ecomodernista 'verde' en la agenda politica del agroextractivismo desplaza la atención de la paradoja del creciente uso de recursos naturales para enfriar el planeta hacia las innovaciones técnico-administrativas que requieren diversos complejos corporativos de cultivos comodín para reproducir sus condiciones naturales y sociales de producción de bioenergía y biomateriales por ‘el bien común.’

Abstract Paraquat®, or N,N‘-dimethyl-4,4‘-bipyridinium dichloride, is a bipyridyl compound used as a non-selective herbicide and desiccant that can cause acute poisoning through all routes of exposure. There is no known antidote, and the available treatments are based on avoiding its absorption and timely removing it, in adults and children. We describe a case series of 14 pediatric patients from the department of Cauca, Colombia, with acute intoxication after oral intake of paraquat. Patients were referred to a medium-high complexity hospital in southwestern Colombia and treated according to an institutional protocol for acute paraquat poisoning. Acute paraquat poisoning after oral ingestion is associated with a high mortality rate, even with timely medical attention, as the compound has no known antidote and quickly reaches systemic concentrations for fulminant poisoning. Based on the available literature, our center has proposed a clinical protocol including early standard management, immunosuppressive and antioxidant treatments, and systemic removal techniques. This protocol suggests an adequate approach to acute paraquat poisoning in the pediatric population.

Resumen El dicloruro de 1,1’-dimetil-4,4’-bipiridilo (Paraquat®) es un compuesto químico de la familia de las piridinas, utilizado como herbicida no selectivo y desecante. Este compuesto puede causar intoxicación aguda por todas las vías de exposición. En el momento, no hay un antídoto conocido y los tratamientos disponibles, incluidos los pediátricos, se basan en contrarrestar su absorción y propiciar su remoción oportuna. Se describe una serie de casos de 14 pacientes pediátricos, procedentes en su mayoría del departamento del Cauca, con intoxicación aguda por ingestión de paraquat. Los pacientes fueron remitidos y atendidos en un hospital de mediana a alta complejidad en el suroccidente colombiano, con un protocolo institucional para el manejo de la intoxicación aguda por el herbicida. La intoxicación aguda con paraquat por vía oral se asocia con una alta tasa de mortalidad, aún con atención médica oportuna, pues fácilmente se alcanzan concentraciones sistémicas para ser fulminante. Basado en la literatura disponible, el Hospital Universitario San José ha propuesto un protocolo clínico -adecuado para la intoxicación aguda por paraquat en población pediátrica- que incluye manejo estándar temprano, tratamiento inmunosupresor y antioxidante, y técnicas para su remoción sistémica

ABSTRACT The purpose of this study was to examine the impact of mindfulness training on selective attention, sustained attention, and inhibitory control in children aged 9 to 11. To achieve this, 114 students participated in the mindfulness program "Sitting Still Like a Frog" and were assessed before and after the program using tests that measure these variables. A quasi-experimental study with counterbalancing was conducted to minimize the learning effect, involving both an experimental group and a control group. The results indicated an impact of the mindfulness practice on the measure of selective attention, although no significant effects were observed for sustained attention or inhibitory control measures. Considering the role of attentional skills in children's academic activities, this outcome underscores the importance of contemplating mindfulness practices in the school context.

RESUMEN El propósito de este trabajo consistió en estudiar el impacto de un entrenamiento en mindfulness sobre la atención selectiva, la atención sostenida y el control inhibitorio en niños de entre 9 y 11 años. Para ello, 114 alumnos participaron del programa de mindfulness Tranquilos y atentos como una rana, siendo previa y posteriormente evaluados con pruebas que recogen medidas de dichas variables. Se realizó un estudio de tipo cuasiexperimental con contrabalanceo para reducir el efecto aprendizaje. Se trabajó con un grupo experimental y un grupo control. Los resultados mostraron un impacto de la práctica sobre la medida de atención selectiva, no así para las medidas de atención sostenida ni de control inhibitorio. Teniendo en cuenta el rol de las habilidades atencionales en la actividad académica de los niños, este resultado resalta la importancia de pensar las prácticas de mindfulness en el contexto escolar.

ABSTRACT Since the beginning of the COVID-19 pandemic, many people suffered from Long Covid Syndrome, in which affected individuals do not recover immediately after the end of the infectious and inflammatory process caused by the virus. The most common neuropsychological symptoms of this syndrome are: memory decline, lack of attention, anxiety and depression. Objective: The purpose of this study was to develop a proposed cognitive rehabilitation protocol for post-COVID individuals with cognitive symptoms. Methods: A rehabilitation proposed protocol focusing on attention and memory was developed, based on the tests used in the neuropsychological evaluation of affected patients. Researchers held weekly sessions for six months, each lasting 60 minutes. Homework activities were also assigned and corrected in the following session. The attention and memory sessions were conducted with activities based on the applied tests. Results: Despite the methodological separation of attention and memory, the activities indirectly affect other cognitive functions and abilities, such as executive function, language, reasoning, execution strategies, and cognitive flexibility. A computer, a sheet of paper, and a pen were used to present the slides for the activities. Attention training included all types of attention: sustained, alternating, selective and divided. Memory training sessions included activities that stimulated both short-term and long-term memory. With each session, the difficulty of the activities was gradually increased. Conclusion: Cognitive rehabilitation already has more consolidated evidence about its effectiveness for the treatment of other pathologies, so it can be thought that it will also be a promising strategy for COVID-19 too. COVID19 COVID 19 COVID-1 pandemic Syndrome virus are decline depression Objective postCOVID post Methods developed patients months 6 minutes session Results abilities function language reasoning strategies flexibility computer paper sustained alternating divided shortterm short term longterm long increased Conclusion pathologies too COVID1 1 COVID-

RESUMO Desde o início da pandemia de COVID-19, muitas pessoas sofreram com a síndrome da COVID longa, em que os indivíduos afetados não se recuperam após o término do processo infeccioso e inflamatório causado pelo vírus. Os sintomas neuropsicológicos mais comuns dessa síndrome são: declínio da memória, falta de atenção, ansiedade e depressão. Objetivo: Desenvolver uma proposta de protocolo de reabilitação cognitiva para indivíduos pós-COVID com sintomas cognitivos. Métodos: Foi desenvolvida uma proposta de protocolo de reabilitação com foco na atenção e na memória, baseada nos testes utilizados na avaliação neuropsicológica dos pacientes afetados. Os pesquisadores realizaram sessões semanais durante seis meses, cada uma com duração de 60 minutos. As atividades de lição de casa também foram atribuídas e corrigidas na sessão seguinte. As sessões de atenção e memória foram realizadas com atividades baseadas nos testes aplicados. Resultados: Apesar da separação metodológica entre atenção e memória, as atividades afetam indiretamente outras funções e habilidades cognitivas, como função executiva, linguagem, raciocínio, estratégias de execução e flexibilidade cognitiva. Foram utilizados computador, folha de papel e caneta para a apresentação dos slides das atividades. O treinamento da atenção incluiu todos os tipos de atenção: sustentada, alternada, seletiva e dividida. As sessões de treinamento de memória incluíram atividades que estimularam memória de curto e longo prazo. A cada sessão, a dificuldade das atividades foi aumentando gradativamente. Conclusão: A reabilitação cognitiva já possui evidências mais consolidadas sobre a sua eficácia para o tratamento de outras patologias, pelo que se pode pensar que na COVID-19 será também uma estratégia promissora. COVID19, COVID19 19, 19 longa vírus são depressão Objetivo pósCOVID pós cognitivos Métodos meses 6 minutos seguinte aplicados Resultados cognitivas executiva linguagem raciocínio computador sustentada alternada dividida prazo gradativamente Conclusão patologias COVID-1 promissora COVID1 1 COVID-

Resumo O Ácido Linoleico Conjugado (CLA) tem chamado a atenção de diversos pesquisadores, principalmente aquele de origem microbiana, devido à sua importância biológica para o consumidor. O presente estudo visa extrair a enzima LA Isomerase da bactéria Lactobacillus paracasei do leite e usar essa enzima na produção de CLA. Meios seletivos, incluindo MRS e MRS-Dagatose, foram usados no isolamento de cepas locais. Os isolados bacterianos selecionados foram testados quanto à sua capacidade de produzir a enzima LA-Isomerase. Foi selecionado o isolado com alta atividade enzimática. Após a extração e purificação parcial da enzima, as condições ideais para a produção de ácido graxo conjugado foram estudadas e os produtos da reação foram identificados usando a tecnologia GC-MS. Verificou-se que 11 isolados possuem capacidade de produzir CLA em diferentes concentrações. O isolado H1 apresentou a maior produção de ácido graxo conjugado, na concentração de 120,45 g.ml-1, e este isolado foi selecionado como fonte para extração enzimática. A atividade enzimática do extrato bruto e parcialmente purificado com sulfato de amônio foi estimada por métodos de coloração em comprimento de onda de 233 nm. O efeito das condições ótimas (pH, temperatura, concentração de ácido linoleico e concentração de enzima) no produto CLA foi estudado usando a enzima LA Isomerase parcialmente purificada e as condições ótimas para produção foram 6,5, 45 °C, 100 μg.ml-1 e 0,7 mL, respectivamente. A técnica de GC-MS mostrou a presença de uma série de produtos de reação que são isômeros do ácido linoleico conjugado (C9T11, T9T12, T10C12) com diferentes concentrações.

Abstract Conjugated Linoleic Acid (CLA) has attracted the attention of many researchers, especially that of microbial origin due to its biological importance to the consumer. The current study aims to extract LA Isomerase enzyme from Lactobacillus paracasei bacteria from milk and to use the enzyme in the production of CLA. Selective media, including MRS and MRS-Dagatose, were used in isolating local strains. The selected bacterial isolates were tested for their ability to produce LA-Isomerase enzyme. The isolate with high enzymatic activity was selected. After extraction and partial purification of the enzyme, the optimal conditions for the production of conjugated fatty acid were studied, and the reaction products were diagnosed using GC-MS technology. It was found that 11 isolates have the ability to produce CLA at different concentrations, H1 isolate showed the highest production of conjugated fatty acid at a concentration of 120.45 g.ml-1, this isolate was selected as the source for enzyme extraction. The enzymatic activity of the crude extract and partially purified with ammonium sulfate was estimated using color methods at wavelength of 233 nm. The effect of the optimum conditions (pH, temperature, linoleic acid concentration and enzyme concentration) on the CLA product was studied using the partially purified LA Isomerase enzyme, the optimum conditions for production were 6.5, 45 °C, 100 μg.ml-1 and 0.7 ml, respectively. The GC-MS technique showed the presence of a number of reaction products that are isomers of conjugated linoleic acid (C9T11, T9T12, T10C12) with different concentrations.

Abstract Since 2018, when he was elected to the presidency, Andrés Manuel López Obrador and his government have spread a belief system among Mexican society that reflects the principles of his political movement and articulates the contents of the so-called Fourth Transformation, also known as 4T. With these principles, an attempt has been made to highlight a different worldview from what the president has referred to as the neoliberal or conservative model that, in his narrative, governed Mexico in the three and a half decades prior to Morena’s arrival in government. The president’s morning press conferences have represented a central and predominant space for the definition and dissemination of the obradorist belief system. In this article, we analyze the scope that it has had among Mexican public opinion. Among the main findings, we document a notable variance in the reception and assimilation of 4T messages, showing that these have permeated much more clearly among supporters of the ruling party and among publics related to the president and his movement, reflecting phenomena of selective attention and assimilation. Given that the obradorism narrative is usually labeled within the current populist rhetoric in the world, we also discuss this aspect in light of our results.

Resumen Desde 2018, cuando fue electo a la presidencia, Andrés Manuel López Obrador y su gobierno han difundido un sistema de creencias entre la sociedad mexicana que refleja los principios de su movimiento político y articula los contenidos de la llamada Cuarta Transformación, también conocida como 4T. Con esos principios se ha buscado destacar una cosmovisión distinta a lo que el presidente se ha referido como el modelo neoliberal o conservador que, en su narrativa, rigió en México en las tres décadas y media previas a la llegada de Morena al gobierno. Las conferencias matutinas del mandatario han jugado un papel central y predominante en la definición y difusión del sistema de creencias obradorista. En este artículo analizamos el alcance y posible impacto que eso ha tenido en la opinión pública mexicana. Entre los hallazgos principales documentamos una notable varianza en la recepción y asimilación de mensajes de la 4T, mostrando que estos han permeado con mucha mayor claridad entre los simpatizantes del partido gobernante y entre los públicos afines al presidente y su movimiento, reflejando fenómenos de atención y asimilación selectivas. Dado que la narrativa del obradorismo suele etiquetarse dentro de la actual retórica populista en el mundo, también discutimos ese aspecto a la luz de nuestros resultados.

Objective: To investigate risk factors associated with impaired attention-related executive functions (EFs) at age 11 and working memory at age 15. Methods: Data from participants of the population-based 2004 Pelotas Birth Cohort at ages 11 (n=3,582) and 15 (n=1,950) were analyzed. The study measured attentional control, cognitive flexibility, and selective attention using the Test of Everyday Attention for Children (TEA-Ch). Spatial working memory was assessed by the Cambridge Neuropsychological Test Automated Battery (CANTAB). Logistic regression was employed to explore the relationship between perinatal and childhood exposures and EF impairment. Results: Low maternal education had a significant negative impact on EFs. At age 11, it was associated with decreased attentional control (OR = 3.04; 95%CI 2.09-4.43), and at age 15, it was linked to impaired spatial working memory (OR = 2.21; 95%CI 1.58-3.09). Additional risk factors included low household income, black or brown maternal skin color, high parity, prematurity, low birth weight, and multiple siblings. Breastfeeding, regardless of duration, was found to be a protective factor against impaired cognitive flexibility (OR = 0.38; 95%CI 0.22-0.65). Conclusion: This study underscores the lasting impact of perinatal exposures on EF development. Policies that mitigate the negative effects of risk factors and promote EF development, especially among vulnerable populations, are needed. Objective attentionrelated related EFs (EFs 1 Methods populationbased population based 200 n=3,582 n3582 n 3 582 (n=3,582 n=1,950 n1950 950 (n=1,950 analyzed TEACh. TEACh TEA Ch . (TEA-Ch) CANTAB. CANTAB (CANTAB) impairment Results OR 3.04 304 04 95CI CI 95 2.094.43, 209443 2.09 4.43 , 2 09 4 43 2.09-4.43) 2.21 221 21 1.583.09. 158309 1.58 3.09 58 1.58-3.09) income color parity prematurity weight siblings Breastfeeding duration 0.38 038 0 38 0.220.65. 022065 0.22 0.65 22 65 0.22-0.65) Conclusion development populations needed 20 n=3,58 n358 (n=3,58 n=1,95 n195 (n=1,95 (TEA-Ch (CANTAB 3.0 30 9 094 2.094.43 20944 209 2.0 443 4.4 2.09-4.43 2.2 583 1.583.09 15830 158 1.5 309 5 1.58-3.09 0.3 03 220 0.220.65 02206 022 0.2 065 0.6 6 0.22-0.65 n=3,5 n35 (n=3,5 n=1,9 n19 (n=1,9 3. 2.094.4 2094 2. 44 4. 2.09-4.4 1.583.0 1583 1. 1.58-3.0 0. 0.220.6 0220 02 06 0.22-0.6 n=3, n3 (n=3, n=1, n1 (n=1, 2.094. 2.09-4. 1.583. 1.58-3. 0.220. 0.22-0. n=3 (n=3 n=1 (n=1 2.094 2.09-4 1.583 1.58-3 0.220 0.22-0 n= (n= 2.09- 1.58- 0.22- (n

Abstract It is not common to encounter arteriovenous malformations (AVMs) during total hip arthroplasty (THA). We report the present case to draw attention to the possibility of an AVM during the direct anterior approach (DAA) for THA, which, if not borne in mind, may lead to the myriad of complications related to excessive bleeding. An 81-year-old female presented to the emergency department with a left femoral neck fracture. She elected to undergo a THA via the DAA. Abnormal appearing blood vessels were present near the ascending circumflex branches, which provided difficulty in achieving hemostasis. Excessive blood loss was noted, and the patient received one unit of packed red blood cells during the operation. Hemoglobin and hematocrit dropped in the days following surgery, requiring several additional transfusions of blood products. When the patient complained of progressive left leg swelling on postoperative day 3, a computed tomography revealed large hematomas within the left adductors and the left iliopsoas muscle. Active extravasation was identified arising from a branch of the left profunda femoral artery, as well as an arteriovenous fistula (AVF) in this area. Bleeding was controlled by selective endovascular coil embolization. As of current knowledge, this is the first reported intraoperative discovery of congenital arteriovenous malformation (AVM) with subsequent development of postoperative arteriovenous fistula and associated symptomatic hematomas in the setting of THA using the DAA. Early recognition and intervention of vascular malformations is essential in preventing potential limb- or life-threatening surgical complication. AVMs (AVMs THA. . (THA) DAA (DAA mind bleeding 81yearold yearold 81 year old fracture branches hemostasis noted operation surgery products 3 muscle artery AVF (AVF area embolization knowledge (AVM limb lifethreatening life threatening complication (THA 8

Resumo Não é comum encontrar malformações arteriovenosas (MAV) durante a artroplastia total do quadril (ATQ). Relatamos o presente caso para chamar a atenção para a possibilidade de uma MAV durante a abordagem anterior direta (AAD) para ATQ, que se não for considerada, pode levar a uma miríade de complicações relacionadas ao sangramento excessivo. Uma mulher de 81 anos foi apresentada ao pronto-socorro com fratura no pescoço do fêmur esquerdo. Ela optou por se submeter a uma artroplastia total do quadril (ATQ) através da AAD. Vasos sanguíneos aparentemente anormais estavam presentes perto dos ramos circunflexos ascendentes, proporcionando dificuldade em alcançar hemostasia. A perda excessiva de sangue foi notada e a paciente recebeu uma unidade de glóbulos vermelhos embalados durante a operação. Hemoglobina e hematócrito caíram nos dias seguintes à cirurgia, exigindo várias transfusões adicionais de produtos sanguíneos. Quando a paciente reclamou de inchaço progressivo na perna esquerda no terceiro dia pós-operatório, a tomografia computadorizada revelou hematomas grandes dentro dos adutores esquerdos e do músculo iliopsoas esquerdo. A extravasão ativa foi identificada a partir de um ramo da artéria femoral esquerda, bem como de uma fístula arteriovenosa (FAV) nesta área. O sangramento foi controlado por embolização seletiva da bobina endovascular. A partir do conhecimento atual, esta é a primeira descoberta intraoperatória relatada de MAC congênita com desenvolvimento subsequente de FAV pós-operatória e hematomas sintomáticos associados no cenário de ATQ utilizando a AAD. O reconhecimento precoce e a intervenção de malformações vasculares são essenciais para prevenir possíveis complicações cirúrgicas de membros ou de risco de vida. (MAV ATQ. . AAD (AAD considerada excessivo 8 prontosocorro pronto socorro esquerdo (ATQ ascendentes hemostasia operação cirurgia pósoperatório, pósoperatório pós operatório, operatório pós-operatório (FAV área endovascular atual pósoperatória operatória vida

Abstract: Introduction: quality indicators are clinical tools used to measure and qualify therapeutic interventions objectively. Objective: this study aims to measure previously established and validated quality indicators (QI) evaluating in-hospital treated urinary tract infections (UTI). Material and methods: this was a consecutive patient, observational, retrospective, descriptive, open clinical study. During two years, we assessed the adherence to eight QI, evaluating the empiric antimicrobial treatment and diagnostic follow-up of in-hospital treated adults diagnosed with community-acquired UTI. Results: a total of 78 cases were evaluated; a performance of 89.7% was observed for culture obtention, along a 46.2 and 48.7% national and international treatment guideline compliance, respectively. It is noted that a low compliance index was pointed out for the clinical condition-guided and microbiological study-guided treatment adjustment items (18.3-31.3% y 28.2-48.27%) but were probably impacted by the short in-hospital-stay average, which was < 72 h in 62% of the cases. Other indicators were deemed poorly assessable, such as selective quinolone use, urinary catheter exchange, renal function adjustment, and plasma concentration-guided adjustment. Conclusions: we conclude that comparing similar reports, QI compliance for community-acquired UTI treated in our institution is identical; nevertheless, there is still room for improvement concerning therapy adjustment practices.

Resumen: Introducción: los indicadores de calidad son herramientas utilizadas para medir y calificar objetivamente intervenciones terapéuticas. Objetivo: medir la adherencia a indicadores de calidad para evaluar el tratamiento de infecciones de vías urinarias (IVU) tratadas de manera intrahospitalaria. Material y métodos: se realizó un estudio clínico descriptivo, observacional, abierto y retrospectivo de pacientes consecutivos durante dos años; se identificó el cumplimiento de un set de ocho indicadores de calidad que evaluó el tratamiento antimicrobiano empírico y el abordaje diagnóstico de adultos internados con diagnóstico de IVU adquirida en la comunidad. Resultados: fueron incluidos y evaluados 78 casos, cumplieron con obtención de cultivos 89.7% de los casos, con adherencia a las guías de tratamiento nacionales e internacionales de 46.2 y 48.7%, respectivamente; se observó un bajo porcentaje de ajuste de terapia en concordancia con el estado clínico y estudios microbiológicos (18.3-31.3% y 28.2-48.27%, respectivamente), esto puede deberse en gran medida al corto tiempo de estancia intrahospitalaria promedio, < 72 h en 62% de los casos. Otros indicadores fueron pobremente evaluables, como el uso selectivo de quinolonas, el recambio del catéter urinario y el ajuste de la terapia a función renal o niveles séricos. Conclusiones: en comparación con reportes semejantes, la adherencia de indicadores de calidad para el tratamiento de IVU en esta institución es equiparable a otras y existen áreas que pueden mejorar en relación con el ajuste de la terapia.

ABSTRACT Objective. To characterize the sexual and reproductive health (SRH) services on offer to the Central American migrant population residing in shelters in Tijuana, Mexico, and identify barriers and facilitators of access to these services by this population, from the provider perspective. Methods. An observational, mixed, cross-sectional study was conducted. Different information collection techniques—consisting of 16 semi-structured interviews with civil-society providers of SRH services to the migrant population, as well as direct observation in 10 shelters in Tijuana—were employed and triangulated. A two-stage, open, selective coding process was carried out. Content analysis was then performed, using an interpretive approach based on five dimensions: approachability, acceptability, availability, affordability, and appropriateness. Results. The provision of SRH services is composed of four elements: target population, nature of providing organization (religious or secular), services offered, and venue of care. The main barriers to access involve irregular migrant status, the low priority given to SRH services, and the discrepancy between user preferences and the services offered. Among facilitating elements, lay/secular orientation of providers and inter-institutional coordination stood out. Conclusions. The provision of SRH services by civil society organizations is wide-ranging and heterogeneous. It ranges from strictly medical attention to other services that affect SRH indirectly, with a view to providing comprehensive care. This represents an opportunity in terms of aspects to facilitate access.

RESUMO Objetivo. Caracterizar a oferta de serviços de saúde sexual e reprodutiva (SSR) para a população migrante da América Central residente em abrigos em Tijuana, México; e identificar as barreiras e os facilitadores de acesso a esses serviços, para essa população, partindo da perspectiva dos prestadores. Métodos. Foi utilizado um delineamento observacional, misto e transversal. Diferentes técnicas de coleta de informações – consistindo em 16 entrevistas semiestruturadas com prestadores de serviços de SSR da sociedade civil para a população migrante, bem como observação direta em 10 abrigos em Tijuana – foram utilizadas e trianguladas. A codificação dos dados foi realizada em duas etapas, aberta e seletiva. Seguiu-se uma análise de conteúdo com uma abordagem interpretativa baseada em cinco dimensões: acessibilidade, aceitabilidade, disponibilidade, exequibilidade e oportunidade. Resultados. O tipo de oferta de serviços de SSR é composto por quatro elementos: população-alvo, orientação das associações e organizações prestadoras (religiosa ou laica), serviços oferecidos e local de atendimento. As principais barreiras durante o processo de acesso relacionam-se com a situação migratória irregular, a baixa prioridade dada à atenção à SSR e a discrepância entre as preferências dos usuários e os serviços ofertados. Entre os elementos facilitadores, destacaram-se a orientação leiga dos prestadores e a coordenação interinstitucional. Conclusões. A oferta de serviços de SSR por associações e organizações da sociedade civil é ampla e heterogênea. Abrange desde serviços assistenciais estritamente médicos até outros que incidem indiretamente na SSR, com vistas à integralidade do cuidado. Isso representa uma oportunidade em termos de aspectos facilitadores do acesso.

RESUMEN Objetivo. Caracterizar la oferta de servicios en salud sexual y reproductiva (SSR) para la población migrante centroamericana que se encuentra en albergues de Tijuana, México; e, identificar las barreras y facilitadores del acceso a estos servicios para esta población, desde la perspectiva de los proveedores. Métodos. Se realizó un estudio con un diseño observacional, mixto, transversal. Se consideró una triangulación de técnicas de recolección de información que consistió en 16 entrevistas semiestructuradas a proveedores de servicios de SSR de la sociedad civil para población en movilidad, y observación directa en 10 albergues de Tijuana. Se realizó una doble codificación, abierta y selectiva. El tipo de análisis fue de contenido con un enfoque interpretativo a partir de cinco dimensiones: accesibilidad, aceptabilidad, disponibilidad, asequibilidad y oportunidad. Resultados. El tipo de oferta de servicios en SSR se compone de cuatro elementos: población objetivo, orientación de las asociaciones y organizaciones (religiosa o laica), servicios ofertados y lugar de atención. Las principales barreras durante el proceso de acceso son: la condición migratoria irregular, la escasa prioridad al cuidado de la SSR y la discrepancia entre las preferencias de usuarios y los servicios ofertados. Entre los elementos facilitadores destaca la orientación laica de proveedores y la coordinación interinstitucional. Conclusiones. La oferta de servicios de SSR por parte de asociaciones y organizaciones civiles es amplia y heterogénea. Abarca servicios de atención estrictamente médica y otros que indirectamente inciden en la SSR con miras a la integralidad de la atención. Esto, representa una oportunidad en términos de aspectos facilitadores de acceso.

ABSTRACT Introduction: Pituitary apoplexy is a syndrome that occurs as a result of an ischemic or hemorrhagic lesion in the pituitary gland, leading to a deficiency of pituitary hormones. It manifests in the form of neurological deterioration with thunderclap headache as the main symptom, with meningeal irritation being an infrequent manifestation. Methods: We present the case of a 53-year-old woman with a history of prolactin-producing madroadenoma that began with headache, nausea and impaired level of consciousness. Incomplete hypopituitarism with normal cortisol level is detected. Cerebrospinal fluid (CSF) is consistent with an aseptic pleocytosis unresponsive to antibiotic therapy. It is associated with oculomotor paresis and a cranial MRI reveals bleeding in the pituitary adenoma with involvement of the cavernous sinus. Results: the initial suspicion is bacterial meningoencephalitis due to fever, stupor and CSF with pleocytosis, although no microorganism is identified and there is no response to antibiotics. CSF from stroke shows aseptic pleocytosis due to meningeal irritation of the subarachnoid space from bleeding and necrosis of the gland. Hypopituitarism can be partial or complete, selective deficiency being more frequent. ACTH deficiency deserves special attention due to the morbidity and mortality that adrenal failure entails. Ophthalmoparesis translates involvement of the cavernous sinus due to an increase in sellar pressure. Conclusions: We emphasize the importance of having a suspected diagnosis of apoplexy in case of an acute neurological condition, to direct the pertinent investigations with hormonal determination and thus initiate early replacement therapy and a neurosurgical approach if necessary; requiring a multidisciplinary management.

RESUMEN Introducción: La apoplejía hipofisaria es un síndrome que se produce como consecuencia de una lesión isquémica o hemorrágica en la glándula pituitaria dando lugar a un déficit de hormonas hipofisarias. Se manifiesta en forma de deterioro neurológico con cefalea en trueno como síntoma prínceps, siendo la irritación meníngea una manifestación infrecuente. Métodos: Presentamos el caso de una mujer de 53 años con antecedente de madroadenoma productor de prolactina que comienza con cefalea, náuseas y deterioro de nivel de consciencia. Se detecta un hipopituitarismo incompleto con nivel de cortisol normal. El líquido cefalorraquídeo (LCR) es consistente con una pleocitosis aséptica sin respuesta a terapias antibióticas. Asocia paresia oculomotora y una RM craneal revela sangrado en el adenoma hipofisario con compromiso de seno cavernoso. Resultados: la sospecha inicial es una meningoencefalitis bacteriana por la fiebre, estupor y LCR con pleocitosis, si bien no se identifica microorganismo y no hay respuesta a antibióticos. El LCR de la apoplejía muestra una pleocitosis aséptica por irritación meníngea del espacio subaracnoideo por el sangrado y la necrosis de la glándula. El hipopituitarismo puede ser parcial o completo, siendo más frecuente el déficit selectivo. Especial atención merece el déficit de ACTH por la morbimortalidad que conlleva el fallo adrenal. La oftalmoparesia traduce implicación de seno cavernoso por incremento en la presión selar. Conclusiones: Destacamos la importancia de tener una sospecha diagnóstica de apoplejía ante un cuadro neurológico agudo para dirigir las investigaciones pertinentes con determinación hormonal y así iniciar una terapia sustitutiva temprana y una actitud neuroquirúrgica en caso de ser necesaria; precisando un manejo multidisciplinar.