ABSTRACT The term 'stealthing' refers to non-consensual condom removal during sexual intercourse. This practice carried out against the will of the person who agreed to engage in sexual intercourse under specific modalities, such as the use of a condom, which, in turn, translates to a disruption in the consent. This article argues that in Chile the deficient regulation of sexual and reproductive rights wouldn't allow the bill about the non-consensual removal of the condom in a sexual intercourse respond to this phenomenon and its normalization. To develop this idea, has been reviewed the legal and jurisprudential situation of countries such as the United Kingdom, New Zealand, Germany, Netherlands, United States, Costa Rica and Colombia, as well as the pronouncement of international law on the sexual and reproductive rights. The article concludes that the lack of regulations on these rights encourages the normalization of sexually abusive behavior.

RESUMEN El término stealthing designa al retiro no consentido del preservativo durante una relación sexual. Esta práctica es realizada ante la negativa o con el desconocimiento de quien consintió tener relaciones sexuales bajo condiciones específicas, como el uso de condón, lo cual genera un quiebre en el consentimiento. Este artículo argumenta que en Chile la deficiente regulación de los derechos sexuales y reproductivos no permitiría que el proyecto de ley que busca sancionar la remoción no consentida del condón en una relación sexual dé respuesta a este fenómeno y su normalización. Para desarrollar esta idea se ha revisado tanto la situación normativa como la jurisprudencial de países como Reino Unido, Nueva Zelanda, Alemania, Países Bajos, Estados Unidos, Costa Rica y Colombia, al igual que el pronunciamiento del derecho internacional sobre los derechos sexuales y reproductivos. El artículo concluye que la falta de normativa sobre estos derechos insta a la normalización de conductas atentatorias contra la sexualidad y la reproducción.

SUMMARY: Studies have shown an association between homocysteine (Hcy) and several pathological conditions, including cardiovascular disease. However, the relationship between Hcy and testicular disorders is still unclear. The present study investigated the effects of Hcy on testicular structure. Thirteen adult Wistar albino rats were divided into two groups. The control group and the methionine group received an oral solution of L-methionine 200 mg /kg per day for six months. Blood samples and testes were collected for subsequent experiments. Serum levels of Hcy and testosterone were analyzed. We examined the histopathological and immunohistochemical localization of GATA-4, vimentin (VIM), connexin-43 (Cx-43), occludin (OCLN), androgen receptor (AR), estrogen receptor 1 (ESR1), estrogen receptor 2 (ESR2) in the rat testis. Results showed that rats receiving methionine showed a reduction in body and testicular weights. Histological and immunohistochemical examination of the testicular tissues of methionine group showed altered structure of seminiferous tubules with decreased immunoexpression of Cx-43, GATA-4, OCLN, VIM, AR, ESR1 and ESR2 compared to control. The results suggest that Hcy has a negative effect on the testes with a probable disruption of spermatogenesis.

RESUMEN: Estudios han demostrado una asociación entre la homocisteína (Hcy) y varias afecciones patológicas, incluidas las enfermedades cardiovasculares. Sin embargo, la relación entre Hcy y los trastornos testiculares aún no está clara. El presente estudio investigó los efectos de la Hcy sobre la estructura testicular. En este trabajo se dividieron trece ratas albinas Wistar adultas en dos grupos. El grupo de control y el grupo de metionina recibieron una solución oral de L-metionina 200 mg/kg por día durante seis meses. Se recogieron muestras de sangre y testículos para experimentos posteriores. Se analizaron los niveles séricos de Hcy y testosterona. Examinamos la localización histopatológica e inmunohistoquímica de GATA-4, vimentina (VIM), conexina-43 (Cx-43), ocludina (OCLN), receptor de andrógenos (AR), receptor de estrógeno 1 (ESR1) y receptor de estrógeno 2 (ESR2) en el testículo de la rata. Los resultados mostraron que las ratas que recibieron metionina presentaron una reducción en el peso corporal y testicular. El examen histológico e inmunohistoquímico de los tejidos testiculares del grupo de metionina mostró una estructura alterada de los túbulos seminíferos con una inmunoexpresión disminuida de Cx-43, GATA-4, OCLN, VIM, AR, ESR1 y ESR2 en comparación con el control. Los resultados sugieren que la Hcy tiene un efecto negativo sobre los testículos con una probable alteración de la espermatogénesis.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and subsequent coronavirus disease 2019 (COVID-19) had widespread disruptive consequences on various sectors including tertiary education. Universities were shut down and forced to introduce emergency remote teaching and learning. This coincided with the period where the authors of this article started advanced professorial training through the Future Professors Programme Phase 2, Cohort 1 (FPP). Like other educators, the authors experienced COVID-19-linked challenges and opportunities and decided to report on this through a review of the literature and reflective writing. While most publications between 2020 and now focused on the challenges and opportunities caused by the pandemic within the teaching and learning environment, challenges and opportunities experienced in the research environment were less reported on. Often, the findings presented also focused on one discipline or in single institutions. This meant that the responses to address pandemic-associated disruptions would be limited in its view and weighted to teaching and learning and specific discipline(s). Set against the background of the South African higher education (HE) system, the authors review how COVID-19 augmented existing challenges as well as how it presented opportunities for improved teaching, learning and research. This is done by providing context to the challenges and opportunities of not only teaching and learning but of the research environment whilst focusing on several disciplines and institutions. While there is an overlap in the COVID-19 experience within the five Institutions (UCT, UWC, UJ, NWU and TUT) in terms of challenges and opportunities, the impact on research was as devastating as it was on teaching and learning with unique scenarios applicable to the respective disciplines/institutions. The supplemental FPP training and teachings placed the authors in a unique position compared to our peers, in our approach to dealing with the academic disruption. While the pandemic had a general negative outlook for most academics, the FPPs programme better prepared the authors to reimagine and reshape our teaching, learning and research practices to face future pandemics.

ABSTRACT Since the transition to democracy, Panama has been characterized by its political and economic stability, which was based on a “transistist” consensus. We propose that this economic and political model is a Panamanian translation of what academia has called rentism in other countries. In 2023, however, it showed signs of a possible cracking of this solidity: on the one hand, the pre-electoral year showed strong signs of disarticulation of the party system as it was known; on the other hand, the most massive social protests of the democratic era took place. Indeed, with climate change and mining opportunities, some economic elites seem to be looking for alternatives to the historical economic model. This generates strong social tensions and could render inoperative the existing party system in the country, which existed precisely around this consensus on transitism.

RESUMEN Desde la transición a la democracia, Panamá se ha caracterizado por su estabilidad política y económica, que se basaba en un consenso transitista. Planteamos que este modelo económico y político es una traducción panameña de lo que la aca- demia ha nombrado rentismo en otros países. En 2023 sin embargo, se mostraron señales de posible resquebrajamiento de esta solidez: por un lado, el año preelec- toral mostró fuertes señales de desarticulación del sistema de partidos tal como se conocía; por otro lado, se desarrollaron las protestas sociales más masivas de la era democrática. Efectivamente, con el cambio climático y las oportunidades mineras, algunas élites económicas parecen buscar alternativas al modelo económico histó- rico. Esto genera tensiones sociales fuertes, y podría volver inoperante el sistema de partidos existente en el país, que existía precisamente en torno a este consenso ante el transitismo.

ABSTRACT Introduction: Burns are devastating injuries associated with high morbidity and mortality. A disruption of the immune system is developed, affecting the function of neutrophils and lymphocytes, first defensing line against pathogens. In order to evaluate the association between the Neutrophil to Lymphocyte Ratio, and the prognosis of the burn injurie, the investigation was performed. Methods: . A descriptive, longitudinal, prospective investigation was developed at the Burn Unit of Calixto García Hospital, from January 2022nd to December 2022nd. All severely burned patients admitted, with ages between 19 and 60 years old, and less than 24 hours from the onset of the accident were included. Patients suffering from chronic conditions were excluded. To determinate the levels of Neutrophil to Lymphocyte Rates, blood samples were taken at the first 72 hours after injury and during the 6th day. A relationship between the levels of Neutrophil to Lymphocyte Ratio, and the prognosis of the trauma was established. Of a total of 134 patients admitted, 36th were included. Results: Male patients were the majority. Fire the main etiological agent, and accidents the first production mode. High levels of Neutrophil to Lymphocyte Ratio were detected since the first 72 hours after trauma, and stayed high during the 6th day of evolution. Patients with poorest life prognosis, showed higher levels of Neutrophil to Lymphocyte Ratio. Conclusion: A direct relationship was found between the levels of Neutrophil- to Lymphocyte Ratio and the severity of the burn injury, and the survival rate.

RESUMEN Introducción: Las quemaduras son lesiones devastantes que se asocian a alta morbilidad y mortalidad. Se produce desbalance inmunológico, afectando los leucocitos, primera línea de defensa ante cualquier noxa, fundamentalmente los neutrófilos y linfocitos. Con el objetivo de evaluar el Índice Neutrófilos-Linfocitos en los lesionados severamente quemados, se realiza éste estudio. Método: . Estudio descriptivo, longitudinal y prospectivo, en el servicio de Caumatología del Hospital Universitario Calixto García, desde enero 2022 a diciembre 2022.Se incluyó a todos los ingresados clasificados como Grandes Quemados, con menos de 24 horas de evolución de la lesión, entre 19 a 60 años. Se excluyó a pacientes con enfermedades crónicas no transmisibles descompensadas. Se tomaron muestras de sangre venosa a las 72 horas y al 6to día post trauma, para determinar valores de Índice Neutrófilos Linfocitos. Se relacionaron dichos valores con el estado al egreso y con el Pronóstico de Vida. De un total de 134 ingresados, 36 cumplieron los criterios de inclusión. Resultados: . Predominaron los lesionados masculinos, el fuego directo el principal agente causal, y los accidentes prevalecieron sobre otros mecanismos de producción. El Índice Neutrófilos Linfocitos se elevó desde las primeras 72 horas de evolución, con valores mayores en los lesionados con peor pronóstico de vida, y en los egresados fallecidos. Conclusión: . Existió una asociación lineal entre los valores de Índice Neutrófilos/Linfocitos en lesionados egresados vivos y los que fallecieron, así como relación directamente proporcional con la gravedad de la lesión.

Resumo Quais ataques cibernéticos às infraestruturas críticas sofreu a Ucrânia entre fevereiro de 2022 e fevereiro de 2023 durante a guerra russo-ucraniana? Nos últimos meses, a Ucrânia vem sofrendo uma grande ofensiva de ataques cibernéticos às suas infraestruturas críticas. Assim, o objetivo deste trabalho é analisar quais ataques cibernéticos às infraestruturas críticas sofreu a Ucrânia dentro do recorte selecionado. Para isso, foi realizada uma pesquisa de método misto, que foi operacionalizada por meio de estatística descritiva, análise documental e revisão sistemática da literatura. Assim, a partir dos dados analisados do CyberPeace Institute, o setor mais atingido foi o de administração pública (66), enquanto a categoria de ataques mais utilizada foi de disrupção (139). Em seguida, avaliamos os tipos de ataques cibernéticos, sendo o mais utilizado o de tipo «DDoS» (135). Já na categoria de atores, a categoria «coletiva» (124), com destaque para o People’s CyberArmy (48), foi a de maior ocorrência. Em suma, concluímos que os ataques às infraestruturas críticas constituem uma questão de defesa nacional, sendo necessário revisar a legislação relacionada a esse tema e garantir que os órgãos responsáveis estejam preparados para enfrentar problemas futuros.

Abstract What cyberattacks did Ukraine’s critical infrastructure experience between February 2022 and February 2023 during the Russo-Ukrainian war? In recent months, Ukraine has experienced a significant increase in cyberattacks on its critical infrastructure. Therefore, the purpose of this study is to analyze the cyberattacks suffered by Ukraine’s critical infrastructure within the selected cutout. A mixed method research approach was used, operationalized through descriptive statistics, documentary analysis, and a systematic literature review. Based on the analyzed data from the CyberPeace Institute, the sector most affected was public administration (66), with the Disruption attack category being the most utilized (139). The types of cyberattacks were also evaluated, with the DDoS type being the most common (135). The collective (124), especially the People’s CyberArmy (48), was the most common in the actor category. In conclusion, we can say that attacks on critical infrastructure are a matter of national defense, which requires a revision of legislation on this issue and ensuring that the responsible bodies are prepared for future challenges.

ABSTRACT Introduction/framework/objectives The legislation gives the possibility for pregnant women with jobs where there are night shifts, to avoid doing them during this stage. However, sometimes the workers themselves question whether this has concrete scientific validity and what this could entail for themselves and their descendants. Not being a topic with much published literature, this review allows to consult a summary of the most up-to-date records at this level, in order to make assertive and scientific decisions regarding conditioning, as well as whether these should be mandatory or optional. Methodology This is a Bibliographic Review, initiated through a search carried out in May 2023 in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP”. Content Night shifts during pregnancy may be associated with greater family-work conflict, tiredness and sleep disturbance; as well as cancers, weight gain, diabetes, high blood pressure and other cardiovascular diseases; in addition to preterm delivery, low birth weight and congenital anomalies. Discussion and Conclusions Night shifts during pregnancy, especially if numerous and/or consecutive, seem to allow for some alterations, whose pathophysiology is reasonably explained/theorized. However, the probability and eventual severity of these issues must be considered by the pregnant woman herself, so that she (duly informed with regard to current medical knowledge on the subject) choose whether she wishes to continue to do some night shifts and, if so, how; since anxiety and disruption of routines can also be harmful, especially on an emotional and/or economic level (more prominently in companies where the pregnant woman has empathy with the tasks, the work team and/or I have a shared transport). It should be decided on a case-by-case basis, as a team, taking into account pregnant´s opinion. It would be interesting for professionals working in a hospital environment, in an institution that has Obstetric service, to focus a little on the topic, portraying the national reality and publishing their research in a magazine in the area, to disseminate knowledge. and national level, with international extrapolation.

RESUMO Introdução/enquadramento/objetivos A legislação consagra a possibilidade de as grávidas com postos de trabalho em que existam turnos noturnos, os evitem durante esta etapa. Contudo, por vezes, as próprias trabalhadoras questionam a validade científica concreta dessa medida e o que isso poderá acarretar para si e para a descendência. Não sendo um tema com muita bibliografia publicada, esta revisão permite consultar uma síntese do que mais atualizado se registou a este nível, de forma a se tomarem decisões assertivas e científicas em relação a condicionamentos, bem como se estes devem ser obrigatórios ou opcionais. Metodologia Trata-se de uma Revisão Bibliográfica, iniciada através de uma pesquisa realizada em maio de 2023, nas bases de dados “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina e RCAAP”. Conteúdo Os turnos noturnos durante a gravidez poderão associar-se a maior conflito família-trabalho, cansaço e perturbação do sono; bem como cancros, aumento de peso, diabetes, hipertensão arterial e outras doenças cardiovasculares; para além de parto pré-termo, baixo peso ao nascer e anomalias congénitas. Discussão e Conclusões Os turnos noturnos durante a gravidez, sobretudo se numerosos e/ou seguidos, parecem possibilitar algumas alterações, cuja fisiopatologia se encontra razoavelmente explicitada/teorizada. Contudo, a probabilidade e eventual gravidade dessas questões devem ser ponderadas pela própria grávida (devidamente informada relativamente aos conhecimentos médicos atuais), para que possa optar se deseja continuar a fazer alguns turnos noturnos e, em caso positivo, de que forma; uma vez que a ansiedade e perturbação de rotinas pode ser também perniciosa, sobretudo a nível emocional e/ou económico (com maior destaque em empresas onde a grávida tenha empatia com as tarefas e com a equipa de trabalho e/ou tenha meio de transporte partilhado). Caberá decidir caso a caso, em equipa, considerando a opinião da própria. Seria aliciante que profissionais a exercer em ambiente hospitalar, em instituição que tenha serviço de Obstetrícia, se debruçassem um pouco sobre o tema, retratando a realidade nacional e publicando a sua investigação em revista da área, para difusão de conhecimentos e nível nacional, com extrapolação internacional.

Abstract This article aims to report the research project on teaching practices mediated by ICT, taking into account its object and problem from the socio-educational conditions in which primary school is produced, with the intention of promoting debates around the current state of teaching in relation with ICT. The research investigates the teaching strategies the teachers develop based on the use of ICT, in primary schools in Río Negro. The qualitative methodological theoretical perspective reflects the institutional, discursive approaches and the pedagogical developments coming from ICT. It is likely that the meanings attributed to teaching practices are challenged by the context of ASPO. Modifications in the way of doing school, because of the emergence of disruption, introduce teaching practices that order the school in another way. The purpose of the research is to explore those other ways.

Resumen Este artículo se propone relatar el proyecto de investigación Prácticas de enseñanza mediadas por TIC, atendiendo a su objeto y problema desde las condiciones socioeducativas en que es producida la escuela primaria, con la intención de promover debates en torno a la actualidad de la enseñanza en relación con las TIC. La investigación indaga en las estrategias de enseñanza que los docentes elaboran con base en el uso de TIC, en escuelas primarias de Río Negro. La perspectiva teórica metodológica cualitativa trasunta los enfoques institucional, discursivo y los desarrollos pedagógicos provenientes de las TIC. Es probable que los sentidos que se les atribuyen a las prácticas de enseñanza se encuentren interpeladas por el contexto de ASPO. Las modificaciones en la forma de hacer escuela, a raíz de la emergencia de la disrupción, introducen prácticas de enseñanza que ordenan de otra manera lo escolar. El propósito de la investigación es explorar esas otras maneras.

Abstract Much is discussed about the climatic changes associated with regional or global atmospheric phenomena. Empiric evidence, however, only sometimes supports such claims even though it is necessary to visualize the strength of their effects and their relevance for the management and conservation agendas of those biosystems supporting the modern lifestyle. This work conducted a time series analysis with monthly precipitation data from the Monte Alto Protected Zone in Hojancha, Costa Rica, between May 2013 and November 2022. A disruption in the temporal pattern was detected in the rainy season of 2017, and it took about two years to return to the state observed back in 2013. Such disruption was linked to a cold period of the ENSO phenomenon, colloquially known as “La Niña”, and followed by a second disruption with an effect lasting until this moment. The data presented herein suggests that ENSO directly affects the precipitation pattern in the Monte Alto Reserve, whose original conservation purpose was to provide drinking water to local populations. The oscillations in the hydrological cycle, apparently more frequent in the last years based on the local context of this analysis, influence the quality of life of the affected populations and deserve monitoring for proper documentation and quantification intended to increase human resilience by means of adaptation.

Resumen Mucho se habla de los cambios climáticos producto de fenómenos atmosféricos de orden regional y global; sin embargo, no siempre se cuenta con evidencia relacionada a ellos. Esta comprobación científica es necesaria para visualizar la dimensión de su efecto y para sentar las bases de manejo y conservación de los servicios ecosistémicos que sustentan el estilo de vida moderno. En este trabajo, se ha hecho un análisis de series de tiempo del registro mensual de precipitación de la Zona Protectora Monte Alto en Hojancha, Costa Rica, para el periodo entre mayo 2013 y noviembre 2022. Se ha descubierto que una disrupción del patrón temporal de precipitación durante la temporada lluviosa del año 2017 tomó alrededor de dos años para regresar a lo observado en el año 2013. Tal disrupción estuvo directamente vinculada con un periodo frío del fenómeno ENSO, conocido coloquialmente como “La Niña” y fue seguida por otra disrupción similar, cuyo efecto continuó hasta finales del 2022. Los datos acá presentados sugieren que el fenómeno ENSO tiene un efecto directo sobre la precipitación de la Zona Protectora Monte Alto, cuya función original en el contexto local es la de proveer agua potable a las comunidades aledañas. Las oscilaciones con variabilidad extrema en el ciclo hidrológico, aparentemente más frecuentes en los últimos años en el contexto local de este análisis, tienen un efecto real sobre la calidad de vida de las poblaciones afectadas y merecen seguir siendo documentadas y cuantificadas para incrementar la resiliencia por adaptación de las sociedades afectadas.

Abstract: Nasal fracture is the most common type of facial fracture in modern populations, and is usually related to interpersonal violence. Nevertheless, this type of injury has been scarcely studied in bioanthropological field contexts. In this study, we characterized and discussed the oldest known Southern Patagonia individual presenting nasal fracture, among other lesions, most probably resulting from interpersonal violence. The nasal fossae and other skull bones from individual 2 from Orejas de Burro 1 site, dated to the Late Holocene, were reanalysed in order to study nasal fractures using a recent method developed by Magalhaes et al. (2020). Orejas de Burro 1-2- presented nine fractures, four of them in the nasal area and showing different timing: one postmortem, two perimortem, and one antemortem. The other facial lesions were four diastatic fractures and one in the fragile septum. The individual presented a high-energy injury resulting in intense bone disruption and displacement of nasal and facial bones produced by a lateral blow, which may be related to an episode of interpersonal violence. While some likely causes are regionally known, it is extremely difficult to assess cause of the injury and the blunt object associated with this episode, since this presents a situation of equifinality. This is one of the oldest cases in South America. It is also one of the first cases showing evidence of traumatic injury, possibly due to an episode of interpersonal violence. Rev Arg Antrop Biol 26(1), 077, 2024. https://doi.org/10.24215/18536387e077

Resumen: La fractura nasal es la lesión traumática facial más común en poblaciones modernas y se suele relacionar a violencia interpersonal. Sin embargo, este tipo de lesión ha sido poco estudiada en el ámbito de la antropología biológica. En este estudio, se caracteriza y discute la fractura nasal más antigua encontrada en Patagonia Austral, probablemente fruto de un evento de violencia interpersonal. Se ha reanalizado la cavidad nasal y otros huesos craneales mediante el método desarrollado por Magalhaes et al. (2020) del individuo 2 del sitio Orejas de Burro 1, datado en el Holoceno tardío. Este sujeto presenta nueve fracturas, cuatro de ellas en el área nasal producidas en distintos momentos: una postmortem, dos perimortem y una antemortem. Las otras lesiones faciales observadas son cuatro fracturas diastáticas y una en el septum. El individuo presenta una lesión de alta energía dando lugar a una ruptura y desplazamiento de los huesos nasales y faciales producidos por un golpe lateral, el cual puede estar relacionado con un episodio de violencia interpersonal. Sin embargo, y a pesar del conocimiento que se tiene de la región, es inverosímil y pretencioso apuntar una causa u objeto especifico causante de dicha lesión. El caso presentado es uno de los más antiguos de Sudamérica. Igualmente, es una de las primeras evidencias de lesión traumática causada por un posible evento de violencia interpersonal. Rev Arg Antrop Biol 26(1), 077, 2024. https://doi.org/10.24215/18536387e077

Abstract The finding of pneumoperitoneum has traditionally been a surgical emergency-indicative of gastrointestinal tract disruption requiring immediate surgical exploration; however, there are conditions involving non-surgical management. There were two cases of pneumoperitoneum in association with viral pneumonia (severe acute respiratory syndrome type 2 coronavirus [SARSCoV-2]) without a history of intestinal pneumatosis or another risk factor for spontaneous pneumoperitoneum that obtained a favorable outcome without surgical intervention. This is the second report of concurrent pneumoperitoneum and coronavirus disease of 2019 (COVID-19) in the literature. A brief review of this relationship and more recent data between pneumoperitoneum and the pathophysiological mechanism of SARS-CoV-2 was also included. This paper seeks to expand knowledge with these two cases to rethink, in part, the surgical dogma of pneumoperitoneum management and to lead the reader further from the pathophysiology point of view.

Resumen El hallazgo de neumoperitoneo ha sido tradicionalmente una urgencia quirúrgica indicativa de disrupción del tracto gastrointestinal que requiere exploración quirúrgica inmediata; sin embargo, existen condiciones que implican manejo no quirúrgico. Se presentan dos casos de neumoperitoneo en asociación con neumonía viral (coronavirus del síndrome respiratorio agudo grave de tipo 2 [SARS-CoV-2]) sin antecedentes de neumatosis intestinal ni otro factor de riesgo de neumoperitoneo espontáneo que obtuvieron un resultado favorable sin intervención quirúrgica. Este es el segundo informe de neumoperitoneo simultáneo y enfermedad por coronavirus de 2019 (COVID-19) en la literatura. También se incluye una breve revisión sobre esta relación y datos más recientes entre el neumoperitoneo y el mecanismo fisiopatológico del SARS-CoV-2. Este trabajo busca ampliar el conocimiento con estos dos casos para replantear, en parte, el dogma quirúrgico del manejo del neumoperitoneo y llevar al lector un poco más allá desde el punto de vista de la fisiopatología.

Abstract Objectives: Estimate the prevalence of dermatological manifestations in Mexican patients with common variable immunodeficiency. Methods: Cross-sectional and retrospective study, based on the analysis of records of patients with a diagnosis of common variable mmunodeficiency, treated at the Siglo XXI National Medical Center (Mexican Social Security Institute), according to the criteria of the European Society of Immunodeficiencies (ESID). and of which only 3 had a genetic diagnosis with the following mutations: IRF2, CTLA4 and PIK-3, belonging to the Immunodeficiency Clinic of the National Medical Center Siglo XXI (IMSS), to evaluate dermatological manifestations, review of laboratory tests: IgA, IgM, IgG and type of replacement therapy with Immunoglobulin. The statistical analysis was carried out with the SPSS program; Descriptive statistics were used to analyze the data, according to the type of variable to be analyzed. Results: 36 patients were included, of which 55.5% were women; with median age 34 years (18-94). The prevalence of dermatological manifestations was 70% (n = 25). 30.5% had a history of infectious dermatosis and 39.5% had a history of non-infectious dermatosis. The most common dermatosis was irritant contact dermatitis in 13.8% of patients. All received replacement therapy with human immunoglobulin, 33.3% intravenously and the rest subcutaneously. Conclusions: Common variable immunodeficiency is an inborn error of immunity, with different clinical manifestations in various organs and systems (the skin is one of these). Dermatological manifestations are not usually described in patients with common variable immunodeficiency; However, it is important to identify them due to their relationship with certain complications (increased risk of superinfection), due to skin disruption and biological therapies.

Resumen Objetivo: Estimar la prevalencia de manifestaciones dermatológicas en pacientes mexicanos con inmunodeficiencia común variable. Métodos: Estudio transversal y retrospectivo, fundamentado en el análisis de expedientes de pacientes con diagnóstico de inmunodeficiencia común variable, atendidos en el Centro Médico Nacional Siglo XXI (Instituto Mexicano del seguro Social), según los criterios de la Sociedad Europea de Inmunodeficiencias (ESID) y de los que solo 3 tenían diagnóstico genético con las siguientes mutaciones: IRF2, CTLA4 y PIK-3, ertenecientes a la Clínica de Inmunodeficiencias del Centro Médico Nacional Siglo XXI (IMSS), para evaluar las manifestaciones dermatológicas, revisión de exámenes de laboratorio: IgA, IgM, IgG y tipo de terapia de reemplazo con Inmunoglobulina. El análisis estadístico se ejecutó con el programa SPSS; para el análisis de los datos se utilizó estadística descriptiva, de acuerdo con el tipo de variable a analizar. Resultados: Se incluyeron 36 pacientes, de los que 55.5% correspondieron a mujeres; con mediana de edad 34 años (18-94). La prevalencia de anifestaciones dermatológicas fue de 70% (n = 25). El 30.5% tuvo antecedente de dermatosis infecciosa y 39.5% dermatosis no infecciosa. La dermatosis más frecuente fue dermatitis de contacto irritativa en 13.8% de los pacientes. Todos recibieron terapia de reemplazo con inmunoglobulina humana, 33.3% por vía intravenosa y el resto por vía subcutánea. Conclusiones: La inmunodeficiencia común variable es un error innato de la inmunidad, con diferentes manifestaciones clínicas en diversos órganos y sistemas (la piel supone uno de estos). Las manifestaciones dermatológicas no suelen describirse en pacientes con inmunodeficiencia común variable; sin embargo, es importante identificarlas por su relación con ciertas complicaciones (incremento del riesgo de sobreinfección), debido a la disrupción de la piel y terapias biológicas.

Abstract: The present work aims to examine the apparent benefits and effects of free trade based on the dynamics of the former General Agreement on Tariffs and Trade (GATT) and its successor, the World Trade Organization (WTO). The eminently ideological nature of the tax premises is denounced according to which its effects are intrinsically beneficial for developing and underdeveloped economies in the generality of the assumptions. In this sense, an attempt is made to demonstrate that the reference institutions have consistently perpetuated the drifts that the "center-periphery" analytical model historically denounced to the latter's detriment. The methodology used has involved a literature review of the GATT system and the international trade framework of the WTO, based on a critical examination of these in relation to the theses of both classical and contemporary structuralist economics. The study's results indicate that the multilateral trade system, along with the trade policies of hegemonic nations, through the functioning first of the GATT and then of the WTO, has resulted in endemically detrimental effects for peripheral economies. In this sense, the implications of this research suggest the need for a reexamination, both at the national and interregional levels, of the currently inequitable terms governing international trade, along with a more active promotion, at both levels, of development policies that prove to be beneficial for economically disadvantaged countries.

Resumen: El presente trabajo tiene como propósito examinar los aparentes beneficios y efectos del libre comercio a partir de la dinámica propia del que fuera el General Agreement on Tariffs and Trade (GATT) y su sucesora, la Organización Mundial de Comercio (OMC). Se denuncia el carácter eminentemente ideológico de las premisas tributarias según las cuales sus efectos son, en la generalidad de los supuestos, intrínsecamente provechosos para las economías en desarrollo y subdesarrolladas. En este sentido, se intenta demostrar que las instituciones de referencia han perpetuado consistentemente las derivas que el modelo analítico "centro-periferia" históricamente denunciara en detrimento de esta última. La metodología empleada ha consistido en la revisión bibliográfica del sistema GATT y el esquema de comercio internacional de la OMC, a partir de un examen crítico de estas últimas en función de las tesis de la economía estructuralista cepalina tanto clásica como contemporánea. Los resultados del estudio señalan que el sistema multilateral comercial y las propias políticas comerciales de las naciones hegemónicas, a través del funcionamiento primero del GATT y luego de la OMC, han supuesto efectos endémicamente disvaliosos para las economías periféricas. Las implicaciones de la presente investigación sugieren la necesidad del reexamen tanto en el ámbito nacional como interregional de los términos -actualmente poco equitativos- que rigen el comercio internacional, y de una promoción más activa, en ambos espacios, de aquellas políticas de desarrollo que sean provechosas para los países económicamente desfavorecidos. Clasificación JEL: F01; F12; F13; F53; F60; F63.

Abstract: Different aspects related to business dynamics motivate the design and execution of strategies. In the case of the Colombian hospitality industry, the recent price regulation, the emergence of disruptive technologies, and events affecting public health demonstrate the need to outline appropriate tactics that lead to an adequate contextualized implementation. This study proposes an Analytic Hierarchy Process (AHP) model to evaluate the set of tactics and strategies most applicable to these current situation alternatives faced by hoteliers in the city of Medellin. The results of the evaluation indicate that intensive, generic business and defensive strategies are the most preferred. In addition, as expected, the results suggest that the pandemic has the greatest weight and should therefore be selected by hotel companies as the priority alternative on which to focus their strategies. JEL classification: M10; H12; L10; Z30; Z31; Z32.

Resumen: Diferentes aspectos asociados a la dinámica empresarial motivan el diseño y ejecución de estrategias. En el caso de la industria hotelera colombiana, la reciente regulación de precios, el surgimiento de tecnologías disruptivas, así como los eventos que afectan la salud pública demuestran la necesidad de delinear tácticas apropiadas que lleven a una adecuada implementación contextualizada. Este estudio propone un modelo de análisis jerárquico de procesos (AHP) para evaluar el conjunto de tácticas y estrategias más aplicables a estas alternativas de situación actual que deben afrontar los hoteleros de la ciudad de Medellín. Los resultados de la evaluación indican que las estrategias intensivas, genéricas de negocio y defensivas son las preferidas. Adicionalmente, los hallazgos sugieren, como era de esperarse, que la pandemia tuvo el mayor peso y por lo tanto debe ser seleccionada por las empresas hoteleras como la alternativa prioritaria en la cual enfocar sus estrategias.

Abstract The structure of the Brazilian labor market underwent substantial changes throughout the 2010s. The low unemployment scenario, with a predominance of the participation of formal employment, observed in the 2000s, progressively deteriorated due to: the deceleration of the pace of growth in Brazil at the beginning of the decade; the 2015-2016 recession; the slow and inexpressive recovery of the post-2017 period; and the health, economic and social crisis caused by the Covid-19 pandemic of 2020. Such factors contributed to the process of disruption of the labor market, in a context of reaffirmation of structural characteristics and recurrence of phenomena such as high informality, high rates of unemployment, and significant labor underutilization. As result, we observed another lost decade in national economic history in dimensions as production, productivity, and labor. 2010s s scenario employment 2000s 20152016 2015 2016 2015-201 recession post2017 post 2017 post-201 period health Covid19 Covid 19 Covid-1 2020 informality underutilization result production productivity 2015201 201 2015-20 post201 post-20 Covid1 1 Covid- 202 201520 20 2015-2 post20 post-2 20152 2 2015- post2 post-

Resumo A estrutura do mercado de trabalho brasileiro passou por modificações substantivas ao longo dos anos 2010. O cenário de baixo desemprego, com dominância da participação do emprego formal, observado nos anos 2000, deteriorou-se progressivamente em função: da desaceleração do ritmo de crescimento do início da década; da recessão de 2015 e 2016; da lenta e inexpressiva recuperação do período pós 2017; e da crise sanitária, econômica e social, provocada pela pandemia da Covid-19 de 2020. Tais fatores contribuíram para o processo de desestruturação do mercado de trabalho, em um contexto de reafirmação de características estruturais e de recorrência de fenômenos como: alta informalidade, desemprego aberto elevado e expressiva subutilização da força de trabalho. Como resultado, observou-se mais uma década perdida na história econômica nacional em todas as dimensões: produção, produtividade e trabalho. JEL: E24, J24. 2010 formal 2000 deteriorouse deteriorou se função 201 2016 2017 sanitária social Covid19 Covid 19 Covid-1 2020 como informalidade resultado observouse observou dimensões produção JEL E24 E J24 J 200 20 Covid1 1 Covid- 202 E2 J2 2