ABSTRACT: This report described the use of acoustic radiation force impulse (ARFI) elastography in the diagnosis of two cases of canine malignant peripheral nerve sheath tumors. Both patients presented with lameness in the thoracic limb and no response to previous clinical treatment or trauma history. Physical examination revealed muscular atrophy in one of the thoracic limbs, in both dogs. B-mode axillary ultrasound showed the presence of a predominantly hypoechogenic, heterogeneous, irregular, nonencapsulated nodule with adjacent reactivity, measuring approximately 20.1 mm x 15.4 mm in the first case and 18.3 mm x 10.7 mm in the second. ARFI elastography was performed, showing areas of significant stiffness, with an average shear wave velocity of 4.12 m/s (case 1) and 4.35 m/s (case 2), suggesting malignancy. In both cases, the affected limb was amputated, and the tumors sent for histopathological analysis, which were; subsequently, diagnosed as malignant tumors of the peripheral nerve sheath. The ultrasonographic methods used were essential in the diagnosis and therapeutic conduct. ABSTRACT (ARFI history limbs dogs Bmode B mode hypoechogenic heterogeneous irregular reactivity 201 20 1 20. 154 15 4 15. 183 18 3 18. 107 10 7 10. second performed stiffness 412 12 4.1 ms m s 435 35 4.3 2, 2 , 2) malignancy amputated analysis subsequently conduct 41 4. 43

RESUMO: O objetivo deste relato é descrever o auxílio da elastografia por impulso de força de radiação acústica (ARFI) no diagnóstico de dois casos de tumores malignos da bainha dos nervos periféricos em canídeos. Ambos os pacientes apresentavam claudicação em membro torácico e já haviam sido tratados clinicamente por outros profissionais, sem resposta ao tratamento ou histórico de trauma. Ao exame físico, foi observada atrofia muscular em apenas um dos membros torácicos, nos dois casos. Foi realizado exame ultrassonográfico axilar. Na avaliação modo B, foi observada a presença de estrutura nodular, predominantemente hipoecogênica, heterogênea, irregular, não encapsulada e com reatividade adjacente, medindo aproximadamente 20.1 mm x 15.4 mm no primeiro caso e 18.3 mm x 10.7 mm no segundo caso. Foi realizada elastografia ARFI, demonstrando a presença de áreas de maior rigidez, com velocidade de ondas de cisalhamento média de 4.12 m/s (caso 1) e 4.35 m/s (caso 2), sugerindo malignidade. Em ambos os casos, foi realizada amputação do membro afetado e os nódulos removidos foram encaminhados para análise histopatológica, na qual se obteve o diagnóstico de tumor maligno da bainha de nervo periférico. Os métodos ultrassonográficos realizados nesses casos foram essenciais para o diagnóstico e conduta terapêutica. RESUMO ARFI (ARFI canídeos profissionais trauma físico torácicos axilar B nodular hipoecogênica heterogênea irregular adjacente 201 20 1 20. 154 15 4 15. 183 18 3 18. 107 10 7 10. rigidez 412 12 4.1 ms m s 435 35 4.3 2, 2 , 2) malignidade histopatológica periférico terapêutica 41 4. 43

Deur die eeue heen moes instellings soos universiteite dikwels hervormings ondergaan as gevolg van beduidende veranderinge of onstabiliteit. Die einde van die 20ste eeu is gekenmerk deur 'n nuwe golf van hervorming, wat steeds voortduur. Hierdie hervormings is aangepor deur faktore soos die massifikasie van universiteite, oproepe tot dekolonialisering en tegno-logiese veranderinge in die 21ste eeu. Die vraag, Wat is 'n universiteit? of Wat behoort 'n universiteit te wees?, het as gevolg hiervan ontstaan. Verder het die hervormingstydperk aan-leiding gegee tot indringender geskiedkundige studies oor die ontstaan en ontwikkeling van universiteite. Om die totstandkoming van die eerste universiteite beter te verstaan, speel stigtings-dokumente en agtergrondinligting van die universiteit 'n belangrike rol. Wanneer die wese van die universiteit ondersoek word, is dit belangrik om die ontstaan van die Middeleeuse universiteit te bestudeer. Wat Middeleeuse universiteite uniek maak, is die ontwerp van 'n model wat wêreldwyd in gebruik geneem is. Teen dié agtergrond is die navorsingsvraag van hierdie artikel: Wat is die faktore wat tot die totstandkoming van die Middeleeuse universiteit as instelling bygedra het? Verskeie faktore, soos die gildestelsel, ekonomiese welvaart en intellektuele ontwikkeling in Europa gedurende die laat Middeleeue, erkenning van die universiteit deur owerhede en die stabilisering van die universiteit deur die formulering van reëls en statute oor hoe 'n universiteit moet funksioneer, is met behulp van navorsing geïdentifiseer. Hierdie faktore was ook aanwesig tydens die stigting van een van die eerste universiteite, en die effek daarvan op byvoorbeeld een van hierdie oudste universiteite, naamlik Bologna word ook in hierdie artikel bespreek. Faktore wat bygedra het tot die totstandkoming van die Middeleeuse universiteit is steeds van toepassing op moderne universiteite en behoort as minimum vereistes beskou te word.

Over the centuries, institutions such as universities have often undergone reforms as a result of significant societal changes or instability. It can be compared to a school system which, when it is functioning well, undergoes no substantial change, but when there is disorder, reform becomes inevitable. The university is an age-old institution that has undergone several reforms to adapt to changing times and challenges. The most prominent university reforms occurred in the late 1800s during the development of the German or Von Humboldt university model. These reforms coincided with a reassessment of the origins and essence of the university, as outlined in Rashdall's major work, The Universities of Europe in the Middle Ages (1895), and Newman's The Idea of a University (1852). Towards the end of the twentieth century, a new wave of reform began, which continues to this day. These reforms were spurred on by factors such as the massification of universities, calls for decolonisation and significant technological changes of the 21st century. Questions such as What is a university? or What should a university be? arose as a result of these changes. This period of reform also gave rise to new historical studies on the origin and development of universities. A natural reaction for any institution drifting away from its core functions is to return to its origins. In this context, founding documents and background information regarding the establishment of an institution play a decisive role. In South Africa, with the significant increase in newly private established higher education institutions over the past decade, the question of the essence of the university is highly relevant. When examining the essence of a university, it is essential to consider Medieval universities. Although Medieval universities would not be considered universities in today's context, they were nevertheless indispensable for the scientific progress of that time. What made medieval universities unique was that they had designed a model that was used worldwide. Even ancient higher education institutions adopted the title of"university". Against this background, the research question of this article is: What are the factors that contributed to the establishment of the medieval university as an institution? A comprehensive literature review was conducted to examine existing knowledge on the subject. This study included influential publications such as Rashdall's The Universities of Europe in the Middle Ages (1895), Haskins's The Rise of the Universities (1923), Cobban's The Medieval Universities: Their Development and Organization (1975), Rüegg's A History of the University in Europe (2004) and Janin's The University in Medieval Life (2014). Relevant background information on the social, economic and cultural context of the Middle Ages as well as the role of ecclesiastical and secular authority structures and the promotion of higher education in a period ofsocial and intellectual change were studied. Primary sources, such as the statutes and founding documents of the first medieval universities, have been analysed to gain insight into their structure, functions and tasks. Several factors, such as the guild system, economic prosperity and intellectual development in Europe during the later Middle Ages, recognition of the university by authorities and the stabilisation of the university through the formulation of rules and statutes on how a university should function, leading to the foundation of the medieval university have been identified by means of this research. These factors were also present during the founding of the first universities, and their effect on, for example, the oldest university, namely Bologna, is also discussed in this article.The concept, universitas magistrorum et scholarium - a community of students and masters - arose as a result of the guild system and formed an integral part of the original universities. Although modern universities offer a wider spectrum of disciplines and perform various other functions, such as research and public service, it is still crucial that the core, namely the exchange of knowledge, is preserved despite administrative and research pressure on lecturers, as well as technological changes, although technology can also improve the relationship between lecturers and students. As already indicated, the economic boom and intellectual development in Europe during the Middle Ages contributed to the establishment of the first universities. Economic prosperity of a community is extremely important as it provides financial support for the establishment and maintenance of a university, as well as for many prospective students and lecturers. Such an economic base creates a favourable climate for encouraging interest in culture and the acquisition of knowledge, emphasising the need for higher education, such as universities. Recognition of the university as an institution by the pope and emperors gave universities the opportunity to expand and develop their individuality as an institution. University regulation continues to play a crucial role in the integrity of a particular institution, emphasising the necessity of participation in quality assurance practices by regulatory bodies as these are of significantl benefit to a university. Finally, the medieval university would not have developed into today's unique, influential institution without going through the stabilisation phase, which was characterised by the formulation of rules and statutes. This phase is equally important for the modern university in continuing high quality teaching. The same applies to factors that contributed to the establishment of the medieval university which should be considered as minimum requirements. In summary, factors that influenced the development of the medieval university remain fundamental to contemporary universities, which should be preserved despite continuous changes and challenges.

SUMMARY: There exists a scarcity of neurocognitive research that has successfully used electrophysiology as an objective tool to assess different learning modalitiesthat are commonly used in anatomy. The objective of this study was to explore the trend in the expression of brain waves in medical students when using different didactic strategies in learning anatomy. An exploratory, observational, cross-sectional study was conducted on 22 first- semester medical students in anatomy. Using didactic strategies with different pedagogical tools such as biological models (human skulls and pig hearts) and/or digital application (Visible Body software), and different evaluation methods, students were grouped into three groups: "EOR1" students who learned using a skull and were evaluated with it; "EOV1" students who learned using a pig heart and were evaluated with the Visible Body software; and "EOV2" for students who learned through the Visible Body software and were evaluated with it. During the evaluation, each student was monitored in real-time using an electroencephalogram and the Emotiv EPOC brain-computer interface system to record the electro-physiological activity of beta (B), theta (T), and gamma (G) waves. The data obtained (the trend of the electrical activity of each wave and its relationship with students' performance in each didactic strategy) were analyzed using Pearson's correlation coefficient. Groups EOR1 and EOV1 had satisfactory results in their evaluations and showed a predominance of B waves (x=67.33) and T waves (x=57.67). Additionally, a strongly positive correlation (r=0.82) was found between the presence of B waves and the duration of T waves. Students who used three-dimensional biological models as a pedagogical tool showed a predominance of B and T waves, which are associated with sensorimotor and exploratory learning necessary for studying anatomy.

RESUMEN: Son escasos los estudios de neurociencia cognitiva que permitan comprender, de manera objetiva, las manifestaciones electrofisiológicas de los estudiantes de medicina expuestos a diferentes herramientas pedagógicas utilizadas en el área de anatomía. El objetivo de este trabajo fue explorar la tendencia en la expresión de las ondas cerebrales de estudiantes de medicina, al utilizar diferentes estrategias didácticas en el aprendizaje de la anatomía. Se realizó un estudio exploratorio, observacional, de corte transversal en 22 estudiantes de medicina de primer semestre en anatomía. Utilizando estrategias didácticas con diferentes herramientas pedagógicas; como modelos biológicos (cráneos humanos y corazones porcinos) y/o aplicación digital (software Visible Body (SVB)), y diferente método de evaluación, se agruparon los estudiantes en tres grupos: “EOR1” estudiantes que aprendieron usando un cráneo y se evaluaron con este, “EOV1” estudiantes que aprendieron usando un corazón porcino y fueron evaluados con el SVB, y “EOV2” para los estudiantes que aprendieron a través del SVB y fueron evaluados con este. Durante la evaluación, cada estudiante fue monitorizado en tiempo real, utilizando un electroencefalograma y el sistema interfaz cerebro - computadora Emotiv EPOC para registrar la actividad electrofisiológica de las ondas beta (B), theta (T) y gamma (G). Los datos obtenidos (tendencia de la actividad eléctrica de cada onda y su relación con el desempeño de los estudiantes en cada estrategia didáctica) fueron analizados usando el índice de correlación de Pearson. Los grupos EOR1 y EOV1, tuvieron resultados satisfactorios en sus evaluaciones y presentaron predominio de ondas B (X=67,33) y T (X=57,67), además, se evidenció una correlación fuertemente positiva (r=0,82) entre la presencia de B y el tiempo de permanencia de T. Los estudiantes que utilizaron modelos biológicos tridimensionales como herramienta pedagógica presentaron predominio de las ondas B y T, asociadas con aprendizajes sensoriomotores y de tipo exploratorio necesarios para el estudio en anatomía.

RESUMEN La era digital ha traído consigo nuevas formas de comunicación y difusión de la información. Dentro del campo científico, la divulgación de la ciencia ha recurrido a nuevos espacios sociales para comunicar sus hallazgos. Sin embargo, aunque la producción científica aumentó durante la pandemia de covid-19, en el ámbito científico se agravó la brecha de género existente en el entorno social. Se realizó una investigación mixta, descriptiva-correlacional y transversal, enfocada en el análisis de 13 165 publicaciones de 17 divulgadores científicos, hombres y mujeres que se caracterizan como microinfluencers de la red social Twitter/X que fueron publicadas entre marzo y junio de 2020 (durante la primera ola de covid-19). Las principales conclusiones muestran que las mujeres comunicadoras científicas estudiadas producen menos contenido propio que sus pares hombres, además de tener métricas más desventajosas; asimismo, hombres y mujeres presentan métricas opuestas de comentarios y relevancia. De la misma forma, al inicio de la pandemia, cuando un hombre y una mujer con el mismo número de seguidores publicaban, si uno de ellos adquiría más favs o retuits, el otro adquiría más comentarios, y viceversa. Finalmente, se destaca que es necesario un enfoque de género que permita reconocer la diferencia de labores entre científicos hombres y mujeres en la ciencia y en la propia divulgación científica.

ABSTRACT The digital age has brought with it new forms of communication and dissemination of information. Within the scientific field, the popularization of science has resorted to new social spaces to communicate its findings. However, although scientific production increased during the covid-19 pandemic, the existing gender gap in the social environment was aggravated in the scientific field. A mixed, descriptive-correlational and cross-sectional research was carried out, focused on the analysis of 13,165 publications of 17 scientific disseminators -men and women who are characterized as micro-influencers of the social network Twitter/X that were published between March and June 2020 (first wave of covid19). The main conclusions show that the women scientific communicators studied produce less of their own content than their male peers, in addition to having more disadvantaged metrics; Likewise, men and women present opposite metrics of comments and relevance. In the same way, at the beginning of the pandemic, when a man and a woman with the same number of followers published, if one of them acquired more favs or retweets, the other acquired more comments, and vice versa. Finally, it is highlighted that a gender approach is necessary that allows recognizing the difference in work between male and female scientists in science and in scientific dissemination itself.

RESUMEN El golpe de calor es una condición médica grave que puede provocar falla orgánica múltiple, e incluso la muerte, si no se identifica e interviene oportunamente. El objetivo es sintetizar narrativamente la mejor evidencia disponible respecto a la prevención, diagnóstico y tratamiento del golpe de calor. Se realizó una búsqueda sistemática en Pubmed/MEDLINE y en repositorios de organismos elaboradores de documentos normativos. Se incluyeron cuatro guías de práctica clínica y ocho documentos técnicos. El diagnóstico golpe de calor se basa en una temperatura corporal superior a 40°C acompañada de síntomas clínicos. La prevención se enfoca en el autocuidado, evitando la exposición excesiva al calor, manteniendo una correcta hidratación y utilizando ropa adecuada. En caso de golpe de calor, es esencial trasladar al paciente a un entorno fresco, hidratarlo y aplicar métodos de enfriamiento físico. El tratamiento se organiza en dos fases. La primera es la prehospitalaria, que incluye la estabilización, enfriamiento pasivo y líquidos intravenosos. La segunda es la hospitalaria, donde se continúa el enfriamiento hasta alcanzar los 39°C en la temperatura rectal. Se deben administrar líquidos para soporte hemodinámico y evitar los antipiréticos. En conclusión, la presente revisión narrativa ha identificado estrategias para el diagnóstico, prevención y tratamiento del golpe de calor, basado en la mejor evidencia disponible.

ABSTRACT Heat stroke is a serious medical condition that can lead to multiple organ failure and even death if not identified and intervened in a timely manner. The objective is to narratively synthesize the best available evidence regarding the prevention, diagnosis and treatment of heat stroke. A systematic search was conducted in Pubmed/MEDLINE and in repositories of standard-setting bodies. Four clinical practice guidelines and eight technical documents were included. The diagnosis of heat stroke is based on a body temperature above 40°C accompanied by clinical symptoms. Prevention focuses on self-care, avoiding excessive exposure to heat, maintaining proper hydration and wearing appropriate clothing. In case of heat stroke, it is essential to move the patient to a cool environment, hydrate and apply physical cooling methods. Treatment is organized in two phases. The first phase is pre-hospital, which includes stabilization, passive cooling and intravenous fluids. The second phase is the hospital phase, where cooling is continued until a rectal temperature of 39°C is reached. Fluids should be administered for hemodynamic support and antipyretics should be avoided. In conclusion, the present narrative review has identified strategies for the diagnosis, prevention and treatment of heat stroke, based on the best available evidence.

RESUMEN El propósito del estudio fue describir las características del síndrome inflamatorio multisistémico asociado a COVID-19 (SIM-C) en los primeros tres años de pandemia en niños de un hospital pediátrico del Perú. Se realizó un estudio observacional, descriptivo con datos de 73 pacientes y se describieron las características clínicas, laboratoriales, tratamiento y complicaciones según la ola de la pandemia y si tuvieron shock. La mediana de edad fue 6 años, las manifestaciones gastrointestinales y mucocutáneas fueron frecuentes en las tres olas. El fenotipo similar a enfermedad de Kawasaki se presentó en 34 (46,6%) pacientes y 21 (28,8%) pacientes desarrollaron shock. El tratamiento más usado fue la inmunoglobulina (95,9%), ácido acetil salicílico (94,5%) y corticoide (86,3%). Cinco (7%) pacientes tuvieron aneurisma coronario y 17 (23,3%) ingresaron a la unidad de cuidados intensivos (UCI). Los pacientes con shock tuvieron mayor alteración laboratorial y necesidad de ventilación mecánica. En conclusión, el SIM-C ha disminuido en los primeros tres años de pandemia posiblemente por la vacunación de COVID-19 en niños.

ABSTRACT This study aimed to describe the characteristics of multisystemic inflammatory syndrome associated with COVID-19 (MIS-C) in the first three years of the pandemic in children in a pediatric hospital in Peru. We conducted an observational, descriptive study with data from 73 patients and described the clinical and laboratory characteristics, treatment and complications according to the wave of the pandemic and whether they had shock. The median age was 6 years, gastrointestinal and mucocutaneous manifestations were frequent in the three waves. Kawasaki disease-like phenotype was present in 34 (46.6%) patients and 21 (28.8%) patients developed shock. The most commonly used treatment was immunoglobulin (95.9%), followed by acetylsalicylic acid (94.5%) and corticosteroid (86.3%). Five (7%) patients had coronary aneurysm and 17 (23.3%) were admitted to the intensive care unit (ICU). Patients with shock had greater laboratorial alteration and need for mechanical ventilation. In conclusion, MIS-C has decreased in the first three years of the pandemic, possibly due to COVID-19 vaccination in children.

ABSTRACT Starting from the decline in intentional homicide in Mexico during 2023, this article analyzes the roots of the violence crisis that has plagued the country for more than fifteen years. In particular, it seeks to answer the question of the factors, events, or conditions that triggered homicidal violence in Mexico starting in 2007. The article collects the main hypotheses proposed on this issue and reviews their explanatory scope. These hypotheses are divided into three groups. The first consists of government actions that had unintended effects. These include the deployment of military operations in various regions of the country starting in December 2006, the implementation of the kingpin strategy, which involves targeting and arresting high-level drug cartel leaders, and the tightening of drug interdiction mechanisms for drugs coming from South America. The second group consists of specific events related to the proximity to the United States. These include the increase in ex-convicts deported from the United States, the rise in the number of firearms coming from the United States, and the increase in the price of cocaine. Finally, references are made to more structural conditions that preceded 2007. Specifically, political alternation and the crisis of local order manifested by the poor state of local police forces and long-term socio-economic explanations. To bring the discussion to the present moment, specifically to the year 2023, the last part of the text offers a reflection on the persistence of these factors and the future challenges that Mexico faces. This section focuses on two issues that are added to the topics reviewed in the first part of the article: the wave of migration that spread throughout 2023 and the incursion of fentanyl into the national drug market, which was exacerbated in the years following the COVID-19 epidemic.

RESUMEN Tomando como punto de partida el descenso del homicidio doloso en México durante el año 2023, este artículo analiza las raíces de la crisis de violencia que acontece en el país desde hace más de quince años. En particular, busca responder a la pregunta sobre los factores, eventos o condiciones que detonaron la violencia homicida en México a partir del año 2007. El artículo recolecta las principales hipótesis planteadas al respecto y revisa su alcance explicativo. Grosso modo éstas se dividen en tres grupos. El primero está constituido por acciones gubernamentales que tuvieron efectos no deseados. Estos son el despliegue de operativos militares en distintas regiones del país a partir de diciembre de 2006; la ejecución de la estrategia de detención de capos conocida como Kingpin Strategy y el endurecimiento de los mecanismos de interdicción de drogas provenientes de América del Sur. El segundo grupo lo forman eventos específicos relacionados a la colindancia con Estados Unidos. Éstos son aumento de ex convictos deportados de Estados Unidos, crecimiento en el número de armas provenientes de Estados Unidos y alza en el precio de la cocaína. Por último, se hace referencia a condiciones más estructurales que anteceden al 2007. En específico la alternancia política y crisis del orden local manifestado por el pobre estado de las policías locales, así como explicaciones socioeconómicas de largo alcance. Con la finalidad de llevar la discusión al momento actual, en específico al año 2023, la última parte del texto ofrece una reflexión sobre la persistencia de estos factores y los retos hacia el futuro que enfrenta México. Esta sección se centra en dos temas que se agregan a las temáticas revisadas en la primera parte del artículo: la ola migratoria que se extendió a lo largo de todo el 2023 y la incursión del fentanilo en el mercado nacional de drogas potenciada en los años que siguieron a la epidemia de COVID-19.

Resumen El trabajo tuvo como objetivo determinar las microestructuras en la interfase y propiedades mecánicas de una soldadura por explosión del acero inoxidable AISI 304 y al carbono AISI 1010. Para el proceso de conformación por embutido y de la soldadura disímil del casquete esférico se utilizó una estampa, donde luego de conformado, se seleccionó como área de análisis el borde y la curvatura del mismo. Con el software SOLIDWORD se estableció la ocurrencia de la deformación y las tensiones durante el proceso. Se determinó que, la unión metalúrgica se logra con una interfase ondulada, la cual difiere de su formación en dependencia de la distancia en que ocurre la detonación, lo cual favorece el compactamiento metalúrgico, donde se origina la formación de ferrita equiaxial en el AISI 1010 y de austenita y martensita en el AISI 304, pero con tamaño de granos más pequeños producto de la onda de choque expansiva, así como la presencia de carburos del tipo M7C3 o Cr23C6. La variación de dureza determinada de 300 HV para el primero y de 450 HV en el segundo, se debe al apilamiento de los granos por deformación plástica. Las mayores deformaciones y tensiones en el casquete esférico ocurren en el radio inferior (fondo), las que se expanden hasta la pared de la estampa.

Abstract The objective the work was to determine the microstructures at the interface and mechanical properties of an explosion welding AISI 304 stainless steel and AISI 1010 carbon steel. For the drawing forming process and the dissimilar welding of the spherical cap, a stamp was used, where after forming, the edge and its curvature were selected as the analysis area. With SOLIDWORD software, the occurrence of deformation and stresses during the process was established. It was determined that the metallurgical union is achieved with a wavy interface, which differs from its formation depending on the distance at which the detonation occurs, which favors metallurgical compaction, where the formation of equiaxial ferrite in the AISI 1010 originates. And austenite and martensite in AISI 304, but with smaller grain sizes as a result the expansive shock wave, as well as the presence of carbides of the M7C3 or Cr23C6 type. The determined hardness variation of 300 HV for the first and 450 HV in the second is due to the stacking of the grains due to plastic deformation. The greatest deformations and stresses in the spherical cap occur in the lower radius (bottom), which expand to the wall of the stamp.

RESUMEN Introducción. La emergencia de COVID-19 causó una pandemia con gran impacto en la mortalidad en Perú. Objetivo. Analizar la magnitud de la mortalidad por COVID-19 e identificar algunas características sociodemográficas. Métodos. Se realizó un estudio descriptivo de tipo ecológico, se analizaron los datos de muertes por COVID-19 durante el periodo 2020-2023, así como indicadores socioeconómicos y demográficos de acceso público. Las variables incluidas en el estudio fueron año de defunción, número de muertes, sexo, grupo etario, provincia de procedencia, región natural, macrorregión, índice de desarrollo humano (IDH), necesidades básicas insatisfechas (NBI) y densidad poblacional. Resultados. Se reportaron 220628 muertes por la COVID-19, de las cuales, 219374 (99,43%) ocurrieron durante la pandemia y 1254 (0,57%) en periodo pospandemia. La tasa de mortalidad acumulada fue de 6,76 muertes/1000 habitantes. La curva de muertes por COVID-19 muestra que entre el 2020-2023 ocurrieron cinco olas siendo la de mayor mortalidad la segunda, seguida por la primera ola. La mortalidad predominó en hombres, adultos mayores (69,77%) y adultos (28,11%). La macrorregión de Lima Metropolitana y Callao tuvo las más altas tasas de mortalidad con 9,36 muertes/1000 habitantes. Las provincias con mayores tasas de mortalidad acumulada fueron las ubicadas en la costa, en quintiles con menos NBI, en quintiles de mayor IDH y en aquellas provincias con mayor densidad poblacional. Conclusiones. La pandemia COVID-19 causó elevada mortalidad en Perú, siendo mayor en varones, adultos mayores, de ciudades de costa, de mayor densidad poblacional y mejores indicadores socioeconómicos.

ABSTRACT Introduction. The COVID-19 emergency caused a pandemic with a great impact on mortality in Peru. Objective. To analyze the magnitude of mortality due to COVID-19 and identify some sociodemographic characteristics. Methods. A descriptive ecological study was carried out, analyzing data on deaths due to COVID-19 during the period 2020-2023, as well as publicly accessible socioeconomic and demographic indicators. The variables included in the study were: year of death, number of deaths, sex, age group, province of origin, natural region, macroregion, human development index (HDI), unmet basic needs (UBN) and population density. Results. 220,628 deaths due to COVID-19 were reported, of which 219,374 (99.43%) occurred during the pandemic and 1,254 (0.57%) in the post-pandemic period; The cumulative mortality rate was 6.76 deaths/1000 inhabitants. The COVID-19 death curve shows that between 2020-2023, five waves occurred, with the second wave having the highest mortality, followed by the first wave. Mortality predominated in men, older adults (69.77%) and adults (28.11%). The macroregion of Metropolitan Lima and Callao had the highest mortality rates with 9.36 deaths/1000 inhabitants. The provinces with the highest cumulative mortality rates were those located on the coast, in quintiles with less NBI, in quintiles with a higher HDI and in those provinces with a higher population density. Conclusions. The COVID-19 pandemic caused high mortality in Peru, being higher in males, older adults, from coastal cities, with higher population density and better socioeconomic indicators.

RESUMEN El propósito del estudio fue describir las características del síndrome inflamatorio multisistémico asociado a COVID-19 (SIM-C) en los primeros tres años de pandemia en niños de un hospital pediátrico del Perú. Se realizó un estudio observacional, descriptivo con datos de 73 pacientes y se describieron las características clínicas, laboratoriales, tratamiento y complicaciones según la ola de la pandemia y si tuvieron shock. La mediana de edad fue 6 años, las manifestaciones gastrointestinales y mucocutáneas fueron frecuentes en las tres olas. El fenotipo similar a enfermedad de Kawasaki se presentó en 34 (46,6%) pacientes y 21 (28,8%) pacientes desarrollaron shock. El tratamiento más usado fue la inmunoglobulina (95,9%), ácido acetil salicílico (94,5%) y corticoide (86,3%). Cinco (7%) pacientes tuvieron aneurisma coronario y 17 (23,3%) ingresaron a la unidad de cuidados intensivos (UCI). Los pacientes con shock tuvieron mayor alteración laboratorial y necesidad de ventilación mecánica. En conclusión, el SIM-C ha disminuido en los primeros tres años de pandemia posiblemente por la vacunación de COVID-19 en niños.

ABSTRACT This study aimed to describe the characteristics of multisystemic inflammatory syndrome associated with COVID-19 (MIS-C) in the first three years of the pandemic in children in a pediatric hospital in Peru. We conducted an observational, descriptive study with data from 73 patients and described the clinical and laboratory characteristics, treatment and complications according to the wave of the pandemic and whether they had shock. The median age was 6 years, gastrointestinal and mucocutaneous manifestations were frequent in the three waves. Kawasaki disease-like phenotype was present in 34 (46.6%) patients and 21 (28.8%) patients developed shock. The most commonly used treatment was immunoglobulin (95.9%), followed by acetylsalicylic acid (94.5%) and corticosteroid (86.3%). Five (7%) patients had coronary aneurysm and 17 (23.3%) were admitted to the intensive care unit (ICU). Patients with shock had greater laboratorial alteration and need for mechanical ventilation. In conclusion, MIS-C has decreased in the first three years of the pandemic, possibly due to COVID-19 vaccination in children.

After the 2010 Maule earthquake (Mw 8.8) major changes were made in seismic regulations at the national level. One of the most interesting aspects was the change in the methodology for the soil classification in the NCh433 design standard. In summary, there was a transition from the use of soil strength parameters to soil dynamic parameters, such as the harmonic average of the shear wave velocity in the first 30 m of the subsoil (Vs30) and the predominant period (Tg), whose incorporation is under review. In this study, results from 4 teams exploring the same 6 sites using various sensors, geometries, and procedures are compared, all of them using Surface Wave Methods (MOS, for its initials in Spanish). It is concluded that, in general, the estimation of Vs30 and Tg are quite robust, but important variations are observed in the shear wave velocity profiles obtained. For that reason, it is necessary the comparison of these results with the stratigraphy. These results point to the limitations and potential of MOS to estimate the dynamic properties of sites.

Tras el terremoto del Maule 2010 (Mw 8.8), grandes cambios se produjeron en la normativa sísmica a nivel nacional. Uno de los aspectos interesantes fue el cambio en la metodología para la clasificación de suelos en la norma NCh433. En pocas palabras, se pasó del uso de parámetros de resistencia al uso de parámetros dinámicos del suelo, como el promedio armónico de la velocidad de propagación de ondas de corte en los 30 m superiores del terreno (Vs30) y el periodo predominante (Tg), que se evalúa incorporarlo. En este estudio, se comparan resultados obtenidos por 4 equipos de trabajo que exploran seis sitios utilizando diversos sensores, geometrías y procedimientos, todos ellos usando Métodos de Ondas Superficiales (MOS). Se observa que, en general, la estimación de Vs30 y Tg son bastante robustas, pero se encuentran importantes variaciones en los perfiles de velocidad obtenidos; es por ello que es necesario contrarestar el resultado con la estratigrafia del sondaje. Estos resultados reflejan las limitaciones y potencialidades de los MOS para estimar las propiedades dinámicas de sitios.

Resumen Introduction: Since March 2020, the World Health Organization (WHO) declared COVID-19 as a pandemic. This crisis had big challenges for the patients with Parkinson's disease (PD), due to the effects related to changes in daily routines, the practice of leisure activities, relationships and mental health leading to secondary deterioration. Our aim was to characterize the emotional state and quality of life in a cohort of patients with Parkinson's disease as well as to explore the perception of the quality of life during the COVID-19 pandemic. Materials and methods: This investigation was conducted as an exploratory mixed study. Descriptive analysis for sociodemographic and clinical variables and, a discourse analysis was carried out based on categories related to the perception of quality of life of patients with PD. Categories analyzed were: Covid-19 pandemic, caregivers, adaptation strategies, management of the disease, and leisure activities. Results: There were twelve patients total in this study. 75% were men with a median age of 75 (SD 2.9). 50% presented mild levels of anxiety and 41% presented mild and severe depression. The QoL was affected for: mobility 37.5 (IRC 10.6-45), body discomfort 25 (IQR 10.4-45.8) and, cognition 21.9 (IQR 14-34.3). 89% lived with their wife and 67% of women lived with one of their children. Discussion: The interview about perception of QoL during Covid-19 pandemic allowed to understand that individual experiences are crucial to improve the management and empowerment the patients, caregivers and families. Conclusion: Quality of life is a factor made up of dynamic dimensions and it is influenced for subjective perspective and changes in environment as a Covid-19 pandemic.

Abstract Introducción: Desde marzo del año 2020, la Organización Mundial de la Salud (OMS) declaró como pandemia al COVID-19 y esta situación representó grandes retos para los pacientes con enfermedad de Parkinson (EP). Los efectos en los cambios de las rutinas diarias, la práctica de actividades lúdicas, el relacionamiento y la salud mental, conllevaron a un deterioro secundario. Nuestro objetivo fue caracterizar el estado emocional y la calidad de vida de una cohorte de pacientes con enfermedad de Parkinson, así como explorar cuál fue la percepción de la calidad de vida en la pandemia causada por COVID-19. Métodos: Esta fue una investigación mixta que incluyó un análisis descriptivo para los datos sociodemográficos y las variables clínicas, y un análisis del discurso con base a las categorías relacionadas con la percepción de la calidad de vida de los pacientes con EP. Las categories analizadas fueron: pandemia COVID-19, cuidadores, estrategias de adaptación, manejo de la enfermedad y actividades lúdicas. Resultados: En este estudio hubo 12 pacientes, de los cuales el 75 % tenían una media de edad de 75 años (DE 2,9), donde el 50 % presentó niveles leves de ansiedad y el 41 % presentó niveles leves y graves de depresión. La calidad de vida (CV) estuvo afectada por: la movilidad 37,5 (RIC 10,6-45), seguida por el malestar corporal 25 (RIC 10,4-45,8) y la cognición 21,9 (RIC 14-34,3). El 89 % de los hombres vivía con su esposa y el 67 % de las mujeres vivían con uno de sus hijos. Discusión: La entrevista sobre la percepción de la CV durante la pandemia COVID-19 permitió comprender que la experiencia personal es fundamental para mejorar el manejo y el empoderamiento de los pacientes, cuidadores y familiares. Conclusiones: La calidad de vida es un factor mediado por dimensiones dinámicas y es afectada por la percepción subjetiva y los cambios en el entorno como la pandemia COVID-19.

ABSTRACT During the first wave of globalization, the signing of trade treaties that contained the Most Favoured Nation clause proliferated. In this paper, we focus on the Argentine case. On the one hand, we propose that the agreements were extended by the need for governments to belong to an informal mercantile network in a world lacking multilateral institutions. On the other hand, we consider that those legal instruments were the key to commercial claims, especially when protectionism intensified toward the end of the nineteenth century, as is evidenced by the actions of the consular and diplomatic system. The main sources used are trade treaties, conventions, and protocols, as well as the Argentine Memoirs of the Ministry of Foreign and Religious Affairs.

RESUMEN Durante la Primera Globalización proliferó la firma de tratados de comercio que contenían la cláusula de Nación Más Favorecida. En este trabajo abordamos el caso argentino y, por un lado, proponemos que los acuerdos se extendieron por la necesidad de los gobiernos de pertenecer a una red informal mercantil en un mundo carente de instituciones multilaterales; por otro, consideramos que aquellos instrumentos jurídicos fueron el argumento central sobre el que se basaron los reclamos comerciales, en especial, cuando se intensificó el proteccionismo a finales del siglo XIX, tal como prueba el accionar del sistema diplomático y consular. Las fuentes utilizadas son los tratados, convenciones y protocolos comerciales, así como las Memorias del Ministerio de Relaciones Exteriores y Culto de Argentina.

Resumen Introducción: En diciembre de 2019, se detectó un brote de enfermedad por un nuevo coronavirus que evolucionó en pandemia con severa morbilidad respiratoria y mortalidad. Los sistemas sanitarios debieron enfrentar una cantidad inesperada de pacientes con insuficiencia respiratoria. En Argentina, las medidas de cuarentena y control sanitario retrasaron el primer pico de la pandemia y ofrecieron tiempo para preparar el sistema de salud con infraestructura, personal y protocolos basados en la mejor evidencia disponible en el momento. En una institución de tercer nivel de Neuquén, Argentina, se desarrolló un protocolo de atención para enfrentar la pandemia adaptado con la evolución de la mejor evidencia y evaluaciones periódicas de la mortalidad hospitalaria. Métodos: Estudio de cohorte observacional para evaluar la evolución de pacientes con COVID-19 con los protocolos asistenciales por la mortalidad hospitalaria global y al día 28 en la Clínica Pasteur de Neuquén en 2020. Resultados: Este informe describe los 501 pacientes diagnosticados hasta el 31 de diciembre de 2020. La mortalidad general fue del 16,6% (83/501) y del 12,2% (61/501) al día 28 de admisión. En los 139 (27,7%) pacientes con ventilación mecánica, la mortalidad general y a los 28 días fue de 37,4% (52/139) y 28,1% (38/139) fallecieron, respectivamente. Los factores de riesgo identificados fueron edad, comorbilidades y altos requerimientos de oxígeno al ingreso. Conclusión: La mortalidad observada en los pacientes hospitalizados en nuestra institución en la primera ola de la pandemia COVID-19 fue similar a los informes internacionales y menor que la publicada en Argentina para el mismo período.

Abstract Introduction: In December 2019, an outbreak of disease due to a new coronavirus was detected that evolved into a pandemic with severe respiratory morbidity and mortality. Health systems had to face an unexpected number of patients with respiratory failure. In Argentina, quarantine and health control measures delayed the first peak of the pandemic and offered time to prepare the health system with infrastructure, personnel and protocols based on the best evidence available at the time. In a third level institution of Neuquén, Argentina, a care protocol was developed to confront the pandemic adapted by evolving best evidence and periodic evaluations of hospital mortality. Methods: Observational cohort study to evaluate the evolution of patients hospitalized for COVID-19 with care protocols in terms of overall hospital mortality and at day 28 at the Pasteur Clinic in Neuquén in 2020. Results: This report describes the 501 patients diagnosed until December 31, 2020. Mortality was 16.6% (83/501) and 12.2% (61/501) on day 28 of admission. Among the 139 (27.7%) patients with mechanical ventilation, overall mortality and at 28 days it was 37.4% (52/139) and 28.1% (38/139), respectively. The risk factors identified were age, comorbidities and high oxygen requirements on admission. Conclusión: The mortality observed in patients hospitalized in our institution during the first wave of COVID-19 pandemic was similar to international reports and lower than other publications in Argentina for the same period.

Abstract Background: In December 2019 the first case of atypical pneumonia were reported in Wuhan-China due to SARS-CoV-2 virus. In the Andean population, adaptation mechanisms to hypoxic and hypobaric environmental condition would favor the decrease in mortality due to COVID-19. Aim: To determine whether altitude is a factor associated with mortality in COVID-19 patients in the Peruvian territory Methods: Observational case-control study analyzing secondary database. We measured association with χ2 and multivariate analysis with simple and multiple logistic regression controlling for age, sex, severity and comorbidities (95%CI). Results: We analyzed data from 616.382 patients during the second wave in 26 regions of Peru (47.7% female and 52.3% male) with an average age of 42.7 ± 18.2 years. The most frequent comorbidity was cardiovascular disease (4.5%), the most frequent symptom was cough (65.2%). In the bivariate analysis, age, sex, degree of severity and comorbidities were significant (p < 0.001; 95%CI) Multiple logistic regression showed that residing between 2,000-3,000 and 4,000-5,000 m a.s.l. provided a 62% and 32% lower probability of death compared to the population residing at less than 1,000 m a.s.l.; 95%CI OR: 0.38 (0.36-0.40) and OR 0.68 (0.59-0.80) respectively. Conclusion: In the Peruvian population, residing above 1,000 m a.s.l. is a protective factor against death from COVID-19.

Resumen Introducción: En diciembre del 2019 se reportaron los primeros casos de neumonía atípica en Wuhan - China, a causa del virus SARSCoV-2. En la población de altura, los mecanismos de adaptación a la condición ambiental hipóxica e hipobárica favorecerían la disminución de la mortalidad por COVID-19. Objetivo: Determinar si la altura es un factor asociado a mortalidad en pacientes con COVID-19 en el territorio peruano. Materiales y Métodos: Estudio de diseño de tipo ecológico analítico de base de datos secundaria. Medimos asociación con χ2 y análisis multivariado con regresión logística simple y múltiple, controlando la edad, sexo, gravedad y comorbilidades con IC 95%. Resultados: Se analizaron los datos de 616.382 pacientes durante la segunda ola en 26 regiones del Perú (47,7% de sexo femenino y 52,3% de sexo masculino) siendo la edad promedio 42,7 ± 18,2 años. La comorbilidad más frecuente fue la enfermedad cardiovascular (4,5%), el síntoma más frecuente fue la tos (65,2 %). En el análisis bivariado la edad, sexo, grado de severidad y comorbilidades fueron significativas (p < 0,001; IC95%). Mediante regresión logística múltiple se observó que residir entre 2.000-3.000 y 4.000-5.000 m s.n.m. proporcionan 62 y 32 % menos probabilidad de muerte en comparación con la población que reside a menos de 1000 m s.n.m.; IC95% OR: 0,38 (0,36-0,40) y OR 0,68 (0,59-0,80), respectivamente. Conclusión: En la población peruana residir a más de 1.000 m s.n.m. constituye un factor de protección frente a la muerte por COVID-19.