Abstract Currently, social media (SM) have evolved beyond their initial purpose, reshaping social and political interactions. This study explores the effect of SM on the circulation of political information in Portoviejo, Ecuador. It examines how SM affects the dissemination and reception of this type of content in the region. Specific objectives included identifying the most used SM platforms, evaluating the predominant political content formats, and measuring their impact on users' political opinions. To this end, a mixed-methodological approach was adopted, both cross-sectional and prospective, and an anonymous survey was conducted, whose results were validated using concordance coefficients and Cronbach's Alpha. The findings reveal a preference for platforms like Facebook, Instagram, TikTok, and YouTube, a diversity in types of multimedia content, exposure to varied political perspectives, and a notable influence on citizens' opinions and electoral decisions. Differences in online interaction levels and in the enrichment of political discourse were also detected, varying according to demographic and generational factors. These results provide a deeper understanding of the political environment in Portoviejo, offering crucial data for making informed political decisions and implementing effective strategies in the current digital context.

Resumen Actualmente, las redes sociales (RS) han evolucionado más allá de su propósito inicial, reconfigurando las interacciones sociales y políticas. Este estudio explora el efecto de las RS en la circulación de información política en Portoviejo, Ecuador. Se investiga cómo las RS afectan la difusión y recepción de este tipo de contenidos en la región. Los objetivos específicos incluyeron la identificación de las plataformas de RS más utilizadas, la evaluación de los formatos de contenido político predominantes y la medición de su impacto en las opiniones políticas de los usuarios. Para ello, se adoptó un enfoque metodológico mixto, tanto transversal como prospectivo, y se llevó a cabo una encuesta anónima cuyos resultados fueron validados mediante coeficientes de concordancia y el Alfa de Cronbach. Los resultados revelan una preferencia por plataformas como Facebook, Instagram, TikTok y YouTube, una diversidad en los tipos de contenidos multimedia, una exposición a variadas perspectivas políticas, y una notable influencia en las opiniones y decisiones electorales de los ciudadanos. También se detectaron diferencias en los niveles de interacción online y en el enriquecimiento del discurso político, variando según factores demográficos y generacionales. Estos resultados aportan una mayor comprensión del entorno político en Portoviejo, ofreciendo datos cruciales para la formulación de decisiones políticas informadas y la implementación de estrategias efectivas en el contexto digital actual.

RESUMEN Objetivo: Describir la frecuencia, las características sociodemográficas y las características clínicas de la coinfección por virus de inmunodeficiencia humana (VIH) y virus de hepatitis B (VHB). Materiales y métodos: Se ejecutó un estudio transversal a partir del entrecruzamiento de las bases de datos de infección por VIH/sida e infección por VHB del sistema de vigilancia epidemiológica del Perú durante 2017 a 2021. Se incluyeron personas de 18 años a más con diagnóstico de la coinfección por VIH y VHB. Se recopilaron las variables año de nacimiento, sexo, lugar de residencia, estadio sida, vía de transmisión de VIH, año de diagnóstico de VIH, año de diagnóstico de VHB, uso de antirretrovirales y año de inicio de antirretrovirales. Se realizó un análisis bivariado y un análisis de correspondencias múltiples (ACM). Las bases de datos del sistema de vigilancia epidemiológica peruano incluyen a toda la población disponible de ese país. Resultados: Se incluyeron 106 adultos con la coinfección por VIH y VHB. La mediana de edad al momento del diagnóstico fue 32 años y el 77,88 % tenía entre 18 y 39 años. El 87,62 % era de sexo masculino. El 68,57 % se diagnosticó entre 2018 y 2019. El 66,02 % residía en la costa de Perú. El 10,87 % se atendió en un departamento distinto al de residencia. El 64,76 % fue diagnosticado con ambas infecciones en menos de un año. El 23,58 % se encontraba en estadio sida y 44,34 % usaba antirretrovirales. Conclusiones: Las personas con la coinfección por VIH y VHB en Perú tienen en su mayoría una mediana de edad de 32 años, residen en la costa, son varones y fueron diagnosticados en menos de 12 meses. Las relaciones del ACM pueden ser explicadas por el acceso al sistema de salud, disponibilidad de pruebas de tamizaje, amplitud de historia clínica e historia natural del VIH.

ABSTRACT Objective: To describe the frequency, sociodemographic and clinical characteristics of human immunodeficiency virus (HIV) and hepatitis B virus (HBV) coinfection. Materials and methods: A crosssectional study was conducted by cross-referencing the HIV/AIDS and HBV infection databases of the epidemiological surveillance system of Peru between 2017 and 2021. Individuals aged 18 years and older who were diagnosed with HIV and HBV coinfection were included. We collected data on variables such as age, sex, region of residence, AIDS stage, HIV transmission route, year of HIV diagnosis, year of HBV diagnosis, antiretroviral use and year of antiretroviral initiation. A bivariate analysis and a multiple correspondence analysis (MCA) were carried out. The databases of the Peruvian epidemiological surveillance system include the entire available population in that country. Results: A total of 106 adults with HIV and HBV coinfection were included. The median age at diagnosis was 32 years, and 77.88 % were between 18 and 39 years old, 87.62 % were male, and 66.02 % lived on the coast of Peru. Out of these patients, 68.57 % were diagnosed between 2018 and 2019, and 10.87 % were treated in a department other than their department of residence. In addition, 64.68 % were diagnosed with both infections in less than one year, 23.58 % were in the AIDS stage, and 44.34 % were using antiretrovirals. Conclusions: Most individuals with HIV and HBV coinfection in Peru have a median age of 32 years, live on the coast, are male, and were diagnosed in less than 12 months. MCA associations can be explained by access to the healthcare system, availability of screening tests, comprehensiveness of clinical history, and natural history of HIV.

Resumen El objetivo del trabajo fue tipificar unidades productivas de doble propósito y caracterizar los recursos para la producción de forrajes y los problemas que afectan a la ganadería en Sinaloa, México. Mediante muestreo no probabilístico se seleccionaron 61 ranchos de ocho municipios del estado de Sinaloa, a través de análisis factorial y análisis clúster fueron identificados cuatro grupos de productores: E1, E2, E3 y E4. Los productores tienen diversos usos de la tierra para la producción de forrajes: siembra de cultivos anuales, praderas, pastoreo en tierras en descanso y uso del agostadero. La sequía es el principal problema para el 52.5 % de los productores. Los productores que cuentan con mayor tamaño de hato (E3 y E4) tienen mayor superficie agrícola y agostadero; sin embargo, presentan una mayor vulnerabilidad en sus sistemas de producción, por lo que tienen que recurrir a la compra de forrajes. El 86.7 % de los productores señaló que el hato ha disminuido por el problema de la sequía, por lo que se requiere del desarrollo de estrategias tecnológicas y políticas para mejorar la producción de forrajes bajo el contexto de cambio climático, y así disminuir la presión y posible deterioro de la superficie agrícola y el agostadero en la región de estudio.

Abstract The objective of the work was to typify dual-purpose production units and characterize the resources for fodder production and the issues affecting livestock production in Sinaloa, Mexico. Through non-probabilistic sampling, 61 ranches were selected from eight municipalities in the state of Sinaloa, and four groups of producers were identified through factor analysis and cluster analysis: E1, E2, E3, and E4. Producers have diverse land uses for fodder production: planting of annual crops, pastures, grazing on fallow land, and use of pasture lands. Drought is the main issue for 52.5 % of the producers. Producers with larger herd sizes (E3 and E4) have more agricultural and grazing land; however, their production systems are more vulnerable and, therefore, they have to resort to the purchase of forage. 86.7 % of the producers pointed out that the herd has decreased due to the problem of drought, which requires the development of technological strategies and policies to improve forage production within the context of climate change, and thus reduce the pressure and potential deterioration of agricultural and pasture land in the study region.

RESUMEN Pólipo colónico hace referencia a lesiones que presentan una protrusión de la mucosa, sin contar la histología. La clasificación más reciente de la OMS está basada en un mejor conocimiento de estas lesiones; sin embargo, su aplicación en la práctica diaria podría estar sujeta a sesgos de variabilidad interobservador que podrían tener implicancias clínicas. Objetivos: Determinar la variabilidad interobservador en el reporte histopatológico y la graduación de displasia de muestras obtenidas de lesiones elevadas de colon en laboratorio privado de la ciudad de Lima. Materiales y métodos: Estudio observacional, descriptivo y prospectivo: Tipo serie de caso. Todas las biopsias de lesiones elevadas de colon recibidas en un periodo de 3 meses fueron evaluadas por dos observadores sin información clínica de los casos, a fin de diagnosticar las lesiones de acuerdo con la clasificación de la OMS. En los casos de diferencias diagnósticos, los casos fueron evaluados en conjunto a fin de llegar a un consenso. Resultados: Se obtuvo un valor del coeficiente Kappa de 0,458 en la clasificación diagnostica de lesiones elevadas de colon, mientras que un valor de Kappa de 0,416 en la evaluación de displasia; indicando una concordancia moderada. Conclusiones: A pesar de lograr un acuerdo moderado entre los evaluadores, este trabajo demuestra la importancia de no solo recaer en criterios morfológicos para la clasificación diagnóstica; si no incluir criterios de localización y tamaño de estas lesiones para poder incrementar la precisión diagnóstica.

ABSTRACT Colonic polyp refers to lesions that exhibit a protrusion of the mucosa, regardless of histology. The most recent WHO classification is based on a better understanding of these lesions; however, its application in daily practice could be subject to interobserver variability biases that could have clinical implications. Objectives: To determine the interobserver variability in the histopathological reporting and grading of dysplasia of samples obtained from elevated colon lesions in a private laboratory in the city of Lima. Materials and methods: Observational, descriptive, and prospective study: Case series type. All biopsies of elevated colon lesions received over a period of 3 months were evaluated by two observers without clinical information of the cases, to diagnose the lesions according to the WHO classification. In cases of diagnostic differences, the cases were evaluated together to reach a consensus. Results: A Kappa coefficient value of 0.458 was obtained in the diagnostic classification of elevated colon lesions, while a Kappa value of 0.416 in the evaluation of dysplasia; indicating moderate agreement. Conclusions: Despite achieving moderate agreement between evaluators, this work demonstrates the importance of not only relying on morphological criteria for diagnostic classification, but also including criteria of location and size of these lesions to increase diagnostic accuracy.

ABSTRACT Agroindustrial potato (Solanum tuberosum L.) waste mainly includes peel and pulp; however, potatoes of low industrial quality are also discarded by industry. A viable alternative to give added value to these byproducts is the use of these as seeds, as well as the use of starch. The objective of this work was to evaluate the physiological quality (germination and vigor), starch content and relationship between these variables in discarded tubers from the industry through chemical-structural analyses to better understand their influence on starch composition. The physiological quality of the potatoes was evaluated through germination and vigor tests; likewise, starch was extracted, and the yield was determined. Physicochemical characterization of the starches was carried out through proximal and structural analysis using nuclear magnetic resonance (NMR). The results showed that the tubers had 100.00% germination and 98.66% vigor and were suitable for use as seeds. The starch yield did not significantly differ. However, characterization of the starch revealed significant differences (p ≤ 0.05) in moisture, ash, carbohydrate and amylose contents, which were influenced by the storage temperature (4 °C) of the tubers subjected to a vigor test, which interferes with enzymatic activity. During germination, the NMR results showed type B crystallinity, which is typical of tubers, indicating that the viability tests did not promote changes in the type of crystallinity. The results obtained can help us understand the effect of germination on the composition of starch and, accordingly, choose the most appropriate applications for this starch, whether food or nonfood.

RESUMEN. Objetivo: El propósito del siguiente estudio fue describir las características sociodemográ-ficas, clínicas y terapéuticas de los pacientes con retinoblastoma (RB), el tumor intraocular más frecuente en niños, que reciben atención médica en una institución oftalmológica de la región Caribe de Colombia. Métodos: Se realizó una serie de casos entre 2016 y 2021. Se incluyeron ojos de pacientes con RB, que recibían atención médica en una sola institución de salud y cumplían con el protocolo de seguimiento establecido. Se realizaron análisis descriptivos de variables relevantes. Resultados: En este estudio se examinaron un total de 21 ojos de 16 pacientes. La edad media en el momento del diagnóstico fue de 17,7 meses y el 50% de los niños eran varones. Utilizando la Clasificación Internacional para el retinoblastoma intraocular, el 42,9% del total de los casos se clasificaron en el grupo D. De los 21 casos, el 71,4% entraron en remisión total sin necesidad de enucleación, y el tratamiento más habitual fue la quimioterapia con Melfalán® vía intraarterial o intravítrea. Conclusiones: Se identificaron hallazgos específicos de pacientes con RB en la costa caribe de Colombia. Estos hallazgos implican que, a pesar de los obstáculos en el acceso a la salud, un diagnóstico temprano y un plan de tratamiento con quimioterapia intraarterial pueden proporcionar un resultado clínico satisfactorio (remisión).

ABSTRACT Purpose: The purpose of the following study was to describe the sociodemographic, clinical, and therapeutic characteristics of patients with retinoblastoma (RB), the most common intraocular tumor in children, receiving medical care in an eyecare institution in the Caribbean region of Colombia. Methods: A case series between 2016 and 2021 was carried out. Eyes of patients with RB, receiving medical care in a single health care institution, and in compliance with the established follow-up protocol, were included. Descriptive analyzes of relevant variables were performed. Results: In this study, a total of 21 eyes of 16 patients were examined. The average age at the time of diagnosis was 17.7 months, and 50% of children were male. Using the International Classification for Intraocular Retinoblastoma, 42.9% of the total cases were classified as group D. Out of the 21 cases, 71.4% went into total remission without the necessity for enucleation, and the most common treatment was chemotherapy, using Melphalan® via intraarterial or intravitreal administration. Conclusion: Specific findings of patients with RB in the Caribbean Coast of Colombia were identified. These findings imply that, despite the obstacles to healthcare access, an early diagnosis and a treatment plan using intraarterial chemotherapy may provide a satisfactory clinical outcome (remission).

Resumo Introdução: este artigo aborda a nefrogeriatria como ciência jovem e o papel da Atenção Primária à Saúde em seu desenvolvimento com o objetivo de abrir uma reflexão sobre as contribuições teóricas e práticas que este ramo pode oferecer na prevenção e retardo da progressão da doença renal crônica (drc) em idosos, enfatizando a necessidade de humanizar o atendimento, como forma de restabelecer a qualidade de vida e capacitar os profissionais de saúde para uma atuação adequada. Desenvolvimento: o artigo analisa a situação da drc e do envelhecimento, o desenvolvimento da nefrogeriatria, a proposta de modelagem da situação da ciência e estratégia, bem como os gigantes da nefrogeriatria; a bibliografia revisada esteve baseada principalmente em publicações da biblioteca Cochrane, Dynamed, PubMed e SciELO. Conclusão: a nefrologia geriátrica (nefrogeriatria) é uma disciplina médica que surgiu recentemente e que requer uma preparação integral dos profissionais de saúde.

Resumen Introducción: en este artículo se aborda la nefrogeriatría como ciencia joven y el papel de la atención primaria de salud en su desarrollo, con el objetivo de abrir una reflexión sobre los aportes teóricos y prácticos que esta rama puede ofrecer en la prevención y retardo de la progresión de la enfermedad renal crónica (ero) en adultos mayores, recalcando en la necesidad de humanizar la atención, como modo de restituir la calidad de vida y empoderar a los profesionales de la salud de un adecuado desempeño. Desarrollo: se analiza en el artículo la situación de la ero y el envejecimiento, el desarrollo de la nefrogeriatría, la propuesta de modelación de la situación de la ciencia y la estrategia, así como los gigantes nefrogeriátricos. Se revisó la bibliografía basada fundamentalmente en las publicaciones de la biblioteca Cochrane, Dynamed, Pubmed y SciELO. Conclusión: la nefrología geriátrica (nefrogeriatría) es una disciplina médica de reciente surgimiento y que requiere la preparación integral de los profesio nales de la salud.

Abstract Introduction: This article elucidates geriatric nephrology (nephrogeriatrics) as a young science and reveals the role of primary health care in its development with the objective of highlighting the theoretical and practical contributions of this specialty in the prevention and attenuation of progression of chronic kidney disease (ckd) in older adults, emphasizing the need to humanize care, as a method of restoring the quality of life and empowering health professionals. Development: A literature search was conducted in the Cochrane, Dynamed, PubMed, and SciELO databases and data were analyzed to elucidate the relationship between ckd and aging, the development of nephrogeriatrics, the proposal for modeling the situation of science and strategy as well as the nephrogeriatric giants. Conclusion: Nephrogeriatrics is a recently emerged medical discipline that warrants the integral preparation of health professionals.

Abstract: Intraoperative neuromonitoring with electroencephalogram (EEG) and processed electroencephalogram (pEEG) allows the evaluation of changes in brain electrical activity and unconsciousness generated by anesthetics, as well as preventing adverse events such as intraoperative recall, drug overdose, hemodynamic and/or neurological compromise, delirium and postoperative cognitive dysfunction. However, cortical electrical activity can be modulated and affected by pathophysiological alterations, independently of the effect of anesthetic drugs, both EEG and pEEG can be helpful in the timely diagnosis of metabolic, hypoxic, and suppression of electrical activity disorders brain, non-convulsive status epilepticus, intracranial hypertension, hypoperfusion or cerebral ischemia. Routine neuromonitoring with the available monitor is recommended in order to improve our experience in order to achieve a patient personalized and precise anesthesia level, arriving to an optimal dose for the maintenance of the mechanisms involved in the autoregulation of cerebral perfusion, understanding brain physiology, function as well as its interaction with drugs and hemodynamic impact to neurosurgical and non-neurosurgical patients, identifying early signs of possible complications derived from the procedure or due to pharmacological effect and their rapid resolution.

Resumen: El neuromonitoreo intraoperatorio con electroencefalograma (EEG) y electroencefalograma procesado (pEEG) permite la evaluación de cambios en la actividad eléctrica cerebral generados por los anestésicos, además de prevenir eventos adversos como recuerdo intraoperatorio, sobredosis farmacológica, compromiso hemodinámico y/o neurológico, delirio y disfunción cognitiva postoperatoria. Sin embargo, la actividad eléctrica cortical puede estar modulada y ser afectada por alteraciones fisiopatológicas, independientemente del efecto de los fármacos anestésicos, por lo que, tanto el EEG como el pEEG pueden ser auxiliares en el diagnóstico oportuno de trastornos metabólicos, hipóxicos, supresión de la actividad eléctrica cerebral, estados epilépticos no convulsivos, hipertensión intracraneal, hipoperfusión o isquemia cerebral. El neuromonitoreo de rutina con el monitor disponible es recomendable con el fin de mejorar nuestra experiencia en su uso para una anestesia personalizada y de precisión, estableciendo estado de profundidad anestésica y dosis farmacológica óptima para el mantenimiento de los mecanismos implicados en la autorregulación de la perfusión cerebral, mejor comprensión de la fisiología, función cerebral y su interacción con los anestésicos e impacto hemodinámico del paciente neuroquirúrgico y no neuroquirúrgico, identificando signos precoces de posibles complicaciones derivadas del procedimiento o por efecto farmacológico y su rápida resolución.

ABSTRACT After observing the difficulties that many teachers had to integrate digital tools in their remote classes during the pandemic, the objective was to establish the relationship between continuing education and digital competence of teachers. The paradigm was positivist with a quantitative-descriptive approach. For data collection, two questionnaires (continuous training, 41 items and digital competence, 54 items) were applied to a sample of 160 teachers and validated by the judgment of five experts. Cronbach's alpha for both variables was greater than 0.9, i.e. of excellent reliability. The continuous training variable registered 21.9% of the total sample under study at the inadequate level, 70% at the regular level and 8.1% at the adequate level. As results, the educational needs dimension registered a regular level of 75.0%; pedagogical needs reached an inadequate level of 26.9%; for human needs, a regular level of 44.4% was reached; and for research needs, the level reached was regular with 73.1%. Concluding that the continuous updating of teachers is linked to the development of their digital skills.

RESUMO Após observar as dificuldades que muitos professores tiveram para integrar ferramentas digitais em suas salas de aula remotas durante a pandemia, o objetivo foi estabelecer a relação entre o treinamento contínuo e a competência digital dos professores. O paradigma foi positivista com uma abordagem quantitativa-descritiva. Para a coleta de dados, dois questionários (treinamento contínuo, 41 itens e competência digital, 54 itens) foram aplicados a uma amostra de 160 professores e validados pelo julgamento de cinco especialistas. A variável treinamento contínuo registrou 21,9% da amostra total do estudo no nível inadequado, 70% no nível regular e 8,1% no nível adequado. Como resultados, a dimensão necessidades educacionais registrou um nível regular de 75,0%; as necessidades pedagógicas alcançaram um nível inadequado de 26,9%; para as necessidades humanas, foi alcançado um nível regular de 44,4%; e para as necessidades de pesquisa, o nível alcançado foi regular com 73,1%. Em conclusão, a atualização contínua dos professores está vinculada ao desenvolvimento de suas habilidades digitais.

RESUMEN Luego de observar las dificultades que muchos docentes tenían para integrar herramientas digitales en sus clases remoto durante la pandemia se planteó el objetivo de establecer la relación entre la formación continua y la competencia digital de docentes. El paradigma fue positivista con enfoque cuantitativo - descriptivo. Para la recolección de datos se aplicaron dos cuestionarios (formación continua, 41 ítems y competencia digital, 54 ítems) a una muestra de 160 docentes, además fueron validados por juicio de cinco expertos. El alfa de Cronbach para ambas variables fue mayor a 0.9, es decir de excelente confiabilidad, la variable formación continua registró en el nivel inadecuado 21.9% de la muestra total en estudio, en el nivel regular 70% y en el nivel adecuado 8.1%. Como resultados se registró en la dimensión necesidades educativas un nivel regular 75.0%; necesidades pedagógicas alcanzóun nivel inadecuado 26.9%; para las necesidades humanas se alcanzó un nivel regular de 44.4%: y para las necesidades investigativas el nivel alcanzado fue regular con 73.1 %. Concluyendo que la actualización continua de los profesores se vincula con el desarrollo de sus habilidades digitales

Resumen Las lipasas son enzimas atractivas para su uso en biotecnología, principalmente aquellas producidas por extremófilos. Recientemente fueron aisladas bacterias termófilas Geobacillus en aguas geotermales del lago del cráter del volcán “El Chichón”, en México. En este trabajo se caracterizó y optimizó la actividad lipolítica de la cepa Geobacillus stearothermophilus CHI1. Esta cepa fue capaz de producir enzimas con máxima actividad lipolítica a 60 °C y 80 °C, con valores de pH de 5, 9 y 11, además de que demostró ser tolerante a solventes y capaz de realizar catálisis independientemente de iones metálicos. Adicionalemente, mostró mayor afinidad hacia sustratos de cadena media. Los resultados de la caracterización y optimización bioquímica sugieren la presencia de más de un tipo de actividad lipolítica presente en Geobacillus stearothermophilus CHI1. Todas estas características hacen que estas enzimas sean atractivas en procesos biotecnológicos a altas temperaturas y pH alcalino (por ejemplo, aditivos detergentes), así como para ayudar a comprender su utilidad biológica en Geobacillus.

Abstract Lipases are enzymes attractive for their use in enzymatic biotechnology, mainly those produced by extremophiles. Recently, the isolation of thermophilic bacteria Geobacillus spp. from the geothermal waters of the crater lake of the “El Chichón” volcano in Mexico was reported. In this work, the lipolytic activity of the G. stearothermophilus CHI1 strain was characterized and optimized. This strain was able to produce enzymes with maximum lipolytic activity at 60 °C and 80°C, with pH values of 5, 9, and 11; showed tolerance of solvents; was able to perform catalysis independently of metal ions; and showed greater affinity towards medium-chain substrates. Results of biochemical characterization and optimization suggest the presence of more than one type of lipolytic activity in Geobacillus stearothermophilus CHI1. All these characteristics make these enzymes attractive in biotechnological processes at high temperatures and alkaline pH (e.g., detergent additives), as well as in the understanding of their biological utility in Geobacillus.

Resumo No contexto digital em que a sociedade se encontra hoje, os idosos devem ter acesso à utilização de tecnologias inovadoras, e uma forma de o fazer é conceber e desenvolver aplicações úteis, valiosas e fáceis de utilizar para eles. Este artigo apresenta os resultados de um estudo realizado para caracterizar práticas de desenvolvimento de software destinadas a gerar ambientes inclusivos para idosos e propor uma forma geral de prática. Para selecionar estudos científicos relevantes que se refiram a práticas e processos de desenvolvimento de software para idosos, foram seguidos procedimentos de revisão sistemática da literatura. Foram utilizados diagramas de classes para descrever como, em cada estudo, os autores definem as práticas que aplicam no desenvolvimento de aplicações destinadas a gerar ambientes inclusivos para pessoas idosas. Os diagramas de classes permitem a descrição de conceitos (classes), que são integrados na conceituação da prática e nas relações estruturais entre essas classes. Além disso, os diagramas de classes permitiram uma visão geral que facilitou a identificação dos elementos comuns e diferenciais da visão dos diferentes autores cujos estudos foram analisados nesta pesquisa. A forma geral de prática resultante desta pesquisa pode facilitar aos desenvolvedores a identificação de elementos importantes que devem ser considerados na criação de aplicativos para idosos. No final, os produtos de softwares desenvolvidos através desta orientação fizeram parte dos processos de alfabetização em Information and Communication Technologies para adultos mais velhos. hoje inovadoras úteis eles literatura como idosas classes, , (classes) disso final velhos (classes

Abstract In the digital context in which society finds itself today, older adults must be allowed to access the use of innovative technologies, and one way to do so is by designing and developing practical, valuable, and easy-to-use applications for them. This article presents the results of a study conducted to characterize software development practices aimed at generating inclusive environments for older adults and proposes a general form of practice. Systematic literature review procedures were followed to select relevant scientific studies that refer to software development practices and processes for older people. Class diagrams were used to describe how, in each study, the authors define the practices they apply to develop applications to generate inclusive environments for older people. Class diagrams describe concepts (classes) integrated into conceptualizing practice and the structural relationships between these classes. Furthermore, the class diagrams allowed a general vision that made it easier to identify the common and differential elements of the vision of the different authors whose studies were analyzed in this research. The general form of practice resulting from this research can make it easier for developers to identify essential elements that should be considered when creating applications for older adults. Ultimately, the software products developed through this orientation have been part of Information and Communication Technologies literacy processes for older adults. today technologies practical valuable easytouse easy them people how classes (classes Furthermore Ultimately

Abstract Background Tumor-derived small extracellular vesicles (sEVs) can promote tumorigenic and metastatic capacities in less aggressive recipient cells mainly through the biomolecules in their cargo. However, despite recent advances, the specific molecules orchestrating these changes are not completely defined. Lactadherin is a secreted 0protein typically found in the milk fat globule membrane. Its overexpression has been associated with increased tumorigenesis and metastasis in breast cancer (BC) and other tumors. However, neither its presence in sEVs secreted by BC cells, nor its role in sEV-mediated intercellular communication have been described. The present study focused on the role of lactadherin-containing sEVs from metastatic MDA-MB-231 triple-negative BC (TNBC) cells (sEV-MDA231) in the promotion of pro-metastatic capacities in non-tumorigenic and non-metastatic recipient cells in vitro, as well as their pro-metastatic role in a murine model of peritoneal carcinomatosis. Results We show that lactadherin is present in sEVs secreted by BC cells and it is higher in sEV-MDA231 compared with the other BC cell-secreted sEVs measured through ELISA. Incubation of non-metastatic recipient cells with sEV- MDA231 increases their migration and, to some extent, their tumoroid formation capacity but not their anchorage-independent growth. Remarkably, lactadherin blockade in sEV-MDA231 results in a significant decrease of those sEV-mediated changes in vitro. Similarly, intraperitoneally treatment of mice with MDA-MB-231 BC cells and sEV-MDA231 greatly increase the formation of malignant ascites and tumor micronodules, effects that were significantly inhibited when lactadherin was previously blocked in those sEV-MDA231. Conclusions As to our knowledge, our study provides the first evidence on the role of lactadherin in metastatic BC cell-secreted sEVs as promoter of: (i) metastatic capacities in less aggressive recipient cells, and ii) the formation of malignant ascites and metastatic tumor nodules. These results increase our understanding on the role of lactadherin in sEVs as promoter of metastatic capacities which can be used as a therapeutic option for BC and other malignancies.

ABSTRACT Smoking constitutes a health problem of great magnitude worldwide, and in Cuba it shows a tendency to increase its incidence, especially in adolescence. An intervention study was carried out in the Medical Office No. 1 of the René Vallejo Ortiz University Polyclinic, in the municipality of Manzanillo, from January to July 2023, with the objective of evaluating the results of the application of an educational intervention program to reduce the risks associated with smoking. The universe consisted of 114 smoking patients in the area, with a sample of 50 patients selected by simple random sampling. The following variables were studied: age, sex, educational level, age of smoking onset, pathologies associated with smoking, level of knowledge. In the study, the predominant age group was male, between 45 and 59 years old, with secondary education level completed; adolescence was identified as the age at which they started smoking. The predominant pathology associated with smoking was arterial hypertension. With the application of the educational program, the level of knowledge about the risks of smoking and how to reduce them increased, most of the patients were motivated to quit smoking, demonstrating the positive impact of the research in the community studied.

RESUMO O tabagismo é um problema de saúde de grande magnitude em todo o mundo, e em Cuba há uma tendência de aumentar sua incidência, especialmente na adolescência. Foi realizado um estudo de intervenção no Consultório Médico nº 1 da Policlínica Universitária "René Vallejo Ortiz", no município de Manzanillo, no período de janeiro a julho de 2023, com o objetivo de avaliar o resultado da aplicação de um programa de intervenção educativa para reduzir os riscos associados ao tabagismo. O universo foi composto por 114 pacientes fumantes na área, e uma amostra de 50 pacientes foi selecionada por amostragem aleatória simples. As seguintes variáveis foram estudadas: idade, sexo, escolaridade, idade de início do tabagismo, doenças associadas ao tabagismo e nível de conhecimento. No estudo, predominou o sexo masculino, com idade entre 45 e 59 anos, com ensino médio completo, e a adolescência foi identificada como a idade em que começaram a fumar. A patologia predominantemente associada ao tabagismo foi a hipertensão arterial. Com a aplicação do programa educativo, o nível de conhecimento sobre os riscos do tabagismo e como reduzi-los aumentou, a maioria dos pacientes foi motivada a parar de fumar, demonstrando o impacto positivo da pesquisa na comunidade estudada.

RESUMEN El tabaquismo constituye un problema de salud de gran magnitud a nivel mundial, y en Cuba muestra una tendencia al aumento de su incidencia, sobre todo, en las edades de la adolescencia. Se realizó un estudio de intervención en el Consultorio Médico No. 1 del Policlínico Universitario “René Vallejo Ortiz”, del municipio Manzanillo, en el período comprendido de enero a julio del 2023, con el objetivo de evaluar el resultado de la aplicación de un programa de intervención educativa para disminuir los riesgos asociados al tabaquismo. El universo estuvo conformado por los 114 pacientes fumadores del área, seleccionada una muestra de 50 pacientes por muestreo aleatorio simple. Se estudiaron las variables: edad, sexo, nivel educacional, edad de inicio del tabaquismo, enfermedades asociadas al hábito de fumar, nivel de conocimiento. En el estudio predominó el sexo masculino en las edades de 45 a 59 años, con nivel educacional secundaria terminada, se identificó la adolescencia como edad en la que comenzaron a fumar. La patología predominante asociada al tabaquismo fue la Hipertensión arterial. Con la aplicación del Programa educativo, se incrementó el nivel de conocimiento acerca de los riesgos del hábito de fumar y como disminuir los mismos, la mayoría de los pacientes se motivó hacia la deshabituación tabáquica, demostrándose el impacto positivo de la investigación en la comunidad estudiada.

Resumen: La fibrilación auricular (FA) es la arritmia más frecuente y se asocia con importante morbilidad, mortalidad y costos. A pesar de los grandes avances en la prevención de eventos embólicos y en el control del ritmo, poco se ha realizado para reducir su prevalencia, progresión e impacto, debido a que incrementa con la edad y con la presencia de múltiples factores de riesgo muy comunes en la población, como obesidad, sedentarismo, alcoholismo, tabaquismo y estrés, así como hipertensión arterial sistémica, diabetes mellitus, insuficiencia cardiaca, apnea del sueño, enfermedad renal crónica, enfermedad pulmonar obstructiva crónica, cardiopatía isquémica y enfermedad vascular cerebral, entre otras comorbilidades importantes. Nuevas evidencias demuestran que las modificaciones en el estilo de vida y el control adecuado de factores de riesgo y comorbilidades pueden ser efectivos en la prevención primaria y secundaria de la FA, especialmente en sus formas paroxísticas; para ello es necesario un manejo multidisciplinario que integre las modificaciones en el estilo de vida, el manejo de factores de riesgo y control de comorbilidades en el tratamiento de la FA en conjunto con el control de ritmo o frecuencia y la anticoagulación. Desafortunadamente, en la práctica clínica, estas estrategias frecuentemente no son tomadas en cuenta, son subutilizadas y poco estudiadas. Los objetivos del presente posicionamiento son: a) revisar la relación entre factores de riesgo y comorbilidades con FA, b) revisar los mecanismos fisiopatológicos de cada una de estas condiciones, c) revisar el impacto del control de factores de riesgo y comorbilidades en el control e impacto de la FA y d) proporcionar guías y recomendaciones para la puesta en práctica de programas de tratamiento multidisciplinario e integral en pacientes con FA.

Abstract: Atrial fibrillation (AF) is the most prevalent arrhythmia and is related to significant morbidity, mortality and costs. In spite of relevant advances in the prevention of embolic events and rhythm control, little has been done to reduce its prevalence, progression and impact since it increases with aging as well as with common risk factors such as alcohol intake, tobacco use and stress as well as with arterial hypertension, diabetes mellitus, heart failure, sleep apnea, kidney failure, chronic pulmonary obstructive disease, ischemic heart disease and stroke, among other important comorbidities. Fortunately, new evidence suggests that lifestyle modifications and adequate risk factors and comorbidities control could be effective in primary and secondary AF prevention, especially in its paroxysmal forms. This is why a multidisciplinary approach integrating lifestyle modifications, risk factors and comorbidities control is necessary for conjunction with rhythm or rate control and anticoagulation. Unfortunately, that holistic approach strategy is not considered, is scarcely studied or is subtilized in general clinical practice. The present statement’s objectives are to: a) Review the relationship between habits, risk factors and illnesses with AF, b) Review the individual and common physiopathology mechanisms of each one of those conditions that may lead to AF, c) Review the effect of control of habits, risk factors and co-morbidities on the control and impact of AF, d) Supply guidelines and recommendations to start multidisciplinary and integrative AF treatment.