Resumo Nas últimas décadas, houve progressos significativos no diagnóstico e no tratamento da distrofia muscular de Duchenne (DMD), considerada a distrofia muscular mais comum na infância. Diretrizes internacionais foram publicadas e revisadas recentemente. Um grupo de especialistas brasileiros desenvolveu um padrão de atendimento baseado em revisão de literatura, com recomendações graduadas pautadas em evidências compiladas em uma publicação dividida em duas partes. A implementação de melhores práticas de manejo ajudou a modificar a história natural desta doença crônica, progressiva, que, no passado, oferecia uma expectativa de vida muito limitada para crianças do sexo masculino. Desde a publicação desse consenso anterior, o diagnóstico, o tratamento com esteroides, a reabilitação e os cuidados sistêmicos ganharam novas possibilidades a partir da divulgação dos resultados de trabalhos originais em algumas dessas áreas. Além disso, as pesquisas e o desenvolvimento de novos fármacos estão em andamento, e algumas intervenções já foram aprovadas para uso em determinados países. Nesse contexto, identificamos a necessidade de rever as recomendações anteriores sobre o manejo dos pacientes brasileiros com DMD. Nosso objetivo principal foi elaborar uma atualização baseada em evidências sobre esses tópicos do consenso.

Abstract In the last few decades, there have been considerable improvements in the diagnosis and care of Duchenne muscular dystrophy (DMD), the most common childhood muscular dystrophy. International guidelines have been published and recently reviewed. A group of Brazilian experts has developed a standard of care based on a literature review with evidence-based graded recommendations in a two-part publication. Implementing best practice management has helped change the natural history of this chronic progressive disorder, in which the life expectancy for children of the male sex in the past used to be very limited. Since the previous publication, diagnosis, steroid treatment, rehabilitation, and systemic care have gained more significant insights with new original work in certain fields. Furthermore, the development of new drugs is ongoing, and some interventions have been approved for use in certain countries. Therefore, we have identified the need to review the previous care recommendations for Brazilian patients with DMD. Our objective was to create an evidence-based document that is an update on our previous consensus on those topics.

RESUMO: O objetivo deste estudo é desenvolver um modelo de regressão linear múltipla para estimar o Preços médios rurais (PRM) no México com informações retiradas do período 1999-2018. As variáveis utilizadas para gerar este modelo foram a oferta e a demanda representadas pela área plantada, produtividade, exportações e o PRM da Agave Tequilero e Mezcalero. A análise foi realizada através do modelo de regressão linear múltipla (MRLM) com o método dos mínimos quadrados e utilizando o pacote estatístico R. As seguintes variáveis foram identificadas como tendo influência significativa na determinação do PRM: o rendimento da Agave Mezcalero (RAM), o PMR da Agave Tequilero e a nova área plantada da Agave Tequilero (NPAATt-6) com um ajuste de 6 períodos. Ao todo, foram gerados três modelos: o modelo 2 foi considerado o mais adequado porque permite fazer previsões futuras com a nova área plantada com Agave Tequilero com dois variáveis independentes. RAM e NPAATt-6 foram úteis na previsão de 65,5% das variações anuais no ARP e ajudaram a reconhecer a tendência negativa do preço da Agave de 2020 a 2024. Portanto, o uso do MRLM para estimar o PMR da Agave pode ser uma ferramenta útil na previsão do desempenho desta cultura.

ABSTRACT: This study developed a multiple linear regression model to estimate the Average rural prices (ARP) in Mexico with information taken from the period 1999-2018. The variables used to generate this model were the supply and demand as represented by planted area, yield, exports and the ARP of Agave Tequilero and Mezcalero. The analysis was carried out through the multiple linear regression model (MLRM) with the least squares method and using the statistical package R. The following variables were identified as having a significant influence on the determination of the ARP: the yield of Agave Mezcalero (YAM), the ARP of Agave Tequilero and the new planted area of Agave Tequilero (NPAATt-6) with an adjustment of 6 periods. Overall, three models were generated: model 2 was considered the most appropriate because it allows carrying out future forecasts with the new planted area with Agave Tequilero with 2 independent variables. YAM and NPAATt-6 were useful in predicting 65.5% of the annual variations in the ARP and helped recognize the negative trend of the Agave price from 2020 to 2024. Therefore, the use of the MLRM to estimate the Agave ARP can be a useful tool in predicting the performance of this crop.

Resumen Emmanuel Levinas en un breve escrito de 1934 intitulado Algunas reflexiones sobre la filosofía del hitlerismo analiza la posibilidad del mal elemental desde una interpretación fenomenológica. Considera que el hitlerismo es un despertar de los sentimientos elementales, los sentimientos son un entrecruzamiento de actos intencionales específicos. Así, la filosofía del hitlerismo sería una expresión de los modos de estar-ahí-en-el-mundo, es un modo de la existencia. El mal elemental establece una relación en la cual el sujeto está encadenado consigo mismo. En escritos posteriores el mal elemental parece estar vinculado con un complejo desarrollo de la metafísica de Occidente. Este artículo se propone estudiar cómo la crítica fenomenológica levinasiana es capaz de suspender el mal elemental, intentando desarticular la política de Occidente a través de la fundamentación de una política fenomenológica que conciba otra relación.

Abstract Emmanuel Levinas in a brief text from 1934 entitled Some Reflections on the Philosophy of Hitlerism analyzes the possibility of elemental evil from a phenomenological interpretation. He considers that Hitlerism is an awakening of elementary feelings, feelings are an intersection of specific intentional acts. Thus, the philosophy of Hitlerism would be an expression of the modes of being-there-in-the-world, it is a mode of existence. Elemental evil establishes a relationship in which the subject is chained to himself. In later writings elemental evil seems to be linked with a complex development of Western metaphysics. This article intends to study how Levinasian phenomenological criticism is capable of suspending elemental evil, trying to dismantle Western politics through the foundation of a phenomenological politics that conceives another relationship.

Resumen Introducción: Hasta donde se tiene conocimiento, la investigación que se presenta constituye el primer trabajo multicéntrico en México que estudia el desarrollo de la aptitud clínica en unidades formadoras de cardiólogos. Objetivo: Determinar el grado de desarrollo de la aptitud clínica en residentes de cardiología en tres unidades médicas de alta especialidad. Métodos: Diseño transversal multicéntrico. Se analizaron todos los estudiantes del ciclo académico 2019-2020. Se construyó un instrumento que evaluó la aptitud clínica a partir de ocho indicadores y 170 ítems; la validez conceptual/de contenido y la confiabilidad fueron valoradas por cinco cardiólogos con experiencia docente y en investigación educativa. Resultados: Por indicador y año de residencia se observaron diferencias estadísticas significativas en la sede CMN20Nov; en HCSXXI e INCICh se observaron diferencias estadísticamente significativas en uno de ocho indicadores. Se estimaron diferencias entre residentes R1 (n = 41) de las tres sedes por indicador, con significación estadística en tres de ocho indicadores. El resultado fue semejante al comparar R2 (n = 35) y R3 (n = 43). Conclusiones: El grado de desarrollo de la aptitud clínica se puede considerar medio en las tres sedes académicas, probablemente debido a que el instrumento exploró situaciones clínicas problematizadas que exigieron del residente la reflexión crítica de su experiencia clínica.

Abstract Introduction: To the best of our knowledge, the research herein presented is the first multicenter study in Mexico to analyze the development of clinical aptitude in medical units that train cardiologists. Objective: To determine the degree of development of clinical aptitude in cardiology residents at three High Specialty Medical Units. Methods: Multicenter, cross-sectional design. All students of the 2019-2020 academic year were included in the study. An instrument was constructed that evaluated clinical aptitude based on eight indicators and 170 items; conceptual/content validity and reliability were assessed by five cardiologists with teaching and educational research experience. Results: By indicator and year of residence, significant statistical differences were observed in the CMN20Nov academic site. At HCSXXI and INCICh, statistically significant differences were observed in one of eight indicators. Differences between R1 residents (n = 41) of all three academic sites were estimated by indicator, with statistical significance being recorded in three of eight indicators. Between R2 (n = 35) and between R3 residents (n = 43), the result was similar. Conclusions: The degree of clinical aptitude development can be considered intermediate in all three academic sites, probably because the instrument explored problematized clinical situations that required the residents to critically reflect on their clinical experience.

Abstrato Introdução: Atualmente, a presença da pandemia de COVID-19 tem impactado toda a população, afetando em maior medida os portadores de doenças crônicas como o diabetes mellitus tipo 2, o que implica em maior sobrecarga para seus principais cuidadores. Objetivo: Identificar as experiências de cuidadores de idosos com diabetes mellitus tipo 2 durante a pandemia de COVID-19. Metodologia: Estudo qualitativo descritivo do tipo fenomenológico baseado na vivência e percepções de sete cuidadores maiores de 18 anos de pacientes com diabetes mellitus tipo 2, foi aplicada uma entrevista estruturada em seis dimensões, os dados foram analisados com o programa estatístico Atlas Ti versão 7.0, o estudo atendeu ao disposto na Lei Geral de Saúde de Pesquisa em Saúde. Resultados: Os cuidadores referiram ter entre 18 e 40 anos, em sua maioria homens, o tempo de cuidado variou de 1 a 20 anos, quanto ao manejo das informações, manifestaram desconhecimento sobre o cuidado, quanto à experiência negativa no cuidado. Em momentos de pandemia, os cuidadores percebiam situações de estresse e geração de estratégias de enfrentamento ao confinamento, no meio social prevaleciam o estresse e a ansiedade, no que se refere ao sentimento de satisfação com o cuidado que referiram estar satisfeitos. Conclusão: Foi identificada uma experiência difícil, frustrante, terrível, perturbadora, assustadora e exasperante no momento da pandemia de COVID-19, bem como a falta de atenção aos cuidadores propensos a sofrer de um transtorno de sobrecarga.

Abstract Introduction: Currently, the presence of the COVID-19 pandemic has impacted the entire population, affecting patients with chronic diseases such as type 2 diabetes mellitus to a greater extent, which implies a greater burden for their main caregivers. Objective: Identify the experiences in caregivers of older adults with type 2 diabetes mellitus during the COVID-19 pandemic. Methodology: Qualitative descriptive study of a phenomenological type based on the lived experience and perceptions of seven caregivers over 18 years of age of patients with type 2 diabetes mellitus, a structured interview was applied in six dimensions, the data were analyzed with the statistical program Atlas Ti version 7.0, the study adhered to the provisions set forth by General Health Law on Health Research. Results: The caregivers reported being between 18 and 40 years old, mostly men, the length of care ranged from 1 to 20 years; regarding the handling of the information, they stated ignorance with respect to care, and regarding the negative experience in the care during pandemics. In this respect, caregivers perceived situations of stress and generation of strategies for coping with confinement, in the social environment stress and anxiety prevailed; regarding the feeling of satisfaction with care they mentioned being satisfied. Conclusion: A difficult, frustrating, awful, disturbing, scary, and exasperating experience was identified at the time of the COVID-19 pandemic, as well as lack of attention towards caregivers who were prone to suffering from an overload disorder.

Resumen Introducción: En la actualidad la presencia de la pandemia por COVID-19 ha impactado en toda la población, afectando con mayor medida a las personas con enfermedades crónicas como la diabetes mellitus tipo 2, lo que implica una mayor carga para sus principales cuidadores. Objetivo: Identificar las experiencias en cuidadores de adultos mayores con diabetes mellitus tipo 2 durante la pandemia COVID-19. Metodología: Estudio cualitativo descriptivo de tipo fenomenológico fundamentado en la experiencia vivida y percepciones de siete cuidadores mayores de 18 años de pacientes con diabetes mellitus tipo 2, se aplicó entrevista estructurada en seis dimensiones, los datos se analizaron con el programa estadístico Atlas Ti versión 7.0, el estudio se apegó a lo establecido en la Ley General de Salud en Materia de Investigación para la Salud. Resultados: Los cuidadores reportaron tener una edad entre 18 y 40 años, en su mayoría hombres, la antigüedad de cuidado osciló entre 1 a 20 años, en cuanto al manejo de la información manifestaron desconocimiento hacia los cuidados, respecto a la experiencia negativa en el cuidado en tiempos de pandemia los cuidadores percibieron situaciones de estrés y generación de estrategias para el afrontamiento ante el confinamiento, en el entorno social prevaleció el estrés y ansiedad, respecto al sentimiento de satisfacción con el cuidado mencionaron estar satisfechos. Conclusión: Se identificó una experiencia difícil, frustrante, horrible, inquietante, terrible y desesperante en época de la pandemia por COVID-19, además existió falta de atención hacia los cuidadores quienes son propensos a sufrir algún trastorno por sobrecarga.

Abstract Authors need of information about the editorial policies (EP) of journals to choose the one that best meets their needs. Aim: To characterize the trends in the EP in the open access (OA) journals cataloged in the area of Social Sciences (CCSS) and in the sub-area Communication in Scopus. Methods: This research was descriptive, cross-sectional, and supported by bibliometrics for analyzing 77 journals. Results: it was observed the predominance of journals published every six months, and that English is the language considered by 90% of the journals for publishing. Although the trend is to standardize the length of the articles, there are variations by gender, and it is measured in characters with spaces, words, and pages. Regarding the processing charge for OA, 55.8% do not require it. Conclusions: It is concluded that the EP of these OA journals in Scopus translates into offering possibilities of visibility to authors and reinforce collaborative research.

Resumen Los autores de artículos necesitan información acerca de ciertas políticas editoriales (PE) de las revistas para elegir la que mejor responda a sus necesidades. Objetivo: caracterizar las tendencias en PE en las revistas de acceso abierto (AA) catalogadas en el área de Ciencias Sociales (CCSS) y en la subárea de Comunicación, en Scopus. Métodos: ésta fue una investigación descriptiva y transversal, apoyada en la bibliometría en la que se analizaron 77 revistas. Resultados: se observa el predominio de revistas con periodicidad semestral y del idioma inglés como lengua considerada por 90% de las revistas. Si bien la tendencia es normar la extensión de los artículos, ésta suele variar según género publicado y se mide en caracteres con espacios, palabras y páginas. En atención al cargo por procesamiento para AA, 55,8% no lo exige. Conclusión: las PE de estas revistas de AA en Scopus se traducen en ofrecer posibilidades de visibilidad a los autores y fortalecer la investigación de forma colaborativa.

Abstract: In this paper, an approach for the classification of paintings by artistic style using color and texture features is proposed. Our approach automatically extracts a set of visual features that effectively discriminate among diverse artistic styles. Additionally, our proposal performs an effective selection of the most relevant features to be used in an artificial neural network architecture. Using the most important features allows our system to achieve an efficient learning process. The proposed system analyzes digitized paintings using a combination of color and texture features, which have shown to be highly discriminatory. Our approach consists of two main stages: training and testing. Firstly, in the training stage, the features from seven artistic styles are extracted to train a multi-layer perceptron. Secondly, the learned model is utilized to determine the artistic style of a given incoming painting to our system. The experimental results, on an extensive dataset of digitized paintings, show that our method obtains a higher accuracy in comparison with those obtained by the state-of-the-art methods. Moreover, our proposal attains a higher accuracy rate using fewer features descriptors.

Resumen La intususcepción intestinal es la invaginación de un segmento de intestino en el interior de otro segmento inmediato, asociado a una alteración en la pared intestinal, siendo en intestino delgado más común por patologías benignas y en intestino grueso por patologías malignas. Presentamos caso de paciente femenino de 30 años, con dolor abdominal de 1 semana de evolución y datos de oclusión intestinal, se somete a laparotomía de urgencia, donde se encuentra intususcepción intestinal en íleon terminal. La intususcepción intestinal generalmente se va a presentar como un cuadro de obstrucción intestinal. El tratamiento es la resección del segmento afectado.

Abstract The intestinal intussusception is the invagination of one segment of the bowel into an immediately adjacent segment, associated to an alteration into the wall, the small intestinal is the most associated a benign pathology and large intestinal by malignant pathologies. We present the case of a 30-year-old female patient, who came to the emergency room due to intense abdominal pain of 1 week of evolution and evidence of intestinal occlusion, who underwent emergency laparotomy, where intestinal intussusception was found in the terminal ileum. Generally, the clinical presentation like an intestinal obstruction. Treatment is resection of the affected segment.

RESUMEN Las infusiones de hojas de guanábana (Annona muricata L.) se han utilizado como medicina alternativa por su composición fitoquímica, actividad farmacológica y citotóxica, que les confieren actividad antibacteriana, antioxidante y anticancerígena. Las infusiones de hojas de guanábana se obtuvieron a 5, 10 y 15 min en muestras colectadas de las regiones de Chiapas y Nayarit en México; se evaluaron fenoles solubles totales (FST), flavonoides (F), taninos condensados (TC), antocianinas totales (AT), actividad antioxidante, reflectancia total atenuada por análisis de espectroscopia infrarroja transformada de Fourier (FTIR-ATR) y actividad citotóxica en líneas celulares MCF7 y HT-29. El contenido promedio de FST, F, TC y AT fue de 0.229±0.006 mg equivalentes de ácido gálico ml-1, 0.177±0.003 mg equivalentes de catequina ml-1, 0.298±0.012 mg equivalentes de cianidina 3-glucósido ml-1 y 0.189±0.003 mg equivalentes de catequina ml-1 respectivamente. El análisis FTIR-ATR determinó grupos carbonilo, hidroxilo, éster y ácidos carboxílicos. La actividad antioxidante por 2,2-difenil-1-picrilhidracilo (DPPH) y 2,2'-azino-bis-3-etilbenzotiazolina-6-ácido sulfónico (ABTS) fue de 0.446±0.014 y 3.53±0.515 mM equivalentes de Trolox ml-1 respectivamente. Los rendimientos de extracción de FST, F, TC y AT mediante infusión fueron 88.41, 66.12, 34.93 y 56.09 respectivamente. La actividad antioxidante fue 50.77% de ABTS y 21.44% de DPPH. Se presentó actividad citotóxica contra la línea celular MCF7 (80%). Las infusiones presentaron un alto contenido de polifenoles, actividad antioxidante y citotóxica.

ABSTRACT Infusions of soursop or graviola (Annona muricata L.) leaves have been used as alternative medicine for their phytochemical composition, pharmacological and cytotoxic activity that are related with antibacterial, antioxidant, and anticancer activities. Infusions of soursop leaves were obtained at 5, 10, and 15 min in samples collected from the Chiapas and Nayarit regions of Mexico. Total soluble phenols (TSP), flavonoids (FC), condensed tannins (CT), total anthocyanins (AC), antioxidant activity, attenuated total reflectance - Fourier transform infrared spectroscopy analysis (FTIR-TRA), cytotoxic activity in MCF7 and HT-29 cell lines were evaluated. The average contents of TSP, FC, CT and AC were as follows: 0.229±0.006 mg gallic acid equivalents ml-1, 0.177±0.003 mg catechin equivalents ml-1, 0.298±0.012 mg cyanidin 3-glucoside equivalents ml-1, and 0.189±0.003 mg catechin equivalents ml-1, respectively. The FTIR-ATR analysis determined carbonyl, hydroxyl, ester, and carboxylic acid groups. The antioxidant activity of 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azino-bis (3-ethylbenzothia-zoline-6-sulfonic acid) (ABTS) were 0.446±0.014 and 3.53±0.515 mM Trolox equivalents ml-1, respectively. The extraction yields of TSP, FC, CT, and AC by infusion were 88.41, 66.12, 34.93, and 56.09%, respectively. The antioxidant activity was 50.77% for ABTS and 21.44% for DPPH. Cytotoxic activity was present against the MCF7 (80%) cell line. The infusions had high polyphenol contents, antioxidant and cytotoxic activities.

Resumen El estudio de los géneros discursivos de las ciencias biomédicas ha priorizado el artículo de investigación en inglés, mientras que otros géneros relevantes, como las revisiones sistemáticas o el caso clínico, han merecido menos interés. Tampoco abundan los estudios discursivos en español sobre la estructura del título que orienten a lectores y autores y faciliten la indexación de esos documentos en bases de datos. Por ello, se propone identificar las estructuras léxico-gramaticales y las funciones retóricas que desempeñan los títulos de casos clínicos en español, además de compararlos con algunas investigaciones previas sobre el mismo componente en géneros odontológicos afines en inglés y español. Para ello, se recopilaron y analizaron 248 títulos de casos clínicos publicados en español en revistas especializadas, con métodos de análisis discursivo, complementados con entrevistas semiestructuradas a informantes expertos del campo. Se encontró: un promedio 12,7 palabras por título; una alta presencia de títulos compuestos por dos (94%) y tres elementos (4%), seguidos de títulos nominales (2%); dos combinaciones retóricas primordiales (1/enfermedad o tratamiento y método, 2/tema, descripción o método); alta presencia de construcciones nominales, modificadas con frases preposicionales (100%) y frases verbales no personales (10%); una mayoría de títulos identifica el género discursivo (‘caso clínico’, ‘reporte de caso’ o ‘caso clínico’) e incluye tanto nombres disciplinares como no disciplinares (‘miasis maxilar’, ‘reporte’). Estos resultados tienen implicaciones pedagógicas para la enseñanza de la escritura académica a estudiantes de odontología y odontólogos en proceso de formación, pues los datos empíricos y ejemplos reales aportados pueden fundamentar el diseño de los programas y la práctica.

Abstract In the study of biomedical discourse genres, priority has been given to research papers in English, while other relevant genres, such as systematic reviews and case reports, have received less attention. Furthermore, there are a few discourse studies in Spanish focusing on the structure of titles that guide readers and authors and facilitate the indexing of these documents in databases. For this reason, the study aims to identify the lexical-grammatical structures and rhetorical functions of clinical case report titles in Spanish and to compare them with previous research that analyze the same variables in related dentistry genres in English and Spanish. To carry out this investigation, we collected and analyzed 248 titles of case reports published in Spanish in specialized journals, with methods of discourse analysis complemented with semi-structured interviews with specialist informants in the field. Results show an average 12.7 words per title; a high presence of compound titles of two (94%) and three components (4%), followed by nominal titles (2%); two main rhetorical combinations (1/disease or treatment and method, 2/topic, description or method); high presence of nominal constructions, modified by prepositional phrases (100%) and non-personal verbal phrases (10%); a majority of titles identifies the discourse genre (‘clinical case report’, ‘case report’) and includes both disciplinary and non-disciplinary nouns (‘maxillary myiasis’, ‘case report’). These results have pedagogical implications for teaching academic writing to dentistry students and in-training dentists, as empirical data and real examples reported may inform syllabus design and the teaching practice.

Resumen El objetivo de este trabajo fue evaluar la carga microbiológica de coliformes totales (CT), Staphylococcus aureus y Salmonella spp en leche y quesos frescos como indicadores de prácticas de proceso que se realizan en queserías de diferentes localidades de la región de Salinas, San Luis Potosí. Se muestrearon 15 establecimientos, se obtuvieron muestras de leche y queso y se les realizó un análisis de composición de la leche y microbiológico. El 65 % de las unidades de producción no pasteuriza la leche o utiliza cuajo natural. Los conteos más elevados en leche fueron de 42 x 109 y 40 x 109 UFC/ml para S. aureus y CT, respectivamente. Para queso, las cuentas de 32 x 109 y 26 x 109 UFC/g para S. aureus y CT, respectivamente. Además, se detectó presencia de Salmonella en leche y queso. Se concluye que la falta de higiene en los utensilios y equipos en los que se elaboran los quesos, así como el uso de cuajo natural, pueden ser un riesgo para la salud del consumidor.

Abstract The objective of this work was to evaluate the microbiological load of total coliforms (TCs), Staphylococcus aureus and Salmonella spp. in milk and fresh cheeses as indicators of process practices carried out in cheese dairies of different localities in the region of Salinas, San Luis Potosí. Fifteen establishments were sampled, milk and cheese samples were obtained, and they underwent a milk composition and microbiological analysis. Sixty-five percent of the production units do not pasteurize the milk, or they use natural rennet. The highest counts in milk were 42 x 109 and 40 x 109 CFU/ml for S. aureus and TCs, respectively. For cheese, the counts were 32 x 109 and 26 x 109 CFU/g for S. aureus and TCs, respectively. In addition, the presence of Salmonella was detected in milk and cheese. The lack of hygiene in the utensils and equipment in which the cheeses are made, as well as the use of natural rennet, can be a risk to the health of the consumer.