Abstract The prevalence of obesity in adults is not homogeneous through space. Its concentration has been linked to the access of individuals to an obesogenic environment. The article analyzes the relationship between the high prevalence of obesity in adults and the unhealthy food environment of the municipalities of Mexico. Methodologically, we evaluate the spatial effect of the municipal conditions that encourage the health problem. The results indicate that the problem is more acute in the municipalities of Yucatan, Colima and the north of the country where the repercussions of the unhealthy food environment have a regional diffusion effect.

Resumen La prevalencia de obesidad en adultos no es homogénea en el espacio, su concentración se vincula con el acceso de los individuos a un ambiente obesogénico. En el artículo se analiza la relación entre el incremento de obesidad en adultos y el ambiente alimentario no-saludable de los municipios de México. Se evalúa el efecto espacial a través de las condiciones municipales que incentivan este problema de salud. Los resultados indican que el ambiente alimentario no-saludable prevalece en los municipios de Colima, la península de Yucatán y el norte del país, donde se difunde su efecto negativo regionalmente.

Abstract The hegemony of the service sector in the global economy has functionally and spatially modified innovation processes. And in the latter, knowledge-intensive services (KIS) are central links because their employees have high levels of qualification and skills. This article analyzes the spatial distribution of employment in CIS with high levels of schooling in the Metropolitan Area of Mexico City (AMCM). Methodologically, we distinguish the type of knowledge they develop (analytical, synthetic and symbolic) and use microdata to understand their educational structure and their levels of spatial concentration. Local spatial autocorrelation indexes (LISA) and nearest neighbor with hierarchical clustering are used in the analysis. The results indicate that slightly more than half of the CIS employment in the AMCM has high schooling, which is characterized by its concentration in clusters of different types of knowledge (multi-CIS clusters) located in a relatively dispersed manner in the metropolitan space.

Resumen La hegemonía del sector servicios en la economía global ha modificado funcional y espacialmente los procesos de innovación. Y en estos últimos, los servicios intensivos en conocimiento (SIC) son eslabones centrales gracias a que sus empleados cuentan con altos niveles de calificación y habilidades. En este artículo se analiza la distribución espacial del empleo en SIC que cuentan con nivel de escolaridad alto en el Área Metropolitana de la Ciudad de México (AMCM). Metodológicamente, se distingue el tipo de conocimiento que desarrollan (analítico, sintético y simbólico) y se utilizan microdatos para conocer su estructura educativa y sus niveles de concentración espacial. En el análisis se utilizan los índices de autocorrelación espacial local (LISA) y el vecino más cercano con clúster jerárquico. Los resultados indican que poco más de la mitad del empleo en SIC del AMCM tiene escolaridad alta, el cual se caracteriza por su concentración en clústeres de distintos tipos de conocimiento (clústeres multi-SIC) localizados de manera relativamente dispersa en el espacio metropolitano.

Abstract Introduction Bone conduction implants, responsible for transmitting sound from an external processor to the inner ear, can be divided into active and passive, depending on the vibratory stimulus location. The use of transcutaneous device has increased, given its aesthetic appeal, the complications and limitations of percutaneous devices, and patient’s treatment adherence, focusing mainly on efficacy. However, various complications are associated with the use of transcutaneous prosthesis, which can often be serious. Objective To approach the literature on complications involving transcutaneous bone-anchored prostheses through a systematic review of articles published in the past 10 years (2011–2021). Data Synthesis The MEDLINE, EMBASE, Scopus, and Cochrane Library databases were searched. All articles written in English reporting on currently available transcutaneous prosthesis implantation and its complications were selected. Studies on both children and adults were included. The data on complications were extracted, and complications were classified as minor or major and associated to each device used. Thirty-seven articles were included in the study, of which 14 were prospective cohort studies, 22 were retrospective case series, and 1 was a case report. Most studies (18) included both adults and children. Moreover, 901 implantations were performed, of which 552 implanted Baha Attract (Cochlear Ltd., Sydney, Australia), 244 implanted BoneBridge (MED-EL, Innsbruck, Austria), and 105 implanted Sophono (Sophono Inc., Boulder, CO, USA]). Furthermore, 192 adverse events were reported (total complication rate, 21.3%), with 161 minor complications (84.3%) and 31 major complications (16.1%). Conclusion Transcutaneous prosthesis is an audiological alternative with fewer complications than percutaneous prosthesis. However, its indication should be judicious because complications are common, and although most complications are minor, serious infections requiring explantation may develop.

ABSTRACT In this paper we reflect on the potential of the “cultural industry” to boost the economy of Mexican cities. Cultural activities have been promoted in large cities to revitalize their economies. In some cases, cultural activities contribute to the local economy with high percentage of their employment and income. These activities also represent a niche that attracts visitors, leave profits, and have become its symbolic brand. The main objective is to study the participation and changes of cultural activities in the economic structure of the 384 cities of the National Urban System (nus) between 2004 and 2014. Methodologically, such activities have been defined as ‘knowledge-intensive services’ (kis) that produce ‘symbolic’ elements: mass media, culture and design. The results indicate that not only large cities have significant kis-symbolic concentration; medium-sized and small ones do as well. This result opens possibilities to implement public policies that focus on the development of kis-symbolic in the local economy.

RESUMEN En este trabajo reflexionamos sobre el potencial de la “industria cultural” para dinamizar la economía de las ciudades en México. Las actividades de orden cultural han sido promovidas en grandes ciudades para revitalizar sus economías y, en algunos casos, aportan un elevado porcentaje de su empleo e ingreso. Representan, además, un nicho que atrae visitantes y genera utilidades, y se han convertido en su marca y sello simbólico. El objetivo central es estudiar la participación y los cambios recientes de las actividades culturales en la estructura económica de las 384 ciudades del Sistema Urbano Nacional (sun) mexicano. Metodológicamente, tales actividades han sido definidas como ‘servicios intensivos en conocimiento’ (knowledge-intensive services, kis) que producen elementos ‘simbólicos’: medios de comunicación masiva, cultura y diseño. Los resultados indican que no solo las grandes ciudades tienen concentraciones sobresalientes de kis-simbólicos, sino también las medianas y pequeñas, lo cual abre un abanico de posibilidades para implementar políticas públicas encaminadas a su desarrollo en el ámbito urbano.

Abstract This research aims to determine absorptive capacity’s impact on innovation in SMEs in Peru. SMEs in Latin America tend to be characterized by technological backwardness, and innovations, if any, tend to be incremental in nature. In Peru, more than half of innovation activities are destined to the acquisition of capital goods. In this sense, rather than generate innovation, SMEs tend to adopt existing innovations. Thus, in order to reap the benefits of innovation adoption, SMEs must possess a high degree of absorptive capacity, understood as the firm’s capacity to value external knowledge, assimilate, and exploit it towards commercial ends. In this respect, Innovate Peru, an innovation agency, grants subsidies to SMEs for facilitating innovation adoption. In collaboration between the public and academic sector, data was recollected from 88 SMEs that were granted this innovation subsidy. This paper contributes to the literature on absorptive capacity and innovation within Latin America, which has been vaguely studied. Likewise, it holds practical implications for top managers from SMEs who are looking to innovative, and policy implications for innovation policy makers, as it validates the effect of an innovation policy instrument.

Resumo Soluções técnicas que são projetadas de cima para baixo (top-down) para lidar com o controle de enchentes, como a canalização, são cada vez mais inacessíveis. Neste trabalho, explorou-se como os líderes comunitários enquadram o conceito de risco, particularmente devido a inundações, e documentamos soluções de baixo para cima (bottom-up), em vez de soluções de cima para baixo, no contexto do furacão Maria e da atual crise financeira. Esta pesquisa visou entrevistar líderes organizacionais de conservação ambiental para avaliar a questão mais ampla do que torna San Juan habitável, e o papel que o gerenciamento de risco de inundação desempenha na definição da habitabilidade. Na percepção dos líderes, abordagens ascendentes para o controle de enchentes, incluindo o papel da infraestrutura verde, é de particular interesse, dada a inviabilidade das atuais medidas de engenharia e do histórico de estratégias de enfrentamento local de curto prazo. A equipe responsável enquadra a pesquisa usando soluções estruturais em contraste com soluções não-estruturais para explorar até que ponto os líderes comunitários se baseiam em visões verdes da cidade ou enfatizam a transição para estratégias mais alinhadas com processos e funções ecológicas. Os resultados da pesquisa podem ajudar a informar os esforços atuais para envolver as comunidades em nível local sobre soluções alternativas para canalização e outras medidas de gerenciamento de enchentes urbanas.

Abstract Top-down technical or engineered solutions to deal with flood control such as channelization are increasingly unaffordable. We explored how community leaders’ frame the concept of risk, particularly due to flooding, and documented bottom-up rather than top-down solutions within the context of Hurricane Maria and the current financial crisis. This research aimed to interview environmental conservation organizational leaders to assess the broader question of what makes San Juan livable, and the role that flooding risk management plays in defining livability. Their perception of bottom-up approaches for flood control, including the role of green infrastructure, is of particular interest given the infeasibility of current engineered measures and their history of short term local coping strategies. Our research team frames the research using structural versus non-structural solutions to explore to what extent community leaders draw upon green visions of the city or emphasize transitioning towards strategies more closely aligned with ecological processes and functions. The research results help to inform current efforts of local community engagement about alternative solutions to channelization and other urban flood management measures.

Resumo: O presente artigo explora as representações masculinas presentes nos discursos que tratam de homens com deficiência física. A partir de uma metodologia que se baseia teoricamente nos estudos sobre deficiência e gênero, aborda representações como estratégias discursivas, com três objetivos: estabelecer uma norma de masculinidade hegemônica, associada à normalidade funcional compulsória transmitida por uma retórica visual maravilhosa; a adaptação dessa masculinidade para fins comerciais através de uma retórica realista; e o desafio às normas acima mencionadas apresentado pela teoria queer.

Abstract: The present work analyzes male representation in the discourse of men with physical disability. Using a methodology that draws theoretically on disability and gender studies, representations were approached as discursive strategies with three evident purposes: to establish a norm of hegemonic masculinity, associated with compulsory functional normality conveyed by a rhetoric of visual wonderfulness, the adaptation of that masculinity for commercial purposes through a realistic rhetoric; and the challenge to these processes presented by queer theory.

Resumen: El objetivo del presente artículo es preguntarnos sobre las representaciones masculinas presentes en los discursos que versan sobre varones con discapacidad física. Desde una metodología que abreva teóricamente en los estudios sobre discapacidad y de genero, se intenta abordar las representaciones como estrategias discursivas, con tres fines evidentes: instaurar una norma de masculinidad hegemónica, asociada a la normalidad funcional compulsiva vehiculizada mediante una retórica visual maravillosa; la adaptación de esa masculinidad con fines comerciales mediante una retórica realista; y el desafío a las normas antes citadas mediante la teoría queer.

Abstract INTRODUCTION: In the present study, we determined the chemical composition of Clinopodium macrostemum essential oil obtained by microwave-assisted hydrodistillation and its effect on the growth and development of Culex quinquefasciatus mosquito larvae. METHODS: The essential oil compounds were identified by gas chromatography-mass spectrometry analysis, and bioassays were conducted to evaluate the influence on the developmental stages of early second instar larvae of Cx. quinquefasciatus until the emergence of adults, using essential oil concentrations of 50, 100, 200, 400, and 800mg/L. RESULTS: The gas chromatography-mass spectrometry analyses revealed that the leaf essential oil of C. macrostemum contained 32 compounds and the major chemical compounds identified were linalool (55.4%), nerol (6.4%), caryophyllene (6.25%), menthone (5.8%), geraniol acetate (4.1%), terpineol (3.7%), and pulegone (2.8%). The essential oil yield obtained by microwave-assisted hydrodistillation was 0.8% at 20 min. The treatments showed lethal concentrations (LC50 and LC90) of 22.49 and 833.35mg/L, respectively, after the final measurement of the total number of dead larvae (second, third, and fourth instars), and LC50 and LC90 of 6.62 and 693.35mg/L, respectively, at the end of the experimental period. The essential oil inhibited the growth and development of the mosquito larvae by 32% (relative growth index = 0.68) at 50mg/L, and up to 47% (relative growth index = 0.53) at 800mg/L. CONCLUSION: The present study demonstrated the larvicidal effect of C. macrostemum essential oil on Cx. quinquefasciatus, which can be attributed to the oxygenate compounds obtained by the extraction method.

ABSTRACT Objective: to analyze the cost-containment strategy for multiple avoidable hospitalizations in a program of Chronic Patient Management (GDC), since its implementation in a health care provider organization. Method: this is a retrospective study with quantitative approach in which a survey was conducted with data obtained through monitoring of 243 patients assisted by the program from 2009 to 2012. Approved by Research Ethics Comitee (CAAE: 34525614.8.0000.5285). Results: in the case of basic conditions, most patients possessed more than one installed disease. Regarding the costs of emergency hospitalization in the year before GDC was BRL 1,323,295.43 and the subsequent year BRL 629,565.89. It was possible to observe how expensive were the patients who presented pathologies that could be avoided. Conclusion: it was concluded that an efficient management in health allows profesionals to offer services in order to a greater number of users with no prejudice to the operators, especially when allocated to preventive actions.

RESUMEN Objetivo: analizar la estrategia de contención de costos de múltiples hospitalizaciones evitables en un programa de Manejo de Pacientes Crónicos (GDC), desde su implementación en una organización de proveedores de atención médica. Método: se trata de un estudio retrospectivo con enfoque cuantitativo en el que se realizó una encuesta con datos obtenidos a través del seguimiento de 243 pacientes atendidos por el programa de 2009 a 2012. Aprobado por el Comité de Ética en Investigación (CAAE: 34525614.8.0000.5285). Resultados: en el caso de condiciones básicas, la mayoría de los pacientes poseían más de una enfermedad instalada. En cuanto a los costos de hospitalización de emergencia en el año anterior a la GDC fue de R $ 1.323.295,43 y el año siguiente BRL 629,565.89. Se pudo observar cuán costosos eran los pacientes que presentaban patologías que podían evitarse. Conclusión: se concluyó que una gestión eficiente en salud permite a los profesionales ofrecer servicios a un mayor número de usuarios sin perjuicio de los operadores, especialmente cuando se les asignan acciones preventivas.

RESUMO Objetivo: analisar a estratégia de contenção de custos por múltiplas internações evitáveis de um Programa de Gerenciamento de Doentes Crônicos (GDC), desde sua implantação, em uma operadora de saúde. Método: estudo retrospectivo, abordagem quantitativa em que foi realizado um levantamento dos dados obtidos através do acompanhamento dos 243 pacientes assistidos pelo programa de 2009 a 2012. Aprovado pelo CEP sob o CAAE: 34525614.8.0000.5285. Resultados: com relação às patologias de base, a maioria dos pacientes possuiu mais de uma doença instalada. Com relação aos custos decorrentes de internação de emergência no ano anterior ao GDC foi de R$1.323.295,43 e no ano posterior R$629.565,89. Foi possível observar o quão custosos foram os pacientes que apresentaram as patologias possíveis de serem evitadas. Conclusão: percebe-se que uma gestão eficiente em saúde possibilita oferecer serviços para um número maior de usuários, sem prejudicar as operadoras, em especial quando alocados em ações envolvendo a prevenção.

El artículo reflexiona sobre la relación entre estructura de juego, narrativa y simbolización de la diferencia sexual dentro de tres videojuegos clásicos de la consola Nintendo de la década de los ochenta. Realiza un análisis situado en un cruce de caminos entre los aportes de los estudios de género, la ludología y la narratología, demostrando cómo dentro de la mecánica del juego, descansa una simbolización de la diferencia sexual que constituye una narrativa épica heroica masculina, y cómo las ambigüedades de género están presentes en el binomio sujeto-jugador, disparadas por la incorporación de lo femenino.

The article reflects on the relationship between game structure, narrative and symbolization of sexual differences among three classic Nintendo games from the decade of the Eighties. An analysis is performed regarding the contributions of gender studies, ludology and narratology, and conveys how within the game strategies lies a symbolization of sexual difference of a masculine epic-heroic narrative, and how gender ambiguities are present in the binomial subject-player through the participation of the feminine.

O artigo reflete sobre a relação entre estrutura de jogo, narrativa e simbolização da diferença sexual dentro de três videogames clássicos da Nintendo da década de oitenta. Realiza uma análise situada em um cruzamento de caminhos entre as contribuições dos estudos de gênero, a ludologia e a narratologia, demostrando como dentro da mecânica do jogo, descansa uma simbolização da diferença sexual que constitui uma narrativa épica heroica masculina, e como as ambiguidades de gênero estão presentes no binômio sujeito-jogador, disparadas pela incorporação do feminino.

The main purpose of this study was to obtain kinetic and equilibrium parameters for the anthraquinone dye r emoval of Remazol Brilliant Blue R dye from aqueous solutions using yeast biomass as biosorbent, and identify the functional groups responsible for biosorption by infrared spectrometry. Biosorption dye kinetics at temperatures of 10 °C, 20 °C, 30 °C and 40 °C were fitted correctly by the pseudo-first and pseudo-second order models. The values of thermodynamic activation parameters indicated that the biosorption process is endothermic and no spontaneous. Sorption isotherm at 20 °C, pH 2,0 and a biomass concentration of 1,0 g L-1 was obtained, finding a value of 127,6 mg g-1 for the saturated monolayer according to the Langmuir model. Infrared studies showed that carboxyl and amide are the main functional groups responsible for dye biosorption.

El propósito principal de este trabajo fue obtener parámetros cinéticos y en equilibrio para el proceso de remoción de colorante de antraquinona azul brillante de remazol R de soluciones acuosas, empleando biomasa de levadura como biosorbente, así como identificar los grupos funcionales responsables de la biosorción por espectrometría de infrarrojo. Las cinéticas de biosorción del colorante a temperaturas de 10 °C, 20 °C, 30 °C y 40 °C se ajustaron correctamente a los modelos de seudo-primer y seudo-segundo orden. Los valores de los parámetros termodinámicos de activación calculados indicaron que el proceso es endotérmico y no espontáneo. Se obtuvo la isoterma de sorción a 20 °C, pH 2,0 y 1,0 g de biomasa L-1, encontrándose un valor de 127,6 mg g-1 para la monocapa saturada de acuerdo al modelo de Langmuir. Los estudios de infrarrojo mostraron que los grupos carboxilo y amida son los principales grupos funcionales responsables de la biosorción del colorante.

Introducción y objetivo: Desde el punto de vista etiológico, el hábito del tabaquismo se asocia con diversas enfermedades del sistema respiratorio, hecho que ocasiona una disminución acelerada de la función ventilatoria y la condición física. Sin embargo, esta relación ha sido poco explorada en población militar. Por tanto, el objetivo de este estudio fue examinar la aptitud aeróbica en hombres jóvenes fumadores, aparentemente sanos, pertenecientes a la Escuela de Cadetes José María Córdova. Materiales y métodos: Estudio observacional, descriptivo y transversal en 43 hombres militares aparentemente sanos; 21 fumadores activos (12 meses de exposición) y 22 no fumadores, con edad promedio de 19 ± 1,1 años. La aptitud aeróbica fue estimada mediante el test de Course-Navette (test de Leger), como indicador del consumo de oxígeno máximo indirecto (VO2). Se analizó la respuesta cronotrópica en ambos grupos. Resultados: Se observaron menores valores en la aptitud aeróbica en el grupo de fumadores frente al grupo de no fumadores (44,1 ± 6,6 mL/kg-1/min-1vs. 56,6 ± 3,5 mL/kg-1/min-1; p = 0,001). Asimismo, el grupo de no fumadores presentó mayor respuesta cronotrópica respecto al grupo de fumadores (167 ± 18 lpm vs. 155 ± 20 lpm; p = 0,05). Conclusiones: La aptitud aeróbica en jóvenes fumadores militares fue significativamente menor que en el grupo de no fumadores. Su identificación temprana podría traer beneficios en la prevención de enfermedades respiratorias, que actualmente cursan con carácter de epidemia en Colombia.

Background and objective: The habit of smoking is etiologically associated with different diseases of the respiratory system. It causes an accelerated decline of the ventilatory function and fitness. However, this relationship has been little explored in military population. Therefore, the aim of this study was to examine the aerobic fitness in young male smokers, apparently healthy belonging to the Cadet School José María Córdova. Materials and methods: An observational, descriptive and transversal study was performed. 43 military subjects, apparently healthy, participated in the study: 21 participants were active smokers (12 months of exposition), and 22 subjects were no-smokers; mean age 19 ± 1.1 years. Aerobic fitness was calculated using the Course Navette test (Leger's test), as an indirect indicator of the maximal oxygen intake (VO2max). Chronotropic response was analyzed in both groups. Results: Lower values of aerobic fitness were found in the smokers in relation to the non-smokers (44.1 ± 6.6 mL·kg-1·min-1vs. 56.6 ± 3.5 mL·kg-1·min-1; P = .0001). Non-smokers group showed a higher chronotropic response against the S group (167 ± 18 bpm vs. 155 ± 20 bpm; P = .05). Conclusion: Aerobic fitness in young military smokers was significantly lower than in the non-smokers group. Its early identification could bring benefits in the prevention of respiratory diseases, which are currently present in Colombia and are qualify as epidemic.

Morgagni hernia is an uncommon variety of non-traumatic diaphragmatic hernia, usually located in the right-side anterior diaphragm. A big herniary sac, which contained the greater omentum, the stomach, and the transverse colon incarcerated due to a retrosternal diaphragmatic defect, was found in an old male patient. This is very unusual finding in the elderly. This patient had a history of cholelithiasis, duodenal ulcer and diastasis recti. He was admitted at the hospital with chest pain, epigastralgia, aerogastria, upper abdominal distension, and vomits. He underwent emergency radiological studies. The diagnosis was based on chest posterior-anterior and lateral X-rays of the chest and the abdomen. Emergency laparotomy was performed to find Morgagni hernia without any vascular effect. The content was removed, the hernia sac was excised, the Morgagni foramen was repaired and cholecistectomy was performed. The recovery of the patient was complete and immediate postoperatively. The six-month follow-up showed no hernia recurrence.

La hernia de Morgagni es una variedad poco frecuente de hernia diafragmática no traumática. En un paciente anciano del sexo masculino se encontró un gran saco herniario que contenía estómago, epiplón mayor y colon transverso, encarcelados a través de un defecto diafragmático retroesternal, lo cual es muy raro en la vejez. El paciente tenía antecedentes de litiasis vesicular, úlcera duodenal y diastasis de los músculos rectos abdominales, e ingresó con dolor torácico, epigastralgia, aerogastria, distensión en la porción superior del abdomen y vómitos. El diagnóstico se obtuvo mediante radiografías posteroanterior y lateral del tórax y del abdomen. Se realizó una laparotomía de urgencia y se encontró una hernia de Morgagni encarcelada sin afectación vascular. Se redujo el contenido, se resecó el saco herniario, se reparó el defecto herniario y se efectuó la colecistectomía. La recuperación posoperatoria fue inmediata y completa. El seguimiento posoperatorio de 6 meses no mostró recidiva herniaria.