Unveiling Melanoma: A Deep Dive into Disparities at a Latin-American Cancer Institute.

INTRODUCTION: The worldwide incidence of melanoma has increased in the last 40 years. Our aim was to describe the clinic-pathological characteristics and outcomes of three cohorts of patients diagnosed with melanoma in a Latin-American cancer institute during the last 20 years. METHODS: We evaluated three retrospective patient cohorts diagnosed with melanoma at Instituto Nacional de Enfermedades Neoplasicas (INEN), a public hospital in Lima, Peru, for the years 2005-2006, 2010-2011, and 2017-2018. Survival rate differences were assessed using the Log-rank test. RESULTS: Overall, 584 patients were included (only trunk and extremities); 51% were male, the mean age was 61 (3-97) years, and 48% of patients resided in rural areas. The mean time to diagnosis was 22.6 months, and the mean Breslow thickness was 7.4 mm (T4). Lower extremity was the most common location (72%). A majority of the patients (55%) had metastases at the time of presentation, with 36% in stage III and 19% in stage IV. Cohorts were distributed as 2005-2006 (n = 171), 2010-2011 (n = 223), and 2017-2018 (n = 190). No immunotherapy was used. Cohort C exhibited the most significant increase in stage IV diagnoses (12.3%, 15.7%, 28.4%, respectively; p < 0.01). The median overall survival rates at the three-year follow-up demonstrated a decline over the years for stages II (97%, 98%, 57%, respectively; p < 0.05) and III (66%, 77%, 37%; p < 0.01). CONCLUSIONS: There has been a worsening in the incidence of late-stage metastatic melanoma in Peru throughout the years, coupled with a significant decline in overall survival rates. This is underscored by the fact that half of the population lives in regions devoid of oncological access.

A hybrid modeling framework for generalizable and interpretable predictions of ICU mortality across multiple hospitals.

The development of reliable mortality risk stratification models is an active research area in computational healthcare. Mortality risk stratification provides a standard to assist physicians in evaluating a patient's condition or prognosis objectively. Particular interest lies in methods that are transparent to clinical interpretation and that retain predictive power once validated across diverse datasets they were not trained on. This study addresses the challenge of consolidating numerous ICD codes for predictive modeling of ICU mortality, employing a hybrid modeling approach that integrates mechanistic, clinical knowledge with mathematical and machine learning models . A tree-structured network connecting independent modules that carry clinical meaning is implemented for interpretability. Our training strategy utilizes graph-theoretic methods for data analysis, aiming to identify the functions of individual black-box modules within the tree-structured network by harnessing solutions from specific max-cut problems. The trained model is then validated on external datasets from different hospitals, demonstrating successful generalization capabilities, particularly in binary-feature datasets where label assessment involves extrapolation.

Microbial communities present in Sargassum spp. leachates from the Mexican Caribbean which are involved in their degradation in the environment, a tool to tackle the problem.

The Sargassum phenomenon is currently affecting the Caribbean in several ways; one of them is the increase of greenhouse gases due to the decomposition process of this macroalgae; these processes also produce large amounts of pollutant leachates, in which several microbial communities are involved. To understand these processes, we conducted a 150-day study on the Sargassum spp environmental degradation under outdoor conditions, during which leachates were collected at 0, 30, 90, and 150 days. Subsequently, a metagenomic study of the microorganisms found in the leachates was carried out, in which changes in the microbial community were observed over time. The results showed that anaerobic bacterial genera such as Thermofilum and Methanopyrus were predominant at the beginning of this study (0 and 30 days), degrading sugars of sulfur polymers such as fucoidan, but throughout the experiment, the microbial communities were changed also, with the genera Fischerella and Dolichospermum being the most predominant at days 90 and 150, respectively. A principal component analysis (PCA) indicated, with 94% variance, that genera were positively correlated at 30 and 90 days, but not with initial populations, indicating changes in community structure due to sargassum degradation were present. Finally, at 150 days, the leachate volume decreased by almost 50% and there was a higher abundance of the genera Desulfobacter and Dolichospemum. This is the first work carried out to understand the degradation of Sargassum spp, which will serve, together with other works, to understand and provide a solution to this serious environmental problem in the Caribbean.

Maternal Risk Factors Associated With Neonatal Outcome in Primiparous, Machala, Ecuador.

Introduction The resulting neonatal, weight of the newborn (NB) is considered as a health indicator since the nutritional status of the neonate can have repercussions on the growth and development of the child until adulthood. Secondly, preterm delivery is associated with several maternal risk factors, such as the presence of anemia, adolescence, or advanced age. The aim of the study was to determine the maternal risk factors related to neonatal outcomes in primiparous. Methods A descriptive, observational, quantitative, longitudinal, and non-experimental study was conducted. Data were collected from women who gave birth from September 2021 to August 2022, in a Microsoft Excel database and the analysis was performed using SPSS software, version 26. Results The study population consisted of 224 pregnant women, aged 16 to 41 years, with a mean of 21 years (SD ± 4 years), the most predominant age range was under 20 years, with 53.33%, 81.7% were of middle socioeconomic status, 50.4% had basic education, 89.7% self-identified as mestizo race, 86.2% were of Ecuadorian nationality, and 96.0% resided in the urban area. A total of 97.8% were term NB, 69.9% were normal weight, and 96.4% had an Apgar score of 8 to 10 in the first minute after birth. Maternal factors related to Apgar 7 were adolescent and elderly women, with an odds ratio (OR) of 2.180; having maternal comorbidity OR: 2.0612; the factors related to preterm and post-term neonates were the degree of primary and basic education, OR: 2.0, without statistical significance (p>0.05). And in relation to low weight and high weight, we have an academic education OR: 3.0417, without statistical significance (p>0.05); and mothers with a history of previous abortions, OR: 8.6000, with high statistical significance (p<0.05). Conclusions Among the main maternal factors related to neonatal outcome in primiparous pregnant women were educational level, age, number of prenatal checkups, and history of previous abortions.

Cirugía en coxa vara por osteogénesis imperfecta. Reporte de dos casos / Coxa vara surgery for osteogenesis imperfecta. A report of two cases

Introducción. La coxa vara es una disminución del ángulo cervicodiafisiario (<110°) y se puede presentar hasta en el 10% de los pacientes con osteogénesis imperfecta (OI), siendo más frecuente en el tipo III. Sus manifestaciones clínicas son alteración en la marcha, acortamiento de la pierna, genu valgo y dolor.Presentación de los casos. Varones de 13 años y 8 años con OI tipo III, signo positivo de Trendelenburg, movilidad articular adecuada y antecedentes de fracturas recurrentes y cirugías previas por deformidades en los que se realizó cirugía para la corrección de coxa vara. Se realizó una evaluación radiográfica y una funcional (escala de Harris) a los 6 y 68 meses de la cirugía, respectivamente.En el caso 1 se logró una corrección de 46° en el ángulo cervicodiafisiario (ángulo inicial: 84°; ángulo final: 130°) y el puntaje en la escala de Harris fue de 70 puntos. En el caso 2, se logró una corrección de 50° (82° vs. 132°), con un puntaje en la escala de Harris de 68 puntos. Conclusiones. la técnica de corrección mediante osteotomía subtrocantérica y la utilización de clavo endomedular y agujas de Kirschner es una opción efectiva para el tratamiento de coxa vara en pacientes con osteogénesis imperfecta

Introduction. Coxa vara is a deformity characterized by a decrease in the neck-shaft angle (<110°) that can occur in up to 10% of patients with osteogenesis imperfecta (OI), being more frequent in type III OI. Its clinical manifestations are gait disturbance, leg shortening, genu valgum, and pain.Case presentation. Male patients aged 13 and 8 years presenting with type III OI, positive Trende-lenburg sign, adequate joint mobility, and a history of recurrent fractures and previous surgeries for deformities, including surgery for coxa vara correction. Radiographic and functional evaluation (Harris scale) were performed 6 and 68 months after surgery, respectively.In the first case, a correction of 46° was obtained (initial angle: 84°; final angle: 130°), as well as a Harris score was 70. In the second case, a correction of 50° (82° vs. 132°) was achieved, with a Harris score of 68 points. Conclusions. Subtrochanteric osteotomy and intramedullary K-wire nailing are effective options for the treatment of coxa vara in patients with osteogenesis imperfecta

Outcomes of Surgical and Mechanical Thrombectomy in Massive Saddle Pulmonary Embolism: A National Perspective.

Introduction Saddle pulmonary embolism (PE) is a type of central PE that involves the bifurcation of the pulmonary arteries. First-line treatment is usually systemic thrombolytics, but surgical and mechanical thrombectomy (ST and MT) are used for patients with contraindications to thrombolytics or right heart strain. This study compares surgical and mechanical thrombectomy trends and outcomes in patients with saddle PE. Methods The data was extracted from the National In-Patient Sample (NIS) from 2016-2018 using the International Classification of Diseases-10-Clinical Modification (ICD-10-CM) diagnosis codes. We used the Cochrane-Armitage trend test to analyze the trends of ST and MT and the chi-square test for statistical analyses. A two-tailed p-value of <0.05 was considered statistically significant. Results The overall trend of MT in saddle PE rose from 2016 to 2018, while ST remained stable. Around 95% of patients undergoing ST/MT were emergent admissions, with 82.5% occurring in teaching hospitals. Patients of age >65 years and more with comorbidity burdens were more likely to undergo MT over ST. In-hospital mortality after ST was 15.1%, and after MT was 11.1% (p:<0.001). The most common complications after ST were congestive heart failure (CHF) and atrial fibrillation (AF), and after MT were vascular events and CHF. Conclusion The use of mechanical thrombectomy has steadily increased during the study period. ST is more common in large/teaching hospitals, weekend admissions, and patients transferred from other facilities. MT is more common in elderly patients with a higher comorbidity burden. Patients who underwent MT had lower mortality, length of hospital stay, and post-procedural complications.

Madeleine and Willy Baranger's contribution to psychoanalysis.

This paper provides a summary of the careers of the psychoanalysts Madeleine and Willy Baranger and the context in which their ideas developed. It will outline their training contributions in Latin American psychoanalytic associations, which culminated in the foundation of the Uruguayan Psychoanalytic Association. The theory of the bipersonal field, later known as the intersubjective field, will be described. This was conceptualized to study the analytic situation when problems of stagnation arise in the analytic process and focuses on the common, unique unconscious phantasy created between analyst and analysand. The concept of the "bastion" and the notion of the "second look" directed toward the intersubjective field will be described as well as the differences between the theory of the intersubjective field and the concept of enactment. The repetition of the analyst will be considered, in particular when the analyst only uses one theory. The distinction between Klein's early Oedipus and the Freudian Oedipus complex, which the Barangers considered to be two different concepts, will be explored. The essential points of Madeleine Baranger's article on "bad faith" will be presented. Finally, the concept of resignification and the use of theoretical complementarity will be highlighted.

Environmental impact of Sargassum spp. landings: an evaluation of leachate released from natural decomposition at Mexican Caribbean coast.

Large volumes of pelagic Sargassum spp. have stranded periodically on the Mexican Caribbean shoreline. The aim of this research was to study the mobility of metals through the leachates released into the environment during the natural decomposition process of Sargassum spp. Fresh Sargassum samples were placed in cone-bed reactors: under laboratory and local environmental conditions. The leachate generated naturally by decomposition in both conditions was recovered periodically and analyses of pH, volume, and metal content were carried out. Sargassum biomass was monitored by electron microscopy, FT-IR, and CHNS analysis. The Sargassum biomass studied presented a C: N ratio of 24.39, making it a potential raw feedstock for biofuels and other value-added products. Calculations performed on leachate production allowed inferring that each ton of fresh Sargassum that decomposes at a controlled temperature of 27 °C can produce 316 L of leachate. This leachate can contain 5.67 g of As and other potentially toxic metals (e.g., B, Al, Cu). At the end of both experiments, the biomass that was incubated for 30 days presented a C: N ratio of 28.86, so it can still be used as raw material for biofuels; however, the Sargassum biomass that remained 180 days in incubation decreased its C:N ratio at 8.45 at this point, it can be considered a waste. The leachate generated during the natural decomposition process of Sargassum on beaches or disposal sites represents a high risk of contamination of the Yucatan Peninsula water system due to the high content of arsenic and the presence of potentially toxic metals.

Cumplimiento de estándares e indicadores de parto y nacimiento humanizado en el centro de salud tipo C Velasco Ibarra, Machala Ecuador / Compliance with standards and indicators of humanized labor and birth in the type C health center Velasco Ibarra, Machala Ecuador

El parto constituye un acontecimiento extraordinario en la vida de la mujer, dado precisamente, por ser la culminación del embarazo humano y al unísono, el inicio de una nueva vida, razón por la que se le atribuye especial interés a nivel universal. Objetivo: Analizar el cumplimiento de estándares e indicadores de parto y nacimiento humanizado en el Centro de Salud Tipo C. Materiales y Métodos: Estudio observacional, descriptivo, prospectivo, de corte transversal. Con una población total de pacientes atendidas en el Servicio de Centro Obstétrico del Instituto "Velasco Ibarra", en Machala Ecuador, de enero a diciembre del 2020. Resultados: 743 pacientes tuvieron control prenatal con más de 5 sesiones, el 100% de los partos fue espontaneo, con ruptura anteparto, sin inducción, en su mayoría con las semanas completas. En cuanto a la presentación del parto 996 casos fueron de presentación cefálica. 862 pacientes no tuvieron acompañantes, sino, el grupo sanitario, médicos y enfermeras y solo a 125 se le permitió tener a su pareja. En cuanto a la posición del parto, 908 estuvieron en posición de litotomía (ginecológica), en cuanto a la analgesia, solo 267 y ninguna requirió anestesia, así como tampoco requirieron sangre, sulfato, hierro ni anticonceptivos postparto. Conclusiones: Se precisa la inclusión del componente humanizador e integral para la concepción del parto como un proceso natural y fisiológico, con la combinación científico-humanista en el logro de una atención con calidad y calidez, donde la mujer ecuatoriana protagonice su proceso de parto como un sujeto de cuidado y no como objeto del mismo(AU)

Childbirth is an extraordinary event in a woman's life, given precisely because it is the culmination of human pregnancy and at the same time the beginning of a new life, which is why special interest is attributed to it at a universal level. Objective: To analyze compliance with humanized childbirth and delivery standards and indicators in the Type C Health Center. Materials and Methods: Observational, descriptive, prospective, cross-sectional study. With a total population of patients treated at the Obstetric Center Service of the "Velasco Ibarra" Institute, in Machala Ecuador from January to December 2020. Results: 743 patients had prenatal control with more than 5 sessions, 100% of deliveries were spontaneous with antepartum rupture, without induction and almost all with complete weeks. And in 3, regarding the presentation of delivery, 996 cases were of cephalic presentation. 862 patients did not have companions, but the health group, doctors and nurses and only 125 were allowed to have their partner. As for the position of delivery, 908 were in the lithotomy (gynecological) position, as for analgesia only 267 and none required anesthesia, nor did they require blood, sulfate, iron, or postpartum contraceptives. Conclusions: the inclusion of the humanizing and integral component is required for the conception of childbirth as a natural and physiological process, with the scientific-humanistic combination in achieving care with quality and warmth, where the Ecuadorian woman is the protagonist of her birth process as a a subject of care and not as its object(AU)

Efectividad del tratamiento con acupuntura en la urgencia hipertensiva / Effectiveness of acupuncture treatment in hypertensive emergency

Introducción: La hipertensión arterial constituye un problema de salud, tanto a nivel mundial como en Cuba, por las complicaciones e implicaciones que tiene en la morbilidad de la población mayor de 15 años. Una mayor y mejor asistencia sanitaria no consiste tan solo en la práctica de costosos tratamientos, sino ante todo en educar, sanitariamente, a la población en la utilización de los recursos de la naturaleza, así como en el empleo de técnicas y la búsqueda de terapias menos invasivas y sin efectos secundarios. Objetivo: Evaluar la efectividad del tratamiento acupuntural en la urgencia hipertensiva. Métodos: Se realizó un estudio cuasi-experimental en el Policlínico Fray Benito, municipio Rafael Freyre, en el período comprendido enero de 2019 y mayo de 2020. El universo lo conformaron todos los pacientes que acudieron al cuerpo de guardia de dicho policlínico, remitidos del consultorio médico de familia con diagnóstico de urgencia hipertensiva. La muestra de estudio se escogió de forma aleatoria y quedó constituida por aquellos pacientes con diagnóstico de urgencia hipertensiva, que cumplieron con los criterios de inclusión y los criterios de exclusión. Las principales variables utilizadas fueron edad, sexo, resultados del tratamiento, presencia de reacciones adversas o no. Conclusiones: Se demostró la efectividad del tratamiento acupuntural en la urgencia hipertensiva en el Policlínico Fray Benito(AU)

Introduction: Hypertension constitutes a health problem, both worldwide and in Cuba, due to the complications and implications it has on the morbidity of the population over 15 years of age. More and better health care does not consist only in the practice of expensive treatments, but above all in educating the population in health, in the use of natural resources, as well as in the use of techniques and the search for less invasive therapies and without side effects. Objectives: To evaluate the effectiveness of acupuncture treatment in hypertensive emergency. Methods: A quasi-experimental study was carried out at Fray Benito Community Clinic, Rafael Freyre municipality, from January 2019 to May 2020. The universe was made up of all the patients who attended the emergency room of said polyclinic, referred from their family doctor's office with emergency hypertensive diagnosis. The study sample was chosen randomly with those patients with a hypertensive emergency diagnosis, who met the inclusion and exclusion criteria. The main variables used were age, sex, treatment results, presence of adverse reactions or not. Conclusions: The effectiveness of acupuncture treatment in hypertensive emergencies was demonstrated at Fray Benito Community Clinic(AU)

Cooperation in the face of thresholds, risk, and uncertainty: Experimental evidence in fisher communities from Colombia.

Cooperation is thought to be a necessary condition to solve collective action dilemmas such as climate change or the sustainable use of common pool resources. Yet, it is poorly understood how situations pervaded by thresholds shape the behaviour of people facing collective dilemmas. Here we provide empirical evidence that resource users facing thresholds maintain on average cooperative behaviours in the sense of maximising their individual earnings while ensuring future group opportunities. A framed field experiment in the form of a dynamic game with 256 Colombian fishers helped us investigate individual behavioural responses to the existence of thresholds, risk and uncertainty. Thresholds made fishers extract less fish compared to situation without thresholds, but risk had a stronger effect on reducing individual fishing effort. Contrary to previous expectations, cooperation did not break down. If cooperation can be maintained in the face of thresholds, then communicating uncertainty is more policy-relevant than estimating precisely where tipping points lay in social-ecological systems.

Valoración de independencia funcional en pacientes geriátricos / Functional Independence assessment in geriatrics patients

Habitualmente las personas adultas mayores presentan cambios físicos, psicológicos, y sociales que afectan las funciones básicas debido al envejecimiento fisiológico. El objetivo de este estudio fue valorar el grado de independencia funcional en pacientes geriátricos y su relación con la edad, nivel de educación y tiempo de residencia. Pacientes y Métodos Se realizó un estudio descriptivo, transversal enfocándose en la valoración del grado de independencia funcional bajo el índice de Barthel; efectuado en residentes con rangos de edad entre 65- 90 años, donde se obtuvo una descripción importante del nivel de independencia en personas de la tercera edad. El total de la población (muestra) fue de 110 residentes (57 mujeres y 53 hombres). Resultados Pacientes del sexo masculino tuvieron mayor independencia funcional (43% hombres vs. 32% mujeres), corroborando una apreciación estadística de un censo nacional hecho en el año 2010. Adicionalmente, los resultados han sido analizados con sus correlaciones y las significancias del nivel de funcionalidad de los residentes respecto a su edad, nivel de educación, y tiempo de residencia. Conclusiones El nivel de instrucción mostró una ligera correlación con su nivel de funcionalidad, sin embargo, no se encontró relación entre la funcionalidad con la edad y/o tiempo de permanencia en el hogar. Futuros estudios a mayor escala deberían ser efectuados para un apoyo estadístico de relevancia.

Older adults usually have physical, psychological, and social changes that affect basic functions due to physiological aging. The objective of this study was to assess the degree of functional independence in geriatric patients and their relationship to age, level of education and time of residence. Patients and Methods A descriptive, cross-cutting study focused on the assessment of the degree of functional independence under barthel's index was carried out; made in residents with age ranges between 65-90 years, where an important description of the level of independence in seniors was obtained. The total population (sample) was 110 residents (57 women and 53 men). Results It showed that men have greater independence functionality (43% men vs. 32% women), corroborating this appreciation with a national census statistic performed in 2010. In addition, the results have been analyzed with its correlation and significance of the Residents' Functional Level outcome regarding to their age, education level, and time in the institution. Conclusions The educational level showed a slight correlation with its physical functionality, however, no connection was found between functionality and age, nor institutionalized time. Further studies should be performed on a major scale to support static relevance

Consolidated Bioprocess for Bioethanol Production from Raw Flour of Brosimum alicastrum Seeds Using the Native Strain of Trametes hirsuta Bm-2.

Consolidated bioprocessing (CBP), which integrates biological pretreatment, enzyme production, saccharification, and fermentation, is a promising operational strategy for cost-effective ethanol production from biomass. In this study, the use of a native strain of Trametes hirsuta (Bm-2) was evaluated for bioethanol production from Brosimum alicastrum in a CBP. The raw seed flour obtained from the ramon tree contained 61% of starch, indicating its potential as a raw material for bioethanol production. Quantitative assays revealed that the Bm-2 strain produced the amylase enzyme with activity of 193.85 U/mL. The Bm-2 strain showed high tolerance to ethanol stress and was capable of directly producing ethanol from raw flour at a concentration of 13 g/L, with a production yield of 123.4 mL/kg flour. This study demonstrates the potential of T. hirsuta Bm-2 for starch-based ethanol production in a consolidated bioprocess to be implemented in the biofuel industry. The residual biomass after fermentation showed an average protein content of 22.5%, suggesting that it could also be considered as a valuable biorefinery co-product for animal feeding.

Influence of two polarization potentials on a bioanode microbial community isolated from a hypersaline coastal lagoon of the Yucatan peninsula, in México.

In recent years, halotolerant biofilms have become a subject of interest for its application in Bioelectrochemical systems for wastewater treatment. To determine if the polarization potential affects the microbial community of a halotolerant bioanode, four bioanodes were poised at potentials of +0.34 V/SHE and - 0.16 V/SHE and the 16S rRNA gene was analyzed through a MiSeq (Ilumina) system. Oceanospirillum, Halomonas and Marinobacterium were the most predominant genus; no previous studies have reported the presence of Oceanospirillum in anodic biofilms. The fitness with the dataset for +0.34 V/SHE with a modified Butler Volmer Monod model, gives a value of K1 was 0.0002 (2.64 A m-2 and 38% coulombic efficiency), indicating the fastest electrochemical reaction. Whereas that -0.16 V/SHE case, the high value of K1 (12.2 with 1.82 A m-2 and 10% coulombic efficiency) indicated that the electron transfer was far from being reversible (Nernstian).

Physicochemical characterization of goat milk produced in the Comarca Lagunera, Mexico.

The purpose of this study was to determine goat milk physicochemical parameters during the feed scarcity season. An evaluation was made for 398 milk samples from 80 multiparous goats belonging to three different production systems: (S1) mechanized milking grazing pasture and harvested residue (alfalfa) and grain supplemented; (S2) system grazing native pasture; and (S3) system grazing native pasture and grain supplemented. The general averages were: fat (FT) 4.0 ± 0.20%, protein (PR) 3.3 ± 0.05%, lactose (LC) 4.9 ± 0.09%, nonfat solids (NFS) 8.9 ± 0.13%, total solids (TS) 14.5 ± 0.20%, temperature (TM) 24.6 ± 1.06°C, and acidity (pH) 6.7 ± 0.049. Most of the physicochemical components of milk were affected (p < 0.0001) by the production system × month interaction and production system × group × month interaction. The FT content was higher (p < 0.05) in S2 (4.56 ± 0.18) than in S1 (3.64 ± 0.20) and S3 (3.50 ± 0.20). LC differed (p < 0.05) in S2 (5.07 ± 0.08) than in S1 (4.77 ± 0.09) and S3 (4.70 ± 0.09). No differences were observed for the rest of the variables (p < 0.05) among the production systems. The study unveiled a higher content of FT, LC, NFS, PR, and TS for S2 than for S1 and S3. This higher content may be explained because S2 only grazed on herbs and shrubs, in contrast to S1 and S3 which were additionally supplemented with grain concentrates.

El papel de las teorías en la transmisión del psicoanálisis / The role of theories in the transmission of psychoanalysis / Le róle des théories dans la transmission de la psychanalyse

Se trata de una comunicación donde los autores se interrogan sobre diversos aspectos de la relación de la teoría con la formación psicoanalítica. Se proponen analizar expresamente el papel de la enseñanza teórica en la transmisión del psicoanálisis. A partir de una viñeta clínica, realizan distintos análisis conceptuales del significado de la situación expuesta, resultando sus comprensiones deudoras de distintos modelos teóricos, como el freudiano clásico, el kleiniano o el lacaniano. A continuación, se interrogan sobre las distintas relaciones posibles entre los diversos modelos o concepciones teóricas, si existiría una relación de divergencia, complementariedad o suplementariedad. Se plantea la hipótesis de si distintas teorías pueden tener el mismo referente clínico y, dado que el resultado fuera afirmativo, si sería beneficioso para la comprensión del analista contar con diferentes comprensiones teóricas. Analizan entonces las ventajas y desventajas de contar con diversas teorías. Defienden que las teorías sean consideradas una construcción y no una realidad ontológica. Entre otros aspectos, sugieren la importancia de desarrollar en el analista en formación la función teorizante más que la adhesión acrítica a un determinado modelo teórico. Por último, señalan obstáculos importantes en relación con el apasionamiento por las teorías para la adquisición de esta función teorizante

In this paper the authors consider various aspects of the relationship between theory and psychoanalytic training. Specifically, they explore the role of theoretical teaching in the transmission of psychoanalysis. From a clinical vignette, they conduct various conceptual analyses of the meaning of the above situation, drawing on different theoretical models, such as classical Freudian, Kleinian and Lacanian, in their understanding. They then question whether there is divergence, complementarity or supplementarity in the different possible relationships between theoretical models or conceptions. They hypothesize, if distinct theories can have the same clinical ref erent, and provided the result is affirmative, whether drawing on diff erent theoretical approaches would be beneficial to the analyst's understanding. They then consider the advantages and disadvantages of using diverse theories. They argue that theories should be considered a construction and not an ontological reality. Among other aspects, they indicate the importance of developing the theorizing function in the analyst-in-training, rather than acritical adhesion to a fixed theoretical model. Lastly, they identify significant obstacles to the acquisition of this theorizing function, in connection with the "passion for theory"

Il s'agit d'une communication dans laquelle les auteurs s'interrogent sur les divers aspects de la relation de la théorie avec la formation psychanalytique. Ils se proposent d' analyser expressément le role de l' enseignement théorique dans la transmission de la psychanalyse. A partir d'une vignette clinique ils réalisent différentes analyses conceptuelles du sens de la situation exposée, leurs compréhensions sont redevables des diff érents modeles théoriques, tels que le freudien, le kleinien ou le lacanien. Ils s'interrogent ensuite sur les différentes relations possibles entre les divers modeles ou conceptions théoriques, s'il pourrait exister une relation de divergence, complémentarité ou supplémentarité. L'hypothese est posée de savoir si différentes théories peuvent avo ir la meme réf érence clinique et, dans un cas affirmatif, s'il serait intéressant pour la compréhension de l' analyste de compter avec diff érentes théories. Ils défendent que les théories soient considérées une construction et non une réalité ontologique. Entre autres aspects, ils suggerent l'importance de développer dans l'analyste en formation la fonction théorisant plus que l' adhésion acritique a un modele théorique déterminé. Pour finir ils signalent des obstacles importants en rapport avec la passion pour les théories pour l' acquisition de cette fonction théorisant

Corn industrial wastewater (nejayote): a promising substrate in Mexico for methane production in a coupled system (APCR-UASB).

In Mexico, the corn tortilla is a food of great economic importance. Corn tortilla production generates about 1500-2000 m3 of wastewater per 600 tons of processed corn. Although this wastewater (also known as nejayote) has a high organic matter content, few studies in Mexico have analyzed its treatment. This study presents fresh data on the potential methane production capacity of nejayote in a two-phase anaerobic digestion system using an Anaerobic-Packed Column Reactor (APCR) to optimize the acidogenic phase and an up-flow anaerobic sludge blanket (UASB) reactor to enhance the methanogenic process. Results indicate that day 8 was ideal to couple the APCR to the UASB reactor. This allowed for a 19-day treatment that yielded 96% COD removal and generated a biogas containing 84% methane. The methane yield was 282 L kg-1 of CODremoved. Thus, two-phase anaerobic digestion is an efficient process to treat nejayote; furthermore, this study demonstrated the possibility of using an industrial application by coupling the APCR to the UASB reactor system, in order to assess its feasibility for biomethane generation as a sustainable bioenergy source.

Preeclampsia associates with RECK-dependent decrease in human trophoblasts migration and invasion.

INTRODUCTION: Preeclampsia is characterized by reduced invasion capacity of trophoblasts involving lower matrix metalloproteinase (MMP) activity. Cell invasion is reduced by reversion-inducing-cysteine-rich protein with Kazal motifs (RECK), a plasma membrane protein that inhibits MMP in several cell types. However, it is unknown whether this mechanism happens in the human placenta from preeclampsia. The hypothesis of this study sustains that RECK expression is increased leading to reduced trophoblasts invasion in preeclampsia. METHODS: RECK expression in the human first trimester trophoblast cell line HTR8/SvNeo and in placentas from normal (n = 4) and preeclampsia (n = 4) pregnancies was evaluated by Western blot and immunofluorescence. MMP-dependent gelatin hydrolyzation was measured by in situ zymography and gelatinase assay in placental and cell extracts. RECK was overexpressed (plasmidial vector transfection) or partially reduced (shRNA) to evaluate its role in HTR8/SVneo cell migration and invasion. RESULTS: RECK was expressed in trophoblasts layer in human placentas. Preeclampsia resulted in higher placental RECK protein abundance, reduced MMP function, and higher level of fibronectin (a MMP substrate) compared with placentas from normal pregnancies. RECK is also expressed in HTR-8/SVneo cells. Reduced RECK expression resulted in higher MMP-dependent gelatin hydrolyzation, associated to higher migration and invasion of HTR8/SVneo cells. However, RECK overexpression associated with reduced hydrolyzation, cell migration and invasion. DISCUSSION: RECK is overexpressed in human trophoblasts from preeclampsia and may be responsible of this disease-associated lower migration and invasion of this cell type.

Entramados humano-naturales como ruta posible hacia la transdisciplinariedad en el campo de la ecología humana y saberes ambientales de la universidad de caldas / Human-natural web as possible route towards transdisciplinarity in the field of human ecology and environmental knowledge at universidad de caldas

En el presente escrito me aproximo a la transdisciplinariedad y la necesidad que tenemos de abordarla desde la maestría en Ecología Humana y Saberes Ambientales de la Universidad de Caldas. Para ello, me remito a la exposición de dos referentes teóricos críticos de la modernidad que ponen de manifiesto dos cosas: en primer lugar, las tensiones existentes entre ciencias sociales y ciencias naturales (fundamentales en nuestra formación) y la necesidad de superarlas, en segundo lugar y no menos importante, las relaciones de poder y los procesos que han hecho que estas dos vertientes de la producción de conocimientos invisibilicen otros sistemas de prácticas y conocimientos presentes en sujetos no-tan-modernos (Martínez-Dueñas, 2012). Se plantea que observar entramados humano-naturales (Escobar, 2013) y la ontología política de los problemas ecológicos-humanos, sugieren un camino adecuado para avanzar hacia la construcción de agendas transdisciplinarias de investigación en ecología humana y saberes ambientales.

This paper offers an approach to transdisciplinarity and the need to engage it in the Human Ecology and Environmental Knowledge Master's Program at Universidad de Caldas, Colombia. To do this, two critical theoretical perspectives on the modernity are presented which illustrate, first, the tension existing between Social and Natural Sciences (essential in the academic background), and the need to overcome them, and secondly and equally important, the power relationships and the process that have made these two aspects of knowledge production to make invisible other systems of practice of knowledge present in not-so-modern actors (Martínez-Dueñas, 2012). This study proposes that observing human-natural webs (Escobar, 2013) and a political ontology of human-ecological problems suggest the adequate route to advance towards the construction of transdisciplinary research agendas in human ecology and environmental knowledge.

Pretreatment of vinasse from the sugar refinery industry under non-sterile conditions by Trametes versicolor in a fluidized bed bioreactor and its effect when coupled to an UASB reactor.

BACKGROUND: During hydrous ethanol production from the sugar refinery industry in Mexico, vinasse is generated. Phenolic compounds and melanoidins contribute to its color and make degradation of the vinasse a difficult task. Although anaerobic digestion (AD) is feasible for vinasse treatment, the presence of recalcitrant compounds can be toxic or inhibitory for anaerobic microorganism. Therefore, this study presents new data on the coupled of the FBR (Fluidized Bed Bioreactor) to the UASB (Upflow Anaerobic Sludge Blanket) reactor under non-sterile conditions by T. versicolor. Nevertheless, for an industrial application, it is necessary to evaluate the performance in this kind of proposal system. RESULTS: Therefore, this study used a FBR for the removal of phenolic compounds (67%) and COD (38%) at non-sterile conditions. Continuous operation of the FBR was successfully for 26 days according to the literature. When the FBR was coupled to the UASB reactor, we obtained a better quality of effluent, furthermore methane content and yield were 74% and 0.18 m3 CH4/ kg CODremoval respectively. CONCLUSIONS: This study demonstrated the possibility of using for an industrial application the coupled of the FBR to the UASB reactor under non-sterile conditions. Continuous operation of the FBR was carried out successfully for 26 days, which is the highest value found in the literature.