The replaceability of the subject in the pandemic postmodernity of the 21st century / La reemplazabilidad del sujeto en la posmodernidad pandémica del siglo xxi

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ABSTRACT Objective: This research article addresses the understanding of the resignification of the concept of love from the transformations generated by the pandemic and the confinement by Covid-19 in Medellín (Colombia) between 2020 and2023, making a brief account of the heuristic memory used for the design, collection and analysis of research information, specifying methodological elements on which the process was based and the ways by which it was possible to come up with new findings; Subsequently, some semantic networks generated in the atlas.ti software are presented with their respective analyzesfrom which a session ofresults and conclusions is projected. Materials and methods: Regarding the investigative structure, four moments were developed. In the first one, the ontoepistemological foundation was developed, for which printed and digital scientific bibliographic sources were used, analyzing more than 250 articles in English and Spanish. The second moment was the development and application of semi-structured interviews to key informants. The third moment was the realization of the panel of experts with the adaptation of the Delphi methodology. The fourth, and last moment, was the analysis of the information collected for the consolidation of the products and results of the research through analysis matrices and the atlas.ti software for qualitative data processing. The research was developed in the city of Medellín from January 2021 to May 2023. The key informants were selected through the intentional sampling model, which responded to the criteria that guided the investigative process. Thus, the main inclusion criteria, for the general population, were being of legal age and having been part of an emotional or family relationship during the period of confinement by Covid-19 in the city of Medellín. The key informants were chosen among consultants of the psychology service, in total, 30 interviews were carried out with the general population. On the other hand, four professionals in psychology were selected whose professional work was related to the attention to the previously described population before, during and after the period of confinement. Finally, four experts were selected to carry out the panel, trained in clinical psychology, social work, sociology and sexology. Results: The data collected was processed through the Atlas.ti software, in which 38files corresponding to the transcripts of interviews with the population, interviews with professionals and panel of experts were collected. Likewise, in the processing of information, six main categories were identified in which 32 emerging codes were grouped, supported by 918 citations of the analyzed instruments. As a result of this research, it has been shown that pandemic postmodernity generated changes regarding the meaning of the concept of love, while exacerbating the characteristic elements of postmodernity, such as the relativization of ties. Added to this is a reality that had a direct impact on such ties, such as the confinement caused by the Covid-19 pandemic, which not only affected people's health, but also caused profound transformations in the social fabric, from in particular, in relational dynamics, as it fostered the permanent use of digital and virtual networks given the mandatory nature of social distancing. In this same logic, the research sought a deep reflection on those new scenarios that were arranged by confinement in the context of postmodernity, particularly analyzing the way in which couples and families began to live new relational experiences in affective matters. . In this way, it is understood that love is a dynamic concept that changes according to the social and contextual particularities that, in this case, generated the pandemic. Among the most significant findings of this research, it is found that, in effect, great and profound transformations have been perceived around the meaning of the concept of love, given that the pandemic and confinement were activators of affective conflicts that had not been processed. in other scenarios. The interviewees state that love has been evolving and that a generational gap is beginning to become evident in the way other generations understood and lived love. In this way, family and couple love have taken on new meanings, which go hand in hand with new structural relational models in emotional and affective contacts. In accordance with the above, a large majority of key informants refer that the rise of the media and, particularly, of social networks, have generated profound effects on the concept of love from the perspective of the couple and the family, basing such changes in the amount of time invested in the use of devices and in the relational logics that are established through the different social networks, in which the possibility of meeting hundreds of people is established, having hundreds of close contacts, but, most of the time, without the possibility of generating deep ties. Conclusions: It is concluded that the Covid-19 pandemic exacerbated the use of digital platforms and, consequently, new relational scenarios were consolidated that continue to feed relativism and the link fragility of postmodernity. When carrying out the analysis of the information obtained during the field work, it is possible to recognize some common discourses among the people who participated in the investigation. In this logic, one could speak of interpretations and conceptualizations that have simply begun to be part of the social construct, perhaps as a kind of imaginary in which ideas that become commonplace are simply accepted, which are influenced, or in some cases cases even defined by the massive consumption of content on social networks. Addressing the theme of love was, as anticipated in the onto-epistemological foundation of the research, dealing with a topic in which all people have something to contribute and about which there is always something to say. Added to this approach is the issue of the pandemic, another reality about which all human beings of the present time have something to say, as it is a recent event that affected the lives of all people. Both realities, love and the pandemic, run the risk of falling into subjectivity, taking into account that they end up being personal experiences that may be far from constructions based on an epistemological reflection and of which it can be said that emotions, sensations andfeelings prevail feelings when trying to talk about them.

Impact of a comprehensive geriatric assessment to manage elderly patients with locally advanced non-small-cell lung cancers: a multicenter prospective study.

PURPOSE: Concurrent chemoradiotherapy (cCRT) is the standard treatment for locally advanced and unresectable non-small-cell lung cancer. Population is aging, and Geriatric assessment (GA) has demonstrated its paper to select fit patients for active treatment and vulnerable, frail patients for interventions and/or palliative care in many histologies. Its role in locally advanced, unresectable non-small-cell lung cancer has been less explored. METHODS: To assess the capability of GA to detect frail patients not suitable for active treatment, we developed this exploratory non-interventional prospective study. All patients ≥ 70 years diagnosed with stage locally advanced and unresectable non-small-cell lung cancer were invited to undergo geriatric assessment. Secondary aims were description of population, exploring GA as prognostic factor, determination of toxicity profile and look for a frailty biomarker. RESULTS: From June 2017 to June 2020, 51 patients were included, of whom 35% (n:18) were classified as frail. Frail patients had less overall survival and more grade 3-4 toxicity. Exploratory results for frailty phenotype are described in the text. CONCLUSIONS: With the results of our study, we confirm that GA can detect frail patients unsuitable for treatment, with a higher risk of toxicity and less overall survival. A trend toward blood-test results for phenotype frailty can be hypothesis generation.

Immunoinformatic approach for multi-epitope vaccine design against Staphylococcus aureus based on hemolysin proteins.

Staphylococcus aureus is a common bacterium that causes a variety of infections in humans. This microorganism produces several virulence factors, including hemolysins, which contribute to its disease-causing ability. The treatment of S. aureus infections typically involves the use of antibiotics. However, the emergence of antibiotic-resistant strains has become a major concern. Therefore, vaccination against S. aureus has gained attention as an alternative approach. Vaccination has the advantage of stimulating the immune system to produce specific antibodies that can neutralize bacteria and prevent infection. However, developing an effective vaccine against S. aureus has proven to be challenging. This study aimed to use in silico methods to design a multi-epitope vaccine against S. aureus infection based on hemolysin proteins. The designed vaccine contained four B-cell epitopes, four CTL epitopes, and four HTL epitopes, as well as the ribosomal protein L7/L12 and pan-HLA DR-binding epitope, included as adjuvants. Furthermore, the vaccine was non-allergenic and non-toxic with the potential to stimulate the TLR2-, TLR-4, and TLR-6 receptors. The predicted vaccine exhibited a high degree of antigenicity and stability, suggesting potential for further development as a viable vaccine candidate. The population coverage of the vaccine was 94.4 %, indicating potential widespread protection against S. aureus. Overall, these findings provide valuable insights into the design of an effective multi-epitope vaccine against S. aureus infection and pave the way for future experimental validations.

Untargeted metabolic analysis of Epaltes mexicana by LC-QTOF-MS: Terpenes with activity against human cancer cell lines.

Epaltes mexicana is a plant widely used in traditional medicine and as a food in Mexico; however, its phytochemical and pharmacological studies are limited. This study aimed to identify the active secondary metabolites of Epaltes mexicana and determine its cytotoxic activity on cancer cell lines. Three organic extracts were obtained by maceration using n-hexane, dichloromethane, and methanol. The n-hexane extract was fractioned by simple column chromatography. Eight terpenes were annotated in collection 6 (C6) by LC-QTOF-MS using a gradient elution and Electrospray Ionization (ESI) in positive ion mode: 1) Gibberellin A15, 2) farfugin A, 3) dehydromyodesmone, 4) eremopetasitenin A1, 5) hydroxyisonobilin, 6) anhydrocinnzeylanine, 7) nigakilactone H and 8) taxodione. On the other hand, C6 showed a concentration-dependent cytotoxic effect on cancer cell lines MCF-7 (Emax = 74.69 ± 6.19 % and IC50 = 6.31 µg/mL), MDA-MB-231 (Emax = 79.28 ± 12.12 % and IC50 = 124.21 µg/mL), and SiHa (Emax = 82.96 ± 6.02 % and IC50 = 124.31 µg/mL). The C6 did not show a cytotoxic effect against DU-145 and non-cancerous cells from the mammary glands MCF-10A. These results indicate cytotoxic specificity on cancer cell lines and support the hypothesis that terpenes identified in E. mexicana must be investigated and developed for non-clinical and clinical trials as potential anti-cancer drugs.

Assessment of oral toxicity of Moringa oleifera Lam aqueous extract and its effect on gout induced in a murine model.

Background and Aim: Although widely employed in traditional remedies globally, the safety and efficacy of Moringa oleifera remain inadequately documented through scientific research. This study evaluated the oral toxicity of M. oleifera leaf aqueous extract (MoAE) and its impact on gout-induced rats. Materials and Methods: 2000 mg/kg was given in a single dose during the acute oral toxicity test, while 100 mg/kg, 250 mg/kg, and 500 mg/kg were given daily for 28 days in the repeated dose toxicity test. 100 mg/kg, 250 mg/kg, and 500 mg/kg MoAE doses were administered during the assessment of its impact on gout caused by monosodium urate. In the hyperuricemia model induced by oxonic acid, serum uric acid levels were assessed and pain response was measured through acetic acid-induced writhing. Results: In acute oral and 28-day repeated dose tests, no indications of toxicity were detected, while MoAE alleviated ankle joint swelling and reduced serum uric acid concentrations in arthritic rats, causing a significant reduction in acetic acid-induced contortions. Conclusion: No acute oral toxicity or toxicity in 28-day repeated doses was found for MoAE, while it exhibited antiarthritic, antihyperuricemic, and pain-relieving effects in the murine model.

Isolation of Protoplasts from Tissues of Mexican Prickly Poppy (Argemone mexicana L.): An Alkaloid-Producing Medicinal Plant.

Protoplasts are plant cells from which the pectocellulosic cell wall has been removed, thus keeping the plasma membrane intact. For plant secondary metabolites research, this system is a powerful tool to study the metabolites' dynamics inside the cells, such as the subcellular localization of proteins, characterization of gene function, transcription factors involved in metabolite pathways, protein transport machinery, and to perform single-cell omics studies. Due to its lack of a cell wall, better images of the interior of the cell can be obtained compared to the whole tissue. This allows the identification of specific cell types involved in the accumulation of specialized metabolites, such as alkaloids, given their autofluorescence properties. Here is a simplified protocol to obtain protoplasts from leaves and in vitro cell cultures from Argemone mexicana, which produces the pharmacologically important alkaloids berberine and sanguinarine.

Morbidity and mortality of emergency surgery in octogenarian patient.

OBJECTIVE: To evaluate the health outcomes (postoperative morbidity and mortality) and the functional status at discharge of elderly patients older than 80 years who underwent emergency surgery. METHOD: Patients > 80 years of age who underwent emergency surgery during one year at the Marqués de Valdecilla University Hospital, Santander, Spain. Preoperative data (age, sex, type of surgery, comorbidity) and postoperative data (complications) were evaluated, as well as in-hospital mortality, at 30 days and 6 months after surgery. RESULTS: Five-hundred-sixty-eight patients underwent emergency surgery between 2018 and 2019. After the review, 407 patients were included in the study. Average age: 86.9 years. Women 61.7%. Mean hospital stay: 10.4 days. Traumatic interventions 41.3%, vascular surgery 19.7%, general-digestive surgery 25.3%. Medium ASA risk: 2.88. Functional status at discharge: 3.15. Postoperative complications: Clavien-Dindo I 40.8%, II 40.3%, IIIA 3.4%, IIIB 2.5%, IVA 3.9%, IVB 2.0% and V 7.1%. Hospital mortality 7.1%, 30-day mortality 10.3%, mortality at 6 months 24.6%. CONCLUSIONS: Patients > 80 years of age undergoing urgent surgery have high preoperative comorbidity, postoperative complications, and high mortality at 30 days and 6 months after surgery. This mortality is more significant in those ASA IV, nonagenarians and those undergoing high-risk surgery.

OBJETIVO: Evaluar los resultados en salud (morbilidad y mortalidad posoperatorias) y el estado funcional al alta de los pacientes mayores de 80 años sometidos a cirugía de urgencia. MÉTODO: Pacientes de edad > 80 años sometidos a cirugía de urgencia durante 1 año en el Hospital Universitario Marqués de Valdecilla, Santander, España. Se evaluaron datos preoperatorios (edad, sexo, tipo de cirugía, comorbilidad) y posoperatorios (complicaciones), así como mortalidad hospitalaria, a los 30 días y a los 6 meses de la cirugía. RESULTADOS: En 2018-2019 fueron operados de urgencia 568 pacientes, de los cuales 407 fueron incluidos en el estudio. Edad media: 86.9 años. El 61.7% fueron mujeres. Estancia media hospitalaria: 10.4 días. El 41.3% fueron intervenciones traumatológicas, el 19.7% cirugía vascular, el 25.3% cirugía general-digestiva. Riesgo ASA medio: 2.88. Estado funcional al alta: 3.15. Complicaciones posoperatorias: Clavien-Dindo I 40.8%, II 40.3%, IIIA 3.4%, IIIB 2.5%, IVA 3.9%, IVB 2.0% y V 7.1%. Mortalidad: hospitalaria 7.1%, a los 30 días 10.3% y a los 6 meses 24.6%. CONCLUSIONES: Los pacientes > 80 años sometidos a cirugía urgente presentan elevada comorbilidad preoperatoria, complicaciones posoperatorias y elevada mortalidad a 30 días y 6 meses de la cirugía. Esta mortalidad es más significativa en los ASA IV, nonagenarios y sometidos a cirugía de alto riesgo.

Hot, dry, and salty: The present and future of an Extremophile model lizard from Argentina.

Global warming poses a threat to lizard populations by raising ambient temperatures above historical norms and reducing thermoregulation opportunities. Whereas the reptile fauna of desert systems is relatively well studied, the lizard fauna of saline environments has not received much attention and-to our knowledge-thermal ecology and the effects of global warming on lizards from saline environments have not been yet addressed. This pioneer study investigates the thermal ecology, locomotor performance and potential effects of climate warming on Liolaemus ditadai, a lizard endemic to one of the largest salt flats on Earth. We sampled L. ditadai using traps and active searches along its known distribution, as well as in other areas within Salinas Grandes and Salinas de Ambargasta, where the species had not been previously recorded. Using ensemble models (GAM, MARS, RandomForest), we modeled climatically suitable habitats for L. ditadai in the present and under a pessimistic future scenario (SSP585, 2070). L. ditadai emerges as an efficient thermoregulator, tolerating temperatures near its upper thermal limits. Our ecophysiological model suggests that available activity hours predict its distribution, and the projected temperature increase due to global climate change should minimally impact its persistence or may even have a positive effect on suitable thermal habitat. However, this theoretical increase in habitat could be linked to the distribution of halophilous scrub in the future. Our surveys reveal widespread distribution along the borders of Salinas Grandes and Salinas de Ambargasta, suggesting a potential presence along the entire border of both salt plains wherever halophytic vegetation exists. Optimistic model results, extended distribution, and no evidence of flood-related adverse effects offer insights into assessing the conservation status of L. ditadai, making it and the Salinas Grandes system suitable models for studying lizard ecophysiology in largely unknown saline environments.

Sodium-Glucose Cotransporter Inhibitors: Cellular Mechanisms Involved in the Lipid Metabolism and the Treatment of Chronic Kidney Disease Associated with Metabolic Syndrome.

Metabolic syndrome (MetS) is a multifactorial condition that significantly increases the risk of cardiovascular disease and chronic kidney disease (CKD). Recent studies have emphasized the role of lipid dysregulation in activating cellular mechanisms that contribute to CKD progression in the context of MetS. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated efficacy in improving various components of MetS, including obesity, dyslipidemia, and insulin resistance. While SGLT2i have shown cardioprotective benefits, the underlying cellular mechanisms in MetS and CKD remain poorly studied. Therefore, this review aims to elucidate the cellular mechanisms by which SGLT2i modulate lipid metabolism and their impact on insulin resistance, mitochondrial dysfunction, oxidative stress, and CKD progression. We also explore the potential benefits of combining SGLT2i with other antidiabetic drugs. By examining the beneficial effects, molecular targets, and cytoprotective mechanisms of both natural and synthetic SGLT2i, this review provides a comprehensive understanding of their therapeutic potential in managing MetS-induced CKD. The information presented here highlights the significance of SGLT2i in addressing the complex interplay between metabolic dysregulation, lipid metabolism dysfunction, and renal impairment, offering clinicians and researchers a valuable resource for developing improved treatment strategies and personalized approaches for patients with MetS and CKD.

Ciliary Madarosis Secondary to Intra-Arterial Chemotherapy for Retinoblastoma Treatment.

Background: Retinoblastoma is the most common intraocular tumor in the pediatric population. Its main therapeutic objectives are to avoid fatal outcomes and preserve vision as much as possible. Intra-arterial chemotherapy (IAC) improves drug delivery and reduces possible systemic adverse effects. This modality allows direct administration of chemotherapeutic agents to intraocular malignancies via the ophthalmic artery (OA), proving to be a feasible and effective method for globe salvage. Most side effects of IAC are local, including eyelash loss of the nasal portion of the eyelid. Summary: We performed a comprehensive review to analyze data regarding ciliary madarosis in patients diagnosed with retinoblastoma treated with IAC. We describe 9 studies with a total of 637 eyes with retinoblastoma that underwent IAC, of which 45 cases presented madarosis. In chemotherapy-induced alopecia, there is hair shaft thinning and breakage. On trichoscopy, the remaining end of the fractured hair will be observed as black dots. Differential diagnoses must include alopecia areata and trichotillomania. Key Messages: Ciliary madarosis secondary to IAC, although transitional, may cause discomfort in patients and family members. Physical examination, as well as a trichoscopic evaluation of the affected area, can help in reaching a prompt diagnosis and prognosis for this particular alopecia.

Adenosine-assisted embolization of cerebral arteriovenous malformations: a systematic review and meta-analysis.

BACKGROUND: Cerebral arteriovenous malformations (AVMs) are complex lesions that can cause hemorrhagic stroke and significant neurological disability. Adenosine induces cardiac standstill and hypotension, which are thought to be useful during cerebral AVM embolization. Herein, we conducted a systematic review and meta-analysis of the technique's safety. METHODS: Following PRISMA guidelines, four databases were queried for studies describing the use of adenosine-assisted embolization of cerebral AVMs. Adenosine-related intraoperative complications, permanent neurological outcomes, morbidity, and mortality assessed the technique's safety. Single proportion analysis under a random-effects model was performed. Heterogeneity was assessed using I² statistics, and publication bias was evaluated through funnel plot analysis and Egger's regression test. RESULTS: Ten studies were included, involving 79 patients (55.7% male) with 79 AVMs (54.4% unruptured and 70.9% Spetzler-Martin grade III-V) who underwent 123 embolizations (80.4% and 5.9% under transarterial and transvenous approaches, respectively) with n-butyl cyanoacrylate (80.4%), ethylene vinyl alcohol (14.4%), or both (5.2%). The incidence of transient adenosine-related intraoperative complications was 0% (95% CI 0% to 3%, I2=24%). Besides, the incidence of adenosine-related morbidity, mortality, and permanent outcomes was 0% (95% CI 0% to 3%, I2=0%). During follow-up, good functional outcomes were reported for 64 patients (81%). CONCLUSIONS: Adenosine's effects on blood flow control can facilitate embolization and mitigate the risk of AVM rupture and embolic agent migration. Although current evidence stems from observational studies, the results of this meta-analysis suggest a safe drug profile due to minimal associated morbidity and mortality. Further research from larger randomized and controlled studies is warranted to attain a higher level of evidence. PROSPERO REGISTRY NUMBER: CRD42023494116.

Genomic insights of S. aureus associated with bovine mastitis in a high livestock activity region of Mexico.

IMPORTANCE: Bovine mastitis, predominantly associated with gram-positive Staphylococcus aureus, poses a significant threat to dairy cows, leading to a decline in milk quality and volume with substantial economic implications. OBJECTIVE: This study investigated the incidence, virulence, and antibiotic resistance of S. aureus associated with mastitis in dairy cows. METHODS: Fifty milk-productive cows underwent a subclinical mastitis diagnosis, and the S. aureus strains were isolated. Genomic DNA extraction, sequencing, and bioinformatic analysis were performed, supplemented by including 124 S. aureus genomes from cows with subclinical mastitis to enhance the overall analysis. RESULTS: The results revealed a 42% prevalence of subclinical mastitis among the cows tested. Genomic analysis identified 26 sequence types (STs) for all isolates, with Mexican STs belonging primarily to CC1 and CC97. The analyzed genomes exhibited multidrug resistance to phenicol, fluoroquinolone, tetracycline, and cephalosporine, which are commonly used as the first line of treatment. Furthermore, a similar genomic virulence repertoire was observed across the genomes, encompassing the genes related to invasion, survival, pathogenesis, and iron uptake. In particular, the toxic shock syndrome toxin (tss-1) was found predominantly in the genomes isolated in this study, posing potential health risks, particularly in children. CONCLUSION AND RELEVANCE: These findings underscore the broad capacity for antibiotic resistance and pathogenicity by S. aureus, compromising the integrity of milk and dairy products. The study emphasizes the need to evaluate the effectiveness of antibiotics in combating S. aureus infections.

1H-NMR Metabolomic Study of the Mushroom Pleurotus djamor for the Identification of Nematocidal Compounds.

Due to the increasing populations of anthelmintic-resistant gastrointestinal nematodes and as a consequence of the adverse effects of synthetic drugs, this study focuses on the search for secondary metabolites with nematocidal activity from the edible mushroom Pleurotus djamor using The proton nuclear magnetic resonance (1H-NMR) metabolomics. The highest activity was shown by the ethyl acetate fractions of mycelium (EC50 290.8 µg/mL) and basidiomes (EC50 282.7 µg/mL). Principal component analysis (PCA) and hierarchical data analysis (HCA) of the 1H-NMR metabolic profiles data showed that the ethanolic extracts, the ethyl acetate, butanol, and water fractions from mycelium have different metabolic profiles than those from basidiomes, while low polarity (hexane) fractions from both stages of fungal development show similar profiles. Orthogonal partial least squares discriminant analysis (OPLS-DA) allowed the identification of signals in the 1H-NMR metabolic profile associated with nematocidal activity. The signals yielded via OPLS-DA and bidimensional NMR analysis allowed the identification of uracil as a component in the ethyl acetate fraction from basidiomes, with an EC50 of 237.7 µg/mL. The results obtained showed that chemometric analyses of the 1H-NMR metabolic profiles represent a viable strategy for the identification of bioactive compounds from samples with complex chemical profiles.

Backup Frontal Drainage System for Urgent Tension Pneumocephalus Management After Chronic Subdural Hematoma Surgery: A Retrospective Cohort Study.

OBJECTIVE: To describe a simple variation of burr hole craniostomy for the management of chronic subdural hematoma (CSDH) that uses a frontal drainage system to facilitate timely decompression in the event of tension pneumocephalus and spares the need for additional surgery. METHODS: We conducted a retrospective analysis of 20 patients with CSDH who underwent burr hole craniostomy and 20 patients who underwent the same procedure alongside the placement of a 5 Fr neonatal feeding tube as a backup drainage for the anterior craniostomy. Depending on the situation, the secondary drain stayed for a maximum of 72 hours to be opened and used in emergency settings for drainage, aspiration, or as a 1-way valve with a water seal. RESULTS: The outcomes of 20 patients who underwent this procedure and 20 controls are described. One patient from each group presented tension pneumocephalus. One was promptly resolved by opening the backup drain under a water seal to evacuate pneumocephalus and the other patient had to undergo a reopening of the craniostomy. CONCLUSIONS: The described variation of burr hole craniostomy represents a low-cost and easy-to-implement technique that can be used for emergency decompression of tension pneumocephalus. It also has the potential to reduce reoperation rates and CSDH recurrence. Prospective controlled research is needed to validate this approach further.

The Art of Cerebral Revascularization: An Illustrative Case Series of Bypass Techniques for Complex Intracranial Aneurysms.

BACKGROUND: Complex intracranial aneurysms (CIAs) comprise a subset of lesions with defiant vascular architecture, difficult access, and prior treatment. Surgical management of CIAs is often challenging and demands an assessment on a case-by-case basis. The generational evolution of bypass surgery has offered a long-standing potential for effective cerebral revascularization. Herein, we aim to illustrate a single-center experience treating CIAs. METHODS: The authors conducted a retrospective analysis of clinical records of patients treated with cerebral revascularization techniques at Hospital Nacional Dos de Mayo, Lima, Peru, during 2018-2022. Relevant data were collected, including patient history, aneurysm features on imaging, preoperative complications, the intraoperative course, aneurysm occlusion rates, bypass patency, neurological function, and postoperative complications. RESULTS: Seventeen patients (70.59% female; median age: 53 years) with 17 CIAs (64.7% saccular; 76.5% ruptured) were included. The most common clinical presentation included loss of consciousness (70.6%) and headaches (58.8%). Microsurgical treatment included first-, second-, and third-generation bypass. In 47.1% of cases, an anastomosis between the superficial temporal artery and the M3 segment was predominantly used, followed by an A3-A3 bypass (29.4%), a superficial temporal artery-M2 bypass (17.6%), and an external carotid artery to M2 bypass (5.9%). The intraoperative aneurysm rupture rate was 11.8%. Postoperative complications included ischemia (40%), cerebrospinal fluid fistulas (26.7%), and pneumonia (20%). At hospital discharge, the median Glasgow Coma Scale score was 14 (range: 10-15). At the 6-month follow-up, 82.4% of patients had a modified Rankin Scale score ≤2, bypass patency was present in all cases, and the morbidity rate was 17.6%. CONCLUSIONS: CIAs represent a spectrum of defiant vascular lesions with a poor natural history. Bypass surgery offers the potential for definitive treatment. Our case series illustrated the predominant role of cerebral revascularization of CIAs with a critical case-by-case approach to provide optimal outcomes in a limited-resource setting.

Medical students' knowledge about human papillomavirus (HPV), HPV vaccine and head and neck cancer.

The Human Papillomavirus (HPV) is a sexually transmitted infection that significantly affects the population worldwide. HPV preventive methods include vaccination, prophylactics, and education. Different types of cancers associated with HPV usually take years or decades to develop after infections, such as Head and Neck Cancer(HNC). Therefore, HPV prevention can be considered cancer prevention. A sample of medical students in Puerto Rico was evaluated to assess their knowledge about HPV, HPV vaccine, and HNC through two previously validated online questionnaires composed of 38 dichotomized questions, we measured HPV, HPV vaccination(HPVK), and HNC knowledge (HNCK). Out of 104 students surveyed, the mean HPVK score obtained was 20.07/26, SD = 3.86, while the mean score for HNCK was 6.37/12, SD = 1.78. Bidirectional stepwise regression showed study year and HPV Vaccine name had been the most influential variables on HPVK and HNCK. MS1 participants scored lower than MS2-MS4 participants, with no significant difference between MS2-MS4 scores. The results reveal knowledge gaps in HPV/HPV Vaccine and HNC among surveyed medical students. Our findings also suggest an association between knowledge of personal vaccination status, self-perceived risk, and how uncertainty in these factors may affect the medical students' understanding of HPV, HPV vaccination, and associated cancers.

La narratividad como perspectiva transdiscursiva para la formación ético-profesional del universitario

El artículo tiene como objetivo caracterizar las potencialidades formativas de la narratividad como criterio y práctica para la educación ético - profesional del estudiante universitario. Entre los resultados se destacó la propuesta de valores formativos transdisciplinares desde la narratividad y de acciones prácticas con una perspectiva transdisciplinar que permite pasar de los presupuestos de la narración a la narratividad como eje transdiscursivo en la formación ético-profesional de las diversas carreras.

The article aims to characterize the formative potential of narrativity as a criterion and practice for the ethical-professional education of the university student. Among the results, the proposal of transdisciplinary training values ​​from narrativity and practical actions with a transdisciplinary perspective that allows moving from the assumptions of narration to narrativity as a transdiscursive axis in the ethical-professional training of the various careers stood out.

Factores asociados al desempeño laboral en el personal de salud del Hospital Materno Infantil Carlos Showing Ferrari, Huánuco 2022 / Factors associated with work performance among the health personnel of Hospital Materno Infantil Carlos Showing Ferrari, Huánuco, 2022

RESUMEN Objetivo: Determinar los factores asociados al desempeño laboral en el personal de salud del Hospital Carlos Showing Ferrari, Huánuco, periodo 2022. Materiales y métodos: Estudio observacional, correlacional y prospectivo, cuya población estuvo constituida por 146 profesionales de la salud y su muestra, por 86. La información se recolectó mediante un cuestionario, donde la variable desempeño laboral fue evaluada con la escala de desempeño laboral individual de Koopmans et al. (Individual Work Performance Questionaire), validada y con confiabilidad alfa de Cronbach mayor a 0,8, y los factores fueron sociodemográficos, laborares y académicos. El análisis estadístico de los datos se realizó mediante la prueba de chi cuadrado, evaluado en el programa SPSS, versión 25. Resultados: Se evidenció que la gran parte de los profesionales de salud mostró un desempeño laboral de nivel muy alto (60,47 %). De manera inferencial, los factores sociodemográficos como las edades de 31 a 45 años (p = 0,027) y de 46 a 60 años (p = 0,045) se asociaron de manera significativa al desempeño laboral de nivel muy alto. En relación con los factores laborales, el tiempo laboral mayor e igual a 21 años (p = 0,049) fue el único factor asociado de manera significativa al desempeño laboral de nivel muy alto. No hubo asociación entre los factores académicos y el desempeño laboral de nivel muy alto (p > 0,05). Conclusiones: Los factores asociados significativamente al desempeño laboral de nivel muy alto en el personal de salud fueron las edades de 31 a 45 años y de 46 a 60 años y el tiempo laboral mayor e igual a 21 años.

ABSTRACT Objective: To determine the factors associated with work performance among the health personnel of Hospital Materno Infantil Carlos Showing Ferrari, Huánuco, in 2022. Materials and methods: An observational, correlational and prospective study with a population of 146 health professionals and a sample size of 86 individuals. The information was collected through a questionnaire, where the variable work performance was evaluated with the Individual Work Performance Questionnaire by Koopmans et al. and validated with Cronbach's Alpha greater than 0.8. The factors analyzed encompassed sociodemographic, work-related and academic variables. The statistical analysis was conducted using the chi-square test and the data were analyzed with IBM SPSS Statistics V25. Results: Most health professionals showed a very high-level work performance (60.47 %). Inferentially, sociodemographic factors such as age 31 to 45 years (p = 0.027) and 46 to 60 years (p = 0.045) were significantly associated with a very high-level work performance. Concerning work-related factors, work time greater than and equal to 21 years (p = 0.049) was the only factor significantly associated with a very high-level work performance. There was no association between academic factors and a very high-level work performance (p > 0.05). Conclusions: The factors significantly associated with a very high-level work performance among the health personnel were age 31 to 45 years and 46 to 60 years and work time greater than and equal to 21 years.

Phytochemical Profiling by UHPLC-Q-TOF/MS and Chemopreventive Effect of Aqueous Extract of Moringa oleifera Leaves and Benzyl Isothiocyanate on Murine Mammary Carcinogenesis.

Moringa oleifera Lam, commonly known as moringa, is a plant widely used both as a human food and for medicinal purposes around the world. This research aimed to evaluate the efficacy of the aqueous extract of Moringa oleifera leaves (MoAE) and benzyl isothiocyanate (BIT) in rats with induced breast cancer. Cancer was induced with 7,12-dimethylbenz[a]anthracene (DMBA) at a dose of 60 mg/kg by orogastric gavage once only. Forty-eight rats were randomly assigned to eight groups, each consisting of six individuals. The control group (healthy) was called Group I. Group II received DMBA plus saline. In addition to DMBA, Groups III, IV, and V received MoAE at 100, 250, and 500 mg/kg/day, respectively, while Groups VI, VII, and VIII received BIT at 5, 10, and 20 mg/kg/day, respectively. Treatment was carried out for 13 weeks. Secondary metabolite analysis results identified predominantly quercetin, caffeoylquinic acid, neochlorogenic acid, vitexin, and kaempferol, as well as tropone, betaine, loliolide, and vitexin. The administration of MoAE at a dose of 500 mg/kg and BIT at 20 mg/kg exhibited a notable decrease in both the total tumor count and the cumulative tumor weight, along with a delay in their onset. Furthermore, they improved the histological grade. A significant decrease in serum levels of VEGF and IL-1ß levels was observed (p < 0.001) with a better effect demonstrated with MoAE at 500 mg/kg and BIT at 20 mg/kg. In conclusion, this study suggests that both the aqueous extract of Moringa oleifera leaves and the benzyl isothiocyanate possess antitumor properties against mammary carcinogenesis, and this effect could be due, at least in part, to the flavonoids and isothiocyanates present in the extract.

Crude Extracts of Pleurotus Spp. and the Presence of Their Proteins in the Ovicidal and Larvicidal Activity of Haemonchus contortus.

Mushrooms of the genus Pleurotus have shown nematophagous activity as it produces many chemical compounds and enzymes affecting parasitic nematodes. This study aimed to extract the inhibitory activity of the five strains of the fungus Pleurotus spp. It was evaluated against eggs and larvae of Haemonchus contortus. The extract of P. ostreatus obtained the highest level of inhibition of eggs at 97.6% (1341 µg/mL) followed by P. pulmonarius (EPP) at 81.2% (774 µg/mL). The extract selected for evaluation against larvae was P. pulmonarius, showing no effect for L3 larvae, but for L4 larvae an immobility effect of 56.93% was observed at 900 µg/mL. The protein profile showed the presence of 23 protein bands in the extract. The crude extract of P. pulmonarius showed degradation of tissues both inside the eggs and larvae L1. Metabolites produced by Pleurotus mushrooms can consider using in agriculture sustainable by utilizing in producing of ovicidal and larvicidal against H. contortus instead of chemical compounds.