Hierarchical Y Zeolite-Based Catalysts for VGO Cracking: Impact of Carbonaceous Species on Catalyst Acidity and Specific Surface Area.

The performance of catalysts prepared from hierarchical Y zeolites has been studied during the conversion of vacuum gas oil (VGO) into higher-value products. Two different catalysts have been studied: CatY.0.00 was obtained from the standard zeolite (Y-0.00-M: without alkaline treatment) and CatY.0.20 was prepared from the desilicated zeolite (Y-0-20-M: treated with 0.20 M NaOH). The cracking tests were carried out in a microactivity test (MAT) unit with a fixed-bed reactor at 550 °C in the 20-50 s reaction time range, with a catalyst mass of 3 g and a mass flow rate of VGO of 2.0 g/min. The products obtained were grouped according to their boiling point range in dry gas (DG), liquefied petroleum gas (LPG), naphtha, and coke. The results showed a greater conversion and selectivity to gasoline with the CatY.0.20 catalyst, along with improved quality (RON) of the C5-C12 cut. Conversely, the CatY.0.00 catalyst (obtained from the Y-0.00-M zeolite) showed greater selectivity to gases (DG and LPG), attributable to the electronic confinement effect within the microporous channels of the zeolite. The nature of coke has been studied using different analysis techniques and the impact on the catalysts by comparing the properties of the fresh and deactivated catalysts. The coke deposited on the catalyst surfaces was responsible for the loss of activity; however, the CatY.0.20 catalyst showed greater resistance to deactivation by coke, despite showing the highest selectivity. Given that the reaction occurs in the acid sites of the zeolite and not in the matrix, the increased degree of mesoporosity of the zeolite in the CatY.0.20 catalyst facilitated the outward diffusion of products from the zeolitic channels to the matrix, thereby preserving greater activity.

Reamputation prevalence after minor feet amputations in patients with diabetic foot, a cross sectional study. / Prevalencia de reamputación en amputaciones menores del pie en pacientes con pie diabético, estudio de corte transversal.

INTRODUCTION: Reported prevalence for reamputation in diabetic foot is diverse, risk factors are not clear for minor amputations. This study aims to determine the prevalence for reamputation in diabetic foot from minor amputations and to evaluate associated factors for such outcome. METHODS: Cross sectional study developed in two hospitals. Patients hospitalized for diabetic foot ulcer (DFU) requiring a minor amputation were included. A descriptive analysis of all variables is presented, as well as prevalence ratios (PR) and a multivariate logistic regression. RESULTS: 48% prevalence for 15 years. Toes were the most frequent minor amputation that required reamputation and above the knee amputation was the most frequent reamputation level (45%). Variables whose PR was associated to reamputation risk were: smoking history (PR 1.32, CI 95% 1.02 - 1.67, p = 0.03), vascular occlusion in doppler (PR 1.47, CI 95% 1.11 - 1.73, p = 0.01), revascularization (PR 1.73, CI 95% 1.31 - 2.14, p = 0.00002), wagner > 3 (PR 1.75, CI 95% 1.16 - 1.84, p = 0.01) and leucocytosis > 11,000 (PR 1.39, CI 95% 1.07 - 1.68, p = 0.01).Leucocytosis > 11,000, Wagner > 3, vascular occlusion in doppler and revascularization were the variables that best predicted the outcome. Furthermore, leucocytosis was the best variable for predicting reamputation (OR 2.4, CI 95% 1.1 - 5.6, p = 0.04). CONCLUSIONS: Reamputation prevalence was 48%. The toes were the minor amputation more frequently requiring reamputation and above the knee was the most frequent reamputation level. Risk for reamputation was associated with variables related to vascular compromise and infection. LEVEL OF EVIDENCE: IV.

An intelligent climate monitoring system for hygrothermal virtual measurement in closed buildings using Internet-of-things and artificial hydrocarbon networks.

Studies analyzing indoor thermal environments comprising temperature and humidity may be insufficient when obtaining data from sensors, which may be susceptible to inaccurate or failed information from internal and external factors. Therefore, this study proposes an intelligent climate monitoring using a supervised learning method for virtual hygrothermal measurement in enclosed buildings used to predict temperature and relative humidity when a sensor failure is detected. The methodology comprises the data collection from a wireless sensor network, the building of the learning model for predicting the dynamics of environmental variables, and the implementation of a sensor failure detection model. We use an artificial hydrocarbon network as the learning model for their simplicity and effectiveness under uncertain and noisy data. The experiments use data acquired in two settings: (1) a laboratory office and (2) a museum storage room. The first scenario has multiple workstations, and the staff turns on or off the air conditioning depending on the feeling of comfort, generating an uncontrolled environment for the variables of interest. The second scenario has controlled temperature and humidity to ensure the conservation conditions of the museum pieces. Both scenarios used 12 sensors that acquired data for one month, providing an average of 58,300 values for each variable. Results of the proposed methodology provide 95% of accuracy in terms of sensor failure detection and identification, and less than 0.22% of tolerance variability in temperature and humidity after sensor accommodation in both scenarios.

A multimodal framework for extraction and fusion of satellite images and public health data.

In low- and middle-income countries, the substantial costs associated with traditional data collection pose an obstacle to facilitating decision-making in the field of public health. Satellite imagery offers a potential solution, but the image extraction and analysis can be costly and requires specialized expertise. We introduce SatelliteBench, a scalable framework for satellite image extraction and vector embeddings generation. We also propose a novel multimodal fusion pipeline that utilizes a series of satellite imagery and metadata. The framework was evaluated generating a dataset with a collection of 12,636 images and embeddings accompanied by comprehensive metadata, from 81 municipalities in Colombia between 2016 and 2018. The dataset was then evaluated in 3 tasks: including dengue case prediction, poverty assessment, and access to education. The performance showcases the versatility and practicality of SatelliteBench, offering a reproducible, accessible and open tool to enhance decision-making in public health.

Beyond Therapeutic Adherence: Alternative Pathways for Understanding Medical Treatment in Type 1 Diabetes Mellitus.

Given the psychosocial and economic costs of behaviors of patients who seem not to benefit from the medications, technologies, and medical therapies available for chronic diseases such as Type 1 Diabetes Mellitus, therapeutic adherence has been identified as one of the main focuses in the intervention. This paper presents contributions from semiotic cultural clinical psychology for understanding problems associated with the implementation of medical treatment in patients with Type 1 Diabetes Mellitus to explore psychological dimensions not yet reported in depth. A narrative review of 24 scientific articles published between 2012 and 2023 is carried out. The information is produced through thematic analysis, and the results are presented in three themes: 1. illness characteristics, 2. adherence and associated concepts, and 3. modes of intervention. It concludes with the development of a two-axis proposal for understanding the experience of patients that privileges psychological aspects involved in the disease and its treatment, considering the approach to the goals of treatment as dynamic and fluctuating rather than as final states.

CD38 promotes hematopoietic stem cell dormancy.

A subpopulation of deeply quiescent, so-called dormant hematopoietic stem cells (dHSCs) resides at the top of the hematopoietic hierarchy and serves as a reserve pool for HSCs. The state of dormancy protects the HSC pool from exhaustion throughout life; however, excessive dormancy may prevent an efficient response to hematological stresses. Despite the significance of dHSCs, the mechanisms maintaining their dormancy remain elusive. Here, we identify CD38 as a novel and broadly applicable surface marker for the enrichment of murine dHSCs. We demonstrate that cyclic adenosine diphosphate ribose (cADPR), the product of CD38 cyclase activity, regulates the expression of the transcription factor c-Fos by increasing the release of Ca2+ from the endoplasmic reticulum (ER). Subsequently, we uncover that c-Fos induces the expression of the cell cycle inhibitor p57Kip2 to drive HSC dormancy. Moreover, we found that CD38 ecto-enzymatic activity at the neighboring CD38-positive cells can promote human HSC quiescence. Together, CD38/cADPR/Ca2+/c-Fos/p57Kip2 axis maintains HSC dormancy. Pharmacological manipulations of this pathway can provide new strategies to improve the success of stem cell transplantation and blood regeneration after injury or disease.

Peer review of GPT-4 technical report and systems card.

The study provides a comprehensive review of OpenAI's Generative Pre-trained Transformer 4 (GPT-4) technical report, with an emphasis on applications in high-risk settings like healthcare. A diverse team, including experts in artificial intelligence (AI), natural language processing, public health, law, policy, social science, healthcare research, and bioethics, analyzed the report against established peer review guidelines. The GPT-4 report shows a significant commitment to transparent AI research, particularly in creating a systems card for risk assessment and mitigation. However, it reveals limitations such as restricted access to training data, inadequate confidence and uncertainty estimations, and concerns over privacy and intellectual property rights. Key strengths identified include the considerable time and economic investment in transparent AI research and the creation of a comprehensive systems card. On the other hand, the lack of clarity in training processes and data raises concerns about encoded biases and interests in GPT-4. The report also lacks confidence and uncertainty estimations, crucial in high-risk areas like healthcare, and fails to address potential privacy and intellectual property issues. Furthermore, this study emphasizes the need for diverse, global involvement in developing and evaluating large language models (LLMs) to ensure broad societal benefits and mitigate risks. The paper presents recommendations such as improving data transparency, developing accountability frameworks, establishing confidence standards for LLM outputs in high-risk settings, and enhancing industry research review processes. It concludes that while GPT-4's report is a step towards open discussions on LLMs, more extensive interdisciplinary reviews are essential for addressing bias, harm, and risk concerns, especially in high-risk domains. The review aims to expand the understanding of LLMs in general and highlights the need for new reflection forms on how LLMs are reviewed, the data required for effective evaluation, and addressing critical issues like bias and risk.

Impact of telephone follow-up on COPD outcomes in pulmonary rehabilitation patients: A randomized clinical trial.

Background: The educational component is a comprehensive part of Pulmonary Rehabilitation (PR), and telephone follow-up (TFU) is an alternative to reinforce face-to-face education. The objective was to determine the effect of telephone follow-up on educational needs, dyspnea, quality of life and functional capacity in Chronic Obstructive Pulmonary Disease (COPD) patients undergoing PR. Methods: Double-blind randomized controlled clinical trial in patients with COPD in a PR program in Cali-Colombia, allocation by randomization tables. All patients received 24 sessions of PR, which included face-to-face education sessions. In addition, the experimental group received telephone calls twice a week to reinforce the face-to-face educational content. The Lung Information Needs Questionnaire (LINQ) was used to measure disease knowledge, the Saint George's Respiratory Questionnaire to measure quality of life, the modified Medical Research Council (mMRC) scale to measure dyspnea, and the 6-minute walking test (6MWT) to measure functional capacity. Results: Thirty-four patients were randomized and 31 were analyzed. PR group with conventional education (PRTE) n=15 and PR group with education plus telephone follow-up (PRTETFU) n=16. Significant improvement from baseline to endpoint in both groups: LINQ (PRTE 4±1.1, p=0.003, PRTETFU 5.8±10.6, p=0.000), mMRC (PRTE 1.6±0.3, p=0.000, PRTETFU 0.6±0.3, p=0.036) and functional capacity (PM6M: PRTE 45.9m±16.1, p=0.013, PRTETFU 62.8m±21.4, p=0.010). Analysis showed differences between groups for changes in LINQ knowledge domain after intervention, with greater improvement for PRTETFU (p=0.018). Discussion: The TFU is an alternative to reinforce the education. This study demonstrated greater positive effects for the autonomous management of the pathology. Conclusion: Adding educational reinforcement through phone calls to patients with COPD during PR leads to improved knowledge and skills for managing the disease.

In vitro toxicity of fine and coarse particulate matter on the skin, ocular and lung microphysiological cell-culture systems.

Particulate matter (PM) has been associated with adverse effects on human health, causing allergies, skin and eye irritation and corrosion, respiratory tract irritation, headaches, bronchoconstriction, cardiopulmonary diseases such as asthma, chronic obstructive pulmonary disease (COPD), lung cancer, reproductive problems, premature deaths, and epigenetic changes that lead to a wide variety of cancers, among other health conditions. The air quality in the Medellín - Colombia presents fluctuations that oscillate between the maximum permissible levels established at the national level and by the WHO, which represents a latent risk to people's health. Although important efforts have been made to quantify the different levels of pollution and administrative measures have been established to mitigate air pollution, little research work has been done to establish the relationship between these levels of pollutants and the effects on biological systems. The objective of the present research was to make a morphological and chemical characterization of particulate matter (PM) captured with a commercial air filter and a electrospun nanofiber membrane and evaluate the cytotoxicity of the each PM extracts in monolayer and co-culture models which recreate microphysiological systems of lung, skin and cornea and propose the possible cellular interactions that lead the cytotoxic response of the chemical compounds found in particulate matter in cities. The morphology and elemental chemical characterization were done with scanning electron microscopy coupled with energy dispersive X-ray spectroscopy (SEM - EDS). For the polycyclic aromatic hydrocarbons detection was made with a chromatographic method accoupled to mass spectrometer. Finally, the cytotoxicity was made in monolayers of A549, HEK001, and SIRC cell lines and microphysiological systems consisting of two-cell layer construct to resemble the interaction between fibroblast and epithelial cells that comprises naturally the corneal, skin and lung tissue. We performed three different cocultures models with BALB/3T3 clone A31 as a feeder layer, using porous Transwell® inserts in the in-contact and non-contact way. Monolayer and co-culture models were exposed to coarse and fine PM (1, 2, and 5 mg/mL) and the cell viability was evaluated at 24 h using an MTT assay. The electrospun nanofibers membranes demonstrates higher efficiency to capture PM with different sizes and high concentration of polycyclic aromatic hydrocarbons, heavy metals, and other chemical compounds responsible of many human diseases. Cytotoxic effects of MP were observed in all models at higher concentration; however, models exposed to fine PM exhibited a significant reduction in cell viability compared to those exposed to coarse PM. In addition, multilayer models are more resistant to PM exposure than monolayer models. Furthermore, the study indicated that, depending on the seeding strategy, different results might be observed: the non-contact model showed higher resistance to PM exposure than in-contact for SIRC and HEK001, but A549 monolayers showed the highest viability response. This study demonstrates the usefulness of applying co-culture models to assess environmental pollutant toxicity, in addition to being a potential alternative method to animal testing for risk assessment.

Interrater Reliability of the Spanish (Colombia) Version of the Post-COVID-19 Functional Status Scale.

Background: COVID-19 has been one of the most critical public health challenges of recent decades. This disease develops severely in one in five patients, and approximately 5% require admission to a critical care unit. Due to the impact of the sequelae, the Post-COVID-19 Functional Status Scale (PCFS) was developed. This study is aimed at determining the interrater reliability of the Spanish (Colombia) version of the PCFS in adult patients with post-COVID-19 infection. Methods: This is an observational study performed with patients diagnosed with COVID-19. Two evaluators repeated the test-retest of the PCFS scale with knowledge and clinical experience in the care of patients with COVID-19 and had previously applied the test. The PCFS assesses functional limitations at discharge and can be used at 4 and 8 weeks to evaluate practical consequences and determine the degree of disability these patients may have. For interrater reliability, Cronbach's alpha was applied with its respective confidence interval and the Bland-Altman method. A 95% confidence interval (CI) was taken as the basis for the interpretation of the Intraclass Correlation Coefficient (ICC). Results: A total of 112 adult patients participated in the study, aged 51.46 ± 15.94 years. It was evidenced that the survival, constant care, and activities of daily living questions have an ICC of one (1.000) with an ICC (1.000-1.000), demonstrating excellent reliability, while those close to one were instrumental activities, role participation, symptoms, and final score with an ICC 0.918 to 0.984 and an ICC (0.881-0.989). Thus, a homogeneous distribution of the interrater data was evident. Conclusions: Excellent interobserver reliability of the Spanish (Colombia) version of the PCFS in patients with different degrees of functional status was reported.

A Systematic Review on the Viruses of Anopheles Mosquitoes: The Potential Importance for Public Health.

Anopheles mosquitoes are the vectors of Plasmodium, the etiological agent of malaria. In addition, Anopheles funestus and Anopheles gambiae are the main vectors of the O'nyong-nyong virus. However, research on the viruses carried by Anopheles is scarce; thus, the possible transmission of viruses by Anopheles is still unexplored. This systematic review was carried out to identify studies that report viruses in natural populations of Anopheles or virus infection and transmission in laboratory-reared mosquitoes. The databases reviewed were EBSCO-Host, Google Scholar, Science Direct, Scopus and PubMed. After the identification and screening of candidate articles, a total of 203 original studies were included that reported on a variety of viruses detected in Anopheles natural populations. In total, 161 viruses in 54 species from 41 countries worldwide were registered. In laboratory studies, 28 viruses in 15 Anopheles species were evaluated for mosquito viral transmission capacity or viral infection. The viruses reported in Anopheles encompassed 25 viral families and included arboviruses, probable arboviruses and Insect-Specific Viruses (ISVs). Insights after performing this review include the need for (1) a better understanding of Anopheles-viral interactions, (2) characterizing the Anopheles virome-considering the public health importance of the viruses potentially transmitted by Anopheles and the significance of finding viruses with biological control activity-and (3) performing virological surveillance in natural populations of Anopheles, especially in the current context of environmental modifications that may potentiate the expansion of the Anopheles species distribution.

Effect of the effective refractive index on the radiative decay rate in nanoparticle thin films.

In this work, we theoretically and experimentally study the influence of the optical environment on the radiative decay rate of rare-earth transitions in luminescent nanoparticles forming a thin film. We use electric dipole sources in finite-difference time-domain simulations to analyze the effect of modifying the effective refractive index of transparent layers made of phosphor nanocrystals doped with rare earth cations, and propose a correction to previously reported analytical models for calculating the radiative decay rate. Our predictions are tested against an experimental realization of such luminescent films, in which we manage to vary the effective refractive index in a gradual and controllable manner. Our model accurately accounts for the measurements attained, allows us to discriminate the radiative and non-radiative contributions to the time-resolved photoluminescence, and provides a way to rationally tune the spontaneous decay rate and hence the photoluminescence quantum yield in an ensemble of luminescent nanoparticles.

NEUROCANTRIAL: study protocol for a randomised controlled trial of a pain neuroscience education programme in adults with cancer pain.

INTRODUCTION: Pain is the second most frequent symptom reported in patients with cancer among the main reasons for consultation. The incorporation of educational modalities in pain intervention processes has been suggested. This study aims to examine the efficacy of neuroscience pain education (PNE) in relation to pain, biopsychosocial variables and functional capacity in comparison with conventional treatment. It is hypothesised that an intervention based on PNE achieves better outcomes than conventional management, in terms of pain, biopsychosocial variables and functional capacity in adults with oncological pain. METHODS AND ANALYSIS: This will be a single-blind, controlled clinical trial in which two groups will be compared using changes in pain as the primary measure. The first group will receive conventional treatment in addition to PNE, and participants will undergo an intervention of nine sessions (one session per week, for a total of 9 weeks), each lasting 30-40 min. Specifically, these sessions will teach biophysiological elements using metaphors that allow the adoption of these concepts related to pain. The second group will receive conventional treatment (pharmacological treatment). For this study, a sample size calculation was made based on the background, where 80 adults with oncological pain were required. An initial evaluation will be made to establish the baseline characteristics, and then, according to the randomisation, the assignment to the PNE group or the control group will be made and the two groups will be summoned again. Ten weeks later, for the intervention evaluation, the statistical analysis plan will be established by protocol and by intention-to-treat. ETHICS AND DISSEMINATION: This protocol complies with all ethical considerations. The authors commit to presenting the study's results. This study was approved by the ethics committees of the Universidad Santiago de Cali, Clínica de Occidente/Angiografía de Occidente. The authors commit to presenting the study's results. TRIAL REGISTRATION NUMBER: NCT05581784.

Prueba de la marcha: Respuestas ventilatorias, cardiovasculares y relación con la distancia recorrida en pacientes con secuelas de tuberculosis / Walk test: Ventilatory and cardiovascular responses and their relationship with the walking distance covered by patients with tuberculosis sequelae / Teste de caminhada: respostas ventilatórias e cardiovasculares e relação com a distância percorrida em pacientes com sequelas de tuberculose

Introducción: La evaluación de los pacientes con tuberculosis pulmonar permite establecer metas de intervención en salud; el test de caminata de los 6 minutos, es ideal para observar la respuesta de todos los sistemas incluidos durante el ejercicio. Objetivo: Describir la respuesta fisiológica de algunas variables ventilatorias y cardiovasculares durante el test de caminata de los 6minutos en pacientes con secuelas de tuberculosis pulmonar, y sus posibles correlaciones de las variables fisiológicas con la distancia recorrida. Materiales y métodos: Estudio descriptivo de corte transversal en 21 pacientes con diagnóstico de secuelas de tuberculosis pulmonar, quienes asistieron a un programa de rehabilitación pulmonar, y realizaron test de caminata de los 6 minutos. Resultados: La edad media fue 49,33±18,82 años, en su mayoría hombres, la media de la distancia fue 348,35±127,833m. Hubo diferencia significativa durante los cuatro momentos analizados con un valor p<0,0001 en frecuencia cardiaca, frecuencia respiratoria y saturación de oxígeno. Hubo correlación fuerte para la edad, consumo de Oxígeno (VO2), número de detenciones, disnea modified Medical Research Council (mMRC), capacidad funcional medida en equivalentes Metabólicos (METS) y Saturación de Oxígeno (SpO2).Conclusión: Pacientes con secuelas de tuberculosis pulmonar en su mayoría hombres, evidencian cambios estadísticamente significativos durante la prueba.

Introduction:The assessment of patients with pulmonary tuberculosis is useful to establish health intervention goals. The 6-minute walk test is key to observing the response of all of the body systems involved in the exercise. Objective:To describe the physiological response of some ventilatory and cardiovascular variables during the 6-minute walk test in patients with pulmonary tuberculosis sequelae and possible correlations between physiological variables and the covered distance. Materials and methods:Descriptive cross-sectional study on 21 patients diagnosed with sequelae caused by pulmonary tuberculosis, who attended a pulmonary rehabilitation program and performed a 6-minute walk test. Results: The mean age of patients was 49.33±18.82 years, mostly men, and the mean distance was 348.35±127833 m. There was a significant difference in heart rate, respiratory rate andoxygen saturation during the four analyzed moments, with a pvalue < 0.0001. There was a strong correlation for age, oxygen consumption (VO2), number of stops, dyspnea modified Medical Research Council (mMRC), functional capacity measured as metabolic equivalents (METS) and oxygen saturation (SpO2). Conclusion:Most male patients with pulmonary tuberculosis sequelae show statistically significant changes during the test.

Introdução:A avaliação de pacientes com tuberculose pulmonar permite estabelecer metas de intervenção em saúde; O teste de caminhada de 6 minutos é ideal para observar a resposta de todos os sistemas incluídos durante o exercício. Objetivo: Descrever a resposta fisiológica de algumas variáveis ventilatórias e cardiovasculares durante o teste de caminhada de 6 minutos em pacientes com sequela de tuberculose pulmonar e suas possíveis correlações das variáveis fisiológicas com a distância percorrida. Materiais e métodos:Estudo transversal descritivo em 21 pacientes diagnosticados com sequelas de tuberculose pulmonar, que frequentavam um programa de reabilitação pulmonar, e realizaram o teste de caminhada de 6 minutos. Resultados:A média de idade foi de 49,33±18,82 anos, a maioria homens, a distância média foi de 348,35±127,833m. Houve diferença significativa nos quatro momentos analisados com valor de p< 0,0001 na frequência cardíaca, frequência respiratória e saturação de oxigênio. Houve uma forte correlação paraidade, consumo de oxigênio (VO2), número de paradas, dispneia modificada do Medical Research Council (mMRC), capacidade funcional medida em equivalentes metabólicos (METS) e saturação de oxigênio (SpO2). Conclusão:Pacientes com sequelas de tuberculose pulmonar, em sua maioria homens, apresentam alterações estatisticamente significativas durante o exame.

El nuevo programa de la especialidad de medicina familiar y comunitaria: una oportunidad que no se debe perder / The new program of the Family and Community Medicine specialty: An opportunity not to be missed

El programa formativo de la especialidad de medicina familiar y comunitaria (MFyC), vigente desde 2005, se encuentra en proceso de revisión y actualización. Este artículo hace aportaciones para profundizar en los contenidos específicos de la especialidad que orienten hacia un desarrollo competencial más significativo.Se plantea, para llevar a cabo una formación orientada a los valores, realizar el despliegue de la función valores y propiciar la creación de espacios asistenciales en los que la experiencia cotidiana de esos valores sea posible.Se propone establecer una escala de valores en la que los 2 valores esenciales del médico de familia sean, por este orden, el compromiso con la persona, en singular, y el compromiso con el conjunto de las personas a su cargo, en plural. A su vez se propone la reorganización del mapa de competencias en torno a 5 integradores competenciales o metacompetencias: el método clínico centrado en el paciente, la gestión clínica de base poblacional, la atención primaria orientada a la comunidad, la promoción de la salud o salud comunitaria basada en activos y la investigación en el ámbito familiar y comunitario.(AU)

The training program for the Family and Community Medicine specialty (MFyC), which has been in effect since 2005, is currently undergoing a review and update process. This article proposes contributions to deepen the specific contents of the specialty in order to guide towards a more significant competency development.To carry out values-oriented training, it is suggested to deploy the values function and promote the creation of care spaces where the daily experience of those values is possible.It is proposed to establish a scale of values where the two essential values of the family physician are, in this order, a commitment to the individual person, and a commitment to the group of people under their care. Additionally, it is proposed to reorganize the competency map around five competency integrators or meta-competencies: patient-centered clinical method, population-based clinical governance, primary care oriented to the community, health promotion or community health based on assets, and research in the family and community field.(AU)

Endogenous PP2A inhibitor CIP2A degradation by chaperone-mediated autophagy contributes to the antitumor effect of mitochondrial complex I inhibition.

Combined inhibition of oxidative phosphorylation (OXPHOS) and glycolysis has been shown to activate a PP2A-dependent signaling pathway, leading to tumor cell death. Here, we analyze highly selective mitochondrial complex I or III inhibitors in vitro and in vivo to elucidate the molecular mechanisms leading to cell death following OXPHOS inhibition. We show that IACS-010759 treatment (complex I inhibitor) induces a reactive oxygen species (ROS)-dependent dissociation of CIP2A from PP2A, leading to its destabilization and degradation through chaperone-mediated autophagy. Mitochondrial complex III inhibition has analogous effects. We establish that activation of the PP2A holoenzyme containing B56δ regulatory subunit selectively mediates tumor cell death, while the arrest in proliferation that is observed upon IACS-010759 treatment does not depend on the PP2A-B56δ complex. These studies provide a molecular characterization of the events subsequent to the alteration of critical bioenergetic pathways and help to refine clinical studies aimed to exploit metabolic vulnerabilities of tumor cells.

[The new program of the Family and Community Medicine specialty: An opportunity not to be missed]. / El nuevo programa de la especialidad de medicina familiar y comunitaria: una oportunidad que no se debe perder.

The training program for the Family and Community Medicine specialty (MFyC), which has been in effect since 2005, is currently undergoing a review and update process. This article proposes contributions to deepen the specific contents of the specialty in order to guide towards a more significant competency development. To carry out values-oriented training, it is suggested to deploy the values function and promote the creation of care spaces where the daily experience of those values is possible. It is proposed to establish a scale of values where the two essential values of the family physician are, in this order, a commitment to the individual person, and a commitment to the group of people under their care. Additionally, it is proposed to reorganize the competency map around five competency integrators or meta-competencies: patient-centered clinical method, population-based clinical governance, primary care oriented to the community, health promotion or community health based on assets, and research in the family and community field.

Estilo cognitivo en la dimension de dependencia-independencia de campo de estudiantes universitarios del área de Manizales / Cognitive Style in the Field Dependence-independence Dimension of University Student from the Manizales Area

Resumen El presente artículo reporta un estudio que busca identificar el estilo cognitivo en la dimensión de independencia-dependencia de campo en una población estudiantil universitaria y establecer sus asociaciones con el género y la carrera que cursan. La muestra total fue de 1.379 estudiantes (797 mujeres y 582 hombres), de tres universidades del área metropolitana de Manizales, Colombia, de 18 carreras profesionales, quienes respondieron la prueba SG-EFT que permite identificar el nivel de independencia de campo. Se llevaron a cabo pruebas t de Student y análisis de varianza para examinar diferencias por género y carrera. Los resultados indican diferencias significativas en los puntajes de la prueba por carrera universitaria en independencia del género, y a su vez, se discuten en relación con resultados previos y sus implicaciones para la construcción del perfil del estudiante en cada carrera.

Abstract This paper reports a study that seeks to identify the cognitive styles, in the field independence-dependence dimension, in a university student population and to establish its associations with gender and career. The total sample consisted of 1.379 students (797 females and 582 males) from three universities in the metropolitan area of Manizales (Colombia), from 18 professional careers, who answered the SG-EFT test which measures levels of field independence. Analyses of variance and t- Student tests were carried out to examine differences by gender and career. Significant differences in the SG-EFT scores were found regarding career choice, independently of gender. Results are discussed with respect to previous findings and their implications for the construction of the student profile in each career.

Rehabilitación cardíaca integral en un caso de paciente con miocardiopatía por SARS-COV-2 / Comprehensive Cardiac Rehabilitation in a Case of a Patient with SARS-CoV-2 Cardiomyopathy

Introducción: Una complicación reportada en la infección por SARS-CoV-2 es la miocardiopatía. Se ha descrito que los pacientes pueden presentar un deterioro significativo de la clase funcional, que limita el desempeño en las actividades de la vida diaria, sociales, familiares y laborales. La rehabilitación cardíaca como componente integral es una alternativa de tratamiento no farmacológica en el manejo de secuelas cardiovasculares ocasionadas por SARS-CoV-2. Objetivo: Describir el impacto de la rehabilitación cardíaca integral en un caso de paciente con miocardiopatía por SARS-CoV-2. Caso clínico: Se presenta el caso de un hombre de 56 años de edad con miocardiopatía por SARS-CoV-2 quien realizó rehabilitación cardíaca integral. Conclusiones: La rehabilitación cardíaca con un componente de intervención integral multidisciplinar permitió al paciente mejorar la capacidad aeróbica, sintomatología, calidad de vida relacionada con la salud y reincorporarse a las actividades sociales, familiares y laborales(AU)

Introduction: A reported complication of SARS-CoV-2 infection is cardiomyopathy. It has been described that patients may present with significant impairment of functional class, limiting performance in activities of daily living, social, family and work. Cardiac rehabilitation as an integral component is a non-pharmacological treatment alternative in the management of cardiovascular sequelae caused by SARS-CoV-2. Objective: To describe the impact of comprehensive cardiac rehabilitation in a case of a patient with cardiomyopathy due to SARS-CoV-2. Case report: We present the case of a 56-year-old patient with SARS-CoV-2 cardiomyopathy who underwent comprehensive cardiac rehabilitation. Conclusions: Cardiac rehabilitation with a comprehensive multidisciplinary intervention component allowed the patient to improve aerobic capacity, symptomatology, health-related quality of life and reincorporation to social, family and work activities(AU)