Consensus document on acute-on-chronic liver failure (ACLF) established by the Mexican Association of Hepatology.

Acute-on chronic liver failure (ACLF) has been an intensively debated topic mainly due to the lack of a unified definition and diagnostic criteria. The growing number of publications describing the mechanisms of ACLF development, the progression of the disease, outcomes and treatment has contributed to a better understanding of the disease, however, it has also sparked the debate about this condition. As an attempt to provide medical professionals with a more uniform definition that could be applied to our population, the first Mexican consensus was performed by a panel of experts in the area of hepatology in Mexico. We used the most relevant and impactful publications along with the clinical and research experience of the consensus participants. The consensus was led by 4 coordinators who provided the most relevant bibliography by doing an exhaustive search on the topic. The entire bibliography was made available to the members of the consensus for consultation at any time during the process and six working groups were formed to develop the following sections: 1.- Generalities, definitions, and criteria, 2.- Pathophysiology of cirrhosis, 3.- Genetics in ACLF, 4.- Clinical manifestations, 5.- Liver transplantation in ACLF, 6.- Other treatments.

Understanding the Experiences of American Indian and Alaska Native Students Enrolled in Allopathic and Osteopathic Medical Degree Programs.

PURPOSE: Despite a growing population, American Indian and Alaska Native (AI/AN) students have seen no meaningful increase in representation in allopathic and osteopathic medical degree programs. While AI/AN medical students are more likely to practice in underserved areas, they face financial and sociocultural obstacles towards doing so. This underscores the need to understand the experiences of these trainees, and identify barriers and facilitators to the successful recruitment, retention, and advancement of AI/AN trainees. METHODS: A survey was administered to members of the Association of Native American Medical Students (ANAMS), an organization representing self-identified Native medical students. This survey elicited demographic information, opinions of institutional climate, and aspects of academic and social experiences during medical school. RESULTS: There were n = 39 complete responses. Over fifty percent of respondents (n = 21) identified as AI/AN alone and not in combination with another racial or ethnic group. Overall, respondents were: Generally, not satisfied with their school's engagement with Native communities and AI/AN health curricula. Likely to report barriers towards their timely advancement in training, namely being a first-generation or low income student, and feelings of imposter syndrome. Likely to report an interest to work in primary care fields and serve AI/AN communities in the future. CONCLUSIONS: This survey identified several barriers to successful AI/AN medical trainee advancement, highlighting opportunities for institutions to foster inclusion of AI/AN trainees and grow the number of Native physicians.

A real-time smart sensor for high-resolution frequency estimation in power systems.

Power quality monitoring is a theme in vogue and accurate frequency measurement of the power line is a major issue. This problem is particularly relevant for power generating systems since the generated signal must comply with restrictive standards. The novelty of this work is the development of a smart sensor for real-time high-resolution frequency measurement in accordance with international standards for power quality monitoring. The proposed smart sensor utilizes commercially available current clamp, hall-effect sensor or resistor as primary sensor. The signal processing is carried out through the chirp z-transform. Simulations and experimental results show the efficiency of the proposed smart sensor.