Selecting postoperative adjuvant systemic therapy for early-stage breast cancer: An updated assessment and systematic review of leading commercially available gene expression assays.

Gene expression assays (GEAs) can guide treatment for early-stage breast cancer. Several large prospective randomized clinical trials, and numerous additional studies, now provide new information for selecting an appropriate GEA. This systematic review builds upon prior reviews, with a focus on five widely commercialized GEAs (Breast Cancer Index®, EndoPredict®, MammaPrint®, Oncotype DX®, and Prosigna®). The comprehensive dataset available provides a contemporary opportunity to assess each GEA's utility as a prognosticator and/or predictor of adjuvant therapy benefit.

Viruela símica: reporte de un caso clínico / Monkey pox: clinical case report

La viruela símica (monkey pox) es una enfermedad infecciosa causada por un virus del género Orthopoxvirus, usualmente acompañada de síntomas sistémicos como: fiebre, cefalea, mialgias, astenia, erupciones cutáneas o lesiones mucosas. Esta enfermedad se transmite por contacto físico con personas infectadas, materiales o animales infectados. Presentamos el caso de un paciente de 6 años que acude a consulta de Atención Primaria por presentar sintomatología compatible con esta sospecha clínica. Se diagnostica viruela símica bajo reacción en cadena de la polimerasa (PCR) positiva y se da de alta con manejo sintomático ambulatorio. (AU)

Monkeypox is a zoonosis-type disease caused by a virus of the genus Orthopoxvirus. Usually accompanied by systemic symptoms such as fever, headache, myalgia, asthenia, skin rashes or mucosal lesions. This disease is transmitted by physical contact with infected people, infected materials or animals. We present the case of a 6-year-old patient who came to primary care for symptoms compatible with clinical suspicion. Monkeypox was diagnosed under positive PCR and discharged with outpatient symptomatic management. (AU)

Financial influence on global risks of zoonotic emerging and re-emerging diseases: an integrative analysis.

BACKGROUND: Emerging and re-emerging infectious diseases (EIDs), such as Ebola virus disease and highly pathogenic influenza, are serious threats to human health and wellbeing worldwide. The financial sector has an important, yet often ignored, influence as owners and investors in industries that are associated with anthropogenic land-use changes in ecosystems linked to increased EIDs risks. We aimed to analyse financial influence associated with EIDs risks that are affected by anthropogenic land-use changes. We also aimed to provide empirical assessments of such influence to help guide engagements by governments, private organisations, and non-governmental organisations with the financial sector to advance a planetary health agenda. METHODS: For this integrative analysis, we identified regions in the world where there was evidence of a connection between EIDs and anthropogenic land-use changes between Nov 9, 1999, and Oct 25, 2021, through a targeted literature review of academic literature and grey literature to identify evidence of drivers of anthropogenic land-use change and their association with commodity production in these regions. We only included publications in English that showed a connection between deforestation and the production of one or more commodities. Publications merely describing spatial or temporal land-use change dynamics (eg, a reduction of forest or an increase of palm-oil plantations) were excluded. As we were assessing financial influence on corporate activities through ownership specifically, we focused our analysis on publicly listed companies. Equity data and data about ownership structure were extracted from Orbis, a company information database. We assessed financial influence by identifying financial entities with the largest equity ownership, descriptively mapping transboundary connections between investors and publicly listed companies. FINDINGS: 227 public and private companies operating in five economic sectors (ie, production of palm oil, pulp and wood products, cocoa, soybeans, and beef) between Dec 15, 2020, and March 8, 2021, were identified. Of these 227, 99 (44%) were publicly listed companies, with 2310 unique shareholders. These publicly listed companies operated in six geographical regions, resulting in nine case-study regions. 54 (55%) companies with complete geographical information were included in the countries network. Four financial entities (ie, Dimensional, Vanguard, BlackRock, and Norway's sovereign wealth fund) each had ownership in 39 companies or more in three of the case-study regions (ie, north America, east Asia, and Europe). Four large US-based asset managers (ie, Vanguard, BlackRock, T Rowe Price, and State Street) were the largest owners of publicly listed companies in terms of total equity size, with ownership amounts for these four entities ranging from US$8 billion to $21 billion. The specific patterns of cross-national ownership depended on the region of interest; for example, financial influence on EIDs risks that was associated with commodity production in southeast and east Asia came from not only global asset managers but also Malaysian, Chinese, Japanese, and Korean financial entities. India, Brazil, the USA, Mexico, and Argentina were the countries towards which investments were most directed. INTERPRETATION: Although commodity supply chains and financial markets are highly globalised, a small number of investors and countries could be viewed as disproportionally influential in sectors that increase EIDs risks. Such financial influence could be used to develop and implement effective policies to reduce ecological degradation and mitigate EIDs risks and their effects on population health. FUNDING: Formas and Networks of Financial Rupture-how cascading changes in the climate and ecosystems could impact on the financial sector.

SARSCoV-2 antibody prevalence and titers in persons living with HIV cared for at a large tertiary reference center in Mexico City.

OBJECTIVE: To assess SARS-CoV-2 antibody prevalence and titers in people living with HIV (PLWHIV) on antiretroviral treatment (ART) enrolled at a tertiary reference hospital in Mexico. METHODS: Two plasma aliquots per person, used for HIV viral load follow-up between 01/2020 and 09/2021, were used to assess total anti-N and neutralizing SARS-CoV-2 antibodies. Sociodemographic, clinical, and SARS-CoV-2 exposure risk information were collected. The risk associated with SARS-CoV-2 exposure and associations with antibody titers were analyzed with logistic, Cox, and linear multivariable models. RESULTS: 803 PLWHIV participated; 233 had detectable SARS-CoV-2 antibodies (prevalent cases), and 132 seroconverted (incident cases). Overall, the adjusted prevalence was 46.45%, with an incidence rate of 3.78 cases/100 person-months. Factors associated with prevalent cases included lower age, location (western zone of Mexico City and the neighboring Mexico State), use of public transport, attendance at meetings without social distancing, and higher CD4 + T cell counts (p < 0.05; multivariable logistic model). BNT162b2 vaccination reduced incident cases (Cox adjusted HR = 0.4; p = 0.013). Notably, previously infected and vaccinated individuals showed maximization of neutralizing activity (p < 0.001). No associations between SARS-CoV-2 neutralization and HIV-related variables (CD4 + T cell counts, viral load, number of years in viral suppression, ART regimen) were found in multivariable analysis. CONCLUSIONS: SARS-CoV-2 infection was associated with community risk rather than HIV-associated variables in PLWH on ART and clinical follow-up. Antibody neutralization activity in vaccinated participants was maximized with previous SARS-CoV-2 infection.

Volting, a Novel Dancing Wheelchair with Augmented Mobility: Pushing Lateral Inclinations.

Wheelchair users are often perceived as someone ill and who will be limited in performing daily activities. This paradigm can be changed if instead to focus on limits, we start to think about the new possibilities that could be explored from their current mobility and technology. We present a novel dancing wheelchair with augmented mobility named Volting. Our novel wheelchair was designed to tilt the seat laterally up to 14°. This inclination is performed proportionally to the inclination of the user by a mechanism based on passive suspensions. Our system was analyzed as a double inverted pendulum and a mathematical model was developed using Euler-Lagrange equations. This analysis was used to calculate the ideal stiffness. Thus, we performed experiments with three distinct stiffness values and varying the weight of participants to analyze the behavior of our mechanism. Our results show that lateral inclinations in our wheelchair can be unstable, low sensitivity or linear tendency. The latter behavior, which is the most appropriate, was obtained using the suspension whose stiffness was close to the ideal value, thus validating our mathematical approach. Moreover, this behavior was maintained even if the user weight varies up to 10kg above the estimated value, ensuring a good performance for varying morphologies. Finally, our device was tested by a professional wheelchair dancer who shows the new possibilities of Volting in terms of mobility.

Critical Electrospinning Parameters for Synthesis Control of Stabilized Polyacrylonitrile Nanofibers.

Polyacrylonitrile (PAN) fibers are widely used as precursors in the manufacture of high-conducting and mechanically resistant carbon fibers. The modulation of such fibers is carried out through electrospinning. In this work, we show the production and control of the morphology of nanometric-range PAN fibers for their potential use as precursors for high-electrical-conductivity carbon fibers. PAN samples dissolved in dimethylformamide (DMF) were prepared at 6, 10, and 12% w/w, at 15 and 25 kV. The impact of the rotation of the collector drum at 100, 300, and 500 RPM was also studied. It was found that the percentage of PAN in the solution proportionally affects the diameter of the fibers and that the preparation potential affects the morphology. The rotation speed, when increased, decreases the diameter, and it has a negative impact on the morphology. Fibers prepared with 6% w/w at 15 kV and 500 RPM show 90 nm diameters, the smallest diameter of all the samples.

Genome-wide association study for growth traits in Blanco Orejinegro and Romosinuano cattle.

Growth traits are economically important characteristics for the genetic improvement of local cattle breeds. Genome-wide association studies (GWAS) provide valuable information to enhance the understanding on the genetics of complex traits. The aim of this study was to perform a GWAS to identify genomic regions and genes associated to birth weight, weaning weight adjusted for 240 days, 16 months, and 24 months weight in Romosinuano (ROMO) and Blanco Orejinegro (BON) cattle. A single-step genomic-BLUP was implemented using 596 BON and 569 ROMO individuals that were genotyped with an Illumina BovineSNP50 BeadChip. There were 25 regions of interest identified on different chromosomes, with few of them simultaneously associated with two or more growth traits and some were common to both breeds. The gene mapping allowed to find 173 annotations on these regions, from which 49 represent potential candidate genes with known growth-related functions in cattle and other species. Among the regions that were associated with several growth traits, that at 24 - 27 MB of BTA14, has important candidate genes such as LYPLA1, XKR4, TMEM68 and PLAG1. Another region of interest at 0.40-0.77 Mb of BTA23 was identified in both breeds, containing KHDRBS2 as a potential candidate gene influencing body weight. Future studies targeting these regions could provide more knowledge to uncover the genetic architecture underlying growth traits in BON and ROMO cattle. The genomic regions and genes identified in this study could be used to improve the prediction of genetic merit for growth traits in these creole cattle breeds.

Analysis of Giardia lamblia Nucleolus as Drug Target: A Review.

Giardia lamblia (G. lamblia) is the main causative agent of diarrhea worldwide, affecting children and adults alike; in the former, it can be lethal, and in the latter a strong cause of morbidity. Despite being considered a predominant disease in low-income and developing countries, current migratory flows have caused an increase in giardiasis cases in high-income countries. Currently, there is a wide variety of chemotherapeutic treatments to combat this parasitosis, most of which have potentially serious side effects, such as genotoxic, carcinogenic, and teratogenic. The necessity to create novel treatments and discover new therapeutic targets to fight against this illness is evident. The current review centers around the controversial nucleolus of G. lamblia, providing a historical perspective that traces its apparent absence to the present evidence supporting its existence as a subnuclear compartment in this organism. Additionally, possible examples of ncRNAs and proteins ubiquitous to the nucleolus that can be used as targets of different therapeutic strategies are discussed. Finally, some examples of drugs under research that could be effective against G. lamblia are described.

Ligand-Based and Structure-Based Virtual Screening of New Sodium Glucose Cotransporter Type 2 Inhibitors.

BACKGROUND: Diabetes mellitus is a metabolic disease that causes multiple complications and common comorbidities, which decreases the quality of life for people affected by the disease. Sodium glucose cotransporter type 2 (SGLT2) participates in the reabsorption of 90% of glucose in the kidneys; therefore, it is an attractive drug target for controlling blood glucose levels. OBJECTIVE: The aim in this work was to obtain new potential SGLT2 inhibitors. METHODS: A ligand-based virtual screening (LBVS) from the ZINC15, PubChem and ChemSpider databases using the maximum common substructure (MCS) scaffold was performed. RESULT: A total of 341 compounds were obtained and analyzed by molecular docking on the active site of SGLT2. Subsequently, 15 compounds were selected for molecular dynamics (MD) simulation analysis. The compounds derived of spiroketal Sa1, Sa4, and Sa9 (≤ 3.5 Å) in complex with the receptor SGLT2 showed good stability during 120 ns of MD. CONCLUSION: These compounds are proposed as potential SGLT2 inhibitors.

Genomic variability and population structure of six Colombian cattle breeds.

Analyses of the genetic diversity of indigenous cattle are essential for implementing conservation programs, promoting their sustainable use and maintaining productive advantages offered by these breeds in local conditions. The aim of this study was to investigate the genetic diversity and population structure of six Colombian cattle breeds: Blanco Orejinegro (BON), Costeño con Cuernos (CCC), Romosinuano (ROM), Sanmartinero (SAM), Casanareño (CAS), and Hartón del Valle (HDV). Two additional breed groups were included for comparison: Zebu (CEB) and a crossbreed of Colombian cattle breeds × Zebu. Genetic diversity within breeds was analyzed using expected heterozygosity (He), inbreeding coefficient (f), and runs of homozygosity (ROH). Population structure was assessed using model-based clustering (ADMIXTURE) and principal components analysis (PCA). Zebu cattle showed the lowest genetic diversity (He = 0.240). Breeds with the highest genetic diversity level were HDV and BON (He = 0.350 and 0.340, respectively). Inbreeding was lower for Colombian cattle breeds ranging between 0.005 and 0.045. Overall, the largest average genetic distance was found among the group of Colombian cattle breeds and Zebu, while the smallest was found between ROM and CCC. Model-based clustering revealed some level of admixture among HDV and CAS cattle which is consistent with their recent history. The results of the present study provide a useful insight on the genetic structure of Colombian cattle breeds.

Safe and just Earth system boundaries.

The stability and resilience of the Earth system and human well-being are inseparably linked1-3, yet their interdependencies are generally under-recognized; consequently, they are often treated independently4,5. Here, we use modelling and literature assessment to quantify safe and just Earth system boundaries (ESBs) for climate, the biosphere, water and nutrient cycles, and aerosols at global and subglobal scales. We propose ESBs for maintaining the resilience and stability of the Earth system (safe ESBs) and minimizing exposure to significant harm to humans from Earth system change (a necessary but not sufficient condition for justice)4. The stricter of the safe or just boundaries sets the integrated safe and just ESB. Our findings show that justice considerations constrain the integrated ESBs more than safety considerations for climate and atmospheric aerosol loading. Seven of eight globally quantified safe and just ESBs and at least two regional safe and just ESBs in over half of global land area are already exceeded. We propose that our assessment provides a quantitative foundation for safeguarding the global commons for all people now and into the future.

Trastornos de la infancia y características sociodemográficas asociadas a la depresión en adultos en una ciudad de Colombia / Childhood disorders and sociodemographic characteristics associated with depression in adults from a Colombian city / Transtornos da infância e características sócio-demográficas associadas à depressão em adultos de uma cidade colombiana

Introducción: Los trastornos emocionales y del comportamiento que se inician en la infancia llevan a cambios que se extienden hasta la edad adulta, con consecuencias sociales. Objetivo: Determinar la asociación de la depresión en la adultez con trastornos mentales de inicio en la infancia y otras condiciones, en Envigado, 2017. Materiales y métodos: Estudio con enfoque cuantitativo, tipo observacional, transversal con intención analítica. El tamaño de la muestra fue de 737 individuos, entre 18 y 65 años. Se aplicó el instrumento CIDI - CAPI de la OMS. El procesamiento y análisis se llevó a cabo en SPSS v. 21 de la Universidad CES y Epidat 4.2. Resultados: La proporción de depresión en la adultez es de 10,8%, en la población de estudio que tuvo antecedente de trastorno por déficit de atención e hiperactividad (TDAH) fue aproximadamente 5,6 veces más que en aquellos que no tenían este antecedente (OR= 6,62; IC95% 1,92-22,7). Conclusiones: El TDAH en la infancia incrementa la probabilidad de presentar depresión en la adultez en la población de Envigado, lo cual soporta la importancia de promover acciones de salud mental en la niñez, para prevenir la depresión en la edad adulta.

Introduction: Emotional and behavioral disorders that begin in childhood lead to adult changes, which have social consequences. Objective: To determine the association of adult depression with childhood onset of mental disorders and other factors in Envigado (Colombia). Materials and methods: A quantitative observational and cross-sectional study was carried out. The sample size was 737 individuals aged between 18 to 65 years. The CIDI-CAPI instrument of the WHO was used. Data processing and analysis was conducted through SPSS v. 21 software from the CES University and Epidat 4.2. Results: The percentage of depression in adults was 10.8%. This figure was 5.6 times greater in the study population that had history of attention deficit hyperactivity disorder (ADHD) compared to individuals who did not have this disorder (OR= 6.62; 95% CI 1.92-22.7). Conclusions: Childhood ADHD increases the probability of depression in the adult population of Envigado, which supports the importance of promoting mental health programs in children in order to prevent adulthood depression.

Introdução: Os transtornos emocionais e comportamentais que se iniciam na infância levam a alterações que se estendem até a idade adulta, com consequências sociais. Objetivo: Determinar a associação da depressão na idade adulta com transtornos mentais de início na infância e outras condições, em Envigado, 2017. Materiais e métodos: um estudo foi realizado com abordagem quantitativa, observacional, transversal e com intenção analítica. O tamanho da amostra foi de 737 indivíduos, entre 18 e 65 anos de idade. Foi aplicado o instrumento CIDI - CAPI da OMS. O processamento e análise foram realizados no SPSS v. 21 da Universidad CES e Epidat 4.2. Resultados: A proporção de depressão na idade adulta é de 10,8%, na população estudada que tinha histórico de transtorno de déficit de atenção e hiperatividade (TDAH) foi aproximadamente 5,6 vezes maior do que naquelas sem esse histórico (OR= 6,62; 95 % CI 1,92-22,7). Conclusões: O TDAH na infância aumenta a probabilidade de apresentar depressão na idade adulta na população de Envigado, o que reforça a importância de promover ações de saúde mental na infância, para prevenir a depressão na idade adulta.

WISP, Wearable Inertial Sensor for Online Wheelchair Propulsion Detection.

Manual wheelchair dance is an artistic recreational and sport activity for people with disabilities that is becoming more and more popular. It has been reported that a significant part of the dance is dedicated to propulsion. Furthermore, wheelchair dance professionals such as Gladys Foggea highlight the need for monitoring the quantity and timing of propulsions for assessment and learning. This study addresses these needs by proposing a wearable system based on inertial sensors capable of detecting and characterizing propulsion gestures. We called the system WISP. Within our initial configuration, three inertial sensors were placed on the hands and the back. Two machine learning classifiers were used for online bilateral recognition of basic propulsion gestures (forward, backward, and dance). Then, a conditional block was implemented to rebuild eight specific propulsion gestures. Online paradigm is intended for real-time assessment applications using sliding window method. Thus, we evaluate the accuracy of the classifiers in two configurations: "three-sensor" and "two-sensor". Results showed that when using "two-sensor" configuration, it was possible to recognize the propulsion gestures with an accuracy of 90.28%. Finally, the system allows to quantify the propulsions and measure their timing in a manual wheelchair dance choreography, showing its possible applications in the teaching of dance.

Scientific mobilization of keystone actors for biosphere stewardship.

The biosphere crisis requires changes to existing business practices. We ask how corporations can become sustainability leaders, when constrained by multiple barriers to collaboration for biosphere stewardship. We describe how scientists motivated, inspired and engaged with ten of the world's largest seafood companies, in a collaborative process aimed to enable science-based and systemic transformations (2015-2021). CEOs faced multiple industry crises in 2015 that incentivized novel approaches. New scientific insights, an invitation to collaborate, and a bold vision of transformative change towards ocean stewardship, created new opportunities and direction. Co-creation of solutions resulted in new knowledge and trust, a joint agenda for action, new capacities, international recognition, formalization of an organization, increased policy influence, time-bound goals, and convergence of corporate change. Independently funded scientists helped remove barriers to cooperation, provided means for reflection, and guided corporate strategies and actions toward ocean stewardship. By 2021, multiple individuals exercised leadership and the initiative had transitioned from preliminary and uncomfortable conversations, to a dynamic, operational organization, with capacity to perform global leadership in the seafood industry. Mobilizing transformational agency through learning, collaboration, and innovation represents a cultural evolution with potential to redirect and accelerate corporate action, to the benefit of business, people and the planet.

New outcomes on how silicon enables the cultivation of Panicum maximum in soil with water restriction.

Climate change increases the occurrence of droughts, decreasing the production of tropical forages through the induction of physiological stress. Si is expected to broaden the limit from physiological stress of forages grown under water restriction, which may come from an improvement in the stoichiometric homeostasis of Si with N and C, favoring physiological aspects. This study assessed whether Si supply via fertigation improves physiological aspects and the water content in the plant by means of an antioxidant defense system and changes in the C:N:Si stoichiometry during the regrowth of two cultivars of Panicum maximum grown under two soil water regimes (70 and 40% of the soil's water retention capacity). The forages studied are sensitive to water deficit without silicon supply. The application of Si via fertigation attenuated the water deficit, favoring plant growth by stabilizing the stoichiometric homeostasis C:N and C:Si, which are responsible for increasing the plant capacity of converting accumulated C in dry mass, favoring the water content of the plant tissue and the photosynthetic efficiency. This study highlights the importance of the physiological function of Si, and effects on the stoichiometry of C and N, which are neglected in most research on forages grown under water restriction.

Hibiscus Acid from Hibiscus sabdariffa L. Inhibits Flagellar Motility and Cell Invasion in Salmonella enterica.

Extracts of Hibiscus sabdariffa L. (commonly called Rosselle or "Jamaica flower" in Mexico) have been shown to have antibiotic and antivirulence properties in several bacteria. Here, an organic extract of H. sabdariffa L. is shown to inhibit motility in Salmonella enterica serovars Typhi and Typhimurium. The compound responsible for this effect was purified and found to be the hibiscus acid. When tested, this compound also inhibited motility and reduced the secretion of both flagellin and type III secretion effectors. Purified hibiscus acid was not toxic in tissue-cultured eukaryotic cells, and it was able to reduce the invasion of Salmonella Typhimurium in epithelial cells. Initial steps to understand its mode of action showed it might affect membrane proton balance.

Electrochemical degradation of amoxicillin in acidic aqueous medium using TiO2-based electrodes modified by oxides of transition metals.

One of the most widely used antibiotics is amoxicillin (AMX), which is the most widely used in humans and animals, but it is discharged metabolically due to its indigestibility. Conventional biological and physicochemical methods for removing AMX from water are not enough to mineralize it; it is only concentrated and transferred to produce new residues that require further processing to remove the new residues. In this research, naked and modified surfaces with TiO2 nanotubes (TiO2,nt) electrophoretically modified with PbO2, IrO2, RuO2, and Ta2O5 were used to evaluate their efficiency in the electrochemical degradation of AMX in acid media (0.1 mol L-1 H2SO4). After their comparison, Pb-Ta 50:50|TiO2,nt|Ti showed the highest removal efficiency of AMX (44.71%) with the lowest specific energy consumption (8.69 ± 0.78 kWh Kg COD-1) and the average instant current efficiency of 26.67 ± 9.19%, in comparison with the others naked and modified surfaces of TiO2,nt∣Ti.

Establishment of triple-negative breast cancer cells based on BMI: A novel model in the correlation between obesity and breast cancer.

Introduction: Obesity has been associated with an increased risk of biologically aggressive variants in breast cancer. Women with obesity often have tumors diagnosed at later stages of the disease, associated with a poorer prognosis and a different response to treatment. Human cell lines have been derived from specific subtypes of breast cancer and have served to define the cell physiology of corresponding breast cancer subtypes. However, there are no current cell lines for breast cancer specifically derived from patients with different BMIs. The availability of those breast cancer cell lines should allow to describe and unravel functional alterations linked to these comorbidities. Methods: Cell cultures were established from tumor explants. Once generated, the triple negative subtype in a patient with obesity and a patient with a normal BMI were chosen for comparison. For cellular characterization, the following assays were conducted: proliferation assays, chemo - sensitivity assays for doxorubicin and paclitaxel, wound healing motility assays, matrix invasion assays, breast cancer cell growth to estradiol by chronic exposure to leptin, induction of endothelial permeability and tumorigenic potential in athymic mice with normo - versus hypercaloric diets with an evaluation of the epithelium - mesenchymal transformation proteins. Results: Two different cell lines, were established from patients with breast cancer: DSG-BC1, with a BMI of 21.9 kg/m2 and DSG-BC2, with a BMI of 31.5 kg/m2. In vitro, these two cell lines show differential growth rates, motility, chemosensitivity, vascular permeability, response to leptin with an activation of the JAK2/STAT3/AKT signaling pathway. In vivo, they displayed distinct tumorigenic potential. In particular, DSG-BC2, presented higher tumorigenicity when implanted in mice fed with a hypercaloric diet. Discussion: To our knowledge, these primary cultures are the first in vitro representation of both breast cancer and obesity. DSG - BC2 presented a more aggressive in vivo and in vitro phenotype. These results support the hypothesis that breast cancer generated in an obese metabolic state may represent a contrasting variant within the same disease. This new model will allow both further comprehension, functional studies and the analysis of altered molecular mechanisms under the comorbidity of obesity and breast cancer.

Brazilian medical education and the incorporation of technologies before and during the COVID-19 pandemic / La educación médica brasileña y la incorporación de tecnología antes y durante la pandemia de COVID-19

Durante la pandemia de COVID-19, se intensificó el uso de tecnologías de la información y la comunicación (TIC). Este estudio tuvo como objetivo investigar la incorporación de las TIC en el proceso de enseñanza-aprendizaje por parte de docentes, estudiantes de grado y posgrado de Medicina de instituciones públicas y privadas brasileñas, antes y durante la pandemia de COVID-19. Se adoptó una encuesta transversal para esta investigación, con recolección de datos, realizada de mayo a septiembre de 2020. Los datos fueron analizados mediante estadística descriptiva y análisis temático. Participaron 242 personas: 153 estudiantes de pregrado, 19 estudiantes de posgrado y 70 profesores. Los participantes consideraron que el apoyo brindado por sus instituciones educativas en 2020 para el uso de las TIC fue bueno (44,2 por ciento, 107/242) o excelente (22,3 por ciento, 54/242). Las tecnologías más utilizadas en 2020 fueron los entornos de aprendizaje virtual (79,8 por ciento, 193/242) y las videoconferencias (77,7 por ciento, 188/242). La mayoría de los encuestados prefiere la modalidad presencial (50,4 por ciento, 122/242), seguida de los que prefieren el uso ocasional de las TIC (22,3 por ciento, 54/242). Los participantes registraron 171 percepciones relacionadas con el uso de las TIC como recurso pedagógico y su importancia durante la pandemia. Los participantes reconocieron el uso complementario de las TIC en sus actividades académicas y consideraron que el apoyo institucional fue adecuado. No se informaron dificultades financieras, pero los participantes mencionaron la falta de formación y el uso limitado de las TIC en actividades prácticas(AU)

During the COVID-19 pandemic, the use of information and communication technologies (ICT) was intensified. This study aimed to investigate the incorporation of ICT in the teaching-learning process by teachers, undergraduate and graduate Medicine students from Brazilian public and private institutions, before and during the COVID-19 pandemic. Cross-sectional survey was used to perform this research, with data collection carried out from May to September 2020. Data were analyzed using descriptive statistics and thematic analysis. There were 242 participants: 153 undergraduate students, 19 graduate students, and 70 faculty members. The participants considered that the support provided by their educational institutions in 2020 for the use of ICT was good (44.2percent, 107/242) or excellent (22.3percent, 54/242). The technologies most often used in 2020 were virtual learning environments (79.8percent, 193/242) and videoconferences (77.7percent, 188/242). The majority of respondents prefer the classroom-based' modality (50.4percent, 122/242), followed by those who prefer the occasional use of ICT (22.3percent, 54/242). The participants registered 171 perceptions related to the use of ICT as a pedagogical resource and its importance during the pandemic. The respondents recognized the complementary use of ICT in their academic activities and considered that the institutional support was adequate. No financial difficulties were reported, but participants mentioned lack of training and limited use of ICT in practical activities. To overcome such gaps, the use of ICT should take into account preferences and specificities of medical education, for which institutions have to prepare themselves pedagogically(AU)

Análisis clínico e histopatológico de la prevalencia de enfermedades cardiacas en muerte súbita. Estudio en autopsias / Clinical and histopathological analysis of the prevalence of cardiac diseases in sudden death: a study based on autopsies

Introducción: un evento de muerte súbita supone un gran impacto para la sociedad, siendo importante su estudio para aportar conocimiento y fortalecer estrategias de promoción y prevención. Objetivo: determinar la prevalencia de los diagnósticos anatomopatológicos cardiacos definitivos y los hallazgos histopatológicos asociados con la muerte súbita de origen cardíaco en los pacientes sometidos a autopsias clínicas realizadas en el Hospital de San José de Bogotá DC, Colombia, durante el período 2015 a 2018. Métodos: estudio descriptivo de corte transversal retrospectivo en pacientes a quienes se les realizó autopsia con diagnóstico de muerte súbita de origen cardiovascular en el servicio de patología del Hospital de SanJosé, Bogotá DC, Colombia. Resultados: se incluyeron 178 autopsias con diagnóstico de muerte súbita cardíaca. El promedio global de edad fue 56.1 años (DE: 15.06) con una relación hombre-mujer de 3:1. El hallazgo macroscópico más frecuente fue cardiomegalia (promedio 428.1 g (DE 112.8), acompañado de la presencia de coronariopatía esclerótica (p=0.000) con obstrucción de la luz de las arterias coronarias mayores de 80% (p=0.037). Conclusiones: los diagnósticos anatomopatológicos definitivos prevalentes en la muerte súbita cardiaca fueron cardiopatía isquémica crónica complicada (65%) e infarto agudo de miocardio (16%), datos similares a los reportados a nivel mundial. La cardiomegalia es un hallazgo frecuente que debe valorarse en forma cuidadosa.

Introduction: a sudden death incident has a great impact on society and its study is important to provide understanding for strengthening promotion and prevention strategies. Objective: to determine the prevalence of definitive anatomopathological cardiac diagnoses and histopathological findings associated with sudden death due to a cardiovascular cause based on autopsies performed at Hospital de San José in Bogotá DC, Colombia, during the period between 2015 and 2018. Methods: retrospective descriptive cross-sectional study of cases of sudden cardiac death of cardiovascular origin diagnosed in autopsies performed at the pathology service of Hospital de San José, Bogotá DC, Colombia. Results: 178 autopsies with a diagnosis of sudden cardiac death were included. The overall mean age was 56.1 years (SD: 15.06). Male/female ratio was 3:1. The most frequent macroscopic finding was cardiomegaly (average 428.1 g (SD 112.8), with the presence of sclerotic coronary artery disease (p=0.000) with a blockage greater than 80% (p=0.037) in the major coronary arteries. Conclusions: the prevalent definitive anatomopathological diagnoses in SCD were complicated chronic ischemic heart disease (65%) and acute myocardial infarction (16%). Data obtained in this study is similar to that reported worldwide. Cardiomegaly is a frequent finding that should be carefully evaluated.