LoRa Technology Propagation Models for IoT Network Planning in the Amazon Regions.

Designing and deploying telecommunications and broadcasting networks in the challenging terrain of the Amazon region pose significant obstacles due to its unique morphological characteristics. Within low-power wide-area networks (LPWANs), this research study introduces a comprehensive approach to modeling large-scale propagation loss channels specific to the LoRaWAN protocol operating at 915 MHz. The objective of this study is to facilitate the planning of Internet of Things (IoT) networks in riverside communities while accounting for the mobility of end nodes. We conducted extensive measurement campaigns along the banks of Universidade Federal do Pará, capturing received signal strength indication (RSSI), signal-to-noise ratio (SNR), and geolocated point data across various spreading factors. We fitted the empirical close-in (CI) and floating intercept (FI) propagation models for uplink path loss prediction and compared them with the Okumura-Hata model. We also present a new model for path loss with dense vegetation. Furthermore, we calculated received packet rate statistics between communication links to assess channel quality for the LoRa physical layer (PHY). Remarkably, both CI and FI models exhibited similar behaviors, with the newly proposed model demonstrating enhanced accuracy in estimating radio loss within densely vegetated scenarios, boasting lower root mean square error (RMSE) values than the Okumura-Hata model, particularly for spreading factor 9 (SF9). The radius coverage threshold, accounting for node mobility, was 945 m. This comprehensive analysis contributes valuable insights for the effective deployment and optimization of LoRa-based IoT networks in the intricate environmental conditions of the Amazon region.

Self-expanding Metal Stents in Malignant Obstruction of the Esophagus: A 25-Year Multicentric Study

Background: Self-expanding metal prostheses improve dysphagia in patients with incurable esophageal cancer (EC). New stents have been introduced, and chemoradiotherapy has been implemented for EC, changing patients' risk profiles. It is unknown whether this has affected palliation with stents. Patients and methods: Retrospective study in three centers in Medellín-Colombia; patients undergoing placement of palliative esophageal prostheses for malignant dysphagia (1997-2022). Major and minor complications after implantation, the influence of oncological therapies, and survival were evaluated for 1997-2009 (n = 289) and 2010-2022 (n = 318). Results: 607 patients underwent esophageal prostheses; 296 (48.8%) became complicated. It was higher in the second period (52.5% vs. 48.1%), as were major complications (20.8% vs. 14.2%, p = 0.033), with no differences in minor complications (33.9% vs 31.8%, p = 0.765). Also, 190 (31.3%) patients presented with recurrent dysphagia, stable in both periods. Migration increased over time (from 13.1% to 18.2%, p = 0.09). The most common minor adverse event was pain, increasing over time (from 24.9% to 33.95%, p < 0.01), and associated factors were chemoradiotherapy, absence of fistula, and squamous cell carcinoma. Acid reflux decreased in the second group (p = 0.038). Twelve percent of patients required another intervention for feeding. Survival was not impacted by time and use of stents. Conclusions: Stents are an alternative in non-surgical malignant dysphagia, although recurrent dysphagia has not decreased over time. Minor stent-related complications are increasing in association with the implementation of chemoradiotherapy.

Antecedentes: Las prótesis metálicas autoexpandibles mejoran la disfagia en pacientes con cáncer esofágico (CE) incurable. En las últimas décadas se han introducido nuevos tipos de stents y se ha implementado la quimiorradioterapia para el CE, generando cambios en los perfiles de riesgo de los pacientes. Se desconoce si estos cambios han afectado la paliación con stents. Pacientes y métodos: Estudio retrospectivo en tres centros de Medellín-Colombia; pacientes sometidos a colocación de prótesis esofágicas paliativas para disfagia maligna (1997-2022). Se evaluaron en dos períodos: 1997-2009 (n = 289) y 2010-2022 (n = 318), complicaciones mayores y menores después del implante, la influencia de las terapias oncológicas y la sobrevida. Resultados: Se evaluaron 607 pacientes sometidos a prótesis esofágicas. 296 (48,8%) se complicaron, y fue mayor en el segundo periodo (52,5% frente a 48,1%), al igual que las complicaciones mayores (20,8% frente a 14,2%, p = 0,033), sin diferencias en complicaciones menores (33,9% frente a 31,8%, p = 0,765). 190 (31,3%) pacientes presentaron disfagia recurrente, estable en ambos períodos. La migración aumentó con el tiempo (de 13,1% a 18,2%, p = 0,09). El evento adverso menor más frecuente fue dolor, que aumentó con el tiempo (de 24,9% a 33,95%, p < 0,01), y los factores asociados fueron quimiorradioterapia, ausencia de fístula y carcinoma de células escamosas. El reflujo ácido disminuyó en el segundo grupo (p = 0,038). El 12% de pacientes requirieron otra intervención para alimentarse. No se impactó la sobrevida con el tiempo y uso de stents. Conclusiones: Los stents son una alternativa en la disfagia maligna no quirúrgica, aunque la disfagia recurrente no ha disminuido con el tiempo. Las complicaciones menores relacionadas con el stent van en aumento, asociadas a la implementación de la quimiorradioterapia.

3D-printed low-cost choke corrugated Gaussian profile horn antenna for Ka-band.

In this work, a fully 3D-printed choke corrugated Gaussian profile horn antenna (GPHA) using high-conductive filaments and a low-cost modular 3D-printing technique is implemented. The choke corrugated GPHA operates in the Ka-band, with a central frequency of 28 GHz. Although the antenna can be printed in one piece as its dimensions are within the printing limits, four pieces compose the three sections of the final 3D-printed antenna. The numerical simulations and measurements of the antenna show a good agreement, validating the possibility of cost-effective modular fabrication of this complex type of antennas.

[Post-colonoscopy colorectal cancer: Evaluation of a cohort in its clinical and colonoscopic characteristics, survival and its causes according to the World Endoscopy Organization]. / Cáncer colorrectal post-colonoscopia: Evaluación de una cohorte en sus características clínicas, colonoscópicas, sobrevida y sus causas según la Organización Mundial de Endoscopia.

Post-colonoscopy colorectal cancer (PCCRC) is a tumor that appears after a normal colonoscopy before the established time for the endoscopic follow up. Its origin reflects the quality of the colonoscopy and the different tumoral biologics between the CRC and the CRCPC. Our aim is to describe the characteristics of the PCCRC in our region, to identify risk factors, to discriminate the potential causes according to the World Endoscopý Organization (WEO) and to determine its impact in the patient's survival. We studied patients with colorectal cancer (CRC) attended at the gastro-oncology clinic of two institutions of Medellin-Colombia, between January 2012 and December 2021 that had been submitted to a colonoscopy between 6-36 months before the colonoscopy in which the CRC was diagnosed. 919 patients during 10 years for CRC, 68 cases of PCCRC (6.9%); It was more frequent in older patients (74 vs. 66 years; p=0.03), with background of adenomatous polyps (36.8% vs. 20.1%; p=0.01) and in right colon (57.4% vs. 40.6%; p=0.006), with a tendency in patients with diverticulosis (41.2% vs. 31.3%; p=0.05) and diabetes (25% vs. 14%; p=0.06); less survival at 5 and 10 years (58% and 55.2% vs. 67% and 63%; p < 0.001). According to the WEO, the PCCRC presents in 61.3% because of abnormal findings omitted in inadequate colonoscopies, 29% in a suitable colonoscopy and 9.7% incomplete resections of adenomas. In conclusion, the rate of PCCRC was 6.9% with more propension in older patients, a background of polyp resection, and proximal colon. According to the WEO, the abnormal findings omitted more frequently were related with inadequate colonoscopies. The patients with PCCRC had less survival.

Complete pathological response in patients with HER2 positive breast cancer treated with neoadjuvant therapy in Colombia / Respuesta patológica completa de pacientes con cáncer de mama HER2 positivo tratadas con quimioterapia neoadyuvante en Colombia.

Introduction: Breast cancer is the most common type of cancer and the leading cause of death by cancer in women in Colombia. Approximately 15 to 20% of breast cancers overexpress HER2. Objective: To analyze the relationship between multiple clinical and histological variables and pathological complete response in patients with HER2-positive breast cancer undergoing neoadjuvant therapy in a specialized cancer center in Colombia. Materials and methods: We performed a retrospective analysis of non-metastatic HER2-positive breast cancer patients who received neoadjuvant therapy between 2007 and 2020 at the Instituto de Cancerología Las Americas Auna (Medellín, Colombia). Assessed parameters were tumor grade, proliferation index, estrogen receptor, progesterone receptor, HER2 status, type of neoadjuvant therapy, pathologic complete response rates, and overall survival. Results: Variables associated with low pathologic complete response rates were tumor grades 1-2 (OR = 0.55; 95% CI = 0.37-0.81; p = 0.03), estrogen receptor positivity (OR =0.65; 95%; CI = 0.43-0.97; p=0.04), and progesterone receptor positivity (OR = 0.44; 95% CI = 0.29-0.65; p = 0.0001). HER2 strong positivity (score 3+) was associated with high pathological complete response rates (OR = 3.3; 95% CI = 1.3-8.35; p=0.013). Five-year overall survival was 91.5% (95% CI = 82.6-95.9) in patients with pathological complete response and 73.6% (95% CI = 66.4-79.6) in patients who did not achieve pathological complete response (p = 0.001). Additionally, the pathological complete response rate was three times higher in patients receiving combined neoadjuvant chemotherapy with anti-HER2 therapy than in those with chemotherapy alone (48% versus 16%). Conclusions: In patients with HER2-positive breast cancer, tumor grade 3, estrogen receptor negativity, progesterone receptor negativity, strong HER2 positivity (score 3+), and the use of the neoadjuvant trastuzumab are associated with higher pathological complete response rates.

Complete pathological response in patients with HER2 positive breast cancer treated with neoadjuvant therapy in Colombia / Respuesta patológica completa de pacientes con cáncer de mama HER2 positivo tratadas con quimioterapia neoadyuvante en Colombia

Introduction. Breast cancer is the most common type of cancer and the leading cause of death by cancer in women in Colombia. Approximately 15 to 20% of breast cancers overexpress HER2. Objective. To analyze the relationship between multiple clinical and histological variables and pathological complete response in patients with HER2-positive breast cancer undergoing neoadjuvant therapy in a specialized cancer center in Colombia. Materials and methods. We performed a retrospective analysis of non-metastatic HER2- positive breast cancer patients who received neoadjuvant therapy between 2007 and 2020 at the Instituto de Cancerología Las Americas Auna (Medellín, Colombia). Assessed parameters were tumor grade, proliferation index, estrogen receptor, progesterone receptor, HER2 status, type of neoadjuvant therapy, pathologic complete response rates, and overall survival. Results. Variables associated with low pathologic complete response rates were tumor grades 1-2 (OR = 0.55; 95% CI = 0.37-0.81; p = 0.03), estrogen receptor positivity (OR = 0.65; 95%; CI = 0.43-0.97; p=0.04), and progesterone receptor positivity (OR = 0.44; 95% CI = 0.29-0.65; p = 0.0001). HER2 strong positivity (score 3+) was associated with high pathological complete response rates (OR = 3.3; 95% CI = 1.3-8.35; p=0.013). Five-year overall survival was 91.5% (95% CI = 82.6-95.9) in patients with pathological complete response and 73.6% (95% CI = 66.4-79.6) in patients who did not achieve pathological complete response (p = 0.001). Additionally, the pathological complete response rate was three times higher in patients receiving combined neoadjuvant chemotherapy with anti- HER2 therapy than in those with chemotherapy alone (48% versus 16%). Conclusion. In patients with HER2-positive breast cancer, tumor grade 3, estrogen receptor negativity, progesterone receptor negativity, strong HER2 positivity (score 3+), and the use of the neoadjuvant trastuzumab are associated with higher pathological complete response rates.

Introducción. El adenocarcinoma de seno es el tipo de cáncer más frecuente y con mayor tasa de mortalidad asociada en mujeres en Colombia. Aproximadamente entre el 15 al 20 % de estos cánceres sobreexpresan el gen HER2. Objetivo. Analizar las asociaciones existentes entre múltiples variables clínicas e histológicas con respecto a la respuesta patológica completa en pacientes con cáncer de mama HER2 positivo que fueron tratadas con quimioterapia neoadyuvante en un centro especializado en el tratamiento del cáncer en Colombia. Materiales y métodos. Se realizó un análisis retrospectivo de las pacientes con cáncer de mama HER2 positivo, no metastásicas, que recibieron quimioterapia neoadyuvante entre el 2007 y el 2020 en el Instituto de Cancerología Las Américas Auna (Medellín, Colombia). Se evaluaron los parámetros de grado tumoral, índice de proliferación, estatus de receptores de estrógeno y de progesterona, tipo de quimioterapia neoadyuvante recibida, tasas de respuesta patológica completa y supervivencia global. Resultados. Las variables asociadas con tasas de respuesta patológica completa más bajas fueron grados tumorales 1-2 (OR = 0,55; IC 95% = 0,37-0,81; p= 0,03), positividad de receptores de estrógeno (OR = 0,65; IC 95 % = 0,43-0,97; p = 0,04) y positividad de receptores de progesterona (OR = 0,44; IC 95 % = 0,29-0,65; p = 0,0001). La positividad fuerte para HER2 (puntaje 3+) se asoció a tasas de respuesta patológica completa más altas (OR = 3.3; IC 95 % = 1,3-8,35; p = 0,013). La supervivencia global a cinco años fue del 91,5 % (IC 95 % = 82,6-95,9) en pacientes con respuesta patológica completa y del 73,6 % (IC 95 % = 66.4-79.6) en pacientes sin respuesta patológica completa (p = 0.001). La tasa de respuesta patológica completa fue tres veces mayor en los pacientes que recibieron quimioterapia neoadyuvante con terapia anti-HER2 comparado con aquellos que recibieron quimioterapia sola sin agentes anti-HER2 (48 % versus 16 %). Conclusión. En pacientes con cáncer de mama con sobreexpresión de HER2, grado tumoral tres, receptores de estrógeno y progesterona negativos, positividad fuerte para HER2 (puntaje 3+) y uso de quimioterapia neoadyuvante con trastuzumab se asociaron con mayores tasas de respuesta patológica completa.

Clinical Risk Scores to Predict Nonsusceptibility to Trimethoprim-Sulfamethoxazole, Fluoroquinolone, Nitrofurantoin, and Third-Generation Cephalosporin Among Adult Outpatient Episodes of Complicated Urinary Tract Infection.

Background: Clinical risk scores were developed to estimate the risk of adult outpatients having a complicated urinary tract infection (cUTI) that was nonsusceptible to trimethoprim-sulfamethoxazole (TMP-SMX), fluoroquinolone, nitrofurantoin, or third-generation cephalosporin (3-GC) based on variables available on clinical presentation. Methods: A retrospective cohort study (1 December 2017-31 December 2020) was performed among adult members of Kaiser Permanente Southern California with an outpatient cUTI. Separate risk scores were developed for TMP-SMX, fluoroquinolone, nitrofurantoin, and 3-GC. The models were translated into risk scores to quantify the likelihood of nonsusceptibility based on the presence of final model covariates in a given cUTI outpatient. Results: A total of 30 450 cUTIs (26 326 patients) met the study criteria. Rates of nonsusceptibility to TMP-SMX, fluoroquinolone, nitrofurantoin, and 3-GC were 37%, 20%, 27%, and 24%, respectively. Receipt of prior antibiotics was the most important predictor across all models. The risk of nonsusceptibility in the TMP-SMX model exceeded 20% in the absence of any risk factors, suggesting that empiric use of TMP-SMX may not be advisable. For fluoroquinolone, nitrofurantoin, and 3-GC, clinical risk scores of 10, 7, and 11 predicted a ≥20% estimated probability of nonsusceptibility in the models that included cumulative number of prior antibiotics at model entry. This finding suggests that caution should be used when considering these agents empirically in patients who have several risk factors present in a given model at presentation. Conclusions: We developed high-performing parsimonious risk scores to facilitate empiric treatment selection for adult outpatients with cUTIs in the critical period between infection presentation and availability of susceptibility results.

Determinación de intersecciones probabilísticas relacionadas con daño cerebral adquirido a partir de la determinación de probabilidades a priori y a posteriori.

BACKGROUND: The acquired brain damage is a common neurological disorder. OBJECTIVE: Determine the probabilistic intersections of variables related to acquired brain damage from the determination of a priori and a posteriori probabilities. METHOD: Analytical retrospective study. A descriptive analysis was carried out, confidence intervals were calculated to obtain the mean and the proportion with α = 0.05 considering the age of the patient and the diagnosis. An analysis of probabilistic intersection, a priori and a posteriori probability was performed considering diagnosis, sex and age decade; finally, chi squared was calculated. RESULTS: 736 patients were analyzed. The most frequent diagnosis was language disorder. The patients diagnosed with memory disorder were the youngest and those diagnosed with degenerative cognitive disorder the oldest. The probability that a patient with sequelae due to acquired brain damage arrives at the hospital, at the language pathology service, to be diagnosed with a language disorder and that this patient is also a man is 29.06%. CONCLUSIONS: The high prevalence of short and long-term disability generated by acquired brain damage highlights the importance of an early and timely detection and diagnosis so that it favors prompt and efficient specialized care.

ANTECEDENTES: El daño cerebral adquirido es un trastorno neurológico común. OBJETIVO: Determinar las intersecciones probabilísticas de variables relacionadas con daño cerebral adquirido a partir de la determinación de probabilidades a priori y a posteriori. MÉTODO: Estudio retrospectivo analítico. Se realizó análisis descriptivo y se calcularon intervalos de confianza para la media y para la proporción con α = 0.05 considerando la edad del paciente y el diagnóstico. Se realizó análisis de intersección probabilística, probabilidad a priori y a posteriori considerando el diagnóstico, el sexo y la década de edad; por último, se utilizó la prueba χ2. RESULTADOS: Se analizaron 736 pacientes. El diagnóstico más frecuente fue el trastorno del lenguaje. Los pacientes diagnosticados con trastorno de memoria fueron los más jóvenes y los diagnosticados con trastorno cognitivo degenerativo los más longevos. La probabilidad de que llegue al hospital, al servicio de patología de lenguaje, un paciente con secuelas por daño cerebral adquirido, sea diagnosticado con trastorno del lenguaje y sea hombre es del 29.06%. CONCLUSIONES: La alta prevalencia de discapacidad a corto y largo plazo generada por el daño cerebral adquirido indica la importancia de la detección y el diagnóstico temprano y oportuno que favorezcan una pronta y eficiente atención especializada.

Cáncer colorrectal post-colonoscopia: Evaluación de una cohorte en sus características clínicas, colonoscópicas, sobrevida y sus causas según la Organización Mundial de Endoscopia

Cáncer colorrectal post-colonoscopia (CCRP) es el tumor que aparece posterior a una colonoscopia normal antes de cumplirse el tiempo establecido para seguimiento endoscópico. Origen multifactorial, refleja la calidad de la colonoscopia y las diferentes biologías tumorales entre los cánceres colorrectales detectados (CCRD) y el CCRP. Nuestro objetivo es describir las características del CCRP en nuestro medio, identificar factores de riesgo, discriminar sus causas según la Organización Mundial de Endoscopia (OME) y determinar el efecto en la sobrevida del paciente. El estudio se realizó en pacientes con cáncer-colorrectal (CCR) atendidos en consulta de gastro-oncología de dos instituciones en Medellín-Colombia, entre enero de 2012 y diciembre de 2021 que se habían sometido a una colonoscopia en los 6 a 36 meses anteriores a la colonoscopia en la que se diagnosticó el CCR. 919 pacientes durante 10 años por CCR, 68 casos de CCRP (6,9%), se encontró que se presenta con más frecuencia en pacientes mayores (74 vs. 66 años; p=0,03), con antecedentes de pólipos adenomatosos (36,8% vs. 20,1%; p=0,01) y en colon derecho (57,4% vs. 40,6%; p=0,006), con una tendencia en pacientes con diverticulosis (41,2% vs. 31,3%; p=0,05) y diabetes (25% vs. 14%; p=0,06); menor sobrevida a 5 y 10 años (58%-55,2% vs. 67%-63%; p<0,001). Según la OME, los CCRP se presentaron en 61,3% por lesiones omitidas en colonoscopias inadecuadas, 29% colonoscopias adecuadas y 9,7% resecciones incompletas de adenomas. En conclusión, la tasa de CCRP fue de 6,9%, con mayor propensión en pacientes de mayores, antecedente de resección de pólipos, y en colon derecho. Acorde a la OME, las lesiones omitidas más frecuentemente se relacionaron con colonoscopias inadecuadas. Los pacientes con CCRP tienen menor sobrevida.

Post-colonoscopy colorectal cancer (PCCRC) is a tumor that appears after a normal colonoscopy before the established time for the endoscopic follow up. Its origin reflects the quality of the colonoscopy and the different tumoral biologics between the CRC and the CRCPC. Our aim is to describe the characteristics of the PCCRC in our region, to identify risk factors, to discriminate the potential causes according to the World Endoscopý Organization (WEO) and to determine its impact in the patient's survival. We studied patients with colorectal cancer (CRC) attended at the gastro-oncology clinic of two institutions of Medellin-Colombia, between January 2012 and December 2021 that had been submitted to a colonoscopy between 6-36 months before the colonoscopy in which the CRC was diagnosed. 919 patients during 10 years for CRC, 68 cases of PCCRC (6.9%); It was more frequent in older patients (74 vs. 66 years; p=0.03), with background of adenomatous polyps (36.8% vs. 20.1%; p=0.01) and in right colon (57.4% vs. 40.6%; p=0.006), with a tendency in patients with diverticulosis (41.2% vs. 31.3%; p=0.05) and diabetes (25% vs. 14%; p=0.06); less survival at 5 and 10 years (58% and 55.2% vs. 67% and 63%; p<0.001). According to the WEO, the PCCRC presents in 61.3% because of abnormal findings omitted in inadequate colonoscopies, 29% in a suitable colonoscopy and 9.7% incomplete resections of adenomas. In conclusion, the rate of PCCRC was 6.9% with more propension in older patients, a background of polyp resection, and proximal colon. According to the WEO, the abnormal findings omitted more frequently were related with inadequate colonoscopies. The patients with PCCRC had less survival.

Inteligencia emocional y su importancia en el proceso formativo de especialidades médico-quirúrgicas / Emotional Intelligence and its Importance on the Training Process as within Medical-Surgical Specialties

Introducción: La inteligencia emocional es una habilidad blanda, definida como la capacidad de reconocer las emociones propias y ajenas para gestionarlas frente a otros de manera adecuada. Este tipo de inteligencia se relaciona con competencias y aptitudes humanas en diferentes áreas sociales, académicas y de trabajo. Objetivo: Describir el papel de la inteligencia emocional en la práctica clínica de los residentes médicos, como marco de referencia para su aplicación en la educación teórico-práctica y la realización de futuras investigaciones. Métodos: Se realizó una revisión de la literatura en las bases de datos PubMed, LILACS y Google Scholar. Se emplearon operadores lógicos mediante distintas combinaciones: MeSH: Emotional Intelligence, Medical Residencies, Education, Medical, Education, Medical, Graduate; y DeCS: Inteligencia Emocional, Residencia Médica, Educación Médica, Educación de Postgrado en Medicina. La búsqueda se limitó por año, idioma y acceso libre, teniendo en cuenta criterios de inclusión y exclusión. Se obtuvieron 279 resultados, de los cuales fueron seleccionados 26 para ser incluidos en la revisión y síntesis de los resultados. Resultados: Los resultados se organizaron según su relación con la inteligencia emocional en: medición en residentes médico-quirúrgicos, niveles de estrés y burnout, empatía en la relación médico-paciente, desempeño académico, bienestar y satisfacción laboral. Conclusiones: La inteligencia emocional en los residentes médico-quirúrgicos se ha relacionado con menores niveles de estrés y burnout, comunicación asertiva, mayor empatía con los pacientes y calidad en la atención médica; además, con elevado rendimiento académico, mejores habilidades de enseñanza, liderazgo y motivación; y, finalmente, con mejor bienestar psicológico, satisfacción laboral y rendimiento clínico(AU)

Introduction: Emotional intelligence is a soft skill, defined as the ability to recognize one's own and others' emotions in view of managing them in front of others adequately. This type of intelligence is related to human competences and skills in different social, academic and occupational areas. Objective: To describe the role of emotional intelligence in the clinical practice of medical residents, as a frame of reference for its application in theoretical-practical education and the development of future research. Methods: A literature review was carried out in the PubMed, LILACS and Google Scholar databases. Logical operators were used by means of different combinations from the Medical Subject Headings: Emotional Intelligence, Medical Residencies, Education, Medical, Education, Medical, Graduate. The following combinations from the Health Sciences Descriptors were also used: "Inteligencia Emocional [emotional Intelligence], Residencia Médica [medical residence], Educación Médica [medical education], Educación de Postgrado en Medicina [postgraduate education in Medicine]. The search was limited by year, language and free access, taking into account inclusion and exclusion criteria. A total of 279 results were obtained, of which 26 were selected to be included in the review and synthesis. Results: The results were organized, according to their relationship with emotional intelligence, in measurement in medical-surgical residents, levels of stress and burnout, empathy in the doctor-patient relationship, academic performance, well-being, and job satisfaction. Conclusions: Emotional intelligence in medical-surgical residents has been related to lower levels of stress and burnout, assertive communication, greater empathy with patients, and quality in medical care; furthermore, with high academic performance, better skills for teaching, leadership and motivation; and, finally, with better psychological well-being, job satisfaction and clinical performance(AU)

Impacto de la publicidad tradicional y digital en la resiliencia de las mipymes del sur de Tamaulipas durante COVID-19 / Impact of conventional and digital advertising on the resilience of MSMEs in southern Tamaulipas during COVID-19

Resumen La publicidad es una parte de la mercadotecnia que ha demostrado, durante décadas y tal vez siglos, ser efectiva para la productividad de los negocios. En México, la pandemia de COVID-19, desde el mes de abril de 2020 y al menos a mayo de 2021, ha dejado estragos comerciales y empresariales diversos, que se pueden apreciar en la quiebra de algunos negocios y en el nacimiento o desarrollo de otros. La resiliencia de las empresas, capacidad de sobreponerse a las adversidades del entorno, ha sido un tema importante durante la pandemia. El objetivo de este trabajo fue determinar en qué medida impacta la publicidad, tanto tradicional como digital, en la resiliencia de las empresas. Se realizó una investigación empírica cuantitativa en el mes de mayo de 2021, en la que se aplicó un cuestionario en línea de 30 ítems a una muestra de 302 micro, pequeñas y medianas empresas de la zona sur del estado de Tamaulipas, México. Los resultados mostraron que las empresas encuestadas manifestaron utilizar casi en la misma proporción la publicidad tradicional y digital. Se encontró además una correlación significativa y positiva entre los dos tipos de publicidad y la resiliencia de las empresas, por lo que se puede recomendar a los empresarios definir estrategias encaminadas a utilizar todos los medios publicitarios para anunciarse y así incrementar la posibilidad de tener sostenibilidad empresarial, en particular en tiempos adversos.

Abstract Advertising is a part of marketing that has proved over decades, and perhaps centuries, to be effective for business productivity. The COVID-19 pandemic in Mexico, which paused large numbers of economic activities from April 2020 to at least May 2021, has left diverse commercial and business disruptions. These can be seen in the bankruptcy of some businesses and in the birth or development of others. The resilience of enterprises, understood as the capacity to overcome the adversities of the environment has been an important topic during the pandemic. The aim of this work was to determine the extent to which both, conventional and digital advertising impact on the resilience of enterprises. An empirical quantitative investigation was carried out in May 2021, in which a 30-item online questionnaire was administered to a sample of 302 micro, small and medium-sized enterprises located in the southern region of Tamaulipas, Mexico. Results showed that the surveyed companies claimed that they use conventional and virtual advertising in almost the same proportion. In addition, a significant positive correlation was found between the use of the two types of advertising and the resilience of enterprises. Therefore, it is advisable for entrepreneurs to define strategies that lead to the use of all advertising mediums in order to increase the possibility of achieving entrepreneurial sustainability, especially in adverse circumstances.

Inorganic Compounds that Aid in Obtaining Somatic Embryos.

Somatic embryogenesis (SE) is a process that allows formation of embryos from somatic cells; this biological process has different stages that first require micropropagation and conditioning of explant, and then induction, multiplication, development, and germination of somatic embryos (SoE), to obtain seedlings that will be acclimatized and grown in a greenhouse to further be cultivated in the field. Inorganic compounds are supplemented by macro- and micronutrients that can conform different culture media, and with other compounds such as a carbon source, vitamins, and plant growth regulators (PGRs), will direct the fate of the plant cells to obtain SoE that will regenerate into plants. The concentration of these inorganic compounds must be optimized, since at very high concentrations they can cause toxicity and at low concentrations they may not induce the desired response. The objective of this chapter is to describe the most significant advances in the use of inorganic elements during the different stages of SE, starting with the description of the most used basal media and later describing the use of the main studied mineral elements during establishment of SE.

Epidemiology of Complicated Urinary Tract Infections due to Enterobacterales Among Adult Patients Presenting in Emergency Departments Across the United States.

In this multicenter study of adult patients who presented to the emergency department with an Enterobacterales complicated urinary tract infection (cUTI), high rates of resistance and co-resistance to commonly used oral antibiotics (fluoroquinolones, trimethoprim-sulfamethoxazole, nitrofurantoin, and third-generation cephalosporins) were observed.

Retrospective Cohort Study of the 12-Month Epidemiology, Treatment Patterns, Outcomes, and Health Care Costs Among Adult Patients With Complicated Urinary Tract Infections.

Background: Limited data are available in the United States on the 12-month epidemiology, outpatient (OP) antibiotic treatment patterns, outcomes, and costs associated with complicated urinary tract infections (cUTIs) in adult patients. Methods: A retrospective observational cohort study of adult patients with incident cUTIs in IBM MarketScan Databases between 2017 and 2019 was performed. Patients were categorized as OP or inpatient (IP) based on initial setting of care for index cUTI and were stratified by age (<65 years vs ≥65 years). OP antibiotic treatment patterns, outcomes, and costs associated with cUTIs among adult patients over a 12-month follow-up period were examined. Results: During the study period, 95 322 patients met inclusion criteria. Most patients were OPs (84%) and age <65 years (87%). Treatment failure (receipt of new unique OP antibiotic or cUTI-related ED visit/IP admission) occurred in 23% and 34% of OPs aged <65 years and ≥65 years, respectively. Treatment failure was observed in >38% of IPs, irrespective of age. Across both cohorts and age strata, >78% received ≥2 unique OP antibiotics, >34% received ≥4 unique OP antibiotics, >16% received repeat OP antibiotics, and >33% received ≥1 intravenous (IV) OP antibiotics. The mean 12-month cUTI-related total health care costs were $4697 for OPs age <65 years, $8924 for OPs age >65 years, $15 401 for IPs age <65 years, and $17 431 for IPs age ≥65 years. Conclusions: These findings highlight the substantial 12-month health care burden associated with cUTIs and underscore the need for new outpatient treatment approaches that reduce the persistent or recurrent nature of many cUTIs.

La telesalud como estrategia de atención primaria en la diabetes mellitus tipo 2 en Colombia / Telehealth as a primary care strategy in type 2 Diabetes Mellitus in Colombia

Resumen Introducción: la monitorización de pacientes con diabetes mellitus tipo 2 es una estrategia costo-efectiva, la cual, con un abordaje integral, disminuye los gastos derivados de la atención. La telesalud es una herramienta enfocada en este propósito. El objetivo de este trabajo consistió en describir el uso de la telesalud para el monitoreo de la diabetes mellitus tipo 2 en Colombia, bajo el marco de la atención primaria. Métodos: se realizó una revisión narrativa mediante la búsqueda en bases de datos (PubMed, Google Scholar, ScienceDirect, Cochrane y EMBASE) y documentos oficiales. Se reunieron 154 documentos y con un análisis de contenido, se seleccionaron 45 artículos y documentos. Resultados: la telesalud es una herramienta útil en el control de pacientes con diabetes. En los estudios revisados se evidencia el potencial de la telesalud en la reducción de los costos y el adecuado control glucémico de esta población. Las herramientas de la tecnología y la comunicación junto con la telesalud, en pacientes diabéticos, podrían favorecer su adecuado autocontrol, beneficiando la disminución de los gastos al sistema de seguridad social. Conclusiones: el uso de la telesalud se presenta como una alternativa para el control glucémico de los pacientes y debe considerarse por parte de los médicos de atención primaria, pues son la puerta de entrada al sistema de salud. Sin embargo, se necesitan más estudios sobre el tema para determinar su beneficio exacto como herramienta para el control de la diabetes mellitus tipo 2 en Colombia, bajo el marco de la atención primaria en salud.

Summary Introduction: Monitoring in patients with type 2 diabetes mellitus is a cost-effective strategy, which with a comprehensive approach, reduces the costs of care. Telehealth is an adequate tool focused on this purpose. Objective: To describe the use of telehealth for monitoring type 2 diabetes mellitus in Colombia under the primary care framework. Methods: A narrative review was carried out by searching databases (PubMed, Google Scholar ScienceDirect, Cochrane, and EMBASE) and official documents. In total, 154 documents were collected; subsequently, a content analysis was carried out and 45 articles and documents were selected. Results: Telehealth is a useful tool in the control of patients with diabetes. In the reviewed studies, the potential of telehealth in reducing costs and adequate glycemic control in this population is evidenced. The tools of technology and communication, together with telehealth in diabetic patients, could favor their adequate self-control, reduction the costs to the social security system. Conclusions: The use of telehealth is presented as an alternative for patients with diabetes, which should be considered by primary care physicians who are the gateway to the health system. However, more studies are needed on the subject, to determine accurately the benefit of telehealth as a tool for control of type 2 diabetes mellitus in Colombia, under the framework of primary health care.

The 30-Day Economic Burden of Newly Diagnosed Complicated Urinary Tract Infections in Medicare Fee-for-Service Patients Who Resided in the Community.

INTRODUCTION: Scant data are available on the 30-day financial burden associated with incident complicated urinary tract infections (cUTIs) in a cohort of predominately elderly patients. This study sought to examine total and cUTI-related 30-day Medicare spending (MS), a proxy for healthcare costs, among Medicare fee-for-service (FFS) beneficiaries who resided in the community with newly diagnosed cUTIs. METHODS: A retrospective multicenter cohort study of adult beneficiaries in the Medicare FFS database with a cUTI between 2017 and 2018 was performed. Patients were included if they were enrolled in Medicare FFS and Medicare Part D from 2016 to 2019, had a cUTI first diagnosis in 2017-2018, no evidence of any UTI diagnoses in 2016, and residence in the community between 2016 and 2018. RESULTS: During the study period, 723,324 cases occurred in Medicare beneficiaries who met the study criteria. Overall and cUTI-related 30-day MS were $7.6 and $4.5 billion, respectively. The average overall and cUTI-related 30-day MS per beneficiary were $10,527 and $6181, respectively. The major driver of cUTI-related 30-day MS was acute care hospitalizations ($3.2 billion) and the average overall and cUTI-related 30-day MS per hospitalizations were $16,431 and $15,438, respectively. CONCLUSION: Overall 30-day MS for Medicare FSS patients who resided in the community with incident cUTIs was substantial, with cUTI-related MS accounting for 59%. As the major driver of cUTI-related 30-day MS was acute care hospitalizations, healthcare systems should develop well-defined criteria for hospital admissions that aim to avert hospitalizations in clinically stable patients and expedite the transition of patients to the outpatient setting to complete their care.

Hipoacusia en pacientes con y sin COVID-19 antes y después de la recuperación de los casos positivos / Hearing loss in patients with and without COVID-19 before and after recovery from positive cases

Introducción y objetivo: Aun son pocos los estudios sobre el daño de la COVID-19 en la audición por lo que se recomienda evaluaciones iniciales y su seguimiento, el objetivo de este estudio fue comparar el grado y tipo de hipoacusia en sujetos con y sin COVID-19 al inicio del padecimiento y después de su recuperación de quienes se confirmó su positividad. Método: Estudio prospectivo, comparativo no experimental. Previa firma del consentimiento informado a una muestra voluntaria de 105 sujetos que acudieron a confirmar positividad a COVID-19 se les realizo audiometría tonal y una revaloración posterior a su recuperación de los positivos Resultados: la hipoacusia superficial sensorial fue más frecuente en el grupo de 35 a 50 años, en el grupo negativo a SARS-Cov-2, los resultados antes-después de la recuperación de los positivos fue significativa en el promedio de 7 frecuencias y frecuencias medias. Discusión: Los resultados de este estudio coinciden con lo publicado en relación con el tipo y grado de hipoacusia, la edad y la no percepción de esta, la diversidad de síntomas de COVID-19 sin diferencias entre los grupos con y sin COVID-19. Las diferencias en los promedios de tonos puros en 7 frecuencias y frecuencias medias no reportadas para el contraste. Conclusiones: el tipo y grado de hipoacusia fue el esperado con respecto a la edad, las diferencias en los promedios antes y después fueron mejores en la segunda evaluación probablemente por la resolución del cuadro inflamatorio. Se recomienda aumentar la muestra y agregar evaluación objetiva de oído medio. (AU)

Introduction and objective: There are still few studies on the damage of COVID-19 in hearing, so initial evaluations and their follow-up are recommended, the objective of this study was to compare the degree and type of hearing loss in subjects with and without COVID-19 at the beginning of the disease and after their recovery of whom their positivity was confirmed. Method: prospective, compa-rative non-experimental study. After signing the informed consent to a voluntary sample of 105 subjects who came to confirm positivity for COVID-19, they underwent tonal audiometry and a reassessment after their recovery of the positives. Results: Sensory superficial hearing loss was more frequent in the group aged 35 to 50 years, in the group negative to SARS-Cov-2, the results before-after the recovery of the positive ones was significant in the average of 7 frequencies and medium frequencies. Discussion: The results of this study coincide with what has been published in relation to the type and degree of hearing loss, age and non-perception of it, the diversity of COVID-19 symptoms without differences between the groups with and without COVID-19. Differences in the averages of pure tones at 7 frequencies and mid-frequencies not reported for contrast. Conclusions: the type and degree of hearing loss was as expected with respect to age, the differences in the averages before and after were better in the second evaluation, probably due to the resolution of the inflammatory condition. It is recommended to increase the sample and add an objective evaluation of the ear half. (AU)

Plasmodiophora brassicae in Mexico: From Anecdote to Fact.

For years, the presence of clubroot disease and its causal agent, Plasmodiophora brassicae, in Mexico has been stated as a fact. However, an intensive search of the scientific literature in English and Spanish, as well as gray literature including theses and government reports, did not reveal any information about the actual detection of the pathogen, affected hosts, or areas with clubroot presence, or any information about clubroot (hernia de la col in Mexico). We followed a multistep process to confirm whether P. brassicae was indeed in Mexico. First, we identified agricultural communities with a history of cruciferous crop cultivation. Second, we asked growers if they had seen clubroot on their crops, using pictures of the characteristic root galls. Third, we collected soil from the locations where clubroot was reported and looked for clubroot/P. brassicae in the soil using several cruciferous bait plants. For the first time we confirm the presence of the clubroot pathogen P. brassicae in Mexico, through a bioassay, the presence of resting spores, and a P. brassicae-specific PCR assay. The identification of P. brassicae in Mexico will contribute to our understanding of the genetic diversity of this elusive and devastating plant pathogen in future studies.[Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

Testing a 5G Communication System: Kriging-Aided O2I Path Loss Modeling Based on 3.5 GHz Measurement Analysis.

Deep knowledge of how radio waves behave in a practical wireless channel is required for the effective planning and deployment of radio access networks in outdoor-to-indoor (O2I) environments. Using more than 400 non-line-of-sight (NLOS) radio measurements at 3.5 GHz, this study analyzes and validates a novel O2I measurement-based path loss prediction narrowband model that characterizes and estimates shadowing through Kriging techniques. The prediction results of the developed model are compared with those of the most traditional assumption of slow fading as a random variable: COST231, WINNER+, ITU-R, 3GPP urban microcell O2I models and field measured data. The results showed and guaranteed that the predicted path loss accuracy, expressed in terms of the mean error, standard deviation and root mean square error (RMSE) was significantly better with the proposed model; it considerably decreased the average error for both scenarios under evaluation.