Reconstructing Sparse Multiplex Networks with Application to Covert Networks.

Network structure provides critical information for understanding the dynamic behavior of complex systems. However, the complete structure of real-world networks is often unavailable, thus it is crucially important to develop approaches to infer a more complete structure of networks. In this paper, we integrate the configuration model for generating random networks into an Expectation-Maximization-Aggregation (EMA) framework to reconstruct the complete structure of multiplex networks. We validate the proposed EMA framework against the Expectation-Maximization (EM) framework and random model on several real-world multiplex networks, including both covert and overt ones. It is found that the EMA framework generally achieves the best predictive accuracy compared to the EM framework and the random model. As the number of layers increases, the performance improvement of EMA over EM decreases. The inferred multiplex networks can be leveraged to inform the decision-making on monitoring covert networks as well as allocating limited resources for collecting additional information to improve reconstruction accuracy. For law enforcement agencies, the inferred complete network structure can be used to develop more effective strategies for covert network interdiction.

A software to prevent delirium in hospitalised older adults: development and feasibility assessment.

BACKGROUND: non-pharmacological interventions to prevent delirium are useful in hospitalised older adults. However, they are poorly implemented in clinical practice. We aimed to develop a software for bedside use by hospitalised older adults and to improve their access to these interventions. METHODS: a transdisciplinary team composed of healthcare professionals, designers, engineers and older adults participated in the development of the software. Scrum methodology was used to coordinate the work of the team, and the software was evaluated in a feasibility study. RESULTS: a software for touchscreen mobile devices that supports Android 5.0 or later was produced, including modules for time-spatial re-orientation, cognitive stimulation, early mobilisation, sensorial support use promotion, sleep hygiene and pain management optimisation. Horizontal disposition, use of colour contrast and large interaction areas were used to improve accessibility. The software's usability and accessibility were evaluated in 34 older adults (average age 73.2 ± 9.1 years) showing that 91.1% of them got access to all the software functions without previous instructions. The clinical feasibility assessment showed that 83.3% of the 30 enrolled hospitalised patients (76 ± 8 years) completed the 5-day protocol of software usage during hospitalisation. Software use was associated with a decreased trend in delirium incidence of 5 of 32 (15.6%) at baseline to 2 of 30 (6.6%) after its implementation. CONCLUSION: a highly accessible and implementable software, designed to improve access to non-pharmacological interventions to prevent delirium in hospitalised older adults, was developed. The effectiveness of the software will be evaluated in a randomised clinical trial.

American Society of Hematology, ABHH, ACHO, Grupo CAHT, Grupo CLAHT, SAH, SBHH, SHU, SOCHIHEM, SOMETH, Sociedad Panamena de Hematología, Sociedad Peruana de Hematología, and SVH 2023 guidelines for diagnosis of venous thromboembolism and for its management in special populations in Latin America.

Implementation of international guidelines in Latin American settings requires additional considerations (ie, values and preferences, resources, accessibility, feasibility, and impact on health equity). The purpose of this guideline is to provide evidence-based recommendations about the diagnosis of venous thromboembolism (VTE) and its management in children and during pregnancy. We used the GRADE ADOLOPMENT method to adapt recommendations from 3 American Society of Hematology (ASH) VTE guidelines (diagnosis of VTE, VTE in pregnancy, and VTE in the pediatric population). ASH and 12 local hematology societies formed a guideline panel comprising medical professionals from 10 countries in Latin America. Panelists prioritized 10 questions about the diagnosis of VTE and 18 questions about its management in special populations that were relevant for the Latin American context. A knowledge synthesis team updated evidence reviews of health effects conducted for the original ASH guidelines and summarized information about factors specific to the Latin American context. In comparison with the original guideline, there were significant changes in 2 of 10 diagnostic recommendations (changes in the diagnostic algorithms) and in 9 of 18 management recommendations (4 changed direction and 5 changed strength). This guideline ADOLOPMENT project highlighted the importance of contextualizing recommendations in other settings based on differences in values, resources, feasibility, and health equity impact.

American Society of Hematology, ABHH, ACHO, Grupo CAHT, Grupo CLAHT, SAH, SBHH, SHU, SOCHIHEM, SOMETH, Sociedad Panameña de Hematología, Sociedad Peruana de Hematología, and SVH 2022 guidelines for prevention of venous thromboembolism in surgical and medical patients and long-distance travelers in Latin America.

BACKGROUND: Venous thromboembolism (VTE) is a common disease in Latin American settings. Implementation of international guidelines in Latin American settings requires additional considerations. OBJECTIVE: To provide evidence-based guidelines about VTE prevention for Latin American patients, clinicians, and decision makers. METHODS: We used the GRADE ADOLOPMENT method to adapt recommendations from 2 American Society of Hematology (ASH) VTE guidelines (Prevention of VTE in Surgical Patients and Prophylaxis for Medical Patients). ASH and 12 local hematology societies formed a guideline panel composed of medical professionals from 10 countries in Latin America. Panelists prioritized 20 questions relevant to the Latin American context. A knowledge synthesis team updated evidence reviews of health effects conducted for the original ASH guidelines and summarized information about factors specific to the Latin American context, that is, values and preferences, resources, accessibility, feasibility, and impact on health equity. RESULTS: The panel agreed on 21 recommendations. In comparison with the original guideline, 6 recommendations changed direction and 4 recommendations changed strength. CONCLUSIONS: This guideline ADOLOPMENT project highlighted the importance of contextualization of recommendations in other settings, based on differences in values, resources, feasibility, and health equity impact.

Emergency and disaster response strategies to support mother-infant dyads during COVID-19.

The COVID-19 pandemic has produced an unprecedented global health crisis. Vulnerable populations, such as breastfeeding mother-infant dyads, are in a particularly delicate situation. Before, during, and after birth mothers and their infants could be exposed to the virus. Due to fear of infection transmission, there has been an increase in separation of COVID-positive mothers and their infants and a decline in breastfeeding, despite research supporting the provision of mother's milk for her infant. During this crisis, evidence-based education counseling and resources can support healthful infant feeding which is necessary for short- and long-term infant growth and development. Using a framework of disaster preparedness and response, we delineate operational guidelines and policy recommendations to support maternal-infant dyads during the COVID pandemic outbreak. Key recommendations include promotion of breastfeeding and milk expression, avoiding the use of formula, engaging healthcare providers in supporting lactation, and incorporating evidence-based breastfeeding and lactation protocols and practices in disaster preparedness and disaster response plans.

ASH, ABHH, ACHO, Grupo CAHT, Grupo  CLAHT, SAH, SBHH, SHU, SOCHIHEM, SOMETH, Sociedad Panameña de Hematología, SPH, and SVH 2021 guidelines for management of venous thromboembolism in Latin America.

BACKGROUND: Venous thromboembolism (VTE) is a common disease in Latin American settings. Implementing international guidelinn Aes in Latimerican settings requires additional considerations. OBJECTIVE: The purpose of our study was to provide evidence-based guidelines about managing VTE for Latin American patients, clinicians, and decision makers. METHODS: We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE)-ADOLOPMENT method to adapt recommendations from 2 American Society of Hematology (ASH) VTE guidelines (Treatment of VTE and Anticoagulation Therapy). ASH and local hematology societies formed a guideline panel comprised of medical professionals from 10 countries in Latin America. Panelists prioritized 18 questions relevant for the Latin American context. A knowledge synthesis team updated evidence reviews of health effects conducted for the original ASH guidelines and summarized information about factors specific to the Latin American context (ie, values and preferences, resources, accessibility, feasibility, and impact on health equity). RESULTS: The panel agreed on 17 recommendations. Compared with the original guideline, 4 recommendations changed direction and 1 changed strength. CONCLUSIONS: This guideline adolopment project highlighted the importance of contextualization of recommendations suggested by the changes to the original recommendations. The panel also identified 2 implementation priorities for the region: expanding the availability of home treatment and increasing the availability of direct oral anticoagulants (DOACs). The guideline panel made a conditional recommendation in favor of home treatment for individuals with deep venous thrombosis and a conditional recommendation for either home or hospital treatment for individuals with pulmonary embolism. In addition, a conditional recommendation was made in favor of DOACs over vitamin K antagonists for several populations.

Strike-slip 23 January 2018 MW 7.9 Gulf of Alaska rare intraplate earthquake: Complex rupture of a fracture zone system.

Large intraplate earthquakes in oceanic lithosphere are rare and usually related to regions of diffuse deformation within the oceanic plate. The 23 January 2018 MW 7.9 strike-slip Gulf of Alaska earthquake ruptured an oceanic fracture zone system offshore Kodiak Island. Bathymetric compilations show a muted topographic expression of the fracture zone due to the thick sediment that covers oceanic basement but the fracture zone system can be identified by offset N-S magnetic anomalies and E-W linear zones in the vertical gravity gradient. Back-projection from global seismic stations reveals that the initial rupture at first propagated from the epicenter to the north, likely rupturing along a weak zone parallel to the ocean crustal fabric. The rupture then changed direction to eastward directed with most energy emitted on Aka fracture zone resulting in an unusual multi-fault earthquake. Similarly, the aftershocks show complex behavior and are related to two different tectonic structures: (1) events along N-S trending oceanic fabric, which ruptured mainly strike-slip and additionally, in normal and oblique slip mechanisms and (2) strike-slip events along E-W oriented fracture zones. To explain the complex faulting behavior we adopt the classical stress and strain partitioning concept and propose a generalized model for large intra-oceanic strike-slip earthquakes of trench-oblique oriented fracture zones/ocean plate fabric near subduction zones. Taking the Kodiak asperity position of 1964 maximum afterslip and outer-rise Coulomb stress distribution into account, we propose that the unusual 2018 Gulf of Alaska moment release was stress transferred to the incoming oceanic plate from co- and post-processes of the nearby great 1964 MW 9.2 megathrust earthquake.

Effect of cold acclimation on the photosynthetic performance of two ecotypes of Colobanthus quitensis (Kunth) Bartl.

The effects of cold acclimation of two ecotypes (Antarctic and Andes) of Colobanthus quitensis (Kunth) Bartl. Caryophyllaceae on their photosynthetic characteristics and performance under high light (HL) were compared. Non-acclimated plants of the Antarctic ecotype exhibited a higher (34%) maximal rate of photosynthesis than the Andes ecotype. In cold-acclimated plants the light compensation point was increased. Dark respiration was significantly increased during the exposure to 4 degrees C in both ecotypes. Cold-acclimated Antarctic plants showed higher Phi(PSII) and qP compared with the Andes ecotype. In addition, the Antarctic ecotype exhibited higher heat dissipation (NPQ), especially in the cold-acclimated state, which was mainly associated with the fast relaxing component of non-photochemical quenching (NPQ(F)). By contrast, the Andes ecotype exhibited a lower NPQ(F) and a significant increase in the slowly relaxing component (NPQ(s)) at low temperature and HL, indicating higher sensitivity to low temperature-induced photoinhibition. Although the xanthophyll cycle was fully operational in both ecotypes, cold-acclimated Antarctic plants exposed to HL exhibited higher epoxidation state of the xanthophyll cycle pigments (EPS) compared with the cold-acclimated Andes ecotype. Thus, the photosynthetic apparatus of the Antarctic ecotype operates more efficiently than that of the Andes one, under a combination of low temperature and HL. The ecotype differences are discussed in relation to the different climatic conditions of the two Colobanthus.

Papillary Tumor of the Pineal Region: Case Report and Literature Review

Papillary tumor of the pineal region (PTPR) is a neuroectodermal tumor thought to originate from cells of the subcommissural organ. Its oncologic properties are still under investigation, as well as the most suitable therapeutic measures for this type of neoplasm.We report the case of a 36-year-old woman with a 1-year history of headache and intermittent diplopia. The magnetic resonance imaging (MRI) scan showed a heterogeneously enhancing mass in the pineal region that caused an acute hydrocephalus, and an emergency shunt derivation was necessary. One week later, the patient was submitted to subtotal tumor resection, and remained asymptomatic in the post-operative period. In the follow-up, the patient remained asymptomatic; in the imaging control 3.5 years after the surgical resection, local recurrence was identified, and the patient was submitted to a local radiation protocol. Our literature review showed an early clinical onset due to intracranial hypertension signs. Definitive clinical onset might be reached only through a histopathological examination. Gross total resection followed by radiotherapy is the current standard of care. Local recurrence is often observed, with rare dissemination to the cerebral spinal fluid. The natural history of the PTPR remains unknown, as well as the best treatment strategy. Large case series with longer follow-ups are necessary for further conclusions.

¿Intervenimos adecuadamente las hernias inguinales? / Do we adequately intervene inguinal hernias?

Introducción. La herniorrafia inguinal es la intervención quirúrgica más frecuente en el ámbito de la cirugía general. El uso de técnicas quirúrgicas con malla ha traído numerosos beneficios, entre los que se pueden mencionar la disminución de la tasa de recidiva y de las complicaciones posoperatorias, y la reducción del tiempo de convalecencia y de reintegración a las actividades cotidianas. Materiales y métodos. Se llevó a cabo un estudio de tipo observacional retrospectivo desde noviembre de 2010 hasta septiembre de 2012 de pacientes diagnosticados con hernia inguinal, que fueron intervenidos quirúrgicamente en una institución de tercer nivel de atención en salud. La recolección de la información se hizo mediante un formato estructurado y la revisión de las historias clínicas. Resultados. De 102 pacientes intervenidos en este lapso de tiempo, 86,3 % eran hombres y 13,7 % mujeres, entre los 14 y 88 años. El 57 % tenía una hernia indirecta unilateral y 28 % presentó una directa unilateral. En 68 % de los pacientes se usó malla y, de estos, a todos se les practicó fijación de la misma. El tipo de malla usada fue mayormente de polipropileno (88 %). El 18,6 % de los pacientes presentó complicaciones posoperatorias. Discusión. La institución estudiada presentó una tasa de utilización de la técnica de Lichtenstein menor a la esperada con relación a otros estudios. La tasa de morbilidad general fue menor, pero el hematoma se presentó el doble de veces que en la mayoría de los reportes de la literatura científica.

Background. Inguinal herniorraphy is the most common surgical procedure performed in general surgery. Using mesh surgical techniques has greatly reduced the relapse rate after the procedure, postoperative complications, recovery time and reintegration to daily activities. Methods. A retrospective observational study of patients diagnosed and surgically treated of inguinal hernia from November 2010 to September 2012 in a third level of care general hospital was performed. The data collection was done through a structured format and review of medical records. Results. In a total of 102 patients, 86.3% were male and 13.7% female, with ages ranging from14 to 88 years old. Most of them had a unilateral indirect hernia (57%) and 28% had a unilateral direct hernia 68 % of the patients were intervened with a mesh technique and all patients received mesh fixation. Most of mesh's type used in the procedures was polypropylene (88%); 18.6 % of patients presented posoperative complications (POP). Discussion. The studied institution showed a lower utilization rate of the Lichtenstein technique than expected according to current literature. The general morbidity rate was lower, but hematoma occurred twice as often than in most literature reports.

De ciudades emergentes a ciudades sostenibles: comprendiendo y proyectando las metrópolis del Siglo XXI / From emerging cities to sustainable cities: understanding and projecting the metropolises of the 21st century

Reflexionando sobre el escenario contemporáneo de las ciudades, uno podría argumentar que el urbanismo de hoy ocurre como resultado de una negociación entre dos fuerzas críticas que, en contraste, dirigen la construcción de las ciudades alrededor en el globo. La primera, fuertemente presente luego de la Revolución Industrial, es la tendencia implosiva impulsada por un entendimiento del desarrollo global como acumulación masiva, alentando la concentración del tejido urbano en mega aglomeraciones que operan bajo los preceptos de un 'capitalismo impaciente'. Así, en aquellos lugares de colocación masiva de capital, aparece lo que podríamos denominar como 'híper-ciudad', una serie de asentamientos que exacerban los atributos de lo urbano en densos centros metropolitanos de gran escala. En estos contextos, el diseño de la ciudad surge como un ejercicio casi exclusivamente material, usualmente desconectado del entendimiento más profundo de las implicancias sociales del urbanismo. Aquí, quien hace ciudad se encuentra obsesionado con la creación de espectáculos urbanos de resonancia global. Este es el impulso que hacia fines del siglo pasado generó las mayores transformaciones del medio construido, alentando la creación y focalizando la atención en la aparición de mega aglomeraciones urbanas que llegaron a acomodar más de veinte millones de personas. Estas 'híper' formaciones urbanas, como Ciudad de México, Bombay, Sao Paulo o Estambul, fueron por largo tiempo los grandes motores del crecimiento económico y social, pero como consecuencia de su rápido y expansivo desarrollo descontrolado se convirtieron en responsables en gran medida del calentamiento global, de la vulnerabilidad urbana y de la aparición de las más extremas expresiones de exclusión social. Su crecimiento fue en cierta forma, más rápido que cualquier posible conceptualización reflexiva, y por tanto más rápido que la formulación de los correctos protocolos de intervención. Hoy, la condición urbana se encuentra en una posición muy distinta. Los patrones de 'implosión' se han convertido en patrones de 'explosión', resituando a la ciudades en un punto de quiebre, enfrentando una condición sin precedentes que ofrece la posibilidad de enmendar los errores del pasado. Los procesos de urbanización están dejando las aglomeraciones masivas y han comenzado a moverse hacia una red secundaria de aglomeraciones urbanas que está creciendo, expandiéndose, y se encuentra aún en construcción. De esta manera, en este preciso momento y especialmente en contextos del sur global, los patrones de crecimiento urbano están cambiando. La atención ­y por tanto la inversión­ se está moviendo desde estas grandes áreas metropolitanas hacia aceleradas ciudades emergentes de tamaño medio. Es en estas aglomeraciones más pequeñas donde ocurrirá el crecimiento urbano en los años venideros, y por tanto en ellas descansa la oportunidad de redireccionar el crecimiento urbano del planeta. Con poblaciones entre 100.000 y 2.000.000 de habitantes, y teniendo tasas de crecimiento económico y demográfico más altas que la media de la región, estas ciudades secundarias son lo que nosotros llamamos 'ciudades emergentes'. En estas urbes de tamaño medio encontramos una expresión más matizada y negociada de la ciudad. Ellas son aún producto de un urbanismo flexible, que responde a condiciones cambiantes. Son suficientemente débiles como para albergar economías vernáculas y ecologías multidimensionales. Debido a su crecimiento exponencial, son incompresibles como entidades bidimensionales, y de hecho son percibidas como ciudades en movimiento, como construcciones tridimensionales de desarrollo incremental. Son ciudades que constantemente se modifican y reinventan a sí mismas, ansiosas por desplegar su potencial. La 'ciudad emergente' es un lugar en donde diseñar reconfiguraciones funcionales es más importante que la construcción del cuerpo arquitectónico, donde lo abierto prevalece sobre lo rígido y la flexibilidad sobre el rigor. En vez de ser lugares para el consumo transnacional, estas ciudades son comúnmente reconocibles como campos de batalla en los que estructuras subnacionales abogan por su lugar en las decisiones centralizadas de gobiernos nacionales, resistiendo contra la ansiedad propia del control centralizado. De esta manera, como son elásticas, tienen la capacidad de adaptarse a las condiciones más inesperadas, encontrando alternativas tangenciales para las problemáticas económicas contemporáneas, y ablandando a su vez las divisiones sociales. Estas ciudades son, en cierta forma, fisuras en las lógicas de poder imperante, alternativas de las cuales aprender sobre estrategias urbanas contra la proliferación de la acumulación despiadada. Hoy el 75% de la población vive en asentamientos de menos de 500.000 habitantes, lo que significa que las 'híper-ciudades' ­que concentran hoy la mayor parte del poder económico y social­ no son el lugar en que se incuba la vida urbana del futuro.