How Do Courts Set Health Policy? The Case of the Colombian Constitutional Court

Alicia Ely Yamin and Oscar Parra-Vera discuss the case of Colombia, where a recent constitutional court decision demonstrates the involvement of the court in protecting fundamental rights to health

Estrategias Pedagógicas en el aula y su Influencia en el desarrollo socioemocional de los Estudiantes

The implementation of pedagogical strategies in classroom processes has a positive influence on the socio-emotional development of students, since it allows them to develop skills that will be useful throughout their lives, both personally and professionally. In addition, by fostering an environment of respect, collaboration, and empathy in the classroom, it contributes to creating a more positive school climate that is conducive to learning. The objective of the study is to establish the influence of pedagogical strategies on the socio-emotional development of students in different educational institutions. In relation to the methodological framework, it is a study with a quantitative approach with a pre-experimental design; For data collection, the survey was used as a technique and the questionnaire as an instrument; Similarly, to process the data, the IBM SPSS Statistics software was used. The findings found resulted in the implementation of pedagogical strategies fostering cooperative learning among students, allowing them to work in teams to achieve a common goal, where students learn to work collaboratively, to communicate and to respect the opinions of their peers, which It helps to develop socio-emotional skills such as empathy and collaboration.    La implementación de las estrategias pedagógicas en los procesos áulicos tiene una influencia positiva en el desarrollo socioemocional de los estudiantes, ya que les permite desarrollar habilidades que les serán útiles a lo largo de su vida, tanto en el ámbito personal como en el profesional. Además, al fomentar un ambiente de respeto, colaboración y empatía en el aula, se contribuye a crear un clima escolar más positivo y propicio para el aprendizaje. El objetivo del estudio es establecer la influencia de las estrategias pedagógicas en el desarrollo socioemocional de los educandos en las diferentes instituciones educativas. En relación al marco metodológico es un estudio con enfoque cuantitativo con diseño pre-experimental; para la recolección de datos se utilizó como técnica la encuesta y como instrumento al cuestionario; de igual forma, para procesar los datos se utilizó el software IBM SPSS Statistics. Los hallazgos encontrados dieron como resultado que la implementación de las estrategias pedagógicas fomentó el aprendizaje cooperativo entre los educandos permitiéndoles trabajar en equipos para alcanzar una meta común, donde los estudiantes aprenden a trabajar colaborativamente, a comunicarse y a respetar las opiniones de sus compañeros, lo que contribuye a desarrollar habilidades socioemocionales como la empatía y la colaboración

Impacts of zero tillage on soil enzyme activities, microbial characteristics and organic matter functional chemistry in temperate soils

Zero tillage management of agricultural soils has potential for enhancing soil carbon (C) storage and reducing greenhouse gas emissions. However, the mechanisms which control carbon (C) sequestration in soil in response to zero tillage are not well understood. The aim of this study was to investigate the links between zero tillage practices and the functioning of the soil microbial community with regards to C cycling, testing the hypothesis that zero tillage enhances biological functioning in soil with positive implications for C sequestration. Specifically, we determined microbial respiration rates, enzyme activities, carbon source utilization and the functional chemistry of the soil organic matter in temperate well drained soils that had been zero tilled for seven years against annually tilled soils. Zero tilled soils contained 9% more soil C, 30% higher microbial biomass C than tilled soil and an increased presence of aromatic functional groups indicating greater preservation of recalcitrant C. Greater CO2 emission and higher respirational quotients were observed from tilled soils compared to zero tilled soils while microbial biomass was 30% greater in zero tilled soils indicating a more efficient functioning of the microbial community under zero tillage practice. Furthermore, microbial enzyme activities of dehydrogenase, cellulase, xylanase, β-glucosidase, phenol oxidase and peroxidase were higher in zero tilled soils. Considering zero tillage enhanced both microbial functioning and C storage in soil, we suggest that it offers significant promise to improve soil health and support mitigation measures against climate change

Effect of SGLT2 inhibitors on stroke and atrial fibrillation in diabetic kidney disease: Results from the CREDENCE trial and meta-analysis

BACKGROUND AND PURPOSE: Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-Analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus. METHODS: CREDENCE randomized 4401 participants with type 2 diabetes mellitus and chronic kidney disease to canagliflozin or placebo. Post hoc, we estimated effects on fatal or nonfatal stroke, stroke subtypes, and intermediate markers of stroke risk including AF/AFL. Stroke and AF/AFL data from 3 other completed large CVOTs and CREDENCE were pooled using random-effects meta-Analysis. RESULTS: In CREDENCE, 142 participants experienced a stroke during follow-up (10.9/1000 patient-years with canagliflozin, 14.2/1000 patient-years with placebo; hazard ratio [HR], 0.77 [95% CI, 0.55-1.08]). Effects by stroke subtypes were: ischemic (HR, 0.88 [95% CI, 0.61-1.28]; n=111), hemorrhagic (HR, 0.50 [95% CI, 0.19-1.32]; n=18), and undetermined (HR, 0.54 [95% CI, 0.20-1.46]; n=17). There was no clear effect on AF/AFL (HR, 0.76 [95% CI, 0.53-1.10]; n=115). The overall effects in the 4 CVOTs combined were: Total stroke (HRpooled, 0.96 [95% CI, 0.82-1.12]), ischemic stroke (HRpooled, 1.01 [95% CI, 0.89-1.14]), hemorrhagic stroke (HRpooled, 0.50 [95% CI, 0.30-0.83]), undetermined stroke (HRpooled, 0.86 [95% CI, 0.49-1.51]), and AF/AFL (HRpooled, 0.81 [95% CI, 0.71-0.93]). There was evidence that SGLT2i effects on total stroke varied by baseline estimated glomerular filtration rate (P=0.01), with protection in the lowest estimated glomerular filtration rate (45 mL/min/1.73 m2]) subgroup (HRpooled, 0.50 [95% CI, 0.31-0.79]). CONCLUSIONS: Although we found no clear effect of SGLT2i on total stroke in CREDENCE or across trials combined, there was some evidence of benefit in preventing hemorrhagic stroke and AF/AFL, as well as total stroke for those with lowest estimated glomerular filtration rate. Future research should focus on confirming these data and exploring potential mechanisms

Insights into DNA catalysis from structural and functional studies of the 8-17 DNAzyme

DNAzymes (deoxyribozymes) are single-stranded DNA molecules endowed with catalytic activity, obtained by in vitro selection. In the past 25 years, dozens of DNAzymes have been identified and employed for applicative purposes, yet our knowledge of the structural and mechanistic basis of DNA catalysis remains very limited. The RNA-cleaving 8-17 DNAzyme, which depends on divalent metal ions for function, is possibly the most studied catalytic DNA in terms of mechanism. It is very efficient, implying that it adopts a combination of distinct catalytic strategies, but until recently it was uncertain which strategies are at play and how they are implemented. Recently, however, new functional studies and the attainment of high-resolution X-ray structures of an 8-17 construct, have offered a great opportunity for a more detailed understanding of its mechanism. This review examines the functional information gathered on 8-17, in the light of the available crystal structures, pointing out the congruences and possible inconsistencies between the functional and structural data. We will analyze separately three aspects of the DNAzyme function: the structural requirements for catalysis, the role of metal ions and the influence of pH on activity. Ultimately, we will contrast the experimental data with a model for the 8-17 mechanism proposed in the crystallographic study, whereby one specific G residue (G14) acts as a general base and a metal-coordinated water molecule acts as a general acid. Throughout this analysis we will signal the most outstanding mechanistic issues that remain to be addressed, with implications for the broader field of DNA catalysis

Effect of homologous transfusions and the autologous blood recovery system in highly complex surgical patients

Introduction: Autologous transfusion has three modalities: autologous transfusion with predeposit, preoperative hemodilution (normovolemic or hypervolemic), and the system for autologous blood recovery (cell saver), whether intraoperative or postoperative.Objective: To show the effectiveness of the use of the autologous blood recovery system in highly complex surgical patients at Alcívar Hospital.Method: Nonexperimental, retrospective study, of indirect observation and with correlational analysis. The sample consisted of 112 patients who underwent surgery for cardiovascular, orthopedic and traumatological conditions, chosen based on inclusion and exclusion criteria. The cell saver system was used in 56 patients and 56 patients used homologous blood transfusions.Results: The cell saver system was beneficial in 93 % of patients; morbidity and mortality decreased, mainly in patients operated for any cardiovascular condition, while the cost-benefit ratio increased, due to the fact prioritization of economic resources. In traumatology and orthopedics, it was not so beneficial, since the amount of blood recovered fluctuated between 300 and 500 mL in conventional interventions, which motivated the use of blood products and increased the cost. In tumor resections and instrumentation of different spine segments, up to 800 mL of blood were recovered, which was significant. The complication rate was lower in patients who used the cell saver system (7 %), compared to patients who used homologous blood products (32 %). A shorter hospital stay was observed in the cell saver group (1-20 days), compared to those who used homologous blood products (over 10 days, while in 5 cases it was over 21 days).Conclusions: The use of the autologous blood recovery system is an effective procedure to infuse blood products with greater safety.</p

Structural and photophysical properties of [(CO)(3)(phen) Re(mu-Br)Re(phen)(CO)(3)](+)[(CO)(3)(+)[Re(mu-Br)(3)Re(CO)(3)](-): Where does its luminescence come from?

Artículo de publicación ISIThe multimetallic complex [[(CO)(3)(phen) Re(mu-Br)Re(phen)(CO)(3)][(CO)(3)[Re(mu-Br)(3)Re(CO)(3)]]center dot CH2Cl2 was prepared by direct reaction of (Re(CO)(3)(THF)Br)(2) (THF: tetrahydrofuran) and 1,10-phenanthroline in a 1:1 ratio, followed by recrystallization in dichloromethane. The compound is an ionic salt where both, cation and anion, are bimetallic complexes. Inside both of them the Re-I centers are bridged by one or three bromides respectively. The compound has an absorption band centered at 375 nm in CH2Cl2, which has been assigned to a MLCT band. Excitation at 375 nm produces luminescent emission at 608 nm. Comparison of these results with closely related rhenium complexes, in addition to Time Dependant-DFT analysis, allow us to propose the [(CO)(3)(phen)Re(g-Br)Re(phen)(CO)(3)](+) cation as main responsible for luminescence. Luminescence lifetime and singlet oxygen formation quantum yield suggest also that the emissive excited state has a triplet character.Direccion de Investigacion Universidad Andres Bello DI-111-12/R Comision Nacional de Ciencia y Tecnologia FONDECYT 1120865 1140343 ACE-0