La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia en los municipios Aguachica, San Martin Cesar y Barrancabermeja Santander.

El conflicto armado ha dejado un gran número de víctimas en Colombia, personas que han perdido territorios, familiares, empleos y demás, pero ante todo han perdido la seguridad y la tranquilidad. Algunas veces estos fenómenos dejan como consecuencia lesiones físicas y psicológicas que han frustrado su proyecto de vida, reconociendo la historia de nuestro país, este tipo de vivencias se han generado por muchos años en varias regiones, no todas las víctimas de las Acciones bélicas, puedan recibir el acompañamiento psicosocial por parte del estado por diferentes motivos. En el siguiente trabajo presentaremos un análisis de las dificultades o impactos psicosociales que han experimentado las personas víctimas del conflicto armado y como éstas llevan en su memoria los recuerdos que les crean resentimientos, frustración, culpa, duelo y emociones que nos les permiten gozar de calidad de vida, se puede visualizar en los relatos presentados, teniendo en cuenta que su mundo giraba en torno a su territorio, una actividad económica especifica o a un ser querido que está ausente, por lo que requirieron algún tipo de atención psicosocial, para de esta manera mitigar los efectos de los hechos violentos. La actividad nos brinda herramientas a los psicólogos en formación, basadas en el estudio y análisis de casos, nos orienta para la creación de preguntas estratégicas, circulares y reflexivas, para implementarlas en el caso elegido a las personas que han vivenciado algún tipo de violencia, elegir estrategias para abordar psicosocialmente a las comunidades, como el caso de Cacarica donde se reflejan los emergentes psicosociales, los impactos que generaron al ser estigmatizados, determinar acciones a implementar para mitigar los impactos negativos en las victimas, en este mismo sentido se deben aplicar las estrategias psicosociales, para darles orientación y el Acompañamiento a las víctimas ante cualquier situación que genere algún tipo de crisis o alteración psíquica generando confianza en las personas para que reconozcan las posibles debilidades y afectaciones que no les permiten tener una estabilidad emocional y al mismo tiempo reconocer y explorar habilidades que desconocían en sí mismos, para resarcir los impactos negativos de las situaciones traumáticas del conflicto armado en Colombia.The armed conflict has left a large number of victims in Colombia, people who have lost territories, family members, jobs and others, but above all they have lost security and tranquility. Sometimes these phenomena leave as a consequence physical and psychological injuries that have frustrated their life project, recognizing the history of our country, this type of experiences has been generated for many years in various regions, not all victims of warlike actions, may receive psychosocial support from the state for different reasons. In the following work we will present an analysis of the difficulties or psychosocial impacts experienced by people who are victims of the armed conflict and how they carry in their memories the memories that create resentment, frustration, guilt, grief and emotions that allow them to enjoy quality life, can be seen in the stories presented, taking into account that their world revolved around their territory, a specific economic activity or a loved one who is absent, so they required some type of psychosocial care, in order to mitigate the effects of violent acts. The activity provides tools to psychologists in training, based on the study and analysis of cases, guides us to create strategic, circular and reflective questions, to implement them in the chosen case for people who have experienced some type of violence, choose strategies to psychosocially approach communities, such as the case of Cacarica where psychosocial emergencies are reflected, the impacts generated by being stigmatized, determine actions to implement to mitigate negative impacts on victims, in this same sense, the psychosocial strategies, to give guidance and accompaniment to victims in any situation that generates some type of crisis or psychic alteration, generating confidence in people so that they recognize possible weaknesses and affections that do not allow them to have emotional stability and at the same time recognize and explore unknown skills They were in themselves, to compensate the negative impacts of the traumatic situations of the armed conflict in Colombia

Selenium, selected inorganic elements, and organochlorine pesticides in bottom material and biota from the Colorado River delta

Concentrations of selenium (Se) in bottom material ranged from 0.6 to 5.0 [mu]g g-1, and from 0.5 to 18.3 [mu]g g-1in biota; 23% of samples exceeded the toxic threshold. Concentrations of DDE in biota exceeded the toxic threshold in 30% of the samples. Greater concentrations of selenium in biota were found at sites with strongly reducing conditions, no output, alternating periods of drying and flooding or dredging activities, and at sites that received water directly from the Colorado River. The smallest Se concentrations in biota were found at sites where an outflow and exposure or physical disturbance of the bottom material were uncommo

Combined dark matter searches towards dwarf spheroidal galaxies with Fermi-LAT, HAWC, H.E.S.S., MAGIC, and VERITAS

Cosmological and astrophysical observations suggest that 85\% of the total matter of the Universe is made of Dark Matter (DM). However, its nature remains one of the most challenging and fundamental open questions of particle physics. Assuming particle DM, this exotic form of matter cannot consist of Standard Model (SM) particles. Many models have been developed to attempt unraveling the nature of DM such as Weakly Interacting Massive Particles (WIMPs), the most favored particle candidates. WIMP annihilations and decay could produce SM particles which in turn hadronize and decay to give SM secondaries such as high energy $\gamma$ rays. In the framework of indirect DM search, observations of promising targets are used to search for signatures of DM annihilation. Among these, the dwarf spheroidal galaxies (dSphs) are commonly favored owing to their expected high DM content and negligible astrophysical background. In this work, we present the very first combination of 20 dSph observations, performed by the Fermi-LAT, HAWC, H.E.S.S., MAGIC, and VERITAS collaborations in order to maximize the sensitivity of DM searches and improve the current results. We use a joint maximum likelihood approach combining each experiment's individual analysis to derive more constraining upper limits on the WIMP DM self-annihilation cross-section as a function of DM particle mass. We present new DM constraints over the widest mass range ever reported, extending from 5 GeV to 100 TeV thanks to the combination of these five different $\gamma$-ray instruments

Management of coronary disease in patients with advanced kidney disease

BACKGROUND Clinical trials that have assessed the effect of revascularization in patients with stable coronary disease have routinely excluded those with advanced chronic kidney disease. METHODS We randomly assigned 777 patients with advanced kidney disease and moderate or severe ischemia on stress testing to be treated with an initial invasive strategy consisting of coronary angiography and revascularization (if appropriate) added to medical therapy or an initial conservative strategy consisting of medical therapy alone and angiography reserved for those in whom medical therapy had failed. The primary outcome was a composite of death or nonfatal myocardial infarction. A key secondary outcome was a composite of death, nonfatal myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. RESULTS At a median follow-up of 2.2 years, a primary outcome event had occurred in 123 patients in the invasive-strategy group and in 129 patients in the conservative-strategy group (estimated 3-year event rate, 36.4% vs. 36.7%; adjusted hazard ratio, 1.01; 95% confidence interval [CI], 0.79 to 1.29; P=0.95). Results for the key secondary outcome were similar (38.5% vs. 39.7%; hazard ratio, 1.01; 95% CI, 0.79 to 1.29). The invasive strategy was associated with a higher incidence of stroke than the conservative strategy (hazard ratio, 3.76; 95% CI, 1.52 to 9.32; P=0.004) and with a higher incidence of death or initiation of dialysis (hazard ratio, 1.48; 95% CI, 1.04 to 2.11; P=0.03). CONCLUSIONS Among patients with stable coronary disease, advanced chronic kidney disease, and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of death or nonfatal myocardial infarction

Health status after invasive or conservative care in coronary and advanced kidney disease

BACKGROUND In the ISCHEMIA-CKD trial, the primary analysis showed no significant difference in the risk of death or myocardial infarction with initial angiography and revascularization plus guideline-based medical therapy (invasive strategy) as compared with guideline-based medical therapy alone (conservative strategy) in participants with stable ischemic heart disease, moderate or severe ischemia, and advanced chronic kidney disease (an estimated glomerular filtration rate of <30 ml per minute per 1.73 m2 or receipt of dialysis). A secondary objective of the trial was to assess angina-related health status. METHODS We assessed health status with the Seattle Angina Questionnaire (SAQ) before randomization and at 1.5, 3, and 6 months and every 6 months thereafter. The primary outcome of this analysis was the SAQ Summary score (ranging from 0 to 100, with higher scores indicating less frequent angina and better function and quality of life). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate the treatment effect with the invasive strategy. RESULTS Health status was assessed in 705 of 777 participants. Nearly half the participants (49%) had had no angina during the month before randomization. At 3 months, the estimated mean difference between the invasive-strategy group and the conservative-strategy group in the SAQ Summary score was 2.1 points (95% credible interval, 120.4 to 4.6), a result that favored the invasive strategy. The mean difference in score at 3 months was largest among participants with daily or weekly angina at baseline (10.1 points; 95% credible interval, 0.0 to 19.9), smaller among those with monthly angina at baseline (2.2 points; 95% credible interval, 122.0 to 6.2), and nearly absent among those without angina at baseline (0.6 points; 95% credible interval, 121.9 to 3.3). By 6 months, the between-group difference in the overall trial population was attenuated (0.5 points; 95% credible interval, 122.2 to 3.4). CONCLUSIONS Participants with stable ischemic heart disease, moderate or severe ischemia, and advanced chronic kidney disease did not have substantial or sustained benefits with regard to angina-related health status with an initially invasive strategy as compared with a conservative strategy