The Impact of Covid19 on Traditional Higher Education in Ecuador

COVID19 forced the educational processes to a radical change. The face-to-face classes suddenly went virtual. This coup challenged teachers and their classroom methodologies to new forms of virtual / digital interaction. The jump generated a significant change that we have not yet managed to measure. For this reason, the present study focuses on analyzing and reflecting on how higher education teachers in Ecuador have assumed the educational changes from the face-to-face model to the virtual / digital mode in the current pandemic context, highlighting the level of familiarity with ICT. Methodologically, the study describes and compares, through the teachers' testimony, the difficulties, strategies and opportunities that they experienced with their students in virtual / digital learning environments. The results identify the most important problems and aspects when teaching distance classes in the face of virtual / digital learning environments. In conclusion, it reflects on the shortcomings and weaknesses of our preparation as teachers. It also points out how the current crisis visualizes the precariousness of the national educational system itself

Ganadería Sustentable. Perspectivas regionales de ganadería sustentable para una visión nacional

El documento que aquí se presenta es un resumen de los temas, experiencias y recomendaciones que, desde diferentes perspectivas, intereses y saberes, aportaron los participantes en el 3er Foro de Ganadería Sustentable. Estamos seguros que el lector encontrará en este “gran menú de ideas” algunas que cubran sus intereses particulares; pero será en el seguimiento de los acuerdos y en la puesta en marcha de las propuestas de colaboración y mejora, que la práctica de la ganadería sustentable podrá consolidarse.GI

Molecules implicated in maternal-fetal iron transport across the placental barrier: Role of Transferrin Receptor 1 and Ferroportin

ABSTRACT: An adequate placental transfer of iron is critical to satisfy the high fetal requirements of this mineral, and to promote proper intrauterine growth and development. It also contributes to the prevention of iron deficiency and anemia, both of which are very frequent during the first two years of life, and associate with increased rates of morbidity and mortality. Different adaptations may occur in the placenta in the production of molecules that take part in the mother-tofetus iron transfer. With them, iron availability to the fetus is assured. Our aim with this review is to familiarize readers with the metabolic and molecular mechanisms of placental iron uptake, transport, regulation and release. With this knowledge, the importance of an adequate maternal iron state before and during pregnancy may be better understood.RESUMEN: La transferencia placentaria adecuada de hierro es crucial para satisfacer los altos requerimientos que el feto tiene de este mineral y para promover su crecimiento y desarrollo intrauterinos apropiados; de otra parte, contribuye a prevenir la ferropenia y la anemia, entidades muy frecuentes durante los dos primeros años de vida, y que se asocian con aumento de la morbilidad y la mortalidad en la infancia. La placenta es un órgano capaz de efectuar diferentes adaptaciones en la producción de las moléculas que participan en el transporte materno-fetal de hierro en respuesta al estado celular de este mineral, para asegurar la mayor disponibilidad para el feto. Esta revisión pretende acercar al lector a los mecanismos metabólicos y moleculares relacionados con la captación y el transporte de hierro por la placenta y con su salida hacia el feto, así como su regulación, para proporcionar elementos que le permitan comprender integralmente la importancia de un adecuado estado de hierro materno antes de la gestación y durante ella

Spanish cultural adaptation and psychometric validation of the Summary of Diabetes Self-Care Activities measure (SDSCA) among persons with type 2 diabetes mellitus

Objetivo: Llevar a cabo la adaptación cultural y la validación psicométrica del Summary of Diabetes Self-Care measure (SDSCA) en población espa˜nola con diabetes mellitus tipo 2. Diseño: Estudio de validación clinimétrica. Emplazamiento: Centros de atención primaria del Distrito Sanitario Málaga-Valle del Guadalhorce. Participantes: 331 personas con diabetes mellitus tipo 2. Mediciones principales: La versión validada en población mexicana del SDSCA fue sometida a equivalencia semántica y de contenido mediante un Delphi de expertos, su legibilidad fue determinada mediante la escala INFLESZ. Posteriormente se llevó a cabo la validación psicométrica, evaluándose validez de constructo mediante análisis factorial exploratorio y confirmatorio (en adelante AFE y AFC), consistencia interna, fiabilidad test-retest y validez discriminante. Resultados: Dos rondas fueron necesarias para alcanzar consenso entre los miembros del panel, posteriormente INFLESZ aportó una buena legibilidad. El modelo trifactorial (dieta, ejercicio físico y autoanálisis) con 7 ítems explicaba un 79,16% de la varianza. El análisis confirmatorio mostró un buen ajuste del modelo del SDSCA-Sp. La consistencia interna fue moderada-baja ( -Cronbach = 0,62) y la fiabilidad test-retest fue evaluada en 198 pacientes (t = 0,462-0,796, p < 0,001) con una correlación global de 0,764 (p < 0,0001). El SDSCA-Sp en una versión válida en la práctica clínica y en investigación para evaluar autocuidados en diabetes mellitus tipo 2 con propiedades clinimétricas similares a las obtenidas en estudios previos

Colorectal cancer: a review

Colorectal cancer (CCR) is the third most common cancer worldwide in men and women, the second largest cause of death related to cancer, and the main cause of death in gastrointestinal cancer. The risk of developing this cancer is related to bad alimentary habits, smoking, intestinal inflammatory disease, polyps, genetic factors, and aging. Of the patients that are diagnosed with colorectal cancer 90% are older than 50, with a median age of 64 years; however, the disease is more aggressive in patients that are diagnosed at younger ages. According to the American Cancer Association, it was accounted for more than 49,700 deaths in 2015. The goal is to reduce the mortality rate with early diagnosis and treatment. Currently, the survival rate is used to predict a patient’s prognosis. The patient is considered to have a positive familial history if a first-degree relative has been diagnosed with colorectal cancer or colonic polyps before the age of 60, or also if two or more first-degree relatives have been diagnosed with cancer or polyps at any age. There are several methods for detecting colorectal cancer, such as the guaiac test, immunochemical test of stool, DNA stool test, sigmoidoscopy, colonoscopy, and barium enema. The stage in which the cancer is detected determines the prognosis, survival, and treatment of the patient. Provide a review about generalities, genetic basis, risk factors, protective factors, clinical course, diagnostic methods, therapy and survival in colorectal cancer. Conducted research from different databases such as PubMed, Medline, MedScape, on the definition, genetic factors, classification, risk factors, protective factors, diagnostic methods, epidemiology, survival and treatment of colorectal cancer. Articles from 2000 to 2017 were included using the following keywords

Alternative Eco-Friendly Methods in the Control of Post-Harvest Decay of Tropical and Subtropical Fruits

The effectiveness on several fruits by the application of alternative methods against fungi is summarized in the present chapter. Several investigations have reported the efficacy of these technologies for controlling fungal infections. Currently, high post-harvest loses have been reported due to several factors such as inefficient management, lack of training for farmers, and problems with appropriate conditions for storage of fruits and vegetables. Even now, in many countries, post-harvest disease control is led by the application of chemical fungicides. However, in this time, awareness about fungi resistance, environmental, and health issues has led to the research of eco-friendly and effective alternatives for disease management. The pathogen establishment on fruits can be affected by the application of GRAS compounds like chitosan, essential oils, salts, among others; besides, their efficacy can be enhanced by their combination with other technologies like ultrasound. Thus, the applications of these alternatives are suitable approaches for post-harvest management of fruits

Actualización de Criterios Diagnósticos y Tratamiento de la Angina de Ludwig

Ludwig’s angina is a rapidly progressive cellulitis that involves sub mandibular, sub lingual and submental spaces bilaterrally. This was due mainly to per apical infections of the second and third mandible molars. Due to the rapid advancement of the clinical (which in certain occasions could even threaten the patient’s life) it is extremely important to know clearly the criteria for early diagnosis of Ludwig’s angina, which will enable us to provide the most appropriate treatment to halt the progress of the clinical and will prevent the onset of life-threatening complications.La angina de Ludwig es una celulitis rápidamente progresiva que compromete bilateralmente los espacios submaxilar, sublingual y submentoniano; y que se origina principalmente por infecciones periapicales de las segundas y terceras molares mandibulares. Debido a la rápida progresión del cuadro, que en algunos casos puede incluso poner en peligro la vida del paciente, es sumamente importante conocer los criterios necesarios para realizar un diagnóstico oportuno de la angina de Ludwig, el cual nos permita brindar el tratamiento más adecuado para detener la progresión del cuadro y prevenir la aparición de complicaciones potencialmente mortales

Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines

Background: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. Methods: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, see Supplementary data) concluded the following: Results: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50–200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. Conclusions: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed

Megaproyectos urbanos y productivos. Impactos socio-territoriales

El desarrollo de megaproyectos productivos trae consigo oportunidades para el crecimiento económico, la generación de empleos y el desarrollo regional. No obstante, en la actualidad, los grandes temas como la expansión urbana, el desarrollo industrial, las cementeras, la minería, el uso intensivo del agua y demás recursos naturales, preocupan a las comunidades por los impactos generados y porque en lo general, no consideran la racionalidad y responsabilidad ambiental y social hacia el entorno. En este contexto son diversos los estudios científicos que, en el marco de la política de económica imperante, intentan posicionarse como alternativas a proyectos económicos que confrontan los intereses particulares y comunitarios y que afectan la salud humana y ambiental. Megaproyectos urbanos y productivos. Impactos socio-territoriales, reúne veinticinco textos académicos sobre las afectaciones que éstos emprendimientos tienen para la sociedad y el entorno. Los temas expuestos recogen experiencias en el desarrollo urbano, industrial, turístico, portuario y aeroportuario, entre otros. Así mismo se retoman temas como la ética, la dialéctica, la política y la economía y su relación en el emprendimiento de megaproyectos. La búsqueda de esquemas productivos racionales y responsables con el entorno, que reivindiquen el derecho de las comunidades a un medio ambiente sano, a la preservación del territorio y sus recursos y de las formas de vida tradicionales, son los referentes para la realización del presente libro. Como elemento central se concibe el territorio como contenedor de identidad y vida, siendo preocupación y tema de estudio de la comunidad académica, las organizaciones de la sociedad civil y las redes de activistas organizados.UAEM, CONACyT, se

SARS-CoV-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome

The aim was to assess the ability of nasopharyngeal SARS-CoV-2 viral load at first patient’s hospital evaluation to predict unfavorable outcomes. We conducted a prospective cohort study including 321 adult patients with confirmed COVID-19 through RT-PCR in nasopharyngeal swabs. Quantitative Synthetic SARS-CoV-2 RNA cycle threshold values were used to calculate the viral load in log10 copies/mL. Disease severity at the end of follow up was categorized into mild, moderate, and severe. Primary endpoint was a composite of intensive care unit (ICU) admission and/or death (n = 85, 26.4%). Univariable and multivariable logistic regression analyses were performed. Nasopharyngeal SARS-CoV-2 viral load over the second quartile (≥ 7.35 log10 copies/mL, p = 0.003) and second tertile (≥ 8.27 log10 copies/mL, p = 0.01) were associated to unfavorable outcome in the unadjusted logistic regression analysis. However, in the final multivariable analysis, viral load was not independently associated with an unfavorable outcome. Five predictors were independently associated with increased odds of ICU admission and/or death: age ≥ 70 years, SpO2, neutrophils > 7.5 × 103/µL, lactate dehydrogenase ≥ 300 U/L, and C-reactive protein ≥ 100 mg/L. In summary, nasopharyngeal SARS-CoV-2 viral load on admission is generally high in patients with COVID-19, regardless of illness severity, but it cannot be used as an independent predictor of unfavorable clinical outcome