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Urofacial syndrome or Ochoa syndrome (UFS or UFOS) is a rare disease characterized by inverted facial expression and bladder dysfunction that was described for the first time in Colombia. It is an autosomal recessive pathology with mutations in the HPSE2 and LRIG2 genes. However, 16% of patients do not have any mutations associated with the syndrome. Despite the importance of neurobiology in its pathophysiology, there are no neurological, neuropsychological, or psychological studies in these patients. A 30-year-old male from Medellín, Colombia, with a significant perinatal history, was diagnosed with grade 4 hydronephrosis on his first ultrasound test. At 4 months of age, symptoms such as hypomimia, lagophthalmos, and recurrent urinary tract infections started to manifest. Imaging studies revealed urinary tract dilatation, vesicoureteral reflux, and a double collector system on his left side, which led to the diagnosis of UFS. Multiple procedures, including vesicostomy, ureterostomy, and enterocystoplasty, were performed. At 20 years of age, he achieved urinary sphincter control. Genetic analysis revealed a founder pathogenic variant, c.1516C > T (p.Arg506Ter), in the HPSE2 gene, which produces a truncated protein that lacks 86 amino acids. This variant is classified as pathogenic according to the ClinVar database for UFS. The mutation age is approximately 260-360 years, and the two alleles share a 7.2-7.4 Mb IBD segment. Moreover, we detected European local ancestry in the IBD segment, which is consistent with a Spanish introduction. Neurological examination, neuropsychological assessment, and psychological testing revealed no abnormalities, except for high stress levels. Clinical analysis of this patient revealed distorted facial expression and detrusor-sphincter dyssynergia, which are typical of patients with UFS. Genetic analysis revealed a pathogenic variant in the HPSE2 gene of European origin and a mutation age of 260-360 years. From a neurological, neuropsychological, and psychological (emotional and personality) perspective, the patient showed no signs or symptoms of clinical interest.

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The identification of protein-ligand interactions plays a pivotal role in elucidating biological processes and discovering potential bioproducts. Harnessing the capabilities of computational methods in drug discovery, we introduce an innovative Inverted Virtual Screening (IVS) pipeline. This pipeline Integrated molecular dynamics and docking analyses to ensure that protein structures are not only energetically favorable but also representative of stable conformations. The primary objective of this pipeline is to automate and streamline the analysis of protein-ligand interactions at both genomic and transcriptomic scales. In the contemporary post-genomic era, high-throughput computational screening for bioproducts, biological systems, and therapeutic drugs has become a cornerstone practice. This approach offers the promise of cost-effectiveness, time efficiency, and optimization of laboratory work. Nevertheless, a notable deficiency persists in the availability of efficient pipelines capable of automating the virtual screening process, seamlessly integrating input and output, and leveraging the full potential of open-source tools. To bridge this critical gap, we have developed a versatile pipeline known as BioProtIS. This tool seamlessly integrates a suite of state-of-the-art tools, including Modeller, AlphaFold, Gromacs, FPOCKET, and AutoDock Vina, thus facilitating the streamlined docking of ligands with an expansive repertoire of proteins sourced from genomes and transcriptomes, and substrates. To assess the pipeline's performance, we employed the transcriptomes of Cereus jamacaru (a cactus species) and Aspisoma lineatum (firefly), along with the genome of Homo sapiens. This integration not only improves the accuracy of ligand-protein interactions by minimizing replicability deviations but also optimizes the discovery process by enabling the simultaneous evaluation of multiple substrates. Furthermore, our pipeline accommodates distinct testing scenarios, such as blind docking or site-specific targeting, which are invaluable in applications ranging from drug repositioning to the exploration of new allosteric binding sites and toxicity assessments. BioProtIS has been designed with modularity at its core. This inherent flexibility empowers users to make custom modifications directly within the source code, tailoring the pipeline to their specific research needs. Moreover, it lays the foundation for seamless integration of diverse docking algorithms in future iterations, promising ongoing advancements in the field of computational biology. This pipeline is available for free distribution and can be download at: https://github.com/BBMDO/BioProtIS.

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RESUMEN Las estrategias para comunicar la información han experimentado muchos cambios, los cuales se han evidenciado en la pandemia. La idea es lograr que se pueda conectar con el estudiante y que la información la reciba de manera clara, oportuna y pertinente, de modo que tendrá los saberes previos para lograr integrar la información de la teoría y la práctica, con el fin de enfrentar con éxito la actividad simulada, así como cuando interactúe con el paciente. En ese contexto, el aula invertida es una estrategia didáctica que brinda videos, podcast, entre otros, para que sean revisados con anticipación, de tal forma que cuando el estudiante realice la actividad presencial o virtual se profundice y se hagan precisiones sobre los conceptos más importantes, usando metodologías activas de participación para lograr el siguiente propósito: El aprendizaje invertido busca un cambio en la dinámica del aprendizaje que apunte como eje del mismo al estudiante. El objetivo de la presente contribución docente es compartir las bondades de esta estrategia usada en estudiantes de la carrera de Odontología dentro del marco del curso de Clínica Estomatológica del Adulto I, dictado en 2023 y que pertenece al quinto ciclo de la carrera de Estomatología en la Universidad Peruana Cayetano Heredia.

ABSTRACT Strategies for communicating information have undergone many changes, which have been evidenced in the pandemic. The idea is to be able to connect with the student and that the information is received in a clear, timely and relevant manner, so that he/she will have the prior knowledge to integrate information from theory and practice, in order to successfully face the simulated activity, as well as when interacting with the patient. In this context, the inverted classroom is a didactic strategy that provides videos, podcasts, among others, to be reviewed in advance, so that when the student performs the face-to-face or virtual activity, the most important concepts are deepened and clarified, using active participation methodologies to achieve the following objective: flipped learning seeks a change in the dynamics of learning that points to the student as its axis. The objective of this teaching contribution is to share the benefits of this strategy used with students of the Dentistry degree program within the framework of the Adult Stomatology Clinic I course, taught in 2023 and which belongs to the fifth semester of the Stomatology degree program at the Universidad Peruana Cayetano Heredia.

RESUMO As estratégias de comunicação de informação sofreram muitas alterações, que são evidentes na pandemia. A ideia é conseguir conectar-se com o aluno e que a informação seja recebida de forma clara, oportuna e relevante, para que ele tenha o conhecimento prévio para poder integrar informações da teoria e da prática, a fim de enfrentar com sucesso a atividade simulada, bem como ao interagir com o paciente. Neste contexto, a sala de aula invertida é uma estratégia didática que disponibiliza vídeos, podcasts, entre outros, para serem revistos previamente, de modo a que, quando o aluno realiza a atividade presencial ou virtual, os conceitos mais importantes sejam aprofundados e clarificados, utilizando metodologias de participação ativa para atingir o seguinte objetivo: A aprendizagem investida procura uma mudança na dinâmica da aprendizagem que aponta para o aluno como eixo da mesma. O objetivo desta contribuição didática é partilhar os benefícios desta estratégia utilizada com os alunos da disciplina de Medicina Dentária no âmbito do curso de Clínica de Estomatologia de Adultos I, ministrada em 2023 e que pertence ao quinto semestre da disciplina de Estomatologia da Universidad Peruana Cayetano Heredia.

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Inverted perovskite solar cells (PSCs) have gained much attention due to their low hysteresis effect, easy fabrication, and good stability. In this research, an inverted perovskite solar cell ITO/PEDOT:PSS/CH3NH3PbI3/PCBM/Ag structure was simulated and optimized using SCAPS-1D version 3.3.10 software. The influence on the device of parameters, including perovskite thickness, total defect density, series and shunt resistances, and operating temperature, are discussed and analyzed. With optimized parameters, the efficiency increased from 13.47% to 18.33%. Then, a new SiOx/ITO/PEDOT:PSS/CH3NH3PbI3/PCBM/Ag device was proposed which includes a silicon-rich oxide (SiOx) layer. This material was used as the down-conversion energy material, which converts high-energy photons (ultraviolet UV light) into low-energy photons (visible light), improving the stability and absorption of the device. Finally, with SiOx, we obtained an efficiency of 22.46% in the simulation. Therefore, the device with the SiOx layer is the most suitable as it has better values for current density-voltage output and quantum efficiency than the device without SiOx.

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Introducción: En las ciencias médicas son diversas las investigaciones asociadas a la modalidad virtual, sobre todo durante la pandemia por COVID-19. Sin embargo, en el campo de la neurofisiología clínica existen pocas experiencias descritas. Objetivo: Describir los resultados del desarrollo virtual de las asignaturas Historia de la Neurociencia y la Neurofisiología en Cuba e Introducción a la Metodología de la Investigación Científica, mediante el aula invertida y el aula virtual en la formación del Técnico Superior en neurofisiología clínica en La Habana. Métodos: Estudio descriptivo de corte transversal y no experimental. Se adecuaron las asignaturas en modalidad virtual, al aplicar un modelo constituido por cuatro fases: preparación, análisis y diseño, desarrollo e implementación, y evaluación. Resultados: Se preparó al claustro en materia de educación virtual. Se diseñaron estrategias didácticas para la virtualización del proceso de enseñanza-aprendizaje, mediante la aplicación del aula invertida y el aula virtual. En la fase de evaluación se obtuvieron valores altos al calcular los indicadores de promoción y calidad, y se aplicó una encuesta a los estudiantes. Para ambas asignaturas predominaron los valores de alta satisfacción en los criterios de la encuesta, excepto en Formas de evaluaciones y Distribución del tiempo en el aprendizaje, con mayores valores de satisfacción media. Conclusión: Los resultados obtenidos en el tránsito a la modalidad virtual cumplieron con los objetivos propuestos en el programa de las asignaturas, por lo que fue posible la enseñanza no presencial mediante el aula invertida y el aula virtual(AU)

Introduction: In medical sciences, there are several pieces of research associated with the virtual modality, especially during the COVID-19 pandemic. However, in the field of clinical neurophysiology, few experiences have been described. Objective: To describe the outcomes of virtually developing the subjects History of Neuroscience and Neurophysiology in Cuba and Introduction to the Methodology of Scientific Research, by means of the inverted classroom and the virtual classroom in the training of higher-degree associates in clinical neurophysiology in Havana. Methods: A descriptive, cross-sectional and nonexperimental study was carried out. The subjects were adapted to the virtual modality by applying a model consisting of four phases: preparation, analysis and design, development and implementation, and evaluation. Results: The faculty was trained in virtual education. Didactic strategies were designed for the virtualization of the teaching-learning process, through the application of the inverted classroom and the virtual classroom. In the evaluation phase, high values were obtained when calculating the promotion and quality indicators, and a student survey was applied. For both subjects, high satisfaction values predominated in the survey criteria, except for evaluations forms and distribution of time for learning, with higher values of the medium satisfaction. Conclusions: The outcomes obtained in the transition to the virtual modality complied with the objectives set in the syllabus of the subjects, making possible non-face-to-face teaching by means of the inverted classroom and the virtual classroom(AU)

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RESUMEN Introducción: La evidencia sobre los efectos del Aula Invertida en las habilidades metacognitivas de los estudiantes es escasa. El presente estudio evalúa estos efectos en las percepciones estudiantiles acerca del conocimiento y la regulación cognitiva durante un curso de cirugía. Métodos: Las percepciones estudiantiles se midieron antes y después de un Aula Invertida convencional en cirugía, utilizando el Metacognitive Awareness Inventory. Las diferencias de medias entre las puntuaciones de las 2 mediciones se evaluaron mediante la prueba de la t de Student (p <0,05) y el tamaño del efecto en el conocimiento y la regulación cognitiva, mediante la prueba de la d de Cohen (IC95%). Resultados: Se incluyó en el análisis a 158 (grupo preintervención) y 155 estudiantes (posintervención). Se encontraron diferencias significativas (p <0,05) y efectos positivos en las habilidades estudiantiles para conocer el propio aprendizaje (conocimiento declarativo) (d = 0,24; IC95%, 0,02-0,47), emplear estrategias de aprendizaje (conocimiento procedimental) (d = 0,19; IC95%, -0,02 a 0,41) y entender cuándo y por qué utilizar dichas estrategias (conocimiento condicional) (d = 0,20; IC95%, -0,01 a 0,42). Además, sobre las capacidades para planificar (d = 0,31; IC95%, 0,09-0,53) y evaluar su aprendizaje (d = 0,31; IC95%, 0,08-0,53). Conclusiones: El Aula Invertida tiene efectos positivos en las habilidades metacognitivas según las percepciones estudiantiles. Se requieren nuevos estudios que comparen estos efectos con otras metodologías de enseñanza en el aula y el sitio de trabajo.

ABSTRACT Introduction: The evidence regarding the effects of the Inverted Classroom on students' metacognitive skills is limited. This study evaluates these effects on student perceptions about knowledge and cognitive regulation during a surgical course. Methods: We measured student perceptions before and after a conventional Inverted Classroom in surgery using the Metacognitive Awareness Inventory. We evaluated the mean differences between the scores of the two measurements using Student's t-test (p< 0.05), and the size of the effect on knowledge and cognitive regulation using Cohen's d test (95%CI). Results: A total of 158 students (pre-intervention) and 155 students (post-intervention) were included in the analysis. Significant differences were found (p<0.05)in, as well as positive effects on, the students' abilities to know their own learning (declarative knowledge) (d = 0.24; 95%CI, 0.02-0.47), to use learning strategies (procedural knowledge) (d = 0.19; 95%CI, -0.02 to 0.41) and to understand when and why to use these strategies (conditional knowledge) (d = 0.20; 95%CI, -0.01 to 0.42), in addition to the abilities to plan (d = 0.31; 95%CI, 0.09-0.53) and to evaluate their learning (d = 0.31; 95%CI, 0.08-0.53). Conclusions: The Inverted Classroom has positive effects on metacognitive skills according to students' perceptions. Further studies are required that compare these effects with other methodologies for teaching in the classroom and the workplace.

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Use of a grazing system that takes into account the ingestive behavior of animals and the physiological characteristics of plants maximizes land use and promotes positive effects on the environment. In this sense, the objective of this study was to evaluate the performance of Pantaneira breed cows, kept in rotated grazing in Mombasa grass (Megathyrsus maximum), with different grazing times. Fifty animals were divided into two treatments: Continuous T1: 24 h and T2-Inverted: 12 h. The experiment lasted 98 days, being determined the production and nutritional quality of the forage, digestibility, intake, and performance of the animals. The design was randomized blocks at 5% probability, with the means compared by the F test. The design used was completely randomized at 5% probability by the T test. There was no significant difference for biomass production (P > 0.05). However, after grazing the Inverted group, the forage showed a lower percentage of leaves and an increase in neutral detergent fiber and acid contents and total carbohydrates, and a reduction in crude protein and ether extract values, as well as a higher digestibility (P < 0.05). The animals of the Continuous group intaked more forage (P < 0.05). The Inverted group had a higher average daily weight gain, in addition to a lower feed conversion (P < 0.001). The animals in the Control group spent more time eating (P < 0.0001) and sleeping (P < 0.0001), while the animals of the Inverted group spent more time in idleness (P < 0.0001) and interacting (P < 0.05). There was no difference in rumination time between treatments (P > 0.05). It was concluded that Inverted grazing improved the quality of Mombasa grass and the performance of cows.

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Transposons are mobile elements that are commonly silenced to protect eukaryotic genome integrity. In plants, transposable element (TE)-derived inverted repeats (IRs) are commonly found near genes, where they affect host gene expression. However, the molecular mechanisms of such regulation are unclear in most cases. Expression of these IRs is associated with production of 24-nt small RNAs, methylation of the IRs, and drastic changes in local 3D chromatin organization. Notably, many of these IRs differ between Arabidopsis thaliana accessions, causing variation in short-range chromatin interactions and gene expression. CRISPR-Cas9-mediated disruption of two IRs leads to a switch in genome topology and gene expression with phenotypic consequences. Our data show that insertion of an IR near a gene provides an anchor point for chromatin interactions that profoundly impact the activity of neighboring loci. This turns IRs into powerful evolutionary agents that can contribute to rapid adaptation.

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Full plastome sequences for land plants have become readily accessible thanks to the development of Next Generation Sequencing (NGS) techniques and powerful bioinformatic tools. Despite this vast amount of genomic data, some lineages remain understudied. Full plastome sequences from the highly diverse (>1,500 spp.) subfamily Tillandsioideae (Bromeliaceae, Poales) have been published for only three (i.e., Guzmania, Tillandsia, and Vriesea) out of 22 currently recognized genera. Here, we focus on core Tillandsioideae, a clade within subfamily Tillandsioideae, and explore the contribution of individual plastid markers and data categories to inform deep divergences of a plastome phylogeny. We generated 37 high quality plastome assemblies and performed a comparative analysis in terms of plastome structure, size, gene content and order, GC content, as well as number and type of repeat motifs. Using the obtained phylogenetic context, we reconstructed the evolution of these plastome attributes and assessed if significant shifts on the evolutionary traits' rates have occurred in the evolution of the core Tillandsioideae. Our results agree with previously published phylogenetic hypotheses based on plastid data, providing stronger statistical support for some recalcitrant nodes. However, phylogenetic discordance with previously published nuclear marker-based hypotheses was found. Several plastid markers that have been consistently used to address phylogenetic relationships within Tillandsioideae were highly informative for the retrieved plastome phylogeny and further loci are here identified as promising additional markers for future studies. New lineage-specific plastome rearrangements were found to support recently adopted taxonomic groups, including large inversions, as well as expansions and contractions of the inverted repeats. Evolutionary trait rate shifts associated with changes in size and GC content of the plastome regions were found across the phylogeny of core Tillandsioideae.

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Resumen Objetivo: Describir resultados de la cirugía de sustitución esofágica con tubo gástrico invertido, vía ascenso retroesternal en dos hospitales pediátricos durante el período marzo 2015 a marzo 2018. Materiales y Método: Un estudio observacional, transversal, con recolección de datos retrospectivo, donde se incluyeron todos los expedientes de pacientes que presentaban patología del esófago por causa adquirida o congénita que fueron operados de sustitución esofágica con tubo gástrico invertido en dos hospitales pediátricos durante 3 años. Resultados: Encontramos 29 niños sometidos a sustitución esofágica, de los cuales 27 cumplieron criterios de inclusión. La edad comprendida entre 2 y 17 años. El 63% corresponde al sexo femenino. La causa más frecuente de sustitución esofágica es por estenosis esofágica por ingesta caustica (92,59%). El 70% presentó algún tipo de complicación luego de la cirugía. La fístula esofagocutánea es la complicación principal con 33,33%. La permanencia en la unidad de cuidados intensivos es menor de 24 horas en un 74% de los niños. Se inicia la vía oral en casi la mitad de casos entre los 10-12 días de posquirúrgico, la estancia hospitalaria es en promedio 18,5 días. La mortalidad es 3,7%. Conclusión: La sustitución esofágica por tubo gástrico invertido vía ascenso retroesternal, es una técnica comparable en resultados a la interposición de colón. Para los autores, el estómago es un órgano ideal para realizar la reconstrucción esofágica, y sus complicaciones son manejables.

Aim: To describe the results of esophageal replacement surgery with an inverted gastric tube via retrosternal ascent in two pediatric hospitals during the period March 2015 to March 2018. Materials and Method: an observational, cross-sectional study with retrospective data collection that included all the records of patients with esophageal discontinuity due to acquired or congenital causes who underwent esophageal replacement surgery with an inverted gastric tube in two pediatric hospitals for 3 years. Results: We found 29 children undergoing esophageal replacement, of which 27 met inclusion criteria. The age between 2 to 17 years. 63% corresponds to the female sex. The most frequent cause of esophageal replacement is esophageal stricture due to caustic ingestion (92.59%). 70% presented some type of complication after surgery. The esophagocutaneous fistula is the main complication with 33.33%. The stay in the intensive care unit is less than 24 hours in 74% of children. The oral route is started in almost half of cases between 10-12 days after surgery; the hospital stay is on average 18.5 days. Mortality is 3.70%. Conclusión: The esophageal substitution by inverted gastric tube via retrosternal ascent is a technique comparable in results to the interposition of the colon. For the authors, the stomach is an ideal organ to perform esophageal reconstruction, and its complications are manageable.

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The plastid genome of flowering plants generally shows conserved structural organization, gene arrangement, and gene content. While structural reorganizations are uncommon, examples have been documented in the literature during the past years. Here we assembled the entire plastome of Bignonia magnifica and compared its structure and gene content with nine other Lamiid plastomes. The plastome of B. magnifica is composed of 183,052 bp and follows the canonical quadripartite structure, synteny, and gene composition of other angiosperms. Exceptionally large inverted repeat (IR) regions are responsible for the uncommon length of the genome. At least four events of IR expansion were observed among the seven Bignoniaceae species compared, suggesting multiple expansions of the IRs over the SC regions in the family. A comparison with 6,231 other complete plastomes of flowering plants available on GenBank revealed that the plastome of B. magnifica is the longest Lamiid plastome described to date. The newly generated plastid genome was used as a source of selected genes. These genes were combined with orthologous regions sampled from other species of Bignoniaceae and all gene alignments concatenated to infer a phylogeny of the family. The tree recovered is consistent with known relationships within the Bignoniaceae.

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BACKGROUND: Plant miRNAs are a class of small non-coding RNAs that can repress gene expression at the post-transcriptional level by targeting RNA degradation or promoting translational repression. There is increasing evidence that some miRNAs can derive from a group of non-autonomous class II transposable elements called Miniature Inverted-repeat Transposable Elements (MITEs). RESULTS: We used public small RNA and degradome libraries from Triticum aestivum to screen for microRNAs production and predict their cleavage target sites. In parallel, we also created a comprehensive wheat MITE database by identifying novel elements and compiling known ones. When comparing both data sets, we found high homology between MITEs and 14% of all the miRNAs production sites detected. Furthermore, we show that MITE-derived miRNAs have preference for targeting degradation sites with MITE insertions in the 3' UTR regions of the transcripts. CONCLUSIONS: Our results revealed that MITE-derived miRNAs can underlay the origin of some miRNAs and potentially shape a regulatory gene network. Since MITEs are found in millions of insertions in the wheat genome and are closely linked to genic regions, this kind of regulatory network could have a significant impact on the post-transcriptional control of gene expression.

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A recent discovery of revolutionary Clustered regularly interspaced palindromic repeats (CRISPR) is a gene-editing tool that provides a type of adaptive immunity in prokaryotic organisms, which is currently used as a revolutionizing tool in biomedical research. It has a mechanism of correcting genome errors, turning on/off genes in cells and organisms. Most importantly playing a crucial function in bacterial defence by identifying and destroying Deoxyribonucleic acid (DNA) segments during bacteriophage invasions since the CRISPR-associated protein 9 (Cas9) enzyme recognizes and cleaves invasive DNA sequences complementary to CRISPR. Therefore, researchers employ this biological device to manipulate the genes to develop new therapies to combat systemic diseases. Currently, the most significant advance at the laboratory level is the generation of cell and animal models, functional genomic screens, live images of the cell genome, and defective DNA repairs to find the cure for genetic disorders. Even though this technology has enormous biomedical applications in various sectors, this review will summarize CRISPR/Cas emphasizing both the therapeutic and diagnostic mechanisms developed in the field of dentistry and the promising attempts to transfer this technology to clinical application. Finally, future developments are also described, which proposes to use CRISPR/Cas systems for prospective clinical dentistry applications.

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AIMS: The objective of this study was to determine the best conditions to produce invertase by Cunninghamella echinulata PA3S12MM and to immobilize and apply the enzyme. METHODS AND RESULTS: The maximum production was verified in 8 days of cultivation at 28°C supplemented with 10 g L-1 apple peel, reaching 1054.85 U ml-1 . The invertase was purified from the DEAE-Sephadex column. The derivative immobilized in alginate-gelatin-calcium phosphate showed reusability >50% for 19 cycles. The derivative immobilized in glutaraldehyde-chitosan showed greater thermostability and at a different pH. The hydrolysis of 15 ml of sucrose 500 g L-1 in a fixed bed reactor (total volume of 31 ml) produced 24.44 µmol min-1 of glucose and fructose at a residence time of 30 min and a conversion factor of 0.5. CONCLUSIONS: The new wild strain C. echinulata PA3S12MM presents high invertase production in medium supplemented with an agro-industrial residue and the immobilized enzyme showed high thermal stability and resistance at a different pH. SIGNIFICANCE AND IMPACT OF THE STUDY: The fungus C. echinulata PA3S12MM is an excellent producer of invertases in Vogel medium supplemented with apple peel. The enzyme is promising for industrial application since it has good performance in reusability and inverted sugar production.

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In this work, an innovative approach using K-means and multivariate curve resolution-purity based algorithm (MCR-Purity) for the evaluation and quantification of carboxymyoglobin (Mb-CO) formation from Deoxy-Myoglobin (Deoxy-Mb) was presented. Through a multilevel multifactor experimental design, samples with different concentrations of Mb-CO were created. The UV-Vis spectra of these samples were submitted to K-means analysis, finding 3 clusters. The mean spectra of the clusters were extracted and it was possible to detect 2 totally differentiable groups through peaks 423 and 434 nm, which are wavelengths related to the Mb-CO and Deoxy-Mb components, respectively. The spectral data were subjected to MCR-Purity analysis. The MCR-Purity result successfully described the analyzed reaction, explaining more than 99.9% of the variance (R2) with a LOF of 1.43%. Then, a predictive model of MbCO was created through the linear relationship between MCR-Purity contributions and known concentrations of MbCO. The performance parameters of the created predictive model were R2CV = 0.98, RMSECV = 0.58 and RPDcv = 7.8 for the training set, and R2P = 0.98, RMSEP = 0.7 and RPDp = 6.8 for the test set. Thus, the predictive model presented an excellent performance considering that the Mb-CO variation is comprised between 0 and 21 µM. Therefore, these results demonstrate that the application of the proposed strategy to the analysis of spectral data presenting overlapping bands is feasible and robust.

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La educación interdisciplinaria a través de aula invertida incluyendo la higiene domiciliaria y peridomiciliaria es un punto de partida importante para evitar la propagación de enfermedades de interés en salud pública. Por tal razón, se propuso como objetivo determinar la influencia de la investigación interdisciplinaria sobre higiene domiciliaria y peridomiciliaria imnerso en el aprendizaje significativo a través del aula invertida en estudiantes de posgrado de la UNMSM en Lima-Perú, 2021. El estudio fue experimental con una muestra de 26 estudiantes. Para la recolección de los datos se utilizaron técnicas pedagógicas con instrumentos de prueba de rendimiento. El análisis de los datos fue con estadística descriptiva en base a frecuencias y porcentajes, además de las pruebas de Kolmogorov-Smirnov y Shapiro-Wilk estimando un nivel de significancia α de 0,05. Como resultado el nivel de competencia de aprendizaje significativo fue 73,08% bueno, 26,92% regular y 0,00% nivel bajo, así mismo, las buenas evidencias de aprendizaje a nivel transversal fue de 88,46% (23/26) de solidez en los conocimientos sobre higiene domiciliaria y peridomiciliaria, y a nivel especifica conocer la fauna nociva y saber investigar sobre su control sanitario con 88,46%, existiendo diferencias significativas entre la proporción de buenas evidencias de las pruebas preliminar y formativa, que muestran el desarrollo del aprendizaje de la investigación interdisciplinaria en los estudiantes del Posgrado de UNMSM. Concluyendo, que la inestigación interdiciplinaria y método de aula invertida contribuyen a la resolución de problemas de la comunidad no solo a nivel educativo sino también ambiental(AU)

Interdisciplinary education through the flipped classroom including home and peridomiciliary hygiene is an important starting point to prevent the spread of diseases of public health interest. For this reason, the objective was to determine the influence of interdisciplinary research on home and peridomiciliary hygiene embedded in meaningful learning through the flipped classroom in postgraduate students of the UNMSM in Lima-Peru, 2021. The study was experimental with a sample of 26 students. Pedagogical techniques with performance test instruments were used for data collection. The analysis of the data was with descriptive statistics based on frequencies and percentages, in addition to the Kolmogorov-Smirnov and Shapiro-Wilk tests, estimating a level of significance α of 0.05. As a result, the level of significant learning competence was 73.08% good, 26.92% regular and 0.00% low level, likewise, the good evidence of learning at the transversal level was 88.46% (23/26 ) of solidity in the knowledge about home and peridomiciliary hygiene, and at a specific level knowing the harmful fauna and knowing how to investigate its sanitary control with 88.46%, with significant differences between the proportion of good evidence of the preliminary and formative tests, which show the development of interdisciplinary research learning in UNMSM Postgraduate students. Concluding that interdisciplinary research and the inverted classroom method contribute to solving community problems not only at an educational level but also at an environmental level(AU)

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Abstract Introduction Sinonasal inverted papilloma is noted for its high rate of recurrence. Staging systems aid to reduce recurrence and avoid excessive surgeries by guiding the selection of the optimal surgical approach. Objective To evaluate the effectiveness of different endoscopic approaches in inverted papilloma by assessing tumor origin site and tumor volume. Methods Krouse classification system that is based on tumor volume was used for staging; furthermore, tumor origin sites were grouped as lateral nasal wall, medial wall and other walls of maxillary sinus. The main treatment method for all patients was endoscopic sinus surgery. Endoscopic extended middle meatal antrostomy, endoscopic Caldwell-Luc and endoscopic medial maxillectomy were the additional surgery types performed in different combinations. Results Fifty-five patients (42 male) with a mean 54.9 ± 14.4 years of age were included. 37 patients were diagnosed with advanced stage inverted papilloma (67.2 %). Recurrence was observed in 12 patients (21.8 %). In early stage lateral nasal wall origination, no recurrence was observed in the simple tumor resection group (0/10). In early stage medial wall origination, no recurrence was observed in the extended middle meatal antrostomy group (0/8). In advanced stage medial wall origination, the recurrence rates of extended middle meatal antrostomy, extended middle meatal antrostomy + endoscopic Caldwell- Luc and endoscopic medial maxillectomy were 100.0 %, 53.8 % and 13.6 %, respectively (p = 0.002). In advanced stage other walls of maxillary sinus origination, recurrence rates of extended middle meatal antrostomy + endoscopic Caldwell-Luc and endoscopic medial maxillectomy were 20 % and 16.6 %, respectively (p = 0.887). Conclusion Tumor origin site, tumor stage and surgery types show an impact on recurrence. Despite the fact that tumor origin site singly could lead to appropriate selection of the surgery type in most cases, tumor stage carries substantial importance in selection of surgery type for sinonasal-inverted papilloma. An operation plan regarding both tumor volume and tumor origin site may aid surgeons in selecting optimal endoscopic surgical method to avoid recurrence or excessive surgeries.

Resumo Introdução O papiloma invertido nasossinusal é conhecido por sua alta taxa de recorrência. Os sistemas de estadiamento ajudam a reduzir a recorrência e evitar cirurgias excessivas e orientam a seleção da abordagem cirúrgica ideal. Objetivo Avaliar a eficácia de diferentes abordagens endoscópicas no papiloma invertido, de acordo com o local de origem e o volume do tumor. Método Para o estadiamento, usou-se o sistema de classificação de Krouse, baseado no volume do tumor; além disso, os tumores foram agrupados de acordo com seus locais de origem: parede nasal lateral, parede medial e outras paredes do seio maxilar. O principal método de tratamento para todos os pacientes foi a cirurgia endoscópica nasossinusal. Foram feitos, em diferentes combinações, os seguintes tipos de cirurgia: antrostomia estendida do meato médio, Caldwell-Luc endoscópica e maxilectomia medial endoscópica. Resultados Foram incluídos 55 pacientes (42 homens) com média de 54,9 ± 14,4 anos. Trinta e sete pacientes foram diagnosticados com papiloma invertido avançado (67,2%). Foi observada recorrência em 12 pacientes (21,8%). No estágio inicial com origem na parede nasal lateral, não foi observada recorrência no grupo de ressecção simples de tumor (0/10). No estágio inicial com origem na parede medial, não foi observada recorrência no grupo de antrostomia estendida do meato médio (0/8). Com tumor em estágio avançado com origem na parede medial, as taxas de recorrência na antrostomia estendida do meato médio, antrostomia estendida do meato médio + Caldwell-Luc endoscópica e maxilectomia medial endoscópica foram de 100,0%, 53,8% e 13,6%, respectivamente (p = 0,002). No tumor em estágio avançado em outras paredes do seio maxilar, as taxas de recorrência na antrostomia estendida do meato médio + Caldwell-Luc endoscópica e maxilectomia medial endoscópica foram de 20% e 16,6%, respectivamente (p = 0,887). Conclusão O local de origem do tumor, o estágio do tumor e os tipos de cirurgia mostram impacto na recorrência. Apesar da consideração de que na maioria dos casos o local de origem do tumor pode, de forma isolada, orientar a seleção apropriada do tipo de cirurgia, o estágio do tumor tem importância substancial na seleção do tipo de cirurgia para papiloma invertido nasossinusal. Um planejamento cirúrgico considerando tanto o volume quanto o local de origem do tumor pode ajudar os cirurgiões a selecionar o tipo ideal de cirurgia endoscópica para evitar recorrências ou remoções excessivas.

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Inverted papilloma is a rare sinonasal neoplasm. It can be locally invasive and potentially degenerate to a malignant tumor. We present a case report of a 36-year-old woman who was treated for nasal inverted papilloma for over 10 years and presented bilateral temporal bone, and pulmonary involvement. Several procedures were performed to completely remove the tumor. Even without evidence of malignant degeneration, the patient continued battling tumor recurrences. To the best of our knowledge, this report presents the first case of a multicentric inverted papilloma with nasal, bilateral temporal bone, and pulmonary metachronous localization. Laryngoscope, 131:E2640-E2642, 2021.

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INTRODUCTION: Sinonasal inverted papilloma is noted for its high rate of recurrence. Staging systems aid to reduce recurrence and avoid excessive surgeries by guiding the selection of the optimal surgical approach. OBJECTIVE: To evaluate the effectiveness of different endoscopic approaches in inverted papilloma by assessing tumor origin site and tumor volume. METHODS: Krouse classification system that is based on tumor volume was used for staging; furthermore, tumor origin sites were grouped as lateral nasal wall, medial wall and other walls of maxillary sinus. The main treatment method for all patients was endoscopic sinus surgery. Endoscopic extended middle meatal antrostomy, endoscopic Caldwell-Luc and endoscopic medial maxillectomy were the additional surgery types performed in different combinations. RESULTS: Fifty-five patients (42 male) with a mean 54.9±14.4 years of age were included. 37 patients were diagnosed with advanced stage inverted papilloma (67.2 %). Recurrence was observed in 12 patients (21.8 %). In early stage lateral nasal wall origination, no recurrence was observed in the simple tumor resection group (0/10). In early stage medial wall origination, no recurrence was observed in the extended middle meatal antrostomy group (0/8). In advanced stage medial wall origination, the recurrence rates of extended middle meatal antrostomy, extended middle meatal antrostomy+endoscopic Caldwell- Luc and endoscopic medial maxillectomy were 100.0 %, 53.8 % and 13.6 %, respectively (p=0.002). In advanced stage other walls of maxillary sinus origination, recurrence rates of extended middle meatal antrostomy+endoscopic Caldwell-Luc and endoscopic medial maxillectomy were 20 % and 16.6 %, respectively (p=0.887). CONCLUSION: Tumor origin site, tumor stage and surgery types show an impact on recurrence. Despite the fact that tumor origin site singly could lead to appropriate selection of the surgery type in most cases, tumor stage carries substantial importance in selection of surgery type for sinonasal-inverted papilloma. An operation plan regarding both tumor volume and tumor origin site may aid surgeons in selecting optimal endoscopic surgical method to avoid recurrence or excessive surgeries.

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RESUMEN El agujero macular es un desorden de la interface vitreorretinal definido como un defecto de espesor completo desde la membrana limitante interna hasta los segmentos externos de los fotorreceptores, que normalmente involucra a la fóvea. Con el desarrollo de la tomografía de coherencia óptica se han mejorado el diagnóstico, el tratamiento y el seguimiento de las enfermedades de la interface vitreorretinal, entre ellas el agujero macular. La vitrectomía pars plana es la técnica quirúrgica de elección para el agujero macular. Se presenta una paciente de 75 años, pseudofáquica, con mejor agudeza visual corregida en el ojo derecho de 0,1 Snellen. Se diagnostica agujero macular grande (810 µm) según su mínima apertura, con 8 meses de evolución. Se realizó vitrectomía pars plana, el levantamiento de la hialodes posterior, el flap invertido de membrana limitante interna, el uso de hexafluoruro de azufre en mezcla 20 por ciento y el posicionamiento de la paciente 24-72 horas. Se logró el cierre anatómico del agujero macular y la recuperación visual de 0,6 Snellen a los seis meses del tratamiento quirúrgico(AU)

ABSTRACT Macular hole is a disorder of the vitreous-retina interface defined as a full-thickness defect from the internal limiting membrane to the external segments of photoreceptors which typically involves the fovea. The development of optical coherence tomography has improved the diagnosis, treatment and follow-up of vitreous-retina interface diseases, among them macular hole. Pars plana vitrectomy is the surgical technique of choice for macular hole. A case is presented of a female 75-year-old pseudophakic patient with best corrected right eye visual acuity of 0.1 on the Snellen chart. Large macular hole is diagnosed (810 µm) according to its minimum opening, of 8 month's evolution. The following procedures were performed: pars plana vitrectomy, posterior hyalode lifting, inverted internal limiting membrane flap, use of sulfur hexafluoride in a 20% mixture, and positioning of the patient for 24-72 hours. Anatomical closure of the macular hole and a visual recovery of 0.6 Snellen were achieved six months after surgery(AU)

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