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Multiple sclerosis (MS) is the most common acquired inflammatory and demyelinating disease in adults. The conventional diagnostic of MS and the follow-up of inflammatory activity is based on the detection of hyperintense foci in T2 and fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) and lesions with brain-blood barrier (BBB) disruption in the central nervous system (CNS) parenchyma. However, T2/FLAIR hyperintense lesions are not specific to MS and the MS pathology and inflammatory processes go far beyond focal lesions and can be independent of BBB disruption. MRI techniques based on the magnetic susceptibility properties of the tissue, such as T2*, susceptibility-weighted images (SWI), and quantitative susceptibility mapping (QSM) offer tools for advanced MS diagnostic, follow-up, and the assessment of more detailed features of MS dynamic pathology. Susceptibility-weighted techniques are sensitive to the paramagnetic components of biological tissues, such as deoxyhemoglobin. This capability enables the visualization of brain parenchymal veins. Consequently, it presents an opportunity to identify veins within the core of multiple sclerosis (MS) lesions, thereby affirming their venocentric characteristics. This advancement significantly enhances the accuracy of the differential diagnostic process. Another important paramagnetic component in biological tissues is iron. In MS, the dynamic trafficking of iron between different cells, such as oligodendrocytes, astrocytes, and microglia, enables the study of different stages of demyelination and remyelination. Furthermore, the accumulation of iron in activated microglia serves as an indicator of latent inflammatory activity in chronic MS lesions, termed paramagnetic rim lesions (PRLs). PRLs have been correlated with disease progression and degenerative processes, underscoring their significance in MS pathology. This review will elucidate the underlying physical principles of magnetic susceptibility and their implications for the formation and interpretation of T2*, SWI, and QSM sequences. Additionally, it will explore their applications in multiple sclerosis (MS), particularly in detecting the central vein sign (CVS) and PRLs, and assessing iron metabolism. Furthermore, the review will discuss their role in advancing early and precise MS diagnosis and prognostic evaluation, as well as their utility in studying chronic active inflammation and degenerative processes.

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Introduction The World Health Organization (WHO) estimates that ∼ 32 million children worldwide are affected by hearing loss (HL). Cochlear implant is the first-line treatment for severe to profound sensorineural HL. It is considered one of the most successful prostheses developed to date. Objective To evaluate the oral language development of pediatric patients with prelingual deafness implanted in a reference hospital for the treatment of HL in southern Brazil. Methods We conducted a retrospective cohort study with a review of medical records of patients undergoing cochlear implant surgery between January 2009 and December 2018. Language development was assessed by reviewing consultations with speech therapy professionals from the cochlear implant group. Results A total of 152 children were included in the study. The mean age at cochlear implant surgery was of 41 months (standard deviation [SD]: ± 15). The patients were divided into six groups considering the type of language most used in their daily lives. We found that 36% of children use oral language as their primary form of communication. In a subanalysis, we observed that patients with developed or developing oral language had undergone cochlear implant surgery earlier than patients using Brazilian Sign Language (Língua Brasileira de Sinais, LIBRAS, in Portuguese) or those without developed language. Conclusion The cochlear implant is a state-of-the-art technology that enables the re-establishment of the sense of hearing and the development of oral language. However, language development is a complex process known to present a critical period to properly occur. We still see many patients receiving late diagnosis and treatment, which implies a delay and, often, the impossibility of developing oral communication. Level of Evidence Level 3 (cohort study).

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A diagnosis of dermatomyositis requires recognition of distinct patterns of skin disease in combination with, and sometimes without, muscle weakness. Often, a striking contrast between involved and uninvolved areas is observed. Familiar patterns include eyelid and midfacial eruptions, Gottron papules/sign, and upper back (shawl sign), central chest (V/open collar sign), and lateral thigh (holster sign) involvement. More recently, new specific antibody/phenotype-associated patterns have been reported. We describe a case series of two distinct patterns of skin involvement in six adult patients with both classical and amyopathic dermatomyositis. Three had paraneoplastic disease. All had intermediate to richly pigmented skin; five were of Afro-Caribbean and one was of Asian-Caribbean descent. Four were men, and two were women. Ages ranged from 41 to 89 years. All patients had concomitant hallmark signs (facial, hand, and/or trunk signs). Three were amyopathic. The first pattern involved a sharply demarcated, horizontally oriented hyperpigmented patch/thin plaque across the shoulders and upper chest, extending up the anterior neck. The second was the combination of the classical upper back shawl distribution with distinct mid-back sparing and diffuse involvement of the lower back. Named patterns help with the recognition of skin rashes in dermatomyositis. Based on the current lexicon describing items of apparel, we liken the first pattern to a "fur stole and turtleneck" sign and the latter to a "halter-back" or "reflected-shawl" sign. Biopsies revealed hyperkeratosis and interface dermatitis, often with epidermal atrophy, compatible with dermatomyositis. These patterns perhaps represent the coalescence of already well-described signs, photo-exacerbation, koebnerization, mechanical stretch, and other currently unclear factors contributing to patterning in dermatomyositis. Pattern distribution recognition is particularly valuable in individuals with richly pigmented skin who may lack typical violaceous erythema. The distinct demarcation led to the initial misdiagnosis of allergic contact dermatitis or other exogenous dermatitis in most of our patients. Further work involves evaluation of antibody phenotype and internal involvement associations. Limitations include lack of specific antibody panels and longitudinal follow-up data.

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Introdução: A Língua Brasileira de Sinais (Libras) é uma língua de natureza visuo-motora com um sistema linguístico e estrutura gramatical próprio e sua aquisição em tempo oportuno é importante para o desenvolvimento cognitivo e comunicativo da criança surda. As famílias ouvintes de crianças surdas devem se engajar no aprendizado dessa língua, uma vez que na ausência do conhecimento da Libras, podem apresentar dificuldades de comunicação e de relacionamento com seu filho surdo. Objetivo: O objetivo deste estudo foi compreender o papel da Libras na comunicação de familiares ouvintes e seus filhos surdos atendidos em um centro de reabilitação. Métodos: Trata-se de um estudo transversal, de caráter qualitativo. Foi aplicado um roteiro de entrevista semiestruturado com 10 questões abertas a pais ouvintes de crianças surdas que participam de atendimentos em um centro de reabilitação. A análise dos dados foi realizada por meio do método análise de conteúdo. Resultados: Ao todo foram entrevistadas 10 mães de crianças surdas. As idades das mães variaram de 21 a 47 anos. Nove mães afirmaram usar a Libras em casa com seus filhos todos os dias e todas relataram usá-la em atividades cotidianas da criança. Todas as mães afirmaram que o uso da Libras trouxe benefícios para o relacionamento na díade mãe-filho. Conclusão: Os achados revelam um importante papel da Libras tanto na comunicação de familiares ouvintes e seus filhos surdos, como no cotidiano desses lares. (AU)

Introduction: The Brazilian Sign Language (Libras) is a visual-motor language with its linguistic system and grammatical structure and its timely acquisition is important for deaf children's cognitive and communicative development. Deaf children's hearing families should engage in learning this language, since not knowing Libras may lead to communication and relationship difficulties with their deaf children. Objective: This study aimed to understand the role of Libras in the communication between hearing family members and their deaf children treated at a rehabilitation center. Methods: This cross-sectional qualitative study applied a semi-structured interview with 10 open-ended questions to hearing parents of deaf children who receive care at a rehabilitation center. Data were analyzed with the content analysis method. Results: Altogether, 10 mothers of deaf children were interviewed. Their ages ranged from 21 to 47 years. Nine mothers said they used Libras at home with their children every day, and all reported using it in their child's daily activities. All mothers stated that the use of Libras brought benefits to the mother-child relationship. Conclusion: The findings highlight the important role of Libras in the daily lives and communication of hearing family members and their deaf children. (AU)

Introducción: La Lengua de Señas Brasileña (Libras) es una lengua visomotora con sistema lingüístico y estructura gramatical propios y su adquisición oportuna es importante para el desarrollo cognitivo y comunicativo del niño sordo. Las familias oyentes de niños sordos deben involucrarse en el aprendizaje de este idioma, ya que en ausencia del conocimiento de Libras, pueden tener dificultades en la comunicación y las relaciones con su hijo sordo. Objetivo: El objetivo de este estudio fue comprender el papel de Libras en la comunicación de los familiares oyentes y sus hijos sordos atendidos en un centro de rehabilitación auditiva. Métodos: Se trata de un estudio transversal, cualitativo. Se aplicó un guión de entrevista semiestructurada con 10 preguntas abiertas a padres oyentes de niños sordos que participan en el cuidado en un centro de rehabilitación. El análisis de los datos se realizó mediante el método de análisis de contenido. Resultados: En total, se entrevistaron 10 madres de niños sordos. Las edades de las madres oscilaron entre 21 y 47 años. Nueve madres dijeron que usan Libras en casa con sus hijos todos los días y todas informaron que lo usan en las actividades diarias de sus hijos. Todas las madres afirmaron que el uso de Libras trajo beneficios a la relación madre-hijo. Conclusión: Los hallazgos revelan un papel importante de Libra tanto en la comunicación de los miembros oyentes de la familia y sus hijos sordos, como en la vida diaria de estos hogares. (AU)

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INTRODUCTION: it is estimated that 302 million people worldwide are affected by osteoarthritis, corresponding to 60% osteoarthritis (OA) of the knee, which responsible 80% of disability in older adults, hence the importance of the association of the sign with the early inflammatory process in OA. OBJECTIVE: to determine the association of digital pressure sign in patients with and without osteoarthritis of the knee. MATERIAL AND METHODS: this was an observational, comparative cross-sectional study, carried out in patients with and without a diagnosis of knee OA, to whom the digital pressure sign was determined. The sample was calculated with the formula for two proportions, obtaining a total of 40 participants per group, obtained by non-probabilistic sampling for convenience. The statistical analysis included frequencies, percentages, 2 and OR. The bioethics regulations in force were respected. RESULTS: the study included 80 participants, with a median age of 48.9 years (RQI 46-53.7), 73.1% were predominantly female sex (38), and a statistically significant association was found between patients with OA and the presence of digital pressure sign, 2 4.62 and p value = 0.41, OR of 2.65. CONCLUSIONS: the presence of digital pressure sign increases the probability of having OA 2.65 times more.

INTRODUCCIÓN: se estima que 302 millones de personas en el mundo son afectadas por osteoartritis, correspondiendo 60% a osteoartritis (OA) de rodilla, causante de 80% de discapacidad en adultos mayores, de ahí la importancia de la asociación del signo de digito-presión con el proceso inflamatorio temprano en OA. OBJETIVO: determinar la asociación del signo de digito-presión en pacientes con y sin osteoartritis de rodilla. MATERIAL Y MÉTODOS: estudio observacional, transversal comparativo, realizado en pacientes con y sin diagnóstico de OA de rodilla, a quienes se les determinó el signo de digito-presión; la muestra se calculó con la fórmula para dos proporciones que determinó un total de 40 participantes por grupo, obtenidos por muestreo no probabilístico por conveniencia; el análisis estadístico incluyó frecuencias, porcentajes, 2 y OR. Se respetó la reglamentación de bioética vigente. RESULTADOS: el estudio incluyó a 80 participantes, con una mediana de edad de 48.9 años (RIQ 46-53.7), predominó el sexo femenino en 73.1% (38). Se encontró asociación estadísticamente significativa entre pacientes con OA y la presencia del signo de digito-presión, 2 4.62 y p = 0.41, OR de 2.65. CONCLUSIONES: la presencia del signo de digito-presión aumenta 2.65 veces más la probabilidad de tener OA.

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Introduction: Literature shows that individuals with disabilities, including hearing impairment, often suffer from untreated dental caries, poor oral hygiene, and compromised periodontal health, leading to adverse effects on oral health. Objetive: This study aims to analyze current evidence concerning dental care strategies for controlling, managing, and preventing biofilm accumulation in patients with hearing impairment. Materials and Methods: A systematic search was conducted in the databases Scopus, Web of Science, SciELO and PubMed between April and May 2022 to identify articles establishing a relationship between periodontal disease and hearing disability. Full-text articles published in English or Spanish between 2012 and 2022 were included. Results: Seventeen articles met the inclusion criteria and were analyzed. These included cross-sectional studies, cohort studies, clinical trials, case reports, and case-control studies. Most studies reported fair to poor oral health status among individuals. Nine different interventions or management approaches for treating periodontal disease in patients with hearing impairment were identified. Conclusions: The current global evidence on the association between periodontal disease and hearing impairment is very limited. Dentists may need to employ various strategies to address communication barriers, as outlined in this study.

Introducción: Según la literatura, las personas en situación de discapacidad presentan caries dentales no tratadas, higiene bucal y estado periodontal deficiente, lo cual puede resultar en efectos negativos para su salud bucal. Objetivo: Analizar la evidencia existente con relación a la atención odontológica enfocada en el control, manejo y prevención de acumulación de biofilm en pacientes con deficiencia auditiva. Materiales y Métodos: Se realizó la búsqueda de artículos en las bases de datos y motor de búsqueda (Scopus, Web of Science, SciELO y PubMed) entre abril y mayo 2022, de acuerdo con la evidencia existente que relacione la enfermedad periodontal y la discapacidad auditiva en la atención odontológica. Se incluyeron artículos de texto completo en idioma inglés o español, con fecha de publicación entre 2012 a 2022. Resultado: Se seleccionó un total de 17 artículos para su análisis. Se encontró estudios transversales, estudios de cohorte, ensayos clínicos, reporte de caso y estudios de casos y controles. La salud oral fue catalogada en estado regular y deficiente en la mayoría de los estudios. Se encontró 9 tipos de intervenciones o manejos para el tratamiento de la enfermedad periodontal en pacientes con hipoacusia. Conclusión: La evidencia existente respecto a la enfermedad periodontal y la deficiencia auditiva es insuficiente a nivel global. Debido a lo anterior, el odontólogo puede abordar los obstáculos comunicativos de diferentes maneras de acuerdo a los métodos descritos en esta publicación.

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Background: Combining osteotomies and soft tissue procedures is believed to reduce sesamoids in their anatomical position and maintain long-term correction when treating hallux valgus deformity. This study determines if a radiologic association exists between a radiolucent sign and a full percutaneous adductor tendon release (PATR), including a cadaveric study and a consecutive case series. Another aim was to determine the intra- and interobserver reliability of these observations. Methods: A prospective observational study was made between 2018 and 2019. First, a PATR was done on cadaveric specimens and, after the procedures, dissected to correlate what was seen fluoroscopically. The clinical group included 39 feet that presented mild-to-moderate HV deformity and were treated with percutaneous osteotomies associated with PATR. Results: Observers 1 and 2 saw a radioscopic radiolucent sign in 100% of cadavers and the patient population. They also observed a triangle-shaped image with an incidence of 75%, which we have named the "triangle sign." Conclusion: The triangle sign may be helpful in the intraoperative confirmation of PATR and latero-plantar capsule release using this percutaneous technique. Level of Evidence: Level II, development of diagnostic criteria.

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"Penumbra sign" is a characteristic finding in magnetic resonance imaging (MRI) of Brodie's abscess, a rare variant of subacute osteomyelitis. We aimed to discuss the imaging finding penumbra sign that will help in the diagnosis of osteomyelitis and may be useful to clinicians in differential diagnosis. A 26-year-old male patient presented to the emergency department with complaints of pain and limping in the right knee that did not go away. He had a history of arthroscopic debridement and percutaneous fixation surgery due to osteochondral fragment 3 years ago. There were no additional findings in the patient's vital parameters, physical examination, and medical history. X-ray imaging revealed two screws in the distal femur and a well-defined sclerotic rim surrounding a radiolucent lesion anterior to the screws. MRI revealed a lesion in the distal femoral metaphysis with low-density fluid and hyperintense granulation tissue surrounding it. After surgical abscess drainage and local debridement, bone cement was placed in the resulting cavity. Teicoplanin treatment was started. The patient was discharged and complete recovery was achieved in the second month. The diagnosis of osteomyelitis is often missed or confused with bone tumors in non-traumatic cases presenting with persistent bone pain. MRI imaging is frequently used in differential diagnosis, and detection of characteristic imaging signs such as the penumbra sign accelerates the diagnosis. In this context, emergency department clinicians, in particular, should be cautious and not forget that early treatment can be started by recognizing these signs.

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Although subungual melanoma is uncommon, it is associated with worse outcomes than melanomas in other locations and accounts for 1% to 23% of all melanomas, depending on the population. The aim of this study was to describe the clinical and histopathologic features of subungual melanoma in a Mexican population. We identified 303 patients with melanoma, and of these, 19% (57 patients with a median age of 71 years) had subungual melanoma. The main sites affected were the lower limbs (52.6%) and the toe (75.4%). The most common histologic subtype was acral lentiginous melanoma (50.9%). Median Breslow thickness was 3 mm, and stage IA tumors were the most common (in 28.1% of patients). Recurrence and metastasis occurred in 19.3% and 8.8% of patients, respectively. The clinical and histopathologic features identified are similar to those described in the literature. Early diagnosis and treatment are crucial for improving prognosis.

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Low health literacy (LHL) significantly impacts patients' ability to participate actively in their healthcare. Registered nurses (RNs) play a crucial role in identifying LHL and addressing patient knowledge gaps and skill deficits. This correlational study examined the relationship between RNs' predictions of patients' health literacy levels (HLL) and the actual HLL of a predominately Hispanic patient population. In addition, personal factors (i.e., demographics) were analyzed to determine their influence on the nurse's predictions and patients' HLL. Data were collected from 84 participant patient-nurse couplets admitted to a medical-surgical unit in a rural setting located on the United States-Mexico border. In addition to demographic information collected via survey, RNs were asked to predict their patient's health literacy abilities while the Newest Vital Sign, a health literacy assessment tool, was deployed to determine the actual HLL of patients participating in the study. Data were analyzed using descriptive statistics, t-tests, and chi-square tests while a Spearman correlational model was used to examine the relationship between predicted HLL and actual HLL. Finally, a logistic regression model was used to analyze the relationship between personal factors and HL data for RNs and patients. Analysis of the data revealed that RNs consistently overestimated patients' abilities, as evidenced by the disparity between patients' actual HLL (mean 1.71) and predicted HLL (mean 4.26) by RNs, with a moderately strong positive relationship (rs = .418). Notably, higher academic preparation and years of experience did not enhance the RNs' ability to identify LHL while the highest level of education completed was the only statistically significant predictor of adequate health literacy in the patient population sampled. These findings emphasize the need to prioritize effective health literacy education in RN academic preparation and clinical practice to support the detection of LHL when a standardized health literacy assessment tool is not utilized in the clinical setting. By recognizing the presence of LHL, healthcare professionals can better support patients' needs and bridge the knowledge gap, ultimately improving patient outcomes.

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Although subungual melanoma is uncommon, it is associated with worse outcomes than melanomas in other locations and accounts for 1% to 23% of all melanomas, depending on the population. The aim of this study was to describe the clinical and histopathologic features of subungual melanoma in a Mexican population. We identified 303 patients with melanoma, and of these, 19% (57 patients with a median age of 71 years) had subungual melanoma. The main sites affected were the lower limbs (52.6%) and the toe (75.4%). The most common histologic subtype was acral lentiginous melanoma (50.9%). Median Breslow thickness was 3 mm, and stage IA tumors were the most common (in 28.1% of patients). Recurrence and metastasis occurred in 19.3% and 8.8% of patients, respectively. The clinical and histopathologic features identified are similar to those described in the literature. Early diagnosis and treatment are crucial for improving prognosis.

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The Hoffmann-Tinel sign is well-known to professionals dealing with nerve lesions and is widely used as a provocative test. It was described by Paul Hoffman and Jules Tinel in the same year (1915), independently. In the present article, a biographical sketch of both authors is presented and the method for eliciting the sign and the sometimes controversial information of its results are discussed.

O sinal de Hoffmann-Tinel é bem conhecido pelos profissionais que lidam com lesões de nervos, sendo amplamente utilizado como um teste provocativo. Foi descrito por Paul Hoffmann e por Jules Tinel no mesmo ano (1915), de forma independente. No presente artigo, é apresentado um esboço biográfico de ambos autores e são discutidas a forma de obter o sinal e as informações, por vezes controversas, fornecidas por seus resultados.

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RESUMO: Esta pesquisa teve por objetivo compreender os desafios e as possibilidades de tradução e contação em Língua Brasileira de Sinais (Libras) das histórias presentes no livro O homem que Calculava, do escritor modernista brasileiro Malba Tahan. Tratase de uma investigação qualitativa que se debruçou sobre o processo de tradução audiovisual das histórias presentes no livro, as adaptações feitas em suas narrativas, os recursos de preparação para a produção e edição dos vídeos, a implementação de recursos gráficos e visuais e, por fim, sua divulgação como produto da pesquisa. As análises indicam o potencial didático que emerge na interação entre os envolvidos no processo de tradução das histórias: professores, intérpretes e discentes (surdo e ouvinte), possibilitando formas de expressão artísticas que exploram a visualidade inerente da língua de sinais aliada a recursos gráficos, tomando as narrativas como elemento central para o desenvolvimento criativo ancorado no ensino da Matemática por meio da leitura e da interpretação de histórias.

ABSTRACT: This research aimed to understand the challenges and possibilities of translation and storytelling in the Brazilian Sign Language (known by the acronym LIBRAS) of the stories present in the book O homem que calculava [The man who counted] by the Brazilian modernist writer Malba Tahan. This is a qualitative investigation that focused on the audiovisual translation process of the stories present in the book, on the adaptations made in its narratives, the preparation resources for the production and editing of the videos, the implementation of graphic and visual resources and, finally, its dissemination as a research product. The analyzes indicate the didactic potential that emerges in the interaction between those involved in the process of translating the stories: teachers, interpreters and students (deaf and hearing), enabling forms of artistic expression that explore the inherent visuality of sign language combined with graphic resources, taking the narratives as a central element for the creative development anchored in the teaching of Mathematics through the reading and interpretation of stories.

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RESUMEN: Los intérpretes en Lengua de Señas Chilena (ILSCh) constituyen un recurso para la inclusión, eliminando barreras de estudiantes sordos que manejan la modalidad visual-gestual para comunicarse. Chile tiene normativa que favorece la participación del ILSCh en distintos ámbitos, y este estudio se centró en los intérpretes en contexto escolar, considerando que existe un desconocimiento de los procesos, implementación, resultados, logros y situación laboral. Las interrogantes del estudio fueron: ¿cuál es el estado actual del ILSCh, las trayectorias formativas, el rol y los desafíos de su quehacer? El objetivo general fue describir la figura del ILSCh y los desafíos que enfrenta en su desempeño laboral en contexto escolar, situados en las regiones Metropolitana y Valparaíso, Chile. El enfoque fue cualitativo, interpretativo, diseño fenomenográfico, descriptivo y transeccional, la muestra intencionada por criterios de 24 intérpretes de nivel escolar. Las técnicas de recogida de información fueron: formulario de identificación, entrevista y grupo focal. Se analizaron las transcripciones con el software Atlas TI. Los resultados muestran la diversidad en la formación, centrada en el vocabulario de la lengua, con mínimas líneas del contexto educativo, desconocimiento del rol, solicitudes de tareas fuera de sus funciones y situaciones laborares sin regulación y diversidad de jefaturas.

ABSTRACT: The interpreters in Chilean Sign Language (ILSCh) constitute a resource for inclusion, eliminating the barriers of deaf students who use the visual-gestural modality to communicate. Chile has regulations that favor the participation of the ILSCh in different áreas, and this study focused on interpreters in the school context, considering that there is a lack of knowledge of the processes, implementation, results, achievements and employment situation. The questions of the study were: What is the current state of the ILSCh, its formative trajectories, its role and the challenges of its work? The general objective was to describe the figure of the ILSCh and the challenges it faces in its work performance in the school context, located in the Metropolitan and Valparaíso regions, Chile. The approach was qualitative, interpretative, phenomenographic, descriptive and transactional design, the sample intentional by criteria of 24 school level interpreters. The information collection techniques were: identification form, interview and focus group. The transcripts were analyzed with the Atlas TI software. The results show the diversity in the training, focused on the vocabulary of the language, with minimal lines of the educational context, lack of knowlegde of the role, requests for tasks outside their functions and work situations without regulation and diversity of leadership.

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El tema de estudio, denominado «El juego, mecanismo de construcción de competencias ciudadanas en el aula universitaria¼, permite realizar una reflexión sobre situaciones reales y tensiones sociales desde el ámbito universitario, en el aula de clase, con un dispositivo disponible en plataforma que cuenta un juego denominado: "Caminos". La mecánica permite escoger un personaje: "Pili o Nico"; seguidamente se lanzan los dados, y se inicia el recorrido, con preguntas en temas relacionados con las competencias ciudadanas, la cívica y la democracia, resolviendo situaciones o dilemas y escogiendo la opción correcta. En el dispositivo, se permite avanzar hasta llegar al meta, finalizando con un taller de reflexión. Además del juego se articulan materiales de apoyo que facilitan la labor docente. En este sentido, el objetivo general es el diseño de una estrategia lúdica-didáctica en un juego en línea para el desarrollo de competencias ciudadanas con estudiantes de carreras cuyo prerrequisito es la materia de Constitución Política. El método planteado es el paradigma positivista a través del método deductivo, con un enfoque mixto, de carácter proyectivo. La validación del instrumento se sometió a un universo de 77 sujetos de estudio, en un centro universitario en la ciudad de Bogotá ­ Colombia. El resultado, es el diseño del instrumento didáctico que articula materiales que facilitan la labor docente. La herramienta lúdica, comprende el lenguaje de señas con ánimo de ser inclusivo. Como conclusión, la contribución permite fortalecer las competencias ciudadanas, reflexionar desde el taller, con casos reales favoreciendo el proceso de enseñanza ­ aprendizaje

The topic of study, called "The game, a mechanism for building citizen competencies in the university classroom", allows reflection on real situations and social tensions from the university environment, in the classroom, with a device available on a platform that There is a game called: "Roads".The game mechanics involve choosing a character, either "Pili or Nico"; subsequently, dice are rolled to start the journey, featuring questions on topics related to citizenship competencies, civics, and democracy, solving dilemmas and selecting the correct option. The device allows progression until reaching the goal, ending with a reflection workshop. In addition to the game, support materials are integrated to facilitate the teaching effort. Thus, the main objective is to design a playful-didactic strategy in an online game for the development of citizenship competencies among students of programs whose prerequisite is the Political Constitution course. The proposed method is the positivist paradigm through deductive reasoning, with a mixed, projective approach. The validation of the instrument involved a universe of 77 study subjects at a university center in Bogotá ­ Colombia. The result is the design of a didactic instrument that integrates materials to aid the teaching process. The playful tool includes sign language to be inclusive. In conclusion, this contribution strengthens citizenship competencies, encourages reflection through the workshop, with real cases benefiting the teaching-learning process.

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Zika virus (ZIKV) and dengue virus (DENV) share a lot of similarities being both phylogenetically closely related, share the same insect vector passage for reaching the host, affinity for the same carbohydrate receptor domains (CRDs), indicating feasible competition between them on the natural field. Here, we prospected interactions of both envelope proteins with a DC-SIGN, a transmembrane c-type lectine receptor with the most implicated CRD with the Flavivirus infection presents on dendritic cells involved in viruses replication processes into the host, and among rares CRD receptors susceptible to interacting with a broad of subtypes of DENV. Protein-protein docking procedures produced structures for molecular dynamics experiments, suggesting the most energetically favorable complex. The difference found in the deltaG results prompted the experimentation with molecular dynamics. To investigate further specific residues involved with such interactions we produced a decomposition analysis using molecular dynamics of the docked proteins evaluated afterward with the Generalized Born Surface Area method. Solvent-accessible surface area (SASA) analysis for both showed very similar but with a slight reduction for ZIKV_E, which agreed with residues SASA analysis highlighting regions more exposed in the ZIVK protein than in DENV. Despite residues PHE313 is reponsible for most of the interactions with the envelope of these arboviruses, ZIKV interacted with this residue in DC-SIGN with lower energies and using more interactions with not expexted residues GLU241 and ARG386. Taken together these results suggest better competitive interaction of ZIKV with the DC-SIGN receptor, particularly in the CRD portion.

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This work addresses the design and implementation of a novel PhotoBiological Filter Classifier (PhBFC) to improve the accuracy of a static sign language translation system. The captured images are preprocessed by a contrast enhancement algorithm inspired by the capacity of retinal photoreceptor cells from mammals, which are responsible for capturing light and transforming it into electric signals that the brain can interpret as images. This sign translation system not only supports the effective communication between an agent and an operator but also between a community with hearing disabilities and other people. Additionally, this technology could be integrated into diverse devices and applications, further broadening its scope, and extending its benefits for the community in general. The bioinspired photoreceptor model is evaluated under different conditions. To validate the advantages of applying photoreceptors cells, 100 tests were conducted per letter to be recognized, on three different models (V1, V2, and V3), obtaining an average of 91.1% of accuracy on V3, compared to 63.4% obtained on V1, and an average of 55.5 Frames Per Second (FPS) in each letter classification iteration for V1, V2, and V3, demonstrating that the use of photoreceptor cells does not affect the processing time while also improving the accuracy. The great application potential of this system is underscored, as it can be employed, for example, in Deep Learning (DL) for pattern recognition or agent decision-making trained by reinforcement learning, etc.

Assuntos

RESUMO

Early gastric cancer is defined as gastric cancer confined to the mucosa or submucosa, irrespective of lymph node metastasis. Endoscopic submucosal dissection is a standard treatment of early gastric cancer. The nonextension sign consists of a protrusion of the surrounding mucosa into the lumen, resembling a trapezoidal shape. This phenomenon occurs when massive submucosal invasion by a cancer increases the thickness and rigidity of the gastric wall and may be useful to differentiate between mucosal or microinvasive submucosal and invasive submucosal cancers. Our case demonstrates the usefulness of the absence of the conventional endoscopic nonextension sign as a marker to decide the adequate approach for mucosal lesions.