RUI Austral (Universidad Austral)
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Lagunas de punibilidad y la hipoaccesoriedad en los delitos de infracción de deber
No full textEl presente trabajo tiene como objeto discurrir acerca del problema fenomenólogico -y su correspondiente recepción normativa- que presentan los llamados delitos de infracción de deber, y -específicamente- respecto de la cuestión de la participación por parte de sujetos no obligados (extraneus) en el hecho principal del sujeto obligado (intraneus).
En particular, aquí se propone vislumbrar cuáles son los argumentos por parte de aquellos que sostienen que resultaría viable dogmática y politicocriminalmente la punición del extraneus que interviene en el hecho del intraneus, cuando éste obra de manera atípica, ya sea de manera vencible, cuando el tipo penal no prevé la morfología subjetiva imprudente, o de modo invencible, cuando el tipo penal reclama -cuanto menos- un hacer imprudente
Diverse cellular origins of adult blood vascular endothelial cells
No full textDisponible en: https://www.sciencedirect.com/science/article/pii/S0012160621001238?via%3DihubAbstract
During embryonic stages, vascular endothelial cells (ECs) originate from the mesoderm, at specific extraembryonic and embryonic regions, through a process called vasculogenesis. In the adult, EC renewal/replacement mostly depend on local resident ECs or endothelial progenitor cells (EPCs). Nevertheless, contribution from circulating ECs/EPCs was also reported. In addition, cells lacking from EC/EPC markers with in vitro extended plasticity were shown to originate endothelial-like cells (ELCs). Most of these cells consist of mesenchymal stromal progenitors, which would eventually get mobilized from the bone marrow after injury. Based on that, current knowledge on different mouse and human bone marrow stromal cell (BM-SC) subpopulations, able to contribute with mesenchymal stromal/stem cells (MSCs), is herein reviewed. Such analyses underline an unexpected heterogeneity among sinusoidal LepR+ stromal/CAR cells. For instance, in a recent report a subgroup of LepR+ stromal/CAR progenitors, which express GLAST and is traced in Wnt1Cre;R26RTom mice, was found to contribute with ELCs in vivo. These GLAST + Wnt1+ BM-SCs were shown to get mobilized to the peripheral blood and to contribute with liver regeneration. Other sources of ELCs, such as adipose, neural and dental pulp tissues, were also published. Finally, mechanisms likely involved in the enhanced cellular plasticity properties of bone marrow/adipose tissue stromal cells, able to originate ELCs, are assessed. In the future, strategies to analyze the in vivo expression profile of stromal cells, with MSC properties, in combination with screening of active genomic regions at the single cell-level, during early postnatal development and/or after injury, will likely help understanding properties of these ELC sources.
Keywords: Bone marrow stromal cells; CAR cells; Endothelial progenitor cells; Epigenetics; Exosomes; GLAST; Hypoxia; Plasticity; Wnt1; scRNA-seq
The Principle of Proportionality in the Right of Access to Public Information: Uses and Potentialities to Mitigate State Discretion when Invoking a Legal Exception. An Analysis from Argentine Law and Robert Alexy's Theory
No full textEl principio de proporcionalidad es un procedimiento de aplicación de normas sobre derechos fundamentales. Si bien nació en Alemania, hoy en día y gracias a la contribución de Robert Alexy, migró a otros sistemas jurídicos. Generalmente, su empleo se aborda desde la perspectiva judicial; es decir, como un mecanismo de control de constitucionalidad.
Este trabajo aborda el principio de proporcionalidad desde otro enfoque, pues mi intención consiste en evaluar su eficacia en el ámbito particular del derecho de acceso a la información pública y, por lo tanto, aplicable en el marco de las decisiones adoptadas por el poder político. De este modo y dado que para Alexy la concepción sobre los derechos fundamentales como requisitos de optimización es indisociable del principio de proporcionalidad, analizaré cada uno de sus submandatos –idoneidad, necesidad y proporcionalidad en sentido estricto– teniendo en cuenta tal caracterización. En particular, enfatizaré en el "principalismo" –reconocimiento de principios y valores en las constituciones– como un elemento determinante de la ponderación. Finalmente, concluiré que el principio de proporcionalidad presenta una estructura argumentativa adecuada para fundamentar las excepciones al derecho de acceso a la información pública que, a la luz del principio de máxima divulgación, deben ser interpretadas restrictivamente.The principle of proportionality is a procedure for the
application of rules on fundamental rights. Although he was born in
Germany, today and thanks to the contribution of Robert Alexy, it
migrated to other legal systems. Generally, their implementation is
approached from the judicial perspective; that is, as a mechanism of
constitutional review. This paper addresses the principle of
proportionality from another perspective, since my intention is to
evaluate its effectiveness in the field of the right of access to public
information and, therefore, applicable within the framework of
decisions taken by political power. In this way, and given that for
Alexy, the conception of fundamental rights as requirements for
optimization is inseparable from the principle of proportionality. I
will analyze each of its sub-mandates (suitability, necessity, and
proportionality in a narrow sense) taking into account such
characterization. I will emphasize “principalism” (recognition of
principles and values in constitutions) as a determining element of
the examination. Finally, I will conclude that the principle of
proportionality presents an adequate argumentative structure to support the exceptions to the right of access to public information
that, considering the principle of maximum disclosure, must be
interpreted restrictively
Can Intubation Be Improved with Endotracheal Tubes Marked with a Color Scale? Randomized Controlled Study
No full textDisponible en: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-1659-0422Abstract
Objective: This study aimed to assess if a color scale in the endotracheal tube (ETT) can help operators to correctly select the size and depth of placement of the ETT and decrease the time required to complete the procedure and compared with the usual numeric ETT scale in a mannequin model.
Study design: The study was conducted in eight centers. Each size of the ETT was identified with a different color. The experimental ETTs had two different colored areas, one for the mouthpiece and another to identify where the ETT should be taped above the lip (an area of 1 cm. The operators were trained as part of the protocol using an instructional video. Four clinical scenarios requiring endotracheal intubation were designed and randomly assigned. Each operator had to select the size and depth of ETT based on the birth weight (BW), and then had to perform four intubations.
Results: A total of 108 operators performed 432 intubations. No differences were found in the correct placement and selection of the ETT. Median time (in seconds) required for intubation using numeric versus experimental tube was: for ETT Ø NRP (Neonatal Resuscitation Program) 2.5, 11.5 versus 8 (p < 0.001), ETT Ø 3, 12 versus 10 (p < 0.001), ETT Ø 3.5, 15.5 versus12 (p = 0.003), ETT Ø 4, 12 versus11 (p = 0.019).
Conclusion: No significant difference was observed in the selection and correct placement of the ETT. However, the intubation time was significantly shorter using the experimental ETT. This device could improve the effectiveness of intubation by reducing the time needed to properly place the ETT at mid trachea.
Key points: · It is an innovative intervention to try to solve a great inconvenience of daily practice.. · The study also raises the difficulty in maintaining the ability of endotracheal intubation.. · It proposes a scale that ensures the correct location with a safe fixation zone..
Thieme. All rights reserved
Identification of optimal therapeutic window for steroid use in severe alcohol-associated hepatitis: A worldwide study
No full textDisponible en: https://pubmed.ncbi.nlm.nih.gov/34166722/Abstract
Background & aims: Corticosteroids are the only effective therapy for severe alcohol-associated hepatitis (AH), defined by a model for end-stage liver disease (MELD) score >20. However, there are patients who may be too sick to benefit from therapy. Herein, we aimed to identify the range of MELD scores within which steroids are effective for AH.
Methods: We performed a retrospective, international multicenter cohort study across 4 continents, including 3,380 adults with a clinical and/or histological diagnosis of AH. The main outcome was mortality at 30 days. We used a discrete-time survival analysis model, and MELD cut-offs were established using the transform-the-endpoints method.
Results: In our cohort, median age was 49 (40-56) years, 76.5% were male, and 79% had underlying cirrhosis. Median MELD at admission was 24 (19-29). Survival was 88% (87-89) at 30 days, 77% (76-78) at 90 days, and 72% (72-74) at 180 days. A total of 1,225 patients received corticosteroids. In an adjusted-survival-model, corticosteroid use decreased 30-day mortality by 41% (hazard ratio [HR] 0.59; 0.47-0.74; p 51. The type of corticosteroids used (prednisone, prednisolone, or methylprednisolone) was not associated with survival benefit (p = 0.247).
Conclusion: Corticosteroids improve 30-day survival only among patients with severe AH, especially with MELD scores between 25 and 39.
Lay summary: Alcohol-associated hepatitis is a condition where the liver is severely inflamed as a result of excess alcohol use. It is associated with high mortality and it is not clear whether the most commonly used treatments (corticosteroids) are effective, particularly in patients with very severe liver disease. In this worldwide study, the use of corticosteroids was associated with increased 30-day, but not 90- or 180-day, survival. The maximal benefit was observed in patients with an MELD score (a marker of severity of liver disease; higher scores signify worse disease) between 25-39. However, this benefit was lost in patients with the most severe liver disease (MELD score higher than 51).
Keywords: MELD; Maddrey discriminant function; alcohol; alcohol-associated liver disease; alcoholic hepatitis; alcoholic liver disease; cirrhosis; corticosteroids; steroids.
Copyright © 2021 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserve
[Idursulfase desensitization in a child with Hunter syndrome (mucopolysaccharidosis II)]
No full textDisponible en: https://www.sap.org.ar/docs/publicaciones/archivosarg/2021/v119n1a20.pdfAbstract in English, Spanish
Enzyme replacement therapy with idursulfase decreases morbidity and improves quality of life of patients with mucopolysaccharidosis ii. Immediate hypersensitivity reactions to this drug have been described. Desensitization is a treatment that induces temporary tolerance to a culprit drug, allowing the allergic patient to receive the medication. We present the case of a 7-year-old patient diagnosed with Hunter syndrome who presented, after 4 years of treatment, two episodes of anaphylaxis during the infusion of idursulfase. Detection of specific immunoglobulin E was carried out using skin tests, with intradermal reaction at a 1/10 dilution (0.2 mg/ml) being positive. A 12-step desensitization protocol was performed without presenting adverse events. The allergological evaluation and the possibility of desensitization were useful tools in the management of our patient.
Keywords: child; enzyme replacement therapy; immediate hypersensitivity; metabolism inborn errors; treatment.
Sociedad Argentina de Pediatría
La responsabilidad penal sucesiva de las personas jurídicas en ocasión de negocios corporativos y su relación con el proceso de debida diligencia anti–corrupción. Un análisis del escenario local y global
No full textTrabajo final para optar al título de Magíster en Derecho Empresario de la Facultad de Derecho de la Universidad AustralLa Ley de Responsabilidad Penal de la Persona Jurídica N° 27.401, dispone la responsabilidad penal de entes ideales por la comisión de cinco delitos tipificados en el Código Penal argentino: (i) cohecho y tráfico de influencias –nacional e internacional–; (ii) negociaciones incompatibles con el ejercicio de las funciones públicas; (iii) concusión; (iv) enriquecimiento ilícito de funcionarios y empleados; (v) balances e informes falsos agravados. En este escenario, no sólo llama la atención la nueva forma de atribuir responsabilidad penal a las personas jurídicas –por defectos en la organización–, sino que también se prevé la transmisión de responsabilidad penal en ocasión de negocios corporativos, introduciendo de esta manera al ordenamiento jurídico, un verdadero instituto como lo es el de la responsabilidad penal sucesiva. El presente trabajo tiene como primer objetivo analizar los diferentes supuestos de responsabilidad sucesiva previstos en la Ley N° 27.401, diferenciando cada uno de ellos, para luego determinar en qué casos y en qué medida existe dicha transmisión de responsabilidad. Consecuentemente, se analiza el impacto que tiene la transmisión de responsabilidad penal entre personas jurídicas sobre el proceso de debida diligencia anti–corrupción en ocasión de negocios corporativos
Failure in all steps of hepatocellular carcinoma surveillance process is frequent in daily practice
No full textDisponible en: https://www.sciencedirect.com/science/article/pii/S1665268121000430?via%3DihubAbstract
Introduction and objectives: Failures at any step in the hepatocellular carcinoma (HCC) surveillance process can result in HCC diagnostic delays and associated worse prognosis. We aimed to estimate the prevalence of surveillance failure and its associated risk factors in patients with HCC in Argentina, considering three steps: 1) recognition of at-risk patients, 2) implementation of HCC surveillance, 3) success of HCC surveillance.
Methods: We performed a multi-center cross-sectional study of patients at-risk for HCC in Argentina seen between10.01.2018 and 10.30.2019. Multivariable logistic regression analysis was used to identify correlates of surveillance failure.
Results: Of 301 included patients, the majority were male (74.8%) with a mean age of 64 years old. At the time of HCC diagnosis, 75 (25%) patients were unaware of their diagnosis of chronic liver disease, and only 130 (43%) patients were under HCC surveillance. Receipt of HCC surveillance was significantly associated with follow-up by a hepatologist. Of 119 patients with complete surveillance, surveillance failure occurred in 30 (25%) patients. Surveillance failure was significantly associated with alpha fetoprotein ≥20 ng/mL (OR 4.0, CI 95% 1.43-11.55).
Conclusions: HCC surveillance failure was frequent in all the evaluated steps. These data should help guide strategies to improve the implementation and results of HCC surveillance in our country.
Keywords: Alpha fetoprotein; Cirrhosis; Failure; Liver cancer; Screening.
Copyright © 2021 AEDV. Published by Elsevier España, S.L.U. All rights reserved
The Important Role of Companies in Situations of Health Crisis: A Corporate Prevention Plan?
No full textEl Covid-19 ha puesto en jaque a diversos actores de nuestra sociedad, entre ellos las empresas. El rol empresarial, dentro del marco de una debida diligencia en su actuar, en tiempos de pandemia, es trascendental no solo para asegurar los derechos humanos de sus trabajadores o entorno cercano, sino también para el bienestar común de la sociedad. Frente a esta situación, el presente artículo propone la necesidad de contar con un Plan de Prevención Corporativo ante emergencias sanitarias bajo siete frentes claves, a fin de que las empresas puedan anticiparse a los efectos que puede tener una pandemia u otra emergencia en sus actividades.Covid-19 has challenged various actors in our society,
including companies. The role of businesses during the pandemic,
within the framework of due diligence, is essential not only to ensure the human rights of its workers and those close to them, but also for
the common welfare of society. Faced with this situation, this article
advances the need to come up with a Corporate Prevention Plan for
health emergencies under seven key fronts, so that companies can
anticipate the effects that a pandemic or other emergency may have
on their activitie
Combination of pose and rank consensus in docking-based virtual screening: the best of both worlds
No full textDisponible en: https://pubs.rsc.org/en/content/articlelanding/2021/RA/D1RA05785EAbstract
The use of high-throughput docking (HTD) in the drug discovery pipeline is today widely established. In spite of methodological improvements in docking accuracy (pose prediction), scoring power, ranking power, and screening power in HTD remain challenging. In fact, pose prediction is of critical importance in view of the pose-dependent scoring process, since incorrect poses will necessarily decrease the ranking power of scoring functions. The combination of results from different docking programs (consensus scoring) has been shown to improve the performance of HTD. Moreover, it has been also shown that a pose consensus approach might also result in database enrichment. We present a new methodology named Pose/Ranking Consensus (PRC) that combines both pose and ranking consensus approaches, to overcome the limitations of each stand-alone strategy. This approach has been developed using four docking programs (ICM, rDock, Auto Dock 4, and PLANTS; the first one is commercial, the other three are free). We undertook a thorough analysis for the best way of combining pose and rank strategies, and applied the PRC to a wide range of 34 targets sampling different protein families and binding site properties. Our approach exhibits an improved systematic performance in terms of enrichment factor and hit rate with respect to either pose consensus or consensus ranking alone strategies at a lower computational cost, while always ensuring the recovery of a suitable number of ligands. An analysis using four free docking programs (replacing ICM by Auto Dock Vina) displayed comparable results.
This journal is © The Royal Society of Chemistry