Universidad del Norte

Pandemic-scale disruptions can trigger disaster-related buying behaviors (DRBBs) that amplify shortages and strain supply chains, making it essential to understand how households adjust essential-goods inventories during crises. Using COVID-19 as an empirical case, this study offers the first multi-country Latin American comparison of DRBBs, measured as revealed changes in household inventory-days, and integrates Prospect Theory and Liquidity Constraints Theory to explain how perceived losses and risk interact with financial capacity. Survey data collected April–June 2020 across seven Latin American countries (N = 1,821) are analyzed using a Poisson rate model with an offset for baseline inventory-days. Results indicate that households with children and those facing greater pandemic severity tend to maintain higher inventory levels of basic supplies, while the effects of income and experienced shortages vary across countries, with reduced purchasing power and constrained access often associated with lower inventory levels. These findings guide targeted interventions to reduce DRBB externalities and protect equitable access to essentials in future crises.

New therapies are improving outcomes even in advanced stages of multiple myeloma. To describe the experience of bispecific antibodies (BsAbs) in Mexico. The study included 41 patients with triple-class refractory (88%) and penta-drug refractory (61%) myeloma. The median number of prior treatment lines was 3, and the median time to response was 2 months. Step-up dosages were administered on an outpatient basis in 34 patients (83%). BsAbs were administered every 2 weeks to 19 patients (46%) and monthly to 17 patients (41.5%). Thirteen of these (31.5%) switched to monthly doses early in treatment and maintained their response. Twenty-five of 38 evaluated patients (66%) achieved a complete response or better, and 84% were negative for minimal residual disease. The median response duration was 10 months, while median progression-free survival and overall survival were 12 and 13 months, respectively. Extramedullary disease, no complete response, positivity for minimal residual disease, and penta-refractoriness were associated with poor outcomes. The adverse events were lower than those reported in clinical trials. In conclusion, using outpatient step-up dosing followed by planned de-escalation to monthly doses of BsAbs in responding patients with MM is feasible, safe, and effective, and may improve access to this novel therapy.

The tectonically active northern Colombian Caribbean margin, where the Magdalena Canyons System (MCS) lies adjacent to the structurally confined La Aguja Canyon (LAC), provides an exceptional natural laboratory to investigate sediment mixing and the partitioning of transport pathways between coastal and deep-marine environments. Here, we integrate new detrital zircon U–Pb geochronology from 18 coastal and offshore samples (~1,900 grains) with published river and coastal datasets to assess how provenance signals are transferred from onshore sources through submarine canyon systems into offshore depocenters. Detrital zircon ages span from

Introdução: A dermatite atópica (DA) é uma dermatose inflamatória crônica que impacta severamente a qualidade de vida. O advento do dupilumabe transformou o tratamento da DA; contudo, os inibidores orais da Janus quinase (JAK) emergiram como alternativas de ação rápida. Objetivo: Comparar a eficácia clínica (EASI-75 e redução do prurido) entre inibidores de JAK (abrocitinibe e upadacitinibe) e dupilumabe em adultos com DA moderada a grave. Métodos: Revisão sistemática e meta-análise de ensaios clínicos randomizados de comparação direta (head-to-head). A extração focou no desfecho de EASI-75 e na redução do prurido (NRS ≥ 4) nas semanas 12 a 16. O risco relativo (RR) foi calculado com modelos de efeitos aleatórios (REML) e meta-regressão de efeitos fixos (FE), utilizando o pacote metafor no software RStudio. Resultados: A análise global de EASI-75 não evidenciou superioridade da classe JAK como um todo (RR 1,06; IC 95% 0,93–1,21; p = 0,4178), apresentando alta heterogeneidade (I² = 70,9%). Contudo, a análise de subgrupo revelou superioridade robusta do upadacitinibe 30 mg sobre o dupilumabe (RR ≈ 1,16; p = 0,0061). Para o alívio do prurido, os iJAK mostraram-se globalmente superiores ao dupilumabe (RR 1,53; IC 95% 1,23–1,91; p = 0,0002), com destaque para abrocitinibe 200 mg (p < 0,0001) e upadacitinibe 30 mg (p < 0,0001). A análise de sensibilidade (leave-one-out) confirmou que a dose de 100 mg de abrocitinibe foi o principal fator de heterogeneidade da classe. Conclusão: Inibidores JAK em altas dosagens são estatisticamente superiores ao dupilumabe na velocidade de alívio do prurido e no clareamento cutâneo (EASI-75) em curto prazo. A classe não deve ser interpretada de forma homogênea, sendo a seletividade e a posologia determinantes cruciais da eficácia.

The integration of Wireless Sensor Networks (WSNs) in Industrial Internet of Things (IIoT) applications presents significant challenges in terms of energy efficiency and network reliability, especially in dynamic industrial environments. The Routing Protocol for Low-Power and High-Loss Networks for Indoor Environments (RPLIE), while designed for low-power lossy networks (LLNs), lacks mechanisms to adequately balance energy consumption, a critical requirement for industrial sustainability. This research introduces an enhancement called Energy-Conscious Routing Protocol for Industrial Environments (EC-RPLIE), which incorporates the Expected Breakage Cost (EBC) metric to optimize energy distribution and network stability by managing medium-term jitter. Through extensive simulations in the Cooja environment, the performance of EC-RPLIE was evaluated against the state-of-the-art RPLIE across topologies of 11, 21, and 31 nodes. Quantitative results demonstrate that EC-RPLIE significantly reduces unnecessary retransmissions by maintaining a superior Packet Delivery Ratio (PDR) and optimizing parent selection. The protocol achieved energy savings of 9.6% in 11-node networks, which increased to 36.8% in high-density 31-node scenarios, effectively doubling the network persistence compared to RPLIE. Additionally, EC-RPLIE improved average latency by 12.68% in dense configurations, confirming its robustness in handling industrial traffic. These findings confirm that EC-RPLIE is particularly effective in high-density networks, where the EBC metric successfully mitigates the 'retransmission storms' typical of standard protocols. This proposal provides a robust framework for enhancing the sustainability and resilience of WSNs in Industry 4.0, offering a scalable solution that addresses the energy-reliability trade-off. The results lay the groundwork for future large-scale implementations in real-world industrial environments.

Moderate-to-severe thyroid eye disease (TED) is a potentially vision-threatening inflammatory condition that requires timely, evidence-based medical management. Although intravenous glucocorticoids remain the mainstay of therapy, several biologic and immunosuppressive agents have emerged as potential alternatives, particularly in steroid-refractory disease. To evaluate and compare the efficacy, safety, and therapeutic positioning of medical treatments for active moderate-to-severe thyroid eye disease. A comprehensive search of PubMed, Embase, and the Cochrane Library was conducted through February 2025. Eligible studies included randomized controlled trials, meta-analyses, systematic reviews, observational cohorts, and selected case series evaluating pharmacological interventions for moderate-to-severe TED. Outcomes of interest were proptosis reduction, Clinical Activity Score (CAS) improvement, diplopia response, and safety/tolerability. A semi-quantitative synthesis approach was used to integrate evidence across heterogeneous study designs. Fifty-eight studies met the inclusion criteria. Intravenous glucocorticoids (IVGCs) demonstrated the most consistent efficacy in controlling inflammatory activity, with modest effects on proptosis and favorable tolerability at cumulative doses below 8 g. Among biologic therapies, teprotumumab showed the greatest magnitude of benefit across all efficacy domains but was limited by safety considerations and access constraints. Rituximab and tocilizumab demonstrated moderate efficacy, particularly in glucocorticoid-resistant cases. Mycophenolate mofetil emerged as the most reliable non-biologic immunosuppressive option. Oral glucocorticoids and several adjunctive therapies showed limited or inconsistent benefit. This systematic review provides an integrated framework to support therapeutic decision-making in moderate-to-severe TED. Intravenous glucocorticoids remain the most consistently supported first-line therapy, while IGF-1R-targeted biologic therapy offers the most comprehensive efficacy across key clinical domains in selected patients. Not registered.