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Background Optimal timing for the start of vasopressors (VP) in septic shock has not been widely studied since it is assumed that fluids must be administered in advance. We sought to evaluate whether a very early start of VP, even without completing the initial fluid loading, might impact clinical outcomes in septic shock. Methods A total of 337 patients with sepsis requiring VP support for at least 6 h were initially selected from a prospectively collected database in a 90-bed mixed-ICU during a 24-month period. They were classified into very-early (VE-VPs) or delayed vasopressor start (D-VPs) categories according to whether norepinephrine was initiated or not within/before the next hour of the first resuscitative fluid load. Then, VE-VPs ( n  = 93) patients were 1:1 propensity matched to D-VPs ( n  = 93) based on age; source of admission (emergency room, general wards, intensive care unit); chronic and acute comorbidities; and lactate, heart rate, systolic, and diastolic pressure at vasopressor start. A risk-adjusted Cox proportional hazard model was fitted to assess the association between VE-VPs and day 28 mortality. Finally, a sensitivity analysis was performed also including those patients requiring VP support for less than 6 h. Results Patients subjected to VE-VPs received significantly less resuscitation fluids at vasopressor starting (0[0–510] vs. 1500[650–2300] mL, p  < 0.001) and during the first 8 h of resuscitation (1100[500–1900] vs. 2600[1600–3800] mL, p  < 0.001), with no significant increase in acute renal failure and/or renal replacement therapy requirements. VE-VPs was related with significant lower net fluid balances 8 and 24 h after VPs. VE-VPs was also associated with a significant reduction in the risk of death compared to D-VPs (HR 0.31, CI95% 0.17–0.57, p  < 0.001) at day 28. Such association was maintained after including patients receiving vasopressors for < 6 h. Conclusion A very early start of vasopressor support seems to be safe, might limit the amount of fluids to resuscitate septic shock, and could lead to better clinical outcomes.

Looking for a biotechnical potential, aqueous extracts of leaves of 12 native species used in the Mayan traditional medicine of the coastal dune and mangrove of Yucatan (Mexico) were selected to evaluate their biological activities. Rhizophora mangle and Manilkara zapota showed the highest free radical scavenging activity (3.94 ± 0.19 and 6.42 ± 0.32 μg/mL, respectively), and the highest antihypertensive activity was obtained from Solanum donianum (0.38 μg/mL). The anti-hyperglycemic activity of these species was also tested; the highest activities were registered with R. mangle. The antimicrobial activity of Malvaviscus arboreus, S. donianum, M. zapota, and R. mangle at 10% (w/v) was positive against six human pathogenic bacteria and Bonellia macrocarpa against one pathogenic fungus. Solanum donianum, M. zapota, B. macrocarpa, and R. mangle were positive against two pathogenic plant fungi. These results show that the aqueous extracts of five native plants of the Yucatan coast have potential as antioxidants, ACE inhibitors, α-amylase and α-glucosidase inhibitors, and as antimicrobials, which make their exploration for utilization in the agricultural and pharmaceutical industries a possibility.

In the field of word recognition and reading, it is commonly assumed that frequently repeated words create more accessible memory traces than infrequently repeated words, thus capturing the word-frequency effect. Nevertheless, recent research has shown that a seemingly related factor, contextual diversity (defined as the number of different contexts [e.g., films] in which a word appears), is a better predictor than word-frequency in word recognition and sentence reading experiments. Recent research has shown that contextual diversity plays an important role when learning new words in a laboratory setting with adult readers. In the current experiment, we directly manipulated contextual diversity in a very ecological scenario: at school, when Grade 3 children were learning words in the classroom. The new words appeared in different contexts/topics (high-contextual diversity) or only in one of them (low-contextual diversity). Results showed that words encountered in different contexts were learned and remembered more effectively than those presented in redundant contexts. We discuss the practical (educational [e.g., curriculum design]) and theoretical (models of word recognition) implications of these findings.

Participatory Integrated Assessment (PIA) has become a vital tool for decision-making for sustainable development, but it faces significant challenges due to the inherent uncertainty of socio-ecological systems. Uncertainty arises from multiple sources, such as incomplete data, knowledge gaps, and unpredictable events, which can lead to inadequate risk estimations and potentially undermine the effectiveness of environmental planning efforts. To address these challenges, this study proposes a qualitative modeling approach for risk estimation in PIA. The approach employs Decision Making under Deep Uncertainty (DMDU) to combine qualitative insights and information from stakeholders with available quantitative data. It allows for the exploration of alternative future states of the world and the identification of robust scenarios that promote sustainable development. The effectiveness of the proposed approach is demonstrated through the Ecological Ordinance of Yucatán, Mexico, a policy-making tool for multi-sectoral environmental planning. The study shows how qualitative DMDU can identify critical uncertainties and provide insights into regional management strategies. It also emphasizes the importance of stakeholder engagement and transparency in the decision-making process. Overall, this study presents a promising approach for addressing multiple forms of uncertainty in PIA and improving ecological risk estimation for decision-making in complex socio-ecological systems.

A promising approach for addressing sustainability problems is to recognize the unique conditions of a particular place, such as problem features and solution capabilities, and adopt and adapt solutions developed at other places around the world. Therefore, research and teaching in international networks becomes critical, as it allows for accelerating learning by sharing problem understandings, successful solutions, and important contextual considerations. This article identifies eight distinct types of research and teaching collaborations in international networks that can support such accelerated learning. The four research types are, with increasing intensity of collaboration: (1) solution adoption; (2) solution consultation; (3) joint research on different problems; and (4) joint research on similar problems. The four teaching types are, with increasing intensity of collaboration: (1) adopted course; (2) course with visiting faculty; (3) joint course with traveling faculty; and (4) joint course with traveling students. The typology is illustrated by extending existing research and teaching projects on urban sustainability in the International Network of Programs in Sustainability, with partner universities from Europe, North America, Asia, and Africa. The article concludes with challenges and strategies for extending individual projects into collaborations in international networks.

Epilepsy, a prevalent neurological disorder characterized by recurrent seizures, significantly impacts individuals’ neurobiological, cognitive, and social lives. This report presents a feasibility study investigating the effects of a computerized cognitive training program on enhancing executive functions, particularly inhibitory control, in children and adolescents with epilepsy. Employing a pre-test–intervention–post-test design, the study involved 26 participants with diverse epileptic syndromes, focusing on those without severe intellectual disabilities. The intervention, based on the CogniFit Inc. platform, consisted of personalized tasks aiming to improve participants’ inhibitory skills over 16 weeks, with an average of 40 sessions completed per participant. Results indicated significant improvements in reaction times and error rates in an anti-saccade task, demonstrating enhanced inhibitory control and general performance post-intervention. These findings suggest that targeted cognitive training is a feasible approach to bolster executive functions in young individuals with epilepsy, potentially improving their academic performance, employability, and social interactions. The study underscores the importance of early cognitive interventions in epilepsy management, highlighting the potential for computerized programs to aid in mitigating cognitive deficits associated with the condition.

This paper advances the field of climate adaptation by addressing two persistent challenges: navigating multiple forms of uncertainty and enabling the construction of actionable future scenarios. Using a methodology grounded in Decision Making under Deep Uncertainty (DMDU), we combine computational modeling with stakeholder-informed metanarratives to connect abstract analysis with grounded, context-specific knowledge. Our study introduces a novel simulation approach to water scarcity vulnerability in Mexico City, revealing that no amount of budget allocation alone can solve the persistent vulnerability of areas like Iztapalapa. This counterintuitive finding, generated through model-based scenarios, was contextualized and explained by community-derived metanarratives that surfaced deep social, political, and historical uncertainties. In doing so, we highlight how simulations and narratives together offer a more robust means of identifying adaptation pathways than either can alone. Our vulnerability model integrates exposure, sensitivity, and adaptive capacity, drawing from both quantitative service indicators and community knowledge. We argue that addressing climate challenges requires cognitive and methodological tools capable of holding plural uncertainties, enabling diverse futures to be imagined and evaluated.

The plant Aeschynomene fascicularis (Fabaceae) has been used in Mayan traditional medicine in the Yucatan peninsula. However, the compounds present in the plant responsible for its curative properties have not yet been investigated. Aeschynomene fascicularis root bark was extracted with 100% methanol to obtain a crude extract. The methanol extract was partitioned successively with solvents with increasing polarity to obtain the corresponding hexane (Hx), dichloromethane (DCM) and ethyl acetate fractions (EtOAc), as well as a residual water-alcoholic fraction. These fractions were tested for their cytotoxic activities using an MTT assay against Hep-2 cancer cell lines. The Hx fraction led to the isolation of spinochalcone C (1), spinochalcone A (2), isocordoin (3) and secundiflorol G (4). Their structures were identified based on spectroscopic evidence and chemical properties. All compounds were subjected to cytotoxicity and antiproliferative assays against a panel of seven cell lines, including one normal-type cell line. Spinochalcone A (2) exhibited cytotoxic activity against DU-145 cell line and antiproliferative activity against the KB cell line. Secundiflorol G (4) showed strong cytotoxic activity towards KB and Hep-2 cell lines. In addition, isocordoin (3) showed moderate activity on KB, Hep-2 and DU-145 cell lines. The active Compounds 2, 3 and 4 are potential therapeutic entities against cancer.