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1.
J Fungi (Basel) ; 10(10)2024 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-39452677

RESUMO

Mytilinidioid fungi are conchiform in nature, with the appearance of bivalve shells or wedge-shaped, rigid, brittle, and carbonaceous hysterothecia growing on the bark of gymnosperms or angiosperms. Based on their morphological characteristics and molecular markers (ITS and LSU), this study describes three new species of mytilinidioid fungi: Ericboehmia mexicana of the family Hysteriaceae of the order Hysteriales and Lophium pinicola and Mytilinidion mexicanum of the family Mytilinidiaceae of the order Mytilinidiales. The first species grows on Liquidambar styracyphlua, the second species grows on Pinus patula, and the third species grows on Acacia californica subsp. pringlei. The specimens studied were deposited in the ENCB Herbarium.

2.
J Fungi (Basel) ; 10(6)2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38921390

RESUMO

The genus Tarzetta is distributed mainly in temperate forests and establishes ectomycorrhizal associations with angiosperms and gymnosperms. Studies on this genus are scarce in México. A visual, morphological, and molecular (ITS-LSU) description of T. americupularis, T. cupressicola, T. davidii, T. durangensis, T. mesophila, T. mexicana, T. miquihuanensis, T. poblana, T. pseudobronca, T. texcocana, and T. victoriana was carried out in this work, associated with Abies, Quercus, and Pinus. The results of SEM showed an ornamented ascospores formation by Mexican Taxa; furthermore, the results showed that T. catinus and T. cupularis are only distributed in Europe and are not associated with any American host.

3.
J Fungi (Basel) ; 9(9)2023 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-37755041

RESUMO

The tropical montane cloud forest is the most diverse and threatened vegetation type in Mexico. In the last decade, the number of described Ascomycetes species has notably increased, reaching more than 1300 species. This study describes six new species based on their molecular and morphological characteristics. Our results suggest that Mexico has the highest number of described species in the Neotropics. However, many other Mexican lineages still need to be described.

4.
MycoKeys ; 96: 127-142, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37252055

RESUMO

Two new species of sequestrate fungi are described from south Mexico based on morphological and molecular evidences. Here we describe Elaphomycescastilloi characterized by the yellowish mycelial mat, dull blue gleba and ascospores of 9.7-11.5 µm; Entolomasecotioides is characterized by the secotioid basidiomata, sulcate, pale cream pileus, and basidiospores of 7-13 × 5-9 µm. Both species grow in montane cloud forest under Quercus sp. in the state of Chiapas, Mexico. Descriptions, photographs, and multilocus phylogeny for both species are presented.

5.
J Fungi (Basel) ; 9(4)2023 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-37108931

RESUMO

The tropical montane cloud forest in Mexico is the most diverse and threatened ecosystem. Mexican macrofungi numbers more than 1408 species. This study described four new species of Agaricomycetes (Bondarzewia, Gymnopilus, Serpula, Sparassis) based on molecular and morphological characteristics. Our results support that Mexico is among the most biodiverse countries in terms of macrofungi in the Neotropics.

6.
MycoKeys ; 92: 95-108, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36761320

RESUMO

Two new species of Trichoglossum are described from south Mexico based on morphological and molecular evidence. Trichoglossumcaespitosum is characterized by the caespitose ascomata, rough and coiled paraphyses and the ascospores with 9-11 septa. Trichoglossumtropicale is characterized by the capitate ascomata, clavate and straight paraphyses and the ascospores with 10-12 septa. Both species grow in the tropical forests of the Yucatán peninsula. Here we provide descriptions and photographs for these species, together with a phylogenetic analyses based on the DNA sequences of nuc rDNA (ITS region and 28S gene) and a comparative table for the species known for America.

7.
MycoKeys ; 83: 123-144, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34616220

RESUMO

The genus Rhytidhysteron is characterised by forming navicular to apothecial hysterothecia, exposing the green, yellow, orange, red, vinaceous or black colours of the hymenium which generally releases pigments in the presence of KOH. The exciple is smooth or striated, the asci bitunicate and ascospores have 1-5 transverse septa. To date, twenty-six Rhytidhysteron species have been described from the Tropics. The present study aims to describe three new species in the Neotropics of Mexico based on molecular methods and morphological features. Illustrations and a taxonomic key are provided for all known species of this genus. Rhytidhysteroncozumelense from the Isla Cozumel Biosphere Reserve, R.esperanzae from the Sierra Juárez, Oaxaca and R.mesophilum from the Sierra Madre Oriental, Hidalgo are described as new species. With the present study, the number of species of Rhytidhysteron known from Mexico is now increased to eight.

8.
NPJ Precis Oncol ; 5(1): 74, 2021 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-34354225

RESUMO

Delta-like protein 3 (DLL3) is highly expressed in solid tumors, including neuroendocrine carcinomas/neuroendocrine tumors (NEC/NET). Rovalpituzumab tesirine (Rova-T) is a DLL3-targeting antibody-drug conjugate. Patients with NECs and other advanced DLL3-expressing tumors were enrolled in this phase I/II study (NCT02709889). The primary endpoint was safety. Two hundred patients were enrolled: 101 with NEC/NET (large-cell NEC, gastroenteropancreatic NEC, neuroendocrine prostate cancer, and other NEC/NET) and 99 with other solid tumors (melanoma, medullary thyroid cancer [MTC], glioblastoma, and other). The recommended phase II dose (RP2D) was 0.3 mg/kg every 6 weeks (q6w) for two cycles. At the RP2D, grade 3/4 adverse events included anemia (17%), thrombocytopenia (15%), and elevated aspartate aminotransferase (8%). Responses were confirmed in 15/145 patients (10%) treated at 0.3 mg/kg, including 9/69 patients (13%) with NEC/NET. Rova-T at 0.3 mg/kg q6w had manageable toxicity, with antitumor activity observed in patients with NEC/NET, melanoma, MTC, and glioblastoma.

9.
J Thorac Oncol ; 16(9): 1559-1569, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33652156

RESUMO

INTRODUCTION: This open-label, phase 1-2 study evaluated the safety and efficacy of rovalpituzumab tesirine (Rova-T), an antibody-drug conjugate targeting DLL3, plus immune checkpoint inhibitors nivolumab plus or minus ipilimumab in previously treated extensive-stage SCLC (ES SCLC). METHODS: Patients with histologically or cytologically confirmed, previously treated (two or more lines of therapy) ES SCLC were enrolled into two cohorts. Cohort 1 received 0.3 mg/kg Rova-T (once every 6 wk for two cycles) plus 360 mg nivolumab (two 3-wk cycles beginning on week 4). Cohort 2 received the same dosage of Rova-T as cohort 1 plus 1 mg/kg nivolumab (four 3-wk cycles) and 1 mg/kg ipilimumab (beginning week 4). Both cohorts received 480 mg nivolumab every 4 weeks starting at week 10. Key objectives were to evaluate safety and tolerability and efficacy (per Response Evaluation Criteria in Solid Tumors version 1.1). The response-related results are based on centrally read data. RESULTS: A total of 42 patients received therapy: cohort 1, n = 30; cohort 2, n = 12. Overall, 43% received two or more previous lines of therapy. All patients experienced one or more treatment-emergent adverse event (TEAE); 41 patients reported AEs considered related to the study drug by the investigator. The most frequent TEAE was pleural effusion (n = 20, 48%); most common grade greater than or equal to 3 was anemia (n = 9, 21%). Three grade 5 TEAEs considered related to the study drug were reported (cohort 1): pneumonitis (n = 2), acute kidney injury (n = 1). The objective response rate was 30% (12 of 40): cohort 1, 27.6% (8 of 29); cohort 2, 36.4% (4 of 11); all partial responses. CONCLUSIONS: Despite encouraging antitumor activity in previously treated ES SCLC, combination therapy with Rova-T and nivolumab plus or minus ipilimumab was not well tolerated at the dose levels and administration schedules evaluated.


Assuntos
Imunoconjugados , Neoplasias Pulmonares , Anticorpos Monoclonais Humanizados , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Benzodiazepinonas , Humanos , Imunoconjugados/uso terapêutico , Ipilimumab/uso terapêutico , Neoplasias Pulmonares/tratamento farmacológico , Nivolumabe/uso terapêutico
10.
J Neurosci Methods ; 268: 43-52, 2016 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-27141856

RESUMO

BACKGROUND: The ability to correlate plastic changes in synaptic physiology with changes in synaptic anatomy has been very limited in the central nervous system because of shortcomings in existing methods for recording the activity of specific CNS synapses and then identifying and studying the same individual synapses on an anatomical level. NEW METHOD: We introduce here a novel approach that combines two existing methods: paired neuron electrophysiological recording and array tomography, allowing for the detailed molecular and anatomical study of synapses with known physiological properties. RESULTS: The complete mapping of a neuronal pair allows determining the exact number of synapses in the pair and their location. We have found that the majority of close appositions between the presynaptic axon and the postsynaptic dendrite in the pair contain synaptic specializations. The average release probability of the synapses between the two neurons in the pair is low, below 0.2, consistent with previous studies of these connections. Other questions, such as receptor distribution within synapses, can be addressed more efficiently by identifying only a subset of synapses using targeted partial reconstructions. In addition, time sensitive events can be captured with fast chemical fixation. COMPARISON WITH EXISTING METHODS: Compared to existing methods, the present approach is the only one that can provide detailed molecular and anatomical information of electrophysiologically-characterized individual synapses. CONCLUSIONS: This method will allow for addressing specific questions about the properties of identified CNS synapses, even when they are buried within a cloud of millions of other brain circuit elements.


Assuntos
Técnicas de Patch-Clamp , Sinapses/fisiologia , Tomografia/métodos , Animais , Região CA3 Hipocampal/citologia , Região CA3 Hipocampal/fisiologia , Potenciais Pós-Sinápticos Excitadores , Hipocampo/fisiologia , Camundongos Endogâmicos C57BL , Microscopia de Fluorescência , Células Piramidais/citologia , Células Piramidais/fisiologia , Ratos Sprague-Dawley , Receptores de AMPA/metabolismo , Técnicas de Cultura de Tecidos , Fixação de Tecidos
11.
Mol Ecol ; 24(23): 5938-56, 2015 12.
Artigo em Inglês | MEDLINE | ID: mdl-26465233

RESUMO

Some of the effects of past climate dynamics on plant and animal diversity make-up have been relatively well studied, but to less extent in fungi. Pleistocene refugia are thought to harbour high biological diversity (i.e. phylogenetic lineages and genetic diversity), mainly as a product of increased reproductive isolation and allele conservation. In addition, high extinction rates and genetic erosion are expected in previously glaciated regions. Some of the consequences of past climate dynamics might involve changes in range and population size that can result in divergence and incipient or cryptic speciation. Many of these dynamic processes and patterns can be inferred through phylogenetic and coalescent methods. In this study, we first delimit species within a group of closely related edible ectomycorrhizal Amanita from North America (the American Caesar's mushrooms species complex) using multilocus coalescent-based approaches; and then address questions related to effects of Pleistocene climate change on the diversity and genetics of the group. Our study includes extensive geographical sampling throughout the distribution range, and DNA sequences from three nuclear protein-coding genes. Results reveal cryptic diversity and high speciation rates in refugia. Population sizes and expansions seem to be larger at midrange latitudes (Mexican highlands and SE USA). Range shifts are proportional to population size expansions, which were overall more common during the Pleistocene. This study documents responses to past climate change in fungi and also highlights the applicability of the multispecies coalescent in comparative phylogeographical analyses and diversity assessments that include ancestral species.


Assuntos
Amanita/classificação , Evolução Biológica , Filogenia , Refúgio de Vida Selvagem , Amanita/genética , Teorema de Bayes , Mudança Climática , DNA Fúngico/genética , Genes Fúngicos , Genética Populacional , Modelos Genéticos , Dados de Sequência Molecular , Técnicas de Tipagem Micológica , América do Norte , Filogeografia , Densidade Demográfica , Análise de Sequência de DNA
12.
Nanoscale Res Lett ; 9(1): 169, 2014 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-24708614

RESUMO

In this work, we present the role of vanadium ions (V+5 and V+3), oxygen vacancies (VO), and interstitial zinc (Zni) to the contribution of specific magnetization for a mixture of ZnO-V2O5 nanoparticles (NPs). Samples were obtained by mechanical milling of dry powders and ethanol-assisted milling for 1 h with a fixed atomic ratio V/Zn?=?5% at. For comparison, pure ZnO samples were also prepared. All samples exhibit a room temperature magnetization ranging from 1.18?×?10-3 to 3.5?×?10-3 emu/gr. Pure ZnO powders (1.34?×?10-3 emu/gr) milled with ethanol exhibit slight increase in magnetization attributed to formation of Zni, while dry milled ZnO powders exhibit a decrease of magnetization due to a reduction of VO concentration. For the ZnO-V2O5 system, dry milled and thermally treated samples under reducing atmosphere exhibit a large paramagnetic component associated to the formation of V2O3 and secondary phases containing V+3 ions; at the same time, an increase of VO is observed with an abrupt fall of magnetization to σ?~?0.7?×?10-3 emu/gr due to segregation of V oxides and formation of secondary phases. As mechanical milling is an aggressive synthesis method, high disorder is induced at the surface of the ZnO NPs, including VO and Zni depending on the chemical environment. Thermal treatment restores partially structural order at the surface of the NPs, thus reducing the amount of Zni at the same time that V2O5 NPs segregate reducing the direct contact with the surface of ZnO NPs. Additional samples were milled for longer time up to 24 h to study the effect of milling on the magnetization; 1-h milled samples have the highest magnetizations. Structural characterization was carried out using X-ray diffraction and transmission electron microscopy. Identification of VO and Zni was carried out with Raman spectra, and energy-dispersive X-ray spectroscopy was used to verify that V did not diffuse into ZnO NPs as well to quantify O/Zn ratios.

13.
Educ. med. super ; 27(2): 211-219, abr.-jun. 2013. ilus, tab
Artigo em Espanhol | LILACS, CUMED | ID: lil-676212

RESUMO

Muchas variables influyen en el rendimiento académico. Entre ellas, la capacidad para comprender enunciados de preguntas y problemas en los exámenes es un factor clave. No obstante, poca atención se ha focalizado en analizar los componentes de un enunciado. Este artículo da cuenta de un estudio desarrollado con el objeto de explorar la comprensión de verbos empleados frecuentemente en evaluaciones escritas. Se empleó un cuestionario de respuesta abierta, aplicado a una muestra de voluntarios, estudiantes de primer semestre de Enfermería en una universidad chilena. El cuestionario fue basado en la taxonomía de Bloom, que a pesar de su antigüedad aún es ampliamente aceptada. Como resultados principales se encontraron significados erróneos atribuidos a los verbos de niveles taxonómicos bajos. Esto da pistas sobre el problema como condicionante de bajo rendimiento académico. Los resultados dieron pie a la implementación de estrategias didácticas que apoyaran el logro de los objetivos de las asignaturas(AU)


There are many variables which affect academic performance. Amongst them, the ability to understand the meaning of questions and problems in written examinations is a crucial aspect. However, little attention has been focused on the skills to analyse problems' components. This article is an account of a research study aimed to explore students' understanding of verbs commonly used in written examinations. In doing so, we used an open-ended questionnaire in a sample of first-year nursing students of a private university, who were all volunteers. The questionnaire design reflected Bloom's taxonomy of cognitive learning, still widely accepted. The main result revealed that the meaning of verbs of the low taxonomy categories was poorly understood. This fact raised the issue of understanding problems as a key factor in low academic performance of students. The results gave rise to the implementation of didactic strategies to support the fulfilment of the learning outcomes(AU)


Assuntos
Humanos , Aptidão , Questões de Prova , Compreensão , Desempenho Acadêmico , Aprendizagem , Estudantes de Enfermagem , Epidemiologia Descritiva , Estudos de Avaliação como Assunto , Estudo Observacional
14.
Mycologia ; 104(4): 880-93, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22466797

RESUMO

Fomitiporia cupressicola sp. nov., found in living Cupressus arizonica, is described on the basis of several collections originating from a high altitude forest in the northern Sierra Madre Occidental, Mexico. The species forms a monophyletic clade, basal to a larger lineage comprising species originating mainly from temperate to Mediterranean areas of the northern hemisphere. The phylogenetic approach in Fomitiporia also revealed multiple unnamed clades within the F. robusta complex in the southern USA and northern Mexico, representing potential species. The status of the F. robusta complex in North America is discussed briefly.


Assuntos
Basidiomycota/classificação , Cupressus/microbiologia , Tipagem de Sequências Multilocus/métodos , Filogenia , Altitude , Sequência de Bases , Basidiomycota/genética , Basidiomycota/crescimento & desenvolvimento , Basidiomycota/isolamento & purificação , Teorema de Bayes , DNA Fúngico/genética , DNA Espaçador Ribossômico/genética , Ecossistema , Evolução Molecular , Genes de RNAr , Especificidade de Hospedeiro , México , Técnicas de Tipagem Micológica , Ribossomos/genética , Alinhamento de Sequência , Análise de Sequência de DNA/métodos , Árvores/microbiologia , Estados Unidos
15.
Educ. med. super ; 25(3): 344-351, jul.-set. 2011.
Artigo em Espanhol | LILACS | ID: lil-617240

RESUMO

A través de este artículo, los autores plantean un rescate al sentido didáctico de la metodología conocida como Aprendizaje Basado en Problemas, tras 40 años de su diseño y posterior masificación en el contexto iberoamericano. Se sostiene que el sentido didáctico no está exactamente en resolver el problema analizado en los tutoriales, sino en desarrollar la cognición en cuanto al razonamiento científico y los atributos sociales: habilidades para comunicar ideas, trabajar dentro de equipos, adoptar responsabilidades, compartir y respetar. Esta estrategia didáctica, entonces, plantea ciertos retos para el tutor, tales como aprender a tolerar el silencio en vez de intervenir para llenar los vacíos durante las discusiones de los estudiantes, la problematización desafiante y el cuestionamiento inductivo.


In this article we highlight the genuine sense of Problem-based learning as a methodology, 40 years after it was proposed and subsequently spread throughout the Iberian-American region. We support the didactic sense is not focused on solving those problems which are analysed in the tutorials, but on developing the cognition in terms of scientific thinking, and social skills such as abilities to communicate ideas, teamwork skills, responsibility, sharing and respecting others. Then, this didactic strategy involves several challenges for the tutor, for instance to learn how to cope and deal with the silence during the tutorials instead of intervening to fill the gaps, or how to do a defiant problematization and an inductive questioning.

16.
Acta bioeth ; 17(1): 133-141, jun. 2011.
Artigo em Espanhol | LILACS | ID: lil-602964

RESUMO

El presente trabajo tiene por objetivo descubrir el significado del respeto y el cuidado -como dimensiones morales del ejercicio de la enfermería- dentro del sistema de creencias y valores en una cultura específica. El enfoque teórico de la cuestión está dado por tres elementos que sostienen nuestras concepciones sobre la práctica de enfermería. Con el primero se esboza una discusión acerca de las relaciones entre ética y enfermería; con el segundo se expone el contexto sociohistórico reciente a través del cual el cuidado toma sentido como objeto de estudio de enfermería. El tercero destaca la dimensión de intersubjetividad y co-construcción del cuidado como práctica sociocultural, y subraya la necesidad de sondear y comprender la significación que las dimensiones morales del cuidado adquieren en la condición de sujeto de cuidados. Fue desarrollada una investigación con enfoque etnográfico, empleando como corpus los textos de entrevistas llevadas a cabo durante el proceso de transculturación del Caring Behaviors Assessment...


The objective of present study is to discover the meaning of respect and care -as moral dimensions of nursing practice- within the system of beliefs and values in a specific culture. The theoretical focus of the topic is given by three elements which support our conceptions of nursing practice. The first one sketches a discussion about relations between ethics and nursing; the second one shows the recent socio historical context through which care acquires meaning as object of studying nursing. The third one emphasizes the inter subjectivity and co-building dimensions of care as socio cultural practices and highlights the need to seek and understand the meaning that moral dimensions of care acquire in subject condition. An ethnographic research was developed using as corpus interviews carry out during the process of trans culture on nursing priorities and health care organizations...


O presente trabalho tem por objetivo descobrir o significado do respeito e do cuidado -como dimensões morais do exercício da enfermagem- dentro do sistema de crenças e valores numa cultura específica. O enfoque teórico da questão está dado por três elementos que sustentam nossas concepções sobre a prática de enfermagem. Com o primeiro se esboça uma discussão acerca das relações entre ética e enfermagem; com o segundo se expõe o contexto sócio-histórico recente através do qual o cuidado toma sentido como objeto de estudo da enfermagem. O terceiro destaca a dimensão de intersubjetividade e co-construção do cuidado como prática sócio-cultural, e sublinha a necessidade de sondar e comprender o significado que as dimensões morais do cuidado adquirem na condição de sujeito de cuidados. Foi desenvolvida uma investigação com enfoque etnográfico empregando como corpus os textos de entrevistas levadas a cabo durante o processo de transculturação do Caring Behaviors Assessment...


Assuntos
Humanos , Adulto , Atitude do Pessoal de Saúde , Cuidados de Enfermagem/ética , Comportamento , Relações Enfermeiro-Paciente , Padrões de Prática em Enfermagem , Cultura , Entrevistas como Assunto , Satisfação do Paciente
17.
Cienc. enferm ; 16(3): 85-101, dic. 2010. ilus
Artigo em Espanhol | LILACS | ID: lil-582875

RESUMO

Esta investigación tuvo por objeto comprender el fenómeno de la discriminación como parte del aprendizaje del cuidado en estudiantes de enfermería, vale decir, comprender de qué manera experimentan el fenómeno de escoger o priorizar a un individuo sobre otro al momento de dar cuidados. Investigación cualitativa, en la que los datos fueron recopilados mediante entrevistas semiestructuradas complementadas mediante el registro de notas de campo. Muestra intencionada compuesta por estudiantes de enfermería de una universidad del sur de Chile, quienes se encontraban cursando el tercer y cuarto año del plan de estudios, y que habían aprobado los cursos profesionales. Hecho esto, aplicamos el método de casos extremos en base al rendimiento académico como criterio principal. Con apoyo de la herramienta Atlas.ti, los datos acopiados fueron sistematizados y reducidos empleando como guía la Teoría Fundamentada en los datos, llegando a emerger cuatro categorías analíticas. Se concluye que los estudiantes realizan una discriminación en favor de sí mismos, fundamentalmente en base a la patología del sujeto de atención y a factores personales de éste, tales como rostro amable, apertura al diálogo, respuesta comunicativa, entre otros. Encontramos en ellos especial interés por las personas con patologías que les resultan interesantes, conocidas, o bien, aquéllas en las que se presagia una estadía suficientemente larga como para participar de la evolución y evaluar los resultados de un plan de cuidados. Estos elementos surgieron como determinantes en las emociones que producen en los aprendices, instándoles a dedicar un mejor cuidado a unas personas que a otras.


The purpose of the research was to understand the phenomenon of "discrimination" as a part of nursing students learning how to provide nursing care, that is, how students make decisions and prioritize nursing care. Using a qualitative research methodology data collection included the use of semi-structured interviews and field notes. The sample was made up of nursing students enrolled in a nursing program in a university in southern Chile. The students had acquired specific clinical skills and were in the third and fourth years of study. The extreme-case method was used based on students' academic scores as mean criterion. Data were analyzed using the Atlas. ti tool followed by application of Grounded Theory techniques to identify four analytical categories. Results showed that nursing students were able to discriminate for themselves, based mainly on criteria about disease and personal factors, such as the attractiveness of a person's face, openness to dialog, level of communication and so on. Findings showed that students paid special attention to people with 'interesting' diseases, known diseases, or health problems which offered students the opportunity to implement nursing care plans and to assess outcomes. These elements emerged like determinant factors based on the emotions that they produce in the beginning students, triggering them to give better care to some individuals over others.


Assuntos
Humanos , Tomada de Decisões , Discriminação Psicológica , Estudantes de Enfermagem/estatística & dados numéricos , Aprendizagem , Seleção de Pacientes , Chile
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