Relations between tactile sensitivity of the finger, arm, and cheek skin over the lifespan showing decline only on the finger.

Touch sensitivity generally declines with age, contributing to loss of manual dexterity and tactile function. We investigated how touch changes over the lifespan, using different tests and on three body sites. We used a classical test of force detection sensitivity, where calibrated monofilaments were applied passively to the right index finger pad, forearm, and cheek. In addition, at the index, we used an active touch spatial discrimination task, developed by our group. Spatial discrimination was estimated through participants' ability to evaluate the distance between parallel bands printed on acrylic plates. Data were collected from 96 healthy women, aged 20-75 years. Force detection and tactile spatial discrimination on the index deteriorated significantly with age; however, no change was found for tactile detection on the forearm or cheek. Tactile detection on the cheek remained remarkably highly sensitive throughout life. There was a significant positive relationship between force detection and spatial discrimination on the index. Further, force detection on the forearm was significantly associated with detection on the index and cheek. Our results suggest a decrease in touch perception with age on the index finger pad, yet a preservation of tactile sensitivity in hairy skin. This opens discussion about the impact of daily activities upon the glabrous hand skin and on the function of hairs in tactile sensitivity. We highlight the need for new methods in evaluating tactile sensitivity on hairy skin.

Editing of endogenous tubulins reveals varying effects of tubulin posttranslational modifications on axonal growth and regeneration.

Tubulin posttranslational modifications (PTMs) modulate the dynamic properties of microtubules and their interactions with other proteins. However, the effects of tubulin PTMs were often revealed indirectly through the deletion of modifying enzymes or the overexpression of tubulin mutants. In this study, we directly edited the endogenous tubulin loci to install PTM-mimicking or -disabling mutations and studied their effects on microtubule stability, neurite outgrowth, axonal regeneration, cargo transport, and sensory functions in the touch receptor neurons of Caenorhabditis elegans. We found that the status of ß-tubulin S172 phosphorylation and K252 acetylation strongly affected microtubule dynamics, neurite growth, and regeneration, whereas α-tubulin K40 acetylation had little influence. Polyglutamylation and detyrosination in the tubulin C-terminal tail had more subtle effects on microtubule stability likely by modulating the interaction with kinesin-13. Overall, our study systematically assessed and compared several tubulin PTMs for their impacts on neuronal differentiation and regeneration and established an in vivo platform to test the function of tubulin PTMs in neurons.

Accuracy of a novel method for IOP measurement without applying pressure on the cornea.

PURPOSE: To assess the accuracy of a prototype novel instrument for intra ocular pressure (IOP) measurements not involving corneal pressure application. DESIGN: Prospective case control study. METHODS: An institutional study including 16 healthy volunteers without ocular pathology. IOP in both eyes of the participants was measured four times in different body positions with the novel prototype and reference instrument (Goldmann applanation tonometer (GAT) or iCare (iCare Finland OY, Vantaa, Finland)). IOP results were compared between the prototype and the reference instruments in 116 pairs of measurement. RESULTS: Overall no statistically significant difference was found between the presented prototype and the reference instrument. Stratifying measurements by instrument used revealed no significant difference for GAT and statistical significant (yet clinically insignificant) difference for iCare. CONCLUSIONS: The presented prototype demonstrates good clinical agreement of IOP measuring results with reference instruments Further large-scale studies assessing this instrument in glaucoma patients are warranted.

Precise tactile localization on the human fingernail.

Fingernails are specialized features of the primate hand, which are believed to contribute to manual dexterity. The sensorimotor functions of fingernails, however, remain poorly understood. This study investigates the ability of humans to precisely localize touches applied to the fingernail plate. Nine different locations on the fingernail were touched and participants judged the location by clicking a mouse cursor on a photograph of their finger. Performance in this condition was compared with stimuli applied to the skin of the fingertip. The results showed that participants are able to localize touch on the fingernails at substantially higher than chance levels. Moreover, the precision of this ability is not appreciably lower than that of the fingertips. These results show that the fingernail is a highly sensitive sensory organ, which is capable of providing rich spatial information about tactile stimuli.

Efficacy of plantar tactile sensation and balance in patients with subacute stroke following plantar kinesio taping: a randomized, cross-over preliminary study.

BACKGROUND: Kinesio tape (KT) is known to enhance tactile sensation. In stroke rehabilitation, KT is often used alongside conventional therapy (CT) to improve balance recovery. OBJECTIVE: In this study, we aimed to evaluate the effectiveness of plantar KT in enhancing plantar tactile sensation (PTS) and balance ability in subacute stroke patients. METHODS: In this randomized crossover trial, 22 subacute stroke participants were randomly assigned to receive no taping, paretic plantar KT, or bilateral plantar KT, with a 24-h washout period between each condition. All participants underwent 30 min of CT. The primary outcome was PTS, involving tactile sensitivity in five areas on the plantar surface and the contact area with the ground of the paretic foot. The one-leg stand (OLS) time, functional reach test (FRT), and timed up-and-go test (TUG) were employed as secondary outcomes. RESULTS: Paretic plantar KT application led to significant increases in the contact area, OLS, FRT, and TUG test times. Particularly, bilateral plantar KT showed significantly greater improvement in PTS compared to paretic plantar KT. Additionally, bilateral plantar KT significantly improved OLS (p < 0.001, η2 = 0.575), FRT (p < 0.001, η2 = 781), and TUG (p < 0.001, η2 = 0.771) times compared with paretic plantar KT. CONCLUSIONS: This study demonstrated that plantar KT improved PTS and balance ability in stroke rehabilitation. The findings suggest that bilateral plantar KT as an adjunct to CT may have a beneficial effect on balance recovery in patients with subacute stroke. TRIAL REGISTRATION: Clinical trial KCT0009048.

Sequence variations and accessory proteins adapt TMC functions to distinct sensory modalities.

Transmembrane channel-like (TMC) proteins are expressed throughout the animal kingdom and are thought to encode components of ion channels. Mammals express eight TMCs (mTMC1-8), two of which (mTMC1 and mTMC2) are subunits of mechanotransduction channels. C. elegans expresses two TMCs (TMC-1 and TMC-2), which mediate mechanosensation, egg laying, and alkaline sensing. The mechanisms by which nematode TMCs contribute to such diverse physiological processes and their functional relationship to mammalian mTMCs is unclear. Here, we show that association with accessory proteins tunes nematode TMC-1 to divergent sensory functions. In addition, distinct TMC-1 domains enable touch and alkaline sensing. Strikingly, these domains are segregated in mammals between mTMC1 and mTMC3. Consistent with these findings, mammalian mTMC1 can mediate mechanosensation in nematodes, while mTMC3 can mediate alkaline sensation. We conclude that sequence diversification and association with accessory proteins has led to the emergence of TMC protein complexes with diverse properties and physiological functions.

Maternal immune activation affects female offspring whisker movements during object exploration in a rat model of neurodevelopmental disorders.

Poly I:C rat offspring are used to investigate the effects of in utero exposure to maternal immune activation (MIA) and have been suggested as a model of neurodevelopmental disorders (NDD). The behavioural symptoms of this model are diverse and can vary with external factors, including the choice of background strain and husbandry practices. Measuring whisker movements provides quantitative, robust measurements of sensory, motor and cognitive behaviours in rodents. In this study, whisker movements were investigated in 50-day-old male and female offspring of MIA-exposed rat dams and compared to age-matched offspring of control (vehicle) dams. Rat offspring were filmed using high-speed videography in a sequential object exploration task with smooth and textured objects. Poly I:C treatment effects were found in female offspring that did not increase whisker mean angular position during object exploration, especially for the smooth object, indicating an attentional deficit. Whisker tracking during object exploration is demonstrated here, for the first time, as a useful, quick and non-invasive tool to identify both treatment effects and sex differences in a model of MIA-induced NDDs.

The Effects of Osteopathic Manipulative Treatment on Brain Activity: A Scoping Review of MRI and EEG Studies.

Osteopathic manipulative treatment (OMT) is a hands-on therapy aiming to achieve the global homeostasis of the patient. OMT focuses on treating the somatic dysfunctions characterized by tissue modifications, body asymmetry, and range-of-motion restrictions. The benefits related to OMT are thought to be associated with the interconnectedness of the body's systems and the inherent capacity for self-healing. However, whether OMT can influence brain activity, and, consequently, neurophysiological responses is an open research question. Our research investigates the literature to identify the effects of OMT on brain activity. The main purpose of the research question is: can OMT influence brain activity and consequently neurophysiological responses? A scoping review was conducted, searching the following databases: PubMed, Google Scholar, and OSTEOMED.DR (Osteopathic Medical Digital Repository), Scopus, Web of Science (WoS), and Science Direct. The initial search returned 114 articles, and after removing duplicates, 69 were considered eligible to be included in the final sample. In the end, eight studies (six randomized controlled trials, one pilot study, and one cross-over study) were finally included and analyzed in this review. In conclusion, OMT seems to have a role in influencing functional changes in brain activity in healthy individuals and even more in patients with chronic musculoskeletal pain. However, further RCT studies are needed to confirm these findings. Registration protocol: CRD42024525390.

Sleep, Mental Health, and the Need for Physical and Real-Life Social Contact with (Non-)Family Members during the COVID-19 Pandemic: A Bayesian Network Analysis.

Background/Objectives: The forced social isolation implemented to prevent the spread of the COVID-19 virus was accompanied by a worsening of mental health, an increase in insomnia symptoms, and the emergence of 'skin hunger'-an increased longing for personal touch. This study aimed to enhance our understanding of the interconnection between sleep, mental health, and the need for physical (NPC) and real-life social contact (NRL-SC). Methods: A total of 2827 adults participated in an online survey during the second COVID-19 lockdown. A Bayesian Gaussian copula graphical model (BGCGM) and a Bayesian-directed acyclic graph (DAG) were estimated, and mixed ANOVAs were carried out. Results: NPC with non-family members (t(2091) = 12.55, p < 0.001, d = 0.27) and relational lifestyle satisfaction (t(2089) = 13.62, p < 0.001, d = 0.30) were lower during the second lockdown than before the pandemic. In our BGCGM, there were weak positive edges between the need for PC and RL-SC on one hand and sleep and mental health on the other. Conclusions: During the second lockdown, people craved less physical contact with non-family members and were less satisfied with their relational lifestyle than before the pandemic. Individuals with a greater need for PC and RL-SC reported poorer mental health (i.e., worry, depression, and mental fatigue).

Texture perception at the foot sole: Comparison between walking, sitting, and to the hand.

We frequently interact with textured surfaces with both our feet and hands. Like texture's importance for grasping, texture perception via the foot sole might provide important signals about the stability of a surface, aiding in maintaining balance. However, how textures are perceived by the foot, and especially under the high forces experienced during walking, is unknown. The current study builds on extensive research investigating texture perception at the hand by presenting everyday textures to the foot while stepping onto them, exploring them with the foot while sitting, and exploring them with the hand. Participants rated each texture along three perceptual dimensions: roughness, hardness, and stickiness. Participants also rated how stable their posture felt when standing upon each texture. Results show that perceptual ratings of each textural dimension were highly correlated across conditions. Hardness exhibited the greatest consistency and stickiness the weakest. Moreover, correlations between stepping and exploration with the foot were lower than those between exploration with the foot and exploration with the hand, suggesting that mode of interaction (high vs low force) impacts perception more than body region used (foot vs hand). On an individual level, correlations between conditions were higher than those between participants, suggesting that differences are greater between individuals than between mode of interaction or body region. When investigating the relationship to perceived stability, only hardness contributed significantly, with harder surfaces rated as more stable. Overall, tactile perception appears consistent across body regions and interaction modes, although differences in perception are greater during walking.

Sensing and feeling: an overview.

Emotional experiences are driven, in part, by the way we process and integrate information from different sensory modalities. Understanding how perceptual and emotional systems interact to give rise to subjective feelings is an important, complex and challenging issue, requiring new approaches and integrative thinking that fuses the fundamentals of low-level sensory perception with higher-level cognitive and affective processes. The Theme Issue 'Sensing and feeling: an integrative approach to sensory processing and emotional experience' showcases fifteen theoretical, empirical, and review articles from experts working at the intersection of perception and emotion, encompassing multiple sensory systems (visual, auditory, tactile and interoceptive), clinical and non-clinical perspectives (e.g. affective disorders and hearing loss), contextual and social perspectives, and complex emotional experiences in special populations. Articles in Part 1 emphasize recent advances across fields in sensory and emotion science and give insights into future directions. Each article in Part 2 provides more detailed and specific methodological approaches or theoretical models, and focuses on basic mechanisms linking sensation to emotional experience. This article is part of the theme issue 'Sensing and feeling: an integrative approach to sensory processing and emotional experience'.

No-touch isolation technique in emergency pancreaticoduodenectomy for neoplastic hemorrhage: Two case reports and review of literature.

BACKGROUND: Emergency pancreaticoduodenectomy (EPD) is a rare event for complex periampullary etiology. Increased intraoperative blood loss is correlated with poor postoperative outcomes. CASE SUMMARY: Two patients underwent EPD using a no-touch isolation technique, in which all arteries supplying the pancreatic head region were ligated and divided before manipulation of the pancreatic head and duodenum. The operative times were 220 and 239 min, and the blood loss was 70 and 270 g, respectively. The patients were discharged on the 14th and 10th postoperative day, respectively. Thirty-two patients underwent EPD for the treatment of neoplastic bleeding. The mean operative time was 361.6 min, and the mean blood loss was 747.3 g. The complication rate was 37.5%. The in-hospital mortality rate was 9.38%. CONCLUSION: The no-touch isolation technique is feasible, safe, and effective for reducing intraoperative blood loss in EPD.

Primary somatosensory cortical processing in tactile communication.

Touch is an essential form of non-verbal communication. While language and its neural basis are widely studied, tactile communication is less well understood. We used fMRI and multivariate pattern analyses in pairs of emotionally close adults to examine the neural basis of human-to-human tactile communication. In each pair, a participant was designated either as sender or as receiver. The sender was instructed to communicate specific messages by touching only the arm of the receiver, who was inside the scanner. The receiver then identified the message based on the touch expression alone. We designed two multivariate decoder algorithms-one based on the sender's intent (sender-decoder), and another based on the receiver's response (receiver-decoder). We identified several brain areas that significantly predicted behavioural accuracy of the receiver. Regarding our a priori region of interest, the receiver's primary somatosensory cortex (S1), both decoders were able to accurately differentiate the messages based on neural activity patterns here. The receiver-decoder, which relied on the receivers' interpretations of the touch expressions, outperformed the sender-decoder, which relied on the sender's intent. Our results identified a network of brain areas involved in human-to-human tactile communication and supported the notion of non-sensory factors being represented in S1. This article is part of the theme issue 'Sensing and feeling: an integrative approach to sensory processing and emotional experience'.

C. elegans touch receptor neurons direct mechanosensory complex organization via repurposing conserved basal lamina proteins.

The sense of touch is conferred by the conjoint function of somatosensory neurons and skin cells. These cells meet across a gap filled by a basal lamina, an ancient structure found in metazoans. Using Caenorhabditis elegans, we investigate the composition and ultrastructure of the extracellular matrix at the epidermis and touch receptor neuron (TRN) interface. We show that membrane-matrix complexes containing laminin, nidogen, and the MEC-4 mechano-electrical transduction channel reside at this interface and are central to proper touch sensation. Interestingly, the dimensions and spacing of these complexes correspond with the discontinuous beam-like extracellular matrix structures observed in serial-section transmission electron micrographs. These complexes fail to coalesce in touch-insensitive extracellular matrix mutants and in dissociated neurons. Loss of nidogen reduces the density of mechanoreceptor complexes and the amplitude of the touch-evoked currents they carry. Thus, neuron-epithelium cell interfaces are instrumental in mechanosensory complex assembly and function. Unlike the basal lamina ensheathing the pharynx and body wall muscle, nidogen recruitment to the puncta along TRNs is not dependent upon laminin binding. MEC-4, but not laminin or nidogen, is destabilized by point mutations in the C-terminal Kunitz domain of the extracellular matrix component, MEC-1. These findings imply that somatosensory neurons secrete proteins that actively repurpose the basal lamina to generate special-purpose mechanosensory complexes responsible for vibrotactile sensing.

Psychometric evaluation of the Social Touch Questionnaire in Chinese adolescents.

Social touch promotes psychological well-being through inducing positive effects on social affiliation and stress alleviation, especially in adolescence. However, there is a scarcity of instruments available for evaluating adolescents' attitude toward social touch in China. The present study aimed to investigate the validity and reliability of the Social Touch Questionnaire (STQ) in Chinese adolescents. A total of 2839 high school students were enrolled, ranging in age from 11 to 19 years. The dimensions of the scale were conducted by exploratory factor analysis, and validated by confirmatory factor analysis. A three-factor model showed the best fit and consisted of the following subgroups: liking of informal social touch, liking of general social touch, and dislike of social touch. Furthermore, positive associations were found between social touch and interaction anxiety, fear of negative evaluation, depressive and anxiety symptoms, and sleep quality. Short-term prediction of dislike of social touch in anxiety symptoms was determined, while no significant predictor of depressive symptoms was found. The STQ demonstrates reliability and validity as a self-report questionnaire designed to assess behaviors and attitudes toward social touch. It effectively adapts to the nuances of the Chinese context among adolescents.

The impact of mechanical stress on anatomy, morphology, and gene expression in Urtica dioica L.

MAIN CONCLUSION: Mechanical stress induces distinct anatomical, molecular, and morphological changes in Urtica dioica, affecting trichome development, gene expression, and leaf morphology under controlled conditions The experiments were performed on common nettle, a widely known plant characterized by high variability of leaf morphology and responsiveness to mechanical touch. A specially constructed experimental device was used to study the impact of mechanical stress on Urtica dioica plants under strictly controlled parameters of the mechanical stimulus (touching) and environment in the growth chamber. The general anatomical structure of the plants that were touched was similar to that of control plants, but the shape of the internodes' cross section was different. Stress-treated plants showed a distinct four-ribbed structure. However, as the internodes progressed, the shape gradually approached a rectangular form. The epidermis of control plants included stinging, glandular and simple setulose trichomes, but plants that were touched had no stinging trichomes, and setulose trichomes accumulated more callose. Cell wall lignification occurred in the older internodes of the control plants compared to stress-treated ones. Gene analysis revealed upregulation of the expression of the UdTCH1 gene in touched plants compared to control plants. Conversely, the expression of UdERF4 and UdTCH4 was downregulated in stressed plants. These data indicate that the nettle's response to mechanical stress reaches the level of regulatory networks of gene expression. Image analysis revealed reduced leaf area, increased asymmetry and altered contours in touched leaves, especially in advanced growth stages, compared to control plants. Our results indicate that mechanical stress triggers various anatomical, molecular, and morphological changes in nettle; however, further interdisciplinary research is needed to better understand the underlying physiological mechanisms.

Choice enhances touch pleasantness.

We value what we choose more than what is imposed upon us. Choice-induced preferences are extensively demonstrated using behavioural and neural methods, mainly involving rewarding objects such as money or material goods. However, the impact of choice on experiences, especially in the realm of affective touch, remains less explored. In this study, we specifically investigate whether choice can enhance the pleasure derived from affective touch, thereby increasing its intrinsic rewarding value. We conducted an experiment in which participants were being touched by an experimenter and asked to rate how pleasant their experience of touch was. They were given either a choice or no choice over certain touch stimulus variables which differed in their relevance: some were of low relevance (relating to the colour of the glove that the experimenter would use to touch them), while others were of high relevance (relating to the location on their arm where they would be stroked). Before and during touching, pupillometry was used to measure the level of arousal. We found that having a choice over aspects of tactile stimuli-especially those relevant to oneself-enhanced the pleasant perception of the touch. In addition, having a choice increases arousal in anticipation of touch. Regardless of how relevant it is to the actual tactile stimulus, allowing one to choose may positively enhance a person's perception of the physical contact they receive.

The reliability and applicability of the Ten Test in hand injuries: A systematic review.

Introduction: The Ten Test (TT) is a touch threshold test that quantifies sensory discrimination by comparing an injured area with a contralateral uninjured area. It's quick, simple, equipment-free and repeatable. However, as a subjective measure, the TT's reliability and applicability need further investigation. This review aimed to investigate if the TT has superior inter- and intra-examiner reliability compared to the widely accepted Weinstein Enhanced Sensory Test (WEST) in a human population of all ages. Methods: A systematic search was conducted on major databases from January 1997 to September 2023 and adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol. Outcomes were assessed with a narrative approach. The included articles were critically appraised according to the Quality Assessment of Diagnostic Accuracy Studies two tool. Results: This review included five articles. High inter-examiner reliability was demonstrated with intraclass correlation coefficient (ICC) values of 0.91 and 0.95, alongside a kappa statistic of 1, as reported by three distinct studies. Intra-examiner reliability displayed some variance, with one study reporting a significant ICC value in four out of six instances. Two studies corroborated that the TT results corresponded with the findings of WEST, each presenting a Spearman rank coefficient of -0.71. Conclusion: Our findings underscore the TT's high inter-examiner reliability, though its intra-examiner reliability exhibited some inconsistencies. Interestingly, certain studies claimed its superiority over the WEST. To validate the TT's use in the clinical setting, more rigorous studies, particularly those comparing pre-operative TT outcomes with intraoperative nerve damage evaluations, are essential.

Research on Convex Fiber Grating Tactile Sliding Sensor Based on Mechanical Fingers.

In order to solve the problem of flexible sliding tactile composite sensing in the actual grasp of intelligent robot fingers, this paper proposes a research on a convex fiber grating tactile sliding sensor based on mechanical fingers. Based on the sensing principle of fiber Bragg grating, 3D printing technology was used to encapsulate the FBG sensor array with elastic 50 A resin, a double-layer "hemispherical cuboid" distributed sensing unit was designed, and the FBG slippery tactile sensor was actually pasted on the surface of the mechanical finger for static and dynamic experiments. The experimental results show that the slippery tactile sensor designed in this paper has a good linear relationship with temperature and strain. The temperature sensitivities of the polymer-packaged FBGs are KT1 = 13.04 pm/°C and KT2 = 12.91 pm/°C, and they have a pressure sensitivity of 40.4 pm/N and 31.2 pm/N, respectively. The FBG sliding tactile sensor not only realizes the identification of the sliding signal generation point and the end point but also completes the classification and identification of sandpaper, cardboard, and polypropylene plastic, and it has a high degree of fit with the robot finger, which has certain application value for the intelligent robot sliding tactile signal perception.

Reducing CLABSI through a quality strategy for the implementation of the aseptic non-touch technique in a pediatric ward.

BACKGROUND: Central line-associated bloodstream infections (CLABSIs) are among the most epidemiologically relevant health care-associated infections. The aseptic non-touch technique (ANTT) is a standardized practice used to prevent CLABSIs. In a pediatric hospital, the overall CLABSI rate was 1.92/1000 catheter days (CD). However, in one unit, the rate was 5.7/1000 CD. METHODS: Nurses were trained in ANTT. For the implementation, plan-do-study-act (PDSA) cycles were completed. Adherence monitoring of the ANTT and epidemiological surveillance were performed. RESULTS: ANTT adherence of 95% was achieved after 6 PDSA cycles. Hand hygiene and general cleaning reached 100% adherence. Port disinfection and material collection had the lowest adherence rates, with 76.2% and 84.7%, respectively. The CLABSI rate decreased from 5.7 to 1.26/1000 CD. CONCLUSION: The implementation of ANTT helped reduce the CLABSI rate. Training and continuous monitoring are key to maintaining ANTT adherence.

INTRODUCCIÓN: Las infecciones relacionadas con catéteres venosos centrales son unas de las infecciones asociadas a la atención de salud con mayor relevancia epidemiológica. La técnica aséptica «no tocar¼ es una práctica estandarizada que se utiliza para prevenir estas infecciones. En un hospital pediátrico, la tasa de infecciones relacionadas con catéteres venosos centrales fue de 1.92/1000 días de catéter. Sin embargo, en una de las unidades la tasa fue de 5.7/1000 días de catéter. MÉTODO: Se capacitaron enfermeras en la técnica aséptica «no tocar¼. Para la implementación se cumplieron ciclos de planificar-hacer-estudiar-actuar (PHEA). Se realizaron seguimiento de la adherencia a la técnica y vigilancia epidemiológica. RESULTADOS: Se logró una adherencia a la técnica aséptica «no tocar¼ del 95% después de seis ciclos. La higiene de manos y la limpieza general alcanzaron un 100% de cumplimiento. La desinfección de los puertos y la recolección de material alcanzaron la menor adherencia, con un 76.2% y un 84.7%, respectivamente. La tasa de infecciones relacionadas con catéteres venosos centrales disminuyó de 5.7 a 1.26 por 1000 días de catéter. CONCLUSIONES: La implementación de la técnica aséptica «no tocar¼ ayudó en la reducción de infecciones relacionadas con catéteres venosos centrales. La capacitación y el seguimiento continuo son clave para mantener el cumplimiento de la técnica.