A Trip Back Home: Resistance to Herbivores of Native and Non-Native Plant Populations of Datura stramonium.

When colonizing new ranges, plant populations may benefit from the absence of the checks imposed by the enemies, herbivores, and pathogens that regulated their numbers in their original range. Therefore, rates of plant damage or infestation by natural enemies are expected to be lower in the new range. Exposing both non-native and native plant populations in the native range, where native herbivores are present, can be used to test whether resistance mechanisms have diverged between populations. Datura stramonium is native to the Americas but widely distributed in Spain, where populations show lower herbivore damage than populations in the native range. We established experiments in two localities in the native range (Mexico), exposing two native and two non-native D. stramonium populations to natural herbivores. Plant performance differed between the localities, as did the abundance of the main specialist herbivore, Lema daturaphila. In Teotihuacán, where L. daturaphila is common, native plants had significantly more adult beetles and herbivore damage than non-native plants. The degree of infestation by the specialist seed predator Trichobaris soror differed among populations and between sites, but the native Ticumán population always had the lowest level of infestation. The Ticumán population also had the highest concentration of the alkaloid scopolamine. Scopolamine was negatively related to the number of eggs deposited by L. daturaphila in Teotihuacán. There was among-family variation in herbivore damage (resistance), alkaloid content (scopolamine), and infestation by L. daturaphila and T. soror, indicating genetic variation and potential for further evolution. Although native and non-native D. stramonium populations have not yet diverged in plant resistance/constitutive defense, the differences between ranges (and the two experimental sites) in the type and abundance of herbivores suggest that further research is needed on the role of resource availability and adaptive plasticity, specialized metabolites (induced, constitutive), and the relationship between genealogical origin and plant defense in both ranges.

Transduction of Amine-Phosphate Supramolecular Interactions and Biosensing of Acetylcholine through PEDOT-Polyamine Organic Electrochemical Transistors.

Organic electrochemical transistors (OECTs) are important devices for the development of flexible and wearable sensors due to their flexibility, low power consumption, sensitivity, selectivity, ease of fabrication, and compatibility with other flexible materials. These features enable the creation of comfortable, versatile, and efficient portable devices that can monitor and detect a wide range of parameters for various applications. Herein, we present OECTs based on PEDOT-polyamine thin films for the selective monitoring of phosphate-containing compounds. Our findings reveal that supramolecular single phosphate-amino interaction induces higher changes in the OECT response compared to ATP-amino interactions, even at submillimolar concentrations. The steric character of binding anions plays a crucial role in OECT sensing, resulting in a smaller shift in maximum transconductance voltage and threshold voltage for bulkier binding species. The OECT response reflects not only the polymer/solution interface but also events within the conducting polymer film, where ion transport and concentration are affected by the ion size. Additionally, the investigation of enzyme immobilization reveals the influence of phosphate species on the assembly behavior of acetylcholinesterase (AchE) on PEDOT-PAH OECTs, with increasing phosphate concentrations leading to reduced enzyme anchoring. These findings contribute to the understanding of the mechanisms of OECT sensing and highlight the importance of careful design and optimization of the biosensor interface construction for diverse sensing applications.

Mechanistic Insights into the Thermal Decomposition of Ammonium Perchlorate: The Role of Amino-Functionalized Magnetic Nanoparticles.

This work reports the characterization and application of two promising nanocatalysts for the thermal decomposition of ammonium perchlorate (AP). To obtain these composite materials, magnetite nanoparticles (Fe3O4 NPs) were functionalized with two different amine derivative groups, tertiary amine (Fe3O4 NPs-A1) and quaternary amine. X-ray photoelectron spectroscopy and differential scanning calorimetry provided mechanistic insights into the thermal decomposition of AP. Furthermore, tertiary and quaternary amine groups play a critical role, where the presence of an extra proton could favor an electron-proton transfer as the rate-determining step. Moreover, Fe3O4 NPs-A1 causes a diminution of the high-temperature decomposition of AP positively to 335 °C, increasing the energy release by 278 J g-1 and consequently affording the lowest activation energy (102 kJ mol-1), indicating a low degree of thermal stability, and accelerating the thermal decomposition of AP.

Heterobimetallic Catalysts for the Thermal Decomposition of Ammonium Perchlorate: Efficient Burning Rate Catalysts for Solid Rocket Motors and Missiles.

We show the synthesis and characterization of four heterobimetallic compounds derived from s-indacene of general formula [{(CO)3Mn}-s-Ic-{MCp*}]q with M = Fe, Co, Ni, and Ru; q = 0, 1+. The complexes reported here were characterized by 1H and 13C NMR, elemental analysis and FT-IR. Additionally, the X-ray crystal structure of [(CO)3Mn-s-Ic-FeCp*] (1) and Mössbauer spectra are reported. The heterobimetallic compounds exhibit higher quasireversible redox potentials compared with ferrocene and catocene under the same reaction conditions. The complexes were tested as catalysts on the thermal decomposition of ammonium perchlorate examined by a differential scanning calorimetry technique to study their catalytic behavior. Compound (1) causes a decrease of ammonium perchlorate's decomposition temperature to 315 °C, consequently increasing the heat release by 138 J·g-1. Conversely, [{(CO)3Mn}-s-Ic'-{CoCp*}] (2) presents a higher heat release (2462 J·g-1), comparable to catocene.

[Innovation in the organization of health services delivery within the Metropolitan System of Solidarity in Peru]. / La innovación en la organización de servicios con el Sistema Metropolitano de la Solidaridad en Perú

OBJECTIVE: Based on the results achieved to date by the Metropolitan System of Solidarity (SISOL) in Peru, this study undertook to analyze the extent to which SISOL has contributed to innovation in the organization of health services delivery. METHODS: SISOL performance indicators were analyzed and compared with those of other health services delivery models in Peru, drawing on data from a survey of 4 570 SISOL users conducted in the last quarter of 2011, National Household Surveys from 2003 through 2011, and statistical data from the Peruvian Ministry of Health and Social Security. RESULTS: SISOL rated high in terms of growth of the demand served in Lima, productivity of human resources in office visits, and levels of user satisfaction. These results are attributed to: (a) the presence of specialists at the first level of care; (b) an innovative public-private structure, as opposed to outsourcing; and (c) a system of incentives based on shared risk management. CONCLUSIONS: The findings support the need for primary health care renewal, especially in urban areas to reduce the proliferation of unnecessary levels and sublevels of care. They also point to the possibility of developing synergistic public-private partnerships in which both sectors share risks and act in collaboration within a single service system. And finally, they indicate that primary care needs to be articulated into the segmented models.

La innovación en la organización de servicios con el Sistema Metropolitano de la Solidaridad en Perú / Innovation in the organization of health services delivery within the Metropolitan System of Solidarity in Peru

OBJETIVO: Tomando como referencia los resultados logrados hasta el momento por el Sistema Metropolitano de la Solidaridad (SISOL) en Perú, el presente trabajo tuvo como objetivo analizar su contribución a la innovación de modelos de organización en la provisión de servicios de salud. MÉTODOS: Se evaluaron los indicadores de desempeño de SISOL, contrastándolos con los de otros modelos de prestación sanitaria del país, con base en datos de una encuesta a 4570 usuarios de SISOL efectuada en el último trimestre del 2011, en las Encuestas Nacionales de Hogares de los años 2003 a 2011 e información estadística del Ministerio de Salud y el Seguro Social peruanos. RESULTADOS: El estudio arrojó resultados positivos para SISOL en términos de crecimiento de la demanda atendida en Lima, la productividad de consultas por recurso humano y los niveles de satisfacción de los usuarios. Tales resultados se explican por a) la presencia de especialistas en el primer nivel de atención; b) una estructura público-privada innovadora, diferente de la tercerización, y c) un sistema de incentivos basado en la gestión de riesgos compartidos. CONCLUSIONES: Los resultados apoyan la necesidad de renovar la atención primaria en salud, en particular para las zonas urbanas, corrigiendo el innecesario escalonamiento que predomina en la actualidad. Muestran además la posibilidad de alianzas público-privadas sinérgicas, donde ambos sectores compartan riesgos y actúen colaborativamente en un solo sistema de servicios. Por último, los resultados convocan a la articulación de la atención primaria en los modelos segmentados.

OBJECTIVE: Based on the results achieved to date by the Metropolitan System of Solidarity (SISOL) in Peru, this study undertook to analyze the extent to which SISOL has contributed to innovation in the organization of health services delivery. METHODS: SISOL performance indicators were analyzed and compared with those of other health services delivery models in Peru, drawing on data from a survey of 4 570 SISOL users conducted in the last quarter of 2011, National Household Surveys from 2003 through 2011, and statistical data from the Peruvian Ministry of Health and Social Security. RESULTS: SISOL rated high in terms of growth of the demand served in Lima, productivity of human resources in office visits, and levels of user satisfaction. These results are attributed to: (a) the presence of specialists at the first level of care; (b) an innovative public-private structure, as opposed to outsourcing; and (c) a system of incentives based on shared risk management. CONCLUSIONS: The findings support the need for primary health care renewal, especially in urban areas to reduce the proliferation of unnecessary levels and sublevels of care. They also point to the possibility of developing synergistic public-private partnerships in which both sectors share risks and act in collaboration within a single service system. And finally, they indicate that primary care needs to be articulated into the segmented models.

The SLC12 family of electroneutral cation-coupled chloride cotransporters.

The SLC12 family encodes electroneutral cation-coupled chloride cotransporters that are critical for several physiological processes including cell volume regulation, modulation of intraneuronal chloride concentration, transepithelial ion movement, and blood pressure regulation. Members of this family are the targets of the most commonly used diuretic drugs, have been shown to be the causative genes for inherited disease such as Gitelman, Bartter and Andermann syndromes, and potentially play a role in polygenic complex diseases like arterial hypertension, epilepsy, osteoporosis, and cancer.

Insulin increases the functional activity of the renal NaCl cotransporter.

OBJECTIVES: Insulin is recognized to increase renal salt reabsorption in the distal nephron and hyperinsulinemic states have been shown to be associated with increased expression of the renal NaCl cotransporter (NCC). However, the effect of insulin on NCC functional activity has not been reported. METHODS: Using a heterologous expression system of Xenopus laevis oocytes, a mouse distal convoluted cell line, mDCT15 cells, endogenously expressing NCC, and an ex-vivo kidney perfusion technique, we assessed the effect of insulin on the activity and phosphorylation of NCC. The signaling pathway involved was analyzed. RESULTS: In Xenopus oocytes insulin increases the activity of NCC together with its phosphorylation at threonine residue 58. Activation of NCC by insulin was also observed in mDCT15 cells. Additionally, insulin increased the NCC phosphorylation in kidney under the ex-vivo perfusion technique. In oocytes and mDCT15 cells, insulin effect on NCC was prevented with inhibitors of phosphatidylinositol 3-kinase (PI3K), mTORC2, and AKT1 kinases, but not by inhibitors of MAP or mTORC1 kinases, suggesting that PI3K-mTORC2-AKT1 is the intracellular pathway required. Additionally, activation of NCC by insulin was not affected by wild-type or mutant versions of with no lysine kinase 1, with no lysine kinase 4, or serum glucocorticoid kinase 1, but it was no longer observed in the presence of wild-type or the dominant negative, catalytically inactive with no lysine kinase 3, implicating this kinase in the process. CONCLUSION: Insulin induces activation and phosphorylation of NCC. This effect could play an important role in arterial hypertension associated with hyperinsulinemic states, such as obesity, metabolic syndrome, or type 2 diabetes mellitus.

Single-incision laparoscopic cholecystectomy: is it a plausible alternative to the traditional four-port laparoscopic approach?

The current standard-of-care for treatment of cholecystectomy is the four port laparoscopic approach. The development of single incision/laparoendoscopic single site surgery (SILC/LESS) has now led to the development of new techniques for removal of the gallbladder. The use of SILC/LESS is now currently being evaluated as the next step in treatment of cholecystectomy. This review is an attempt to consolidate the current knowledge and analyze the feasibility of world-wide implementation of SILC/LESS.

Advances in WNK signaling of salt and potassium metabolism: clinical implications.

Recent evidence due to the discovery of a family of kinases implicated in arterial hypertension now points to the underlying molecular mechanisms that dictate Na(+), K(+) and water handling in the nephron. These new key players need to be understood in order to fully comprehend the pathophysiology, manifestations, and treatment of common clinical entities such as hypovolemic shock, congestive heart failure, primary hyperaldosteronism, nephrotic syndrome and hypertension. It is through the analysis of the volume status and electrolyte abnormalities that commonly present with these diseases that we can begin to create a link between the abstract concept of a kinase regulation and how a patient will respond to a particular treatment. This review is an attempt to bridge that gap.

Independent regulation of Na+ and K+ balance by the kidney.

The understanding of the independent regulation of sodium and potassium by the kidney has remained elusive. Recent evidence now points to dissimilar regulatory mechanisms in ion handling, dependent on the presence of either aldosterone alone or angiotensin II with aldosterone among other factors. This review summarizes past and present information in an attempt to reconcile the current concepts of differential regulation of sodium and potassium balance through the with-no-lysine (K) kinase (WNK) system and the previous knowledge regarding ion transport mechanisms in the distal nephron.

Nedd4-2 modulates renal Na+-Cl- cotransporter via the aldosterone-SGK1-Nedd4-2 pathway.

Regulation of renal Na(+) transport is essential for controlling blood pressure, as well as Na(+) and K(+) homeostasis. Aldosterone stimulates Na(+) reabsorption by the Na(+)-Cl(-) cotransporter (NCC) in the distal convoluted tubule (DCT) and by the epithelial Na(+) channel (ENaC) in the late DCT, connecting tubule, and collecting duct. Aldosterone increases ENaC expression by inhibiting the channel's ubiquitylation and degradation; aldosterone promotes serum-glucocorticoid-regulated kinase SGK1-mediated phosphorylation of the ubiquitin-protein ligase Nedd4-2 on serine 328, which prevents the Nedd4-2/ENaC interaction. It is important to note that aldosterone increases NCC protein expression by an unknown post-translational mechanism. Here, we present evidence that Nedd4-2 coimmunoprecipitated with NCC and stimulated NCC ubiquitylation at the surface of transfected HEK293 cells. In Xenopus laevis oocytes, coexpression of NCC with wild-type Nedd4-2, but not its catalytically inactive mutant, strongly decreased NCC activity and surface expression. SGK1 prevented this inhibition in a kinase-dependent manner. Furthermore, deficiency of Nedd4-2 in the renal tubules of mice and in cultured mDCT(15) cells upregulated NCC. In contrast to ENaC, Nedd4-2-mediated inhibition of NCC did not require the PY-like motif of NCC. Moreover, the mutation of Nedd4-2 at either serine 328 or 222 did not affect SGK1 action, and mutation at both sites enhanced Nedd4-2 activity and abolished SGK1-dependent inhibition. Taken together, these results suggest that aldosterone modulates NCC protein expression via a pathway involving SGK1 and Nedd4-2 and provides an explanation for the well-known aldosterone-induced increase in NCC protein expression.

Recursos humanos en salud al 2011: evidencias para la toma de decisiones / Health manpower to 2011: evidence for decision making

El presente documento sistematiza los avances y dificultades en relación a la línea de base de discusión y generación de propuestas en el campo de los recursos humanos, así como identifica las nuevas tendencias o fenómenos generados al 2011, haciendo pública la información y análisis de la problemática de recursos humanos en salud en el Perú.

Recursos humanos en salud al 2011: Evidencias para la toma de decisiones / Health manpower to 2011: Evidence for decision making

El presente documento sistematiza los avances y dificultades en relación a la línea de base de discusión y generación de propuestas en el campo de los recursos humanos, así como identifica las nuevas tendencias o fenómenos generados al 2011, haciendo pública la información y análisis de la problemática de recursos humanos en salud en el Perú(AU)

Aldosterone paradox: differential regulation of ion transport in distal nephron.

The mechanisms through which aldosterone promotes apparently opposite effects like salt reabsorption and K(+) secretion remain poorly understood. The identification, localization, and physiological analysis of ion transport systems in distal nephron have revealed an intricate network of interactions between several players, revealing the complex mechanism behind the aldosterone paradox. We review the mechanisms involved in differential regulation of ion transport that allow the fine tuning of salt and K(+) balance.

The health benefits of social mobilization: experiences with community-based Integrated Management of Childhood Illness in Chao, Peru and San Luis, Honduras.

This article reviews the implementation of the community component of the Integrated Management of Childhood Illness (IMCI) strategy in Chao, Peru (2001 to 2004) and San Luis, Honduras (2003 to 2005). An evaluation was conducted in 2005 and included a project documentation review, key-informant interviews, and a household level baseline and follow-up survey of the WHO/UNICEF key family practices in each intervention site. The promotion of the key family practices in Chao and San Luís demonstrated measurable success. In comparison with the initial survey in 2002, the percentage of participant mothers ( N = 78) in Chao in 2004 who knew that they should breastfeed exclusively for at least six months increased from 33% to 94%; the presentation of complete vaccination records for one-year-old children increased by 19%; the recognition of danger signs for pneumonia increased 18% and for diarrhea by 8%; and the percentage of mothers who received four or more prenatal check-ups increased by 25%. A dramatic reduction in malaria cases was also attributed to the intervention in Chao. In San Luis, a quasi-experimental, random household sample ( N = 300) showed that the incidence of diarrheal disease among children under five years old declined by 18% between survey rounds (from 44% in August 2004 to 26% in December 2005). Social mobilization has promoted inter-sector consensus-building around community health issues, especially those related to maternal and child health. The promotion of the participation of representatives from various organizations via the community IMCI social-actor methodology has led to increased civic cooperation. Positive changes in health behaviors have been documented through an increase in preventive health practices, greater demand for primary health care services, and concrete community actions to improve public health.

Estudio "análisis y propuesta de criterios de acreditación de campos de práctica en la formación de pre y postgrado de los profesionales de salud" / Study "analysis and proposal of criteria of accreditation of fields of practice in the pre and post-graduate training of health professionals"

El presente informe resume los resultados del "Estudio sobre Campos de Práctica en la Formación en Salud" encargado por el Instituto de Desarrollo de Recursos Humanos em Salud (IDREH) y el Proyecto AMARES.El estudio se llevó adelante en los meses de noviembre y diciembre del 2006 y enero Del 2007, y tuvo como objetivo "contribuir a la identificación y dimensionamiento de lós problemas relacionados a los espacios de aprendizaje y campos de práctica, en lãs instituciones de salud del país, en particular en Lima Metropolitana, con vistas a mejorar su regulación". Este propósito hizo que el estudio fuese a la vez descriptivo, exploratorio y propositivo, esto es, buscase arribar a un cuadro dimensionado de la situación de la asignación y utilización de los campos de práctica clínica en la formación en salud, pero también explorase las percepciones de los principales actores sociales sobre la regulación de lós denominados "campos clínicos", y plantease recomendaciones sobre el marco regulatório y estándares de acreditación de campos de práctica clínica en formación en salud.

Los sistemas descentrados de recursos humanos en salud: el caso del Perú, 1990-2005 / Unbalanced human resources systems in health: the Peruvian case, 1990-2005

El artículo concluye que el Perú es hoy un ejemplo de un sistema descentrado de recursos humanos en salud, por haber vivido un ciclo largo de deterioro, que empezó en la década de los 90, que lo ha llevado a un dislocamiento entre la oferta y demanda de recursos humanos en salud, la no gobernabilidad de la formación en salud y un trade off entre el desempeño y la precarización salarial y laboral del personal. Se analizan cinco cambios: a) el dislocamiento entre el mundo del trabajo y el mundo de la formación en salud; b) la ampliación de la producción de servicios de salud, a partir de un mayor rendimiento de la fuerza laboral; c) el cambio del régimen laboral, la pauperización del personal y afectación del status de las profesiones de salud; d) la "revolución de las capacidades" del personal de salud y su viraje a la formación de postgrado, la educación continua y al gerencialismo; y e) el reemplazo de la gobernanza y gobernabilidad por la autorregulación, en un contexto de ausencia de un punto de equilibrio del sistema de recursos humanos que promueva rectificaciones. Se concluye que las políticas de recursos humanos desean desarrollar competencias y desempeño sin promover el desarrollo humano de la fuerza laboral en salud.

This article concludes that today Peru is an example for an unbalanced policy of human resources in health for having lived a long cycle of decline that began in the 90s. This led to a situation characterized by an unbalance between offer and demand of human resources in health, the non-governability of health training and a trade-off between performance and unstable wages and labor conditions for the health personnel. Five key-points are analyzed: a) the dissociation between health work and health education; b) the increase of the productivity of health services based on a higher performance of the health personnel; c) the change of the labor regime from the system of appointments to the system of contracts and the pauperization and insecurity of the health personnel and the status of the health professional; d) the "revolution of the health staff's capacities" claiming for post-degree training, continued education and management; and e) the replacement of governance and governability by self-regulation in a context lacking a point of equilibrium allowing for corrections in the system. We suggest that the human resources policies in health adopted in Peru and many other Latin-American countries were trying to develop competences and performance without promoting the development of human resources in the health area.

Evaluación del grado de vulnerabilidad de la autonomía funcional en una población de adultos mayores en San Miguel de Tucumán / Vulnerability degree evaluation of the functional autonomy un a population of adults at San Miguel de Tucumán

Se realizó una investigación para evaluar el grado y tipo de vulnerabilidad en que se encuentra una Población de Adultos Mayores (PAM) en San Miguel de Tucumán, teniendo en cuenta la Autonomía Funcional y el riesgo de perderla. La investigación se realizó utilizando la Encuesta de "Evaluación del Riesgo Funcional del Adulto Mayor en el Nivel Primario de Atención" del Ministerio de Salud de Chile. Se entrevistaron 250 Adultos Mayores (AM), en sus domicilios, y se utilizó como variable estadística, los 21 factores de Riesgo Funcional contenidos en la Encuesta. Como resultado de esta investigación pudo evidenciarse que la PAM estudiada presenta un Alto Grado de vulnerabilidad, con riesgo de perder la Autonomía Funcional si no se intervienen en ellos en forma Preventiva y Programada. (AU)