The human factor and ergonomics in Patient Safety.

The human condition is linked to error in any activity that is performed, and the healthcare world is no exception. The origin of human error does not lie within the perversity of human nature, instead, it has its origins in latent failures in the healthcare environment and is a consequence of the processes and procedures applied. The science of the Human Factor deals with the application of knowledge to people (capabilities, characteristics and limitations), with the design and the management of the equipment they use and with the environments in which they work and the activities they carry out. Part of the Human Factor are the non-technical skills. These skills greatly influence people's behavior and, therefore, their performance and the quality of healthcare in a very complex socio-technical system.

Interspecies conflict, precarious reasoning, and the gull problem in the Gulf of Maine.

Contemporary conservation science requires mediating conflicts among nonhuman species, but the grounds for favoring one species over another can be unclear. We examined the premises through which wildlife managers picked sides in an interspecies conflict: seabird conservation in the Gulf of Maine (GOM). Managers in the GOM follow a simple narrative dubbed the gull problem. This narrative assumes Larus gulls are overpopulated and unnatural in the region. In turn, these assumptions make gulls an easy target for culling and lethal control when the birds come into conflict with other seabirds, particularly Sterna terns. Surveying historical, natural historical, and ecological evidence, we found no scientific support for the claim that Larus gulls are overpopulated in the GOM. Claims of overpopulation originated from a historical context in which rising gull populations became a nuisance to humans. Further, we found only limited evidence that anthropogenic subsidies make gulls unnatural in the region, especially when compared with anthropogenic subsidies provided for other seabirds. The risks and consequences of leveraging precarious assumptions include cascading plans to cull additional gull populations, obfuscation of more fundamental environmental threats to seabirds, and the looming paradox of gull conservation-even if one is still inclined to protect terns in the GOM. Our close look at the regional history of a conservation practice thus revealed the importance of not only conservation decisions, but also conservation decision-making.

Conflicto interespecífico, razonamiento precario y el problema de las gaviotas en el Golfo de Maine Resumen La ciencia de la conservación actual requiere mediar conflictos entre las especies no humanas, pero los fundamentos para favorecer a una especie por encima de otra pueden ser poco claros. Analizamos las premisas mediante las cuales los gestores de fauna eligen bandos en un conflicto interespecífico: la conservación de aves marinas en el Golfo de Maine (GDM). Los gestores en el GDM siguen una narrativa simple llamada el problema de las gaviotas. Esta narrativa asume que las gaviotas del género Larus no son nativas y tienen una sobrepoblación en la región. En cambio, estas suposiciones hacen que las gaviotas sean un objetivo fácil para el sacrificio y el control letal cuando las aves entran en conflicto con otras aves marinas, en particular con los charranes del género Sterna. Censamos la evidencia histórica, ecológica y de historia natural y no encontramos respaldo científico alguno para la afirmación de que hay una sobrepoblación de gaviotas Larus en el GDM. Esta afirmación se originó a partir de un contexto histórico en el que el incremento poblacional de las gaviotas se volvió una molestia para los humanos. Además, encontramos evidencia limitada de que los subsidios antropogénicos hacen que las gaviotas no sean nativas en la región, en especial cuando los comparamos con los subsidios antropogénicos proporcionados a otras aves marinas. Los riesgos y consecuencias de impulsar suposiciones precarias incluyen los planes en cascada para sacrificar poblaciones adicionales de gaviotas, la ofuscación de amenazas ambientales más fundamentales para las aves marinas y la paradoja inminente de la conservación de las gaviotas­incluso si todavía se inclinan por proteger a los charranes en el GDM. Esta mirada detallada de la historia regional de una práctica de conservación nos reveló la importancia no sólo de las decisiones de conservación, sino también de la toma de decisiones de conservación.

The association between the human papillomavirus (HPV) and the diagnosis of bladder cancer: systematic review and meta-analysis.

BACKGROUND: Bladder cancer (BC) is the seventh most common cancer worldwide. Not every infection ends as cancer, although the HPV-induced carcinogenesis is a complex process consequence of inflammation. To determine the association between human papillomavirus (HPV) and the diagnosis of bladder cancer. METHODS: We carried out a systematic review according to Cochrane and PRISMA recommendations. We searched in EMBASE, Medline (Ovid), and The Cochrane Central Register of Controlled Trials (CENTRAL), from inception to nowadays. We included case-control studies. The risk of bias assessment was performed based on QUADAS2. We performed a random effect Meta-analysis. RESULTS: We included 14 studies in qualitative and quantitative analysis. There was mainly a low risk of bias. We finally found a strong association between the presence of HPV and bladder cancer diagnosis (OR 4.18 95%CI 2.63-6.66; I2 = 40%). CONCLUSIONS: HPV is currently associated with the diagnosis of bladder cancer.

The urogenital microbiome in chronic kidney disease patients on peritoneal dialysis.

INTRODUCTION AND OBJECTIVES: Diabetes, dyslipidemia, older age, gender, urinary tract infections, and recent antibiotic intake have been associated with a decrease in the urobiome richness and other fluctuations in this microbiome. Gut and blood microbiome have been reported to be altered in patients with chronic kidney disease (CKD), and specifically in peritoneal dialysis (PD) patients. Still, there are currently no studies describing the urogenital microbiome in CKD-PD patients. In this study we characterized the urobiome profile in 46 PD patients and analyzed its clinical and inflammatory parameters. MATERIALS AND METHODS: Mid-stream urine, fecal and blood samples were collected from 46 patients undergoing PD at Centro Hospitalar Universitário de São João (CHUSJ) in Porto, Portugal. Exclusion criteria were age under 18 years old, inability to give informed consent, history of infection in the last three months, and antibiotic intake in the last three months. The microbiome communities were analyzed by amplification and sequencing of the V3-V4 region of the bacterial 16S rRNA gene. Correlations with the patients' clinical data and inflammatory profile were performed. RESULTS: CKD-PD patients presented a unique urobiome profile dominated by Bacillota, Actinomycetota and Pseudomonadota and characterized by a lower Shannon diversity than fecal and blood microbiome. The taxonomic profiles of urogenital samples were organized in multiple subtypes dominated by populations of Lactobacillus, Staphylococcus, Streptococcus, Gardnerella, Prevotella, Escherichia-Shigella, being similar to other non-PD-CKD patients. Gender, sCD14, residual diuresis and history of peritonitis were significantly associated to variations in the urobiome. Although not reaching statistical significance, diabetes and the time on PD also showed association with particular taxonomic groups. Depletion of Gardnerella, Staphylococcus, Corynebacterium, Lactobacillus or Dermabacter populations correlated with CKD-PD patients with history of diabetes, history of peritonitis and altered levels of sCD14. CONCLUSIONS: Our results highlight urogenital microbiome as a potential partner and/or marker in the overall health state of CKD-PD patients.

Biodiversity conservation, human-animal interactions, and zootherapy in ecological knowledge of Indonesian Healers.

We examined the entanglement of biodiversity conservation, human-animal interactions, zootherapy, and local beliefs among Sumatran Healers and their local community by completing an ethnography of 43 Indigenous Healers across 8 tribes in Bengkulu Province, Sumatra, Indonesia. Data collection tools were interviews, observations, videos, photographs, and a researcher journal. Of the 43 Healers, 30 used animals and mentioned 62 species. Of the animals identified, the International Union for Conservation of Nature Red List lists 34% (n = 21) as endangered, decreasing, or vulnerable, including Sumatran tiger (Panthera tigris sumatrae), Sumatran elephant (Elephas maximus sumatranus), and Sumatran rhinoceros (Dicerorhinus sumatrensis). Of the 30 Healers using animals, 50% (n = 15) practiced healing with at least one endangered, decreasing, or vulnerable animal. We defined 3 personas: Healer self-persona, Healer-imposed persona, and community-imposed persona. A persona represented a group's opinions and sentiments related to Healers killing animals for medicinal purposes. Using an iterative data analysis process, we grouped the data across the 3 personas into 5 themes: ease of killing and preparing animals, emotions related to killing animals, animal value, relationship to religion, and Healers are tricksters. The complexity of merging the identities of Healers and the community within an actor-network embodies the relationality of actions, interactions, and feelings among Healers, between Healers and animals, and between Healers and the community. Conservationists should be cognizant of Healers' medicinal use of animals, views of human-animal interactions, and zootherapy from all social and emotional perspectives. The data led to defining Indigenous Healer ecological knowledge components of zootherapy, human-animal interactions, and biodiversity conservation.

Conservación de la biodiversidad, interacciones humano­fauna y zooterapia dentro del conocimiento ecológico de los curanderos indonesios Resumen Analizamos la complejidad de la conservación de la biodiversidad, las interacciones humano­fauna, la zooterapia y las creencias locales de los curanderos y su comunidad local mediante una etnografía de 43 curanderos indígenas de ocho tribus en la provincia de Bengkulu en Sumatra, Indonesia. Usamos entrevistas, observaciones, videos, fotografías y una bitácora de investigador como herramientas de recolección de datos. De los 43 curanderos, 30 usaban animales y mencionaron 62 especies. El 34% (n = 21) de los animales identificados están catalogados como en peligro, en disminución o vulnerables en la Lista Roja de la Unión Internacional para la Conservación de la Naturaleza, incluidos el tigre de Sumatra (Panthera tigris sumatrae), el elefante de Sumatra (Elephas maximus sumatranus) y el rinoceronte de Sumatra (Dicerorhinus sumatrensis). De los 30 curanderos que usan animales, el 50% (n = 15) practica la sanación con al menos una especie en peligro, en disminución o vulnerable. Definimos tres percepciones: autopercepción de curandero, percepción impuesta de curandero y percepción impuesta de comunidad. Cada percepción representó las opiniones y sentimientos de un grupo con respecto a la matanza de animales por cuestiones medicinales. Usamos un proceso de análisis de datos repetitivos para agrupar la información de las tres percepciones en tres temas: facilidad para matar y preparar animales, emociones relacionadas con matar animales, valor del animal, relación con la religión y los curanderos son estafadores. La complejidad de combinar las identidades de los curanderos dentro de una red de actores representa cómo se relacionan las acciones, interacciones y sentimientos dentro de la comunidad de curanderos, entre los curanderos y los animales y entre los curanderos y la comunidad. Los conservacionistas deben ser conscientes desde todas las perspectivas sociales y emocionales del uso medicinal que los curanderos dan a los animales, las percepciones sobre las interacciones humano­fauna y la zooterapia. Esta información nos llevó a definir los componentes del conocimiento ecológico de los curanderos indígenas en materia de zooterapia, interacciones humano­fauna y conservación de la biodiversidad.

Global patterns of human-wildlife spatial associations and implications for differentiating conservation strategies.

Understanding the global patterns of human and wildlife spatial associations is essential for pragmatic conservation implementation, yet analytical foundations and indicator-based assessments that would further this understanding are lacking. We integrated the global distributions of 30,664 terrestrial vertebrates and human pressures to map human-nature index (HNI) categories that indicate the extent and intensity of human-wildlife interactions. Along the 2 dimensions of biodiversity and human activity, the HNI allowed placement of terrestrial areas worldwide in one of 4 HNI categories: anthropic (human-dominated areas), wildlife-dominated (little human influence and rich in wildlife), co-occurring (substantial presence of humans and wildlife), and harsh-environment (limited presence of humans and wildlife) areas. The HNI varied considerably among taxonomic groups, and the leading driver of HNI was global climate patterns. Co-occurring regions were the most prevalent (35.9%), and wildlife-dominated and anthropic regions encompassed 26.45% and 6.50% of land area, respectively. Our results highlight the necessity for customizing conservation strategies to regions based on human-wildlife spatial associations and the distribution of existing protected area networks. Human activity and biodiversity should be integrated for complementary strategies to support conservation toward ambitious and pragmatic 30×30 goals.

Patrones globales de las asociaciones espaciales entre humanos y fauna y las implicaciones para la diferenciación de las estrategias de conservación Resumen Es esencial entender los patrones globales de asociaciones entre humanos y fauna para la implementación pragmática de la conservación. Aun así, son muy pocos los fundamentos analíticos y las evaluaciones basadas en indicadores que incrementarían este conocimiento. Integramos la distribución global de 30,664 vertebrados terrestres y presiones humanas para mapear las categorías del índice de naturaleza humana (INH) que indican la extensión e intensidad de las interacciones humano­fauna. El INH permitió la colocación de áreas terrestres en todo el mundo en las dos dimensiones de la biodiversidad y las actividades humanas dentro de una de las cuatro categorías del INH: áreas antrópicas (dominadas por humanos), dominadas por fauna (poca influencia humana y rica en fauna), co­ocurrentes (presencia sustancial de humanos y fauna) y de ambiente severo (presencia limitada de humanos y fauna). El INH varió considerablemente entre los taxones, y el factor principal fueron los patrones climáticos mundiales. Las regiones co­ocurrentes fueron las más frecuentes (35.9%) las regiones antrópicas y dominadas por fauna englobaron el 26.45% y 6.50% del área terrestre respectivamente. Nuestros resultados enfatizan la necesidad de personalizar las estrategias de conservación acorde a la región con base en las asociaciones espaciales entre humanos y fauna y la distribución de las redes existentes de áreas protegidas. La actividad humana y la biodiversidad deberían estar integradas para las estrategias complementarias para respaldar a la conservación hacia los objetivos ambiciosos y pragmáticos de 30 para el 30.

A framework for understanding the human experience of nature through cognitive mapping.

Human behavior is a key driver of the biodiversity crisis, and addressing it requires changing individual choices and actions. Yet, the same processes that imperil biodiversity (e.g., urbanization) also alienate people from the experience of nature, eroding care for the natural world. Although averting this extinction of experience is increasingly recognized as a major contemporary conservation challenge, understanding of what constitutes nature experience remains elusive and few empirical studies have explored it directly. Most researchers have used nature interactions as a stand-in for experience, even though experience extends beyond interactions. We aimed to determine what constitutes the experience of nature and to propose a holistic, empirically derived framework that incorporates the multiple dimensions and components of the experience of nature. Using a mixed-method approach across 3 countries (the United States, Switzerland, and Israel), we conducted a multistage, conceptual content, cognitive mapping (3CM) exercise with 106 participants. This methodology included developing a prompt to capture participants' perceptions of nature experiences and subsequently refining and organizing their input into distinct components and underlying dimensions through an iterative engagement process. Beyond multisensory interactions with nature, experience of nature consisted of 2 dimensions: the circumstances in which interactions occur and the internal responses that encompass various cognitive, affective, and restorative benefits associated with nature interactions. These 3 dimensions had 33 components that occurred consistently across participants in the 3 countries. Frequently mentioned components included seeing animals, landscapes, or scenery; lack of human influence; weather conditions; relaxing, recharging; feeling good; and awe for nature. Fear and nature experienced at home were the least mentioned components. Together, our results showed that nature experience is a combination of nature interactions, circumstances, and internal responses. The emphasized components underscore the significance of offering access to extensive, less human-influenced natural spaces. This in turn can foster a profound nature experience, cultivating feelings of connectedness and care for nature.

Un marco de trabajo para entender la experiencia humana de la naturaleza a través del mapeo cognitivo Resumen El comportamiento humano es un factor clave en la crisis de la biodiversidad, por lo que abordarlo requiere cambios en las acciones y elecciones individuales. Aun así, los mismos procesos que ponen en peligro la biodiversidad (p. ej.: la urbanización) también alejan a las personas de experimentar la naturaleza, lo que disminuye el cuidado por la naturaleza. Aunque cada vez se reconoce más que evitar la extinción de las experiencias es un reto importante para la conservación, todavía no está claro qué constituye una experiencia de la naturaleza y pocos estudios empíricos lo han estudiado directamente. La mayoría de los investigadores ha usado las interacciones con la naturaleza como un sustituto para las experiencias, aunque éstas van más allá de las interacciones. Buscamos determinar qué constituye a las experiencias de la naturaleza y proponer un marco holístico y empírico que incorpore las múltiples dimensiones y componentes de la experiencia de la naturaleza. Usamos una estrategia de método mixto en tres países (EUA, Suiza e Israel) para realizar un ejercicio de un mapeo cognitivo de contenido conceptual en varias fases (3CM) con 106 participantes. Esta metodología incluyó el desarrollo de una entrada para capturar la percepción de los participantes con respecto a las experiencias de la naturaleza y con ello refinar y organizar sus contribuciones en diferentes componentes y dimensiones subyacentes por medio de un proceso iterativo de participación. Más allá de las interacciones multisensoriales con la naturaleza, las vivencias de la naturaleza consistieron en dos dimensiones: las circunstancias en las que ocurren las interacciones y las respuestas internas que engloban varios beneficios cognitivos, afectivos y restauradores asociados con las interacciones con la naturaleza. Estas dos dimensiones contaron con 33 componentes que aparecieron constantemente entre los participantes de los tres países. Con frecuencia mencionaron componentes que incluían avistamiento de animales o paisajes; la ausencia de influencia humana; las condiciones del clima; relajarse, recargarse; sentirse bien; y asombro por la naturaleza. El miedo y la naturaleza vivida en casa fueron los componentes menos mencionados. En conjunto, nuestros resultados mostraron que las vivencias de la naturaleza son una combinación de interacciones con la naturaleza, circunstancias y respuestas internas. Los componentes enfatizados resaltan la importancia de ofrecer acceso a los espacios naturales extensos con menos influencia humana. Esto a la vez puede promover una experiencia profunda de la naturaleza, lo que genera sentimientos de conexión y cuidado de la naturaleza.

The urogenital microbiome in chronic kidney disease patients on peritoneal dialysis / El microbioma urogenital en pacientes con enfermedad renal crónica en diálisis peritoneal

Introduction and objectives: Diabetes, dyslipidemia, older age, gender, urinary tract infections, and recent antibiotic intake have been associated with a decrease in the urobiome richness and other fluctuations in this microbiome. Gut and blood microbiome have been reported to be altered in patients with chronic kidney disease (CKD), and specifically in peritoneal dialysis (PD) patients. Still, there are currently no studies describing the urogenital microbiome in CKD-PD patients. In this study we characterized the urobiome profile in 46 PD patients and analyzed its clinical and inflammatory parameters. Materials and methods: Mid-stream urine, fecal and blood samples were collected from 46 patients undergoing PD at Centro Hospitalar Universitário de São João (CHUSJ) in Porto, Portugal. Exclusion criteria were age under 18 years old, inability to give informed consent, history of infection in the last three months, and antibiotic intake in the last three months. The microbiome communities were analyzed by amplification and sequencing of the V3–V4 region of the bacterial 16S rRNA gene. Correlations with the patients’ clinical data and inflammatory profile were performed. Results: CKD-PD patients presented a unique urobiome profile dominated by Bacillota, Actinomycetota and Pseudomonadota and characterized by a lower Shannon diversity than fecal and blood microbiome. The taxonomic profiles of urogenital samples were organized in multiple subtypes dominated by populations of Lactobacillus, Staphylococcus, Streptococcus, Gardnerella, Prevotella, Escherichia-Shigella, being similar to other non-PD-CKD patients. Gender, sCD14, residual diuresis and history of peritonitis were significantly associated to variations in the urobiome. Although not reaching statistical significance, diabetes and the time on PD also showed association with particular taxonomic groups... (AU)

Introducción y objetivos: Diabetes, dislipemia, edad avanzada, género, infecciones del tracto urinario y toma reciente de antibióticos, entre otras, se han asociado a una disminución en la riqueza del urobioma y a otras fluctuaciones de dicho microbioma.Recientemente, se han descrito alteraciones en losmicrobiomas intestinal y en sangreen pacientes con enfermedad renal crónica (ERC) y, específicamente, en pacientes en diálisis peritoneal (DP).A pesar de ello, aún no existen estudios que describan el microbioma urogenital en pacientes en DP. En el presente trabajo, caracterizamos el urobioma en 46 pacientes en DP. Pacientes y métodos: Se recogieron muestras de orina (micción espontánea), heces y sangre de 46 pacientes en DP del Centro HospitalarUniversitário de São João en Oporto, Portugal. Los criterios de exclusión fueron edad menor a 18 años, incapacidad para entenderel consentimiento informado, e historia de infección y toma de antibióticos en los últimos 3 meses. Las comunidades microbiológicas fueron analizadas por amplificación y secuenciación de las regiones V3-V4 del 16S rRNA bacteriano. Se realizaron correlaciones con los datos clínicos y el perfil inflamatorio de los pacientes. Resultados: Los pacientes en DP presentaron un urobioma único dominado por Bacillota, Actinomycetota yPseudomonadota, y caracterizado por una menor diversidad de Shannon que los microbiomas en sangre e intestinal. Los perfiles taxonómicos de las muestras urogenitales se organizaron en múltiples subtipos dominados por poblaciones de Lactobacillus, Staphylococcus, Streptococcus, Gardnerella, Prevotella, Escherichia-Shigella, siendo similar al descrito para otros pacientes con ERC no en DP.Género, factor sCD14, diuresis residual yantecedentes de peritonitis se asociaron de forma significativa a cambios en el urobioma... (AU)

The influence of social identity on attitudes toward wildlife.

Wildlife conservation depends on supportive social as well as biophysical conditions. Social identities such as hunter and nonhunter are often associated with different attitudes toward wildlife. However, it is unknown whether dynamics within and among these identity groups explain how attitudes form and why they differ. To investigate how social identities help shape wildlife-related attitudes and the implications for wildlife policy and conservation, we built a structural equation model with survey data from Montana (USA) residents (n = 1758) that tested how social identities affect the relationship between experiences with grizzly bears (Ursus arctos horribilis) and attitudes toward the species. Model results (r2  = 0.51) demonstrated that the hunter identity magnified the negative effect of vicarious property damage on attitudes toward grizzly bears (ß = -0.381, 95% confidence interval [CI]: -0.584 to -0.178, p < 0.001), which in turn strongly influenced acceptance (ß = -0.571, 95% CI: -0.611 to -0.531, p < 0.001). Our findings suggested that hunters' attitudes toward grizzly bears likely become more negative primarily because of in-group social interactions about negative experiences, and similar group dynamics may lead nonhunters to disregard the negative experiences that out-group members have with grizzly bears. Given the profound influence of social identity on human cognitions and behaviors in myriad contexts, the patterns we observed are likely important in a variety of wildlife conservation situations. To foster positive conservation outcomes and minimize polarization, management strategies should account for these identity-driven perceptions while prioritizing conflict prevention and promoting positive wildlife narratives within and among identity groups. This study illustrates the utility of social identity theory for explaining and influencing human-wildlife interactions.

La influencia de la identidad social sobre la actitud hacia la fauna Resumen La conservación de la fauna depende de condiciones de apoyo tanto sociales como biofísicas. La identidad social, como ser cazador o no, con frecuencia está asociada a las diferentes actitudes hacia la fauna. Sin embargo, no sabemos si las dinámicas dentro y entre estos grupos de identidad explican cómo las actitudes se forman y porqué son diferentes. Construimos un modelo de ecuación estructural con información de encuestas realizadas a 1,758 residentes de Montana (Estados Unidos) para conocer cómo la identidad social ayuda a formar la actitud relacionada con la fauna y las implicaciones que tiene para la conservación y políticas de fauna. El modelo analizó cómo la identidad social afecta la relación entre las experiencias con osos pardos (Ursus arctos horribilis) y la actitud hacia la especie. Los resultados del modelo (r2 = 0.51) demostraron que la identidad de cazador aumentaba el efecto negativo del daño indirecto a la propiedad sobre la actitud hacia los osos (ß=-0.381, 95% CI -0.584 a -0.178, p<0.001), lo cual en cambio tenía una gran influencia sobre la aceptación (ß=-0.571, 95% CI -0.611 a -0.531, p<0.001). Nuestros descubrimientos sugieren que la actitud de los cazadores hacia los osos probablemente se vuelve más negativa principalmente debido a las interacciones sociales del endogrupo en torno a las experiencias negativas; las dinámicas similares pueden llevar a los no cazadores a menospreciar las experiencias negativas que los miembros del exogrupo han tenido con los osos. Dada la influencia profunda que tiene la identidad social sobre la cognición humana y el comportamiento en una miríada de contextos, los patrones que observamos probablemente sean importantes en una variedad de situaciones de conservación de fauna. Para promover los resultados positivos de conservación y minimizar la polarización, las estrategias de manejo deberían considerar estas percepciones influenciadas por la identidad mientras se prioriza la prevención de conflictos y se promueven narrativas positivas de fauna dentro y entre los grupos de identidad. Este estudio demuestra la utilidad que tiene la teoría de identidad social para explicar e influenciar las interacciones humano-fauna.

El cadáver en los sistemas jurídicos colombiano y español: una discusión jurídica, ética y bioética / El cadàver en els sistemes jurídics colombià i espanyol: una discussió jurídica, ètica i bioètica / The corpse in the Colombian and Spanish legal systems: Alegal, ethical and bioethical discussion

El objeto de este trabajo es contribuir al desarrollo conceptual de la categoría jurídica del cadáver en razón a la dificultad que representa la dualidad de sujeto–objeto y que eventualmente puede generar una desprotección al mismo. El estudio se limita a las legislaciones de España y Colombia, cuya regulación, además de estar estrechamente relacionada en sus orígenes, es similar en muchos aspectos. La hipótesis sostenida es que el cadáver es una sustancia corpórea que contiene información personal y en virtud de ello, la bioética se convierte en una fuente útil para su tratamiento y regulación.(AU)

L'objecte d'aquest treball és contribuir al desenvolupament conceptual de la categoria jurídica del cadàver en raó a la dificultat que representa la dualitat de subjecte–objectei que, eventualment, pot generar una des protecció a aquest. L'estudi es limita a les legislacions d'Espanya i Colòmbia, que a més d'estar estretament relacionada en els seus orígens, és similar en molts aspectes. La hipòtesi sostinguda és que el cadàver és una substància corpòria que conté informació personal i en virtut d'això, la bioètica es converteix en una font útil per al seu tractament i regulació.(AU)

The purpose of this work is to contribute to the conceptual development of the legal category of the corpse because of the difficulty represented by the duality of subject–object, which can eventually generate a lack of protection for the corpse. The study is limited to the legislation of Spain and Colombia, whose regulations, in addition to being closely related in their origins, are similar in many aspects. The hypothesis sustained is that the corpse is a corporeal substance that contains personal informationand by this, bioethics becomes a useful source of bioethical principles for its treatment and regulation.(AU)

Análisis de la inmunidad de las mujeres infectadas por el virus del papiloma humano y su relación con la lesión intraepitelial cervical / Immunity analysis in women infected with human papillomavirus and its link with cervical intraepithelial lesion (IMVIR study)

Introducción: El objetivo principal es estudiar los marcadores de NK memoria presentes en sangre periférica en pacientes con lesiones cervicales intraepiteliales de alto grado CIN2/3 frente a mujeres sin lesiones o con lesiones de bajo grado. Los objetivos secundarios son estudiar la relación entre el perfil de las células NK memoria y la infección o no por VPH, así como la persistencia viral en las mujeres infectadas por VPH. Material y métodos: Se trata de un estudio observacional prospectivo de una cohorte de mujeres reclutadas desde el año 2019, durante un periodo de 2años, en la unidad del tracto genital inferior en las consultas de ginecología general del Instituto de Salud de la Mujer del Hospital Clínico San Carlos. Los grupos de pacientes incluidos en el estudio son el grupo de estudio: mujeres con infección por VPH y con lesión cervical de alto grado (CIN2+); el grupo control1: mujeres con infección por el VPH sin lesión cervical de alto grado, y el grupo control2: mujeres sin infección por el VPH y sin lesión. Resultados: Durante el estudio se han reclutado 115 pacientes. Nos encontramos con un mayor número de NK «memoria» en pacientes infectadas, tanto en el grupo control1 como en el grupo de estudio, en comparación con el grupo control2. Además, cuando se analizan las pacientes no fumadoras, la expresión de NKp30 es significativamente menor en el grupo control1. Conclusiones: Los resultados ponen de manifiesto una probable menor capacidad para desarrollar funciones adaptativas por parte de las células NK en estas pacientes fumadoras frente a las no fumadoras. Un mejor conocimiento de la biología de las células NK y su papel en la infección por el VPH podría permitir el desarrollo de estrategias para manipular su funcionamiento (inmunoterapias) con un propósito pronóstico y terapéutico.(AU)

Introduction: The main objective is to study the NK markers present in circulating blood in patients with high grade intraepithelial cervical lesions compared with women without lesions or low grade lesions. The secondary objectives of the study are to understand the relationship between the NK memory like cells and the infection with HPV, as well as the persistence of the infection. Methods and materials: It is an observational prospective study that studies women from 2019 for 2years seen in ginecology rooms in Hospital Clínico San Carlos. The group of patients studied are: women with infection by HPV and high grade lesions, women with infection by HPV but no lesion or low grade lesion and women without lesion or infection. Results: We have recruited 115 patients. We have found more memory like NK cells in patients infected by HPV. And when we analyze the non-smoking patients, the expression of NKp30 is lower in patients infected without lesion. Conclusions: The results show that there could be less capacity to generate an adaptative function by NK in smoking patients than in non-smoking. A better knowledge of the NK cells biology and its role in the infection by HPV could allow us to manipulate with a therapeutic and prognostic end.(AU)

Vulneración del derecho a la alimentación del infante: Análisis del incumplimiento de la pensión de alimentos en Perúy el posible papel del Nutricionista / Violation of the right to food for children: Analysis of Non-compliance with child support in Peru and the potential role of the Nutritionist

Antecedentes: El incumplimiento de la pensión de alimentos tiene un impacto negativo en la protección de la infancia, incrementando el riesgo de malnutrición e inseguridad alimentaria. Las relaciones familiares y la confianza en el sistema de justicia también se pueden ver afectadas.Objetivo: Describir las características de las deudas de pensión mensual de alimentos en Perú, según el área geográfica y la jurisdicción del órgano judicial.Materiales y métodos: Se desarrolló un estudio transversal mediante el análisis de los casos de deuda de pensión de alimentos del 2019, según el Registro de Deudores Alimentarios Morosos (REDAM) del Poder Judicial del Perú. Se realizó un análisis descriptivo de las deudas de pensión de alimentos por región y jurisdicción del órgano judicial.Resultados: Se incluyeron 750 registros de deudores de pensión de alimentos, y se identificó que solo 0.53% de los deudores subsano su deuda. Se encontraron diferencias entre las deudas de pensión de alimentos entre las regiones de Perú. Los indicadores de desarrollo humano y vulnerabilidad a la inseguridad alimentaria tuvieron una tendencia semejante que las pensiones de alimentos entre las regiones de Perú.Conclusión: Las deudas de pensión de alimentos se caracterizaron por provenir en mayor proporción de varones con trabajo, y se identificaron más casos de deudores en la sierra peruana.(AU)

Background: Noncompliance with child support paymentshas a negative impact on the protection of children, increas-ing the risk of malnutrition and food insecurity. Family rela-tionships and trust in the justice system can also be affected.Objective: To describe the characteristics of monthly childsupport debts in Peru, according to the geographic area andjurisdiction of the judicial authority.Materials and Methods: A cross-sectional study wasconducted by analyzing the cases of child support debt from2019, according to the Register of Delinquent Child SupportDebtors (REDAM) of the Judiciary of Peru. A descriptive analy-sis of child support debt by region and jurisdiction of the ju-dicial authority was carried out. Results: 750 records of child support debtors were in-cluded, and it was identified that only 0.53% of the debtorspaid off their debt. Differences were found in child supportdebt between the regions of Peru. Human development indi-cators and vulnerability to food insecurity had a similar trendas child support payments among the regions of Peru.Conclusion: Child support debts were characterized ascoming mostly from employed males, and more cases ofdebtors were identified in the Peruvian highlands.(AU)

Conhecimento para apoio aos profissionais responsáveis pelo diagnóstico de citologia anal: revisão narrativa e interpretação de critérios citomorfológicos

Resumo:Introdução:O câncer anal é uma patologia considerada rara, apesar de crescente na população. A citologia anal tem sido uma aposta para diagnosticar as alterações pré-neoplásicas, evitando a evolução ao câncer. Objetivos:I) Abordar aspectos de satisfatoriedade da amostra celular e revisar os critérios citomorfológicos dos achados benignos e malignos nos esfregaços de citologia anal. II) Tornar este artigo um instrumento de suporte aos profissionais de saúde que atuam no setor de Citopatologia vinculados ao Sistema Único de Saúde (SUS) ou à iniciativa privada. Métodos:Revisão narrativa, com busca nas bases PubMed, Science Direct e SciELO, de fevereiro a abril/2023. Desenvolvimento:A análise da literatura aponta para a aplicação da citologia anal para diagnóstico das alterações induzidas pelo Papilomavírus Humano (HPV) no canal anal. O rastreamento se baseia na semelhança ao controle do câncer de colo uterino e à história natural da doença, reconhecendo que as lesões precursoras evoluem ao câncer invasivo. Essa janela entre a lesão e o câncer abre espaço para detecção precoce. Oportunamente, a técnica pode diagnosticar agentes responsáveis por outras Infecções Sexualmente Transmissíveis (IST). Conclusão: Qualificar os laudos de diagnóstico citopatológico pode apoiar o cuidado desde a atenção primária. O intuito deste trabalho foi contribuir com o processo de aprendizagem dos profissionais da saúde e apoiar a saúde pública nas estratégias de garantia de cuidado às pessoas.

Manejo en atención primaria de las infecciones de transmisión sexual (II). Lesión ulcerada genital. Vulvovaginitis. Virus del papiloma humano / Management of sexually transmitted diseases in primary care (II). Genital ulcers. Vulvovaginitis. Human papilloma virus

En el presente artículo abordamos tres síndromes clínicos infecciosos con diferentes gérmenes como causantes, pero tienen en común que las manifestaciones que presentan son a nivel genital. Algunos son estrictamente originados por gérmenes de transmisión sexual, pero otros no. Hablaremos en este capítulo de las vulvovaginitis, de la lesión ulcerada genital y del virus del papiloma humano, tres grandes entidades que presentan una tasa no menospreciable de consulta en atención primaria, en aumento en los últimos años, y que como profesionales de salud debemos saber abordar por completo, desde su manejo diagnóstico, pasando por su correcto tratamiento y finalizando con los posteriores controles. En estas entidades es tan importante el correcto abordaje como el saber recomendar la prevención, el estudio de contactos y los cribados de otras infecciones que pueden presentarse concomitantemente.(AU)

In this paper we approach three clinical syndromes with different microbial agents that cause sexually transmitted diseases (STD) with a common condition: the symptomatology is in the genital area. Some of these microbial agents are transmitted strictly sexually, but not all. In this section we will discuss about vulvovaginitis, genital ulcers and human papilloma virus, three syndromes which have increased their incidence in recent years and primary care must know its management: diagnosis, correct treatment, controls, and study of sexual contacts. The optimal approach is as important as knowing how to recommend prevention of STD, contact study and screening for other infections that can be present at the same time although asymptomatically.(AU)

Respiratory syncytial virus infection in adults: Differences with influenza.

INTRODUCTION: Respiratory syncytial virus (RSV) causes an acute respiratory illness similar to influenza, although there are few data comparing both of them in adults. The existence of clinical differences between these two infections could have implications for their management. MATERIALS AND METHODS: Retrospective observational cohort study including 63 adults with positive PCR for RSV and 221 for influenza during winter 2018-2019. Epidemiological, clinical characteristics and outcomes were contrasted between both groups. RESULTS: Compared to influenza, RSV-positive patients presented a higher association with active neoplasia (OR=2.9; 95% CI: 1.2-6.9), dependence for basic activities of daily living (OR=3.4; 95% CI: 1.4-8.2) and immunosuppression due to chronic glucocorticoid administration (OR=7.6; 95% CI: 1.6-36.1). At diagnosis, fever was less common (OR=0.3; 95% CI: 0.2-0.7), and C-reactive protein level ≥100mg/l was more frequent (OR=2.1; 95% CI: 1.0-4.5). They developed bacterial co-infection by Staphylococcus aureus in a higher proportion (OR=8.3; 95% CI: 1.5-46.9) and presented a greater need for admission to the intensive care unit (OR=5.4; 95% CI: 1.4-19.2). CONCLUSION: RSV is an important cause of respiratory illness in adults during the influenza season. It especially affects vulnerable patients with chronic underlying diseases, and has a higher morbidity than influenza. For all these reasons, specific detection, prevention and treatment of RSV is necessary in order to reduce the consumption of health care resources due to RSV disease in adults.

[Management of sexually transmitted diseases in primary care (II). Genital ulcers. Vulvovaginitis. Human papilloma virus]. / Manejo en atención primaria de las infecciones de transmisión sexual (II). Lesión ulcerada genital. Vulvovaginitis. Virus del papiloma humano.

In this paper we approach three clinical syndromes with different microbial agents that cause sexually transmitted diseases (STD) with a common condition: the symptomatology is in the genital area. Some of these microbial agents are transmitted strictly sexually, but not all. In this section we will discuss about vulvovaginitis, genital ulcers and human papilloma virus, three syndromes which have increased their incidence in recent years and primary care must know its management: diagnosis, correct treatment, controls, and study of sexual contacts. The optimal approach is as important as knowing how to recommend prevention of STD, contact study and screening for other infections that can be present at the same time although asymptomatically.

Partial purification of linoleic acid isomerase enzyme from Lactobacillus paracasei bacteria isolated from milk

Abstract Conjugated Linoleic Acid (CLA) has attracted the attention of many researchers, especially that of microbial origin due to its biological importance to the consumer. The current study aims to extract LA Isomerase enzyme from Lactobacillus paracasei bacteria from milk and to use the enzyme in the production of CLA. Selective media, including MRS and MRS-Dagatose, were used in isolating local strains. The selected bacterial isolates were tested for their ability to produce LA-Isomerase enzyme. The isolate with high enzymatic activity was selected. After extraction and partial purification of the enzyme, the optimal conditions for the production of conjugated fatty acid were studied, and the reaction products were diagnosed using GC-MS technology. It was found that 11 isolates have the ability to produce CLA at different concentrations, H1 isolate showed the highest production of conjugated fatty acid at a concentration of 120.45 g.ml-1, this isolate was selected as the source for enzyme extraction. The enzymatic activity of the crude extract and partially purified with ammonium sulfate was estimated using color methods at wavelength of 233 nm. The effect of the optimum conditions (pH, temperature, linoleic acid concentration and enzyme concentration) on the CLA product was studied using the partially purified LA Isomerase enzyme, the optimum conditions for production were 6.5, 45 °C, 100 g.ml-1 and 0.7 ml, respectively. The GC-MS technique showed the presence of a number of reaction products that are isomers of conjugated linoleic acid (C9T11, T9T12, T10C12) with different concentrations.

Resumo O Ácido Linoleico Conjugado (CLA) tem chamado a atenção de diversos pesquisadores, principalmente aquele de origem microbiana, devido à sua importância biológica para o consumidor. O presente estudo visa extrair a enzima LA Isomerase da bactéria Lactobacillus paracasei do leite e usar essa enzima na produção de CLA. Meios seletivos, incluindo MRS e MRS-Dagatose, foram usados no isolamento de cepas locais. Os isolados bacterianos selecionados foram testados quanto à sua capacidade de produzir a enzima LA-Isomerase. Foi selecionado o isolado com alta atividade enzimática. Após a extração e purificação parcial da enzima, as condições ideais para a produção de ácido graxo conjugado foram estudadas e os produtos da reação foram identificados usando a tecnologia GC-MS. Verificou-se que 11 isolados possuem capacidade de produzir CLA em diferentes concentrações. O isolado H1 apresentou a maior produção de ácido graxo conjugado, na concentração de 120,45 g.ml-1, e este isolado foi selecionado como fonte para extração enzimática. A atividade enzimática do extrato bruto e parcialmente purificado com sulfato de amônio foi estimada por métodos de coloração em comprimento de onda de 233 nm. O efeito das condições ótimas (pH, temperatura, concentração de ácido linoleico e concentração de enzima) no produto CLA foi estudado usando a enzima LA Isomerase parcialmente purificada e as condições ótimas para produção foram 6,5, 45 °C, 100 g.ml-1 e 0,7 mL, respectivamente. A técnica de GC-MS mostrou a presença de uma série de produtos de reação que são isômeros do ácido linoleico conjugado (C9T11, T9T12, T10C12) com diferentes concentrações.

Partial purification of linoleic acid isomerase enzyme from Lactobacillus paracasei bacteria isolated from milk / Purificação parcial da enzima isomerase do ácido linoleico da bactéria Lactobacillus paracasei isolada do leite

Conjugated Linoleic Acid (CLA) has attracted the attention of many researchers, especially that of microbial origin due to its biological importance to the consumer. The current study aims to extract LA Isomerase enzyme from Lactobacillus paracasei bacteria from milk and to use the enzyme in the production of CLA. Selective media, including MRS and MRS-Dagatose, were used in isolating local strains. The selected bacterial isolates were tested for their ability to produce LA-Isomerase enzyme. The isolate with high enzymatic activity was selected. After extraction and partial purification of the enzyme, the optimal conditions for the production of conjugated fatty acid were studied, and the reaction products were diagnosed using GC-MS technology. It was found that 11 isolates have the ability to produce CLA at different concentrations, H1 isolate showed the highest production of conjugated fatty acid at a concentration of 120.45 g.ml-1, this isolate was selected as the source for enzyme extraction. The enzymatic activity of the crude extract and partially purified with ammonium sulfate was estimated using color methods at wavelength of 233 nm. The effect of the optimum conditions (pH, temperature, linoleic acid concentration and enzyme concentration) on the CLA product was studied using the partially purified LA Isomerase enzyme, the optimum conditions for production were 6.5, 45 °C, 100 µg.ml-1 and 0.7 ml, respectively. The GC-MS technique showed the presence of a number of reaction products that are isomers of conjugated linoleic acid (C9T11, T9T12, T10C12) with different concentrations.

O Ácido Linoleico Conjugado (CLA) tem chamado a atenção de diversos pesquisadores, principalmente aquele de origem microbiana, devido à sua importância biológica para o consumidor. O presente estudo visa extrair a enzima LA Isomerase da bactéria Lactobacillus paracasei do leite e usar essa enzima na produção de CLA. Meios seletivos, incluindo MRS e MRS-Dagatose, foram usados no isolamento de cepas locais. Os isolados bacterianos selecionados foram testados quanto à sua capacidade de produzir a enzima LA-Isomerase. Foi selecionado o isolado com alta atividade enzimática. Após a extração e purificação parcial da enzima, as condições ideais para a produção de ácido graxo conjugado foram estudadas e os produtos da reação foram identificados usando a tecnologia GC-MS. Verificou-se que 11 isolados possuem capacidade de produzir CLA em diferentes concentrações. O isolado H1 apresentou a maior produção de ácido graxo conjugado, na concentração de 120,45 g.ml-1, e este isolado foi selecionado como fonte para extração enzimática. A atividade enzimática do extrato bruto e parcialmente purificado com sulfato de amônio foi estimada por métodos de coloração em comprimento de onda de 233 nm. O efeito das condições ótimas (pH, temperatura, concentração de ácido linoleico e concentração de enzima) no produto CLA foi estudado usando a enzima LA Isomerase parcialmente purificada e as condições ótimas para produção foram 6,5, 45 °C, 100 µg.ml-1 e 0,7 mL, respectivamente. A técnica de GC-MS mostrou a presença de uma série de produtos de reação que são isômeros do ácido linoleico conjugado (C9T11, T9T12, T10C12) com diferentes concentrações.

Polyphenol analysis in human milk by a rapid, cost-effective, and accurate micromethod: translational development / Análise de polifenóis no leite humano por meio de um micrométodo rápido, econômico e preciso: desenvolvimento translacional

ABSTRACT Objective: To develop a rapid method for analysing polyphenols, which are potentially active antioxidants against neonatal oxidative stress, from small human milk (HM) volumes. Methods: Acid and alkaline extractions were compared using two dyes: Folin-Ciocalteu and Fast Blue BB. Linearity, sensitivity, recovery percentage, polyphenol content, precision, and stability were assessed in 14 HM samples and compared using the Kruskal-Wallis H test (p<0.05). The best technique was applied to 284 HM samples to determine their polyphenolic content and its association with maternal diet by multifactorial linear regression. Results: Acidic extraction successfully recovered the gallic acid reference standard, whereas alkaline extraction overestimated it. Calibration curves for all methods were linear (R2>0.96) up to 500 mg/L. All bicarbonate-based Folin-Ciocalteu methods assayed were stable and repeatable, whereas Fast Blue BB-based variants were not. HM polyphenols (mean=94.68 mg/L) positively correlated to the dietary intake of hydroxycinnamic acids, the most consumed polyphenolic family in this population. Conclusions: A bicarbonate-based Folin-Ciocalteu micromethod allowed the accurate determination of polyphenols in HM, which might be useful for translational research settings and HM banks.

RESUMO Objetivo: Desenvolver um método rápido para analisar polifenóis, que são antioxidantes potencialmente ativos contra o estresse oxidativo neonatal, em pequenos volumes de leite humano (LH). Métodos: Foram comparadas extrações ácidas e alcalinas usando dois corantes: Folin-Ciocalteu e Fast Blue BB. Foram avaliadas variáveis como linearidade, sensibilidade, percentagem de recuperação, teor de polifenóis, precisão e estabilidade em 14 amostras de LH, comparadas usando o teste de Kruskal-Wallis H (p<0,05). A melhor técnica foi aplicada a 284 amostras de LH para determinar seu teor polifenólico e sua associação com a dieta materna por regressão linear multifatorial. Resultados: A extração ácida recuperou com sucesso o padrão de referência do ácido gálico, enquanto a extração alcalina o superestimou. As curvas de calibração para todos os métodos foram lineares (R2>0,96) até os 500 mg/L. Todos os métodos testados baseados em Folin-Ciocalteu com bicarbonato foram estáveis e repetíveis, enquanto as variantes baseadas em Fast Blue BB não. Os polifenóis do HM (média=94,68 mg/L) correlacionaram-se positivamente com a ingestão dietética de ácidos hidroxicinâmicos, a família de polifenóis mais consumida nesta população. Conclusões: Um micrométodo baseado em bicarbonato de Folin-Ciocalteu permitiu a determinação precisa de polifenóis no HM, o que pode ser útil para configurações de pesquisa translacional e bancos de HM.

Maternal impacts of a physically disabled baby birth: A comparative study / Impactos maternos do nascimento de um bebê com deficiência física: um estudo comparativo

Objective This study aims to assess the emotional impacts of the baby's physical disability on the mother. Method It is an exploratory investigation carried on with two mother-infant dyads, only one of which gave birth to a physically disabled baby, both participating in a larger case-control investigation. The tools used included the Beck Anxiety and Depression Inventories, the Parental Reflective Functioning Questionnaire, the Ages and Stages Questionnaire as well as semi-structured interviews. Results Both mothers showed similar reports and parenting levels, but the one whose baby had a disability scored higher on anxiety and depression, in connection with the baby's low level of development. Conclusion It is concluded that, in order to achieve the same levels of a typical parenting condition, greater adaptation mechanisms are required.

Objetivo Este artigo tem como objetivo avaliar impactos emocionais da deficiência física do bebê na mãe. Método Trata-se de um estudo exploratório realizado com duas díades, uma composta um bebê com deficiência e sua mãe e outra por um bebê sem deficiência e sua mãe, provenientes de uma pesquisa maior com desenho caso-controle. Foram utilizados a Entrevista Semiestruturada, Inventários Beck de Ansiedade e Depressão, Questionário de Função Reflexiva Parental e Ages and Stages Questionnaire. Resultados As mães demonstraram relatos e níveis de parentalidade semelhantes, mas a do bebê com deficiência apresentou maiores scores para ansiedade e depressão, relacionados ao baixo nível de desenvolvimento do filho. Conclusão Conclui-se que mecanismos de adaptação são necessários para se obter os mesmos níveis de parentalidade de uma condição típica.