Statin use is not associated with inflammation among Chilean women of Mapuche and non-Mapuche ancestry with gallstones.

Aim: Statins are associated with lower risk of gallstones due to anti-inflammatory effects. We assessed whether statins impact circulating inflammation among Chilean women with gallstones. Materials & methods: 200 Mapuche women were matched on statin use and age to 200 non-Mapuche women in the Chile Biliary Longitudinal Study. We analyzed 92 inflammatory biomarkers using multivariable-adjusted regression models, random forests and pathway analyses. Results: Statins were not significantly associated with any inflammation marker when women were analyzed jointly or stratified by ancestry. No significant associations were found through random forest methods and pathway analyses. Discussion: We did not find significant associations between statin use and inflammation markers in women with gallstones, suggesting that statins do not reduce inflammation once gallstones have formed.

Statins are prescribed to lower cholesterol and can also decrease the risk of gallstone formation by reducing inflammation. We assessed whether statin use reduces inflammation among women who have already developed gallstones. We analyzed 92 inflammation markers among 400 women in Chile, including 200 women with Mapuche Amerindian ancestry and 200 women of Latina/European ancestry. We found that statin use was not correlated with inflammation in this group of women overall nor by ancestry. This may mean that statin use does not reduce inflammation in women who already were diagnosed with gallstones.

Biodegradation of Polystyrene by Galleria mellonella: Identification of Potential Enzymes Involved in the Degradative Pathway.

Galleria mellonella is a lepidopteran whose larval stage has shown the ability to degrade polystyrene (PS), one of the most recalcitrant plastics to biodegradation. In the present study, we fed G. mellonella larvae with PS for 54 days and determined candidate enzymes for its degradation. We first confirmed the biodegradation of PS by Fourier transform infrared spectroscopy- Attenuated total reflectance (FTIR-ATR) and then identified candidate enzymes in the larval gut by proteomic analysis using liquid chromatography with tandem mass spectrometry (LC-MS/MS). Two of these proteins have structural similarities to the styrene-degrading enzymes described so far. In addition, potential hydrolases, isomerases, dehydrogenases, and oxidases were identified that show little similarity to the bacterial enzymes that degrade styrene. However, their response to a diet based solely on polystyrene makes them interesting candidates as a potential new group of polystyrene-metabolizing enzymes in eukaryotes.

Adenomyomas of the Gallbladder: An Analysis of Frequency, Clinicopathologic Associations, and Relationship to Carcinoma of a Malformative Lesion.

CONTEXT.­: The nature and associations of gallbladder (GB) "adenomyoma" (AM) remain controversial. Some studies have attributed up to 26% of GB carcinoma to AMs. OBJECTIVE.­: To examine the true frequency, clinicopathologic characteristics, and neoplastic changes in GB AM. DESIGN.­: Cholecystectomy cohorts analyzed were 1953 consecutive cases, prospectively with specific attention to AM; 2347 consecutive archival cases; 203 totally embedded GBs; 207 GBs with carcinoma; and archival search of institutions for all cases diagnosed as AM. RESULTS.­: Frequency of AM was 9.3% (19 of 203) in totally submitted cases but 3.3% (77 of 2347) in routinely sampled archival tissue. A total of 283 AMs were identified, with a female to male ratio = 1.9 (177:94) and mean size = 1.3 cm (range, 0.3-5.9). Most (96%, 203 of 210) were fundic, with formed nodular trabeculated submucosal thickening, and were difficult to appreciate from the mucosal surface. Four of 257 were multifocal (1.6%), and 3 of 257 (1.2%) were extensive ("adenomyomatosis"). Dilated glands (up to 14 mm), often radially converging to a point in the mucosa, were typical. Muscle was often minimal, confined to the upper segment. Nine of 225 (4%) revealed features of a duplication. No specific associations with inflammation, cholesterolosis, intestinal metaplasia, or thickening of the uninvolved GB wall were identified. Neoplastic change arising in AM was seen in 9.9% (28 of 283). Sixteen of 283 (5.6%) had mural intracholecystic neoplasm; 7 of 283 (2.5%) had flat-type high-grade dysplasia/carcinoma in situ. Thirteen of 283 cases had both AM and invasive carcinoma (4.6%), but in only 5 of 283 (1.8%), carcinoma arose from AM (invasion was confined to AM, and dysplasia was predominantly in AM). CONCLUSIONS.­: AMs have all the features of a malformative developmental lesion, and may not show a significant muscle component (ie, the name "adeno-myoma" is partly a misnomer). While most are innocuous, some pathologies may arise in AMs, including intracholecystic neoplasms, flat-type high-grade dysplasia or carcinoma in situ, and invasive carcinoma (1.8%, 5 of 283). It is recommended that gross examination of GBs include serial slicing of the fundus for AM detection and total submission if one is found.

Citizen scientists study beach litter along 12,000 km of the East Pacific coast: A baseline for the International Plastic Treaty.

Anthropogenic Marine Litter (AML) accumulating on beaches causes damage to coastal ecosystems and high costs to local communities. Volunteers sampled AML on 130 beaches along the central and southern East Pacific coasts, with AML densities ranging from 0.46 to 2.26 items m-2 in the different countries. AML composition was dominated by plastics and cigarette butts, the latter especially in Mexico and Chile. The accumulation of AML in the upper zones of the beaches and substantial proportions of cigarette butts, glass and metal pointed mainly to local sources. Statistical modelling of litter sources on continental beaches revealed that tourism, access and related infrastructure (e.g. parking lots) best explained AML densities, while plastic densities were also influenced by the distance from river mouths and national Gross Domestic Product. Large-scale monitoring can be a useful tool to evaluate the effectiveness of public policies that should primarily focus on land sources.

Evaluation of trefoil factor 3 as a non-invasive biomarker of gastric intestinal metaplasia and gastric cancer in a high-risk population / Evaluación de Trefoil factor 3 como un biomarcador no invasivo para la detección de metaplasia intestinal y cáncer gástrico en una población de alto riesgo

Background: Adenocarcinoma is preceded by chronic atrophic gastritis, gastric intestinal metaplasia and dysplasia. Trefoil factor 3 (TFF3) is a peptide secreted by goblet cells, which is abundantly present in intestinal metaplasia. Aim: To evaluate the utility of serum TFF3 as a non-invasive biomarker for the diagnosis of intestinal metaplasia and gastric cancer. Methods: Single-center, cross-sectional study of 274 patients who consecutively underwent upper gastrointestinal endoscopy with gastric biopsies (updated Sydney system). TFF3 levels were measured in serum by a commercial ELISA kit. Patients with normal histology or chronic atrophic gastritis without intestinal metaplasia comprised the control group. In addition, 14 patients with invasive gastric cancer were included as a reference group. The association between TFF3 levels and intestinal metaplasia was assessed by logistic regression. Results: Patients with intestinal metaplasia (n=110) had a higher median TFF3 level as compared to controls (n=164), 13.1 vs. 11.9ng/mL, respectively (p=0.024). Multivariable logistic regression showed a no significant association between TFF3 levels and intestinal metaplasia (OR=1.20; 95%CI: 0.87–1.65; p-trend=0.273). The gastric cancer group had a median TFF3 level of 20.5ng/mL, and a significant association was found (OR=3.26; 95%CI: 1.29–8.27; p-trend=0.013). Conclusion: Serum levels of TFF3 do not discriminate intestinal metaplasia in this high-risk Latin American population. Nevertheless, we confirmed an association between TFF3 levels and invasive gastric cancer.(AU)

Introducción: El adenocarcinoma gástrico es precedido por la gastritis crónica atrófica, metaplasia intestinal y displasia gástrica. Trefoil factor 3 (TFF3) es un péptido secretado por las células caliciformes, que están abundantemente presentes en la metaplasia intestinal. Objetivo: Evaluar la utilidad de TFF3 sérico como biomarcador no invasivo para el diagnóstico de metaplasia intestinal y cáncer gástrico. Métodos: Estudio transversal, de 274 pacientes a los que se les realizó endoscopia digestiva alta consecutivamente con biopsias gástricas (sistema Sydney actualizado). Los niveles de TFF3 se midieron en suero mediante un kit de ELISA comercial. Los pacientes con histología normal o gastritis crónica atrófica sin metaplasia intestinal formaron el grupo control. Además, se incluyeron como grupo de referencia 14 pacientes con cáncer gástrico avanzado. La asociación entre los niveles de TFF3 y la metaplasia intestinal se evaluó mediante una regresión logística. Resultados: Los pacientes con metaplasia intestinal (n=110) presentaron una mediana de TFF3 más alta en comparación con el grupo control (n=164), 13,1 vs. 11,9ng/ml, respectivamente (p=0,024). Sin embargo, la regresión logística multivariable no mostró una asociación significativa entre los niveles de TFF3 y la metaplasia intestinal (OR=1,20; IC95%: 0,87-1,65; p-trend=0,273). El grupo de cáncer gástrico tuvo una mediana significativamente mayor de TFF3 de 20,5ng/ml (OR=3,26; IC95%: 1,29-8,27; p-trend=0,013). Conclusión: Los niveles séricos de TFF3 no permiten el diagnóstico no invasivo de metaplasia intestinal en esta población latinoamericana de alto riesgo. La asociación entre los niveles de TFF3 y el cáncer gástrico avanzado fue confirmada.(AU)

Machine learning applied in maternal and fetal health: a narrative review focused on pregnancy diseases and complications.

Introduction: Machine learning (ML) corresponds to a wide variety of methods that use mathematics, statistics and computational science to learn from multiple variables simultaneously. By means of pattern recognition, ML methods are able to find hidden correlations and accomplish accurate predictions regarding different conditions. ML has been successfully used to solve varied problems in different areas of science, such as psychology, economics, biology and chemistry. Therefore, we wondered how far it has penetrated into the field of obstetrics and gynecology. Aim: To describe the state of art regarding the use of ML in the context of pregnancy diseases and complications. Methodology: Publications were searched in PubMed, Web of Science and Google Scholar. Seven subjects of interest were considered: gestational diabetes mellitus, preeclampsia, perinatal death, spontaneous abortion, preterm birth, cesarean section, and fetal malformations. Current state: ML has been widely applied in all the included subjects. Its uses are varied, the most common being the prediction of perinatal disorders. Other ML applications include (but are not restricted to) biomarker discovery, risk estimation, correlation assessment, pharmacological treatment prediction, drug screening, data acquisition and data extraction. Most of the reviewed articles were published in the last five years. The most employed ML methods in the field are non-linear. Except for logistic regression, linear methods are rarely used. Future challenges: To improve data recording, storage and update in medical and research settings from different realities. To develop more accurate and understandable ML models using data from cutting-edge instruments. To carry out validation and impact analysis studies of currently existing high-accuracy ML models. Conclusion: The use of ML in pregnancy diseases and complications is quite recent, and has increased over the last few years. The applications are varied and point not only to the diagnosis, but also to the management, treatment, and pathophysiological understanding of perinatal alterations. Facing the challenges that come with working with different types of data, the handling of increasingly large amounts of information, the development of emerging technologies, and the need of translational studies, it is expected that the use of ML continue growing in the field of obstetrics and gynecology.

Whole tumour cell-based vaccines: tuning the instruments to orchestrate an optimal antitumour immune response.

Immunotherapy, particularly those based on immune checkpoint inhibitors (ICIs), has become a useful approach for many neoplastic diseases. Despite the improvements of ICIs in supporting tumour regression and prolonging survival, many patients do not respond or develop resistance to treatment. Thus, therapies that enhance antitumour immunity, such as anticancer vaccines, constitute a feasible and promising therapeutic strategy. Whole tumour cell (WTC) vaccines have been extensively tested in clinical studies as intact or genetically modified cells or tumour lysates, injected directly or loaded on DCs with distinct adjuvants. The essential requirements of WTC vaccines include the optimal delivery of a broad battery of tumour-associated antigens, the presence of tumour cell-derived molecular danger signals, and adequate adjuvants. These factors trigger an early and robust local innate inflammatory response that orchestrates an antigen-specific and proinflammatory adaptive antitumour response capable of controlling tumour growth by several mechanisms. In this review, the strengths and weaknesses of our own and others' experiences in studying WTC vaccines are revised to discuss the essential elements required to increase anticancer vaccine effectiveness.

Evaluation of first and second trimester maternal thyroid profile on the prediction of gestational diabetes mellitus and post load glycemia.

Maternal thyroid alterations have been widely associated with the risk of gestational diabetes mellitus (GDM). This study aims to 1) test the first and the second trimester full maternal thyroid profile on the prediction of GDM, both alone and combined with non-thyroid data; and 2) make that prediction independent of the diagnostic criteria, by evaluating the effectiveness of the different maternal variables on the prediction of oral glucose tolerance test (OGTT) post load glycemia. Pregnant women were recruited in Concepción, Chile. GDM diagnosis was performed at 24-28 weeks of pregnancy by an OGTT (n = 54 for normal glucose tolerance, n = 12 for GDM). 75 maternal thyroid and non-thyroid parameters were recorded in the first and the second trimester of pregnancy. Various combinations of variables were assessed for GDM and post load glycemia prediction through different classification and regression machine learning techniques. The best predictive models were simplified by variable selection. Every model was subjected to leave-one-out cross-validation. Our results indicate that thyroid markers are useful for the prediction of GDM and post load glycemia, especially at the second trimester of pregnancy. Thus, they could be used as an alternative screening tool for GDM, independently of the diagnostic criteria used. The final classification models predict GDM with cross-validation areas under the receiver operating characteristic curve of 0.867 (p<0.001) and 0.920 (p<0.001) in the first and the second trimester of pregnancy, respectively. The final regression models predict post load glycemia with cross-validation Spearman r correlation coefficients of 0.259 (p = 0.036) and 0.457 (p<0.001) in the first and the second trimester of pregnancy, respectively. This investigation constitutes the first attempt to test the performance of the whole maternal thyroid profile on GDM and OGTT post load glycemia prediction. Future external validation studies are needed to confirm these findings in larger cohorts and different populations.

Evaluation of trefoil factor 3 as a non-invasive biomarker of gastric intestinal metaplasia and gastric cancer in a high-risk population.

BACKGROUND: Adenocarcinoma is preceded by chronic atrophic gastritis, gastric intestinal metaplasia and dysplasia. Trefoil factor 3 (TFF3) is a peptide secreted by goblet cells, which is abundantly present in intestinal metaplasia. AIM: To evaluate the utility of serum TFF3 as a non-invasive biomarker for the diagnosis of intestinal metaplasia and gastric cancer. METHODS: Single-center, cross-sectional study of 274 patients who consecutively underwent upper gastrointestinal endoscopy with gastric biopsies (updated Sydney system). TFF3 levels were measured in serum by a commercial ELISA kit. Patients with normal histology or chronic atrophic gastritis without intestinal metaplasia comprised the control group. In addition, 14 patients with invasive gastric cancer were included as a reference group. The association between TFF3 levels and intestinal metaplasia was assessed by logistic regression. RESULTS: Patients with intestinal metaplasia (n=110) had a higher median TFF3 level as compared to controls (n=164), 13.1 vs. 11.9ng/mL, respectively (p=0.024). Multivariable logistic regression showed a no significant association between TFF3 levels and intestinal metaplasia (OR=1.20; 95%CI: 0.87-1.65; p-trend=0.273). The gastric cancer group had a median TFF3 level of 20.5ng/mL, and a significant association was found (OR=3.26; 95%CI: 1.29-8.27; p-trend=0.013). CONCLUSION: Serum levels of TFF3 do not discriminate intestinal metaplasia in this high-risk Latin American population. Nevertheless, we confirmed an association between TFF3 levels and invasive gastric cancer.

Reappraisal of T1b gallbladder cancer (GBC): clinicopathologic analysis of 473 in situ and invasive GBCs and critical review of the literature highlights its rarity, and that it has a very good prognosis.

There are highly conflicting data on relative frequency (2-32%), prognosis, and management of pT1b-gallbladder carcinoma (GBC), with 5-year survival ranging from > 90% in East/Chile where cholecystectomy is regarded as curative, versus < 50% in the West, with radical operations post-cholecystectomy being recommended by guidelines. A total of 473 in situ and invasive extensively sampled GBCs from the USA (n = 225) and Chile (n = 248) were re-evaluated histopathologically per Western invasiveness criteria. 349 had invasive carcinoma, and only 24 were pT1. Seven cases previously staged as pT1b were re-classified as pT2. There were 19 cases (5% of all invasive GBCs) qualified as pT1b and most pT1b carcinomas were minute (< 1mm). One patient with extensive pTis at margins (but pT1b focus away from the margins) died of GBC at 27 months, two died of other causes, and the remainder were alive without disease (median follow-up 69.9 months; 5-year disease-specific survival, 92%). In conclusion, careful pathologic analysis of well-sampled cases reveals that only 5% of invasive GBCs are pT1b, with a 5-year disease-specific survival of > 90%, similar to findings in the East. This supports the inclusion of pT1b in the "early GBC" category, as is typically done in high-incidence regions. Pathologic mis-staging of pT2 as pT1 is not uncommon. Cases should not be classified as pT1b unless extensive, preferably total, sampling of the gallbladder to rule out a subtle pT2 is performed. Critical appraisal of the literature reveals that the Western guidelines are based on either SEER or mis-interpretation of stage IB cases as "pT1b." Although the prognosis of pT1b-GBC is very good, additional surgery (radical cholecystectomy) may be indicated, and long-term surveillance of the biliary tract is warranted.

Anomalous (Exergonic) Behavior in the Transfer of Electrons between Donors and Acceptors: Mobility, Energy, Caloric Capacity, and Entropy.

Understanding the kinetics of electron transfer reactions involves active research in physics, chemistry, biology, and nano-tech. Here, we propose a model to apply in a broader framework by establishing a connection between thermodynamics and kinetics. From a purely thermodynamic point of view, electronic transfer Marcus' theory is revisited; consequently, calculations of thermodynamic variables such as mobility, energy, and entropy are provided. More significantly, two different regimes are explicitly established. In the anomalous region, an exergonic process associated with negative heat capacity appears. Further, in the same region, mobility, energy, and entropy decrease when the temperature increases.

Machine learning-based models for gestational diabetes mellitus prediction before 24-28 weeks of pregnancy: A review.

Gestational Diabetes Mellitus (GDM) is a hyperglycemia state that impairs maternal and offspring health, short and long-term. It is usually diagnosed at 24-28 weeks of pregnancy (WP), but at that time the fetal phenotype is already altered. Machine learning (ML)-based models have emerged as an auspicious alternative to predict this pathology earlier, however, they must be validated in different populations before their implementation in routine clinical practice. This review aims to give an overview of the ML-based models that have been proposed to predict GDM before 24-28 WP, with special emphasis on their current validation state and predictive performance. Articles were searched in PubMed. Manuscripts written in English and published before January 1, 2022, were considered. 109 original research studies were selected, and categorized according to the type of variables that their models involved: medical, i.e. clinical and/or biochemical parameters; alternative, i.e. metabolites, peptides or proteins, micro-ribonucleic acid molecules, microbiota genera, or other variables that did not fit into the first category; or mixed, i.e. both medical and alternative data. Only 8.3 % of the reviewed models have had validation in independent studies, with low or moderate performance for GDM prediction. In contrast, several models that lack of independent validation have shown a very high predictive power. The evaluation of these promising models in future independent validation studies would allow to assess their performance on different populations, and continue their way towards clinical implementation. Once settled, ML-based models would help to predict GDM earlier, initiate its treatment timely and prevent its negative consequences on maternal and offspring health.

Physical and anthropogenic drivers shaping the spatial distribution of microplastics in the marine sediments of Chilean fjords.

Several studies have focused on the presence and distribution of microplastics within the water column of coastal waters, but the dynamics of these particles in sediments have received little attention. Here we examine the concentrations and characteristics of microplastics in sediment samples collected from 35 stations within the Inner Sea of Chiloé, Chilean Patagonia. Current velocity, grain size, intensity of salmon farming activities, and human population density were all evaluated as factors potentially explaining concentrations and distribution of microplastic particles within these sediments. Microplastics were detected in all samples, with the highest abundance represented by fibers (88%), fragments (10%) and films (2%). Across the sampled sites, microplastic concentrations averaged 72.2 ± 32.4 (SD) items per kg dw (dry weight) sediment, with the principal polymers identified as polyethylene terephthalate (PET), acrylic, polypropylene (PP) and polyurethane (PUR). Approximately 40% of the variability in distribution and abundance of microplastics was explained by current velocity combined with proximity and intensity of local salmon production activities. SYNOPSIS: Marine currents and aquaculture intensity explain abundance and dynamics of microplastics in marine sediments.

Interactive virtual scenarios as a technological resource to improve musculoskeletal clinical reasoning skills of undergraduate physiotherapy students.

BACKGROUND: Clinical reasoning is a fundamental competency in the learning process of health professionals. Since learning with traditional methods presents difficulties, teaching with interactive virtual scenarios is a good alternative. OBJECTIVE: To describe the impact of a blended training with interactive virtual scenarios for the development of clinical reasoning skills in undergraduate physiotherapy students. METHODS: A sample of 92 students solved eight storylines. Assessment error percentage, clinical pattern recognition, satisfaction, and the perception of difficulty were obtained. A proportions test was used to compare baseline and final assessments. To analyze the relationship between the variables, multilevel univariate logistic regression models were built. RESULTS: A significant difference was observed in the error percentage between baseline and final assessment (p < .001). Comparing the last storyline to the first one, there were 2.63 times more possibilities to correctly recognize the pattern. The error percentage was associated with the opportunity to recognize the pattern precisely (p < .001). Thus, for each increasing unit in the error percentage, the possibility to correctly recognize the pattern decreased by 11% (OR = 0.89). CONCLUSIONS: The use of this innovative blended training with virtual scenarios allowed students to systematically improve their recognition abilities of clinical patterns and decrease mistakes in the decision-making process.

Do the heel-rise test and isometric strength improve after Achilles tendon repair using Dresden technique?

BACKGROUND: Achilles' tendon ruptures result in impaired plantar flexion strength and endurance. It is interesting to know the plantar flexion strength, the number of heel-rise repetitions, and the maximal calf circumference following Achilles' tendon ruptures repair. METHODS: Both the injured and non-injured legs of thirty male patients with Achilles' tendon ruptures treated with the percutaneous Dresden technique were compared with the ankle function of 30 healthy participants. Rehabilitation involved partial weight-bearing for three weeks and then increased to full weight-bearing and ankle exercises. RESULTS: The injured legs had weaker plantar flexion strength (1.64 ± 0.17 Nm/kg) compared with the non-injured legs (1.91 ± 0.24 Nm/kg; p = 0.002) and the healthy participants' legs (1.93 ± 0.32 Nm/kg; p < 0.001). The non-injured leg had greater ability in doing heel-rise repetitions (39.4 ± 6.1 rep.) compared with the injured legs (37.2 ± 5.7 rep.; p < 0.023) and the healthy participants' legs (31.0 ± 13.0 rep.; p < 0.001). CONCLUSIONS: The injured leg had not recovered full isometric strength but had improved heel-rise repetition.

Microplastic pollution on the soil and its consequences on the nitrogen cycle: a review.

Microplastics (MPs) correspond to plastics between 0.1 µm and 5 mm in diameter, and these can be intentionally manufactured to be microscopic or generated from the fragmentation of larger plastics. Currently, MP contamination is a complicated subject due to its accumulation in the environment. They are a novel surface and a source of nutrients in soils because MPs can serve as a substrate for the colonization of microorganisms. Its presence in soil triggers physical (stability of aggregates, soil bulk density, and water dynamics), chemical (nutrients availability, organic matter, and pH), and biological changes (microbial activity and soil fauna). All these changes alter organic matter degradation and biogeochemical cycles such as the nitrogen (N) cycle, which is a key predictor of ecological stability and management in the terrestrial ecosystem. This review aims to explore how MPs affect the N cycle in the soil, the techniques to detect it in soil, and their effects on the physicochemical and biological parameters, emphasizing the impact on the main bacterial groups, genes, and enzymes associated with the different stages of the N cycle.

Teachers' voices seeking humanized teaching in nursing: virtual experiences during the pandemic / Vozes ensinantes em busca de uma educação humanizada em enfermagem: experiências virtuais em pandêmica / Voces docentes en búsqueda de una enseñanza humanizada en enfermería: experiencias virtuales en pandemia

ABSTRACT Objective: to describe the experience of implementing the online training entitled "Humanization of the training processes in Nursing, care for all", targeted at Nursing teachers from a Chilean university, as well as to analyze their interventions in the virtual forum. Method: a qualitative research study, of the case study type, through content analysis based on the forum interventions of 12 training participants who gave their consent. The online training delivered to professors from a Chilean Nursing school carried out from May to November 2020 is described, and the categories obtained by means of content analysis are presented. Results: for the participants, humanized care has a personal dimension and a public-political dimension. In turn, humanized teaching in Nursing implies that teachers recognize their students as whole individuals in their generational and social contexts, but that they also recognize themselves as people with self-knowledge needs and aware of their possibilities and limitations when practicing their profession. Reflective teaching is an opportunity to humanize Nursing training. Conclusion: this virtual training during the pandemic and the participants' reflections allowed us to understand conceptual and experiential elements about humanization of care and of training. The participants disclose the aspects in which they can exert an influence for a more humanized culture, such as self-recognition and acknowledgment of their students as individuals in a context. The remaining challenge is to investigate influential strategies at the institutional and political levels to attain more humanized care and education.

RESUMO Objetivo: descrever a experiência de implantação do curso virtual "Humanização dos processos formativos em enfermagem, cuidado para todos", dirigido a docentes de enfermagem de uma escola chilena, e a análise de suas intervenções no fórum virtual. Método: pesquisa qualitativa, do tipo estudo de caso, por meio de análise de conteúdo a partir das intervenções em fórum de 12 cursistas que deram seu consentimento. É descrito o curso virtual ministrado a professores de uma escola de enfermagem chilena entre maio e novembro de 2020 e apresentadas as categorias obtidas por meio da análise de conteúdo. Resultados: para os participantes, o cuidado humanizado possui dimensão pessoal e público-política. Por su parte, la enseñanza humanizada de enfermería implica que el docente reconozca al estudiante como una persona integral en su contexto generacional y social, pero también se reconozca a sí mismo como persona con necesidades de autoconocimiento, y conciencia de sus posibilidades y limitaciones al ejercer sua profissão. O ensino reflexivo é uma oportunidade para humanizar a formação do enfermeiro. Conclusão: este curso virtual sobre pandemia e as reflexões dos participantes permitiram compreender elementos conceituais e vivenciais sobre a humanização do atendimento e a formação. Os participantes tornam visíveis os aspectos em que podem influenciar para uma cultura mais humanizada, como o reconhecimento de si e dos seus alunos como pessoas em contexto. Permanece o desafio de investigar estratégias influentes no nível institucional e político para um atendimento e educação mais humanizados.

RESUMEN Objetivo: describir la experiencia de implementación del curso virtual "Humanización de los procesos formativos en enfermería, cuidado para todos", dirigido a docentes de enfermería de una escuela chilena, y el análisis de sus intervenciones en el foro virtual. Método: investigación cualitativa, tipo estudio de caso, mediante análisis de contenido a partir de las intervenciones en el foro de 12 participantes del curso que brindaron su consentimiento. Se describe el curso virtual impartido a docentes de una escuela de enfermería chilena entre mayo y noviembre de 2020 y se presentan las categorías obtenidas mediante análisis de contenido. Resultados: para los participantes, el cuidado humanizado posee una dimensión personal y otra pública-política. Por su parte, la enseñanza humanizada de enfermería implica que el docente reconozca al estudiante como una persona integral en su contexto generacional y social, pero también se reconozca a sí mismo como persona con necesidades de autoconocimiento, y conciencia de sus posibilidades y limitaciones al ejercer su profesión. La enseñanza reflexiva es una oportunidad de humanizar la formación enfermera. Conclusión: este curso virtual en pandemia y las reflexiones de los participantes nos permitieron comprender elementos conceptuales y experienciales sobre la humanización de los cuidados y de la formación. Los participantes dejan visibles los aspectos en los que ellos pueden incidir para una cultura más humanizada como el reconocimiento de sí mismos y de sus estudiantes como personas en contexto. Queda el desafío de indagar en estrategias influyentes a nivel institucional y político para un cuidado y educación más humanizada.

Dysregulated Immune Responses in COVID-19 Patients Correlating With Disease Severity and Invasive Oxygen Requirements.

The prognosis of severe COVID-19 patients has motivated research communities to uncover mechanisms of SARS-CoV-2 pathogenesis also on a regional level. In this work, we aimed to understand the immunological dynamics of severe COVID-19 patients with different degrees of illness, and upon long-term recovery. We analyzed immune cellular subsets and SARS-CoV-2-specific antibody isotypes of 66 COVID-19 patients admitted to the Hospital Clínico Universidad de Chile, which were categorized according to the WHO ten-point clinical progression score. These included 29 moderate patients (score 4-5) and 37 severe patients under either high flow oxygen nasal cannula (18 patients, score 6), or invasive mechanical ventilation (19 patients, score 7-9), plus 28 convalescent patients and 28 healthy controls. Furthermore, six severe patients that recovered from the disease were longitudinally followed over 300 days. Our data indicate that severe COVID-19 patients display increased frequencies of plasmablasts, activated T cells and SARS-CoV-2-specific antibodies compared to moderate and convalescent patients. Remarkably, within the severe COVID-19 group, patients rapidly progressing into invasive mechanical ventilation show higher frequencies of plasmablasts, monocytes, eosinophils, Th1 cells and SARS-CoV-2-specific IgG than patients under high flow oxygen nasal cannula. These findings demonstrate that severe COVID-19 patients progressing into invasive mechanical ventilation show a distinctive type of immunity. In addition, patients that recover from severe COVID-19 begin to regain normal proportions of immune cells 100 days after hospital discharge and maintain high levels of SARS-CoV-2-specific IgG throughout the study, which is an indicative sign of immunological memory. Thus, this work can provide useful information to better understand the diverse outcomes of severe COVID-19 pathogenesis.

The Chile Biliary Longitudinal Study: A Gallstone Cohort.

Gallbladder cancer (GBC) is a highly fatal cancer that can be cured through cholecystectomy if identified early. The presence of gallstones is the primary risk factor for GBC, but few people with gallstones develop GBC. A key question is what drives the development of GBC among persons with gallstones. We initiated the Chile Biliary Longitudinal Study (Chile BiLS) to address this question. From 2016 to 2019, Chile BiLS enrolled 4,726 women aged 50-74 years with ultrasound-detected gallstones from southern-central Chile, accounting for an estimated 36% of eligible women with gallstones in the study area. The median age was 59 years; 25% of the women were Amerindian (Mapuche), 60% were obese, 25% had diabetes, and 6% had cardiovascular disease. Participants will be followed for gallbladder dysplasia or cancer for 6 years. As of April 30, 2020, over 91% of those eligible completed the year 2 follow-up visit. Data being collected include epidemiologic and sociodemographic information, anthropometric measurements, blood pressure, and tooth counts. Biosamples being taken include baseline plasma, buffy coat, red blood cells, serum, blood clot from serum, and PAXgene whole blood (PreAnalytiX GmbH, Hombrechtikon, Switzerland). Complete gallbladder sampling is conducted for most participants undergoing cholecystectomy. The Chile BiLS cohort study will increase our understanding of GBC etiology and could identify potential risk stratification and early detection strategies in high-risk areas.

Inflammatory profiles in Chilean Mapuche and non-Mapuche women with gallstones at risk of developing gallbladder cancer.

Chile has high incidence rates of gallbladder cancer globally, particularly among Amerindian women, who also have a high prevalence of gallstones. We examined differences in inflammatory biomarkers between Mapuche and non-Mapuche women from the Chile Biliary Longitudinal Study, a cohort of women with ultrasound-detected gallstones. We randomly selected 200 Mapuche women frequency matched to non-Mapuche women on age and statin use Inflammatory biomarkers were analyzed using a multiplex assay and linear regression to assess associations of a priori markers (CCL20, CXCL10, IL-6, and IL-8) with ethnicity. Novel biomarkers were analyzed using exploratory factor analysis (EFA) and sufficient dimension reduction (SDR) to identify correlated marker groups, followed by linear regression to examine their association with ethnicity. The mean values of IL-8 were higher in Mapuche than non-Mapuche women (P = 0.04), while CCL20, CXCL10, and IL-6 did not differ significantly by ethnicity. EFA revealed two marker groups associated with ethnicity (P = 0.03 and P < 0.001). SDR analysis confirmed correlation between the biomarkers and ethnicity. We found higher IL-8 levels among Mapuche than non-Mapuche women. Novel inflammatory biomarkers were correlated with ethnicity and should be studied further for their role in gallbladder disease. These findings may elucidate underlying ethnic disparities in gallstones and carcinogenesis among Amerindians.