Hindfoot Alignment in Flexible Cavovarus Deformity Under Orthostatic and Coleman Block Test Positions: A Weightbearing Computed Tomography Study.

BACKGROUND: Flexible cavovarus deformity is prevalent and the Coleman block test is frequently used to assess the first ray plantarflexion malpositioning in the overall deformity as well as the flexibility of the hindfoot. The objective was to assess and compare the weightbearing computed tomography (WBCT) 3-dimensional (3D) changes in clinical and bone alignment in flexible cavovarus deformity patients when performing the Coleman block test when compared to normal standing position and to controls. METHODS: Twenty patients (40 feet) with flexible cavovarus deformity and 20 volunteer controls (40 feet) with normal foot alignment underwent WBCT imaging of the foot and ankle. Cavovarus patients were assessed in normal orthostatic and Coleman block test positions. Foot and ankle offset (FAO), hindfoot alignment angle (HAA), talocalcaneal angle (TCA), subtalar vertical angle (SVA) and talonavicular coverage angle (TNCA) and a CT-simulated soft tissue envelope image, WBCT clinical hindfoot alignment angle (WBCT-CHAA), were evaluated by 2 readers. Measurements were compared between cavovarus nonstressed and stressed positions and to controls. P values of .05 or less were considered significant. RESULTS: The intra- and interobserver intraclass correlation coefficient were good or excellent for all WBCT measurements. Cavovarus patients demonstrated significant correction of WBCT-CHAA (9.7 ± 0.4 degrees), FAO (2.6 ± 0.4%), and TNCA (8.8 ± 1.8 degrees) when performing the Coleman block test (all P values <.0001). However, WBCT-CHAA and FAO measurements were still residually deformed and significantly different from controls (P values of .001 and <.0001, respectively). TNCA values corrected to values similar to healthy controls (P = .29). No differences were observed in cavovarus patients during Coleman block test for the coronal measures: HAA, TCA, and SVA measurements. CONCLUSION: In this study, we observed improvement in the overall 3D WBCT alignment (FAO), axial plane adduction deformity (TNCA), as well as CT simulated clinical hindfoot alignment (WBCT-CHAA) in flexible cavovarus deformity patients when performing a Coleman block test. However, we did not find improvement in measures of coronal alignment of the hindfoot, indicating continued varus positioning of the hindfoot in these patients. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

Ankle instability in pediatric and adolescent patients diagnosed with lateral malleolus avulsion fracture: Analysis of clinical and functional outcomes of ligament injury repair surgery.

BACKGROUND: Some children and adolescents can develop persistent pain and instability following inversion injuries of the ankle. In these cases, imaging exams could reveal small bone fragments distal to the lateral malleolus. For these patients, regular conservative treatment may not be successful, requiring additional management, which can include surgical treatment. This study aimed to present the short-to-midterm functional and clinical outcomes of a series of 12 pediatric and adolescent patients who underwent ligament repair surgery due to chronic instability associated with the presence of osseous components in the lateral ligaments. METHODS: A review of 12 patients treated with surgical ligament reconstruction of the ankle was evaluated. Clinical and functional evaluations were based on comparing the Visual Analogue Scale (VAS), AOFAS ankle-hindfoot score, and residual symptoms before and after the surgical intervention. RESULTS: Before the reconstructive approach, the mean VAS was 2.41 and the mean AOFAS score was 74.16. After the procedure, the standard VAS declined to zero, and the AOFAS score was 100 in all patients. The mean follow-up was 6.33 months. CONCLUSION: The surgical approach in children and adolescents with symptomatic ankle instability due to the presence of osseous fragments after an initial inversion trauma provided adequate clinical and functional results at short-to-midterm follow-up. LEVEL OF EVIDENCE: Level IV, retrospective case series.

A multidisciplinary approach to analyze the antimicrobial resistance in natural ecosystems.

Antimicrobial Resistance (AMR) poses a global threat to both human health and environmental well-being. Our study delved into Costa Rican wildlife reserves, uncovering a substantial human impact on these ecosystems and underscoring the imperative to pinpoint AMR hotspots. Embracing a One Health perspective, we advocated for a comprehensive landscape analysis that intricately intertwined geographic, climatic, forest, and human factors. This study illuminated the link between laboratory results and observed patterns of antimicrobial use, thereby paving the way for sustainable solutions. Our innovative methodology involved deploying open-ended questions to explore antimicrobial usage across livestock activities, contributing to establishing a comprehensive methodology. Non-invasive sampling in wildlife emerged as a critical aspect, shedding light on areas contaminated by AMR. Feline species, positioned at the apex of the food chain, acted as sentinels for environmental health due to heightened exposure to improperly disposed waste. Regarding laboratory findings, each sample revealed the presence of at least one antimicrobial resistance gene (ARG). Notably, genes encoding resistance to tetracyclines dominated (94.9%), followed by beta-lactams (75.6%), sulfonamides (53.8%), aminoglycosides (51.3%), quinolones (44.9%), phenicols (25.6%), and macrolides (20.5%). Genes encoding polymyxins were not detected. Moreover, 66% of samples carried a multi-resistant microbiome, with 15% exhibiting resistance to three antimicrobial families and 51% to four. The absence of a correlation between forest coverage and ARG presence underscored the profound human impact on wildlife reserves, surpassing previous estimations. This environmental pressure could potentially modify microbiomes and resistomes in unknown ways. As not all antimicrobial families encoding ARGs were utilized by farmers, our next step involved evaluating other human activities to identify the primary sources of contamination. This comprehensive study contributed crucial insights into the intricate dynamics of AMR in natural ecosystems, paving the way for targeted interventions and sustainable coexistence.

A case study on pharmaceutical residues and antimicrobial resistance genes in Costa Rican rivers: A possible route of contamination for feline and other species.

In this investigation, the presence of antibiotics and pharmaceuticals in Costa Rican surface waters, specifically in regions near feline habitats, was examined. The study revealed that 47% of the water samples contained detectable traces of at least one antibiotic. Ciprofloxacin and norfloxacin were the most frequently detected compounds, each with a detection rate of 27%. Other antibiotics, such as erythromycin, roxithromycin, and trimethoprim, were also found but at lower frequencies, around 14%. Notably, all antibiotic concentrations remained below 10 ng/L, with ciprofloxacin, norfloxacin, and erythromycin showing the highest concentrations. Furthermore, the investigation revealed the presence of non-antibiotic pharmaceutical residues in the water samples, typically at concentrations below 64 ng/L. Tramadol was the most frequently detected compound, present in 18% of the samples. The highest concentrations were observed for acetaminophen and tramadol, measuring 64 and 10 ng/L, respectively. Comparing these findings with studies conducted in treated wastewater and urban rivers, it became evident that the concentrations of antibiotics and pharmaceuticals were notably lower in this study. While previous research reported higher values, the limited number of studies conducted in protected areas raises concerns about the potential environmental impact on biodiversity. In summary, these results emphasize the importance of monitoring pharmaceutical residues and antimicrobial resistance genes ARGs in vulnerable ecosystems, especially those in close proximity to feline habitats in Costa Rica. Additionally, the study delved into the detection of (ARGs). All tested water samples were positive for at least one ARG, with the blaTEM gene being the most prevalent at 82%, followed by tetS at 64% and qnrB at 23%. Moreover, this research shed light on the complexity of evaluating ARGs in environmental samples, as their presence does not necessarily indicate their expression. It also highlighted the potential for co-selection and co-regulation of ARGs, showcasing the intricate behaviors of these genes in aquatic environments.

W-doped Lanthanum Molybdenum Oxide/Lithium-Sodium-Potassium Carbonate Composite Membranes for Carbon Dioxide Permeation.

Single-phase tungsten-doped lanthanum molybdenum oxide (La2MoWO9) ceramic powders were synthesized using the complex polymerization technique. Porous ceramic pellets were obtained by thermally removing graphite, which served as a pore former. The porous pellets were then impregnated with molten eutectic lithium-sodium-potassium carbonates. The energy dispersive X-ray analysis and scanning electron microscopy (FEG-SEM) images of the external and fracture surfaces of the La2MoWO9-(Li,Na,K)2CO3 composite dual-phase membrane revealed the percolation of the carbonate mixture through the pores. Electrochemical impedance spectroscopy measurements conducted at temperatures below and above the melting point of the eutectic carbonate composition demonstrated the contributions of oxygen and carbonate ions to the ionic conductivity of the dual membrane. The electrical conductivity of the carbonate ions within the membrane was continuously monitored for over 1300 h with negligible degradation, implying that the membrane could be used for long-term monitoring of CO2 without aging effects. A comparison of FEG-SEM images taken before and after this endurance test suggested minimal fouling, indicating that the membrane could potentially replace similar zirconia- and ceria-based composite membranes.

A comparative analysis of clinical, functional and radiographic outcomes of patients with and without fusion between the first and second metatarsals after the lapidus procedure.

BACKGROUND: The aim of this study was to compare the clinical, functional and radiographic outcomes in patients who underwent the original Lapidus procedure (OLP) with fusion and undesired non-fusion between the first (M1) and second (M2) metatarsals. METHODS: A retrospective and comparative analysis of 29 patients (38 feet) who underwent the OLP was performed. They were divided in two groups: (1) 23 feet in which fusion occurred and (2) 15 with undesired non-fusion. Clinical and functional data were assessed with the VAS for pain, AOFAS, LEFS and SF-12. SF-12 comprises physical and mental health scales (PCS-12 and MCS-12). Radiographic parameters assessed were bony and soft tissue forefoot widths (BSFW), intermetatarsal-angle (IMA) and HV-angle (HVA). RESULTS: Separately, the groups presented significant improvements in all questionnaires (p < 0.001), except on MCS-12 (fusion p = 0.08 and non-fusion p = 0.27). When comparing both groups, patients with fusion had higher AOFAS scores (p < 0.05). Both groups presented the same improvements on BSFW, IMA and HVA (p = 0.09, p = 0.16, p = 0.52 and p = 0.63). CONCLUSION: Excellent results were observed, even when without fusion between M1 and M2. Patients who evolved with fusion between the M1 and M2 showed greater improvements in the AOFAS score. LEVEL OF EVIDENCE: III, retrospective comparative study.

Unmet Needs of CKD in Latin America: A Review from Expert Virtual Working Group.

Chronic kidney disease (CKD) represents a major challenge for Latin American (LatAm) because of its epidemic proportions. Therefore, the current status and knowledge of CKD in Latin America is not clearly understood. Moreover, there is a paucity of epidemiologic studies that makes the comparison across the countries even more difficult. To address these gaps, a virtual kidney expert opinion meeting of 14 key opinion leaders from Argentina, Chile, Colombia, Costa Rica, Dominican Republic, Ecuador, Guatemala, Mexico, and Panama was held in January 2022 to review and discuss the status of CKD in various LatAm regions. The meeting discussed the following: (i) epidemiology, diagnosis, and treatment of CKD, (ii) detection and prevention programs, (iii) clinical guidelines, (iv) state of public policies about diagnosis and management of chronic kidney disease, and (v) role of innovative therapies in the management of CKD. The expert panel emphasized that efforts should be made to implement timely detection programs and early evaluation of kidney function parameters to prevent the development or progression of CKD. Furthermore, the panel discussed the importance of raising awareness among health care professionals; disseminating knowledge to the authorities, the medical community, and the general population about the kidney and cardiovascular benefits of novel therapies; and the need for timely updating of clinical practice guidelines, regulatory policies, and protocols across the region.

Staged reconstruction of the hallux for infected non-union using bulk autograft and a customized implant: Case report.

This case report illustrates the outcome of a deep infection following internal fixation of a fracture of the big toe. Hallux amputation could be avoided through staged salvage procedure. This paper can assist readers on how to effectively and safely recognize and treat this type of injury.

S-nitrosylation is required for ß2AR desensitization and experimental asthma.

The ß2-adrenergic receptor (ß2AR), a prototypic G-protein-coupled receptor (GPCR), is a powerful driver of bronchorelaxation, but the effectiveness of ß-agonist drugs in asthma is limited by desensitization and tachyphylaxis. We find that during activation, the ß2AR is modified by S-nitrosylation, which is essential for both classic desensitization by PKA as well as desensitization of NO-based signaling that mediates bronchorelaxation. Strikingly, S-nitrosylation alone can drive ß2AR internalization in the absence of traditional agonist. Mutant ß2AR refractory to S-nitrosylation (Cys265Ser) exhibits reduced desensitization and internalization, thereby amplifying NO-based signaling, and mice with Cys265Ser mutation are resistant to bronchoconstriction, inflammation, and the development of asthma. S-nitrosylation is thus a central mechanism in ß2AR signaling that may be operative widely among GPCRs and targeted for therapeutic gain.

Direct Conversion of Methane to C2 Hydrocarbons in Solid-State Membrane Reactors at High Temperatures.

Direct conversion of methane to C2 compounds by oxidative and nonoxidative coupling reactions has been intensively studied in the past four decades; however, because these reactions have intrinsic severe thermodynamic constraints, they have not become viable industrially. Recently, with the increasing availability of inexpensive "green electrons" coming from renewable sources, electrochemical technologies are gaining momentum for reactions that have been challenging for more conventional catalysis. Using solid-state membranes to control the reacting species and separate products in a single step is a crucial advantage. Devices using ionic or mixed ionic-electronic conductors can be explored for methane coupling reactions with great potential to increase selectivity. Although these technologies are still in the early scaling stages, they offer a sustainable path for the utilization of methane and benefit from the advances in both solid oxide fuel cells and electrolyzers. This review identifies promising developments for solid-state methane conversion reactors by assessing multifunctional layers with microstructural control; combining solid electrolytes (proton and oxygen ion conductors) with active and selective electrodes/catalysts; applying more efficient reactor designs; understanding the reaction/degradation mechanisms; defining standards for performance evaluation; and carrying techno-economic analysis.

Staged salvage of diabetic foot with Chopart amputation and intramedullary nailing.

We present a stepwise surgical approach that can be used, in lieu of a transtibial amputation, to preserve the lower limb in the setting of severe diabetic foot infections. A 63-year-old male status post left midfoot (Lisfranc's) amputation presented to our hospital with a 4-year history of a left foot diabetic ulcer with associated purulent drainage and intermittent chills. On initial exam, the patient's left foot amputation stump was plantarflexed, grossly erythematous, and edematous. The associated diabetic foot ulcer was actively draining purulent fluid. Following workup with radiography and ultrasound, the patient was diagnosed with a post-operative infection of the midfoot at the level of the amputation stump secondary to diabetic neuropathy. Our approach to management was a staged and included (1) surgical irrigation and debridement of the distal stump wound, (2) provisional negative pressure therapy, (3) a second-look procedure, and (4) a tibiotalocalcaneal fusion was performed using a lateral transfibular and plantar approach, after wound closure and resolution of active infection was achieved. At 36-month follow-up, the patient was fully weight-bearing in stiff sole sneakers with no gross overt alteration of gait pattern. The patient scored 79 points when assessed by the hindfoot American Orthopaedic Foot and Ankle Society Ankle-Hindfoot outcome score. In the patient with diabetes and cardiological restrictions, a Chopart amputation is preferred due to the decreased level of energy expenditure required for ambulation as compared to over more proximal levels of amputation.

Oxygen vacancy engineering of TaOx-based resistive memories by Zr doping for improved variability and synaptic behavior.

Resistive switching (RS) devices are promising forms of non-volatile memory. However, one of the biggest challenges for RS memory applications is the device-to-device (D2D) variability, which is related to the intrinsic stochastic formation and configuration of oxygen vacancy (VO) conductive filaments (CFs). In order to reduce the D2D variability, control over the formation and configuration of oxygen vacancies is paramount. In this study, we report on the Zr doping of TaOx-based RS devices prepared by pulsed-laser deposition as an efficient means of reducing the VOformation energy and increasing the confinement of CFs, thus reducing D2D variability. Our findings were supported by XPS, spectroscopic ellipsometry and electronic transport analysis. Zr-doped films showed increased VOconcentration and more localized VOs, due to the interaction with Zr. DC and pulse mode electrical characterization showed that the D2D variability was decreased by a factor of seven, the resistance window was doubled, and a more gradual and monotonic long-term potentiation/depression in pulse switching was achieved in forming-free Zr:TaOxdevices, thus displaying promising performance for artificial synapse applications.

Educação física escolar, tecnologias digitais e saúde: incursões exploratórias pela literatura / Physical education, digital technologies and health: exploratory for aysinto the literature / Educación física escolar, tecnologías digitales y salud: incursiones exploratorias a través de la literatura

Considerando a onipresença das tecnologias digitais atualmente e o massivo consumo destas por escolares, este estudo objetiva descrever e discutir os achados de uma revisão exploratória do conhecimento sobre a abordagem do tema saúde na Educação Física escolar que consideram os dispositivos/aplicativos tecnológicos. Trata-se de uma revisão não sistemática e investiga a literatura acadêmica da Educação Física considerando periódicos reconhecidamente relevantes que dialoguem diretamente com a educação. A busca centrou-se nos termos "escola", "tecnologia" e "saúde", sendo o diálogo na esfera escolar o principal critério de inclusão. Os achados apontam para 20 publicações que foram organizadas em categorias temáticas: a) tecnologia e suas implicações pedagógicas; b) monitoramento e uso de dados, um debate ético e; c) jogos digitais e tecnologias móveis. Destacam-se debates centrados em implicações pedagógicas de usos tecnológicos pelos professores, além de aspectos vinculados à exibição de si, quantificação de si e gamificação da vida pelos alunos.

Considering the ubiquity of digital technologies today and the massive consumption of these by schoolchildren, this study aims to describe and discuss the findings of an exploratory review of knowledge on the approach to health in school Physical Education that consider technological devices / applications. It is a non-systematic review and investigates the academic literature of Physical Education considering periodically relevant journals that dialogue directly with education. The search focused on the terms "school", "technology" and "health", with dialogue in the school sphere being the main inclusion criterion. The findings point to 20 publications that were organized into thematic categories: a) technology and its pedagogical implications; b) monitoring and use of data, an ethical debate and; c) digital games and mobile technologies. There are debates centered on the pedagogical implications of technological uses by teachers, in addition to aspects linked to self-display, self-quantification and gamification of life by students.

Considerando la ubicuidad de las tecnologías digitales actualmente y el consumo masivo por parte de jóvenes escolares, este estudio objetivo describe y discute los resultados de una revisión exploratoria del conocimiento sobre lo tema salud en la educación física escolar que considera los dispositivos/aplicaciones tecnológicas. Es una revisión no sistemática e investiga la literatura académica de Educación Física considerando publicaciones relevantes que dialogan directamente con la educación. La búsqueda se centró en los términos "escuela", "tecnología" y "salud", siendo el diálogo escolar el principal criterio inclusivo. Los hallazgos apuntan a 20 publicaciones que se organizaron en categorías: a) tecnología y sus implicaciones pedagógicas; b)monitoreo y uso de datos, un debate ético y; c)juegos digitales y tecnologías móviles. Hay debates centrados en las implicaciones pedagógicas de los usos tecnológicos de los docentes, además de los aspectos vinculados a la autoexposición, la auto cuantificación y la gamificación de la vida de los estudiantes.

SAXS signature of the lamellar ordering of ionic domains of perfluorinated sulfonic-acid ionomers by electric and magnetic field-assisted casting.

At present, small angle X-ray scattering (SAXS) studies of perfluorinated sulfonic-acid ionomers (PFSAs) are unable to fully determine the true shape of their building blocks, as recent SAXS modelling predicts disk- and rod-like nanoionic domains as being equally possible. This scenario requires evidence-based findings to unravel the real shape of PFSA building blocks. Herein, a SAXS pattern signature for a lamellar nanophase separation of the ionic domains of Nafion is presented, backed by mid and far infrared spectroscopy (MIR and FIR) and wide angle X-ray scattering (WAXS) data of Nafion in different ionic forms, a broad range of ionic phase contents (EW ∼ 859-42 252 g eq-1) and temperatures. The study indicates that the lamellar arrangement of the ionic domains is the most representative morphology that accounts for the physical properties of this ionomer. The lamellar SAXS reflections of Nafion are enhanced in electric and magnetic field-aligned membranes, as confirmed by atomic force microscopy (AFM). Electric and magnetic field-assisted casting of Nafion allowed producing nanostructured and anisotropic films with the lamellas stacked perpendicularly to the field vector, which is the direction of interest for several applications. Such nanostructured Nafion membranes are bestowed with advanced optical and proton transport properties, making them promising materials for solar and fuel cells.

Minimally invasive tenodesis for peroneus longus tendon rupture: A case report and review of literature.

BACKGROUND: Peroneal tendon disorders are common causes of lateral hindfoot pain. However, total rupture of the peroneal longus tendon is rare. Surgical treatment for this condition is usually a side-to-side tenodesis of the peroneal longus tendon to the peroneal brevis tendon. While the traditional procedure involves a long lateral curved incision, this approach is associated with damage to the lateral soft tissues (up to 24% incidence). CASE SUMMARY: A 50-year-old female had developed pain at the lateral aspect of the hindfoot 1 mo after an ankle sprain while walking in the street. Previous treatments were anti-inflammatory drugs, ice, rest and Cam-walker boot. At physical exam, there was pain and swelling over the course of the peroneal tendons. Ankle instability and cavovarus foot deformity were ruled out. Eversion strength was weak (4/5). Imaging showed complete rupture of the peroneal longus tendon associated with a sharp hypertrophic peroneal tubercle. Surgical repair was indicated after failure of conservative treatment (physiotherapy, rest, analgesics, and ankle stabilizer). A less invasive approach was performed for peroneal longus tendon debridement and side-to-side tenodesis to the adjacent peroneal brevis tendon, with successful clinical and functional outcomes. CONCLUSION: Peroneus longus tendon tenodesis can be performed through a less invasive approach with preservation of the lateral soft tissue integrity.

Interplay of α/ß-Relaxation Dynamics and the Shape of Ionomer Building Blocks.

The relation between the α/ß relaxations and the shape of the building blocks of ionomer materials is a key factor for programming an important temperature-dependent property: the memory of shape. However, the morphology of ionomers is indirectly obtained via modeling of small angle X-ray scattering (SAXS) data owing to the hardly accessible image characterization of the nanometric building blocks ‒ micelle-like cylindrical polymeric aggregates (radius ~2-6 nm and length >100 nm). Herein, broadband dielectric spectroscopy (BDS) measurements, free from electrode polarization effects, allowed identifying the time and temperature dependence of the polarization of different length scales of the ionomer matrix, and more importantly, by directly providing the aspect ratio of the radius and length of the polymeric aggregates for each desired temperature. This finding is essential for controlling the shape of ionomer based functional products under several stimuli conditions, thereby advancing remarkable applications, such as four dimensional (4D) printing.

Internal Fixation of Displaced Intra-articular Fractures of the Hallux Through a Dorsomedial Approach: A Technical Tip.

Phalangeal fractures of the toes represent common injuries of the forefoot. In the hallux, most fractures occur at the distal phalanx and frequently result from a direct crushing type of injury. Intra-articular fractures of the hallux are usually treated nonoperatively, except when the fragments are displaced and the joint is incongruent. Displaced fractures treated nonoperatively can result in degenerative arthritis of the interphalangeal joint, causing pain and range of motion limitation, hindering gait and weightbearing. The aim of this study was to present an option of operative approach in the treatment of displaced interphalangeal joint fractures of the hallux, along the medial border of the extensor hallucis longus tendon. It is our understanding that this approach minimizes injury to the soft tissue envelope, allowing a rigid fixation and early weightbearing and range of motion. LEVELS OF EVIDENCE: Level V: Expert opinion.

A constituição do mundo e de si-próprio no enlace existencial mãe-bebê / The constitution of the world and the one's own body in the mother-baby existential enlace / La constitucíon del mundo y del si-mismo en la unión existencial de la madre y el bebé

O presente escrito trata de uma fenomenologia acerca da constituição de mundo e de si-próprio a partir do corpo-infans. A existência humana demanda um mundo. Sua formação se dá em meio às vivências de sociabilidade que possibilitam a apropriação dos sentidos na corporeidade. Essa constituição do horizonte cultural tem como alicerce o enlace existencial mãe-bebê, cuja relação é abertura para uma possibilidade de mundo. O papel existencial da mãe tem como fundo a sociabilidade vivida; a mulher ao se tornar mãe apropria-se dos modos de maternagem existentes em sua sociabilidade e os seus cuidados para com o corpo do infans são o fundamento para a constituição do mundo do infans. Por fim, entende-se que a mãe e o bebê constituem-se em meio aos seus papeis existenciais vividos e que o mundo formado pelo infans sempre esteja ligado às suas vivências com a mãe.

This paper is about the phenomenology of the world's constitution from the body-infans. Human living-experience claims a world. Its formation occur in the middle of the social-experiences that makes the embodied appropriation of meaning possible. This constitution of the cultural horizon has, as its foundation, the mother-baby's existential enlace, whose relation is the opening for a possible world. The existential role of the mother has the living sociability as its background; the woman who became a mother takes possession of the existing mothering styles in her sociability and her caring for the body-infans becomes the basis for the constitution of the infans's world. Lastly, It is known that the mother and the baby are constituted by living their existential role, and that the world constituted by the infans is always connected by its living-experiences with the mother.

Este escrito es una fenomenología sobre la constitución del mundo y del si-mismo a partir del cuerpo-infans. La existencia humana exige un mundo. Su formación se lleva a cabo en medio de las experiencias de sociabilidad que permiten la apropiación de los sentidos en la corporalidad. Esta constitución del horizonte cultural tiene como fundamento la unión existencial madre-hijo cuya relación es la apertura para una posibilidad de mundo. El papel existencial de la madre es como contexto para la sociabilidad vivida; cuando la mujer se convierte en madre, ella se apropia de los modos existentes del cuidado infantil en suya sociabilidad y suyos cuidados para el cuerpo del infans son la base para la constitución del mundo-infans. Por último, se lo entiende que la madre y el bebé están en medio de sus funciones existenciales experimentadas y el mundo formado por el infans es siempre conectado a sus experiencias con la madre.

Environmental aspects related to tuberculosis and intestinal parasites in a low-income community of the Brazilian Amazon.

We carried out a cross-sectional study from January to December 2015 on 1,425 inhabitants from a floating population in the Brazilian Amazon (Murinin district, Pará State) to describe the population-based prevalence of tuberculosis (TB) from 2011 to 2014, recent TB contacts (rCts) latently infected with Mycobacterium tuberculosis (LTBI) , the coverage of the local health network, socio-environmental factors, and frequency of intestinal parasitic infection (IPI). We found that the sanitary structure was inadequate, with latrines being shared with other rooms within the same accommodation; well water was the main source of water, and 48% of families had low incomes. The average rate of TB was 105/100, 000 inhabitants per year; one third of TB patients had been household contacts of infected individuals in the past, and 23% of rCts were LTBI. More than half (65%) of 44% of the stools examined (representing 76% of the housing) had IPIs; the highest prevalence was of fecal-oral transmitted protozoa (40%, Giardia intestinalis ), followed by soil-transmitted helminths (23%). TB transmission may be related to insufficient disease control of rCts, frequent relocation, and underreporting. Education, adopting hygienic habits, improving sanitation, provision of a treated water supply and efficient sewage system, further comprehensive epidemiological surveillance of those who enter and leave the community and resources for basic treatment of IPIs are crucial in combating the transmission of these neglected diseases.