Secondary Embryogenesis of Linaloe in Temporary Immersion Bioreactor-Type RITA®.

The linaloe [Bursera linanoe (La Llave) Rzed, Calderon and Medina] is an endemic species of Mexico, representative of the low deciduous forest of the states of Guerrero, Puebla, Morelos, and Oaxaca, and has been of great economic importance for the people, mainly for the artisanal use of its aromatic wood that is used to make boxes, trunks, and furniture that are manufactured in Olinala, Guerrero, Mexico; and industrial, thanks to the fine aroma of its essential oil (linalool), which is used in the manufacture of perfumes and pharmaceuticals. Overexploitation has endangered the species in recent years, and propagation by seed and/or cuttings has produced very poor results compared to those obtained with other recalcitrant Bursera species. The protection of endangered species makes urgent the need to propose new alternatives for its propagation. Somatic embryogenesis is a reliable and feasible technique, including induction, maintenance, multiplication, and maturation of embryos, often in semisolid culture media; however, the recent use of liquid media has allowed semi-automation in temporary immersion bioreactors, for example, the RITA® system, which favors both the multiplication rate and the final conversion to seedlings.

Differential Associations between Weight Status (Obesity, Overweight, and Underweight) and Substance Use in Young Adulthood.

BACKGROUND: Past evidence suggests obesity co-occurs with tobacco/nicotine, cannabis, and alcohol use in young adulthood, but whether this relationship extends to nicotine or cannabis vaping is unclear. Furthermore, differential relationships between substance use and specific weight status categories (obesity, overweight, and underweight) have not been assessed. This study assessed prevalence of tobacco/nicotine, cannabis, and alcohol use by weight status categories in young adulthood. METHODS: Of the 1322 young adults (18-29 years; 20.5 ± 2.3 years; 63% female; 42% Hispanic/Latino/a/x, 30% Asian-American/Asian, 18% Caucasian/White, 7% Multiracial, and 2% African-American/Black) from a public, urban university were surveyed on their health-risk behaviors in the spring and fall of 2021. RESULTS: Multinomial logistic regression models assessed six-month follow-up substance use prevalence (never, lifetime but no past 30-d use, and past 30-d use) by baseline weight status (obese, overweight, underweight; reference: healthy weight). Obesity predicted lower odds of past 30-d nicotine vaping (aOR [95% CI] = 0.27 [0.08-0.92]). Overweight predicted higher odds of lifetime combustible cannabis (aOR [95% CI] = 1.58 [1.08-2.30]) and past 30-d binge drinking (aOR [95% CI] = 1.79 [1.12-2.85]). Underweight was associated with lower odds of lifetime cannabis vaping (aOR [95% CI] = 0.35 [0.12-0.99]) and combustible cannabis (aOR [95% CI] = 0.38 [0.16-0.87]). CONCLUSIONS: Differential relationships between obesity and overweight on tobacco/nicotine, cannabis, and alcohol use suggest greater specificity is needed when evaluating relationships between higher weight status and substance use. It appears that overweight young adults may be at higher risk of substance use than obese young adults. Greater efforts to consider multiple weight status groups, not just obese, may have significant implications for tobacco/nicotine prevention and intervention efforts targeting vulnerable populations.

Delivering alone in a pandemic: Anticipated changes to partner presence at birth are associated with prenatal distress.

INTRODUCTION: The COVID-19 pandemic has impacted individuals across the world, and in particular, dramatically affected the experience of pregnancy and childbirth for many expectant mothers. The transition to parenthood is a time of increased risk for mental health problems, and maternal prenatal stress is associated with long-term maternal and infant health implications. The current study explored whether COVID-19 related changes to mothers' childbirth plans and prenatal health care experiences during the first wave of pandemic lockdowns in the U.S. were associated with self-reported depression, anxiety, and stress. METHOD: In spring 2020; we surveyed 641 pregnant women on their pregnancy and birth plans, as well as their mental health, during the COVID-19 pandemic. RESULTS: Women anticipating changes to the presence of their partner at birth also reported heightened symptoms of depression, anxiety, and stress. Additionally, women who anticipated changes to the timing of delivery reported both higher anxiety and higher perceived stress. DISCUSSION: These findings extend initial work suggesting increased risk for mental health problems in pregnant women during the COVID-19 pandemic by highlighting specific pandemic-related disruptions to pregnancy and birth that may have contributed to prenatal distress. Monitoring and intervention for these mothers and their infants are warranted. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Childhood parasitic infections and gastrointestinal illness in indigenous communities at Lake Atitlán, Guatemala.

Lake Atitlán has experienced a decline in water quality resulting from cultural eutrophication. Indigenous Mayans who already face disproportionate health challenges rely directly on the lake water. Our objectives were to: (1) estimate prevalence of shedding of water-borne fecal parasites among children 5 years of age and younger, (2) assess household-reported incidence of gastrointestinal illness in children, and (3) characterize water sources, treatment, and sanitation conditions in households. We hypothesized that household use of untreated lake water results in increased risk of shedding of parasites and gastrointestinal symptoms. A cross-sectional fecal sampling and physical exam of 401 children were conducted along with WASH surveys in partnership with healthcare providers in seven communities. Fecal samples were screened for Giardia lamblia and Cryptosporidium parvum, using a rapid ELISA, with a portion examined by microscope. The prevalence of parasite shedding was 12.2% (9.7% for Giardia; 2.5% for Cryptosporidium). Risk factors for Giardia shedding included age 3 years or older (3.4 odds ratio, z-stat = 2.781 p = 0.0054), low height-for-age z-score (2.3 odds ratio, z-stat = 2.225, p = 0.0216), lack of any household water treatment (2.5 odds ratio, z-stat = 2.492, p < 0.0012), and open access to household latrine (2.04 odds ratio, z-stat = 1.992, p = 0.0464). The majority (77.3%) of households reported water treatment, boiling and gravity fed filters as the most widespread practices. The vast majority of households (92%) reported usage of a latrine, while 40% reported open and shared access beyond their household. An overwhelming majority of households reported diarrhea and fever several times per year or greater, with approximately half reporting vomiting at that frequency. Lake water use was identified as a risk factor for households reporting frequent gastrointestinal symptoms (odds ratio of 2.5, 4.4, and 2.6; z-stat of 3.10, 3.65, and 3.0; p-values of 0.0021, 0.0003, and 0.0028, for diarrhea, vomiting, and fever, respectively) in children 5 years of age and younger. The frequency of gastrointestinal illness with a strong link to lake drinking water cannot be explained by the prevalence of protozoa, and risk from other enteropathogens must be explored. Improving access to water treatment and sanitation practices could substantially reduce the parasite burden faced by developing children in the region.

Effects of dexamethasone in traumatic brain injury patients with pericontusional vasogenic edema: A prospective-observational DTI-MRI study.

Cerebral edema is a frequent and serious complication in traumatic brain injury (TBI) patients. The objective is to study the effect of dexamethasone in patients with brain contusions, and to assess its effect on the vasogenic component of the pericontusional edema.Prospective-observational study to quantify, using magnetic resonance imaging, the volume of the edema before and after 10 days of dexamethasone in patients with brain contusions. Using diffusion tensor imaging, we have examined the effect of dexamethasone on fractional anisotropy (FA) and apparent diffusion coefficient (ADC). To assess changes, the pre- and post-treatment values for each patient were compared using a paired-samples Student t test.We included 30 TBI patients, 15 in each group. The volume of the vasogenic edema in the group of patients treated with dexamethasone decreased from 22 to 19 mL and this decrease was statistically significant (P < .05). Nevertheless, in the non-steroids group the volume of the vasogenic edema increased from 11 to 15 mL. There was a significant decrease in the ADC value (from 1.78-1.59; P < .05); and a significant increase in the FA value (0.09-0.11; P < .05) in the patients treated with dexamethasone.Using diffusion tensor imaging we have shown in a selected group of TBI patients with vasogenic pericontusional edema, a reduction of edema volume, a decrease in the ADC and an increase in the FA after treatment with dexamethasone. However, we have no data if such results are beneficial in terms of improving functional outcome.

Symptoms of anxiety, depression and self-care behaviors during the COVID-19 pandemic in the general population.

INTRODUCTION: The COVID-19 pandemic can have important psychosocial consequences in the population. OBJECTIVE: To determine the levels of anxiety, depression and self-care symptoms during the COVID-19 pandemic in the general population. METHOD: Online survey distributed over three weeks using a non-probability sampling. The PHQ-9 Patient Health Questionnaire, the GAD-7 Generalized Anxiety Disorder Scale and Visual analog scale for self-care behaviors were used. Between-group (anxiety and depression) descriptive and comparison analyses were carried out. RESULTS: Out of 1508 included participants, 20.8% had symptoms of severe anxiety, while 27.5% showed symptoms of severe depression. Being a woman, being single, having no children, having medical comorbidities and a history of mental health care were risk factors for developing symptoms of anxiety and depression; 66 to 80 % of the population complied with self-care recommendations. A need for receiving mental health care was identified in our study population. CONCLUSION: A larger number of individuals with moderate to severe anxiety and depression symptoms were observed than in other pandemics. COVID-19 pandemic psychological effects are considered an emerging public health problem, and implementation of programs for their care is therefore recommended.

INTRODUCCIÓN: La pandemia por COVID-19 puede tener consecuencias psicosociales importantes en la población. OBJETIVO: Determinar los niveles de síntomas de ansiedad, depresión y conductas de autocuidado durante la pandemia de COVID-19 en población general. MÉTODO: Encuesta en línea distribuida durante tres semanas mediante muestreo no probabilístico. Se empleó el Cuestionario sobre la Salud del Paciente PHQ-9, la Escala del Trastorno de Ansiedad Generalizada GAD-7 y la Escala análoga visual de conductas de autocuidado. Se realizaron análisis descriptivos y de comparación entre los grupos con ansiedad y depresión. RESULTADOS: Se incluyeron 1508 participantes, 20.8 % presentó síntomas de ansiedad grave y 27.5 %, síntomas de depresión grave. Ser mujer, soltero(a) no tener hijos, presentar comorbilidad médica y antecedentes de atención a la salud mental estuvieron relacionados con la presencia de mayores niveles de síntomas de ansiedad y depresión; 66 a 80 % de la población cumplía con las recomendaciones de autocuidado. Se identificó la necesidad de recibir atención de salud mental. CONCLUSIÓN: Se observó mayor número de individuos con síntomas de ansiedad y depresión moderadas a graves que en otras pandemias. Los efectos psicológicos de la pandemia de COVID-19 se consideran un problema de salud mental pública emergente, por lo que se recomienda la implementación de programas para su atención.

Symptoms of anxiety and depression and self-care behaviors during the COVID-19 pandemic in the general population / Síntomas de ansiedad, depresión y conductas de autocuidado durante la pandemia de COVID-19 en la población general

Abstract Introduction: The COVID-19 pandemic can have important psychosocial consequences in the population. Objective: To determine the levels anxiety and depression symptoms and self-care behaviors during the COVID-19 pandemic in the general population. Method: Online survey distributed over three weeks using a non-probability sampling. The PHQ-9 Patient Health Questionnaire, the GAD-7 Generalized Anxiety Disorder Scale and a self-care behaviors visual analogue scale were used. Between-group (anxiety and depression) descriptive and comparison analyses were carried out. Results: Out of 1508 included participants, 20.8 % had symptoms of severe anxiety, while 27.5 % showed symptoms of severe depression. Being a woman, being single, having no children, having medical comorbidities and a history of mental health care were associated with the presence of higher levels of anxiety and depression symptoms; 66 to 80 % of the population complied with self-care recommendations. A need for receiving mental health care was identified in our study population. Conclusion: A larger number of individuals with moderate to severe anxiety and depression symptoms were observed than in other pandemics. COVID-19 pandemic psychological effects are considered an emerging public mental health problem, and implementation of programs for their care is therefore recommended.

Resumen Introducción: La pandemia por COVID-19 puede tener consecuencias psicosociales importantes en la población. Objetivo: Determinar los niveles de síntomas de ansiedad, depresión y conductas de autocuidado durante la pandemia de COVID-19 en población general. Método: Encuesta en línea distribuida durante tres semanas mediante muestreo no probabilístico. Se empleó el Cuestionario sobre la Salud del Paciente PHQ-9, la Escala del Trastorno de Ansiedad Generalizada GAD-7 y la Escala análoga visual de conductas de autocuidado. Se realizaron análisis descriptivos y de comparación entre los grupos con ansiedad y depresión. Resultados: Se incluyeron 1508 participantes, 20.8 % presentó síntomas de ansiedad grave y 27.5 %, síntomas de depresión grave. Ser mujer, soltero(a) no tener hijos, presentar comorbilidad médica y antecedentes de atención a la salud mental estuvieron relacionados con la presencia de mayores niveles de síntomas de ansiedad y depresión; 66 a 80 % de la población cumplía con las recomendaciones de autocuidado. Se identificó la necesidad de recibir atención de salud mental. Conclusión: Se observó mayor número de individuos con síntomas de ansiedad y depresión moderadas a graves que en otras pandemias. Los efectos psicológicos de la pandemia de COVID-19 se consideran un problema de salud mental pública emergente, por lo que se recomienda la implementación de programas para su atención.

E-cigarette use among young adults: A latent class analysis examining co-use and correlates of nicotine vaping.

INTRODUCTION: Although a significant proportion of young adults report e-cigarette use (nicotine vaping), little is known about co-use with other substances, including correlates that predict co-use. The current study aimed to identify co-occurring substance use patterns and evaluate multiple correlates in a college student sample. METHODS: 435 participants (21.4 ± 2.9 years; 57% women; 41% Hispanic/Latina/o, 29% Asian-American/Pacific Islander, 17% Caucasian/White, 6% Multiracial, and 5% African-American/Black) from a large, urban university were recruited in-person and completed an online survey in the fall of 2018 and the spring of 2019. RESULTS: Using latent class analysis (LCA), four substance use patterns were identified: Binge Drinkers (7%); e-cigarette Users (8%); Cannabis Users (14%); and Low Substance Users (71%). The e-cigarette Users class was characterized by moderate or greater use (>5 days of nicotine vaping in past 30-days) as well as past 30-day binge drinking and cannabis use. Higher levels of deviant peer affiliation (aOR = 1.28[1.11-1.47], p < .01), impulsivity-lack of premeditation (aOR = 1.36[1.05-1.78], p < .05), and lower levels of social anxiety (aOR = 0.94[0.88-0.99], p < .05), predicted membership in the e-cigarette Users class. CONCLUSIONS: The most pervasive co-occurring substance use was observed among the e-cigarette Users class. Young adults reporting moderate or greater levels of nicotine vaping tended to engage in binge drinking and cannabis use, which may ultimately increase risk of deleterious health outcomes. Deviant peer affiliation and impulsivity-lack of premeditation (but not internalizing symptoms) predicted membership in the e-cigarette Users class; consequently, public health efforts may benefit from increased selectivity in targeting young adults for e-cigarette prevention and intervention services.

Micronutrient supplementation of lactating Guatemalan women acutely increases infants' intake of riboflavin, thiamin, pyridoxal, and cobalamin, but not niacin, in a randomized crossover trial.

BACKGROUND: Maternal supplementation during lactation could increase milk B-vitamin concentrations, but little is known about the kinetics of milk vitamin responses. OBJECTIVES: We compared acute effects of maternal lipid-based nutrient supplement (LNS) consumption (n = 22 nutrients, 175%-212% of the RDA intake for the nutrients examined), as a single dose or at spaced intervals during 8 h, on milk concentrations and infant intake from milk of B-vitamins. METHODS: This randomized crossover trial in Quetzaltenango, Guatemala included 26 mother-infant dyads 4-6 mo postpartum who were randomly assigned to receive 3 treatments in a random order: bolus 30-g dose of LNS (Bolus); 3 × 10-g doses of LNS (Divided); and no LNS (Control), with control meals. Mothers attended three 8-h visits during which infant milk consumption was measured and milk samples were collected at every feed. Infant intake was assessed as $\mathop \sum \nolimits_{i\ = \ 1}^n ( {{\rm{milk\ volum}}{{\rm{e}}_{{\rm{feed\ }}n}} \times \ {\rm{nutrient\ concentratio}}{{\rm{n}}_{{\rm{feed}}\ n}}} )$ over 8 h. RESULTS: Maternal supplementation with the Bolus or Divided dose increased least-squares mean (95% CI) milk and infant intakes of riboflavin [milk: Bolus: 154.4 (138.2, 172.5) µg · min-1 · mL-1; Control: 84.5 (75.8, 94.3) µg · min-1 · mL-1; infant: Bolus: 64.5 (56.1, 74.3) µg; Control: 34.5 (30.0, 39.6) µg], thiamin [milk: Bolus: 10.9 (10.1, 11.7) µg · min-1 · mL-1; Control: 7.7 (7.2, 8.3) µg · min-1 · mL-1; infant: Bolus: 5.1 (4.4, 6.0) µg; Control: 3.4 (2.9, 4.0) µg], and pyridoxal [milk: Bolus: 90.5 (82.8, 98.9) µg · min-1 · mL-1; Control: 60.8 (55.8, 66.3) µg · min-1 · mL-1; infant: Bolus: 39.4 (33.5, 46.4) µg; Control: 25.0 (21.4, 29.2) µg] (all P < 0.001). Only the Bolus dose increased cobalamin in milk [Bolus: 0.054 (0.047, 0.061) µg · min-1 · mL-1; Control: 0.041 (0.035, 0.048) µg · min-1 · mL-1, P = 0.039] and infant cobalamin intake [Bolus: 0.023 (0.020, 0.027) µg; Control: 0.015 (0.013, 0.018) µg, P = 0.001] compared with Control. Niacin was unaffected. CONCLUSIONS: Maternal supplementation with LNS as a Bolus or Divided dose was similarly effective at increasing milk riboflavin, thiamin, and pyridoxal and infant intakes, whereas only the Bolus dose increased cobalamin. Niacin was unaffected in 8 h. This trial was registered at clinicaltrials.gov as NCT02464111.

Implementation Analysis of a Perioperative Patient Safety Program in Guatemala.

BACKGROUND: The implementation of programs to improve patient safety remains challenging in low- and middle-income countries. The goal of our study was to define the barriers and facilitators to implementation of a perioperative patient safety program in Guatemala. MATERIAL AND METHODS: We conducted semi-structured interviews with 16 staff pre-intervention and a follow-up focus group discussion 1 year later in the perioperative department at the Roosevelt Hospital in Guatemala. We performed qualitative thematic analysis to identify barriers and facilitators to the implementation process, with analysis guided by the Consolidated Framework for Implementation Research. RESULTS: We found several dominant themes affecting implementation of a patient safety program. Implementation facilitators included strong prioritization of patient needs, program compatibility with existing workflow, and staff attributes. Barriers included a lack of knowledge about patient safety, limited resources, limited leadership engagement, and lack of formal implementation leaders. Several program modifications were made to enhance successful implementation iteratively during the implementation process. DISCUSSION: Our analysis highlights several dominant themes which affect the implementation of a perioperative safety program in Guatemala. Understanding the barriers and facilitators to implementation during program deployment allows for program modification and improvement of the implementation process itself.

Developing a national patient safety plan in Guatemala.

OBJECTIVE: Patient safety is challenging for health systems around the world, particularly in low-and middleincome countries such as Guatemala. The goal of this report is to summarize a strategic planning process for a national patient safety plan in Guatemala. METHODS: This strategic planning process involved multiple stakeholders, including representatives of the Guatemala Ministry of Health and Social Assistance, medical leadership from across the public health system, and academic experts from Guatemala and the United States of America. We used mixed methods (quantitative and qualitative surveys) and a nominal group technique at a national symposium to prioritize patient safety challenges across Guatemala, and subsequent meetings to develop a national patient safety plan. RESULTS: This national patient safety plan outlines four domains to advance patient safety across the public hospital system over a five-year period in Guatemala: leadership and governance, training and awareness, safety culture, and outcome metrics. For each domain, we developed a set of goals, activities, outputs, and benchmarks to be overseen by the Ministry of Health. CONCLUSIONS: With this national patient safety plan, Guatemala has made a long-term commitment to improving patient safety across the public hospital system of Guatemala. Future efforts will require its extension to all levels of the Guatemalan health system.

Evaluating the feasibility of two post-hoc correction techniques for mitigating posture-induced measurement errors associated with wearable motion capture.

Wearable motion capture systems are commonly used to measure body kinematics outside of laboratory settings. However, commercially available systems are designed to be used with typically developed adult populations, and assume users begin with a typical standing posture. Individuals with cerebral palsy and other neuromuscular pathologies often present atypical postures that can introduce significant errors in kinematics measurements from wearable motion capture. This study examines two post-hoc correction techniques for rectifying posture-induced errors in kinematic data: (1) Direct three-dimensional realignment of the measured body segment orientations, or (2) adding the initial static joint angle to the dynamic joint angle measurements. Gait kinematics were measured for eight able-bodied participants using a commercial wearable motion capture system. Participants walked with a typical gait, simulated crouch gait, and simulated equinus. The resulting kinematics from the uncorrected and post-hoc corrected trials were compared against simultaneously recorded measurements from an optoelectric motion capture system. Both correction techniques significantly decreased the posture-induced errors in lower-limb joint angle measurements. This work establishes a basis for the application of post-hoc correction techniques, aimed at improving the performance of wearable kinematic measurement systems when used with individuals having non-typical postures.

Developing a national patient safety plan in Guatemala

[ABSTRACT]. Objective. Patient safety is challenging for health systems around the world, particularly in low- and middleincome countries such as Guatemala. The goal of this report is to summarize a strategic planning process for a national patient safety plan in Guatemala. Methods. This strategic planning process involved multiple stakeholders, including representatives of the Guatemala Ministry of Health and Social Assistance, medical leadership from across the public health system, and academic experts from Guatemala and the United States of America. We used mixed methods (quantitative and qualitative surveys) and a nominal group technique at a national symposium to prioritize patient safety challenges across Guatemala, and subsequent meetings to develop a national patient safety plan. Results. This national patient safety plan outlines four domains to advance patient safety across the public hospital system over a five-year period in Guatemala: leadership and governance, training and awareness, safety culture, and outcome metrics. For each domain, we developed a set of goals, activities, outputs, and benchmarks to be overseen by the Ministry of Health. Conclusions. With this national patient safety plan, Guatemala has made a long-term commitment to improving patient safety across the public hospital system of Guatemala. Future efforts will require its extension to all levels of the Guatemalan health system.

[RESUMEN]. Objetivo. La seguridad del paciente constituye un reto para los sistemas de salud de todo el mundo, particularmente en los países de ingresos medianos y bajos como Guatemala. El objetivo del presente informe es resumir el proceso de planificación estratégica para elaborar un plan nacional sobre seguridad del paciente en Guatemala. Métodos. En el proceso de planificación estratégica participaron varios interesados directos, entre los cuales se encontraron representantes del Ministerio de Salud Pública y Asistencia Social de Guatemala, autoridades médicas de todo el sistema de salud pública, así como expertos académicos de Guatemala y Estados Unidos de América. Para establecer las prioridades en cuanto a los retos que deben abordarse en Guatemala en materia de seguridad del paciente se utilizó un método mixto (encuestas cuantitativas y cualitativas) y la técnica de grupo nominal en un simposio nacional, y posteriormente se realizaron reuniones para elaborar un plan nacional sobre la seguridad del paciente. Resultados. En el plan nacional sobre la seguridad del paciente se presentan cuatro ámbitos en los cuales se puede impulsar la seguridad del paciente en todos los hospitales públicos de Guatemala en un período de cinco años: liderazgo y gobernanza, capacitación y concientización, cultura de seguridad y métodos para medir los resultados. Se creó un conjunto de metas, actividades, resultados y puntos de referencia para cada ámbito, que estarán bajo la supervisión del Ministerio de Salud. Conclusiones. Con este plan nacional sobre la seguridad del paciente, Guatemala ha adquirido el compromiso a largo plazo de mejorar la seguridad del paciente en los hospitales públicos del país. Las iniciativas que se emprendan en el futuro requerirán que se extienda a todos los niveles del sistema de salud guatemalteco.

[RESUMO]. Objetivo. A segurança do paciente representa um desafio aos sistemas de saúde em todo o mundo, sobretudo nos países de baixa e média renda como a Guatemala. O presente tem o objetivo de descrever sucintamente o processo de planejamento estratégico para um plano nacional de segurança do paciente na Guatemala. Métodos. Este processo de planejamento estratégico contou com a participação de diversos interessados diretos, como representantes do Ministério da Saúde e Assistência Social da Guatemala, autoridades médicas da área de saúde pública e especialistas acadêmicos da Guatemala e dos Estados Unidos. Métodos combinados (pesquisas quantitativas e qualitativas) e técnica de grupo nominal foram usados em um simpósio nacional para priorizar os desafios em segurança do paciente na Guatemala e reuniões subsequentes foram realizadas para elaborar o plano nacional de segurança do paciente. Resultados. No plano nacional de segurança do paciente, são definidos quatro domínios para fazer avançar o processo de segurança do paciente no sistema hospitalar público em um período de cinco anos: liderança e governança; capacitação e conscientização; cultura de segurança e métricas para mensuração dos resultados. Um conjunto de metas, atividades, resultados e parâmetros de referência foi elaborado para cada domínio, a ser supervisado pelo Ministério da Saúde. Conclusões. Com este plano nacional de segurança do paciente, a Guatemala assumiu um compromisso de longo prazo de melhorar a segurança do paciente no sistema hospitalar público. Esforços devem ser empreendidos para expandir o plano a todos os níveis do sistema de saúde da Guatemala.

Virulence genes and resistance to antibiotics of beta-hemolytic streptococci isolated from children in Chiapas, Mexico.

INTRODUCTION: Among beta-hemolytic streptococci, Streptococcus pyogenes causes a wide variety of human disease including pharyngitis, necrotizing fasciitis and streptococcal toxic syndrome. Group A Streptococcus (GAS) uses a variety of virulence traits to colonize and then cause damage to the host; others species of beta-hemolytic streptococci are considered as emerging pathogens for humans. Despite its recognized virulence, only few studies have investigated virulence factors of GAS strains isolated in Mexico. METHODOLOGY: We conducted an epidemiological study to investigate the prevalence of GAS strains in child illnesses in Chiapas Mexico. Virulence genes encoding proteases, DNases, superantigens, as well as susceptibility to antibiotics were investigated. RESULTS: During 2010, 2013 and 2014, beta-hemolytic streptococci (N=12) were isolated from cases of bacterial infections including pharyngitis and bacteremia, with a prevalence of 0.42, 0.04 and 0.20%, respectively. S. pyogenes was the most frequent species (33%) followed by S. agalactiae and S. dysgalactiae subsp. equisimilis (25%, each). Most GAS strains encoded genes for proteases: scpA, speB, spyCEP and mac (75%), followed by sdaD and sdaB (DNases) (50%), speA and speG (superantigens; 50 and 25%, respectively). The scpA gene was amplified in all S. agalactiae strains and in ~35% of SDSE strains. Strains were all susceptible to beta-lactams, cephalosporins and quinolones. CONCLUSIONS: The present study provides evidence on the epidemiology of beta-hemolytic streptococci infecting children at the southeast Mexico, their virulence traits and sensitivity to first-line antibiotics.

Estrés, cuidado espiritual y percepción de los comportamientos de cuidado del personal de enfermería / Stress, spiritual care and perception of care behaviors of nursing staff

A través de un abordaje cuantitativo correlacional se determinó la relación entre el estrés, el cuidado espiritual y los comportamientos de cuidado en el personal de enfermería que labora en servicios para la atención de personas con enfermedad crónica no transmisible ECNT. Al observar dicha relación se evidenció la importancia de mejorar el conocimiento en relación al cuidado espiritual del personal de enfermería para ilustrar mejor cómo el cuidado que se brinda a estas personas debe estar basado en la humanización y puedan apoyar actividades que ayuden al personal de enfermería en situaciones que le generen algún grado de estrés. Objetivo: Establecer la relación entre el estrés y el cuidado espiritual con la percepción de los comportamientos de cuidado del personal de enfermería que labora en instituciones de salud que atienden a pacientes con enfermedad crónica. Método: El diseño fue de tipo cuantitativo, no experimental, correlacional, donde se realizó un muestreo intencional no probabilístico de sujetos, teniendo en cuenta la población de enfermeras y auxiliares de enfermería que laboran en instituciones de alta y mediana complejidad, en colaboración con el Centro de Investigaciones Oncológicas Clínica San Diego y la Organización Colegial de Enfermería, Colombia; donde se obtuvo un tamaño total de muestra de 216 personas que cumplieron con el criterio de inclusión de llevar más de un año trabajando con paciente crónico. Se aplicaron los instrumentos Escala de estrés en enfermería (NSS), Escala de evaluación de la espiritualidad y el cuidado espiritual (SCSSR) y la Escala de Comportamientos de cuidado de Sharon Horner (Versión Profesional). Se realizó nueva validación interna de los instrumentos (análisis factorial confirmatorio), análisis descriptivo y prueba de hipótesis sobre correlación no paramétrica, bajo el modelo de ecuaciones estructurales. Resultados: los participantes fueron en su mayoría mujeres, la edad correspondió a un 47.7% de personas que tienen entre 20 y 29 años, y un 35.65 % entre 30 y 39 años. Los servicios que mostraron mayor número de participantes son los de hospitalización con un 44 %. La correlación con la espiritualidad fue positiva lo cual indica que a medida que ésta aumenta, la percepción del comportamiento del cuidado también lo hace; en caso contrario, el estrés tiene un comportamiento inverso; es decir que a medida que este aumenta, la percepción del comportamiento de cuidado disminuye. Sin embargo, dichas correlaciones fueron bajas (cercanas a cero) Dado que valor p < α para espiritualidad, se rechaza H0, por lo tanto, existe evidencia estadística para afirmar que la percepción del comportamiento de cuidado depende del cuidado espiritual. Para el caso del estrés valor p> α, no se rechaza H0, es decir que no existe evidencia estadística para afirmar que la percepción del comportamiento de cuidado depende del nivel de estrés. Conclusión: Al dar respuesta a la relación existente entre las variables del estudio, se pudo determinar que efectivamente el comportamiento del cuidado si depende del cuidado espiritual que tiene la enfermera hacia su paciente por lo tanto, enfermería al ser el sujeto que está en constante relación con esta clase de personas, se convierte en el motor que dinamiza el proceso en sí de enfermedad que lleva la persona con enfermedad crónica y es el cuidado espiritual, el que permite brindar un cambio al cuidado que se brinda.

Through a quantitative correlative approach, the relationship between stress, spiritual care and care behaviors in nursing staff working in services for the care of people with chronic noncommunicable disease (CND). Upon observing this relationship, the importance of improving knowledge in relation to the spiritual care of the nursing staff was evidenced in order to affirm the care provided to this type of patients based on humanization and support activities that help the nursing staff in situations that can generate some kind of stress. Objective: Establish the relationship between stress and spiritual care with the perception of nursing care behaviors that work in health institutions that care for patients with chronic disease. Method: The design is quantitative, not experimental, correlational, where an intentional non-probabilistic sampling of subjects was carried out, taking into account the population of nurses and nursing assistants who work in institutions of high and medium complexity, in collaboration with the Centro de Investigaciones Oncológicas Clínica San Diego and the Organización Colegial de Enfermería, Colombia; where a total sample size of 216 people who met the inclusion criteria of having been working with a chronic patient for more than a year was obtained. The instruments Stress Scale in Nursing, Spiritual Care and Spiritual Assessment Scale from Sharon Horner Care Behavior Scale (Professional Version) were applied. We performed new internal validation of the instruments (confirmatory factor analysis), descriptive analysis and hypothesis testing on non-parametric correlation, under the structural equations model. Results: The participants were mostly women, referring to age: 47.7% are between 20 and 29 years old, and 35.65% between 30 and 39 years old. The services that show the greatest number of participants are those of hospitalization with 44%. The correlation with spirituality is positive, which indicates that as it increases the behavior of care, it also does so, otherwise, stress has an inverse behavior; that is, as it increases, the care decreases. However, these correlations are low (close to zero) Given that p α for spirituality, H0 is rejected, therefore there is statistical evidence to affirm that care behavior depends on spiritual care. In the case of stress value p> α, H0 is not rejected, that is to say that there is no statistical evidence to affirm that behavioral care depends on the level of stress. Conclusion: By responding to the relationship between the variables of the study, it was possible to determine that the care behavior does depend on the spiritual care the nurse has towards her patient. Nursing, has being the subject that is in constant relationship with the patient, and becomes the engine that dynamizes the process itself of illness that leads the person with chronic disease and is spiritual care, which allows you to offer a change to the type of care that is provided

Efficient purification of arsenic-contaminated water using amyloid-carbon hybrid membranes.

We show the purification of arsenic-contaminated water using amyloid fibril-based membranes, which adsorb both the arsenate (+5) and arsenite (+3) oxidation forms at efficiencies of ∼99%. Binding isotherms indicate that amyloid fibrils possess multiple binding residues capable of strongly adsorbing arsenic ions via metal-ligand interactions, delaying the saturation of the membrane. We also show that these membranes can be reused for several cycles without any efficiency drop, and validate our technology in purifying real contaminated ground water by removing arsenic with an efficiency as high as 99.6%. These results make this technology promising for inexpensive, efficient and low-energy removal of arsenic from contaminated water.

Organización, mantenimiento y preservación de la Colección de Cultivos Bacterianos del Instituto de Ciencias Biológicas de la Universidad de Ciencias y Artes de Chiapas (UNICACH), México / Organization, maintenance, and preservation of the Bacterial Culture Collection of the Biological Sciences Institute, University of Science and Arts of Chiapas (UNICACH), Mexico

Los ceparios o colecciones de microorganismos son fuentes de recursos genéticos cuyo propósito es la preservación de la diversidad biológica, garantizando su disponibilidad para actividades de docencia, investigación y comerciales. En este trabajo se verificó la viabilidad, pureza y características biológicas de las bacterias que conforman el cepario del Instituto de Ciencias Biológicas de la Universidad de Ciencias y Artes de Chiapas, y se organizó y estructuró la información obtenida en un portal virtual, para propiciar la cooperación académica. El cepario cuenta con 33 microorganismos, la mayoría del género Streptococcus y Escherichia (45,1 y 21,2%, respectivamente). Del primer género, se confirmó la identificación de S. pyogenes (40%), exhibiendo la mayoría genes que codifican para DNAsas. Con respecto al segundo género, un 58,3% de las bacterias fueron confirmadas taxonómicamente como E. coli. De esta especie, la colección cuenta con las cepas prototipo causantes de diarrea y que han preservado sus rasgos genéticos por más de cinco años. Dicho acervo ha impulsado actividades de docencia e investigación, a nivel local e internacional. Es importante que los ceparios sean fuentes sustentables de recursos biológicos, para la adquisición y suministro de especies bacterianas, con la finalidad de fomentar la interacción con la comunidad académica.

Strain collections or bacterial culture collections are genetic resources whose purpose is the preservation of biological diversity, ensuring their availability for teaching, research and trade activities. In this work viability, purity and biological characteristics of bacteria from the bacterial collection of the Institute of Biological Sciences, University of Science and Arts of Chiapas were studied. Information was structured and organized in a virtual site, to promote academic cooperation. The strain bank includes 33 microorganisms, most of the genus Streptococcus and Escherichia (45.1 and 21.2%, respectively). For Streptococcus, the identification of S. pyogenes (40%) was confirmed, by determination of most DNAses encoding genes. For Escherichia 58.3% were taxonomically confirmed as E. coli. For this species, the collection includes typical strains that produce diarrhea and their genetic traits have been preserved for more than five years. This bacterial culture collection has stimulated teaching and research activities at local and international levels. Strain collections are important sources of biological material which can provide bacterial species, in order to encourage interaction with the academic community.

Iron metabolism in obesity: how interaction between homoeostatic mechanisms can interfere with their original purpose. Part II: epidemiological and historic aspects of the iron/obesity interaction.

The change from a mainly vegetarian fare to meat consumption went along with brain growth and increased insulin resistance to improve brain's glucose supply. Meat consumption increased iron bioavailability and, thus, physical and mental fitness. The "predation-release-hypothesis" proposes that group coordination, arms and fire abolished the survival advantage of lean individuals from predation. The "thrifty gene-hypothesis", in contrast, proposes that surviving repeated episodes of starvation increased efficiency of food utilization in the offspring; they learned to utilize every available calorie. As a consequence of either mechanism, improved food security will increase prevalence of obesity along with that of its fatal consequences, such as diabetes, hypertension, heart diseases, and cancer. Thus, improved food security collides with the biologically evolved mechanisms to store excessive calories in preparation for a famine that never came. The crash between homoeostatic mechanisms and human intervention caused the presently observed pandemia of obesity and explains why it is so difficult to avoid, in spite of its well known and often fatal consequences.

Iron metabolism in obesity: how interaction between homoeostatic mechanisms can interfere with their original purpose. Part I: underlying homoeostatic mechanisms of energy storage and iron metabolisms and their interaction.

Adipose tissue plasticity mediated by inflammation is an important evolutionary achievement to survive seasonal climate changes. It permits to store excessive calories and to release them if required, using inflammatory cells to remove the debris. This process is regulated by a complex interaction of cytokines (TNF-α, IL-6), adipokines (adiponectin, apelin, liptin), adhesion molecules (ICAM-1, VCAM-1, E-selectin) and transcription factors (NF-κB, HIF-1α). Iron mediates electron transfer as an essential component of e.g. myeloperoxidase, hemoglobin, cytochrome C and ribonucleotide reductase. Conversely, unbound iron can catalyze oxidation of lipids, proteins, and DNA. To balance the essential with the potentially toxic function requires an efficient iron homoeostasis. This is mediated by hepcidin's interaction with the iron-exporter ferroportin, to adapt intestinal iron absorption and body iron-sequestration to changes in demand. In addition, the interaction of iron-responsive elements (IRE) and iron-responsive proteins (IRP), the IRE/IRP-mechanism, regulates cellular iron homoeostasis. Obesity-induced inflammation interacts with both these mechanisms and disturbs iron availability by impairing its absorption, and by sequestering it in the reticuloendothelial system. Both mechanisms lead to anemia and reduce physical fitness which, in a vicious cycle, can support the development of pathological obesity. Thus, interaction between these two sets of beneficial regulatory mechanisms can become detrimental in situations of ample calorie supply.

Differences in circulating non-transferrin-bound iron after oral administration of ferrous sulfate, sodium iron EDTA, or iron polymaltose in women with marginal iron stores.

BACKGROUND: The adverse interactions between iron supplements and malaria have driven the assessment of new therapeutic options for anemia prophylaxis in areas holoendemic for falciparum malaria. OBJECTIVE: To determine the responses of circulating non-transferrin-bound iron (NTBI) and plasma iron to three different oral iron compounds--ferrous sulfate, sodium iron ethylenediaminetetraacetate (NaFeEDTA), and iron polymaltose (IPM)--in women with marginal iron stores. METHODS: Serum samples from 10 Guatemalan women with marginal iron stores were collected every 90 minutes over a period of 270 minutes, after the individually randomized administration of 100 mg of iron from each of the three studied iron compounds or water alone. Serum iron concentration was quantified by the ferrozine method, and circulating NTBI concentration was determined with a fluorometric competitive binding assay. Kinetic responses and maximal cumulative changes in serum concentrations of iron and NTBI were compared between the four treatments. Comparison was made with data from the same protocol in iron-adequate men. RESULTS: The serum iron and NTBI responses to ferrous sulfate were significantly greater than those to water and the other two iron compounds. Serum iron responses to IPM did not differ from those to water alone. CONCLUSIONS: The administration of the two "slow-release" iron compounds, NaFeEDTA and IPM, resulted in a highly significant suppression of the appearance of NTBI in the circulation in the postsupplement period. These two bioavailable forms of iron supplement could represent a safe option for supplementation in malarial areas. The slope of the iron-NTBI relationship is steeper in men than in women.