[Design of a nursing assessment instrument during pregnancy monitoring in Primary Health care and the validation of its content]. / Diseño de un instrumento de valoración enfermera para el seguimiento de embarazo en Atención Primaria de salud y la validación de su contenido.

OBJECTIVE: This research aims to develop a nursing assessment tool, based on Gordon's Health Functional Patterns, through a content validation by a committee of experts, applying a Delphi technique. DESIGN: An assessment instrument with 53 items has been designed. SITE: It is carried out within the framework of a doctoral thesis, for its implementation by midwives of Primary Health Care. PARTICIPANTS: The committee was made up of 16 professionals with a hide clinical, teaching and research experience who all participated in the entire validation process. INTERVENTION: It has been assessed as a whole and in each of the items through four rounds of consultations, establishing a positive assessment of more than 60% to accept each item, as well as incorporating the suggestions provided by the committee. The final version had to reach a unanimous consensus. MAIN MEASUREMENTS: All items were accepted with a score higher than 60%. RESULTS: There were no contradictions between the inputs provided by the experts, so all of them were integrated into the final version that has a 100% approval by the committee. CONCLUSION: After this process, a new assessment tool is presented to be applied by primary care midwives in the pregnancy monitoring. The questionnaire has been piloted with 50 pregnant women, determining the most prevalent nursing diagnoses, establishing the workload for the midwife of her implementation of individualized care plans to improve some health indicators of pregnant women.

Adenosine increases PD-L1 expression in mesenchymal stromal cells derived from cervical cancer through its interaction with A2AR/A2BR and the production of TGF-ß1.

Mesenchymal stromal cells (MSCs) together with malignant cells present in the tumor microenvironment (TME), participate in the suppression of the antitumor immune response through the production of immunosuppressive factors, such as transforming growth factor beta 1 (TGF-ß1). In previous studies, we reported that adenosine (Ado), generated by the adenosinergic activity of cervical cancer (CeCa) cells, induces the production of TGF-ß1 by interacting with A2AR/A2BR. In the present study, we provide evidence that Ado induces the production of TGF-ß1 in MSCs derived from CeCa tumors (CeCa-MSCs) by interacting with both receptors and that TGF-ß1 acts in an autocrine manner to induce the expression of programmed death ligand 1 (PD-L1) in CeCa-MSCs, resulting in an increase in their immunosuppressive capacity on activated CD8+ T lymphocytes. The addition of the antagonists ZM241385 and MRS1754, specific for A2AR and A2BR, respectively, or SB-505124, a selective TGF-ß1 receptor inhibitor, in CeCa-MSC cultures significantly inhibited the expression of PD-L1. Compared with CeCa-MSCs, MSCs derived from normal cervical tissue (NCx-MSCs), used as a control and induced with Ado to express PD-L1, showed a lower response to TGF-ß1 to increase PD-L1 expression. Those results strongly suggest the presence of a feedback mechanism among the adenosinergic pathway, the production of TGF-ß1, and the induction of PD-L1 in CeCa-MSCs to suppress the antitumor response of CD8+ T lymphocytes. The findings of this study suggest that this pathway may have clinical importance as a therapeutic target.

Adenosine Increases the Immunosuppressive Capacity of Cervical Cancer Cells by Increasing PD-L1 Expression and TGF-ß Production through Its Interaction with A2AR/A2BR.

The present study provides evidence showing that adenosine (Ado) increases the expression of programmed death ligand 1 (PD-L1) in cervical cancer (CeCa) cells by interacting with A2AR/A2BR and that TGF-ß1 acts in an autocrine manner to induce PD-L1 expression, enhancing the immunosuppressive effects of CeCa cells on activated T lymphocytes (ATLs) and CD8+ cytotoxic T lymphocytes (CTLs) specific for antigenic peptides derived from E6 and E7 proteins of HPV-16. Interestingly, the addition of the antagonists ZM241385 and MRS1754, which are specific for A2AR and A2BR, respectively, or SB-505124, which is a selective TGF-ß1 receptor inhibitor, to CeCa cell cultures significantly inhibited PD-L1 expression. In addition, supernatants from CeCa cells that were treated with Ado (CeCa-Ado Sup) increased the expression of PD-1, TGF-ß1, and IL-10 and decreased the expression of IFN-γ in ATLs. Interestingly, the addition of an anti-TGF-ß neutralizing antibody strongly reversed the effect of CeCa-Ado Sup on PD-1 expression in ATLs. These results strongly suggest the presence of a feedback mechanism that involves the adenosinergic pathway, the production of TGF-ß1, and the upregulation of PD-L1 expression in CeCa cells that suppresses the antitumor response of CTLs. The findings of this study suggest that this pathway may be clinically important and may be a therapeutic target.

Cash flow management and its effect on firm performance: Empirical evidence on non-financial firms of China.

The main purpose of this research is to investigate the impact of changes in cash flow measures and metrics on firm financial performance. The study uses generalized estimating equations (GEEs) methodology to analyze longitudinal data for sample of 20288 listed Chinese non-financial firms from the period 2018:q2-2020:q1. The main advantage of GEEs method over other estimation techniques is its ability to robustly estimate the variances of regression coefficients for data samples that display high correlation between repeated measurements. The findings of study show that the decline in cash flow measures and metrics bring significant positive improvements in the financial performance of firms. The empirical evidence suggests that performance improvement levers (i.e. cash flow measures and metrics) are more pronounced in low leverage firms, suggesting that changes in cash flow measures and metrics bring more positive changes in low leverage firms' financial performance relatively to high leveraged firms. The results hold after mitigating endogeneity based on dynamic panel system generalized method of moments (GMM) and sensitivity analysis considering the robustness of main findings. The paper makes significant contribution to the literature related to cash flow management and working capital management. Since, this paper is among few to empirically study, how cash flow measures and metrics are related to firm performance from dynamic stand point especially from the context of Chinese non-financial firms.

Inhibition of CD73 expression or A2AR blockade reduces MRP1 expression and increases the sensitivity of cervical cancer cells to cisplatin.

Recently, a link between the biological activity of CD73 in solid tumors and multidrug resistance protein (MRP) has been proposed. Cisplatin (CP) is the most widely used anticancer agent to treat advanced and recurrent cervical cancer (CC). However, multidrug resistance protein-1 (MRP1) is overexpressed in approximately 85% of these tumors and has been strongly associated with cisplatin resistance (CPR). In this study, we examine the involvement of CD73 and the interaction of adenosine (ADO) with its receptors (ARs) in MRP1 expression in CC cells. We found that ADO positively modulates MRP1 expression in CC cells in a dose-dependent manner. The inhibition of CD73 expression with a CD73-targeted siRNA and A2AR blockade with the selective antagonist ZM241385 significantly decreased MRP1 expression and the extrusive capacity of CC cells, making them significantly more sensitive to CP treatment than cancer cells treated with MK-751, a specific MRP1 inhibitor. These results suggest CD73 inhibition or blocking ADO signaling through A2AR could be strategies to reverse CPR in patients with advanced or recurrent CC, which is characterized by very low response rates to CP (10%-20%).

Conocimientos sobre medidas de bioseguridad ante la COVID-19 en estudiantes de Enfermería / Knowledge about biosecurity measures against COVID-19 in nursing students

Fundamento: los riesgos que implica el quehacer de los profesionales de la salud en el ejercicio de su práctica cotidiana demandan incorporar los elementos concernientes a la bioseguridad a sus funciones. Objetivo: determinar el nivel de conocimiento y la aplicación de las normas de bioseguridad en estudiantes de enfermería ante la COVID-19. Métodos: se realizó un estudio descriptivo transversal durante el mes de octubre de 2020 en el Hospital Clínico-Quirúrgico "Comandante Faustino Pérez Hernández" y el Hospital Pediátrico "Eliseo Noel Camaño" de Matanzas. Se utilizaron métodos teóricos: histórico-lógico e inductivo-deductivo; y empíricos: cuestionario y el análisis documental. Resultados: a través de la aplicación del cuestionario se obtuvo que el 100 % de los estudiantes tienen un adecuado conocimiento sobre el lavado y secado de las manos, el 83,3 % mostró conocimientos adecuados sobre el uso de equipos de protección personal, mientras que el 100 % conoce el uso del nasobuco en la atención a pacientes con infección respiratoria, además se pudo conocer que el 55,5 % hacen uso de los medios de protección siempre, y el 45,5 % solo lo usan algunas veces. Conclusiones el nivel de conocimiento y la aplicación de las normas de bioseguridad en estudiantes de enfermería ante la COVID-19 fueron en su mayoría adecuados, lo que implica diseñar una capacitación sobre el tema dirigida a aquellos que la necesiten.

Background: the risks involved in the work of health professionals in the exercise of their daily practice demand the incorporation of elements concerning biosafety into their functions. Objective: to determine the level of knowledge and the application of biosafety standards in nursing students while facing COVID-19. Methods: a cross-sectional descriptive study was carried out during the month of October 2020 at the "Comandante Faustino Pérez Hernández" Clinical-Surgical Hospital and the "Eliseo Noel Camaño" Pediatric Hospital in Matanzas. Theoretical methods were used: historical-logical and inductive-deductive; and empirical ones: questionnaire and documentary analysis. Results: through the implentation of the questionnaire, it was obtained that 100% of the students have adequate knowledge about washing and drying their hands, 83.3% showed adequate knowledge about the use of personal protective equipment, while 100% know the use of the facemask in the care of patients with respiratory infection, in addition it was possible to know that 55.5% always use the means of protection, and 45.5% only use it sometimes. Conclusions: the level of knowledge and the application of biosafety standards in nursing students before COVID-19 was mostly adequate, which implies designing training on the subject aimed at those who need it.

Satisfacción de pacientes y prestadores de servicios en el Instituto de Hematología e Inmunología / Satisfaction of Patients and Service Providers in the Institute of Hematology and Immunology

Introducción: La satisfacción del paciente y el prestador de servicio asistencial de salud es una variable multidimensional de la calidad en la atención médica. La comunicación, la atención y cortesía, el tiempo de espera percibido, la aplicación de una tecnología de avanzada y una infraestructura idónea son los factores que se deben trabajar para incrementar dicha satisfacción. Objetivo: Identificar el nivel de satisfacción de pacientes, familiares y prestadores de servicios en el Instituto de Hematología e Inmunología. Métodos: Se realizó un estudio descriptivo de corte transversal, durante cinco años (2017-2021). El universo lo conformaron 1004 personas, seleccionados mediante un muestreo aleatorio simple. Se aplicaron para la evaluación de la satisfacción las técnicas de encuestas y entrevistas. Resultados: Se identificó el nivel de satisfacción de las personas respecto a las dimensiones evaluadas sobresaliendo en más del 90 por ciento el trato recibido, la eficiencia en los servicios prestados y la privacidad en salas de asistencia médica. Resultó ser de un 93 por ciento el compromiso y la entrega de los prestadores de servicios y más del 70 por ciento del personal se capacitó. Se analizaron varios indicadores a partir de encuestas de tipo cerradas, abiertas y entrevistas. Conclusiones: La identificación del nivel de satisfacción de pacientes, familiares y prestadores de servicios permite mitigar o eliminar la mayoría de las inconformidades lo que contribuye a la mejora en los servicios asistenciales, docentes e investigativos, que avalan los logros alcanzados por el instituto en la actualidad(AU)

Introduction: Patient and healthcare provider satisfaction is a multidimensional variable of healthcare quality. Communication, care and politeness, the perceived waiting time, the application of advanced technology, as well as an adequate infrastructure, are the factors that should be worked on to increase such satisfaction. Objective: To identify the level of satisfaction of patients, family members and service providers at the Institute of Hematology and Immunology. Methods: A descriptive and cross-sectional study was carried out during five years (2017-2021). The universe consisted of 1004 people, selected by simple random sampling. The survey and interview techniques were used to evaluate satisfaction. Results: The level of satisfaction of the people was identified, with respect to the evaluated dimensions; received treatment, efficiency of provided services and privacy in medical care rooms stood out in more than 90 percent. The commitment and dedication of the service providers was 93 percent, while more than 70 percent of the personnel received training. Several indicators were analyzed based on closed or open-ended surveys and interviews. Conclusions: The identification of the level of satisfaction among patients, family members and service providers allows mitigating or eliminating most of the nonconformities, contributing to the improvement in care, teaching and research services, which confirms the achievements attained by the institute nowadays(AU)

Projecting Spanish fertility at regional level: A hierarchical Bayesian approach.

The transition from a demographic regime of high mortality and high fertility to one with low mortality and low fertility is universal and comes along with the process of socio-economic modernization. The Spanish total fertility rate has decreased to below replacement levels in the last decades. The decline has persisted since the 1960s and is diverse across the country. Based on that diversity, the use of population forecasts, not only at national but at regional levels, for planning purposes (governments and private sector) with large horizons has become a must to provide essential services. Using a Bayesian hierarchical model we constructed probabilistic fertility forecasts for Spain at the regional level. Although this approach is already issued by the United Nations little research has been done focusing on the Spanish subnational level. Our objective is to disaggregate the national projections of the total fertility rate for Spain into regional forecasts. The results of this research will show the model fitting, first to the national level and then using a multifaceted and continuous evolution of fertility over time, at the regional level, to check its convergence.

Evidence that cervical cancer cells cultured as tumorspheres maintain high CD73 expression and increase their protumor characteristics through TGF-ß production.

Recently, a link between the biological activity of CD73 and tumorigenicity in solid tumors has been proposed. We previously reported that the generation of adenosine (Ado) by the activity of CD73 in cervical cancer (CC) cells induces transforming growth factor-beta 1 (TGF-ß1) production to maintain CD73 expression. In the present study, we analyzed the participation of TGF-ß1 in CD73 expression and the development of protumoral characteristics in CaSki CC cells cultured as tumorspheres (CaSki-T) and in monolayers (CaSki-M). Compared with those in CaSki-M cells, CD73 expression and Ado generation ability were significantly increased in CaSki-T cells. CaSki-T cells exhibited enrichment in the CSC-like phenotype due to increases in the expression levels of stem cell markers (CD49f, CK17, and P63; OCT4 and SOX2), greater sphere formation efficiency (SFE), and an increase in the percentage of side population (SP) cells. Interestingly, compared with CaSki-M cells, CaSki-T cells produced a greater amount of TGF-ß1 and presented a marked protumor phenotype characterized by a significant decrease in the expression of major histocompatibility complex class-I (MHC-I) molecules, an increase in the expression of multidrug resistance protein-I (MRP-I) and vimentin, and an increase in the protein expression levels of Snail-1 and Twist, which was strongly reversed with TGF-ß1 inhibition. These results suggest that the presence of TGF-ß1-CD73-Ado feedback loop can promote protumoral characteristics in the CC tumor microenvironment.

Implementación del sistema de gestión de calidad en el Instituto de Hematología e Inmunología / Implementation of the Quality Management System in the Institute of Hematology and Immunology

Introducción: Un sistema de gestión de calidad brinda la estructura organizativa, los procesos, los procedimientos y las herramientas para implementar las actividades y alcanzar los objetivos requeridos. Es un proceso en el que participan directivos, operativos y administrativos. Todos deben reconocer y asumir su responsabilidad para el éxito de la implementación o mejoramiento del sistema y deben esforzarse para alcanzarlo. Objetivo: Exponer el proceso de implementación del sistema de gestión de calidad del Instituto de Hematología e Inmunología. Métodos: Se realizó una investigación descriptiva. Se realizaron encuestas, entrevistas y auditorías para mostrar el desarrollo del sistema de gestión de calidad del Instituto de Hematología e Inmunología. El período de estudió fue de 2017-2020 e incluyó 32 áreas del instituto. Resultados: Se crearon los documentos del sistema de gestión de calidad y el plan de gestión. Se capacitó al personal. Se definieron las políticas, el objetivo y la proyección estratégica de la calidad. Se elaboró y se puso en ejecución todo el sistema documental, con un total de más de 590 documentos. Las tareas derivadas del plan de gestión de la calidad se cumplieron en un 81,25 por ciento, esto permitió identificar las áreas de mejoras Conclusiones: La implementación del sistema de gestión de calidad es trascendental para elevar el buen desempeño de una organización de salud y constituye el motor impulsor para lograr la calidad merecida en todos los servicios asistenciales que brinda, lo cual demuestra su importancia para alcanzar los resultados que espera y necesita el sistema de salud cubano(AU)

Introduction: A quality management system provides the organizational structure, processes, procedures and tools to implement activities and achieve the required objectives. It is a process with the participation of management, operational and administrative personnel. All of them must recognize and assume their responsibility for the successful implementation or improvement of the system and must strive to achieve it. Objective: To describe the implementation process of the quality management system in the Institute of Hematology and Immunology. Methods: A descriptive research was carried out. Surveys, interviews and audits were conducted to show the development of the quality management system in Institute of Hematology and Immunology. The study period was 2017-2020 and included 32 institutional areas. Results: The corresponding documents were created for the quality management system and the management plan. The personnel received training. Quality policies, objective and strategic projection were defined. The entire document system was developed and implemented, with a total of more than 590 documents. The tasks derived from the quality management plan were completed at 81.25 percent, which allowed the identification of areas for improvement. Conclusions: The implementation of the quality management system is transcendental to raise the good performance of a health organization, as well as the driving force to achieve the deserved quality in all the care services provided by any institution, which shows its importance to achieve the outcomes expected and needed by the Cuban health system(AU)

Las personas con trastorno mental grave en un programa de alojamiento supervisado por un Equipo Comunitario Asertivo / People with severe mental disorders in a housing program supervised by an Assertive Community Team

El objetivo de este trabajo es evaluar la actitud y satisfacción de 182 pacientes con trastorno mental grave alojados en pisos y residencias supervisadas, sus redes sociales, las necesidades de atención y los cambios clínicos. Se recogieron datos sociodemográficos y clínicos. Se aplicaron los cuestionarios de Actitudes del Usuario (CAU), de Red Social (CURES) y la Escala ENAR-CPB de Valoración de los Niveles de Atención Residencial, con repetición a los dos años. El 86% refirieron mejoría en su vida, 77% en su enfermedad y 50% en sus relaciones sociales. Se observó una reducción significativa en las necesidades de atención a los dos años. Un 86% no tuvo ingresos hospitalarios, frente al 99% del año previo. En general, encontramos una buena aceptación de los alojamientos, con mejoría en las relaciones sociales, la estabilidad clínica y hospitalizaciones. Gracias al tratamiento asertivo comunitario, la mayoría consideraba que había habido una mejoría en su enfermedad y en sus vidas. (AU)

The aim of this work was to evaluate the attitude and satisfaction of 182 patients with severe mental disorder in supervised accommodation, their social networks, their care needs and clinical changes. Sociodemographic and clinical data were collected. The User Attitudes Questionnaire (CAU), the Social Network Questionnaire (CURES) and the Scale of Assessment of the Levels of Residential Attention for people with Severe Mental Disorder (ENAR-CPB) were administered with repetition at two years. 86% of them reported improvement in their life, 77% in their illness, and 50% in their social relationships. There was a significant reduction in care needs at two years. 86% of the participants did not have hospital admissions, compared to 99% the previous year. In general, we found a good acceptance of the accommodations, as well as an improvement in their social relationships, clinical stability, and hospitalizations. Thanks to the assertive community treatment, the majority considered that there was an improvement both in their disease and in their lives. (AU)

Caracterización inmunogenética de donantes cadavéricos cubanos en el año 2019 / Immunogenetic characterization of Cuban cadaveric donors in 2019

Introducción: El trasplante es la opción terapéutica más favorable para las personas con insuficiencia renal crónica. El donante puede ser cadavérico o donante vivo, emparentado o no. Los resultados del trasplante están en relación con varios factores inmunológicos y no inmunológicos. Objetivo: Caracterizar inmunogenéticamente a los donantes cadavéricos cubanos para trasplante renal. Métodos: Se realizó un estudio transversal y descriptivo de los donantes cadavéricos durante el año 2019. Se analizó la región de procedencia, sexo, color de la piel y rangos de edades de los donantes, así como, grupo sanguíneos ABO y Rhesus Rh; serología para VIH, Virus de hepatitis B(VHB) y Virus de hepatitis C (VHC); y hábitos tóxicos. Resultados: Se estudió un total de 95 donantes cadavéricos, 62 provenientes del occidente y 33 del centro del país. El 63,2 por ciento fueron masculinos y 36,8 por ciento femenino. El grupo de edad de mayor frecuencia fue 40 - 60 años y la edad media de 49,45 años. El 58,95 por ciento de los pacientes fueron de grupo sanguíneo O; 30,53 por ciento grupo A y los grupos B y AB tuvieron 5,26 por ciento de prevalencia; y solo 8 fueron Rh negativos. Todos tuvieron serología para VIH, VHB y VHC negativas. Las enfermedades asociadas más frecuentes fueron la hipertensión arterial y la diabetes mellitus. Conclusiones: Los donantes cadavéricos durante el año 2019 mostraron características similares a las reportadas por otros estudios. El aumento de las edades de los donantes incide en la aparición de enfermedades asociadas y esto pudiera repercutir en el resultado del trasplante(AU)

Introduction: Transplantation is the most favorable therapeutic option for people with chronic renal failure. The donor can be a cadaveric or living donor, related or not. Transplant outcomes are related to various immunological and non-immunological factors. Objective: To characterize Cuban cadaveric donors for renal transplantation Materials and methods: A cross-sectional and descriptive study of cadaveric donors was carried out during the year 2019. The region of origin, sex, skin color and age ranges of the donors were analyzed, as well as ABO and Rhesus Rh blood groups; serology for HIV, Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV), and toxic habits. Results: A total of 95 cadaveric donors were studied, 62 from the West and 33 from the Center of the country. 63.2 percent were male and 36.8 percent female due to the most frequent age group being 40-60 years and the mean age of 49.45 years. 58.95 percent of the patients were of blood group O, 30.53 percent group A and groups B and AB had 5.26 percent prevalence; and only 8 were Rh negative. All had negative serology for HIV, HBV and HCV. The most frequent associated diseases were arterial hypertension and diabetes mellitus. Conclusions: The cadaveric donors during the year 2019 showed characteristics similar to those reported by other studies. The increase in the age of the donors affects the appearance of associated diseases and this could affect the result of the transplant(AU)

Riesgos laborales de tipo psicosocial y desgaste psíquico en trabajadores de una administración pública mexicana / Occupational Risks of the Psychosocial Type and Psychic Attrition in Mexican Public Administration Workers

RESUMEN Objetivo: Identificar la relación de los riesgos laborales de tipo psicosocial y el desgaste psíquico con respuestas de estrés en 985 trabajadores de una administración pública mexicana. Materiales y métodos: El diseño del estudio es no experimental, transversal y cuantitativo. Se aplicó la batería para el estudio de las condiciones de trabajo de carácter psicosocial CTCPSMAC, validada para población iberoamericana, con Alpha de Crombach 0.927 y población mexicana 0,931. Se realizó el análisis de datos a través del programa IBM SPSS Statistics 21 mediante un análisis bivariado y regresión logística binaria. Resultados: Características personales, relaciones interpersonales en el trabajo y carga y ritmo de trabajo están asociados a respuestas cognitivo-emocional, conductual y fisiológica. Ambientes laborales y amortiguadores del riesgo psíquico están asociados a las respuestas conductual y isiológica. Concepción de las tareas del puesto de trabajo está asociada a las respuestas cognitivo-emocional y fisiológicas. La exposición a una mala interrelación trabajo con problemas familiares o sociales y características de la empresa, está asociada a respuesta conductual. Conclusiones: La investigación mostró que en la organización pública objeto de estudio existe una relación signiicativa entre los factores de riesgo psicosocial del entorno laboral y las respuestas de estrés por parte de los trabajadores que integran la misma, poniendo en riesgo la salud de estos, por lo que es importante considerar el cumplimiento de la Norma Oficial Mexicana NOM-035-STPS-2018, que recién entró en vigencia.

ABSTRACT Objective: The purpose of the present study is to identify the relationship of occupational risks of psychosocial type and psychic attrition with stress responses in 985 Mexican public administration workers. Materials and methods: The study design is non-experimental, cross-sectional, and quantitative. The CTCPSMAC questionnaire, used to study the work conditions of a psychosocial nature, was applied, validated for an Ibero-American population, with a 0.927 Crombach's Alpha; and a 0.931 value for a Mexican population. Data analysis was performed through the IBM SPSS Statistics 21 program, using a bivariate analysis and binary logistic regression. Results: Personal characteristics, interpersonal relationships at work, and work load and rhythm are associated with cognitive-emotional, behavioral, and physiological responses. Work environments and psychic risk buffers are associated with behavioral and physiological responses. Conception of job duties is associated with cognitive-emotional and physiological responses. Exposure to a bad work interrelation with family or social problems, and company characteristics is associated with behavioral response. Conclusions: The research showed that, in the public organization under study, there is a significant relationship between the psychosocial risk factors of the work environment and the stress responses by the workers who integrate it, putting their health at risk,thus, it is important to consider compliance with the Official Mexican Standard NOM-035-STPS-2018, which has just been enacted.

Satisfacción laboral y compromiso organizacional: un análisis de percepción en el sector sanitario / Job satisfaction and organizational commitment: an analysis of perception in the healthcare sector

Es importante el estudio de variables del comportamiento organizacional, ya que ayudan a la empresa a tener una mejor gestión de los recursos humanos, debido a que la satisfacción laboral tiene relaciones positivas y estadísticamente significativas con el desempeño laboral. El objetivo de este estudio fue medir los niveles de percepción laboral de empleados del sector sanitario del área pública y privada, con respecto a las variables satisfacción laboral y compromiso organizacional. El estudio es de tipo transversal y descriptivo, el instrumento de medición es una encuesta que consta de 3 partes y la muestra estuvo conformada por 271 administrativos. Se presentaron análisis univariados principales, luego un análisis de conglomerados para segmentar a los participantes, y finalmente se efectúan modelos de regresión. Se determinó que existen tres segmentos de trabajadores que son claramente definidos, compuestos por aquellos administrativos con una baja percepción en general (21% y 42%, respectivamente), aquellos con una percepción media (54% y 38%, respectivamente) y aquellos con una percepción alta (25% y 20%, respectivamente). Se confirma que el compromiso organizacional afecta significativamente y de forma positiva a la satisfacción laboral(AU)

The study of variables of organizational behavior is important, since they help the company better manage its human resources, as job satisfaction has been positively and significantly correlated with job performance. The objective of this study was to measure the levels of job perception of employees in the public and private healthcare sector, with respect to job satisfaction and organizational commitment. The study was cross-sectional and descriptive, and the measurement instrument was a survey consisting of three sections. The study sample consisted of 271 administrative staff. We present the main univariate analysis results, followed by a cluster analysis to segment the participants, and then regression analysis. We identified three clearly defined segments of workers, consisting of administrative staff with a low overall perception of hob satisfaction and organizational commitment (21% and 42%, respectively), those with a medium perception (54% and 38%, respectively) and those with a high perception (25% and 20%, respectively). The results confirm that organizational commitment significantly and positively affects job satisfaction(AU)

Phylogenomics of Salvia L. subgenus Calosphace (Lamiaceae).

The evolutionary relationships of Salvia have been difficult to estimate. In this study, we used the Next Generation Sequencing method Hyb-Seq to evaluate relationships among 90 Lamiaceae samples, including representatives of Mentheae, Ocimeae, Salvia subgenera Audibertia, Leonia, Salvia, and 69 species of subgenus Calosphace, representing 32 of Epling's sections. A bait set was designed in MarkerMiner using available transcriptome data to enrich 119 variable nuclear loci. Nuclear and chloroplast loci were assembled with hybphylomaker (HPM), followed by coalescent approach analyses for nuclear data (ASTRAL, BEAST) and a concatenated Maximum Likelihood analysis of chloroplast loci. The HPM assembly had an average of 1,314,368 mapped reads for the sample and 527 putative exons. Phylogenetic inferences resolved strongly supported relationships for the deep-level nodes, agreeing with previous hypotheses which assumed that subgenus Audibertia is sister to subgenus Calosphace. Within subgenus Calosphace, we recovered eight monophyletic sections sensu Epling, Cardinalis, Hastatae, Incarnatae, and Uricae in all the analyses (nDNA and cpDNA), Biflorae, Lavanduloideae, and Sigmoideae in nuclear analyses (ASTRAL, BEAST) and Curtiflorae in ASTRAL trees. Network analysis supports deep node relationships, some of the main clades, and recovers reticulation within the core Calosphace. The chloroplast phylogeny resolved deep nodes and four monophyletic Calosphace sections. Placement of S. axillaris is distinct in nuclear evidence and chloroplast, as sister to the rest of the S. subg. Calosphace in chloroplast and a clade with "Hastatae clade" sister to the rest of the subgenus in nuclear evidence. We also tested the monophyly of S. hispanica, S. polystachia, S. purpurea, and S. tiliifolia, including two samples of each, and found that S. hispanica and S. purpurea are monophyletic. Our baits can be used in future studies of Lamiaceae phylogeny to estimate relationships between genera and among species. In this study, we presented a Hyb-Seq phylogeny for complex, recently diverged Salvia, which could be implemented in other Lamiaceae.

A single dose of SARS-CoV-2 FINLAY-FR-1A vaccine enhances neutralization response in COVID-19 convalescents, with a very good safety profile: An open-label phase 1 clinical trial.

BACKGROUND: As a first step towards a vaccine protecting COVID-19 convalescents from reinfection, we evaluated FINLAY-FR-1A vaccine in a clinical trial. METHODS: Thirty COVID-19 convalescents aged 22-57 years were studied: convalescents of mild COVID-19, asymptomatic convalescents, both with PCR-positive at the moment of diagnosis; and individuals with subclinical infection detected by viral-specific IgG. They received a single intramuscular injection of the FINLAY-FR-1A vaccine (50 µg of the recombinant dimeric receptor binding domain). The primary outcomes were safety and reactogenicity, assessed over 28 days after vaccination. The secondary outcome was vaccine immunogenicity. Humoral response at baseline and following vaccination was evaluated by ELISA and live-virus neutralization test. The effector T cellular response was also assessed. Cuban Public Registry of Clinical Trials, WHO-ICTRP: https://rpcec.sld.cu/en/trials/RPCEC00000349-En. FINDINGS: No serious adverse events were reported. Minor adverse events were found, the most common, local pain: 3 (10%) and redness: 2 (6·7%). The vaccine elicited a >21 fold increase in IgG anti-RBD antibodies 28 days after vaccination. The median of inhibitory antibody titres (94·0%) was three times greater than that of the COVID-19 convalescent panel. Virus neutralization titres higher than 1:160 were found in 24 (80%) participants. There was also an increase in RBD-specific T cells producing IFN-γ and TNF-α. INTERPRETATION: A single dose of the FINLAY-FR-1A vaccine against SARS-CoV-2 was an efficient booster of pre-existing natural immunity, with excellent safety profile. FUNDING: Partial funding for this study was received from the Project-2020-20, Fondo de Ciencia e Innovación (FONCI), Ministry of Science, Technology and the Environment, Cuba.   RESUMEN. ANTECEDENTES: Como un primer paso hacia una vacuna que proteja a los convalecientes de COVID-19 de la reinfección, evaluamos la vacuna FINLAY-FR-1A en un ensayo clínico. MÉTODOS: Se estudiaron treinta convalecientes de COVID-19 de 22 a 57 años: convalecientes de COVID-19 leve y convalecientes asintomáticos, ambos con prueba PCR positiva al momento del diagnóstico; e individuos con infección subclínica detectada por IgG específica viral. Los participantes recibieron una dosis única por vía intramuscular de la vacuna FINLAY-FR-1A (50 µg del dominio de unión al receptor recombinante dimérico del SARS CoV-2). Las variables de medida primarias fueron la seguridad y la reactogenicidad, evaluadas durante 28 días después de la vacunación. La variable secundaria, la inmunogenicidad. La respuesta humoral, al inicio del estudio y después de la vacunación, se evaluó por ELISA y mediante la prueba de neutralización del virus vivo. También se evaluó la respuesta de células T efectoras. Registro Público Cubano de Ensayos Clínicos, WHO-ICTRP: https://rpcec.sld.cu/en/trials/RPCEC00000349-En. RESULTADOS: No se reportaron eventos adversos graves. Se encontraron eventos adversos leves, los más comunes, dolor local: 3 (10%) y enrojecimiento: 2 (6·7%). La vacuna estimuló un incremento >21 veces de los anticuerpos IgG anti-RBD 28 días después de la vacunación. La mediana de los títulos de anticuerpos inhibidores (94·0%) fue aproximadamente tres veces mayor que la del panel de convalecientes de COVID-19. Se encontraron títulos de neutralización viral superiores a 1:160 en 24 (80%) de los participantes. También hubo un aumento en las células T específicas de RBD que producen IFN-γ y TNF-α. INTERPRETACIÓN: Una sola dosis de la vacuna FINLAY-FR-1A contra el SARS-CoV-2 reforzó eficazmente la inmunidad natural preexistente, con un excelente perfil de seguridad. FINANCIAMIENTO: Se recibió un financiamiento parcial del Proyecto-2020-20, Fondo de Ciencia e Innovación (FONCI), Ministerio de Ciencia, Tecnología y Medio Ambiente, Cuba.

Development of the Level of Preventive Action Method by Observation of the Characteristic Value for the Assessment of Occupational Risks on Construction Sites.

The special circumstances of the high accident rate in the construction industry compared to other sectors are significant and represent a major concern for many countries. Construction work involves a large number of risks that cause or may cause accidents with serious consequences for the worker's health, even death. The Level of Preventive Action is a novel methodology of occupational risk assessment adapted to building works. It is based on the development of the mathematical formulation of William T. Fine's method. Its implementation covers four of the techniques for combating risk: Safety at Work, Industrial Hygiene, Ergonomics and Psychosociology. It evaluates, quantitatively, the amount of preventive action required based on the characteristic complexity of the work units, their location and their interdependence. The method protocol defines a new observation parameter called Characteristic Value which is inherent to the real situation of the construction process. The aim of this study is to develop the characterisation of the Characteristic Value in the Level of Preventive Action method. It also justifies the procedure to obtain this Characteristic Value and how its implementation and result should be interpreted. Finally, the methodology is applied on a real case.

Influence of Wind Speed on CO2 and CH4 Concentrations at a Rural Site.

Meteorological variables have a noticeable impact on pollutant concentrations. Among these variables, wind speed is typically measured, although research into how pollutants respond to it can be improved. This study considers nine years of hourly CO2 and CH4 measurements at a rural site, where wind speed values were calculated by the METEX model. Nine wind speed intervals are proposed where concentrations, distribution functions, and daily as well as annual cycles are calculated. Contrasts between local and transported concentrations are around 5 and 0.03 ppm for CO2 and CH4, respectively. Seven skewed distributions are applied, and five efficiency criteria are considered to test the goodness of fit, with the modified Nash-Sutcliffe efficiency proving to be the most sensitive statistic. The Gumbel distribution is seen to be the most suitable for CO2, whereas the Weibull distribution is chosen for CH4, with the exponential function being the worst. Finally, daily and annual cycles are analysed, where a gradual decrease in amplitude is observed, particularly for the daily cycle. Parametric and nonparametric procedures are used to fit both cycles. The latter gave the best fits, with the agreement being higher for the daily cycle, where evolution is smoother than for the annual cycle.

Mycobacterial Growth Inhibition Assay (MGIA) as a Host Directed Diagnostic Tool for the Evaluation of the Immune Response in Subjects Living With Type 2 Diabetes Mellitus.

The lack of efficient and cost-effective diagnostic tools contributes to poor control of tuberculosis in endemic countries. Moreover, host biological processes influence susceptibility, and infection resolution. It is well known that comorbidities such as type 2 diabetes mellitus (DM2) affect the host immune response, making individuals more susceptible to Mycobacterium tuberculosis infection. Currently, there are no laboratory tools that can identify those subjects who have a higher risk of developing the disease. In this study, we used a whole blood mycobacterial growth inhibition assay to assess the immune response capacity to inhibit mycobacterial growth between healthy subjects and those living with DM2 with optimal and poor glycemic control. We also measured cytokine levels in the culture supernatant by cytokine bead arrays. We included 89 patients with DM2: 54 patients with optimal control (mean age 56.2 ± 11.75 years) and 35 patients with poor control (mean age 52.05 ± 9.94 years). We also included 44 healthy subjects as controls (mean age 42.12 ± 11.75 years). We compared the Δlog UFC (a value that represents the difference between mycobacterial growth in the control tube versus the subject's blood) between each group. Our results demonstrate that patients with DM2 had a lower capacity to inhibit M. tuberculosis growth (Δlog UFC DM2 subjects 0.9581 (-0.3897 to 2.495) vs Δlog UFC healthy subjects 0.7190 (-0.2678 to 2.098); p=0.013). Comparing subjects living with DM2 (optimal and poor glycemic control) vs healthy subjects, we found only significant differences between healthy subjects and patients poorly controlled (Δlog UFC optimal control group 0.876 (-0.3897 to 2.495); Δlog UFC poor control group 1.078 (0.068 to 2.33); Δlog UFC healthy subjects 0.7190 (-0.2678 to 2.098); p= 0.022). Therefore, glycemic control assessed by glycosylated hemoglobin values influences the capacity of the host to control the infection. Our results confirm that the whole blood mycobacterial growth inhibition assay has potential utility as an in vitro marker of M. tuberculosis immunological control in vivo in subjects living with DM2. This assay can be used to evaluate the immune response of each individual against M. tuberculosis, allowing clinicians to choose a more specific host-directed therapy.