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Up-conversion emission from HfO2 nanoparticles, as a host lattice, doped with Er3+ and Yb3+ ions and codoped with alkaline cations Li+ and Na+ obtained. The HfO2 nanoparticles, about 80 nm in diameter, were synthesized by the hydrothermal method at 200 °C for 1.3 h, and an additional heat treatment at 1000 °C was necessary to ensure the dopants incorporation into the host lattice. These nanoparticles were studied by means of XRD, Raman Spectroscopy, SEM, EDS, PL, CL, and up-conversion luminescence. First, the doping was performed with Er3+ ions in different percentages. The photoluminescence and cathodoluminescence studies showed an inefficient emission, and only at 7 at % Er3+ ions, the sample presented emissions at 522, 545, and 656 nm corresponding to the transitions of the Er3+ ions. So, codoping was carried out, and HfO2: Er3+/Yb3+ generated an efficient conversion process. The atom percentage of Yb3+ ions was fixed (7 at % Yb3+), and the Er3+ content was varied, showing the highest emission intensity at 3 at % Er3+ ions. Subsequently, the up-conversion emission intensity was optimized by varying the percentage of Yb3+ ions and keeping the Er3+ ion content fixed (3 at %). Adding cations such as Na+ and Li+ in different percentages, a notable improvement of the up-conversion emission intensities in the HfO2: Er3+/Yb3+ nanoparticles was obtained. The up-conversion emission bands observed were located at â¼523 and 544 nm, corresponding to the electronic transitions 2H11/2 â 4I15/2 and 4S3/2 â 4I15/2, respectively. While the bands at â¼652 and 673 nm correspond to the transition 4F9/2 â 4I15/2, respectively. The excitation of these materials with infrared radiation (980 nm) produced noticeable emission bands in the red spectral range, whereas excitation with accelerated electrons (CL) generated prominent bands in the green region.
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A total of 3,860 accessions from the global in trust clonal potato germplasm collection w3ere genotyped with the Illumina Infinium SolCAP V2 12K potato SNP array to evaluate genetic diversity and population structure within the potato germplasm collection. Diploid, triploid, tetraploid, and pentaploid accessions were included representing the cultivated potato taxa. Heterozygosity ranged from 9.7% to 66.6% increasing with ploidy level with an average heterozygosity of 33.5%. Identity, relatedness, and ancestry were evaluated using hierarchal clustering and model-based Bayesian admixture analyses. Errors in genetic identity were revealed in a side-by-side comparison of in vitro clonal material with the original mother plants revealing mistakes putatively occurring during decades of processing and handling. A phylogeny was constructed to evaluate inter- and intraspecific relationships which together with a STRUCTURE analysis supported both commonly used treatments of potato taxonomy. Accessions generally clustered based on taxonomic and ploidy classifications with some exceptions but did not consistently cluster by geographic origin. STRUCTURE analysis identified putative hybrids and suggested six genetic clusters in the cultivated potato collection with extensive gene flow occurring among the potato populations, implying most populations readily shared alleles and that introgression is common in potato. Solanum tuberosum subsp. andigena (ADG) and S. curtilobum (CUR) displayed significant admixture. ADG likely has extensive admixture due to its broad geographic distribution. Solanum phureja (PHU), Solanum chaucha (CHA)/Solanum stenotomum subsp. stenotomum (STN), and Solanum tuberosum subsp. tuberosum (TBR) populations had less admixture from an accession/population perspective relative to the species evaluated. A core and mini core subset from the genebank material was also constructed. SNP genotyping was also carried out on 745 accessions from the Seed Savers potato collection which confirmed no genetic duplication between the two potato collections, suggesting that the collections hold very different genetic resources of potato. The Infinium SNP Potato Array is a powerful tool that can provide diversity assessments, fingerprint genebank accessions for quality management programs, use in research and breeding, and provide insights into the complex genetic structure and hybrid origin of the diversity present in potato genetic resource collections.
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Introducción: la comprensión histomorfológica y biomolecular del íleon terminal; sitio clave en el control de la absorción nutricional, del metabolismo, sistema inmunitario, microbiota intestinal, y función de órganos extradigestivos; justifica su participación en los procesos inflamatorios intestinales, como pudiera ser en la infección por el SARS-CoV2. Objetivos: describir las evidencias biomoleculares de los componentes tisulares del íleon que justifican su función en el eje hepático-intestinal, y citar hallazgos histomorfológicos del íleon en fallecidos de la COVID-19. Adquisición de información: se realizó una revisión sistemática, crítica de los estudios biomoleculares sobre los enterocitos, la barrera epitelial intestinal, microbiota y permeabilidad intestinal del íleon que fundamentan su función de barrera epitelial, reportados en sitios Web (PubMed, Scielos, Lilacs, y Elservier), entre 2000 a 2021, y se citan hallazgos preliminares de cortes histomorfológicos del íleon en fallecidos de la COVID-19. Desarrollo se describen las evidencias biomoleculares del íleon normal, y la repercusión de su pérdida, disbiosis e hiperpermeabilidad en los procesos inflamatorios intestinales; también se citan hallazgos histomorfológicos preliminares de ileítis en fallecidos de la COVID-19, que pudiera fundamentar la importancia de la intuición biomolecular del íleon en el equilibrio salud-enfermedad, cuya pérdida justificaría el progreso clínico de la COVID-19. Conclusiones: la revisión integral del íleon y la cita de los hallazgos histomorfológicos preliminares de ileítis en fallecidos de la COVID-19, motiva realizar estudios amplios, que infieran su papel en el progreso clínico de la COVID-19 y justifique el futuro de nuevas intervenciones terapéuticas para su integridad.
Introduction terminal ileum, key site of control of nutritional absorption, metabolism, immune system, intestinal microbiota and extradigestive organ function. Histomorphological and biomolecular understanding of the ileum justifies its participation in intestinal inflammatory processes, such as SARS-CoV2 infection. Objective to describe the biomolecular evidence of the tissue components of the ileum that justifies its function in the hepatic-intestinal axis, and to cite histomorphological findings of the ileum in deaths from COVID-19. Information acquisition a systematic review was carried out, critical of reports between 2000 and 2021, on websites (PubMed, Scielos, Lilacs, and Elservier), of the biomolecular studies of the ileum (enterocytes, intestinal epithelial barrier, microbiota and intestinal permeability), which support its epithelial barrier function, and preliminary findings of histomorphological sections of the ileum in deaths from COVID-19 are cited. Development: biomolecular evidence of the normal ileum is described, and the repercussion of its loss, dysbiosis and hyperpermeability in intestinal inflammatory processes, and preliminary histomorphological findings of ileitis in deaths from COVID-19 are cited, which could substantiate the importance of the biomolecular intuition of the ileum in the health-disease balance, that its loss would justify the clinical progress of COVID-19. Conclusions: the comprehensive review of the ileum and the citation of the preliminary histomorphological findings of ileitis in deaths from COVID-19 motivates conducting extensive studies that infer its role in the clinical progress of COVID-19 and justify the future of new interventions. therapeutic for its integrity.
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Introducción: La innovación en la atención de la salud es una fuerza impulsora en la búsqueda de un equilibrio entre la limitación de costos y la calidad de la atención médica y, en la actualidad, emerge como paradigma la innovación integral que no descuida ninguna de sus dimensiones y se desarrolla en sus distintos niveles: de país, de institución y de las personas que la llevan a vías de hecho. Objetivo: Estudiar la trayectoria de innovación que, con un enfoque integral, ha llevado al Centro Nacional de Cirugía de Mínimo Acceso a convertirse en obligada referencia cuando se habla de instituciones hospitalarias con un alto nivel de calidad del servicio que se presta, en pro de la salud pública del país. Posicionamiento: La innovación integral, que combina la introducción de tecnologías médicas con innovaciones organizacionales en sistemas de gestión, permite alcanzar resultados importantes en la calidad de la atención médica y la formación de profesionales competentes en procederes terapéuticos y quirúrgicos mínimamente invasivos. Conclusiones: El análisis realizado permitió definir cuatro etapas en la trayectoria de innovación del Centro Nacional de Cirugía de Mínimo Acceso: Núcleo (1980-1992), Fundación (1993-2005), Consolidación (2006-2015), Acreditación y Certificación (2016-2022). Se caracterizan los elementos esenciales de cada etapa hasta llegar a la actual, en la que se logra que los resultados de la innovación organizacional y en tecnologías médicas del centro sean reconocidos en diferentes instancias y contribuyan a brindar servicios de salud de alta calidad.
Introduction: Innovation in health care is a driving force in the search for a balance between cost limitation and quality of medical care; today comprehensive innovation that does not neglect any of its dimensions, emerging as a paradigm. It is developed at its different levels: country, institution and the people who take it to reality. Objective: To study the trail of innovation that, with a comprehensive approach, has led the National Center for Minimum Access Surgery to become an unavoidable reference when talking about hospital institutions with a high level of quality of service, in favor of the public health of the country. Positioning: Comprehensive innovation, which combines the introduction of medical technologies with organizational innovations in management systems, allows achieving important results in the quality of medical care and the training of competent professionals in minimally invasive therapeutic and surgical procedures. Conclusions: The analysis carried out allowed us to define four stages in the innovation trajectory of the National Center for Minimum Access Surgery: Nucleus (1980-1992), Foundation (1993-2005), Consolidation (2006-2015), Accreditation and Certification (2016- 2022). The essential elements of each stage are characterized up to reaching the current one, in which the results of this institution's organizational innovation and medical technologies are recognized at different instances, and they contribute to providing high-quality health services.
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Introducción: La endotelitis es causada por mecanismos complejos asociados a comorbilidades inmunitario-metabólicas como expresión del daño producido por diversos agentes, como el caso de las acciones proinflamatorias debidas a la interacción del virus SARS-CoV-2 con los ácidos biliares, que pueden estar implicadas en la mortalidad por la COVID-19. Objetivo: Describir las evidencias biomoleculares de la citotoxicidad de los ácidos biliares sobre el endotelio y la posible relación con la endotelitis de los cortes histológicos de tejidos de fallecidos por la COVID-19, asociada o no a las comorbilidades conocidas. Métodos: Se realizó una revisión sistemática y crítica de los artículos reportados sobre ácidos biliares y endotelitis desde 1963 hasta 2021 en los sitios web (PubMed, SciELO, Lilacs y Elservier). Se citó la histología del tejido pulmonar con daño endotelial en 34 fallecidos por COVID-19 en el Hospital Militar Central "Luis Díaz Soto", cuyos cortes histológicos fueron examinados en el Hospital Clínico Quirúrgico "Hermanos Ameijeiras". Asimismo, se describieron las acciones y las propiedades físico-químicas de los ácidos biliares que pudieran relacionarse con la endotelitis observada en dichos cortes histológicos. Conclusiones: Los ácidos biliares hidrofóbicos conjugados con glicinas, por sus propiedades e incrementos séricos hallados en las comorbilidades inmunitario-metabólicas y en las enfermedades hepato-intestinales, pudieran tener un papel en la endotelitis presente en pacientes de la COVID-19, con estadíos graves y críticos(AU)
Introduction: Endotheliitis is caused by complex mechanisms associated with immune-metabolic comorbidities as an expression of the damage produced by various agents, such as the case of proinflammatory actions due to the interaction of the SARS-CoV-2 virus with bile acids, which may be involved in mortality from COVID-19. Objective: To describe the biomolecular evidence of bile acid cytotoxicity on the endothelium and the possible relationship with endothelitis of histological sections of tissues from COVID-19 deaths, associated or not with known comorbidities. Methods: A systematic and critical review of the articles reported on bile acids and endothelitis from 1963 to 2021 was conducted on the websites (PubMed, SciELO, Lilacs and Elservier). It was cited the histology of lung tissue with endothelial damage in 34 deceased by COVID-19 at "Luis Díaz Soto" Central Military Hospital, whose histological sections were examined at "Hermanos Ameijeiras" Clinical Surgical Hospital. Likewise, the actions and physicochemical properties of bile acids that could be related to observed endothelitis in these histological sections were described. Conclusions: Hydrophobic bile acids conjugated with glycine, due to their properties and serum increases found in immune-metabolic comorbidities and hepato-intestinal diseases, could have a role in endothelitis present in COVID-19 patients, with severe and critical stages(AU)
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Humanos , Literatura de Revisão como Assunto , Bases de Dados BibliográficasRESUMO
INTRODUCTION: Bile acids are signaling molecules with immune, metabolic and intestinal microbiota control actions. In high serum concentrations they increase inflammatory response from the liver-gut axis, until causing multiorgan failure and death; therefore, they may be associated with COVID-19's clinical progression, as a consequence of tissue and metabolic damage caused by SARS-CoV-2. While this topic is of considerable clinical interest, to our knowledge, it has not been studied in Cuba. OBJECTIVE: Study and preliminarily characterize patients admitted with a diagnosis of COVID-19 and high levels of serum bile acids. METHODS: A preliminary exploratory study was carried out with descriptive statistical techniques in 28 COVID-19 patients (17 women, 11 men; aged 19-92 years) who exhibited high levels of serum bile acids (≥10.1 µmol/L) on admission to the Dr. Luis Díaz Soto Central Military Hospital in Havana, Cuba, from September through November 2021. RESULTS: On admission patients presented hypocholesterolemia (13/28; 46.4%), hyperglycemia (12/28; 43.0%) and hyper gamma-glutamyl transpeptidase (23/28; 84.2%). Median blood glucose (5.8 mmol/L) and cholesterol (4.1 mmol/L) were within normal ranges (3.2â6.2 mmol/L and 3.9â5.2 mmol/L, respectively). Severe or critical stage was the most frequent (13/28) and median serum bile acids (31.6 µmol/L) and gamma-glutamyl transferase (108.6 U/L) averaged well above their respective normal ranges (serum bile acids: 0â10 µmol/L; GGT: 9â36 U/L). Arterial hypertension was the most frequent comorbidity (19/28; 67.9%). CONCLUSIONS: Severe or critical stage predominated, with serum bile acids and gamma-glutamyl transferase blood levels above normal ranges. The study suggests that serum bile acid is toxic at levels ≥10.1 µmol/L, and at such levels is involved in the inflammatory process and in progression to severe and critical clinical stages of the disease. In turn, this indicates the importance of monitoring bile acid homeostasis in hospitalized COVID-19 patients and including control of its toxicity in treatment protocols.
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Ácidos e Sais Biliares , COVID-19 , Feminino , Humanos , Masculino , Ácidos e Sais Biliares/sangue , COVID-19/sangue , COVID-19/diagnóstico , Cuba/epidemiologia , Hospitais , SARS-CoV-2 , Transferases , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou maisRESUMO
Introduction: Herein, we tested the hypothesis that Asymptomatic P. vivax (Pv) infected individuals (Asym) feature different epidemiological, clinical and biochemical characteristics, as well as hematological parameters, potentially predictive of clinical immunity in comparison to symptomatic Pv infected individuals (Sym). Methodology: Between 2018 - 2021, we conducted 11 population screenings (PS, Day 0 (D0)) in 13 different riverine communities around Iquitos city, in the Peruvian Amazon, to identify Pv Sym and Asym individuals. A group of these individuals agreed to participate in a nested case - control study to evaluate biochemical and hematological parameters. Pv Asym individuals did not present common malaria symptoms (fever, headache, and chills), had a positive/negative microscopy result, a positive qPCR result, reported no history of antimalarial treatment during the last month, and were followed-up weekly until Day 21 (D21). Control individuals, had a negative malaria microscopy and qPCR result, no history of antimalarial treatment or malaria infections during the last three years, and no history of comorbidities or chronic infections. Results: From the 2159 individuals screened during PS, data revealed a low but heterogeneous Pv prevalence across the communities (11.4%), where most infections were Asym (66.7%) and submicroscopic (82.9%). A total of 29 Asym, 49 Sym, and 30 control individuals participated in the nested case - control study (n=78). Ten of the individuals that were initially Asym at D0, experienced malaria symptoms during follow up and therefore, were included in the Sym group. 29 individuals remained Asym throughout all follow-ups. High levels of eosinophils were found in Asym individuals in comparison to Sym and controls. Conclusion: For the first-time, key epidemiological, hematological, and biochemical features are reported from Pv Asym infections from the Peruvian Amazon. These results should be considered for the design and reshaping of malaria control measures as the country moves toward malaria elimination.
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Malária Vivax , Malária , Infecções Assintomáticas/epidemiologia , Humanos , Malária Vivax/epidemiologia , Peru/epidemiologia , PrevalênciaRESUMO
Introducción: El Programa de Maestría en Cirugía de Mínimo Acceso responde a necesidades sociales y perspectivas del Sistema Nacional de Salud. Los resultados de sus investigaciones impactan en los Objetivos de Desarrollo Sostenible No. 3 Salud y bienestar y No. 4 Educación de calidad. Objetivo: Exponer cómo la Maestría en Cirugía de Mínimo Acceso impacta en el desarrollo sostenible, a partir de las investigaciones realizadas. Métodos: Se realizó una investigación cualitativa y retrospectiva en el Centro Nacional de Cirugía de Mínimo Acceso. La técnica de investigación empleada fue el análisis documental y bibliográfico, con la revisión de los informes de las tesis finales de maestría y de la autoevaluación del programa, en sus dos primeras ediciones (2015 y 2018), según el Sistema de Evaluación y Acreditación de Maestrías. Resultados: El Programa contó con 30 egresados, cuyas investigaciones abordaron el tratamiento laparoscópico del cáncer entre otros temas. Asimismo, la producción científica en la Edición 02 resultó de 100 publicaciones, 159 reconocimientos sociales relevantes y la edición de 3 libros. Conclusiones: La investigación y la creación de conocimiento e innovación en el Programa de Maestría en Cirugía de Mínimo Acceso han permitido fomentar soluciones de desarrollo sostenible en esta área del conocimiento. La producción científica y la socialización de los resultados obtenidos en eventos nacionales e internacionales propician su implementación en el Sistema Nacional de Salud. De esta forma, los resultados de investigación del programa contribuyen al logro de los Objetivos de Desarrollo Sostenible(AU)
Introduction:The program of the Master's degree in Minimal Access Surgery responds to social needs and perspectives of the national health system. The results of its research have an impact on Sustainable Development Goals 3, "Good health and well-being, and 4, Quality education. Objective: To present how the Master's Degree Course in Minimal Access Surgery impacts on sustainable development, upon the base of the researches conducted. Methods: A qualitative and retrospective research was carried out at the National Center for Minimal Access Surgery. The research technique used was the document and bibliographic analysis, with the review of the reports of the final master's theses and the self-evaluation of the program, in its first two editions (2015 and 2018), according to the Evaluation and Accreditation System for Master's Degree Programs. Results: The program had 30 graduates, whose researches addressed, among other topics, the laparoscopic treatment of cancer. Also, the scientific production in the Edition 02 turned out to be one hundred publications, 159 relevant social recognitions, and the edition of three books. Conclusions: Research and the creation of knowledge and innovation in the Master's Degree Program in Minimal Access Surgery have allowed fostering sustainable development solutions in this area of knowledge. The scientific production and the socialization of the results obtained in national and international events favor their implementation in the national health system. Thus, the research results of the program contribute to the achievement of the Sustainable Development Goals(AU)
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Humanos , Editoração , Logro , Procedimentos Cirúrgicos Minimamente Invasivos/educação , Conhecimento , Relatório de Pesquisa , Desenvolvimento Sustentável/tendências , Estudos Retrospectivos , Pesquisa Qualitativa , Programas de Pós-Graduação em SaúdeRESUMO
BACKGROUND: Few studies have used implementation science frameworks to identify determinants of PrEP prescription by healthcare providers. In this work, we developed and psychometrically examined a questionnaire using the theoretical domains framework (TDF) and the consolidated framework for implementation research (CFIR). We used this questionnaire to investigate what factors influence the intention of healthcare providers to offer PrEP care and advocate for PrEP. METHODS: We conducted a cross-sectional study in 16 HIV healthcare organizations in Colombia. A 98-item questionnaire was administered online to 129 healthcare professionals. One hundred had complete data for this analysis. We used exploratory factor analysis to assess the psychometric properties of both frameworks, and multinomial regression analysis to evaluate the associations of the frameworks' domains with two outcomes: (1) intention to offer PrEP care and (2) intention to advocate for PrEP impmentation. RESULTS: We found support for nine indices with good internal consistency, reflecting PrEP characteristics, attitudes towards population needs, concerns about the use of PrEP, concerns about the role of the healthcare systems, knowledge, beliefs about capabilities, professional role, social influence, and beliefs about consequences. Notably, only 57% of the participants were likely to have a plan to care for people in PrEP and 66.7% were likely to advocate for PrEP. The perception of the need for PrEP in populations, the value of PrEP as a practice, the influence of colleagues, and seeing PrEP care as a priority was related to being less likely to be unwilling to provide or advocate for PrEP care. CONCLUSION: Our findings suggested the importance of multilevel strategies to increase the provision of PrEP care by healthcare providers including adquisition of new skills, training of PrEP champions, and strength the capacity of the health system.
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Surface enhanced Raman spectroscopy (SERS) is considered a versatile and multifunctional technique with the ability to detect molecules of different species at very low molar concentration. In this work, hierarchical ZnO microspheres (ZnO MSs) and Ag/ZnO MSs were fabricated and decorated by hydrothermal and photodeposition methods, respectively. For Ag deposition, precursor molar concentration (1.9 and 9.8 mM) and UV irradiation time (5, 15, and 30 min) were evaluated by SEM, TEM, X-ray diffraction and Raman spectroscopy. X-ray diffraction showed a peak at 37.9° corresponding to the (111) plane of Ag, whose intensity increases as precursor concentration and UV irradiation time increases. SEM images confirmed the formation of ZnO MSs (from 2.5 to 4.5 µm) building by radially aligned two-dimensional ZnO nanosheets with thicknesses below 30 nm. The Raman spectra of Ag/ZnO MSs exhibited a vibration mode at 486 cm-1 which can be directly associated to Ag deposition on ZnO MSs surface. The performance of SERS substrate was evaluated using rhodamine 6G. The SERS substrate grown at 9.8 mM during 30 min showed the best SERS activity and the ability to detect methylene blue at 10-9 M.
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COVID-19/prevenção & controle , Infecção Hospitalar/prevenção & controle , Controle de Infecções/organização & administração , Procedimentos Cirúrgicos Operatórios , COVID-19/epidemiologia , Cuba/epidemiologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , SARS-CoV-2RESUMO
BACKGROUND: 1. Colombia with 1941 known recorded bird species is one of the most species rich countries in the world. Efforts are necessary to conserve, study and promote sustainable use of this important taxonomic group throughout Colombia's vast territory.2. In an ideal world, informed decisions that are based on sound scientific information should be likelier to have successful outcomes. Nevertheless, there are barriers that make it difficult to access and use information in a timely fashion. Those same barriers impede the study, conservation and sustainable use of bird species in Colombia. On the other hand, given that there is good documentation about the ecology of a large number of species, information about the distribution of birds can be easily incorporated into decision-making processes, once this information becomes readily available in a consumable format using Geographic Information Sciences tools.3. In this context, the main objective of this paper is to present the first compilation of the current distribution of 1889 (97%) species of birds in Colombia, using expert criteria. The shapefiles were used to show the distribution and diversity of bird species in Colombia under both geopolitical and conservation geographic units.4. The information provided in this paper can be used as a baseline for a huge number of initiatives that aim to strengthen conservation efforts and improve knowledge about one the most unique taxonomic groups in the country. These range from land use planning strategies at the municipal or department scale to sustainable use of bird species - such as those initiatives related to bird watching - in Colombia. NEW INFORMATION: This study has considered three key aspects: 1) the importance of birds for Colombia's ecosystems, 2) the privileged place of Colombia in bird species richness and 3) the importance of data mobilisation in formats easily consumable by Geographic Information Systems (GIS) to facilitate the processes of informed decision-making. We present the first compilation - in shapefile format - for 1889 of the 1941 bird species recorded from Colombia. Using this novel collection, we showed the species richness of birds in Colombia's 33 Departments plus its Captial District (DPs), 1122 Municipalities (MNs), 58 protected areas (PAs), 39 Regional Autonomous Corporations (the authorities responsible within their respective jurisdictions for regulating the environment and renewable natural resources in Colombia; CARs) and 916 Collectively Titled Territories (including both indigenous reservations and afro-descendant communities; CTTs). In addition, we provide a list of known bird species richness for the above geographic units found in the available literature. The information provided here can be used as a baseline for a huge number of initiatives concerning the study, conservation and sustainable use of bird species present in Colombia, providing access to key features of bird distribution that should facilitate decision-making.
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OBJECTIVE: The present study aimed to determine the association between chronic exposure to fine particulate matter (PM2.5), sociodemographic aspects, and health conditions with COVID-19 mortality in Colombia. METHODS: We performed an ecological study using data at the municipality level. We used COVID-19 data obtained from government public reports up to and including July 17th, 2020. We defined PM2.5 long-term exposure as the 2014-2018 average of the estimated concentrations at municipalities obtained from the Copernicus Atmospheric Monitoring Service Reanalysis (CAMSRA) model. We fitted a logit-negative binomial hurdle model for the mortality rate adjusting for sociodemographic and health conditions. RESULTS: Estimated mortality rate ratios (MRR) for long-term average PM2.5 were not statistically significant in either of the two components of the hurdle model (i.e., the likelihood of reporting at least one death or the count of fatal cases). We found that having 10% or more of the population over 65 years of age (MRR = 3.91 95%CI 2.24-6.81), the poverty index (MRR = 1.03 95%CI 1.01-1.05), and the prevalence of hypertension over 6% (MRR = 1.32 95%CI1.03-1.68) are the main factors associated with death rate at the municipality level. Having higher hospital beds capacity is inversely correlated to mortality. CONCLUSIONS: There was no evidence of an association between long-term exposure to PM2.5 and COVID-19 mortality rate at the municipality level in Colombia. Demographics, health system capacity, and social conditions did have evidence of an ecological effect on COVID-19 mortality. The use of model-based estimations of long-term PM2.5 exposure includes an undetermined level of uncertainty in the results, and therefore they should be interpreted as preliminary evidence.
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Poluentes Atmosféricos , Poluição do Ar , COVID-19 , Idoso , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Colômbia/epidemiologia , Exposição Ambiental/análise , Humanos , Mortalidade , Material Particulado/análise , SARS-CoV-2RESUMO
RESUMEN Introducción: La gestión del conocimiento es vital para las organizaciones de salud con vistas a garantizar la calidad de sus servicios. Objetivo: Evaluar la gestión del conocimiento en el Centro Nacional de Cirugía de Mínimo Acceso. Métodos: Se realizó una investigación descriptiva de tipo transversal. Se elaboró, validó y aplicó una encuesta a 20 trabajadores del Centro en los meses de noviembre y diciembre de 2018. Se estudió la variable gestión del conocimiento, a través de sus elementos caracterizadores, los cuales fueron evaluados en dos dimensiones: importancia y frecuencia. Los datos se procesaron mediante los métodos de estadística descriptiva con el uso del programa SPSS v.21. Resultados: Se identificaron el compromiso de la alta dirección del centro con la gestión del conocimiento, la existencia de una infraestructura tecnológica suficiente para apoyar sus actividades, así como la necesidad de fortalecer los intercambios entre especialistas para compartir los resultados de investigación y aprovechar las lecciones aprendidas de los errores médicos y las no conformidades, para lo cual se requirió destinar tiempo y recursos. Conclusiones: El Centro Nacional de Cirugía de Mínimo Acceso es una institución con una destacada actividad en gestión del conocimiento. La aplicación de la encuesta para evaluar la gestión del conocimiento en el centro permitió identificar las oportunidades de mejora necesarias en apoyo a la innovación y la calidad del servicio de salud que se presta, lo que potencia aún más actividades como la formación profesional y el intercambio de las lecciones aprendidas entre los especialistas para el aprendizaje organizacional.
ABSTRACT Introduction: Knowledge management is vital for health organizations in order to guarantee the quality of their services. Objective: To evaluate knowledge management at the National Center for Limited Access Surgery. Methods: A descriptive cross-sectional investigation was carried out. A survey was prepared, validated and applied to 20 employees at this institution from November to December 2018. The knowledge management variable was studied, through its characterizing elements, which were evaluated in two dimensions: importance and frequency. The data were processed through descriptive statistics methods with the use of SPSS v.21 program. Results: The investigation identified the institution top management commitment with knowledge management, the existence of a sufficient technological infrastructure to support its activities, as well as the need to strengthen exchanges between specialists to share research results and take advantage of lessons learned from medical errors and non-conformities, for which time and resources were required. Conclusions: The National Center for Limited Access Surgery is an institution with outstanding activity in knowledge management. The application of the survey to evaluate knowledge management in the institution allowed identifying the necessary improvement opportunities in support of innovation and the quality of the health service provided, which further enhances professional training and exchange of lessons learned among specialists for organizational learning.
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Humanos , Qualidade da Assistência à Saúde/tendências , Gestão do Conhecimento , Centros Cirúrgicos , Procedimentos Cirúrgicos Minimamente InvasivosRESUMO
Resumen El aumento progresivo de las sanciones disciplinarias no es un hecho aislado o ajeno a las dinámicas sociales y políticas de Colombia, podemos decir, que tanto el desarrollo normativo en términos de creación de leyes así como las diferentes posturas jurisprudenciales respecto al tema influyen en la tendencia de crecimiento; también lo hacen las condiciones sociales y los eventos coyunturales que involucran responsabilidad de funcionarios del Estado y, específicamente, en el aumento de funcionarios públicos, se puede ver la relación entre la concentración de funcionarios en un territorio y las sanciones disciplinarias que se imponen en este.
Abstract The progressive increase in disciplinary sanctions is not an isolated or unrelated fact to the social and political dynamics of Colombia. It can be said that both regulatory development in terms of the creation of laws, as well as the different jurisprudential postures on the issue influence the growth trend, so do social conditions and contemporary events, which involve responsibility for State officials. Moreover, specifically, in the increase of public officials, the relationship between the concentration of civil servants in a territory and the disciplinary sanctions, which are imposed in it, can be appreciated.
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Resumen El objetivo del presente trabajo fue analizar las propiedades psicométricas y obtener los baremos para población Boyacá Colombia del Cuestionario de Madurez Neuropsicológica Escolar CUMANES. Se realizó un estudio descriptivo cuantitativo de carácter psicométrico, se evaluaron 400 niños escolarizados, con edades entre 7 y 11 años, M = 8,94 y DE = 1,812 años. Para cuantificar la consistencia intema se estimó Alfa de Cronbach y Omega de McDonald obteniendo puntuaciones aceptables. Para identificar la estructura interna de la prueba se implementó Análisis Factorial Exploratorio el cual sugiere una dimensión del constructo y Análisis Factorial Confirmatorio permitió evidenciar buen ajuste del factor encontrado. No se hallaron diferencias estadísticamente significativas mediante la variable sexo pero si por edad. Se requieren más investigaciones en población latinoamericana que corroboren posibles diferencias culturales en la ejecución de las subpruebas del CUMANES. Finalmente, se presentan baremos para estudiantes colombianos según edad.
Abstract The objective of this study was to analyze the psychometric properties and obtain the scales for the Boyacá Colombia population of the School Neuropsychological Maturity Questionnaire CUMANES. A descriptive quantitative study of psychometric character was carried out, 400 school children were evaluated, with ages between 7 and 11 years, M = 8,94 and SD = 1,812 years. To quantify the internal consistency, Cronbach's Alpha and McDonald's Omega were estimated obtaining acceptable scores. To identify the internal structure of the test, Exploratory Factor Analysis was implemented, which suggests a dimension of the construct and confirmatory factor analysis allowed to show good adjustment of the found factor. No statistically significant differences were found by the sex variable but by age. More research is needed in the Latin American population to corroborate possible cultural differences in the execution of the subtests of CUMANES. Finally, scales are presented for Colombian students according to age.
Assuntos
Humanos , Masculino , Feminino , Criança , Desenvolvimento Infantil , Inquéritos e Questionários , Neuropsicologia , Psicometria , Reprodutibilidade dos Testes , Análise Fatorial , Colômbia , Distribuição por Idade e Sexo , Correlação de DadosRESUMO
Introducción: Estudios anatomofisiológicos y biomoleculares de la vesícula biliar han permitido redefinir su función no solo como reservorio de la secreción biliar, sino como protectora intestinal, concepto que se fundamenta en su capacidad de control de la bioactividad y la toxicología de los ácidos biliares, el metabolismo del colesterol, los fosfolípidos y otros componentes de la secreción hepatobiliar. Objetivo: Describir las actualidades de la funcionabilidad de la vesícula biliar como reservorio y protectora del tracto digestivo dirigido a que cirujanos generales, gastroenterólogos, clínicos y fisiólogos amplíen sus conocimientos sobre la función de la vesícula biliar. Métodos: Se realiza una revisión crítica de las funciones de la vesícula biliar que favorecen mantener la integridad de la pared intestinal. Conclusión: La descripción actualizada de la funcionabilidad de la vesícula biliar ofrece un resultado relevante dentro del marco conceptual en relación a su función protectora que se traduce en el mantenimiento de la integridad del epitelio y la microbiota intestinal(AU)
Introduction: Anatomic-physiological and biomolecular studies of the gallbladder have made it possible to redefine its function not only as a reservoir for bile secretion, but also as intestinal protector. This concept is supported by its capacity to control the bioactivity and toxicology of bile acids, cholesterol metabolism, phospholipids and other components of hepatobiliary secretion. Objective: Present an update on the role of the gallbladder as reservoir and protector of the digestive tract intended for general surgeons, gastroenterologists, clinicians and physiologists to broaden their knowledge about the functions of the gallbladder. Methods: A critical review was conducted of the functions of the gallbladder which facilitate maintenance of the integrity of the intestinal wall. Conclusion: The updated description of the functions of the gallbladder is a relevant contribution to the conceptual framework of its protective function, which ensures the maintenance of the integrity of the epithelium and the intestinal microbiota(AU)
Assuntos
Humanos , Microbioma Gastrointestinal , Gastroenterologistas , Bile/fisiologia , Trato Gastrointestinal/fisiologia , Vesícula Biliar/fisiologiaRESUMO
Introducción: los ácidos biliares no solo tienen como actividad biológica regular la absorción de vitaminas liposolubles, colesterol y lípidos, sino actúan también como moléculas de señalización, moduladores de la proliferación celular intestinal, de la expresión de genes y del metabolismo energético según estudios in vitro e in vivo; en condiciones fisiológicas mantienen su homeostasis, que al ser interrumpida promueve suacción toxicológica. Objetivo: describir la actualidad de los nuevos conocimientos sobre la actividad biológica y toxicológica de los ácidos biliares en el aparato digestivo, dirigido a cirujanos generales, gastroenterólogos, clínicos y fisiólogos que les permitan contextualizar el proceso inflamación-carcinogénesis relacionado con los efectos toxicológicos de los ácidos biliares. Método: se realizó una revisión sistemática de la actividad biológica y toxicológica de los ácidos biliares para los cirujanos generales, gastroenterólogos, clínicos y fisiólogos, como herramienta útil en la compresión fisiopatológico del metabolismo de los ácidos biliares. Conclusión: los ácidos biliares desempeñan una función clave como moléculas de señalización en la modulación de la proliferación de células epiteliales, la expresión de genes y el metabolismo energético, que cuando se interrumpe su homeostasis se promueve la acción tóxica de estos, lo que se traduce en el proceso inflamación-carcinogénesis digestiva(AU)
Introduction: bile acids not only have as a regular biological activity the absorption of fat-soluble vitamins, cholesterol and lipids, but also act as signaling molecules, modulators of intestinal cell proliferation, gene expression and energy metabolism according to in vitro studies and in vivo; under physiological conditions they maintain their homeostasis, which when interrupted promotes their toxicological action. Objective: to describe the news of the new knowledge about the biological and toxicological activity of bile acids in the digestive system, aimed at general surgeons, gastroenterologists, clinicians and physiologists that allow them to contextualize the inflammation-carcinogenesis process related to the toxicological effects of bile acids. Method: A systematic review of the biological and toxicological activity of bile acids was performed for general surgeons, gastroenterologists, clinicians and physiologists, as a useful tool in the pathophysiological compression of bile acid metabolism. Conclusion: bile acids play a key role as signaling molecules in the modulation of epithelial cell proliferation, gene expression and energy metabolism, which when their homeostasis is interrupted, their toxic action is promoted, which translates in the inflammation-digestive carcinogenesis process(AU)
Assuntos
Humanos , Ácidos e Sais Biliares/análise , Ácidos e Sais Biliares/toxicidade , Disponibilidade Biológica , Sistema Digestório/metabolismoRESUMO
RESUMEN Introducción: El desescalamiento de las medidas para controlar la epidemia por la COVID-19 en Cuba no exonera la vigilancia permanente para evitar rebrotes. Objetivo: Mostrar el diseño de un sistema de vigilancia epidemiológica hospitalaria para la detección precoz de casos sospechosos en la etapa pos COVID-19. Métodos: Investigación cualitativa. Se localizó información en las bases de datos Lilacs, Ebsco e Hinari con los descriptores: vigilancia en salud, monitoreo epidemiológico y servicios de vigilancia epidemiológica. A partir de las definiciones de casos objeto de vigilancia, se definieron los objetivos del sistema, premisas, atributos y subsistemas. Se tuvo en cuenta la metodología utilizada en un sistema de vigilancia en Cuba desarrollado y modificado por especialistas cubanos. Resultados: El sistema se estructura a partir de cuatro componentes: entrada de datos, procesamiento de los datos obtenidos de encuestas epidemiológicas aplicadas a pacientes y acompañantes, salida de la información con la descripción del tipo de caso y retroalimentación; está conformado por cuatro subsistemas: Diagnóstico Clínico, de Laboratorio, Epidemiológico y Estadístico. El sistema ha detectado precozmente casos sospechosos en pacientes hospitalizados, previo a la intervención quirúrgica y a otros procederes mínimos invasivos. Conclusiones: Se muestra el diseño de un sistema de vigilancia epidemiológica hospitalaria, como herramienta de trabajo, conformado por cuatro subsistemas para obtener los datos que facilitan la detección precoz de casos sospechosos de COVID-19 y su confirmación y establecer acciones de prevención y control del riesgo tanto para el Centro Nacional de Cirugía de Mínimo Acceso como para las organizaciones involucradas
ABSTRACT Introduction: Cuba prepares for recovery and for keeping the COVID-19 epidemic under control in the national territory. Gradual de-escalation of measures until getting into the new normal does not exempt permanent surveillance to avoid new outbreaks. Objective: Show the procedure used in the design of a hospital epidemiological surveillance´s system for the early detection of suspected cases in the pos-COVID-19 stage. Methods: Qualitative research. It was located information in the databases Lilacs, Ebsco and Hinari with the descriptors: health surveillance, epidemiological monitoring, and services of epidemiological surveillance. From the definition of cases under surveillance, there were defined the objectives of the system, premises, attributes and subsystems. It was taken into account the methodology used in a surveillance system in Cuba which was developed and modified by Cuban specialists. Results: The system is structured from four components: data entry, processing of data collected in epidemiological surveys applied to patients and their companions, and data output with the description of the type of case and feedback. This is also formed by four subsystems: clinical diagnosis, laboratory diagnosis, epidemiological diagnosis and statistical diagnosis. The system has early detected suspicious cases in hospitalized patients before surgical interventions and other minimal invasive procedures. Conclusions: A hospital epidemiological surveillance system is designed as a working tool for obtaining information that facilitates the early detection of COVID-19 suspected cases and their confirmation, and to establish risk prevention and control actions for both the National Center of Minimal Access Surgery and the organizations involved.
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RESUMEN Los materiales a base de silicato de calcio han demostrado ser bioactivos debido a su capacidad para producir apatita carbonatada biológicamente compatible. El objetivo de este estudio fue analizar la bioactividad de Biodentine™ y MTA Repair HP® en contacto con discos de dentina humana, que se obturaron y dividieron aleatoriamente para formar cuatro grupos: grupo 1 Biodentine™, grupo 2 MTA Repair HP®, grupo control positivo MTA Angelus® y grupo control negativo IRM®, los cuales se incubaron en solución PBS durante 10 días, para posterior análisis por medio de MEB-EDS y Espectroscopía Raman. Los tres materiales a base de silicato de calcio analizados en este estudio demostraron ser bioactivos pues al entrar en contacto con una solución a base de fosfato desencadenaron la precipitación inicial de fosfato de calcio amorfo, que actúa como precursor durante la formación de apatita carbonatada.
ABSTRACT Calcium silicate-based materials have been shown to be bioactive due to their ability to produce biologically compatible carbonated apatite. The objective of this study was to analyze the bioactivity of Biodentine ™ and MTA Repair HP® in contact with human dentine discs, which were sealed and divided randomly to form four groups: group 1 Biodentine™, group 2 MTA Repair HP®, positive control group MTA Angelus® and negative control group IRM®, which were incubated in PBS solution for 10 days, for a subsequent analysis by means of MEB-EDS and Raman spectroscopy. The three calcium-based materials analyzed in this study proved to be bioactive because upon contact with a phosphate-based solution they were triggered at the onset of amorphous calcium phosphate, as the precursor during the formation of carbonated apatite.