Preclinical study of CD19 detection methods post tafasitamab treatment.

Introduction: Several CD19 targeted antibody-based therapeutics are currently available for patients with diffuse large B-cell lymphoma (DLBCL), including the Fc-modified antibody immunotherapy tafasitamab. This therapeutic landscape warrants the evaluation of potential sequencing approaches. Prior to a subsequent CD19-targeted therapy, CD19 expression on tafasitamab-treated patient biopsy samples may be assessed. However, no standardized methods for its detection are currently available. In this context, selecting a tafasitamab-competing CD19 detection antibody for immunohistochemistry (IHC) or flow cytometry (FC) may lead to misinterpreting epitope masking by tafasitamab as antigen loss or downregulation. Methods: We analyzed a comprehensive panel of commercially available CD19 detection antibody clones for IHC and FC using competition assays on tafasitamab pre-treated cell lines. To remove bound tafasitamab from the cell surface, an acidic dissociation protocol was used. Antibody affinities for CD19 were measured using Surface Plasmon Resonance (SPR) or Bio-Layer Interferometry (BLI). Results: While CD19 was successfully detected on tafasitamab pre-treated samples using all 7 tested IHC antibody clones, all 8 tested FC antibody clones were confirmed to compete with tafasitamab. An acidic dissociation was demonstrated essential to circumvent CD19 masking by tafasitamab and avoid false negative FC results. Discussion: The current study highlights the importance of selecting appropriate CD19 detection tools and techniques for correct interpretation of CD19 expression. The findings presented herein can serve as a guideline to investigators and may help navigate treatment strategies in the clinical setting.

Minimalist revision of Mesochorus Gravenhorst, 1829 (Hymenoptera: Ichneumonidae: Mesochorinae) from Área de Conservación Guanacaste, Costa Rica, with 158 new species and host records for 129 species / Revisión minimalista de Mesochorus Gravenhorst, 1829 (Hymenoptera: Ichneumonidae: Mesochorinae) del Área de Conservación Guanacaste, Costa Rica, con 158 especies nuevas y registros de hospedantes para 129 especies

Introduction: Species of Mesochorus are found worldwide and members of this genus are primarily hyperparasitoids of Ichneumonoidea and Tachinidae. Objectives: To describe species of Costa Rican Mesochorus reared from caterpillars and to a lesser extent Malaise-trapped. Methods: The species are diagnosed by COI mtDNA barcodes, morphological inspection, and host data. A suite of images and host data (plant, caterpillar, and primary parasitoid) are provided for each species. Results: A total of 158 new species of Mesochorus. Sharkey is the taxonomic authority for all. Conclusions: This demonstrates a practical application of DNA barcoding that can be applied to the masses of undescribed neotropical insect species in hyperdiverse groups.

Introducción: Las especies de Mesochorus se encuentran en todo el mundo y los miembros de este género son principalmente hiperparasitoides de las familias Ichneumonoidea y Tachinidae. Objetivos: Describir las especies de Mesochorus costarricenses obtenidas de orugas y en menor medida por trampas Malaise. Métodos: Las especies se diagnosticaron mediante el uso de código de barra molecular por COI del ADNmt, inspección morfológica y datos del huésped. Se proporciona un conjunto de imágenes y datos de los huéspedes (planta, oruga y parasitoide primario) para cada especie. Resultados: Se encontró un total de 158 nuevas especies de Mesochorus. Sharkey es la autoridad taxonómica para todas las especies. Conclusiones: Se demuestra una aplicación práctica del código de barras de ADN que se puede aplicar a grandes cantidades de especies de insectos neotropicales no descritas para grupos hiperdiversos.

Percepción del liderazgo enfermero ejercido en instituciones de tercer nivel de atención en Armenia (Colombia) / Perception of nursing leadership exercised in tertiary care institutions in Armenia (Colombia)

Objetivo principal: conocer la percepción sobre el liderazgo de enfermería desarrollado durante el ejercicio profesional en un grupo de enfermeros vinculados a instituciones de salud públicas y privadas de tercer nivel de atención en un municipio de Colombia. Metodología: investigación cualitativa del tipo de estudio de casos; se realizó entrevistas semiestructuradas a enfermeros del área asistencial con dedicación exclusiva de tiempo completo. Para el análisis de los datos, se utilizó la técnica de análisis de contenido, mediante el Software IRaMuTeQ. Resultados principales: En total participaron 13 enfermeros, los datos analizados fueron clasificados en dos categorías temáticas, a saber: (a) Significados y características del liderazgo en enfermería, y (b) Roles y ámbitos del liderazgo. Conclusión principal: El concepto de liderazgo se relaciona con dinámicas de trabajo en equipo desde relaciones jerárquicas. Es necesario reflexionar sobre el objeto disciplinar, para el caso el acto de cuidado de enfermería para el desarrollo del liderazgo requerido y en congruencia con las visiones epistémicas actuales.(AU)

Objective: to know the perception of nursing leadership developed during professional practice in a group of nurses linked to public and private tertiary care health institutions in a Colombian municipality. Methods: qualitative research of the case study type; Semi-structured interviews were conducted with nurses from the care area with full-time exclusive dedication. For data analysis, the content analysis technique was used, using the IRaMuTeQ Software. Results: A total of 13 nurses participated, the data analyzed were classified into two thematic categories, namely: a) Meanings and characteristics of leadership in nursing and; b) Roles and areas of leadership. Conclusions: The concept of leadership is related to teamwork dynamics from hierarchical relationships; it is necessary to reflect on the disciplinary object, in this case the act of nursing care for the development of the required leadership and in congruence with the current epistemic visions.(AU)

Estrategias didácticas desarrolladas con estudiantes de enfermería para el logro de competencias profesionales: Revisión integrativa / Estratégias didáticas desenvolvidas com estudantes de enfermagem para o alcance de competências profissionais: revisão integrativa / Didactic strategies develop ed hit nursing students to achieve professional competencies: Integrative review

The development of didactic strategies that contribute to the achievement of professionalcompetences, requires a continuous thought of social relevance that guides the construction of disciplinary knowledge consistent with the epistemological nature of the profession and for the training of competent nurses. At present, nursing students report confusion and dissatisfaction with theprogress of their learning, compromising the achievement of the provided competencies. It is essential to recognize the didactic strategies developed by nursing students to achieve learning outcomes, proposed as indicators of the quality of care learned, within the framework of professionalcompetencies. In this work, an integrative literature review was carried out using the electronic resourcesof ProQuest and EBSCO, 15 studies were included, most of them quasi-experimental, carried outmainly in Brazil, during 2018. The use of active didactic strategies was identified, which involve thestudent in the construction of knowledge related to specific teaching-learning phenomena such ascommunication skills, instrumental (assessment, diagnosis or intervention). It is necessary to transit,through these strategies, to pedagogical and didactic proposals that articulate disciplinaryknowledge for the analysis and resolution of care situations that are typically faced at the beginningof professional practice.(AU)

El desarrollo de estrategias didácticas que aportan al logro de competencias profesionalesrequiere una continua reflexión de pertinencia social que orienta la construcción de conocimientosdisciplinares coherentes con la naturaleza epistemológica de la profesión y para la formación deenfermeros competentes. Actualmente los estudiantes de enfermería refieren confusión e insatisfacción frente al progreso de su aprendizaje, comprometiendo el logro de las competencias previstas.Resulta indispensable reconocer las estrategias didácticas desarrolladas en estudiantes de enfermería para el logro de resultados de aprendizaje, propuestos como indicadores de la calidad del cuidado aprendido, en el marco de las competencias profesionales. Para esto se realizó una revisiónintegrativa de literatura mediante los recursos electrónicos de ProQuest y EBSCO; se incluyeron 15estudios, la mayoría cuasi-experimentales, realizados principalmente en Brasil, durante el año 2018.Se identificó la utilización de estrategias didácticas activas, que involucran al estudiante en la construcción de conocimientos relacionados con fenómenos de enseñanza-aprendizaje específicos comohabilidades comunicativas, instrumentales (valoración, diagnóstico o intervención). Se hace necesario transitar, mediante estas estrategias, a propuestas pedagógicas y didácticas articuladoras de saberes disciplinares para el análisis y la resolución de situaciones de cuidado a las que típicamentese hace frente al inicio del ejercicio profesional.(AU)

O desenvolvimento de estratégias didáticas que contribuam para o alcance das competên-cias profissionais requer uma reflexão contínua de relevância social que oriente a construção desaberes disciplinares condizentes com a natureza epistemológica da profissão e para a formação deenfermeiros competentes. Atualmente os estudantes de enfermagem relatam confusão e insatisfaçãocom o andamento de sua aprendizagem, comprometendo o alcance das competências planejadas. Éimprescindível reconhecer as estratégias didáticas desenvolvidas nos estudantes de enfermagempara o alcance dos resultados de aprendizagem, propostas como indicadores da qualidade do cuidado aprendido, no âmbito das competências profissionais. Para isso, foi realizada uma revisão integrativa da literatura utilizando os recursos eletrônicos da ProQuest e EBSCO; Foram incluídos 15estudos, a maioria quase experimentais, realizados principalmente no Brasil, durante 2018. Foi identificada a utilização de estratégias didáticas ativas, que envolvem o aluno na construção de conhecimentos relacionados a fenômenos específicos de ensino-aprendizagem, como habilidades de comunicação, instrumental (avaliação, diagnóstico ou intervenção). É necessário transitar, por meiodessas estratégias, para propostas pedagógicas e didáticas que articulem saberes disciplinares paraa análise e resolução de situações de cuidado tipicamente enfrentadas no início da prática profissional.(AU)

Incidence of acute respiratory symptoms and COVID-19 infection in children in public schools in Bogotá, Colombia, from July to November, 2020 / Incidencia de síntomas respiratorios agudos y COVID-19 en niños de escuelas públicas de Bogotá, Colombia, entre julio y noviembre de 2020

Introduction: More than 90% of children infected with COVID-19 worldwide developed mild to moderate disease. In Colombia, during 2020, COVID-19 infections in children stayed below 9.2% of the total cases, with no trends for age group or sex. Objective: To estimate the incidence of acute respiratory symptoms and COVID-19 in children from public schools in Bogotá, Colombia during the second semester of 2020. Material and methods: A telephone survey was conducted in over 5,000 scholar children. Antecedents and use of health services were informed. Descriptive statistics were used. Results: A total of 151.470 persons per day accounting for an IR of 157,8 per 100,000 people; almost three times the rate reported by the official surveillance system in the city. Conclusion: A lack of diagnosis and consultation in children was found compared to the general population. Further research is needed to elucidate the true burden of the disease in children.

Introducción. Más del 90% de los niños infectados con COVID-19 en el mundo, desarrollaron enfermedad leve a moderada. En Colombia, durante el 2020, la infección del COVID-19 en niños se mantuvo por debajo de 9,2 % del total de los casos sin tendencias por grupo de edad o sexo. Objetivo. Estimar la incidencia de síntomas respiratorios agudos y COVID19 en niños de escuelas públicas en Bogotá (Colombia) durante el segundo semestre de 2020. Materiales y métodos. Se hizo una encuesta telefónica en más de 5.000 escolares. Se recolectó información de antecedentes médicos y uso de servicios de salud. La información obtenida se describió mediante estadística descriptiva. Resultados. Se contabilizó un total de 151.470 personas al día para una tasa de incidencia de 157,8 en 100.000 personas, casi tres veces la tasa reportada por el sistema de vigilancia oficial de la ciudad. Conclusión. Se encontraron deficiencias en el diagnóstico y consulta de los niños, al compararlos con la población general. Se necesita más investigación para dilucidar la verdadera carga de la enfermedad en la población infantil.

Nivel de autocuidado, conocimientos y recursos en personas con insuficiencia renal crónica / Level of Self-Care, Knowledge and Resources in People Living with Chronic Renal Failure

Introducción: La insuficiencia renal crónica es un problema multifactorial, progresivo e irreversible que afecta la vida y salud de millones de personas; su tratamiento requiere de la adherencia a la terapia de elección y el desarrollo de habilidades de autocuidado. La falta de autocuidado genera incremento en los costes físicos, psicológicos, sociales y económicos a nivel individual, familiar, social y hospitalario. Objetivo: Determinar las conductas de autocuidado, los conocimientos y recursos relacionados con la práctica en un grupo de personas que convive con insuficiencia renal en terapia de hemodiálisis. Métodos: Investigación mixta con diseño explicativo secuencial, con primera etapa cuantitativa y segunda cualitativa. Se aplicó el instrumento de valoración nivel de autocuidado a 121 personas asistentes a terapias de hemodiálisis en dos unidades renales de la ciudad; posteriormente, se realizó entrevista a profundidad a las personas con niveles adecuado de autocuidado, los datos fueron categorizados y analizados mediante el software ATLAS TI versión 8. Resultados: El 76,03 por ciento presentó nivel poco adecuado de autocuidado, las dimensiones de mejor desempeño fueron sueño, descanso y recreación con un 55,37 por ciento y relaciones interpersonales con 58,67 por ciento. Los conocimientos presentes se encuentran a nivel receptivo y se destacan los recursos de apoyo social, tanto instrumentales como emocionales. Conclusiones: La construcción de prácticas de autocuidado requiere de la participación genuina entre los diferentes actores del cuidado de la salud, con el propósito de empoderar a la persona para un actuar fundamentado desde la comprensión de su condición y la gestión de su propia salud(AU)

Introduction: Chronic renal failure is a multifactorial, progressive and irreversible problem affecting the life and health of millions of people; its treatment requires adherence to the therapy of choice and the development of self-care skills. The lack of self-care increases physical, psychological, social and economic costs at the individual, family, social and hospital levels. Objective: To determine self-care behaviors, knowledge and resources related to practice in a group of people living with renal failure on hemodialysis therapy. Methods: A mixed research with sequential explanatory design, as well as a quantitative first stage and a qualitative second stage, was carried out. The self-care assessment instrument was applied to 121 people attending hemodialysis therapies in two renal care units of the city. Subsequently, an in-depth interview was conducted with people who possessed adequate levels of self-care. The data were categorized and analyzed using the software ATLAS TI (version 8). Results: 76.03 percent presented inadequate level of self-care. The dimensions with best performance were sleep, rest and leisure, accounting for 55.37 percent, as well as interpersonal relations, accounting for 58.67 percent. There is knowledge at a receptive level, while social support resources, both instrumental and emotional, stand out. Conclusions: The construction of self-care practices requires genuine participation among the different healthcare actors, with the purpose of empowering the person in view of performing actions based on the understanding of his or her condition and the management of his or her own health(AU)

Length of preoperative hospital stay is the dominating risk factor for surgical site infection in neurosurgery: A cohort data-driven analysis.

Background: The number of days of preoperative hospital stay (PHS) is a modifiable variable that has shown contradictory surgical site infection (SSI) risk factor results in neurosurgery. We sought to pinpoint the day of PHS length related with a marked increase of risk of SSI. Methods: From a tertiary teaching hospital, January 2015-December 2017, prospectively collected nonpercutaneous neurosurgery procedures with standard antibiotic prophylaxis and 1-year follow-up were evaluated. SSI risk factors were assessed through multiple logistic regression models with different thresholds of PHS. Results: A total of 1012 procedures were included in the study. Incidence of SSI was 4.4%. The median PHS was higher in those with SSI than in those without (1 day, interquartile range [IQR]: 7 vs. 0 days, IQR: 1, respectively, P = 0.002). By the amount of six days of PHS, this exposure risk past the threshold of significance for impact on wound infection (OR 2.8; CI 1.23-6.39, P = 0.014). Operative time past 4 h (OR 2.11; CI 1.12-3.98; P = 0.021), and in some models, previous surgery at same admission were also identified by multivariate analysis as increasing postoperative SSI risk. Conclusion: The gradual increase of the SSI OR associated with longer PHS days was the highest risk factor of SSI in our cohort of patients. Studies directed to reduce this complication should consider the PHS.

Dilemas éticos de enfermería en la limitación del esfuerzo terapéutico del paciente críticamente enfermo

Propósito/Contexto. En unidades de cuidado intensivo las acciones están dirigidas a recuperar, preservar o mejorar la vida de los pacientes, sin embargo, cuando tras intentarlo todo, solo se evidencia la prolongación de la vida en situaciones de sufrimiento, se considera la limitación del esfuerzo terapéutico (LET) como alternativa para un buen morir. Este artículo tiene como objetivo identificar los dilemas éticos que surgen en la enfermería, relacionados con la LET en pacientes adultos, hospitalizados en unidades de cuidado intensivo. Metodología/Enfoque. Se hizo una revisión crítica de la literatura, en cinco bases de datos. Se obtuvieron 31 artículos que cumplían con los criterios de selección del estudio. Resultados/Hallazgos. Del análisis integrativo surgieron cinco categorías relacionadas con los dilemas éticos e intervenciones de la enfermería en la LET: la participación de la enfermería en la toma de decisiones, la relación enfermera-paciente y su familia, los factores limitantes en la implementación de la LET y la búsqueda del buen morir. Discusión/Conclusiones/Contribuciones. La intervención de la enfermería es trascendental en el final del ciclo de vida del paciente crítico, sin embargo, su participación en el proceso es aún invisible. Los profesionales de enfermería necesitan adquirir habilidades y conocimientos en áreas como la comunicación empática y la ética en los cuidados al final de la vida para orientar una atención integral en salud en el proceso de la LET.

Purpose/Context. In intensive care units, actions aim to recover, preserve, or improve patients' lives; however, when life is just being extended under suffering after trying everything, limitation of therapeutic effort (LTE) is considered an alternative for a good death. This article establishes the ethical dilemmas and the nursing interventions in LTE in adult intensive care. Methodology/Approach. A critical review of the literature was made in five databases. We obtained 31 articles that met the study selection criteria. Results/Findings. Of the integrative analysis, five categories emerged related to ethical dilemmas and nursing interventions in LTE: nursing participation in decision-making, the nurse-patient/family relationship, the limiting factors in implementing LTE, and the search for a good death. Discussion/Conclusions/Contributions. Nursing makes far-reaching interventions at the end of the critical patient's life cycle; nevertheless, their participation in the process is still invisible. Nursing professionals need to acquire skills and knowledge of empathic communication, ethics, and the fundamentals of end-of-life care to guide comprehensive health care in the LTE process.

Objetivo/contexto. Nas unidades de cuidados intensivos, as ações dirigem-se a recuperar, preservar ou melhorar a vida dos doentes, no entanto, depois de tentar tudo, só se evidencia o prolongamento da vida em situações de sofrimento, considera-se a Limitação do Esforço Terapêutico (LET) como uma alternativa para um bom morrer. Neste artigo estabelecem-se os dilemas éticos e as intervenções de enfermagem na LET do paciente, em cuidados intensivos adulto. Metodologia/Abordagem. Foi feita uma revisão crítica da literatura, em cinco bases de dados. Foram obtidos 31 artigos que cumpriam os critérios de seleção do estudo. Resultados/Descobertas. Da análise integrativa surgiram cinco categorias relacionadas com os dilemas éticos e intervenções da enfermagem na LET: a participação da enfermagem na tomada de decisões, a relação enfermeira-paciente e sua família, os fatores limitantes na implementação de LET e a procura de um bom morrer. Discussão/Conclusões/Contribuições. A enfermagem tem intervenções transcendentais no final do ciclo de vida do paciente crítico; no entanto, sua participação no processo ainda é invisível. Os profissionais de enfermagem precisam adquirir habilidades e conhecimentos em áreas como a comunicação empática, a ética, nos fundamentos dos cuidados no final da vida, para orientar uma atenção integral à saúde no processo da LET.

Daratumumab Plus Atezolizumab in Previously Treated Advanced or Metastatic NSCLC: Brief Report on a Randomized, Open-Label, Phase 1b/2 Study (LUC2001 JNJ-54767414).

INTRODUCTION: The programmed death-ligand 1 inhibitor atezolizumab improves progression-free survival (PFS) and overall survival (OS) for patients with previously treated advanced NSCLC. Preclinical studies indicate that targeting CD38-positive cells with daratumumab may synergistically enhance atezolizumab's antitumor activity by increasing the effector T-cell activity. METHODS: This phase 1b-2 study included a safety run-in (one cycle of daratumumab plus atezolizumab) and randomized phases (daratumumab plus atezolizumab versus atezolizumab alone). The primary objective of the randomized phase was to compare overall response rates. The secondary objectives included evaluations of safety, clinical benefit rate (stable disease or better), PFS, OS, and pharmacokinetics. RESULTS: In total, 99 patients were enrolled (safety run-in, n = 7; randomized, n = 46 per arm). In the randomized phase, the overall response rate was 4.3% for daratumumab plus atezolizumab and 13.0% for atezolizumab alone (OR: 0.30; 95% confidence interval: 0.03-1.92). The respective clinical benefit rates were 52.2% and 43.5%. No improvements were observed in the median PFS or median OS for combination therapy. The study was terminated because of the limited efficacy of daratumumab plus atezolizumab. CONCLUSIONS: Daratumumab plus atezolizumab therapy did not improve efficacy versus atezolizumab monotherapy for patients with previously treated advanced NSCLC.

Novel antimicrobial cecropins derived from O. curvicornis and D. satanas dung beetles.

Antibiotic resistance is an increasing global problem and therapeutic alternatives to traditional antibiotics are needed. Antimicrobial and host defense peptides represent an attractive source for new therapeutic strategies, given their wide range of activities including antimicrobial, antitumoral and immunomodulatory. Insects produce several families of these peptides, including cecropins. Herein, we characterized the sequence, structure, and biological activity of three cecropins called satanin 1, 2, and curvicin, found in the transcriptome of two dung beetle species Dichotomius satanas and Onthophagus curvicornis. Sequence and circular dichroism analyses show that they have typical features of the cecropin family: short length (38-39 amino acids), positive charge, and amphipathic α-helical structure. They are active mainly against Gram-negative bacteria (3.12-12.5 µg/mL), with low toxicity on eukaryotic cells resulting in high therapeutic indexes (TI > 30). Peptides also showed effects on TNFα production in LPS-stimulated PBMCs. The biological activity of Satanin 1, 2 and Curvicin makes them interesting leads for antimicrobial strategies.

New Insect Host Defense Peptides (HDP) From Dung Beetle (Coleoptera: Scarabaeidae) Transcriptomes.

The Coleoptera Scarabaeidae family is one of the most diverse groups of insects on the planet, which live in complex microbiological environments. Their immune systems have evolved diverse families of Host Defense Peptides (HDP) with strong antimicrobial and immunomodulatory activities. However, there are several peptide sequences that await discovery in this group of organisms. This would pave the way to identify molecules with promising therapeutic potential. This work retrieved two sources of information: 1) De-novo transcriptomic data from two species of neotropical Scarabaeidae (Dichotomius satanas and Ontophagus curvicornis); 2) Sequence data deposited in available databases. A Blast-based search was conducted against the transcriptomes with a subset of sequences representative of the HDP. This work reports 155 novel HDP sequences identified in nine transcriptomes from seven species of Coleoptera: D. satanas (n = 76; 49.03%), O. curvicornis (n = 23; 14.83%), (Trypoxylus dichotomus) (n = 18; 11.61%), (Onthophagus nigriventris) (n = 10; 6.45%), (Heterochelus sp) (n = 6; 3.87%), (Oxysternon conspicillatum) (n = 18; 11.61%), and (Popillia japonica) (n = 4; 2.58%). These sequences were identified based on similarity to known HDP insect families. New members of defensins (n = 58; 37.42%), cecropins (n = 18; 11.61%), attancins (n = 41; 26.45%), and coleoptericins (n = 38; 24.52%) were described based on their physicochemical and structural characteristics, as well as their sequence relationship to other insect HDPs. Therefore, the Scarabaeidae family is a complex and rich group of insects with a great diversity of antimicrobial peptides with potential antimicrobial activity.

Evaluación prospectiva de las iniciativas en contra de las zoonosis de países de América Latina / Prospective evaluation of the initiatives against the zoonoses of Latin American countries

RESUMEN Objetivo Evaluar comparativamente las iniciativas a escala nacional en contra de las zoonosis en países de América Latina mediante la adaptación de la evaluación prospectiva. Materiales y Métodos Se analizó la vigilancia de los eventos de interés en salud pública y medidas ejecutadas y se adaptó el método de evaluación prospectiva de Haegeman con cinco criterios: evaluación, pertinencia, eficacia, oportunidad y sostenibilidad; estos fueron especificados y aplicados de manera cualitativa para medir el logro y el efecto de cada una de las iniciativas, determinando la eficacia de manera objetiva y acortando el tiempo de comparabilidad. Resultados Los principales objetivos de los programas de zoonosis son reducir morbimortalidad, fortalecer la vigilancia epidemiológica y capacidad nacional. Los eventos vigilados se clasificaron en virales, bacterianos, parasitarios y acciones contra la mordedura por animal ponzoñoso y tenencia responsable de mascotas. Las medidas para controlar las zoonosis incluyen cinco actividades: promoción, prevención, diagnóstico, vigilancia y control. De los cinco criterios valorados, se infirió que las iniciativas siguen las recomendaciones de los reglamentos internacionales. Incluyeron colaboración ¡ntersectorial y corresponsabilidad social y fueron consecuentes con los objetivos planteados y sostenibles en el tiempo. Conclusiones La evaluación prospectiva evidenció que la pertinencia de los programas se ve reflejada en cómo los objetivos se enfocan en las necesidades de la sociedad frente a los riesgos de contagio de enfermedades zoonóticas. Las acciones implementadas de manera colaborativa apuntan a generar un impacto positivo con la sociedad y el ecosistema.

ABSTRACT Objective To evaluate comparatively national-scale initiatives against zoonoses in LA countries through the adaptation of prospective evaluation. Materials and Methods The surveillance of events of interest in public health and the measures carried out were analyzed and the prospective evaluation method of Haegeman was adapted, with five criteria: evaluation, relevance, efficacy, timeliness and sustainability; they were specified and applied qualitatively to measure the achievement and effect of each of the initiatives; determining the effectiveness objectively and shortening the comparability time. Results The main objectives of zoonoses programs are to reduce morbidity and mortality, strengthen epidemiological surveillance and national capacity. Monitored events are classified into: viral, bacterial, parasitic and actions against poisonous animal bites and responsible pet ownership. Measures to control zoonoses include five activities: promotion, prevention, diagnosis, surveillance, and control. From the five criteria evaluated, it is inferred that the initiatives follow the recommendations of international regulations, include intersectoral collaboration and social co-responsibility, and are consistent with the objectives set and sustainable over time. Conclusions The prospective evaluation shows that the relevance of the programs is reflected in how the objectives are focused on the needs of society in the face of the risks of contagion of zoonotic diseases and the actions implemented collaboratively aim to generate a positive impact with society and the ecosystem.

Manifestaciones neurológicas por COVID-19. Reporte de casos en Hospital Militar Central Bogotá, Colombia, y revisión de la literatura / Neurological Manifestations due to COVID-19. Case Report at Hospital Militar Central Bogotá, Colombia, and Literature Review / Manifestações neurológicas pela COVID-19. Relato de casos no Hospital Militar Central Bogotá, Colombia, e revisão da literatura

Resumen: acorde a las fuentes epidemiológicas de la Organización Mundial de la Salud, en la última década, entre las principales causas de mortalidad más del 55 % resultaban de enfermedades no transmisibles, predominando la isquemia cardiaca y el accidente cerebrovascular como causales. En el 2019, con la aparición del nuevo coronavirus, COVID-19, como etiología de la pandemia que ha impactado tanto en salud como económica y socialmente al mundo, las cifras de la curva de las causas usuales de mortalidad han cambiado no solo a causa del efecto directo de la enfermedad en los múltiples órganos, sino también por los efectos indirectos en relación con falta de acceso a atención médica en enfermedades crónicas. Dado que es una enfermedad transmisible, el COVID-19 produce alteraciones, principalmente respiratorias y vasculares, sin embargo, el mayor conocimiento de los aspectos fisiopatológicos de la enfermedad ha revelado el compromiso de múltiples sistemas, destacando el sistema nervioso central como un objetivo del virus que impacta en las secuelas y los desenlaces de los pacientes, de modo que se documentan manifestaciones neurológicas hasta en un 55 %. El objetivo de esta revisión es caracterizar una serie de casos de pacientes en el Hospital Militar Central, mediante la descripción de aspectos fisiopatológicos y clínicos del compromiso neurológico.

Summary: according to the epidemiological sources of the World Health Organization, In the last decade, among the leading causes of mortality, more than 55 % resulted from non-communicable diseases, predominating cardiac ischemia, and stroke as the leading causes. In 2019, with the appearance of the new coronavirus, COVID-19, as an etiology of the pandemic that has Impacted health, economy, and society, the familiar figures of the mortality curve have changed, not only because of the direct effect of the disease on multiple organs, but also because of the Indirect effects, concerning lack of access to medical care in chronic diseases. Since it is a communicable disease, COVID-19 produces alterations, mainly respiratory and vascular; however, the greater knowledge of the pathophysiological aspects of the disease has revealed the involvement of multiple systems, highlighting the central nervous system as a target of the virus that impacts on the sequelae and outcomes of patients, so neurological manifestations are documented up to 55 %. The objective of this review Is to characterize a series of cases of patients in Hospital Militar Central, by the description of pathophysiological and clinical aspects of the neurological compromise.

Resumo: de acordo com fontes epidemiológicas da Organização Mundial da Saúde, na última década, entre as principais causas de mortalidade, mais de 55 % resultavam de doenças não transmissíveis, com predominância da Isquemia cardíaca e do acídente cerebrovascular como causais. Em 2019, com o surgimento no novo coronavirus (COVID-19), como etiologia da pandemia que vem Impactando tanto em saúde quanto económica e socialmente o mundo inteiro, as cifras da curva das causas usuais de mortalidade vêm mudando não somente devido ao efeito direto da doença nos múltiplos órgãos, mas também aos efeitos indiretos com relação à falta de acesso à atenção médica em doenças crónicas. Tendo em vista que é uma doença transmissível, a COVID-19 produz alterações principalmente respiratórias e vasculares, contudo o maior conhecimento dos aspectos fisiopatológicos da doença revela o comprometimento de vários sistemas, destacando o nervoso central como um objetivo do vírus, que Impacta nas sequelas e nos desenlaces dos pacientes, de modo que são registradas manifestações neurológicas de até 55 %. O objetivo desta revisão é caracterizar uma série de casos de pacientes no Hospital Militar Central, mediante a descrição de aspectos flsiopatológicos e clínicos do comprometimento neurológico.

Synesthesia does not help to recover perceptual dominance following flash suppression.

Grapheme-colour synesthesia occurs when letters or numbers elicit an abnormal colour sensation (e.g., printed black letters are perceived as coloured). This phenomenon is typically reported following explicit presentation of graphemes. Very few studies have investigated colour sensations in synesthesia in the absence of visual awareness. We took advantage of the dichoptic flash suppression paradigm to temporarily render a stimulus presented to one eye invisible. Synesthetic alphanumeric and non-synesthetic stimuli were presented to 21 participants (11 synesthetes) in achromatic and chromatic experimental conditions. The test stimulus was first displayed to one eye and then masked by a sudden presentation of visual noise in the other eye (flash suppression). The time for an image to be re-perceived following the onset of the suppressive noise was calculated. Trials where there was no flash suppression performed but instead mimicked the perceptual suppression of the flash were also tested. Results showed that target detection by synesthetes was significantly better than by controls in the absence of flash suppression. No difference was found between the groups in the flash suppression condition. Our findings suggest that synesthesia is associated with enhanced perception for overt recognition, but does not provide an advantage in recovering from a perceptual suppression. Further studies are needed to investigate synesthesia in relation to visual awareness.

Significados atribuido al evento coronario agudo desde la perspectiva familiar / Significados atribuídos à síndrome coronária aguda na perspectiva da família / Meanings attributed to the acute coronary event from the family perspective

El incremento de las enfermedades cardiovasculares (ECV), representa una carga asistencial y económica, relacionada con la mortalidad, la morbilidad y sus secuelas, impactando la experiencia de vida de quien desarrolla el evento y de su familia. Al ser enfermería, una profesión que propende por el cuidado integral de las personas requiere reconocer los significados atribuidos al evento coronario agudo (ECA) desde la perspectiva familiar, para resignificar conductas que pueden constituirse en riesgos para la salud del sistema familiar que comparte experiencias de vida, en pro de mejorar la calidad de vida y el bienestar integral de las personas. Para esto, se desarrolló un estudio cualitativo, con enfoque fenomenológico; los sujetos fueron identificados mediante informantes claves, la información se recolecto por medio de entrevistas a profundidad. El análisis temático interpretativo permitió identificar tres categorías: interpretación del evento, atención en salud y necesidades de cuidado. Desde las cuales resulta importante reflexionar sobre el cuidado de enfermería como un proceso de interacción genuina entre el cuidador profesional y los sujetos de cuidado, en este caso la familia, para propender por el bienestar y la salud integral del sistema familiar durante la hospitalización y la recuperación de la persona con ECA. (AU)

The increase of cardiovascular diseases (CVD), represents a burden of care and economic, related to mortality, morbidity and its aftermath, impacting the life experience of who develops the event and his family. Objective: To understand the meaning attributed to the acute coronary event from the family perspective in a group of people residing in the department of Quindío, Colombia; to redefine behaviors that may constitute risks to the health of the family system that shares life experiences, to improve the quality of life and the integral well-being of the people. Methodology: qualitative study, with phenomenological approach; the subjects were identified by key informants, the information was collected through in-depth interviews. Results: The interpretive thematic analysis identified three distinct categories: interpretation of the event, health care and care needs. Conclusion: It is important to reflect on the care of nursing as a genuine process of interaction between the professional caregiver and the subjects of care, in this case the family, for ensuring the well-being and wholeness of the family system during hospitalization and recovery of the person with ECA.(AU)

O incremento das doenças cardiovasculares (DCV) representa uma carga assistencial e econômica, relacionada com a mortalidade e suas consequências, impactando na experiência de vida de quem a padece e sua família. Objetivo: compreender o significado atribuído ao evento coronariano agudo na perspectiva da família em um grupo de pessoas residentes no departamento de Quindío-Colômbia; ressignificar condutas que podem constituirse em riscos para a saúde do sistema familiar que comparte experiências de vida, em pro de melhorar a qualidade de vida e o bemestar integral das pessoas. Metodologia: estudo qualitativo com enfoque fenomenológico; os sujeitos foram identificados mediante informantes chaves, a informação foi coletada por meio de entrevista em profundidade. Resultados: a análise temática interpretativa permitiu identificar três categorias: interpretação da síndrome; atenção em saúde e; necessidades de cuidado. Conclusão: é importante refletir sobre o cuidado de enfermagem como um processo de interação genuína entre o cuidador profissional e os sujeitos de cuidado, neste caso, a família, para propender pelo bem-estar e a saúde integral do sistema familiar durante a internação e recuperação da pessoa com SCA.(AU)

Sleep quality does not mediate the negative effects of chronodisruption on body composition and metabolic syndrome in healthcare workers in Ecuador.

BACKGROUND AND AIMS: The objective of the present work was to determine to what extent sleep quality may mediate the association between chronodisruption (CD) and metabolic syndrome (MS), and between CD and body composition (BC). METHODOLOGY: Cross-sectional study which included 300 adult health workers, 150 of whom were night shift workers and thereby exposed to CD. Diagnosis of MS was made based on Adult Treatment Panel III criteria. Sleep quality was measured using the Pittsburgh Sleep Quality Index. Body mass index (BMI), fat mass percentage, and visceral fat percentage were measured as indicators of body composition (BC). Data were analyzed using logistic, linear regression and structural equation models. RESULTS: The odds of health workers exposed to CD to suffer MS was 22.13 (IC95 8.68-66.07) when the model was adjusted for age, gender, physical activity and energy consumption. CD was also significantly associated with an increase in fat mass and visceral fat percentages, but not to BMI. Surprisingly, there was not enough evidence supporting the hypothesis that sleep quality contributes to the association between CD and MS or between CD and BC. CONCLUSIONS: Sleep quality does not mediate the negative effects of CD on MS nor on BC.

Incidence of acute respiratory symptoms and COVID-19 infection in children in public schools in Bogotá, Colombia, from July to November, 2020 / Incidence of acute respiratory symptoms and COVID-19 infection in children in public schools in Bogotá, Colombia, from July to November, 2020

INTRODUCTION: More than 90% of children infected with COVID-19 worldwide developed mild to moderate disease. In Colombia, during 2020, COVID-19 infections in children stayed below 9.2% of the total cases, with no trends for age group or sex. OBJECTIVE: To estimate the incidence of acute respiratory symptoms and COVID-19 in children from public schools in Bogotá, Colombia during the second semester of 2020. MATERIAL AND METHODS: A telephone survey was conducted in over 5,000 scholar children. Antecedents and use of health services were informed. Descriptive statistics were used. RESULTS: A total of 151.470 persons per day accounting for an IR of 157,8 per 100,000 people; almost three times the rate reported by the official surveillance system in the city. CONCLUSION: A lack of diagnosis and consultation in children was found compared to the general population. Further research is needed to elucidate the true burden of the disease in children.

Introducción. Más del 90% de los niños infectados con COVID-19 en el mundo, desarrollaron enfermedad leve a moderada. En Colombia, durante el 2020, la infección del COVID-19 en niños se mantuvo por debajo de 9,2 % del total de los casos sin tendencias por grupo de edad o sexo. Objetivo. Estimar la incidencia de síntomas respiratorios agudos y COVID19 en niños de escuelas públicas en Bogotá (Colombia) durante el segundo semestre de 2020. Materiales y métodos. Se hizo una encuesta telefónica en más de 5.000 escolares. Se recolectó información de antecedentes médicos y uso de servicios de salud. La información obtenida se describió mediante estadística descriptiva. Resultados. Se contabilizó un total de 151.470 personas al día para una tasa de incidencia de 157,8 en 100.000 personas, casi tres veces la tasa reportada por el sistema de vigilancia oficial de la ciudad. Conclusión. Se encontraron deficiencias en el diagnóstico y consulta de los niños, al compararlos con la población general. Se necesita más investigación para dilucidar la verdadera carga de la enfermedad en la población infantil.

Transiciones experimentadas por una persona portadora del virus de la inmunodeficiencia humana / Transitions experienced by a person living with the human immunodeficiency virus

Introducción: El virus de la inmunodeficiencia humana destruye las células del sistema inmunológico, genera alteraciones en la condición de salud de quien lo contrae a nivel físico, emocional, espiritual y social. Constituye un acontecimiento que cambia la vida y debe ser analizado integralmente para desarrollar un acompañamiento terapéutico efectivo. Objetivo: Comprender las transiciones experimentadas por una persona que vive con el virus de inmunodeficiencia humana, la naturaleza de la transición, las condiciones facilitadoras e inhibidoras y los patrones de respuesta desde la teoría de las transiciones. Métodos: Investigación cualitativa con diseño de historia de vida, realizada en Armenia, Colombia durante el 2018. Se realizó entrevista a profundidad a una persona, desde los postulados de Afaf Meleis, los datos fueron categorizados y analizados mediante el software ATLAS TI versión 7. Resultados: Se logró evidenciar una transición de salud-enfermedad, con patrón múltiple simultánea y secuencial, al recibir el diagnóstico suyo y de su hijo, requiriendo ajustes en el desempeño de su rol (transición situacional- organizativa). Se identificaron conocimientos previos acerca del virus y el compromiso con el tratamiento farmacológico. Además, se evidenció el amor y la fe hacia Dios, a quien le atribuye gran parte de su recuperación junto con el acompañamiento familiar y de su grupo de apoyo. Conclusiones: Resulta importante crear un perfil individual del paciente, que conlleve a un óptimo acompañamiento desde estrategias educativas, motivacionales, participativas y colectivas para abordar la dimensión física, emocional, espiritual y social de las personas que viven con el virus de inmunodeficiencia humana(AU)

Introduction: The human immunodeficiency virus destroys the cells of the immune system, generates changes in the health condition of those who contract it on a physical, emotional, spiritual and social level; It constitutes a life-changing event and must be comprehensively analyzed to develop effective therapeutic support. Objective: Understand the transitions experienced by a person living with the human immunodeficiency virus, the nature of the transition, the facilitating and inhibiting conditions and the response patterns from the theory of transitions. Methods: Qualitative research with life history design, carried out in Armenia, Colombia during 2018. An in-depth interview was conducted to a person, from the postulates of Afaf Meleis, the data was categorized and analyzed using the ATLAS TI version 7 software. Results: It was possible to demonstrate a health-disease transition, with a simultaneous and sequential multiple pattern, upon receiving the diagnosis from her and her son, requiring adjustments in the performance of his role (situational-organizational transition); Previous knowledge about the virus and commitment to pharmacological treatment were identified. In addition, love and faith towards God was evident, to whom he attributes a large part of his recovery along with family accompaniment and his support group. Conclusions: It is important to create an individual profile of the patient, which leads to optimal support from educational, motivational, participatory and collective strategies to address the physical, emotional, spiritual and social dimension of people living with the human immunodeficiency virus(AU)

Assessing Lateral Interaction in the Synesthetic Visual Brain.

In grapheme-color synesthesia, letters and numbers evoke abnormal colored perceptions. Although the underlying mechanisms are not known, it is largely thought that the synesthetic brain is characterized by atypical connectivity throughout various brain regions, including the visual areas. To study the putative impact of synesthesia on the visual brain, we assessed lateral interactions (i.e., local functional connectivity between neighboring neurons in the visual cortex) by recording steady-state visual evoked potentials (ssVEPs) over the occipital region in color-grapheme synesthetes (n = 6) and controls (n = 21) using the windmill/dartboard paradigm. Discrete Fourier Transform analysis was conducted to extract the fundamental frequency and the second harmonics of ssVEP responses from contrast-reversing stimuli presented at 4.27 Hz. Lateral interactions were assessed using two amplitude-based indices: Short-range and long-range lateral interactions. Results indicated that synesthetes had a statistically weaker signal coherence of the fundamental frequency component compared to the controls, but no group differences were observed on lateral interaction indices. However, a significant correlation was found between long-range lateral interactions and the type of synesthesia experience (projector versus associator). We conclude that the occipital activity related to lateral interactions in synesthetes does not substantially differ from that observed in controls. Further investigation is needed to understand the impact of synesthesia on visual processing, specifically in relation to subjective experiences of synesthete individuals.

Scientific Productivity and Cancer-Related Mortality: A Case Study of a Positive Association in Colombia.

PURPOSE: Cancer morbidity represents an increasing public health issue; this worldwide phenomenon also is true for emerging upper-middle-income countries, such as Colombia. The main purpose of this study was to uncover the relationship between scientific productivity and cancer-related mortality in our setting. METHODS: We conducted a temporal-trend ecologic study by means of bibliometric analysis from records of publications from SCOPUS database with Colombian institutional affiliations between 2000 and 2015. Productivity and overall mortality were estimated and compared using econometric modeling to identify potential correlations. Additional exploratory analyses per six most frequent cancer sites were performed. RESULTS: Of 2,645 publication records retrieved, 1,464 (55.3%) met selection criteria to be classified as Colombian scientific production (interobserver agreement, 92.96%; κ = 0.859; 95% CI, 0.800 to 0.918). Overall, 79.6% of the records corresponded to original or in-press articles; furthermore, almost half (49.7%) embodied descriptive study designs. Selected records reported a median of five authors and three different affiliations per publication; 66% had been cited at least once up to September 2017. The most-studied cancer-specific locations were cervix (16.1%), breast (11.5%), and stomach (9.8%), but nonspecific locations had the largest combined participation (23.4%). An increasing trend in scientific productivity was correlated to decreasing trend in overall cancer mortality, which was reported as an inverse proportional relationship in the linear regression modeling (r = -0.958; P < .001). Graphic analyses per cancer-specific sites revealed heterogeneous behaviors of this relationship. CONCLUSION: Colombian cancer-specific scientific productivity demonstrated a steady growth as opposed to a decreasing mortality trend in the recent years. The research output is predominantly descriptive with relatively low interinstitutional partnership and low impact in the international scientific community.