SARS-CoV-2 Mu variant in dogs visiting veterinary clinics during the third pandemic peak in Eastern Colombia.

The global presence of SARS-CoV-2 in household pets is acknowledged, yet documentation remains scarce, leaving many regions unexplored. Thus, our study sought to fill this gap by investigating SARS-CoV-2 presence in dogs visiting veterinary clinics during the third pandemic peak in eastern Colombia. We collected and analyzed 43 oropharyngeal and rectal swabs using real-time PCR assays targeting the Envelope Gene of SARS-CoV-2. Out of these, two dogs tested positive, indicating an infection rate of 4.7%. Further examination through complete sequencing and phylogenetic analysis revealed the lineage B.1.621 for the SARS-CoV-2 genome. Consequently, our study unveils the first documented cases of Canis lupus familiaris infected with the Mu variant of SARS-CoV-2, the variant with the most death burden during the whole pandemic in Colombia. Remarkably, these cases presented mild and reversible respiratory and gastrointestinal symptoms, or no clinical manifestations at all. This sheds light on the virus's interaction with our four-legged companions, offering valuable insights into its transmission dynamics and potential effects on animal health.

Validation of a New Digital and Automated Color Perception Test.

Although color vision deficiencies are very prevalent, there are no ideal methods for assessing color vision in all environments. We compared a new digital and automated method that quantifies color perception for the three protan, deutan, and tritan axes with two of the most commonly used color tests in daily practice: the Ishihara 38 plates test and the Farnsworth-Munsell 100-Hue test. One hundred patients underwent a triple examination composed of the new DIVE Color Test, the Ishihara test, and the Farnsworth-Munsell 100-Hue test. The DIVE Color Test was performed twice in forty participants to assess its repeatability. In the trichromatic group, the mean age stood at 20.57 ± 9.22 years compared with 25.99 ± 15.86 years in the dyschromatic group. The DIVE and Ishihara tests exhibited excellent agreement in identifying participants with color deficiency (Cohen's kappa = 1.00), while it was 0.81 when comparing DIVE and Farnsworth. The correlation between the global perception values of Farnsworth (TES) and DIVE (GCS) was 0.80. The repeatability of the DIVE Color Test was high according to Bland-Altman analysis with an intraclass correlation coefficient of 0.83. According to Ishihara, the DIVE Color Test proved to be an effective and reproducible tool for red-green color vision deficiency detection, capable of determining the severity of the defect in each of the three axes faster and more accurately than both Ishihara and Farnsworth.

Seroprevalence and coprological prevalence of liver fluke Fasciola hepatica in cattle and sheep from Santander department, Colombia.

Fasciola hepatica is a parasite with a worldwide distribution that affects several mammals, including humans, and is considered a public health problem. Therefore, the aim of this study was to determine the prevalence of Fasciola hepatica in humans, cattle and sheep, as well as to evaluate factors associated with the prevalence. A total of 185 serum samples from sheep, 290 from cattle, and 114 from humans were collected and processed using an in-house developed ELISA to detect IgG antibodies against F. hepatica. Additionally, 185 stool samples from sheep and 290 from cattle were examined using a Dennis sedimentation technique. Risk factors were analyzed using epidemiological surveys. The overall seroprevalence was 46.5% (86/185) in sheep, 32.5% (94/289) in cattle, and no humans tested positive for the infection. The coprological prevalence was 47.7% (86/180) in sheep and 33.7% (98/290) in cattle. Female gender and cattle living with alternate grazing management showed 2.5 and 6.5 times higher probability of infection, respectively. Bovines coexisting with sheep exhibited a higher risk of infection (odds ratio [OR]=4.3) compared to those without sheep. We concluded that F. hepatica in cattle and sheep has an endemic behavior, and therefore represents a problem of public health for rural communities.

The first report of Dirofilaria repens infection in dogs from Colombia.

Dirofilariasis is a mosquito-borne disease caused by Dirofilaria parasites, affecting both wild and domestic animals, including humans considered as accidental hosts. Dirofilaria repens is the principal causative agent of dirofilariasis in the Old World, with increasing reports of the parasite in countries where it has not been previously identified, due to several factors such as the expansion of mosquito vectors' geographical distribution. By utilizing newly designed primers for molecular detection and confirming through next-generation sequencing, here, we report the first plausible cases of D. repens in dogs from Colombia. Our results support the classification of this species as an emergent pathogen in the Americas. Finally, we encourage an increase in diagnostic and surveillance efforts to prevent and control the current and future dirofilariasis cases in this region.

Correction to: My Home Quarantine on an App: A Qualitative Visual Analysis of Changes in Family Routines During the COVID-19 Pandemic in Chile.

[This corrects the article DOI: 10.1007/s11133-023-09531-z.].

My Home Quarantine on an App: A Qualitative Visual Analysis of Changes in Family Routines During the COVID-19 Pandemic in Chile.

This article presents original findings from a longitudinal qualitative study on changes in individual and family life associated with safety and health measures implemented during the COVID-19 pandemic in three regions of Chile. We developed a methodological approach based on multimodal diaries in a mobile application, in which participants submitted photographs and texts to express changes in their daily lives under residential confinement. Content and semiotic visual analyses show a significant loss in instances of collective recreation, partially compensated through new personal and productive activities performed at home. Our results suggest that modal diaries serve as potential tools to capture people's perceptions and meanings as their lives go through exceptional and traumatic times. We assert that using digital and mobile technologies in qualitative studies could allow subjects to actively participate in the co-construction of fieldwork and produce quality knowledge from their situated perspectives. Supplementary Information: The online version contains supplementary material available at 10.1007/s11133-023-09531-z.

Sow mortality in a pig production system in the midwestern USA: Reasons for removal and factors associated with increased mortality.

BACKGROUND: Sow mortality has become a growing concern in the pig production industry over the past decade. Therefore, we aimed to describe sow mortality and associated factors in a production system in the midwestern USA. METHODS: Mortality records from 2009 to 2018 for four farrow-to-wean farms were described. Environmental, farm- and individual-level factors associated with weekly mortality and individual risk of dying throughout a sow's lifetime were assessed. RESULTS: Deaths occurred at a median of 116 days from last service, or 26 days postpartum. The median parity upon death was two. Overall, the main reasons for death were locomotion (27%) and reproduction (24%). A higher weekly number of deaths was associated with spring (incidence rate ratio [IRR] 1.27, compared to winter). Sows had a higher mortality when they were exposed to at least one porcine reproductive and respiratory syndrome (PRRS) outbreak during their lifetime (IRR 1.55) and when housed in groups (pens) during gestation (IRR 1.32). Conversely, they had  a lower mortality when housed in filtered farms (IRR 0.76), accounting for an interaction term between parity at removal and PRRS outbreak exposure. LIMITATIONS: Issues with data completion and information accuracy were present, and prospective data collection throughout sows' lifetimes is still needed. CONCLUSION: Efforts to reduce infectious diseases within the herd and manage environmental stressors should help reduce mortality.

Development of oculomotor control throughout childhood: A multicenter and multiethnic study.

Although steady fixation is a key aspect of a proper visual function, it is only subjectively assessed in young and uncooperative children. In the present study, we characterize the development of fixational behavior throughout childhood in a large group of healthy children 5 months of age and up, recruited in five geographically diverse sites. In order to do it, we examined 802 healthy children from April 2019 to February 2020. Their oculomotor behavior was analyzed by means of an automated digital system, based on eye-tracking technology. Oculomotor outcomes were gaze stability, fixation stability and duration of fixations (for both long and short fixational tasks), and saccadic reaction time. Ninety-nine percent of all recruited children were successfully examined. Fixational and saccadic performance improved with age throughout childhood, with more pronounced changes during the first 2 years of life. Gaze and fixation tended to be more stable with age (p < 0.001 for most the outcomes), and saccades tended to be faster. In a multivariate analysis, including age and ethnicity as independent variables and adjusting by data quality, age was related with most fixational outcomes. Our automated digital system and eye-tracking data allow us to quantitatively describe the development of oculomotor control during childhood, assess visual fixation and saccadic performance in children 5 months of age and up, and provide a normative reference of fixational outcomes for clinical practice.

Effectiveness of an Educational Intervention With High-Fidelity Clinical Simulation to Improve Attitudes Toward Teamwork Among Health Professionals.

BACKGROUND: Failures in teamwork are a common reason for adverse medical events. The goals of this study are to evaluate attitudes toward teamwork among an interprofessional group of health professionals and to analyze the effectiveness of an educational intervention with high-fidelity clinical simulation to improve these attitudes. METHOD: An educational intervention was developed that used a 6-hour session that included three simulated clinical cases. The Attitudes Toward Health Care Teams Scale was used for assessment. Mean difference before and after the intervention was calculated with the Wilcoxon test. RESULTS: Positive attitude toward teamwork after completion of the training activities was measured. The health care professionals who showed the most positive attitude toward teamwork were physicians (93.92, SD = 6.58) and resident physicians (95.01, SD = 6.33). The greatest increase was observed among orderlies (p < .001) and nursing assistants (p < .001). CONCLUSION: The use of clinical simulation for interprofessional training of health care professionals showed a positive effect on attitudes toward teamwork. [J Contin Educ Nurs. 2021;52(10):457-467.].

Identification of Multiple Blastocystis Subtypes in Domestic Animals From Colombia Using Amplicon-Based Next Generation Sequencing.

Blastocystis is frequently reported in fecal samples from animals and humans worldwide, and a variety of subtypes (STs) have been observed in wild and domestic animals. In Colombia, few studies have focused on the transmission dynamics and epidemiological importance of Blastocystis in animals. In this study, we characterized the frequency and subtypes of Blastocystis in fecal samples of domestic animals including pigs, minipigs, cows, dogs, horses, goats, sheep, and llama from three departments of Colombia. Of the 118 fecal samples included in this study 81.4% (n = 96) were positive for Blastocystis using a PCR that amplifies a fragment of the small subunit ribosomal RNA (SSU rRNA) gene. PCR positive samples were sequenced by next generation amplicon sequencing (NGS) to determine subtypes. Eleven subtypes were detected, ten previously reported, ST5 (50.7%), ST10 (47.8%), ST25 (34.3%), ST26 (29.8%), ST21 (22.4%), ST23 (22.4%), ST1 (17.9%), ST14 (16.4%), ST24 (14.9%), ST3 (7.5%), and a novel subtype, named ST32 (3.0%). Mixed infection and/or intra -subtype variations were identified in most of the samples. Novel ST32 was observed in two samples from a goat and a cow. To support novel subtype designation, a MinION based sequencing strategy was used to generate the full-length of the SSU rRNA gene. Comparison of full-length nucleotide sequences with those from current valid subtypes supported the designation of ST32. This is the first study in Colombia using NGS to molecularly characterize subtypes of Blastocystis in farm animals. A great diversity of subtypes was observed in domestic animals including subtypes previously identified in humans. Additionally, subtype overlap between the different hosts examined in this study were observed. These findings highlight the presence of Blastocystis subtypes with zoonotic potential in farm animals indicating that farm animals could play a role in transmission to humans.

Comparison between five coprological methods for the diagnosis of Balantidium coli cysts in fecal samples from pigs.

BACKGROUND AND AIM: Balantidium coli is a protozoan that can infect humans and non-human primates, being the domestic pigs the animals most affected by this parasite. This study aimed to compare the performance of five coprological methods for diagnosis of Balantidium coli cysts in fecal samples from pigs. MATERIALS AND METHODS: From September to December 2019, 558 fecal samples were collected from the rectum of backyard pigs in the Bucaramanga metropolitan area, Colombia. The average age of the sampled animals was 3-4 months. Fecal samples collected were tested using the following coprological techniques: Direct examination with Lugol's iodine solution, buffered saline, centrifugation/flotation and McMaster techniques, and Ziehl-Neelsen method. RESULTS: The results indicate that B. coli cysts were diagnosed most frequently through direct examination with Lugol's iodine solution (52.7% of the samples) followed by direct examination with a buffered saline solution (37.6%). Moderate concordance (k=0.41; p<0.05) was determined between direct method with Lugol's iodine and buffered saline solution, McMaster and buffered saline (k=0.35; p<0.05), and centrifugation/flotation and buffered saline (k=0.28; p<0.05) showed a fair degree of concordance. The rest of the comparisons were classified as poor. The flotation techniques (centrifugation/flotation and McMaster) did not show good recovery of cysts. CONCLUSION: It is concluded that the most efficient method for diagnosing this parasitosis was to an association between direct examination with Lugol's iodine solution and buffered saline.

Root Canal Filling Quality Comparison of a Premixed Calcium Silicate Endodontic Sealer and Different Carrier-Based Obturation Systems.

BACKGROUND: The number of voids within the root canal obturation is a relevant parameter to describe the quality of the technique, as well as to predict long-term prognosis. The aim of this study was to evaluate the quality of root canal obturation in curved root canals filled with Thermafil, GuttaCore, GuttaFusion and lateral compaction with AH Plus and EndoSequence BC sealer, by means of percentage of gutta-percha and sealer filled area. METHODS: 200 curved canals of mandibular molars were divided in five groups (n = 40). Each specimen was evaluated at 3, 6 and 9 mm from the apex. A total of 600 samples were analyzed. Obturation was performed with either Thermafil (TH), GuttaCore (GC), GuttaFusion (GF) or lateral compaction (LC), using AH Plus as sealer. In another group EndoSequence BC sealer (BC) was used. Subgroups (n = 20) were made depending on the use of sonic activation during the placement of the sealer. The percentage of total obturation material was analyzed as an indirect measurement of percentage of voids. RESULTS: GF showed a better performance at the apical level, while GC showed the higher percentage of total obturation at the coronal area. No differences were observed for the activation of sealers in any of the groups. Statistical analysis was performed by using two-way ANOVA. Statistical significance was set at CI: 95% (p < 0.05). CONCLUSIONS: Sonic activation of sealers did not show any benefit to avoid the presence of voids within obturation of curved canals. Following the manufacturer recommendations, we found that TH did not show benefits when applied to curved canals.

A survey for potentially zoonotic parasites in backyard pigs in the Bucaramanga metropolitan area, Northeast Colombia.

BACKGROUND AND AIM: Backyard pigs farming is a rearing system associated with poor hygienic and sanitary conditions of the pig, often causing public health and food safety problems. Therefore, this study was conducted to investigate the occurrence of potentially zoonotic parasites in population pig reared under backyard farming in the Bucaramanga metropolitan area, Northeast Colombia. MATERIALS AND METHODS: From September to December 2019, a total of 558 fecal samples from 64 backyard pig farms were examined for the presence of enteric protozoan infection. The coprological diagnosis was done by direct examination using Lugol's iodine solution, buffered saline solution, and Kinyoun technique. In addition, blood samples were collected from 200 pigs. Serum was collected and used for the detection of Trichinella spiralis and Taenia solium cysticercosis infections, using the enzyme-linked immunosorbent assay. RESULTS: The overall prevalence of zoonotic protozoa in the Bucaramanga metropolitan area was 65.2%, reporting 52.7% prevalence for Balantidium coli, 33.7% for Entamoeba coli, and 5.7% for Cryptosporidium spp. Regarding the prevalence by municipalities, there was no statistical association (p>0.05), indicating that the prevalence was similar in the region under study. Pigs >7 months of age showed to be a risk factor for B. coli infection, indicating that the prevalence increases with the age, while pigs raised at >1000 masl and access to latrines, increased infection risk for E. coli and Cryptosporidium spp. infections. In the present study, T. spiralis infection was not detected in the analyzed sera, while T. solium cysticercosis infection was found to be 40.5%. CONCLUSION: The high prevalence of protozoan infections and porcine cysticercosis reported in this study could be due to poor facilities, and lack of hygiene in the facilities, and suggests the possible transmission of these parasite populations between pigs and humans, thus increasing the transmission of parasites zoonotic potential. Therefore, appropriate sanitary management practices and deworming programs should be adopted to reduce the prevalence of these infectious agents.

Prevalence of Dirofilaria immitis in shelter dogs in Bucaramanga metropolitan area, Colombia.

The heartworm Dirofilaria immitis is the causative agent of cardiopulmonary dirofilariosis in dogs and cats and also infects humans. The current knowledge about this parasite in South America is scarce compared to North America and Europe. Nevertheless, this parasite has been reported in some regions of Colombia. The objective of this study was to determine the prevalence and risk factors associated with D. immitis infection in shelter dogs from Bucaramanga metropolitan area. We performed a cross-sectional study using blood samples from shelter dogs. Microfilariae testing of whole blood included a blood smear and modified Knott's test. Antigen testing of serum was performed using the Anigen Rapid HW Ag Test Kit 2.0 ®. A descriptive analysis and univariable logistic regression analysis were applied. A total of 207 whole blood samples, from 7 shelters dogs in the Bucaramanga metropolitan area, were utilized. The overall prevalence of D. immitis observed in shelter dogs in the Bucaramanga metropolitan area by blood smears and modified Knott's test was 6.3% (13/ 207) and 0.5% (1/207) by immunochromatography test kit. Regarding the prevalence by municipalities, there was a statistical association (P < .05), indicating that the prevalence was higher in dogs in Girón municipality. Likewise, there was a statistical association (P < .05) between the prevalence with respect to heartworm knowledge and mosquito control. For prevalence by gender, age group, dog breed, and hair length, there was no statistical association (P > .05). For Girón municipality there was a 7.1 times (OR = 7.1; CI95% 0.8-59.2; P < .05) increased infection risk. This study provides current data and the first known report of the prevalence of D. immitis microfilaremia and antigenemia in shelter dogs in the Bucaramanga metropolitan area, and these results could be useful for designing new control measures for this infection. We observed that the prevalence of both microfilaremia and antigenemia was significantly lower in these sampled dogs compared to previous reports.

Current status of prevalence and risk factors associated with liver fluke Fasciola hepatica in cattle raised in different altitudinal regions of Colombia.

Fasciola hepatica is a trematode parasite with a worldwide distribution that affects mammals, including humans, and is considered a major food safety and public health problem. A research was conducted in three hundred eighty-five livestock farms located in different altitudinal regions of Colombia between February 2017 and March 2018 with the aim to determine the coprological prevalence, seroprevalence (SP) and risk factors associated with liver fluke F. hepatica. A total of 5620 fecal sample were collected from cattle and processed using sedimentation technique. Additionally, 597 blood samples were collected and processed by an ELISA test. The coprological prevalence of F. hepatica in animals and herds was 6.4% and 38.4%, respectively. Regarding the prevalence by municipalities, there was statistical association (P < .05), indicating that the prevalence was higher in those municipalities above 2000 masl (meters above sea level). Regarding risk factors, cattle raised in municipalities at 2000 to 3000 masl showed about 4 (OR = 3.96 [CI95% 3.1-5]; P < .05) times higher probability for infection than those raised at lower altitude. Cattle from 2 to 3 year of age, showed almost 4 times (OR = 3.7[CI95% 2.5-5.4]; P < .05), increased infection risk. Females and dairy breeds showed almost 2 (OR = 1.9 [CI95% 1.3-2.6]; P < .05) and 10 times (OR = 10 [CI95% 7.8-12.8]; P < .05), respectively, increased infection risk. The presence of antibodies anti- F. hepatica (SP = 37.8%; [CI95% 35.8-39.7]; P < .05) in cattle of the region under study is confirmed, which suggests an endemic behavior of this parasitosis. The present study provides current information on the prevalence of F. hepatica in different altitudinal regions of Colombia, and these findings could be useful for designing new holistic control measures for the liver fluke F. hepatica infection.

Prevalence and risk factors of gastrointestinal parasites in backyard pigs reared in the Bucaramanga Metropolitan Area, Colombia.

Backyard pigs have been associated with poor sanitary conditions and the development of parasitic diseases, often causing public health and food safety problems. Therefore, the aim of this study was to determine the prevalence and risk factors for gastrointestinal parasites in backyard pigs. 279 animals were sampled from thirty-two backyard pig farms located in the Bucaramanga, Floridablanca, Giron and Piedecuesta municipalities, from Bucaramanga Metropolitan Area, Colombia. Fecal samples were taken directly from the rectum and processed by four coprological techniques. The overall prevalence of gastrointestinal parasites was 91%, being the highest values for Balantidium coli and Eimeria sp. Regarding the prevalence by municipalities, there was no statistical association (p ≥ 0.05) indicating that the prevalence was similar in the region under study. Floridablanca municipality, free-ranging pigs, access to latrines, and consumption of spring water showed to be a risk factor for nematodes, while Giron municipality, pigs > 7 months of age and access to latrines, increased infection risk for coccidian. We concluded that there is a high prevalence of gastrointestinal parasites in backyard pigs from the Bucaramanga Metropolitan Area, and that it could be controlled by improving management practices and farm facilities.

Associations among individual gilt birth weight, litter birth weight phenotype, and the efficiency of replacement gilt production.

Selection for larger litter size has increased the number of low individual birth weight (BWi) pigs and produced sows with a repeatable low average litter birth weight phenotype (BWP). Using an average of 3.6 litters records per sow, BWP was established in 644 nucleus-multiplication sows producing replacement gilts in a large commercial operation and classified as low (L-BWP, <1.18 kg, n = 85), medium (M-BWP, ≥1.18 to ≤1.35 kg, n = 250), or high (H-BWP, >1.35 kg, n = 309) on the basis of a BWi of 1.18 kg below which there was a high risk of early mortality and the average BWi (1.35 kg) for the population. In subsequent litters, potential replacement gilts born to these sows (n = 7,341) received a unique identification tag that allowed the impact of BWi, BWP, and their interactions on the efficiency of replacement gilt production to be evaluated. Negative effects of BWi on mortality until day 4 after birth were confirmed (P < 0.05) and cumulative losses to weaning, to day 70 of age, and to final pre-selection at 165 d of age were affected (P ≤ 0.05) by the interaction between BWP and BWi. Among the 2,035 gilts for which records for selection efficiency and production to fourth parity were available, a lower BWi decreased the probability of gilts reaching pubertal estrus (P < 0.05) after 21 and 28 d of boar stimulation starting at 180 d of age, with no effect of BWP. Overall, neither BWi, BWP, nor their interaction affected age at puberty. After breeding, only the main effect of BWP affected productivity and retention in the sow herd. In parities 1 and 2, percent stillborn was higher in litters born to gilts from H-BWP compared with L-BWP dams (P < 0.05), and in parity 2, total born and born alive were lower in sows derived from H-BWP compared with other BWPs. There were no differences in retention based on BWP classes until parity 2, after which retention tended (P ≤ 0.09) to be lower in sows derived from H-BWP compared with L-BWP dams. These results provide evidence that sow BWP is an important factor in the overall efficiency of replacement gilt management. This study also confirms that effective gilt selection and pre-breeding management protocols support excellent sow lifetime productivity and mitigate the risk of a high BWP in the litter of origin affecting retention in the breeding herd.

Does education about death and dying decrease stress generated in the dissection room? / ¿Disminuye el estrés generado en la sala de disección la formación sobre la muerte y el moribundo?

SUMMARY: Positive effects on reducing students' stress have been reported across numerous university settings when anatomy preparatory seminars have been provided. To date, this type of preparation for coping with cadaver dissection has not been studied in Spanish universities. The aim of this study is to evaluate how first-year Spanish medical students face the dissecting room and whether previous preparation about death and dying reduces the stress generated. We performed an interventional study with students who received preparatory classes before the dissection practices (Experimental Group, EG) and with students who did not (Control Group, CG). Sociodemographic data and a self-assessment on stress symptoms were collected through a questionnaire completed before and after the dissection practices. No differences were found in the self-report of symptoms of stress among students who consider themselves religious or not, or between students who had a family member in the healthcare environment or not. However, in the EG, the students who had ample experience with terminally ill patients or death reported fewer stress symptoms. Unexpectedly, the number of selfreported stress symptoms after the dissection practice was higher in EG students. In conclusion the stress levels of first-year Spanish medical students not only did not improve after receiving preparatory classes about death and dying and discussion groups, but it gets worse. We found a relationship between student stress measured and experience with terminally ill patients or death. Additional studies are needed to identify the most suitable preparation for Spanish medical students.

RESUMEN: Se han informado efectos positivos en la reducción del estrés en los estudiantes de numerosos entornos universitarios cuando se han impartido seminarios preparatorios de anatomía. Hasta la fecha, este tipo de preparación para hacer frente a la disección del cadáver no se ha estudiado en las universidades españolas. El objetivo de este estudio es evaluar cómo los estudiantes de medicina españoles de primer año se enfrentan a la sala de disección y si la preparación previa sobre la muerte y el moribundo reduce el estrés generado. Realizamos un estudio de intervención con estudiantes que recibieron clases preparatorias antes de las prácticas de disección (Grupo Experimental, GE) y con estudiantes que no las recibieron (Grupo de Control, GC). Se recogieron datos sociodemográficos y síntomas de estrés mediante un cuestionario de autoevaluación antes y después de las prácticas de disección. No se encontraron diferencias en los síntomas de estrés valorados, entre los estudiantes que se consideran religiosos y los que no, ni tampoco entre los estudiantes que tenían o no un familiar en el entorno sanitario. Sin embargo, en el GE, en los estudiantes que tenían una amplia experiencia con pacientes con enfermedades terminales o con la muerte se observaron menos síntomas de estrés. Inesperadamente, el número de síntomas de estrés recogidos después de la práctica de disección fue mayor en los estudiantes del GE. En conclusión, los niveles de estrés de los estudiantes españoles de medicina de primer año no solo no mejoraron después de recibir las clases preparatorias sobre la muerte y el moribundo y establecer grupos de discusión, sino que empeoraron. Encontramos una relación entre la medición del estrés en los estudiantes y la experiencia con pacientes con enfermedades terminales o con la muerte. Se necesitan estudios adicionales para identificar la preparación más adecuada para los estudiantes de medicina españoles.

Development of a system based on artificial intelligence to identify visual problems in children: study protocol of the TrackAI project.

INTRODUCTION: Around 70% to 80% of the 19 million visually disabled children in the world are due to a preventable or curable disease, if detected early enough. Vision screening in childhood is an evidence-based and cost-effective way to detect visual disorders. However, current screening programmes face several limitations: training required to perform them efficiently, lack of accurate screening tools and poor collaboration from young children.Some of these limitations can be overcome by new digital tools. Implementing a system based on artificial intelligence systems avoid the challenge of interpreting visual outcomes.The objective of the TrackAI Project is to develop a system to identify children with visual disorders. The system will have two main components: a novel visual test implemented in a digital device, DIVE (Device for an Integral Visual Examination); and artificial intelligence algorithms that will run on a smartphone to analyse automatically the visual data gathered by DIVE. METHODS AND ANALYSIS: This is a multicentre study, with at least five centres located in five geographically diverse study sites participating in the recruitment, covering Europe, USA and Asia.The study will include children aged between 6 months and 14 years, both with normal or abnormal visual development.The project will be divided in two consecutive phases: design and training of an artificial intelligence (AI) algorithm to identify visual problems, and system development and validation. The study protocol will consist of a comprehensive ophthalmological examination, performed by an experienced paediatric ophthalmologist, and an exam of the visual function using a DIVE.For the first part of the study, diagnostic labels will be given to each DIVE exam to train the neural network. For the validation, diagnosis provided by ophthalmologists will be compared with AI system outcomes. ETHICS AND DISSEMINATION: The study will be conducted in accordance with the principles of Good Clinical Practice. This protocol was approved by the Clinical Research Ethics Committee of Aragón, CEICA, on January 2019 (Code PI18/346).Results will be published in peer-reviewed journals and disseminated in scientific meetings. TRIAL REGISTRATION NUMBER: ISRCTN17316993.

Prevalence and risk factors associated with liver fluke Fasciola hepatica in cattle and sheep in three municipalities in the Colombian Northeastern Mountains.

Fasciola hepatica is a parasitic trematode of worldwide distribution, which affects cattle and a large number of mammals, including man. An investigation was carried out to the Colombian Northeastern Mountain between October 2017 and February 2018 with the aim to determine the prevalence and risk factors associated with Fasciola hepatica. Thirty-four farms whose owners agreed to participate in the study were included. Overall, 103 bovines and 97 sheep were examined. A fecal and blood sample was collected from each animal, and all the samples were identified and stored in a refrigerated box to be transported to the Parasitology laboratory for analysis. Fecal samples were processed with a coprological technique, and blood by ELISA test. A written epidemiological survey was applied on all farms. The results indicate 20.5% of coprological prevalence and 41.5% of seroprevalence (SP). Evidence of the parasite was demonstrated in the three municipalities; however, statistical differences were found (P < .05), with higher seropositivity in Duitama municipality (SP = 83.3%). Regarding risk factor, pure breeds of cattle showed 2.5 (SP = 56.1, OR = 2.5) times higher of infection than crossed breed. Cattle and sheep from 12 to 24 months of age, showed 2.5 (SP = 66.7%, OR = 2.5) and 5.9 times (SP = 44.2%, OR = 5.9), respectively, increased infection risk. The presence of snails on the farms had higher odds for testing F. hepatica-positive, therefore, showed to be an important risk factor. The presence of antibodies against F. hepatica in cattle and sheep from the region under study suggests it is endemic and should be controlled by control and prevention programs in the farms.