Medición de la fuerza muscular en adultos como predictor de extubación en Unidades de Cuidados Intensivos. Revisión narrativa / Measurement of muscular strength in adults as a predicator of extubation in intensive care units. Narrative review

Resumen: Introducción: uno de los principales efectos de la ventilación mecánica invasiva es la lesión de los músculos respiratorios, específicamente, sobre el diafragma en el que pueden ocurrir alteraciones estructurales y funcionales que modifican parcial o totalmente su función. Durante la ventilación mecánica se produce un proceso de atrofia por desuso de dicho músculo. Por ello la utilidad clínica de la medición de la fuerza muscular diafragmática es importante para conocer si el paciente tiene la capacidad de activar los mecanismos protectores de la vía aérea para lograr la extubación exitosa y el retiro del ventilador mecánico en el menor tiempo posible. Objetivos: describir la medición de la fuerza muscular como predictor de la extubación en las unidades de cuidados intensivos. Material y métodos: se realizó una revisión de la literatura, entre 2011 y 2022. Resultados: los pacientes que son sometidos a ventilación mecánica invasiva prolongada generalmente desarrollan una afección muscular diafragmática, lo que se convierte en una problemática para el proceso de extubación temprana, por lo cual es vital conocer los métodos de medición de fuerza muscular como predictor de extubación.

Abstract: Introduction: one of the main effects of invasive mechanical ventilation is injury to the respiratory muscles, specifically the diaphragm. In which structural and functional alterations can occur that partially or totally modify its function. During mechanical ventilation, a process of disuse atrophy of said muscle occurs. Therefore, the clinical utility of measuring diaphragmatic muscle strength is important to know if the patient has the ability to activate the protective mechanisms of the airway to achieve successful extubation and removal of the mechanical ventilator in the shortest time possible. Objective: describe the measurement of muscle strength as a predictor of extubation in intensive care units. Material and methods: a literature review was carried out, carried out between 2011 and 2022. Results: patients who are subjected to prolonged mechanical ventilation generally develop a diaphragmatic muscle disorder, becoming a problem for the weaning, for it is important know the methods of measuring muscle strength.

New detection method of SARS-CoV-2 antibodies toward a point-of-care biosensor.

The outbreak of COVID-19, a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is regarded as the most severe of the documented coronavirus pandemics. The measurement and monitoring of SARS-CoV-2 antibody levels by serological tests are relevant for a better epidemiological and clinical understanding of COVID-19. The aim of this work was to design a method called the SARS-CoV-2 antibody detection method (SARS-CoV-2 AbDM) for fluorescence immunodetection of anti-SARS-CoV-2 IgG and IgM on both plate and microfluidic chip. For this purpose, a system with magnetic beads that immobilize the antigen (S protein and RBD) on its surface was used to determine the presence and quantity of antibodies in a sample in a single reaction. The SARS-CoV-2 AbDM led to several advantages in the performance of the tests, such as reduced cost, possibility of performing isolated or multiple samples, potential of multiplex detection, and capacity to detect whole blood samples without losing resolution. In addition, due to the microfluidic chip in conjunction with the motorized actuated platform, the time, sample quantity, and operator intervention during the process were reduced. All these advantages suggest that the SARS-CoV-2 AbDM has the potential to be developed as a PoC that can be used as a tool for seroprevalence monitoring, allowing a better understanding of the epidemiological and clinical characteristics of COVID-19 and contributing to more effective and ethical decision-making in strategies to fight against the COVID-19 pandemic.

Efectos de la contaminación ambiental sobre la salud de la población mediante una revisión narrativa / Effects of environmental pollution on populations health through a narrative review

Mediante la disminución de los niveles de contaminación del aire los países pueden reducir la carga en morbilidad derivada de accidentes cerebrovasculares, cáncer de pulmón y neumopatías crónicas y agudas. Por lo tanto, el objetivo de esta investigación fue determinar los efectos a corto y largo plazo que tiene la contaminación ambiental sobre la salud de la población por medio de una revisión narrativa de tipo cualitativo y descriptivo. El método de búsqueda e identificación de los estudios se realizó por medio de las siguientes bases de datos electrónicas: Medline, Pubmed, Science Direct, entre otras; con un estado del arte de máximo 5 años posteriores a su fecha de publicación. De acuerdo con la búsqueda realizada en las bases de datos, se seleccionaron un total de 10 artículos en los cuales se encontraron diferentes efectos de la contaminación ambiental en la salud humana a nivel respiratorio, cardiovascular, hepático, neurológico, gestacional, inmunológico, entre otros sistemas a causa del material particulado encontrado en el ambiente como los son del PM 2.5, PM10 Y otros gases relacionados con la contaminación y los efectos sobre la salud. Los resultados de esta revisión narrativa confirman los efectos asociados a la contaminación ambiental a corto plazo y largo plazo del aumento de las concentraciones de las partículas contaminantes encontradas en el ambiente. Palabras claves: contaminación ambiental, partículas contaminantes, efectos corto plazo, efectos largo plazo, material particulado.

By lowering air pollution levels, countries can reduce the burden of disease from strokes, lung cancer, and chronic and acute lung diseases. Therefore, the objective of this research was to determine the short and long-term effects of environmental pollution on the health of the population through a qualitative and descriptive narrative review. The search and identification method of the studies was carried out through the following electronic databases: Medline, Pubmed, Science Direct, among others; with a state of the art of a maximum of 5 years after its publication date. According to the search carried out in the databases, a total of 10 were selected in which different effects of environmental pollution on human health were found at the respiratory, cardiovascular, liver, neurological, gestational, and immune levels, among other systems. due to particulate matter found in the environment such as PM 2.5, PM10 and other gases related to pollution and health effects. The results of this narrative review confirm the short-term and long-term effects associated with environmental pollution of increased concentrations of polluting particles found in the environment.

Clinical Application of Epithelial Sodium Channel (ENaC) as a Biomarker for Arterial Hypertension.

Arterial hypertension (HTN) is a global public health concern and an important risk factor for cardiovascular diseases and renal failure. We previously reported overexpression of ENaC on the plasma membrane of human platelets is a hallmark of HTN. In this double-blinded study of an open population (n = 167), we evaluated the sensitivity and specificity of a diagnostic assay based on gold nanoparticles (AuNPs) conjugated to an antibody against epithelial sodium channel (ENaC) expressed on platelets, which is detected using a fluorescent anti-ENaC secondary antibody and spectrofluorometry. Using the cutoff value for the AuNP-anti-ENaC assay, we confirmed the diagnosis for 62.1% of patients with clinical HTN and detected 59.7% of patients had previously undiagnosed HTN. Although some shortcomings in terms of accurately discriminating healthy individuals and patients with HTN still need to be resolved, we propose this AuNP-anti-ENaC assay could be used for initial screening and early diagnosis to critically improve opportune clinical management of HTN.

Assessment of Factors Influencing Personal Exposure to Air Pollution on Main Roads in Bogota: A Mixed-Method Study.

Background and Objectives: Particulate Matter (PM), particles of variable but small diameter can penetrate the respiratory system via inhalation, causing respiratory and/or cardiovascular diseases. This study aims to evaluate the association of environmental particulate matter (PM2.5) and black carbon (BC) with respiratory health in users of different transport modes in four roads in Bogotá. Materials and Methods: this was a mixed-method study (including a cross sectional study and a qualitative description of the air quality perception), in 300 healthy participants, based on an exploratory sequential design. The respiratory effect was measured comparing the changes between pre- and post-spirometry. The PM2.5 and black carbon (BC) concentrations were measured using portable devices. Inhaled doses were also calculated for each participant according to the mode and route. Perception was approached through semi-structured interviews. The analysis included multivariate models and concurrent triangulation. Results: The concentration of matter and black carbon were greater in bus users (median 50.67 µg m-3; interquartile range (-IR): 306.7). We found greater inhaled dosages of air pollutants among bike users (16.41 µg m-3). We did not find changes in the spirometry parameter associated with air pollutants or transport modes. The participants reported a major sensory influence at the visual and olfactory level as perception of bad air quality. Conclusions: We observed greater inhaled doses among active transport users. Nevertheless, no pathological changes were identified in the spirometry parameters. People's perceptions are a preponderant element in the assessment of air quality.

Disparities in Local Wellness Policies Implementation Across Maryland Schools.

BACKGROUND: School-level implementation of district-level local wellness policies (LWPs) is needed to create school environments that promote nutrition and physical activity (PA). Disparities in classroom-specific LWPs implementation were examined. METHODS: An administrator survey (N = 756 schools; 24/24 districts) included 6 classrooms LWP best-practice items (fully/not fully implemented: restricting food celebrations or rewards, incorporating PA breaks or integrating PA in curricula, restricting withholding or using PA as punishment). A sum score (alpha = .71; elementary and middle/high examined separately) was used to examine associations with student body income (free-and-reduced priced meals (FARMS): ≤40%, 41-75%, ≥75%), race/ethnicity, and school location (rural/urban/suburban), accounting for district-level clustering, with moderation examined. RESULTS: Classroom implementation scores were: elementary = 3.1 ± 1.8 (range: 0-6/6 items) and middle/high = 2.3 ± 1.6 (range:0-5/5 items). Among elementary and middle/high schools, 65% and 55% had >40% FARMS, 39% and 46% had ≥50% white student body, and 24% and 23% were urban, respectively. Elementary schools with >40% of FARMS-eligible students and middle/high schools with <25% white students reported implementing fewer items. Location was not associated with classroom practices nor was moderation observed. CONCLUSIONS: Disparities in classroom-specific LWP best practices implementation were observed by income and race/ethnicity. Tailored support may be needed to improve classroom LWP implementation in schools serving low-income students.

An optical-based biosensor of the epithelial sodium channel as a tool for diagnosing hypertension.

Arterial hypertension (HTN) is a world health concern presenting difficulties for its early detection. It leads to cardiovascular and kidney complications that increase morbidity in adults. Overexpression in the epithelial sodium channel (ENaC) in membrane platelets can be related with the presence of HTN and thus can be used as a biomarker to detect this medical condition. Here, we propose a method for HTN diagnosis based on gold nanoparticles (GNPs) conjugated to an antibody against the ENaC present on platelets. These functionalized GNPs were analyzed by Zeta potential, dynamic light scattering, electron microscopy, and other spectroscopic techniques. To verify that the GNPs and α-ENaC antibodies formed conjugates (GNPs-antiENaC) that maintained their specificity to the target, we carried out an indirect immunofluorescence detection assay of GNPs-antiENaC bound to a secondary antibody labeled with a fluorophore. Our results show that the presence of GNPs increase the fluorescence intensity in platelets treated with GNPs-antiENaC conjugates. It is also observed a clear tendency of the fluorescence signal in platelets treated with the conjugates that could be used for discrimination between normotensive and hypertensive samples. The proposed assay can be implemented as a very sensitive routine test to diagnose HTN.

Impact of Complicated Urinary Tract Infection on Renal Graft Function.

BACKGROUND: Urinary tract infection (UTI) is the most common infectious complication after renal transplantation. It is uncertain whether the development of UTI has an impact on renal graft function. The objective of this study was to evaluate the effects of complicated and recurrent UTI on 2-year renal graft function. METHODS: This was a historical cohort study in renal transplantation patients in a kidney transplant center. All renal transplant recipients from June 2004 to September 2016 were included. A linear regression analysis was performed to study the association between the outcome (variation in estimated glomerular filtration rate [eGFR] by the Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI] equation between month 1 and month 24 post-transplant) and the UTI. The approval of the Ethics and Research Committee to carry out this study was obtained. RESULTS: In total, 276 kidney transplants were performed during the observation period. Of the transplant patients, 193 (69.9%) did not develop a UTI and 83 (30.1%) presented at least 1 complicated UTI. Patients who presented at least 1 UTI had a variation in eGFR during the observation period of -12.6 mL/min/1.73 m2 (95% confidence interval [CI] -4.5 to -20.7 mL/min/1.73 m2; P = .02), compared with those without a UTI. Said difference persisted in the adjusted model controlling for variables that have an impact on the eGFR. This difference was -10.7 mL/min/1.73 m2 (95% CI -3.1 to -18.2 mL/min/1.73 m2; P = .006). CONCLUSION: The findings suggest that the occurrence of complicated UTI has a negative impact on graft function and that prevention and monitoring of UTIs should be stepped up to avoid their deleterious effects on graft function.

Alterations to the contents of plasma membrane structural lipids are associated with structural changes and compartmentalization in platelets in hypertension.

Arterial hypertension (HTN) can lead to serious organ damage. Several mechanisms have been implicated in the pathogenesis of HTN including constitutive activation of platelets, which increases the risk of aggregation and clot formation. We recently demonstrated the plasma membranes of platelets from patients with HTN exhibit modified structural and physicochemical properties; Raman and Fourier transform infrared by attenuated total reflectance (FTIR-ATR) spectroscopy also indicated lipid content and protein structure alterations. This study aimed to precisely quantify the constituents of the main structural phospholipids and cholesterol in the plasma membranes of platelets from patients with HTN and normotensive individuals. We also assessed the consequence of these alterations on platelet structure and function. Liquid chromatography coupled to triple quadrupole mass spectrometry revealed the plasma membranes of HTN platelets contained less cholesterol and phosphatidylcholine, more phosphatidylserine and phosphatidylethanolamine and had similar sphingosine contents. Atomic force microscopy revealed HTN platelets exhibited increased surface roughness and more pleats. Transmission electron microscopy revealed diminution of the internal membranous structures in HTN platelets. Our findings strongly suggest plasma membrane lipid content alterations-including cholesterol depletion-occur in HTN, and these alterations may induce morphological and physiological abnormalities that participate in the functional changes associated with hypertension.

Alterations to plasma membrane lipid contents affect the biophysical properties of erythrocytes from individuals with hypertension.

Genetic and environmental factors may contribute to high blood pressure, which is termed essential hypertension. Hypertension is a major independent risk factor for cardiovascular disease, stroke and renal failure; thus, elucidation of the etiopathology of hypertension merits further research. We recently reported that the platelets and neutrophils of patients with hypertension exhibit altered biophysical characteristics. In the present study, we assessed whether the major structural elements of erythrocyte plasma membranes are altered in individuals with hypertension. We compared the phospholipid (phosphatidylcholine, phosphatidylethanolamine, phosphatidylserine, sphingosine) and cholesterol contents of erythrocytes from individuals with hypertension (HTN) and healthy individuals (HI) using LC/MS-MS. HTN erythrocytes contained higher phosphatidylcholine, phosphatidylethanolamine and phosphatidylserine contents and a lower cholesterol content than HI erythrocytes. Furthermore, atomic force microscopy revealed important morphological changes in HTN erythrocytes, which reflected the increased membrane fragility and fluidity and higher levels of oxidative stress observed in HTN erythrocytes using spectrophotofluorometry, flow cytometry and spectrometry. This study reveals that alterations to the lipid contents of erythrocyte plasma membranes occur in hypertension, and these alterations in lipid composition result in morphological and physiological abnormalities that modify the dynamic properties of erythrocytes and contribute to the pathophysiology of hypertension.

Building Blocks for Healthy Children: Evaluation of a Child Care Center-Based Obesity Prevention Pilot Among Low-Income Children.

OBJECTIVE: To assess the impact of a multilevel nutrition intervention for low-income child care environments, staff, and center-enrolled children. DESIGN: A cluster-randomized, controlled trial conducted among eligible centers. Staff and parent self-report surveys and objective field observations at baseline and follow-up were conducted. SETTING: A total of 22 low-income child care centers (enrolling ≥ 25 2- to 5-year-old children). PARTICIPANTS: Children aged 18-71 months; 408 children and 97 staff were randomized into intervention (208 children and 50 staff) and waitlist-control groups (200 children and 45 staff). Retention rates were high (87% for children and 93% for staff). INTERVENTION(S): A 6-session, 6-month director's child nutrition course with on-site technical support for center teachers. MAIN OUTCOME MEASURE(S): Center nutrition/physical activity environment; staff feeding styles, dietary patterns, and attitudes about food; child food preferences and dietary patterns. ANALYSIS: Covariance regression analyses to assess the intervention effect, adjusting for clustering within centers. RESULTS: Significant intervention effects were found for the center nutrition training/education environment (b = 3.01; P = .03), nutrition total scores (b = 1.29; P = .04), and staff-level prompting/encouraging feeding styles (b = 0.38; P = .04). No significant intervention effects were found for child-level measures. CONCLUSIONS AND IMPLICATIONS: Curriculum-driven training and implementation support improved nutritional policies and practices and staff-child interactions during meals. Future research could extend the intervention to families and the evaluation to children's dietary behaviors and weight changes.

Gastric sleeve surgery in hemodialysis: A case report.

INTRODUCTION: Morbid obesity in chronic kidney disease patients on hemodialysis limits access to renal transplantation. We report here a case of a surgical procedure for weight reduction in a hemodialysis patient and adjustment of dry weight through bioelectrical impedance. CASE PRESENTATION: A 44-year-old male with CKD on hemodialysis for 26 years. After 3 years on dialysis, he underwent a cadaveric kidney transplant. However, after 8 years of transplant, he loses the kidney graft and returns to dialysis treatment. The patient's BMI increased to 42 kg/m2 and he had difficult-to-control hypertension and severe sleep apnea. Behavioral, nutritional and pharmacologic measures were not sufficient to achieve an adequate weight control. Thus, a surgical procedure for weight reduction was considered. The patient underwent a laparoscopic gastric sleeve without any complications. Dry weight was adjusted through bioelectrical impedance before each hemodialysis session. The patient did not display hypotension, cramps, or fluid overload. After a 30 kg weight loss, the patient's BMI was 28.3 kg/m2, allowing registration on the kidney transplant waitlist. DISCUSSION: Obesity in CKD restricts access to kidney transplant waitlist. Bariatric surgery has proven to be safe and effective for sustained weight loss and it seems that the fact that a patient is dialysis dependent does not independently increase post-operatory complications. CONCLUSION: Surgical procedures for weight reduction in dialysis patients does not independently increase the risk for adverse outcomes after bariatric surgery. The estimation of DW through BIA is an effective method for avoiding complications generated by excessive or deficient ultrafiltration.

Volatile compounds from beneficial or pathogenic bacteria differentially regulate root exudation, transcription of iron transporters, and defense signaling pathways in Sorghum bicolor.

KEY MESSAGE: Our results show that Sorghum bicolor is able to recognize bacteria through its volatile compounds and differentially respond to beneficial or pathogens via eliciting nutritional or defense adaptive traits. Plants establish beneficial, harmful, or neutral relationships with bacteria. Plant growth promoting rhizobacteria (PGPR) emit volatile compounds (VCs), which may act as molecular cues influencing plant development, nutrition, and/or defense. In this study, we compared the effects of VCs produced by bacteria with different lifestyles, including Arthrobacter agilis UMCV2, Bacillus methylotrophicus M4-96, Sinorhizobium meliloti 1021, the plant pathogen Pseudomonas aeruginosa PAO1, and the commensal rhizobacterium Bacillus sp. L2-64, on S. bicolor. We show that VCs from all tested bacteria, except Bacillus sp. L2-64, increased biomass and chlorophyll content, and improved root architecture, but notheworthy A. agilis induced the release of attractant molecules, whereas P. aeruginosa activated the exudation of growth inhibitory compounds by roots. An analysis of the expression of iron-transporters SbIRT1, SbIRT2, SbYS1, and SbYS2 and genes related to plant defense pathways COI1 and PR-1 indicated that beneficial, pathogenic, and commensal bacteria could up-regulate iron transporters, whereas only beneficial and pathogenic species could induce a defense response. These results show how S. bicolor could recognize bacteria through their volatiles profiles and highlight that PGPR or pathogens can elicit nutritional or defensive traits in plants.

School wellness team best practices to promote wellness policy implementation.

Schools with wellness teams are more likely to implement federally mandated Local Wellness Policies (LWPs, Local Education Agency-level policies for healthy eating/physical activity). Best practices have been developed for wellness teams based on minimal empirical evidence. The purpose of this study is to determine, among schools with wellness teams, associations between LWP implementation and six wellness team best practices (individually and as a sum score). An online survey targeting Maryland school wellness leaders/administrators (52.4% response rate, 2012-2013 school year) was administered that included LWP implementation (17-item scale: categorized as no, low, and high implementation) and six wellness team best practices. Analyses included multi-level multinomial logistic regression. Wellness teams were present in 311/707 (44.0%) schools, with no (19.6%), low (36.0%), and high (44.4%) LWP implementation. A sum score representing active wellness teams (mean=2.6) included: setting healthy eating/physical activity goals (66.9%), informing the public of LWP activities (71.4%), meeting ≥4times/year (45.8%), and having school staff (46.9%), parent (25.4%), or student (14.8%) representation. In adjusted models, goal setting, meeting ≥4times/year, and student representation were associated with high LWP implementation. For every one-unit increase in active wellness team sum score, schools were 41% more likely to be in high versus no implementation (Likelihood Ratio=1.41, 95% C.I.=1.13, 1.76). In conclusion, wellness teams meeting best practices are more likely to implement LWPs. Interventions should focus on the formation of wellness teams with recommended composition/activities. Study findings provide support for wellness team recommendations stemming from the 2016 Healthy, Hunger-Free Kids Act final rule.

Implementation of Local Wellness Policies in Schools: Role of School Systems, School Health Councils, and Health Disparities.

BACKGROUND: Written local wellness policies (LWPs) are mandated in school systems to enhance opportunities for healthy eating/activity. LWP effectiveness relies on school-level implementation. We examined factors associated with school-level LWP implementation. Hypothesized associations included system support for school-level implementation and having a school-level wellness team/school health council (SHC), with stronger associations among schools without disparity enrollment (majority African-American/Hispanic or low-income students). METHODS: Online surveys were administered: 24 systems (support), 1349 schools (LWP implementation, perceived system support, SHC). The state provided school demographics. Analyses included multilevel multinomial logistic regression. RESULTS: Response rates were 100% (systems)/55.2% (schools). Among schools, 44.0% had SHCs, 22.6% majority (≥75%) African-American/Hispanic students, and 25.5% majority (≥75%) low-income (receiving free/reduced-price meals). LWP implementation (17-items) categorized as none = 36.3%, low (1-5 items) = 36.3%, high (6+ items) = 27.4%. In adjusted models, greater likelihood of LWP implementation was observed among schools with perceived system support (high versus none relative risk ratio, RRR = 1.63, CI: 1.49, 1.78; low versus none RRR = 1.26, CI: 1.18, 1.36) and SHCs (high versus none RRR = 6.8, CI: 4.07, 11.37; low versus none RRR = 2.24, CI: 1.48, 3.39). Disparity enrollment did not moderate associations (p > .05). CONCLUSIONS: Schools with perceived system support and SHCs had greater likelihood of LWP implementation, with no moderating effect of disparity enrollment. SHCs/support may overcome LWP implementation obstacles related to disparities.

Sensitivity analysis for the EEG forward problem.

Sensitivity analysis can provide useful information when one is interested in identifying the parameter θ of a system since it measures the variations of the output u when θ changes. In the literature two different sensitivity functions are frequently used: the traditional sensitivity functions (TSF) and the generalized sensitivity functions (GSF). They can help to determine the time instants where the output of a dynamical system has more information about the value of its parameters in order to carry on an estimation process. Both functions were considered by some authors who compared their results for different dynamical systems (see Banks and Bihari, 2001; Kappel and Batzel, 2006; Banks et al., 2008). In this work we apply the TSF and the GSF to analyze the sensitivity of the 3D Poisson-type equation with interfaces of the forward problem of electroencephalography. In a simple model where we consider the head as a volume consisting of nested homogeneous sets, we establish the differential equations that correspond to TSF with respect to the value of the conductivity of the different tissues and deduce the corresponding integral equations. Afterward we compute the GSF for the same model. We perform some numerical experiments for both types of sensitivity functions and compare the results.

Historias de vida de niños (as) con cancer: construcción de significado y sentido / Children with cancer life stories: cultural construction of sense and meaning

Se realizó un estudio cualitativo con base en las historias de vida narradas mediante una actividad lúdico-creativa por 3 niños y 3 niñas con leucemia linfoblásticaaguda, entre los 7 y los 15 años de edad, acogidos por la Fundación Diana Sarmiento de Bogotá, con el fin de conocer el sentido y significado que le dan al cáncer en sus vidas. El análisis de los hallazgos establece que este grupo de niños y niñas muestran gran capacidad para sobreponerse a sus circunstancias, lo cual lleva a buscar respuestas en la teoría sobre la resiliencia que afirma que además de aspectos inherentes a su personalidad como su inteligencia, reflexividad y responsividad, los niñas(as) resilientes cuentan con familias que los reconocen y/o con entidades que los impulsan, como lo hace esta Fundación que busca fortalecerlos a nivel psicoemocional. Como aspectos importantes de su experiencia, en sus autobiografías destacan: la primera hospitalización; las intervenciones dolorosas; el fuerte impacto del cáncer en sus vidas, que cambiaron a partir de la enfermedad, generándoles limitaciones, y el sufrimiento de sus familias. Es recurrente el sentido espiritual que los niños y las niñas le dan a su experiencia la cual integran a su sentido de vida como una prueba de Dios que deben superar. Esto lleva a considerar la importancia de que la enfermería oncológica y otras disciplinas de la salud tengan en consideración la dimensión espiritual dentro delos procesos de cuidado a estos niños(as) e incluyanel fortalecimiento de la resiliencia en ellos(as).

Efecto de la segregación en el transporte reactivo

El estudio de los fenómenos de transporte contribuye a comprender los procesos de dispersión de solutos en el suelo, el agua y el aire, conocimiento necesario para analizar el efecto de las actividades humanas sobre el ambiente. En este trabajo se analiza la influencia de la segregación en el modelado del transporte de dos reactivos en medio poroso y se presentan los gráficos resultantes de las simulaciones, que muestran la evolución temporal de los dos reactivos y la concentración del producto en distintas situaciones, comparándolos con datos experimentales obtenidos de la literatura