Site-specific serology unveils cross-reactive monoclonal antibodies targeting influenza A hemagglutinin epitopes.

Efficient identification of human monoclonal antibodies targeting specific antigenic sites is pivotal for advancing vaccines and immunotherapies against infectious diseases and cancer. Existing screening techniques, however, limit our ability to discover monoclonal antibodies with desired specificity. In this study, we introduce a novel method, blocking of binding (BoB) enzyme-linked immunoassay (ELISA), enabling the detection of high-avidity human antibodies directed to defined epitopes. Leveraging BoB-ELISA, we analyzed the antibody response to known epitopes of influenza A hemagglutinin (HA) in the serum of vaccinated donors. Our findings revealed that serum antibodies targeting head epitopes were immunodominant, whereas antibodies against the stem epitope, although subdominant, were highly prevalent. Extending our analysis across multiple HA strains, we examined the cross-reactive antibody response targeting the stem epitope. Importantly, employing BoB-ELISA we identified donors harboring potent heterosubtypic antibodies targeting the HA stem. B-cell clonal analysis of these donors revealed three novel, genealogically independent monoclonal antibodies with broad cross-reactivity to multiple HAs. In summary, we demonstrated that BoB-ELISA is a sensitive technique for measuring B-cell epitope immunogenicity, enabling the identification of novel monoclonal antibodies with implications for enhanced vaccine development and immunotherapies.

Association between telomere length and cognitive function among cognitively unimpaired individuals at risk of Alzheimer's disease.

INTRODUCTION: Leukocyte telomere length (LTL) is an objective biomarker of biological aging, and it is proposed to play a crucial role in Alzheimer's disease (AD) risk. We aimed at evaluating the cross-sectional association between LTL and cognitive performance in middle-aged cognitively unimpaired individuals at increased risk of AD. METHODS: A total of 1520 participants from the ALFA cohort were included. Relative telomere length was measured in leukocytes through qPCR. LTL was residualized against age and sex, and associations with cognitive performance were assessed in short and long groups based on residualized LTL (rLTL). Interactions with sex and genetic risk of AD were tested. RESULTS: Non-linear associations were found between LTL and episodic memory (EM). Better EM was associated with longer rLTL among women in the short rLTL group. DISCUSSION: Results suggest a potential role of telomeres in the cognitive aging process with sex-specific patterns.

"Perinatal loss, a devastating cyclone": A situation-specific nursing theory.

PURPOSE: The aim of this paper is to develop a preliminary theory that explores in depth into understanding the experiences of women who have suffered a spontaneous perinatal loss during any trimester of their pregnancy regarding their emotional response to this loss. DESIGN: A grounded theory approach was used, and 25 in-depth interviews were conducted with Spanish women who suffered a spontaneous perinatal loss. METHODS: Theoretical sampling and constant comparative analysis were used to reach theoretical saturation. EQUATOR guidelines were followed, using the COREQ checklist. RESULTS: The "Perinatal loss, a devastating cyclone," a situation-specific nursing theory, explains the process that a woman experiences when she loses her baby at any stage of pregnancy, drawing an analogy with tropical cyclones as natural disasters that destroy everything in their path. This situation-specific theory includes three dimensions, explaining the phases identified in the perinatal loss process (phase prior to impact [before the perinatal loss], impact phase [diagnostic moment], emergency phase [hospital care], relief or honeymoon phase [return home], disillusionment or stock-taking phase [after the first postloss days at home], reconstruction and recovery phase [grief construction process] and consequences [with an eye to the future]). Three intervention areas were described around the perinatal loss process: "rescue area" (partner, grandparents, and siblings of the deceased baby), "relief area" (healthcare professionals), and "base camp" (society). CONCLUSION: The situation-specific nursing theory "Perinatal loss, a devastating cyclone" is the final product of a grounded theory study that provided an in-depth analysis of women's experiences when they suffer a spontaneous perinatal loss at any point in their pregnancy. CLINICAL RELEVANCE: The situation-specific theory "Perinatal loss, a devastating cyclone" with the seven identified phases and the three areas of intervention could be used as a framework for healthcare professionals in their clinical practice as a guide to support women in this disfranchised grief.

Compositional structural brain signatures capture Alzheimer's genetic risk on brain structure along the disease continuum.

INTRODUCTION: Traditional brain imaging genetics studies have primarily focused on how genetic factors influence the volume of specific brain regions, often neglecting the overall complexity of brain architecture and its genetic underpinnings. METHODS: This study analyzed data from participants across the Alzheimer's disease (AD) continuum from the ALFA and ADNI studies. We exploited compositional data analysis to examine relative brain volumetric variations that (i) differentiate cognitively unimpaired (CU) individuals, defined as amyloid-negative (A-) based on CSF profiling, from those at different AD stages, and (ii) associated with increased genetic susceptibility to AD, assessed using polygenic risk scores. RESULTS: Distinct brain signatures differentiated CU A-individuals from amyloid-positive MCI and AD. Moreover, disease stage-specific signatures were associated with higher genetic risk of AD. DISCUSSION: The findings underscore the complex interplay between genetics and disease stages in shaping brain structure, which could inform targeted preventive strategies and interventions in preclinical AD.

Imaging of Multiple Myeloma: Present and Future.

Multiple myeloma (MM) is the second most common adult hematologic malignancy, and early intervention increases survival in asymptomatic high-risk patients. Imaging is crucial for the diagnosis and follow-up of MM, as the detection of bone and bone marrow lesions often dictates the decision to start treatment. Low-dose whole-body computed tomography (CT) is the modality of choice for the initial assessment, and dual-energy CT is a developing technique with the potential for detecting non-lytic marrow infiltration and evaluating the response to treatment. Magnetic resonance imaging (MRI) is more sensitive and specific than 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for the detection of small focal lesions and diffuse marrow infiltration. However, FDG-PET/CT is recommended as the modality of choice for follow-up. Recently, diffusion-weighted MRI has become a new technique for the quantitative assessment of disease burden and therapy response. Although not widespread, we address current proposals for structured reporting to promote standardization and diminish variations. This review provides an up-to-date overview of MM imaging, indications, advantages, limitations, and recommended reporting of each technique. We also cover the main differential diagnosis and pitfalls and discuss the ongoing controversies and future directions, such as PET-MRI and artificial intelligence.

Genetic characterization of the ALFA study: Uncovering genetic profiles in the Alzheimer's continuum.

INTRODUCTION: In 2013, the ALzheimer's and FAmilies (ALFA) project was established to investigate pathophysiological changes in preclinical Alzheimer's disease (AD), and to foster research on early detection and preventive interventions. METHODS: We conducted a comprehensive genetic characterization of ALFA participants with respect to neurodegenerative/cerebrovascular diseases, AD biomarkers, brain endophenotypes, risk factors and aging biomarkers. We placed particular emphasis on amyloid/tau status and assessed gender differences. Multiple polygenic risk scores were computed to capture different aspects of genetic predisposition. We additionally compared AD risk in ALFA to that across the full disease spectrum from the Alzheimer's Disease Neuroimaging Initiative (ADNI). RESULTS: Results show that the ALFA project has been successful at establishing a cohort of cognitively unimpaired individuals at high genetic predisposition of AD. DISCUSSION: It is, therefore, well-suited to study early pathophysiological changes in the preclinical AD continuum. Highlights Prevalence of ε4 carriers in ALzheimer and FAmilies (ALFA) is higher than in the general European population The ALFA study is highly enriched in Alzheimer's disease (AD) genetic risk factors beyond APOE AD genetic profiles in ALFA are similar to clinical groups along the continuum ALFA has succeeded in establishing a cohort of cognitively unimpaired individuals at high genetic AD risk ALFA is well suited to study pathogenic events/early pathophysiological changes in AD.

Bioaccumulation of titanium dioxide nanoparticles in green (Ulva sp.) and red (Palmaria palmata) seaweed.

A bioaccumulation study in red (Palmaria palmata) and green (Ulva sp.) seaweed has been carried out after exposure to different concentrations of citrate-coated titanium dioxide nanoparticles (5 and 25 nm) for 28 days. The concentration of total titanium and the number and size of accumulated nanoparticles in the seaweeds has been determined throughout the study by inductively coupled plasma mass spectrometry (ICP-MS) and single particle-ICP-MS (SP-ICP-MS), respectively. Ammonia was used as a reaction gas to minimize the effect of the interferences in the 48Ti determination by ICP-MS. Titanium concentrations measured in Ulva sp. were higher than those found in Palmaria palmata for the same exposure conditions. The maximum concentration of titanium (61.96 ± 15.49 µg g-1) was found in Ulva sp. after 28 days of exposure to 1.0 mg L-1 of 5 nm TiO2NPs. The concentration and sizes of TiO2NPs determined by SP-ICP-MS in alkaline seaweed extracts were similar for both seaweeds exposed to 5 and 25 nm TiO2NPs, which indicates that probably the element is accumulated in Ulva sp. mainly as ionic titanium or nanoparticles smaller than the limit of detection in size (27 nm). The implementation of TiO2NPs in Ulva sp. was confirmed by electron microscopy (TEM/STEM) in combination with energy dispersive X-Ray analysis (EDX).

Pediculosis humanus capitis in 6-7 years old schoolchildren in Valencia, Spain.

OBJECTIVES: Pediculosis humanus capitis is a worldwide public health concern that affects mostly school-aged children. The aim of this study is to determine the rate of pediculosis and to determine possible risk factors in a group of primary school children in Valencia, Spain; 227 children, 6-7 years old, were selected from 7 schools. METHODS: A self-reported questionnaire completed by the parents/guardians about the presence of pediculosis in their children and their knowledge about pediculosis. The results recorded in the questionnaire were analysed by SPSS® software. RESULTS: 30.4% of the children had pediculosis. The results showed significant variation (p < 0.05) in prevalence depending on the following factors: sex, hair length, level of parental education, family size, presence of affected family member in the home, and frequency of hair washing. Less than half of parents/guardians showed an appropriate level of knowledge on pediculosis. Pediculosis remains a health problem in Valencian schoolchildren. The family size and existence of another member with pediculosis were shown to be the main potentiating factors. CONCLUSIONS: Parents are not sufficiently informed about pediculosis and adopt inappropriate practices. There is a need to promote studies with the objective of determining risk factors for pediculosis as well as the need for actions to increase the knowledge of parents and healthcare professionals on this parasitosis to prevent outbreaks in the community, assure correct treatment and maintain effective epidemiological surveillance.

Embryonic Development of Pediculus humanus capitis: Morphological Update and Proposal of New External Markers for the Differentiation Between Early, Medium, and Late Eggs.

BACKGROUND AND OBJECTIVES: The head louse Pediculus humanus capitis is a cosmopolitan ectoparasite that causes pediculosis. In the study of human lice, little research focuses on embryonic development. Currently, external markers of embryonic development represent a new approach in the evaluation of ovicidal drugs. The objective of this work was to update the morphology of embryonic development and propose novel external markers to differentiate between early, medium, or late P. h. capitis eggs. METHODS: Using stereoscopic light microscopy, we describe the morphological characteristics of P. h. capitis eggs with a special focus on embryonic development. RESULTS: The morphological analysis of the eggs revealed the presence of an operculum with ten aeropyles, although no micropyles were observed. For the first time, the presence of defective eggs that were non-viable due to the apparent absence of yolk granules was documented. The early eggs presented yolk granules and developing germ bands, while the medium eggs presented an embryonic rudiment and the outlines of the eyes and limbs. In late eggs, the head with eyes and antennae, the thorax with three pairs of legs, and the abdomen with six pairs of spiracles were observed as formed structures. At the end of this stage, the embryos acquired the morphology of the nymph I stage. CONCLUSION: We propose novel biomarkers (e.g., the presence of spiracles and antennae, the proportion of the egg occupied by the embryo) to facilitate the differentiation between the developmental stages. The updated morphological characteristics of P. h. capitis eggs facilitate the standardization of toxicological tests in the quest for ovicidal drugs.

Effectiveness of a Meningococcal Group B Vaccine (4CMenB) in Children.

BACKGROUND: In September 2015, the four-component, protein-based meningococcal serogroup B vaccine (4CMenB; Bexsero) became available for private purchase in Spain. METHODS: We conducted a nationwide matched case-control study to assess the effectiveness of 4CMenB in preventing invasive meningococcal disease in children. The study included all laboratory-confirmed cases of invasive meningococcal disease in children younger than 60 months of age between October 5, 2015, and October 6, 2019, in Spain. Each case patient was matched with four controls according to date of birth and province. 4CMenB vaccination status of the case patients and controls was compared with the use of multivariate conditional logistic regression. RESULTS: We compared 306 case patients (243 [79.4%] with serogroup B disease) with 1224 controls. A total of 35 case patients (11.4%) and 298 controls (24.3%) had received at least one dose of 4CMenB. The effectiveness of complete vaccination with 4CMenB (defined as receipt of at least 2 doses, administered in accordance with the manufacturer's recommendations) was 76% (95% confidence interval [CI], 57 to 87) against invasive meningococcal disease caused by any serogroup, and partial vaccination was 54% (95% CI, 18 to 74) effective. Complete vaccination resulted in an effectiveness of 71% (95% CI, 45 to 85) against meningococcal serogroup B disease. Vaccine effectiveness with at least one dose of 4CMenB was 64% (95% CI, 41 to 78) against serogroup B disease and 82% (95% CI, 21 to 96) against non-serogroup B disease. With the use of the genetic Meningococcal Antigen Typing System, serogroup B strains that were expected to be covered by 4CMenB were detected in 44 case patients, none of whom had been vaccinated. CONCLUSIONS: Complete vaccination with 4CMenB was found to be effective in preventing invasive disease by serogroup B and non-serogroup B meningococci in children younger than 5 years of age.

The voice of memory in hospital birth: A phenomenological study.

OBJECTIVE: To examine the perception of the hospital birth experience in women at 8 weeks and 8 months after the birth and to determine if there have been any changes in that perception. DESIGN: This was a prospective qualitative study with a phenomenological approach based on semi-structured, individual and in-depth interviews at 8 weeks and 8 months after childbirth as well as participant's observations. The data were transcribed and analysed thematically using ATLAS.ti 8 software. PARTICIPANTS: 43 women participated in the first interview, and 33 of those participated in the second interview. SETTING: Donostia University Hospital, Gipuzkoa, Spain, 2016-2017. FINDINGS: Two main topics emerged from the data analysis which summarize the women's perception of childbirth: (1) memory allows us to recall the experience of hospital birth in time and space; (2) some moments are specially remembered. In the second topic, three subtopics were distinguished: fondest memory: meeting the newborn for the first time; highlighted positive memories: support from partners and professionals; and the worst memories were marked by feelings of worry and fear. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: In the perception of the birth experience, positive and negative memories remain in intensity and continuity for at least up to 8 months. Their creation and evocation are highly influenced by the emotional experience and the initial visual impact of meeting the newborn for the first time, which constitutes a milestone in women's lives. The emotions experienced in childbirth and during the postpartum period shape the awareness, memory and new identity of being a mother.

Seguir en lo mismo: representaciones de paz y conflicto de jóvenes del catatumbo ¿paz imperfecta o paz imposible?

Este artículo constituye una aproximación a la comprensión de las representaciones sociales de paz y conflicto de un grupo de estudiantes de un centro educativo del Catatumbo, territorio ubicado en el departamento Norte de Santander en la frontera con Venezuela y caracterizado por la presencia de grupos ilegales y el aumento de cultivos ilícitos. La investigación se fundamenta en el enfoque procesual de la teoría de las representaciones sociales a partir de las dimensiones de actitud, información y campo de representación. Estas representaciones se entienden como constructos objetivados y anclados en las prácticas sociales de esta población. Los hallazgos muestran una visión dual sobre la paz: una paz en apariencia imposible que se preserva como imaginario de esperanza, una especie de escepticismo que actúa subrepticiamente como factor de sobrevivencia; y una visión de temor y rechazo al conflicto armado, a los actores armados y al olvido del Estado. Se concluye que frente a estas representaciones de una paz indeleble pero motivadora, y un conflicto asociado a la perversidad y a la muerte, solo se puede sobrevivir con la imaginación representada en lo que los jóvenes llaman malicia indígena.

This article is an approach to understanding the social representations of peace and conflict of a group of students from an educational center in Catatumbo, a territory located in the Department of Norte de Santander, on the border with Venezuela, and characterized by the presence of illegal groups and the increase of illicit crops. The research is based on the process approach of the theory of social representations from the dimensions of attitude, information, and field of representation. These representations are understood as objectified constructs anchored in the social practices of this population. The findings show a dual vision of peace: a seemingly impossible peace that is preserved as an imaginary of hope, a kind of skepticism that acts surreptitiously as a survival factor, and a vision of fear and rejection of the armed conflict, the armed actors, and the oblivion of the State. It is concluded that, in the face of these representations of an indelible but motivating peace, and a conflict associated with perversity and death, one can only survive with imagination, represented in what the young people call indigenous malice.

Genetically predicted telomere length and Alzheimer's disease endophenotypes: a Mendelian randomization study.

Telomere length (TL) is associated with biological aging, consequently influencing the risk of age-related diseases such as Alzheimer's disease (AD). We aimed to evaluate the potential causal role of TL in AD endophenotypes (i.e., cognitive performance, N = 2233; brain age and AD-related signatures, N = 1134; and cerebrospinal fluid biomarkers (CSF) of AD and neurodegeneration, N = 304) through a Mendelian randomization (MR) analysis. Our analysis was conducted in the context of the ALFA (ALzheimer and FAmilies) study, a population of cognitively healthy individuals at risk of AD. A total of 20 single nucleotide polymorphisms associated with TL were used to determine the effect of TL on AD endophenotypes. Analyses were adjusted by age, sex, and years of education. Stratified analyses by APOE-ɛ4 status and polygenic risk score of AD were conducted. MR analysis revealed significant associations between genetically predicted longer TL and lower levels of CSF Aß and higher levels of CSF NfL only in APOE-ɛ4 non-carriers. Moreover, inheriting longer TL was associated with greater cortical thickness in age and AD-related brain signatures and lower levels of CSF p-tau among individuals at a high genetic predisposition to AD. Further observational analyses are warranted to better understand these associations.

Organosilicon-Based Plasma Nanocoating on Crust Leather for Water-Repellent Footwear.

In this study, functional nanocoatings for water-repellent footwear leather materials were investigated by chemical plasma polymerisation by implanting and depositing the organosilicon compound hexamethyldisiloxane (HMDSO) using a low-pressure plasma system. To this end, the effect of monomers on leather plasma deposition time was evaluated and both the resulting plasma polymers and the deposited leather samples were characterised using different experimental techniques, such as: Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS) and scanning electron microscopy (SEM). In addition, leather samples were tested by standard tests for color change, water resistance, surface wetting resistance and dynamic water contact angle (DWCA). The resulting polysiloxane polymers exhibited hydrophobic properties on leather. Furthermore, these chemical surface modifications created on the substrate can produce water repellent effects without altering the visual leather appearance and physical properties. Both plasma coating treatments and nanocoatings with developed water-repellency properties can be considered as a more sustainable, automated and less polluting alternative to chemical conventional processing that can be introduced into product-finishing processes in the footwear industry.

Genetically predicted telomere length and its relationship with neurodegenerative diseases and life expectancy.

Telomere length (TL) is a biomarker of biological aging. Shorter telomeres have been associated with mortality and increased rates of age-related diseases. However, observational studies are unable to conclude whether TL is causally associated with those outcomes. Mendelian randomization (MR) was developed for assessing causality using genetic variants in epidemiological research. The objective of this study was to test the potential causal role of TL in neurodegenerative disorders and life expectancy through MR analysis. Summary level data were extracted from the most recent genome-wide association studies for TL, Alzheimer's disease (AD), Parkinson's disease, Frontotemporal dementia, Amyotrophic Lateral Sclerosis, Progressive Supranuclear Palsy and life expectancy. MR estimates revealed that longer telomeres inferred a protective effect on risk of AD (OR = 0.964; adjusted p-value = 0.039). Moreover, longer telomeres were significantly associated with increased life expectancy (ßIVW  = 0.011; adjusted p-value = 0.039). Sensitivity analyses suggested evidence for directional pleiotropy in AD analyses. Our results showed that genetically predicted longer TL may increase life expectancy and play a protective causal effect on AD. We did not observe significant causal relationships between longer TL and other neurodegenerative diseases. This suggests that the involvement of TL on specific biological mechanisms might differ between AD and life expectancy, with respect to that in other neurodegenerative diseases. Moreover, the presence of pleiotropy may reflect the complex interplay between TL homeostasis and AD pathophysiology. Further observational studies are needed to confirm these results.

Evaluación del Síndrome de burnout en la Secretaría de Educación Departamental de Norte de Santander (Colombia) / Evaluation of the Burnout Syndrome in the Departmental Education Secretariat of Norte de Santander (Colombia)

RESUMEN Objetivo Identificar la prevalencia del síndrome de burnout en el recurso humano de la Secretaría de Educación Departamental (SED) de Norte de Santander (Colombia) durante el año 2020. Métodos Se aplicó el cuestionario Maslach Burnout Inventory (MBI) a una muestra de 366 trabajadores. Resultados Este estudio muestra que los funcionarios son personas que actualmente no presentan el síndrome, pero se obtuvo una puntuación del 6% en referencia a la tendencia media y el 4% pertenecen a la tendencia alta. Se evidencia una futura aparición de síntomas asociados a estrés, agotamiento emocional, irritabilidad, frustración y depresión. Del 4% (13 personas) que dio tendencia alta al síndrome de burnout, el 54% corresponden al género femenino y 46%, al masculino, y en cuanto al cargo, 12 personas son docentes y 1 persona es directivo. Conclusiones La SED manifiesta un desconocimiento del síndrome y una diferencia con respecto al concepto del estrés.

ABSTRACT Objective Identify the prevalence of the burnout syndrome in the human resource of the Departmental Education Secretariat (SED, by its initials in Spanish) of Norte de Santander (Colombia) during 2020. Methods The Maslach Burnout Inventory (MBI) questionnaire was applied to a sample of 366 workers. Results This study shows that officials are people who do not currently have the syndrome, but a score of 6% is presented in reference to the average trend and 4% belong to the high trend. A future appearance of symptoms associated with stress, emotional exhaustion, irritability, frustration, and depression was evidenced. Out of the 4% (13 people) who gave a high tendency to burnout syndrome, 54% correspond to the female gender and 46% to the male, and in terms of position, 12 people are teachers and 1 person is a manager. Conclusions The SED manifests a lack of knowledge of the syndrome and a difference with respect to the concept of stress.

Ultrasonication followed by enzymatic hydrolysis as a sample pre-treatment for the determination of Ag nanoparticles in edible seaweed by SP-ICP-MS.

Seaweed can bioaccumulate nanomaterials that would be transferred to the trophic chain. This work describes the optimization of a method for the separation of silver nanoparticles (AgNPs) from seaweed using an ultrasound-assisted enzymatic hydrolysis method and ulterior determination by single particle inductively coupled plasma mass spectrometry (SP-ICP-MS). The following parameters affecting the isolation of AgNPs were optimized using a Palmaria palmata (red seaweed) sample previously exposed to AgNPs: type of sonication (bath vs. ultrasonic probe), ultrasound amplitude, sonication time, sonication mode (pulsed vs. continuous sonication), concentration of the enzymes mixture (Macerozyme R-10®), and enzymatic hydrolysis time. The stability of AgNPs during extraction was tested by transmission electron microscopy (TEM) and using a standard of 15 nm of polyvinylpyrrolidone (PVP)-coated AgNPs analyzed by SP-ICP-MS. The analytical performance was evaluated with good results. For total Ag determination, the limits of detection and quantification were 2.2 and 7.7 ng g-1, respectively; and for AgNPs determination, the limits of detection in size and number were 14 nm and 4.34 × 107 part g-1, respectively. Besides, the matrix effect, the repeatability and the analytical recovery were also studied. Finally, the method was applied to the analysis of several red (Palmaria palmata) and green (Ulva sp.) seaweed samples.

Validação das atividades de enfermagem em centro de material esterilizado / Validation of nursing activities in a material and sterilization center / Validación de actividades de enfermería en un centro de material esterilizado

Objetivo: Validar as atividades de enfermagem do diagnóstico "Risco para contaminação de produtos para saúde (PPS)". Método: Trata-se de um estudo exploratório, descritivo, metodológico, de validação, utilizando-se o modelo adaptado de Fehring. Participaram 128 enfermeiros especialistas na área de centro cirúrgico e centro de material e esterilização, segundo critérios predefinidos. Utilizou-se instrumento composto de questões fechadas em que se atribuiu um valor conforme escala Likert para cada atividade. Neste estudo, consideraram-se validadas as atividades que apresentaram índice de validade de conteúdo de 0,95. Estudo aprovado pelo Comitê de Ética em Pesquisa. Resultados: Validaram-se 20 atividades de enfermagem para 12 fatores de risco e cinco intervenções. O fator de risco que não obteve representatividade em suas atividades foi "Esterilização de cargas sem o uso do pacote teste desafio". Conclusão: Conclui-se que a disposição das atividades de enfermagem relacionadas aos fatores de risco está adequada, uma vez que foram validadas com índice de validade de conteúdo de 0,95. O conhecimento produzido auxilia na implementação de atividades validadas, promo-vendo um cuidado de forma indireta de qualidade, baseando-se nos princípios da segurança do paciente

Objective: To validate the nursing activities of the diagnosis "Risk of contamination of health products". Method: This is an exploratory, descriptive, methodological, validation study, using the model adapted from Fehring. According to predefined criteria, 128 nurses specialized in the sur-gical center and material and sterilization center participated. An instrument composed of closed questions was used, in which a value according to the Likert scale was assigned to each activity. In this study, activities that presented a content validity index of 0.95 were considered validated. This study was approved by the Research Ethics Committee. Results: Twenty nursing activities were validated for 12 risk factors and 5 interventions. The risk factor that was not representative in its activities was "Sterilization of loads without the use of the process challenge device". Conclusion: The nursing activi-ties related to the risk factors have been found adequate, since they were validated with a content validity index of 0.95. The knowledge produced helps in the implementation of validated activities, promoting quality care indirectly, based on the principles of patient safety.

Objetivo: Validar las actividades de enfermería del diagnóstico "Riesgo por contaminación de productos sanitarios". Método: Se trata de un estudio exploratorio, descriptivo, metodológico, de validación, utilizando el modelo adaptado de Fehring. Participaron 128 enfermeras especialistas del centro quirúrgico y del centro de material y esterilización, según criterios predefinidos. Se utilizó un instrumento compuesto por preguntas cerradas, donde a cada actividad se le asignó un valor según la escala de Likert. En este estudio, se consideraron validadas las actividades que presentaron un índice de validez de contenido de 0,95. Estudio aprobado por el Comité de Ética en Investigación. Resultados: 20 actividades de enfermería fueron validadas para 12 factores de riesgo y cinco intervenciones. El factor de riesgo que no fue representativo en sus actividades fue "Esterilización de cargas sin utilizar el paquete de prueba de desafío". Conclusión: Se concluye que la provisión de actividades de enfermería relacionadas con los factores de riesgo es ade-cuada, una vez que fueron validadas con un índice de validez de contenido de 0,95. El conocimiento producido ayuda en la implementación de activida-des validadas, promoviendo indirectamente una atención de calidad, basada en los principios de seguridad del paciente.

Fortified Snack Preferences among Patients with Cancer.

Fortified snacks can increase nutrient intake among patients with cancer. The aim of this study was to identify snack foods preferred as potential vehicles for fortification and how experienced symptoms influence preferences.A study-specific survey among 150 patients identified snack foods for fortification, influence of symptom presence, desired nutrients and characteristics of a fortified snack, and perception of oral nutritional supplements.Patients had mainly breast, gastrointestinal, lung, and colorectal tumors. Soup, yogurt, cheese, fruit juice, egg products, and protein bars were identified as suitable fortified snacks by >60% of subjects. Desired characteristics for snacks included nutritious, flavorful, convenient, ready to eat, easy to chew, and easy to swallow. Vitamins, minerals, and protein were the nutrients of interest. Three clusters of symptoms were identified that predicted patients' desired characteristics of fortified snacks and satisfaction with food-related life. Patients in High and Moderate symptom clusters were more likely to have reduced food intake and higher consumption of oral nutritional supplements.Preferences for fortified snacks and their characteristics are influenced by symptom presence. The results of this study provide insight to guide the development of fortified snacks for patients with cancer.

Evaluation of the Chagas VirClia® and Chagas TESA VirClia® for the Diagnosis of Trypanosoma cruzi Infection.

Chagas disease (CD), caused by the protozoan Trypanosoma cruzi, is an important problem of public health even in regions where it is not endemic. Spain ranks second worldwide in terms of imported cases of T. cruzi infection in the chronic phase. The diagnosis in this stage is made via the detection of antibodies against T. cruzi. Therefore, we aimed to evaluate the sensitivity and specificity of two fully automated chemiluminescence immunoassays, Chagas VirClia® (CHR), which uses a mixture of recombinant antigens, and Chagas TESA VirClia® (TESA), the first chemiluminescence assay based on excretion-secretion antigens of trypomastigotes, both designed in monotest format. A retrospective case-control study was performed using 105 well-characterized samples: 49 from patients with CD, 22 from uninfected individuals, and 32 from patients with other pathologies. Sensitivity was 98% for CHR and 92% for TESA. In contrast, the specificity in both was 100%. Cross-reactivity was observed in leishmaniasis (2/10). CHR meets the criteria to become a tool for serological screening, while TESA has the potential for confirmation and cross-reaction discrimination. The monotest format allows its application in laboratories with a small number of samples. The high specificity of both assays is useful in areas where leishmaniasis is endemic.