Exposure and Knowledge of Sharps Injuries among Medical Students in Seven States of Mexico

Background: Medical students are vulnerable to accidental exposure to blood-borne pathogens when performing clinical activities. Knowledge of both the prevalence of exposure and necessary reporting procedures is important to minimize the risk of harm to medical students. Methods: A cross-sectional online survey of medical students from 19 universities from seven states in Mexico was utilized to determinethe prevalence of needle stick injuries amongst medical students and the associated reporting procedures. Results: We included 312 respondents; of these, 52.24% were men and 47.76% were women, and the mean age was 23.19 years (SD ± 2.11 years). Nearly all of them (94.23%) were medical students doing clerkships in public hospitals. Mean knowledge score of blood-borne pathogens was 3.6 (SD ± 1.16) on a scale of 0-10 designed specifically for this study. Thirty-five per cent of the respondents had sustained a needle stick injury at some point during their medical school training, and 33.97% reported some type of mucocutaneous exposure. Overall, the non-reporting rate of needle stick injury was 48.34%. Approximately 25% of the respondents were not familiar with reporting procedures in the event of a needle stick injury or mucocutaneous exposure; 61.50% had received information from their hospital about the standard protocol to follow after a blood or body fluid exposure. Conclusion: In this Mexican population of medical students, there is a high risk of suffering needle stick injuries  during medical training. Furthermore, knowledge regarding prevention, evaluation, and reporting of needle stick injuries is suboptimal

ETHICS: THE JOURNEY IN SEARCH OF A SATISFYING LIFE.

Background: Health professionals must change the ethics of the "third person", where moral actions carried out by other people are judged as correct / incorrect, for the ethics of the first person oriented to personal excellence, vocation to good and to dignity of a person. Objective: To explore the knowledge and ethical training of health professionals working in the field of Nephrology. Method: A survey of 37 items on the basic notions of ethics was applied to the participants of the annual IMIN Meeting. Results: 85 surveys were obtained, 79% think that the laws enacted today respond to economic interests; 82% express that we cannot accept moral absolutes, however, 89% think that practical reason that directs our behavior recognizes human good in search of plenitude. 44% feel that it is not possible to act according to justice on a regular basis, and 94% express that virtue ethics look to the integral good of the person. Conclusions: The philosophical reflection, so typical of the human being, constitutes an ethical requirement in search of the truth of the good that must be chosen to achieve fullness, in the work of health agents in the field of Nephrology. Keywords: bioethics, nephrology, personal autonomy

Self-Healing Photocurable Epoxy/thiol-ene Systems Using an Aromatic Epoxy Resin

A rapid and efficient method to obtain self-healing epoxy resins is discussed. This method is based on the use of a thiol-disulfide oligomer obtained by partial oxidation of a multifunctional thiol using a hypervalent iodine (III) compound as oxidant. The oligomer was characterized by Fourier transform infrared spectroscopy (FTIR), Raman and nuclear magnetic resonance spectroscopies, and gel permeation chromatography (GPC). The oligomer was a joint component of the thiol-ene system along with a tetra-allyl-functionalized curing agent. The kinetics of the photopolymerization of diglycidylether of bisphenol A (DGEBA) revealed that conversions of the epoxy groups as high as 80% were achieved in only 15 minutes by increasing the concentration of the thiol-ene system in the formulation. The disulfide bonds introduced in the copolymer using the thiol-disulfide oligomer allowed the repairing of the test specimens in as little as 10 minutes when the specimens were heated at 80°C or for 500 minutes at room temperature. The analysis of the mechanical properties using dynamic mechanical analysis (DMA) showed that the specimens displayed a healing efficiency up to 111% compared with the unhealed specimens, depending on the amount of polythioethers present in the copolymer

Caracterización electroquímica de recubrimientos Zn-Al sobre fundición nodular grado 2, obtenidos por proyección térmica por flama con alambre

Thermal spray is a technology that involves heating a material in the form of powder or wire, which is brought to a molten or semi-molten state, then propelled by a stream of gas or compressed air and deposited on a metallic, ceramic or polymeric substrate, with appropriate roughness conditions. The main objective of this research is to perform electrochemical characterization employing electrochemical impedance spectroscopy and electrochemical noise techniques of a Zn-15Al alloy deposited on a ductile iron grade 65-45-12 (2) through flame thermal spray technique with wire to the Zn-Al coating shows good homogeneity, good adhesion and a substantial improvement in corrosion resistance.  La proyección térmica o rociado térmico es una tecnología que implica calentar un material que está en forma de polvo o alambre y llevarlo a un estado fundido o semifundido, para luego propulsarlo mediante una corriente de gas o aire comprimido y depositarlo sobre un sustrato metálico, cerámico o polimérico, que tenga condiciones de rugosidad adecuadas. La investigación realizó la caracterización electroquímica mediante las técnicas de espectroscopia de impedancia electroquímica y ruido electroquímico de una aleación Zn-15Al depositada sobre una fundición nodular grado 65-45-12 (2), por medio de la técnica de proyección térmica por llama con alambre, donde el recubrimiento de Zn-Al presenta buena homogeneidad, buena adherencia y una mejora sustancial en la resistencia a la corrosión

High-flow nasal cannula therapy for hypoxemic respiratory failure in patients with COVID-19.

INTRODUCTION: High-flow nasal cannula (HFNC) therapy in patients with hypoxemic respiratory failure due to COVID-19 is poorly understood and remains controversial. METHODS: We evaluated a large cohort of patients with COVID-19-related hypoxemic respiratory failure at the temporary COVID-19 hospital in Mexico City. The primary outcome was the success rate of HFNC to prevent the progression to invasive mechanical ventilation (IMV). We also evaluated the risk factors associated with HFNC success or failure. RESULTS: HFNC use effectively prevented IMV in 71.4% of patients [270 of 378 patients; 95% confidence interval (CI) 66.6-75.8%]. Factors that were significantly different at admission included age, the presence of hypertension, and the Charlson comorbidity index. Predictors of therapy failure (adjusted hazard ratio, 95% CI) included the comorbidity-age-lymphocyte count-lactate dehydrogenase (CALL) score at admission (1.27, 1.09-1.47; p < 0.01), Rox index at 1 hour (0.82, 0.7-0.96; p = 0.02), and no prior steroid treatment (0.34, 95% CI 0.19-0.62; p < 0.0001). Patients with HFNC success rarely required admission to the intensive care unit and had shorter lengths of hospital stay [19/270 (7.0%) and 15.0 (interquartile range, 11-20) days, respectively] than those who required IMV [104/108 (96.3%) and 26.5 (20-36) days, respectively]. CONCLUSION: Treating patients with HFNC at admission led to improvement in respiratory parameters in many patients with COVID-19

Memorias del Séptimo Foro de la Enseñanza de las Matemáticas

En el Séptimo Foro de Enseñanza de las Matemática Ibero 2017 se abordaron temas relacionados con el uso de la historia de las matemáticas en el aula, las transformaciones en las habilidades, destrezas y conocimientos en los alumnos universitarios en la primera década del 2000, el uso de plataformas digitales en la enseñanza de las matemáticas; se expuso sobre situaciones problema en la vida cotidiana relacionados con las matemáticas escolares y la modelación matemática, sobre la historia de la enseñanza de las matermáticas, entre otros temas.ITESO, A.C.Universidad Iberoamericana, Campus Santa F

Systolic blood pressure and the risk of kidney replacement therapy and mortality in patients with chronic kidney disease stage 4-5

Introduction In patients with chronic kidney disease stage 4 and 5 (CKD stages 4-5) without dialysis and arterial hypertension, it is unknown if the values of systolic blood pressure (SBP) considered in control <120 mmHg are associated with kidney replacement therapy (KRT) and mortality. Methods In this retrospective cohort study, hypertensive CKD stages 4-5 patients attending the Renal Health Clinic at the Hospital Civil de Guadalajara were enrolled. We divided them into those that achieved SBP 120 mmHg), the uncontrolled group. Our primary objective was to analyze the association between the controlled group and KRT; the secondary objective was the mortality risk, and if there were subgroups of patients that achieved more benefit. Data were analyzed using Stata software, version. 15.1. Results During 2017 to 2022 a total 275 hypertensive CKD stages 4-5 patients met the inclusion criteria for the analysis, 62 in the controlled group and 213 in the uncontrolled group; mean age 61 years, 49.82% were male, SBP was significantly lower in the controlled group (111 mmHg) compared to the uncontrolled group (140 mmHg), eGFR was similar between groups (20.41 ml/min/1.73m2). There was a tendency to increase the mortality risk in the uncontrolled group (HR 6.47 [0.78-53.27]; p= 0.082) and an association by the Kaplan-Meir analysis (Log-rank p= 0.043). The subgroup analysis for risk of KRT in the controlled group revealed that patients ≥ 61 years had a lower risk of KRT (HR 0.87 [95% CI, 0-76-0.99]; p=0.03, p of interaction = 0.005), but no differences were found in the subgroup analysis for mortality. In a follow-up of 1.34 years, no association was found in the risk of KRT according to the controlled or uncontrolled groups in a multivariate Cox analysis. Conclusion In a retrospective cohort of patients with CKD stages 4-5 and hypertension, SBP >120 mmHg was not associated with risk of KRT but could be associated with the risk of death. Clinical trials are required in this group of patients to demonstrate the impact of reaching the SBP goals recommended by the KDIGO guidelines

Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM2.5 air pollution, 1990-2019 : an analysis of data from the Global Burden of Disease Study 2019

Background Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2.5 originating from ambient and household air pollution.Methods We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2.5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure-response curve from the extracted relative risk estimates using the MR-BRT (meta-regression-Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2.5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2.5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals.Findings In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2.5 exposure, with an estimated 3.78 (95% uncertainty interval 2.68-4.83) deaths per 100 000 population and 167 (117-223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13.4% (9.49-17.5) of deaths and 13.6% (9.73-17.9) of DALYs due to type 2 diabetes were contributed by ambient PM2.5, and 6.50% (4.22-9.53) of deaths and 5.92% (3.81-8.64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2.5.Interpretation Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2.5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.Peer reviewe

Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM2.5 air pollution, 1990-2019 : An analysis of data from the Global Burden of Disease Study 2019

Background Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air pollution. Methods We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2·5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure–response curve from the extracted relative risk estimates using the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2·5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2·5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals. Findings In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2·5 exposure, with an estimated 3·78 (95% uncertainty interval 2·68–4·83) deaths per 100 000 population and 167 (117–223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13·4% (9·49–17·5) of deaths and 13·6% (9·73–17·9) of DALYs due to type 2 diabetes were contributed by ambient PM2·5, and 6·50% (4·22–9·53) of deaths and 5·92% (3·81–8·64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2·5. Interpretation Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2·5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes