Ciencia y persuasión social en la medicalización de la infancia en España, siglos XIX-XX Science and social persuasion in the medicalization of childhood in 19th- and 20th-century Spain

Este trabajo indaga la conversión en rutinaria de la visita del médico de niños en España. Estudia la sustitución de modelos de atención al embarazo, parto y crianza, tradicionalmente opacos para varones y objeto de cuidados mediante agentes populares, por otros accesibles a la medicina académica. A partir de la situación existente a nivel popular en el último tercio del siglo XIX, exploramos la repercusión de campañas de divulgación científica - entendidas como crítica sin cuartel a lo que se construyó como cultura popular - y la proliferación de dispositivos asistenciales gratuitos. La oferta de vigilancia sobre la alimentación de lactantes permitió familiarizar a las madres con la asistencia facultativa en la enfermedad, hasta que, en la segunda mitad del siglo XX, la Pediatría se centró preferentemente en las patologías y la Puericultura dejó de ser especialidad médica para convertirse en identidad profesional subalterna.<br>The article explores how childhood visits to doctors first became routine in Spain. The introduction of new models of prenatal care, childbirth, and childrearing required the extension of academic medicine into a terrain traditionally occupied by practitioners of popular medicine. Focusing on the status quo for most of the population in the final third of the nineteenth century, the study examines the repercussion of the era's scientific outreach campaigns (expressions of harsh criticism of what popular culture had constructed) and the spread of free health assistance. In particular, it highlights how attention to the nutritional needs of nursing mothers helped these women gain familiarity with the medical assistance available in the case of illness - so much so that by the second half of the twentieth century, the issues of health education and promotion had been relegated to a secondary plane within the medical profession

Sensitivity of the Cherenkov Telescope Array to spectral signatures of hadronic PeVatrons with application to Galactic Supernova Remnants

The local Cosmic Ray (CR) energy spectrum exhibits a spectral softening at energies around 3 PeV. Sources which are capable of accelerating hadrons to such energies are called hadronic PeVatrons. However, hadronic PeVatrons have not yet been firmly identified within the Galaxy. Several source classes, including Galactic Supernova Remnants (SNRs), have been proposed as PeVatron candidates. The potential to search for hadronic PeVatrons with the Cherenkov Telescope Array (CTA) is assessed. The focus is on the usage of very high energy γ-ray spectral signatures for the identification of PeVatrons. Assuming that SNRs can accelerate CRs up to knee energies, the number of Galactic SNRs which can be identified as PeVatrons with CTA is estimated within a model for the evolution of SNRs. Additionally, the potential of a follow-up observation strategy under moonlight conditions for PeVatron searches is investigated. Statistical methods for the identification of PeVatrons are introduced, and realistic Monte-Carlo simulations of the response of the CTA observatory to the emission spectra from hadronic PeVatrons are performed. Based on simulations of a simplified model for the evolution for SNRs, the detection of a γ-ray signal from in average 9 Galactic PeVatron SNRs is expected to result from the scan of the Galactic plane with CTA after 10 h of exposure. CTA is also shown to have excellent potential to confirm these sources as PeVatrons in deep observations with O(100) hours of exposure per source

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Delaying surgery for patients with a previous SARS-CoV-2 infection

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