The decolonial empathy of two Maya documentaries shown at the XIII CLACPI film festival : FicMayab

In this article, I analyze two short documentaries Kat at Kat’ex? (2017) and Sepur Zarco: la vida después de la sentencia (2018), both directed by the Maya-K’iche-Kaqchikel media maker from Guatemala, Eduardo Say, and shown at the XIII CLACPI Film Festival-FicMayab’. Both movies feature Mayan witnesses to and survivors of the violence of the civil war in Guatemala. They share their stories of loss and pain with the diverse audiences convened by the festival. I argue that these movies, in referring to the past, constitute platforms in which these witnesses enact forms of reproduction of life through embodied social practices and acts of care that, in turn, portray them as agents of the reconstitution of their own present. I contend that these movies extend an invitation to the Western(ized) viewer to relate to the Maya testimonios of pain and realities, both within the films’ frame and outside of it. I use the term “decolonial empathy” to refer to this invitation that considers the Maya peoples’ self-determination in the face of state violence and its legacies.peer-reviewe

Evaluación del serodiagnóstico en el absceso hepático amebiano

fase de la evaluación. El estudio de este grupo nos ayudaría a obtener valores reales de sensibilidad, especificidad y valores predictivos y nos darían una estimación real de la capacidad discriminatoria de la prueba para obtener el verdadero valor del área bajo la curva y no el casi ideal que informamos aquí. Summary This study was carried out to evaluate the diagnostic efficacy of a serological test for amebic liver abscess (ALA) in an endemic amoebiasis area. An enzyme-linked immunosorbent assay (ELISA) to detect specific IgG against Entamoeba histolytica using a solid phase with high adherent capacity was applied.El presente estudio fue diseñado para evaluar la eficacia del diagnóstico serológico del absceso hepático amibiano (AHA). Se utilizó una prueba de ELISA para la detección en suero de IgG especifica, utilizando una fase sólida con una alta capacidad de adherencia. Se estudiaron 147 personas; 22 pacientes con sospecha clínica y ultrasonográfica de AHA, 30 individuos completamente sanos, 9 portadores asintomáticos de E. histolytica, 35 con colitis amebiana pasada, 35 con otras parasitosis intestinales, 9 con otras patologías hepáticas y 6 con colitis amebiana presente. El rendimiento global de la prueba fue analizado por medio de las curvas del receptor-operador y del área bajo la curva. Se determinó que existe una diferencia significativa en la densidad óptica (DO) de los siete grupos estudiados (Kruskal-Wallis entre todos los grupos: p=0,0001); esta diferencia no existe cuando, al comparar, se elimina el grupo 1 del análisis (Kruskal-Wallis exceptuando el grupo 1: p=0,8203). El área bajo la curva ROC fue igual a 0,9941, dato muy cercano al ideal que es 1. Se recomienda la utilización de esta fase sólida teniendo en cuenta la importancia de la fase de bloqueo con albúmina de huevo. Se determinó que, a pesar de estar en una zona donde el diagnóstico de amebiasis es frecuente, las infecciones intestinales por esta ameba no presentan niveles detectables de IgG especifica contra E. histolytica por esta prueba. Sin embargo, es importante ampliar la cantidad de personas estudiadas en estos grupos, principalmente, en el grupo de pacientes con otras patologías hepáticas puesto que este grupo incluye las entidades clínicas con las que realmente se debe hacer el diagnóstico diferencial de (AHA) (absceso hepático piógeno (AHP), principalmente) para poder realizar la última fase de la evaluación. El estudio de este grupo nos ayudaría a obtener valores reales de sensibilidad, especificidad y valores predictivos y nos darían una estimación real de la capacidad discriminatoria de la prueba para obtener el verdadero valor del área bajo la curva y no el casi ideal que informamos aquí

Conocimiento y empoderamiento en el manejo de Caiman yacare en la cuenca del río Iténez (Amazonía boliviana)

El año 1997, Bolivia inició el Programa Nacional para la Conservación y Aprovechamiento Sostenible de Lagarto (Caiman yacare) (PNCASL). Desde entonces se exporta anualmente de forma legal entre 30 000 y 45 000 pieles provenientes de la Amazonia boliviana. En más de diez años de vigencia del PNCASL, los primeros eslabones de la cadena productiva del lagarto siguen débiles, por lo que se considera fundamental el fortalecimiento del actor local a través de la participación y el uso del conocimiento ecológico tradicional integrado con aportes técnicos científicos que orienten las prácticas de manejo del recurso hacia un manejo adaptativo a nivel local y regional. El presente trabajo describe métodos participativos utilizados en el marco de la elaboración del plan de manejo de lagarto en el sur del Parque Departamental y Área Natural de Manejo Integrado (PD ANMI) Iténez, situado al noreste de la Amazonia boliviana. En primer lugar, se describe el método utilizado para la zonificación del área de aprovechamiento en función a las potencialidades de uso de cada zona. Segundo, se describe cómo se realizó el monitoreo de las poblaciones naturales de lagarto y se discute como los resultados de monitoreo fueron interpretados por los actores locales para sugerir un cupo de aprovechamiento. Finalmente, se presentan y discuten dos métodos de monitoreo participativo ampliamente utilizado: el cálculo de la Captura por Unidad de Esfuerzo (CPUE) y la medición del tamaño de los individuos cazados. Este último método también permite transparentar el beneficio económico colectivo y per cápita de la venta de las pieles a las curtiembres.Em 1997, a Bolívia iniciou o Programa Nacional para a Conservação e Aproveitamento Sustentável do jacaré (Caiman yacare) (PNCASL). Desde então, sao legalmente exportados anualmente entre 30.000 e 45.000 peles provenientes da Amazônia boliviana. Em mais de dez anos de vigencia do PNCASL, os primeiros elos na cadeia produtiva do jacaré continuam fracos, motivo pelo qual é considerado essencial fortalecer o ator local através da participação e uso de conhecimento ecológico tradicional integrado, além de insumos técnico-científicos que orientem as práticas de manejo do recurso para gestão adaptativa a nivel local e regional. O presente trabalho descreve métodos participativos utilizados no marco de elaboração do plano de manejo do jacaré no sul do parque departamental AMNI Iténez, localizado no nordeste da Amazôníia boliviana. Primeiro, é descrito o método utilizado para o zoneamento da área de explorado de acordo com as potencialidades de uso de cada zona. Segundo, é descrito como se realiza o monitoramento das populações naturais dos jacarés e apresentada urna discussáo sobre a interpretação dos resultados do monitoramento pelos atores locais para sugerir urna quota de exploração. Finalmente, são apresentados e discutidos dois métodos de monitoramento participativo amplamente utilizados: o cálculo de Captura por Unidade de Esforço (CPUE) e a medição de tamanho dos indivíduos cagados. O último método também permite analisar com maior clareza o benefício econômico coletivo e per capita da venda de peles para os curtumes.In 1997, Bolivia initiated the National Program for the Conservation and Sustainable Use of the spectacled caiman (iCaiman yacare) (PNCASL). Bolivia has exported between 30 000 and 45 000 caiman skins annually from the Bolivian Amazon since this time. In more than 10 years of the PNCASL, the first link in the value chain of this caiman species (the hunters) remains weak. It is essential to strengthen the local stakeholders making better use of their practices and traditional ecological knowledge and integrating them with scientific inputs to guide adaptive resource management at local, regional and national levels. This paper describes participatory methods used in the context of preparing the Management Plan for the Southern part of the Departmental Park and Natural Integrated Management Area Iténez, located in the northeastern Bolivian Amazon. First, we describe the method used for zonation according to the hunting potential of each area. Second, we describe how local hunters conducted the monitoring of natural caiman populations and discuss how the monitoring results were used to suggest hunting quota. Finally, we present and discuss two methods widely used in participatory monitoring: the calculation of the catch per unit effort (CPUE) and recording the size of individuals hunted. The latter method also provides transparent data on collective and individual economic benefits from the sales of the caiman skins

Primer implante coclear exitoso en América Latina después de ototoxicidad severa inducida por aminoglucósidos en un paciente peruano curado de una tuberculosis extremadamente resistente.

Introduction: Multidrug-resistant tuberculosis is a significant public health problem for which drugs are used with many adverse effects. Among the devastating consequences of these diseases, there is a wide variation in the incidence of ototoxicity and hearing loss in patients with multidrug-resistant and extremely resistant tuberculosis. Cochlear implants may be indicated in patients with unilateral/severe bilateral hearing loss with no benefit from conventional hearing aids, but their use in patients with tuberculosis is rare. Case report: We present the first case of a right unilateral cochlear implant performed on a 34-year-old Peruvian patient who presented profound sensorineural hearing loss of cochlear origin. Conclusion: Cochlear implant surgery is an essential milestone in the treatment of patients with auditory sequelae of tuberculosis treatment. Close monitoring of possible complications of tuberculosis treatment should be strengthened in countries with a high incidence of multidrug-resistant and extremely resistant tuberculosis.Introducción: La tuberculosis multidrogorresistente es un importante problema de salud pública para el que se utilizan fármacos con múltiples efectos adversos. Entre las devastadoras consecuencias de estas enfermedades, existe una amplia variación en la incidencia de ototoxicidad y pérdida auditiva en pacientes con tuberculosis multirresistente y extremadamente resistente. Los implantes cocleares pueden estar indicados en pacientes con pérdida auditiva unilateral/bilateral severa sin beneficio de los audífonos convencionales, pero su uso en pacientes con tuberculosis es raro. Reporte de un caso: Presentamos el primer caso de implante coclear unilateral derecho realizado a un paciente peruano de 34 años que presentaba hipoacusia neurosensorial profunda de origen coclear. Conclusión: La cirugía de implante coclear es un hito fundamental en el tratamiento de los pacientes con secuelas auditivas del tratamiento de la tuberculosis. Se debe fortalecer la vigilancia estrecha de las posibles complicaciones del tratamiento de la tuberculosis en los países con una alta incidencia de tuberculosis multirresistente y extremadamente resistente

Production of HIV Particles Is Regulated by Altering Sub-Cellular Localization and Dynamics of Rev Induced by Double-Strand RNA Binding Protein

Human immunodeficiency virus (HIV)-1 encoded Rev is essential for export from the nucleus to the cytoplasm, of unspliced and singly spliced transcripts coding for structural and nonstructural viral proteins. This process is spatially and temporally coordinated resulting from the interactions between cellular and viral proteins. Here we examined the effects of the sub-cellular localization and dynamics of Rev on the efficiency of nucleocytoplasmic transport of HIV-1 Gag transcripts and virus particle production. Using confocal microscopy and fluorescence recovery after bleaching (FRAP), we report that NF90ctv, a cellular protein involved in Rev function, alters both the sub-cellular localization and dynamics of Rev in vivo, which drastically affects the accumulation of the viral protein p24. The CRM1–dependent nuclear export of Gag mRNA linked to the Rev Response Element (RRE) is dependent on specific domains of the NF90ctv protein. Taken together, our results demonstrate that the appropriate intracellular localization and dynamics of Rev could regulate Gag assembly and HIV-1 replication

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance

Aguas del Iténez o Guaporé

Bolivia y Brasil comparten una de las cuencas más atractivas y preservadas de la te-giuri amazônica: la cuenca del rio llénez o Guaporé, que escurre tanto sobre el lecho rocoso del Escudo Precámbrico Brasilefto como sobre las Hanuras del Beni. Estas influencias hacen que la cuenca del iténez tenga una elevada heterogeneidad de habitats, una fauna acuálica peculiar y un alto valor de conservation. Este patrimo­nio binacional posée un potencial importante para la conservación de la diversidad regional y cl dcsar rollo sostcniblc participativo de las comunidades locales. El libro contiene un resumen del conotimìento de la cuenca y sus recursos, generado en los últimos 10 anos por un equipo de investigadores bolivianos, brasilefios y de otras nacionalidades. Se presenta una descripeión del medio fisico, así como resultados relevantes sobre la biodiversidad acuática, con énfasis en algas, peces, reptiles y mamíferos. El aporte más notable del libro, adernas de la descripeión ecológica del ecosistema, son las lecciones aprendidas que surgieron de experiências locales sobre la élaboration participativa de herramientas para la gestion de los recursos hidrobiológicos.A Bolívia e o Brasil compartilham uma das bacias hidrográficas mais atrativas e preservadas da região amazônica: a bacia do Rio Iténez ou Guaporé. A combinação das influências do escudo pré-cambriano brasileiro e da planícies do Beni é uma das razões pela qual existem na região elevada heterogeneidade de habitats, fauna aquática peculiar e alto grau valor dc conservação. Eslc patrimônio binacional possui potencial significativo para a conservação da diversidade regional e desenvolvimento sustentável participativo das comunidades locais. O livro contém um resumo do conhecimento da bacia e seus recursos, gerado nos últimos dez anos por uma equipe de pesquisadores bolivianos, brasileiros e de outras nacionalidades. Apresentamos uma descrição do meio físico, bem como resultados relevantes da biodiversidade aquática, com ênfase em algas, peixes, répteis e mamíferos. A contribuição mais notável do livro, além da descrição ecológica do ecossistema, é a descrição das lições aprendidas que surgiram a partir de experiências locais sobre elaboração participativa de ferramentas para a gestão dos recursos aquáticos presentes nesta bacia