Categorización emocional del sistema internacional de imágenes afectivas en una muestra colombiana

The International Affective Picture System (IAPS) is a battery of images used to induce discrete emotional reactions. In this study an IAPS subsample of 200 images was analysed to elicit discrete negative emotions and propose a new categorization of them, according to which discrete negative emotions (disgust, fear, sadness, or anger) they induce, in contrast to a dimensional model of emotion including emotional valence, intensity, and dominance, usually used in the literature. Through a sample by convenience, 447 participants of 3 universities in Bogotá, Colombia, were recruited and shown 60 IAPS images and asked them to what extent they felt fear, sadness, disgust, anger, happiness, or satisfaction when looking at each image. By using the overlap of 95% confidence intervals of the mean of 6 emotions ratings for every image, results revealed that 51.5% of images induced simple emotions (19.5% fear, 16.5% sadness, 13.0% disgust and 2.5% anger), 43% of images induced complex emotions, including more than one negative emotion, 1.5% emotions mixed one negative and one positive emotion, and 4% were undetermined emotions

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Utilization of mechanical power and associations with clinical outcomes in brain injured patients: a secondary analysis of the extubation strategies in neuro-intensive care unit patients and associations with outcome (ENIO) trial

Background: There is insufficient evidence to guide ventilatory targets in acute brain injury (ABI). Recent studies have shown associations between mechanical power (MP) and mortality in critical care populations. We aimed to describe MP in ventilated patients with ABI, and evaluate associations between MP and clinical outcomes. Methods: In this preplanned, secondary analysis of a prospective, multi-center, observational cohort study (ENIO, NCT03400904), we included adult patients with ABI (Glasgow Coma Scale ≤ 12 before intubation) who required mechanical ventilation (MV) ≥ 24&nbsp;h. Using multivariable log binomial regressions, we separately assessed associations between MP on hospital day (HD)1, HD3, HD7 and clinical outcomes: hospital mortality, need for reintubation, tracheostomy placement, and development of acute respiratory distress syndrome (ARDS). Results: We included 1217 patients (mean age 51.2&nbsp;years [SD 18.1], 66% male, mean body mass index [BMI] 26.3 [SD 5.18]) hospitalized at 62 intensive care units in 18 countries. Hospital mortality was 11% (n = 139), 44% (n = 536) were extubated by HD7 of which 20% (107/536) required reintubation, 28% (n = 340) underwent tracheostomy placement, and 9% (n = 114) developed ARDS. The median MP on HD1, HD3, and HD7 was 11.9&nbsp;J/min [IQR 9.2-15.1], 13&nbsp;J/min [IQR 10-17], and 14&nbsp;J/min [IQR 11-20], respectively. MP was overall higher in patients with ARDS, especially those with higher ARDS severity. After controlling for same-day pressure of arterial oxygen/fraction of inspired oxygen (P/F ratio), BMI, and neurological severity, MP at HD1, HD3, and HD7 was independently associated with hospital mortality, reintubation and tracheostomy placement. The adjusted relative risk (aRR) was greater at higher MP, and strongest for: mortality on HD1 (compared to the HD1 median MP 11.9&nbsp;J/min, aRR at 17&nbsp;J/min was 1.22, 95% CI 1.14-1.30) and HD3 (1.38, 95% CI 1.23-1.53), reintubation on HD1 (1.64; 95% CI 1.57-1.72), and tracheostomy on HD7 (1.53; 95%CI 1.18-1.99). MP was associated with the development of moderate-severe ARDS on HD1 (2.07; 95% CI 1.56-2.78) and HD3 (1.76; 95% CI 1.41-2.22). Conclusions: Exposure to high MP during the first week of MV is associated with poor clinical outcomes in ABI, independent of P/F ratio and neurological severity. Potential benefits of optimizing ventilator settings to limit MP warrant further investigation

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Updating trait-based moral judgment

Estudios recientes en psicología del juicio moral y en filosofía experimental se interesan principalmente por la dimensión emocional/ racional de los juicios morales y su posible asociación con intuiciones éticas deontológicas o utilitarias. Si bien esta aproximación responde a una serie de consideraciones teóricas y aplicadas importantes, esta no permite dar cuenta de otras intuiciones reflejadas en los juicios morales. La presente disertación se interesa por una óptica diferente del juicio moral a partir de la Ética de la Virtud. Después de determinar qué rasgos de personalidad son moralmente relevantes en la sociedad colombiana y qué tan generales estos son considerados a través de diferentes contextos se propusieron y probaron empíricamente una serie de modelos algorítmicos que pretenden dar cuenta del proceso psicológico que desemboca en estos juicios morales. Los resultados sugieren que este proceso se ajusta a una forma modificada de un cálculo bayesiano de actualización de creencias."Recent studies in moral psychology and experimental philosophy have focused on the possible link between emotion/ reflexion and deontologic/ utilitarian moral judgment. Despite the basic and applied consequences of this research program this program fails to reflect a number of intuitions reflected in moral judgment. This dissertation adopts a different approach to moral judgment and favours judgment dealing with character rather than specific action. First, I determined the morally relevant traits in Colombian society and how generalizable they are across different circumstances I proposed and empirycally testes a number of algorithmic models theorized to reflect the psychological process explaining character based moral judgment. Results suggest that this process fits a modified Bayesian belief updating algorithm."Doctor en PsicologíaDoctorad

Virtues disunited and the folk psychology of character

Despite the recent attention given to moral character in moral psychology and moral philosophy, there is little evidence on how the folk concept of character is structured. Virtue ethics literature suggests a number of views formalizing how different virtues or vices are structured in overall virtuous or vicious character. The Unity of Virtues View (UV) assumes that any virtue implies all other virtues through practical wisdom. On the contrary, the Disunity of Virtues View (DUV) argues that different virtues or vices do not imply one another. Finally, the Limited Unity of Virtues View (LUV) suggests that UV is true when considering specific spheres of life but DUV is true when considering overall character. Here, we report an experiment that suggests that the folk concept of moral character follows an intuitive Limited Unity of Virtues view. Also, folk beliefs about moral character differ between virtuous and vicious character. The psychological and philosophical implications of these findings are discussed. Materials (in Spanish) and data analysis scripts for all studies are available in OSF: https://osf.io/72ywp/. © 2020, © 2020 Informa UK Limited, trading as Taylor and Francis Group

Virtues disunited and the folk psychology of character

Despite the recent attention given to moral character in moral psychology and moral philosophy, there is little evidence on how the folk concept of character is structured. Virtue ethics literature suggests a number of views formalizing how different virtues or vices are structured in overall virtuous or vicious character. The Unity of Virtues View (UV) assumes that any virtue implies all other virtues through practical wisdom. On the contrary, the Disunity of Virtues View (DUV) argues that different virtues or vices do not imply one another. Finally, the Limited Unity of Virtues View (LUV) suggests that UV is true when considering specific spheres of life but DUV is true when considering overall character. Here, we report an experiment that suggests that the folk concept of moral character follows an intuitive Limited Unity of Virtues view. Also, folk beliefs about moral character differ between virtuous and vicious character. The psychological and philosophical implications of these findings are discussed. Materials (in Spanish) and data analysis scripts for all studies are available in OSF: https://osf.io/72ywp/. © 2020, © 2020 Informa UK Limited, trading as Taylor and Francis Group

No es correcto, pero está permitido: efectos de redacción en el juicio moral

This study aims to provide evidence about two widely held assumptions in the experimental study of moral judgment. First, that different terms used to ask for moral judgment (e.g., blame, wrongness, permissibility. . . ) can be treated as synonyms and hence used interchangeably. Second, that the moral and legal status of the judged action are independent of one another and thus moral judgment have no influence of legal or other conventional considerations. Previous research shows mixed results on these claims. We recruited 660 participants who provided moral judgment to three identical sacrificial dilemmas using seven different terms. We experimentally manipulated the explicit legal status of the judged action. Results suggest that terms that highlight the utilitarian nature of the judged action cause harsher moral judgments as a mechanism of reputation preservation. Also, the manipulation of the legal status of the judged action holds for all considered terms but is larger for impermissibility judgments. Taken as a whole, our results imply that, although subtle, different terms used to ask for moral judgment have theoretically and methodologically relevant differences which calls for further scrutiny