Comités de etica de investigación en humanos: el desafío de su fortalecimiento en Colombia.

Introduction. Ethics committees are a necessary resource to guarantee ethical integrity in human research; they must apply international standards in their ethical evaluation of research projects involving human subjects.Objective. The ethics committees for human research of Colombia were characterized, and recommendations for strengthening them were formulated.Materials And Methods. In 2003, 280 groups with research projects involving human subjects were selected from a list of research groups which form part of the science and technology network of Colciencias. (Colciencias is the Colombian national agency that promotes and funds science and technology.) Eighty percent (224) of the projects were associated with 40 institutions, consisting of universities, hospitals, and public or private research centers. Thirty of these institutions had at least one ethics committee for evaluating use of human subjects. A questionnaire was mailed to each of these Committees, requesting information concerning its their compostition, regulations, multidisciplinarity, plurality, representativity and independence. The World Health Organization's Operational Guidelines for Ethic Committees that Evaluate Biomedical Research (TDR/PRD/ETHICS/2000) was used as reference for the analysis. In 5 of the cities, supplemental information was obtained by direct discussions with members of the ethics committees.Results. Twenty-six committees responded to the questionnaire. The results indicated that 47% of the committee members were physicians, but only 23% of the committees had representatives from the community. In 60% of the Committees, members were not independent from the organization in which it was based. Seventy percent had established operating procedures. Lack of national regulations and limited education in research ethics were mentioned as the main drawbacks in providing effective guidance.Conclusions. These observations led to the conclusion that national guidelines must be established for ethics committees that correspond to international standards. Committee members must be trained before accepting committee responsibilities. Finally, new committees must be created along with the improvement of the currently existing committees for reinforcing and promoting the importance of ethical integrity in research.Introducción. Los comités de ética de investigación en humanos que aplican los estándares internacionales en la evaluación ética de proyectos de investigación son un recurso indispensable para garantizar la integridad ética de la investigación en humanos. Objetivo. El presente trabajo se propuso conocer las características de los comités de ética de investigación en humanos y sus necesidades con miras a su fortalecimiento en Colombia. Materiales y métodos. En el 2003, se seleccionaron 280 grupos de investigación en humanos de un listado de grupos de investigación que acudieron a la convocatoria del año 2002 de la Red de Ciencia y Tecnología de Colciencias. El 80% de estos grupos pertenecía a 40 instituciones entre universidades, hospitales y centros de investigación públicos y privados. Treinta de 40 instituciones tenían comité de ética. Se les envió un cuestionario que indagaba sobre la constitución, reglamentación, composición multidisciplinaria, pluralidad, representatividad e independencia de los comités. Las respuestas se analizaron utilizando como referencia las Guías operacionales para comités de ética de investigación biomédica (TDR/PRD/ETHICS/2000). Se complementó la información obtenida mediante discusiones con miembros de estos comités en cinco ciudades del país. Resultados. Veintiséis comités respondieron la encuesta. El 47% de los miembros eran médicos, 23% de los comités tenía un miembro representante de la comunidad, 40% tenía un miembro independiente, 70% tenía manual de operaciones. Mencionaron la necesidad de mejorar la constitución de los comités, la capacitación de sus miembros, la regulación y las guías nacionales. Conclusión. Es urgente que en Colombia se elaboren guías nacionales para los comités de ética de investigación basados en estándares internacionales, se capacite a sus miembros y se promueva la integridad ética de la investigación

Spatio-temporal clusters and patterns of spread of dengue, chikungunya, and Zika in Colombia

Background Colombia has one of the highest burdens of arboviruses in South America. The country was in a state of hyperendemicity between 2014 and 2016, with co-circulation of several Aedes- borne viruses, including a syndemic of dengue, chikungunya, and Zika in 2015. Methodology/Principal findings We analyzed the cases of dengue, chikungunya, and Zika notified in Colombia from January 2014 to December 2018 by municipality and week. The trajectory and velocity of spread was studied using trend surface analysis, and spatio-temporal high-risk clusters for each disease in separate and for the three diseases simultaneously (multivariate) were identified using Kulldorff’s scan statistics. During the study period, there were 366,628, 77,345 and 74,793 cases of dengue, chikungunya, and Zika, respectively, in Colombia. The spread pat- terns for chikungunya and Zika were similar, although Zika’s spread was accelerated. Both chikungunya and Zika mainly spread from the regions on the Atlantic coast and the south- west to the rest of the country. We identified 21, 16, and 13 spatio-temporal clusters of den- gue, chikungunya and Zika, respectively, and, from the multivariate analysis, 20 spatio-tem- poral clusters, among which 7 were simultaneous for the three diseases. For all disease- specific analyses and the multivariate analysis, the most-likely cluster was identified in the south-western region of Colombia, including the Valle del Cauca department. Conclusions/Significance The results further our understanding of emerging Aedes-borne diseases in Colombia by providing useful evidence on their potential site of entry and spread trajectory within the country, and identifying spatio-temporal disease-specific and multivariate high-risk clusters of dengue, chikungunya, and Zika, information that can be used to target interventions.https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000149799https://orcid.org/0000-0002-7597-387

Comparison of the efficacy of long-lasting insecticidal nets PermaNet® 2.0 and Olyset® against Anopheles albimanus under laboratory conditions

Insecticide-treated nets provide a reduction in human-vector contact through physical barrier, mortality and/or repellent effects that protect both users and non-users, thereby protecting the wider community from vector-borne diseases like malaria. Long-lasting insecticide-treated nets (LLINs) are the best alternative. This study evaluated the bioefficacy of LLINs PermaNet® 2.0 and Olyset® under laboratory conditions with Anopheles albimanus. The laboratory strain was evaluated for insecticide susceptibility with selected insecticides used for malarial control. Regeneration time and wash resistance were evaluated with the standard bioassay cone technique following WHO guidelines. Heat assistance was used for Olyset® nets; the nets were exposed to four different temperatures to speed the regeneration process. The regeneration study of PermaNet® 2.0 showed that efficacy was fully recovered by 24 h after one and three washes and wash resistance persisted for 15 washes. Regeneration of Olyset® nets was not observed for nets washed three times, even with the different temperature exposures for up to seven days. Thus, for Olyset® the wash resistance evaluation could not proceed. Differences in response between the two LLINs may be associated with differences in manufacturing procedures and species response to the evaluated LLINs. PermaNet® 2.0 showed higher and continuous efficacy against An. albimanus

A Functional Phylogenomic View of the Seed Plants

A novel result of the current research is the development and implementation of a unique functional phylogenomic approach that explores the genomic origins of seed plant diversification. We first use 22,833 sets of orthologs from the nuclear genomes of 101 genera across land plants to reconstruct their phylogenetic relationships. One of the more salient results is the resolution of some enigmatic relationships in seed plant phylogeny, such as the placement of Gnetales as sister to the rest of the gymnosperms. In using this novel phylogenomic approach, we were also able to identify overrepresented functional gene ontology categories in genes that provide positive branch support for major nodes prompting new hypotheses for genes associated with the diversification of angiosperms. For example, RNA interference (RNAi) has played a significant role in the divergence of monocots from other angiosperms, which has experimental support in Arabidopsis and rice. This analysis also implied that the second largest subunit of RNA polymerase IV and V (NRPD2) played a prominent role in the divergence of gymnosperms. This hypothesis is supported by the lack of 24nt siRNA in conifers, the maternal control of small RNA in the seeds of flowering plants, and the emergence of double fertilization in angiosperms. Our approach takes advantage of genomic data to define orthologs, reconstruct relationships, and narrow down candidate genes involved in plant evolution within a phylogenomic view of species' diversification

In vivo hippocampal subfield volumes in bipolar disorder—A mega-analysis from The Enhancing Neuro Imaging Genetics through Meta-Analysis Bipolar Disorder Working Group

The hippocampus consists of anatomically and functionally distinct subfields that may be differentially involved in the pathophysiology of bipolar disorder (BD). Here we, the Enhancing NeuroImaging Genetics through Meta‐Analysis Bipolar Disorder workinggroup, study hippocampal subfield volumetry in BD. T1‐weighted magnetic resonance imaging scans from 4,698 individuals (BD = 1,472, healthy controls [HC] = 3,226) from 23 sites worldwide were processed with FreeSurfer. We used linear mixed‐effects models and mega‐analysis to investigate differences in hippocampal subfield volumes between BD and HC, followed by analyses of clinical characteristics and medication use. BD showed significantly smaller volumes of the whole hippocampus (Cohen's d = −0.20), cornu ammonis (CA)1 (d = −0.18), CA2/3 (d = −0.11), CA4 (d = −0.19), molecular layer (d = −0.21), granule cell layer of dentate gyrus (d = −0.21), hippocampal tail (d = −0.10), subiculum (d = −0.15), presubiculum (d = −0.18), and hippocampal amygdala transition area (d = −0.17) compared to HC. Lithium users did not show volume differences compared to HC, while non‐users did. Antipsychotics or antiepileptic use was associated with smaller volumes. In this largest study of hippocampal subfields in BD to date, we show widespread reductions in nine of 12 subfields studied. The associations were modulated by medication use and specifically the lack of differences between lithium users and HC supports a possible protective role of lithium in BD

La participación de la mujer en el desarrollo sostenible del Pueblo Kichwa de Rukullakta (Ecuador)

Las mujeres kichwas realizan actividades productivas, reproductivas y de distribución en un modelo de organización patriarcal. En 2009 se modificó el reglamento del Pueblo Kichwa de Rukullakta (PKR) para facilitar la participación de la mujer en la gobernanza organizativa y productiva de la comunidad. Las mujeres han impulsado asociaciones y actividades con las que han mejorado las oportunidades de desarrollo sostenible (DS) de sus comunidades. Se presenta una breve referencia del enfoque de género en América Latina. Se utiliza metodología cualitativa (observación participante, grupos focales y entrevistas en profundidad) y cuantitativa (censo de la Fundación TNC). Se realiza un análisis de la participación de la mujer en las actividades de los cuatro modelos de comercialización del PKR. Cuando las mujeres participan en las asociaciones de organización productiva y de distribución, hay mejores resultados en el DS del territorio. Aunque hay un avance gradual de la participación de la mujer en todas las actividades, aún se mantiene una cierta distribución de tareas de acuerdo con las costumbres del pueblo kichwa.Les dones kichwes realitzen activitats productives, reproductives i de distribució en un model d'organització patriarcal. El 2009 es va modificar el reglament del Pueblo Kichwa de Rukullakta (PKR) per facilitar la participació de la dona en la governança organitzativa i productiva de la comunitat. Les dones han impulsat associacions i activitats amb les quals han millorat les oportunitats de desenvolupament sostenible (DS) de les seves comunitats. Es presenta una breu referencia a l'enfocament de gènere a l'Amèrica Llatina. S'utilitza metodologia qualitativa (observació participant, grups focals i entrevistes en profunditat) i quantitativa (cens de la Fundació TNC). Es realitza una anàlisi de la participació de la dona en les activitats dels quatre models de comercialització del PKR. Quan les dones participen en les associacions d'organització productiva i de distribució, hi ha més bons resultats en el DS del territori. Tot i que hi ha un avanç gradual de la participació de la dona en totes les activitats, encara es manté una certa distribució de tasques d'acord amb els costums del poble kichwa.Kichwa women perform productive, reproductive and distribution duties in a patriarchal system. In 2009, the regulations of the Kichwa People of Rukullakta (PKR) were modified to foster the participation of women in the organizational and productive governance of the community. Women have promoted associations and activities that have improved the opportunities for sustainable development (SD) in their communities. A brief reference to the gender approach in Latin America is presented. Qualitative (participant observation, focus groups and in-depth interviews) and quantitative (TNC Foundation Census) methodologies are used. An analysis is conducted of the participation of women in the activities of the four PKR marketing models. When women are members of association that organize and distribute production, there are better SD results in the territory. Although gradual progress is being made in the participation of women in all activities, there is still a certain distribution of tasks in accordance with the customs of the Kichwa people

Comparison of the efficacy of long-lasting insecticidal nets PermaNet® 2.0 and Olyset® against Anopheles albimanus under laboratory conditions

Insecticide-treated nets provide a reduction in human-vector contact through physical barrier, mortality and/or repellent effects that protect both users and non-users, thereby protecting the wider community from vector-borne diseases like malaria. Long-lasting insecticide-treated nets (LLINs) are the best alternative. This study evaluated the bioefficacy of LLINs PermaNet® 2.0 and Olyset® under laboratory conditions with Anopheles albimanus. The laboratory strain was evaluated for insecticide susceptibility with selected insecticides used for malarial control. Regeneration time and wash resistance were evaluated with the standard bioassay cone technique following WHO guidelines. Heat assistance was used for Olyset® nets; the nets were exposed to four different temperatures to speed the regeneration process. The regeneration study of PermaNet® 2.0 showed that efficacy was fully recovered by 24 h after one and three washes and wash resistance persisted for 15 washes. Regeneration of Olyset® nets was not observed for nets washed three times, even with the different temperature exposures for up to seven days. Thus, for Olyset® the wash resistance evaluation could not proceed. Differences in response between the two LLINs may be associated with differences in manufacturing procedures and species response to the evaluated LLINs. PermaNet® 2.0 showed higher and continuous efficacy against An. albimanus

El psicoanálisis y la pasión: La posición del sujeto

El presente artículo es el resultado de una investigación de carácter conceptual, desde la perspectiva psicoanalítica, para mostrar cómo en la concepción de la enfermedad mental, Freud introduce la dimensión del sujeto en lo concerniente a la pulsión-pasión en la conformación de la neurosis. Freud, de formación médico-psiquiátrica, recibe de su tradición algunas concepciones etiológicas de la enfermedad en dos vías principales: La concepción de la enfermedad por vía de los accidentes externos e internos y por una concepción hereditaria o predisponente de la enfermedad, de la cual Freud toma distancia para pensar la enfermedad mental como realidad psíquica, introduciendo allí la responsabilidad del sujeto de su propio malestar, en tanto producto de conflictos que se generan en relación con la pulsión –pasión en el orden de lo sexual

La dimensión del Pathos en la Filosofía y en la Psiquiatria clásica

El presente artículo, es el resultado de una investigación de carácter conceptual, desde las perspectivas de la Filosofía y la Psiquiatría clásica, que hacen un recorrido por la enfermedad observando la variación que se tiene de la concepción del pathos, incluida en la línea de investigación: Subjetividad y Salud Mental, perteneciente al Grupo de Investigación en Psicología Sujeto, Sociedad y Trabajo, de la Universidad Pontificia Bolivariana, Medellín. El artículo tiene como objetivo rastrear el concepto del pathos en el mundo antiguo, en relación con la dimensión ética en tanto physis, en la Edad Media, donde se piensa a través de una concepción teológica del mundo, y en la Modernidad, donde el pathos se transforma en enfermedad mental a partir de la concepción científic

Assessing the reporting of Dengue, Chikungunya and Zika to the National Surveillance System in Colombia from 2014-2017: A Capture-recapture analysis accounting for misclassification of arboviral diagnostics.

BackgroundChikungunya, dengue, and Zika are three different arboviruses which have similar symptoms and are a major public health issue in Colombia. Despite the mandatory reporting of these arboviruses to the National Surveillance System in Colombia (SIVIGILA), it has been reported that the system captures less than 10% of diagnosed cases in some cities.Methodology/principal findingsTo assess the scope and degree of arboviruses reporting in Colombia between 2014-2017, we conducted an observational study of surveillance data using the capture-recapture approach in three Colombian cities. Using healthcare facility registries (capture data) and surveillance-notified cases (recapture data), we estimated the degree of reporting by clinical diagnosis. We fit robust Poisson regressions to identify predictors of reporting and estimated the predicted probability of reporting by disease and year. To account for the potential misclassification of the clinical diagnosis, we used the simulation extrapolation for misclassification (MC-SIMEX) method. A total of 266,549 registries were examined. Overall arboviruses' reporting ranged from 5.3% to 14.7% and varied in magnitude according to age and year of diagnosis. Dengue was the most notified disease (21-70%) followed by Zika (6-45%). The highest reporting rate was seen in 2016, an epidemic year. The MC-SIMEX corrected rates indicated underestimation of the reporting due to the potential misclassification bias.ConclusionsThese findings reflect challenges on arboviruses' reporting, and therefore, potential challenges on the estimation of arboviral burden in Colombia and other endemic settings with similar surveillance systems