Política migratoria de México hacia Centroamérica y presión estadounidense

En anys recents, el govern mexicà ha reforçat el control de la migració centreamericana com a part de la política dels Estats Units basada en l’establiment d’obstacles creixents a la immigració. Les acciones indiquen que el procés d’acumulació de capital a l’economia dels Estats Units ha provocat la creació d’un exèrcit de reserva de treball de tal magnitud que la capitalització té lloc sense necessitat de recórrer a la immigració. Atès que aquesta resulta cada vegada més inconvenient, augmenten les pressions al govern de Mèxic perquè adopti mesures que tendeixin a limitar l’entrada i el moviment de migrants centreamericans en trànsit cap als Estats Units. Una conseqüència d’aquesta estratègia és l’increment de les transgressions dels drets humans del migrants, mentre que les condicions socials dels seus país d’origen continuen sense millorar.In recent years, the Mexican government has strengthened its control of Central American migration as a part of the United States’ policy based on establishing growing obstacles to immigration. US measures indicate that the process of capital accumulation in the North American economy has given rise to the creation of a reserve army of labor of a such scale that capitalization can take place with no need to turn to immigration. As immigration becomes more and more inconvenient, we witness growing pressure on Mexico’s Government to implement measures aimed at limiting the entrance and movement of Central American migrants going to United States. A consequence of this strategy is an increase of the infringement of the migrants’ human rights, while the social conditions in their countries of origin do not improve.En años recientes, el gobierno mexicano reforzó el control de la migración centroamericana como parte de la política de Estados Unidos basada en el establecimiento de crecientes obstáculos a la inmigración. Las acciones indican que el proceso de acumulación de capital en la economía estadounidense ha dado lugar a la creación de un ejército de reserva laboral, en una magnitud tal que la capitalización trascurre sin necesidad de recurrir a la inmigración. Al resultar ésta cada vez más inconveniente, crecen las presiones sobre el gobierno de México para que tome medidas tendentes a restringir la entrada y el movimiento de migrantes centroamericanos que se dirigen a Estados Unidos. Una consecuencia de esta estrategia es el incremento de transgresiones de los derechos humanos de los migrantes, al mismo tiempo que las condiciones sociales en los países de origen no mejoran

HTLV-1 infection in solid organ transplant donors and recipients in Spain

HTLV-1 infection is a neglected disease, despite infecting 10-15 million people worldwide and severe illnesses develop in 10% of carriers lifelong. Acknowledging a greater risk for developing HTLV-1 associated illnesses due to immunosuppression, screening is being widely considered in the transplantation setting. Herein, we report the experience with universal HTLV testing of donors and recipients of solid organ transplants in a survey conducted in Spain. All hospitals belonging to the Spanish HTLV network were invited to participate in the study. Briefly, HTLV antibody screening was performed retrospectively in all specimens collected from solid organ donors and recipients attended since the year 2008. A total of 5751 individuals were tested for HTLV antibodies at 8 sites. Donors represented 2312 (42.2%), of whom 17 (0.3%) were living kidney donors. The remaining 3439 (59.8%) were recipients. Spaniards represented nearly 80%. Overall, 9 individuals (0.16%) were initially reactive for HTLV antibodies. Six were donors and 3 were recipients. Using confirmatory tests, HTLV-1 could be confirmed in only two donors, one Spaniard and another from Colombia. Both kidneys of the Spaniard were inadvertently transplanted. Subacute myelopathy developed within 1 year in one recipient. The second recipient seroconverted for HTLV-1 but the kidney had to be removed soon due to rejection. Immunosuppression was stopped and 3 years later the patient remains in dialysis but otherwise asymptomatic. The rate of HTLV-1 is low but not negligible in donors/recipients of solid organ transplants in Spain. Universal HTLV screening should be recommended in all donor and recipients of solid organ transplantation in Spain. Evidence is overwhelming for very high virus transmission and increased risk along with the rapid development of subacute myelopathy

Plan gallego de hospitalización a domicilio. Estrategia HADO 2019-2023

Documento estratéxico que pretende potenciar e consolidar a hospitalización a domicilio como un modelo asistencial do Servizo Galego de Saúde e garantir o seu desenvolvemento nos próximos seis anos, establecendo criterios homoxéneos de atención coa finalidade de normalizar os modelos asistenciais, carteira de servizos e fluxos de traballo para asegurar una asistencia sanitaria de calidadeDocumento estratégico que pretende potenciar y consolidar la hospitalización a domicilio como un modelo asistencial del Servicio Gallego de Salud y garantizar su desarrollo en los próximos seis años, estableciendo criterios homogéneos de atención con la finalidad de normalizar los modelos asistenciales, cartera de servicios y flujos de trabajo para asegurar una asistencia sanitaria de calida

estudos artísticos

A revista Gama prossegue o aprofundamento da sua linha editorial específica e dentro do projeto mais alargado de desafiar criadores a debaterem e apresentar a obra de outros criadores, dentro do espaço descentrado que é o universo dos idiomas ibéricos. Trata-se de, dentro deste tema mais abrangente, revisitar arquivos, autores de épocas um pouco recuadas, de resgatar do esquecimento o património que existe e urge apresentar, discutir, colocar em ação, fazer funcionar, pela voz dos artistas. A arte necessita de ser ativada por intermédio do pensamento, e com ele, do discurso. Há vozes silenciosas que aguardam olhos, ouvidos, inquietações, deslumbramentos. Quando uma peça é descoberta é como se voltasse a ser feita: esse é o paradoxo do documento. A arte é vestígio e ao mesmo tempo universalidade, eternidade. É local e total. É sempre, em simultâneo, sem contradição, facto e possibilidade, presença e ausência. Os vinte e quatro artigos apresentados neste número cinco da Revista Gama oferecem outros tantos pontos de vista sobre os discursos artísticos. Recupera-se obra desconhecida, mostram-se obras, descobrem-se autores desaparecidos. Aqui a arte depositou-se, precipitou-se, tornou-se visível ao resgate. O resgate, operação de amor, é feito por artistas. Os públicos estão no futuro, à nossa espera.info:eu-repo/semantics/publishedVersio

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

Lactose permease lipid selectivity using Förster resonance energy transfer

International audienceThe phospholipid composition that surrounds a membrane protein is critical to maintain its structural integrity and, consequently, its functional properties. To understand better this in the present work we have performed FRET measurements between the single tryptophan residue of a lactose permease Escherichia coli mutant (single-W151/C154G LacY) and pyrene-labeled phospholipids (Pyr-PE and Pyr-PG) at 37 degrees C. We have reconstituted this LacY mutant in proteoliposomes formed with heteroacid phospholipids, POPE and POPG, and homoacid phospholipids DOPE and DPPE, resembling the same PE/PG proportion found in the E. coli inner membrane (3:1, mol/mol). A theoretical model has been fitted to the experimental data. In the POPE/POPG system, quantitative model calculations show accordance with the experimental values that requires an annular region composed of approximately approximately 90 mol% PE. The experimental FRET efficiencies for the gel/fluid phase-separated DOPE/POPG system indicate a higher presence of PG in the annular region, from which it can be concluded that LacY shows clear preference for the fluid phase. Similar conclusions are obtained from analysis of excimer-to-monomer (E/M) pyrene ratios. To test the effects of this on cardiolipin (CL) on the annular region, myristoyl-CL and oleoyl-CL were incorporated in the biomimetic POPE/POPG matrix. The experimental FRET efficiency values, slightly larger for Pyr-PE than for Pyr-PG, suggest that CL displaces POPE and, more extensively, POPG from the annular region of LacY. Model fitting indicates that CL enrichment in the annular layer is, in fact, solely produced by replacing PG and that myristoyl-CL is not able to displace PE in the same way that oleoyl-CL does. One of the conclusions of this work is the fact that LacY inserts preferentially in fluid phases of membranes

Impacto de la COVID-19 en el tratamiento del infarto agudo de miocardio con elevación del segmento ST. La experiencia Española

The COVID-19 outbreak has had an unclear impact on the treatment and outcomes of patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to assess changes in STEMI management during the COVID-19 outbreak. Using a multicenter, nationwide, retrospective, observational registry of consecutive patients who were managed in 75 specific STEMI care centers in Spain, we compared patient and procedural characteristics and in-hospital outcomes in 2 different cohorts with 30-day follow-up according to whether the patients had been treated before or after COVID-19. Suspected STEMI patients treated in STEMI networks decreased by 27.6% and patients with confirmed STEMI fell from 1305 to 1009 (22.7%). There were no differences in reperfusion strategy (> 94% treated with primary percutaneous coronary intervention in both cohorts). Patients treated with primary percutaneous coronary intervention during the COVID-19 outbreak had a longer ischemic time (233 [150-375] vs 200 [140-332] minutes, P < .001) but showed no differences in the time from first medical contact to reperfusion. In-hospital mortality was higher during COVID-19 (7.5% vs 5.1%; unadjusted OR, 1.50; 95%CI, 1.07-2.11; P < .001); this association remained after adjustment for confounders (risk-adjusted OR, 1.88; 95%CI, 1.12-3.14; P = .017). In the 2020 cohort, there was a 6.3% incidence of confirmed SARS-CoV-2 infection during hospitalization. The number of STEMI patients treated during the current COVID-19 outbreak fell vs the previous year and there was an increase in the median time from symptom onset to reperfusion and a significant 2-fold increase in the rate of in-hospital mortality. No changes in reperfusion strategy were detected, with primary percutaneous coronary intervention performed for the vast majority of patients. The co-existence of STEMI and SARS-CoV-2 infection was relatively infrequent.S