Otredad, verdad y mundo, una reflexión fenomenológica sobre la discapacidad - Other, truth and world, a phenomenological reflection on disability

El presente trabajo se propone aclarar el fenómeno de la discapacidad en relación con la fenomenología de la empatía que elabora Edmund Husserl. Y es un esfuerzo por tratar de dilucidar, a la luz de los conceptos de intersubjetividad, intuición de esencias, intencionalidad y discapacidad, lo que sea que es la verdad. Para este cometido serán de gran importancia los volúmenes de Husserliana I, IV, XVIII y XIX, y de igual forma las investigaciones realizadas por el profesor Roberto Walton, Rosemary Rizo-Patrón de Lerner, entre otros fenomenólogos.  

Physical, Chemical and Processing Postharvest Technologies in Strawberry

Strawberry (Fragaria × ananassa) is a fruit of great acceptance worldwide but has characteristics that make it a highly perishable fruit, with shelf life of about a week, which makes it difficult to transport and store it to consumer places. Throughout the years, post-harvest techniques have been studied to extend their useful life and improve their properties. Strawberry deterioration may be due to various factors such as overripe, fungal involvement, moisture loss, mechanical damage, among others. Among the techniques which have been tried to slow the deterioration of the fruit are the use of modified atmospheres and treatments gases, use of edible coatings and smart packings, application of radiation of various types, use of chemical treatments among many others. In this chapter, we will examine the most relevant treatments applied to the strawberry to extend its useful life and improve its organoleptic quality that have been reported in the literature

Severe Pneumococcal Pneumonia Causes Acute Cardiac Toxicity and Subsequent Cardiac Remodeling

Rationale: Up to one-third of patients hospitalized with pneumococcal pneumonia experience major adverse cardiac events (MACE) during or after pneumonia. In mice, Streptococcus pneumoniae caninvade themyocardium, induce cardiomyocyte death, and disrupt cardiac function following bacteremia, but it is unknown whether the same occurs in humans with severe pneumonia. Objectives: We sought to determine whether S. pneumoniae can (1) translocate the heart, (2) induce cardiomyocyte death, (3) causeMACE, and (4) induce cardiac scar formation after antibiotic treatment during severe pneumonia using a nonhuman primate (NHP) model. Methods: We examined cardiac tissue from six adult NHPs with severe pneumococcal pneumonia and three uninfected control animals. Three animals were rescued with antibiotics (convalescent animals). Electrocardiographic, echocardiographic, and serum biomarkers of cardiac damage were measured (troponin T, N-terminal pro-brain natriuretic peptide, and heart-type fatty acid binding protein). Histological examination included hematoxylin and eosin staining, immunofluorescence, immunohistochemistry, picrosirius red staining, and transmission electron microscopy. Immunoblots were used to assess the underlying mechanisms. Measurements and Main Results: Nonspecific ischemic alterations were detected by electrocardiography and echocardiography. Serum levels of troponin T and heart-type fatty acid binding protein were increased (P,0.05) after pneumococcal infection in both acutely ill and convalescent NHPs. S. pneumoniae was detected in the myocardium of all NHPs with acute severe pneumonia. Necroptosis and apoptosis were detected in the myocardium of both acutely ill and convalescent NHPs. Evidence of cardiac scar formation was observed only in convalescent animals by transmission electron microscopy and picrosirius red staining. Conclusions: S. pneumoniae invades the myocardium and induces cardiac injury with necroptosis and apoptosis, followed by cardiac scarring after antibiotic therapy, in anNHP model of severe pneumonia

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Long-term thermal sensitivity of Earth’s tropical forests

The sensitivity of tropical forest carbon to climate is a key uncertainty in predicting global climate change. Although short-term drying and warming are known to affect forests, it is unknown if such effects translate into long-term responses. Here, we analyze 590 permanent plots measured across the tropics to derive the equilibrium climate controls on forest carbon. Maximum temperature is the most important predictor of aboveground biomass (−9.1 megagrams of carbon per hectare per degree Celsius), primarily by reducing woody productivity, and has a greater impact per °C in the hottest forests (>32.2°C). Our results nevertheless reveal greater thermal resilience than observations of short-term variation imply. To realize the long-term climate adaptation potential of tropical forests requires both protecting them and stabilizing Earth’s climate

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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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

Evaluation of the use of reactive oxygen species (ROS) generated through oxyion® technology in strawberry (Fragaria × ananassa (Duchesne ex Weston) Duchesne ex Rozier cv. Monterrey) storage

Reactive oxygen species (ROS) play a key role in oxidative stress processes at the biological level. In most cases the presence of these chemical species is undesirable due to the impact they have on tissues and cellular structures, however, their effects can be used to control the incidence of microorganisms responsible for deterioration processes in fruits and vegetables. In the present study the feasibility of combining low temperature storage with the presence of reactive oxygen species generated using Oxyion® technology to control the deterioration process in strawberry (Fragaria X ananassa) was studied. The treatments used were as follows: control storage (4°C ± 2°C without Oxyion®) and ROS storage (4°C ± 2°C with Oxyion®), for two product categories according to weight and maturation state according to NTC 4103 (ICONTEC, 1997). The variables were monitored with measuring points at 1, 3, 5, 7, 10 and 15 days after harvest in percentage of loss of mass, soluble solids, respiratory intensity, acidity, resistance, color and ethylene and significant interactions among variables. At the conclusion of the study, Oxyion® technology was found to have statistically significant differences compared to control, and have allowed to less weight loss, higher resistance and lower exogenous ethylene production, extending the life of strawberry cv. Monterrey in a 40% during storage, additionally the losses by action of microorganisms present in strawberries surface were reduced considerably, generating a positive precedent in the processes of storage and conservation of fruits for Colombia.Las especies reactivas de oxigeno (ROS) tienen un papel primordial en los procesos de estrés oxidativos a nivel biológico. En la mayoría de los casos la presencia de dichas especies químicas es indeseable debido al impacto que tienen sobre tejidos y estructuras celulares, sin embargo, sus efectos pueden ser empleados para controlar la incidencia de microorganismos responsables de procesos de deterioro en frutas y hortalizas. En el presente estudio se estudió la viabilidad de compaginar el almacenamiento a baja temperatura con la presencia de especies reactivas de oxigeno generadas empleando la tecnología Oxyion® para el control del proceso de deterioro en fresa (Fragaria X ananassa). Los tratamientos empleados fueron almacenamiento control (4°C± 2°C sin Oxyion®) y almacenamiento ROS (4°C± 2°C con Oxyion®), para dos categorías del producto de acuerdo con el peso y estado de maduración según la NTC 4103 (ICONTEC, 1997). Las variables fueron monitoreadas con puntos de medición en 1, 3, 5, 7, 10 y 15 días después de cosecha en porcentaje de pérdida de masa, sólidos solubles, intensidad respiratoria, acidez, resistencia, color y etileno. Adicionalmente se analizaron los efectos y las interacciones significativas entre variables. Al concluir el estudio, se determinó que la tecnología Oxyion® presentó diferencias estadísticamente significativas en comparación con el control, e indujo a una menor pérdida de peso, mayor resistencia y menor producción exógena de etileno, prolongando la vida útil de la fresa cv. Monterrey en un 40% durante almacenamiento, adicionalmente las pérdidas por acción de microorganismos presentes en la superficie de las fresas se redujeron de forma considerable, generando un precedente positivo en los procesos de almacenamiento y conservación de frutas para Colombia

Lead extraction in non-cardiac surgery centers: Easier said than done

SCOPUS: ed.jinfo:eu-repo/semantics/publishe