Five Feet Apart (2019) by Justin Baldoni

Movies are a helpful tool to learn and teach which allow us to depict from different points of view the complexity of the illness. In this paper we focus on the educational tools we saw in the movie Five feet apart about cystic fibrosis, where we can see the daily aspects that patients have to endure in a hospital, from their feeding, treatment and infections, as well as the importance of physical contact with the people around because they must keep a distance of 2 m between them. It also depicts the infections caused by multi-resistant bacteria like Burkholderia cepacia and the alternative methods to treat it like lung transplant which allows patients to extend their life expectancy.El cine es una efectiva herramienta de enseñanza - aprendizaje que permite ilustrar desde diversos enfoques los procesos complejos de la enfermedad. En este artículo hacemos hincapié sobre estas herramientas educativas que nos brinda la película A dos metros de ti / Five feet apart, sobre la fibrosis quística. En la que se retratan los aspectos diarios que sobrellevan los pacientes dentro de un hospital desde su alimentación, tratamiento e infecciones. A la vez, la necesidad del contacto físico que tienen con las personas que conviven; ya que estos pacientes deben mantenerse alejados entre sí, a dos metros de distancia. Además, trata de las infecciones causadas por bacterias multirresistentes como Burkholderia cepacia y métodos alternativos como el proceso de trasplante pulmonar que permite prolongar la vida en paciente con fibrosis quística

Use of High-Flow Cannula in Pediatric Patients With Respiratory Failure: A Prospective Cohort Study in Three High-Altitude Hospitals

BACKGROUND AND AIMS: Acute respiratory failure (ARF) is a common cause of morbimortality, and a frequent reason for admission to the pediatric intensive care unit (PICU). It requires a high-flow oxygen device as treatment. Our aim is to determine the frequency and main indications for the use of high-flow nasal cannula (HFNC), and the prevalence of HFNC failure and its main causes, in three hospitals. METHODS: It is a multicenter prospective cohort study, developed in three hospitals in Bogota. Eligible patients were children older than 1 month and younger than 18 years who presented ARF and required management with an HFNC. The study was carried out between April 2020 and December 2021. The follow-up was carried out at 1, 6, and 48 h after starting the management. RESULTS: Of 685 patients included in the study, 296 developed ARF. The prevalence of patients with ARF who required management with HFNC was 48%. The frequency of the pathologies that cause the ARF was: Bronchiolitis was the most frequent pathology (34.5%), followed by asthmatic crisis (15.5%) and pneumonia (12.7%). The average time of use of HFNC was 81.6 h. Regarding treatment failure with HFNC, 15 patients presented torpid evolution and required invasive mechanical ventilation, with a prevalence of therapeutic failure of the HFNC of 10.6%. CONCLUSION: The use of HFNC is more frequent in patients with bronchiolitis, in children under 2 years of age and in males, which is in line with what has been reported in the literature. In addition, the failure rate of HFNC is low (10.6%), and it may be useful in other pathologies besides bronchiolitis, such as asthma, pneumonia, among others. It opens the possibility to continue evaluating the role of HFNC in pediatric pathology in new studies

Use of High-Flow Cannula in Pediatric Patients with Respiratory Failure: A Prospective Cohort Study in Three High-Altitude Hospitals

BACKGROUND AND AIMS: Acute respiratory failure (ARF) is a common cause of morbimortality, and a frequent reason for admission to the pediatric intensive care unit (PICU). It requires a high-flow oxygen device as treatment. Our aim is to determine the frequency and main indications for the use of high-flow nasal cannula (HFNC), and the prevalence of HFNC failure and its main causes, in three hospitals. METHODS: It is a multicenter prospective cohort study, developed in three hospitals in Bogota. Eligible patients were children older than 1 month and younger than 18 years who presented ARF and required management with an HFNC. The study was carried out between April 2020 and December 2021. The follow-up was carried out at 1, 6, and 48 h after starting the management. RESULTS: Of 685 patients included in the study, 296 developed ARF. The prevalence of patients with ARF who required management with HFNC was 48%. The frequency of the pathologies that cause the ARF was: Bronchiolitis was the most frequent pathology (34.5%), followed by asthmatic crisis (15.5%) and pneumonia (12.7%). The average time of use of HFNC was 81.6 h. Regarding treatment failure with HFNC, 15 patients presented torpid evolution and required invasive mechanical ventilation, with a prevalence of therapeutic failure of the HFNC of 10.6%. CONCLUSION: The use of HFNC is more frequent in patients with bronchiolitis, in children under 2 years of age and in males, which is in line with what has been reported in the literature. In addition, the failure rate of HFNC is low (10.6%), and it may be useful in other pathologies besides bronchiolitis, such as asthma, pneumonia, among others. It opens the possibility to continue evaluating the role of HFNC in pediatric pathology in new studies

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

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

Interações tróficas em plantas Zea spp. envolvendo os herbivoros Spodoptera frugiperda (J. E. Smith), Diatrea saccharalis (Fabricius) e o predador Doru luteipes Scudder

The earwigs (Dermaptera) contains mostly nocturnal insects, which are considered subsocial due to formation of aggregated family groups and maternal care. Species of Dermaptera have been shown to play an important role as generalist predators in different crop systems worldwide. Despite that, the knowledge about their behavior and insect-plant interactions remains poorly understood. The earwig Doru luteipes (Dermaptera: Forficulidae) is one of the most important generalist predators in different crops, especially in maize (Zea mays ssp. mays) by voraciously consuming eggs and larvae of Spodoptera frugiperda (Lepidoptera: Noctuidae) and Diatraea saccharalis (Lepidoptera: Crambidae), key pests in this crop. Maize is one of most produced cereals in the word. However, great losses are registered annually due to pest attacks, despite the use of pesticides. Studies have demonstrated that domesticated plants such as maize have reduced defenses against herbivores in detriment to intensely selecting for rapid growth and high yield, when compared with their wild ancestors\' species known as teosintes (Zea spp.). This thesis focuses on the study of the trophic interactions which occur in the system \'Zea plants - herbivores caterpillars - predator earwig\' and is divided in four chapters. In the Chapter 1 is present a general introduction and the thesis outline. In the Chapter 2, we studied through scent collection and multiple-choice bioassays, the communication between D. luteipes individuals which influences their predatory behavior. Our results indicate that earwigs can produce and use chemical cues by conspecifics to orientate them towards foraging resources. In the Chapter 3, we investigated the predation behavior of earwigs during photo- and scotophase and their preference for maize volatiles induced by S. frugiperda or D. saccharalis at different time intervals (early and old damage). Behavior, olfactometry bioassays and plant volatile collections were conducted. As was hypothesized, earwigs showed a predation activity only during night. Besides that, they were attracted by maize odors produced by both caterpillars and showed significant preference to early-damage odors over old-damage. Therefore, it is considered that early-damage volatiles (Green Leaf Volatiles-GLVs) could be the key compounds of D. luteipes attraction. In the last part (Chapter 4) was explored how domestication of Zea plants influences insect-plants interactions through plant defense. Experiments about food utilization by caterpillars, olfactometry bioassays and plant volatile collections were conducted. Interestingly, as in the previous chapter, we suggest that GLVs have an important role in earwig attraction. The results show that life-history of Zea plants influences plant defense and consequently the plant-insect interactions. In conclusion, our findings bring a new contribution to the knowledge about plant defenses in a tritrophic context and predatory strategies in D. luteipes, which would promote alternatives to optimize the conservation and biological control of pest by predators in the field.As tesourinhas (Dermaptera) são em sua maioria insetos noturnos considerados sub-sociais devido ao cuidado maternal e à formação de grupos familiares agregados. Espécies de Dermaptera possuem um papel importante como predadores generalistas em diferentes culturas em todo mundo. Apesar disso, o conhecimento sobre seu comportamento e as interações inseto-planta permanecem pouco estudadas. A tesourinha Doru luteipes Scudder (Dermaptera: Forficulidae) é um dos predadores mais frequentes em diferentes culturas, especialmente no milho (Zea mays ssp. mays), devido ao voraz consumo de ovos e lagartas de Spodoptera frugiperda e Diatraea saccharalis, pragas chave nesta cultura. O milho é um dos cereais mais produzidos no mundo, embora grandes perdas sejam registradas anualmente devido ao ataque de pragas, apesar do uso de agroquímicos. Estudos recentes demostraram que plantas domesticadas tais como o milho têm reduzido suas defesas contra os herbívoros em detrimento à intensa seleção de cultivares de rápido crescimento e alta produtividade, quando comparados com seus ancestrais selvagens conhecidos como teosintos (Zea spp.). Esta tese foca no estudo das interações tróficas que ocorrem no sistema \'plantas Zea - lagartas herbívoras - tesourinhas predadoras\' e foi dividida em quatro capítulos. No Capítulo 1, apresenta-se uma introdução geral e o esboço da tese. No Capítulo 2, a partir da coleta de voláteis de adultos de D. luteipes e ensaios de múltipla escolha, foi estudada a comunicação química entre estes indivíduos que influencia o comportamento de predação. No Capítulo 3 foi investigado o comportamento de predação das tesourinhas durante a foto e escotofase, e a preferência delas pelos voláteis do milho induzidos por S. frugiperda ou D. saccharalis, em diferentes intervalos de tempo (dano recente ou dano tardio). As tesourinhas mostraram atividade predatória apenas durante a noite, e foram atraídas pelos odores do milho atacados pelas duas lagartas. O dano recente (voláteis de folhas verdes-VFVs) contêm os compostos chaves para a atração de D. luteipes. No Capítulo 4 foi explorado como a domesticação das plantas Zea influenciam as interações com insetos por meio das defesas de plantas. Assim como no capitulo anterior, os VFVs apresentaram um importante papel na atração das tesourinhas. Os resultados indicaram que a história de vida do gênero Zea influenciou as defesas das plantas e consequentemente, as interações inseto-planta. Em conclusão, o presente trabalho traz novas contribuições ao conhecimento sobre defesas de plantas num contexto tritrófico, bem como às estratégias de predação em D. luteipes, o qual pode gerar ferramentas para otimizar a conservação e controle biológico de pragas por predadores em campo

Bioecologia comparada de duas linhagens de Telenomus remus Nixon (Hymenoptera: Platygastridae) parasitando ovos de Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae)

A criação massal em condições de laboratório afeta a atividade e vigor dos parasitoides e,consequentemente, opotential como agentes de controle biológico. No Brasil, Telenomus remus foi introduzido em1986 e obtiveram-se altos níveis de parasitismo sobre Spodoptera frugiperda em testes de laboratório. Entretanto, estes níveis não foram obtidos em condições de campo.Assim, para ampliar abasegenéticadas linhagens e determinar possíveisdiferenças naatividade e vigor, opresente estudo objetivou: (1) realizara introdução deuma nova linhagem de T. remus no Brasil, a partir da Venezuela; (2) comparar a biologia das duas linhagens (uma coletada em culturas de milho e introduzida e outra,criadapor cerca de 600 gerações em laboratório) por meio da avaliaçãode parâmetros reprodutivos etabela de vida de fecundidade; (3) comparar as respostas funcionais; (4) avaliar a qualidade das linhagens utilizando-se a atividadede voo e a emergência como critérios. A espécie foi confirmada por taxonomista e foi confirmadaa sua especificidade porS. frugiperda. As duas linhagens demostraram similaridade genética em padrõesde restrição para asregiões 16S e ITS1, embora a linhagem importada apresentasse qualidadesuperior. Osparâmetros de fecundidadedemostraram que alinhagem introduzida temum potencial de aumento populacional maior e éintrinsecamente mais agressiva. As duas linhagens apresentaram resposta funcional tipo III, comestabilizaçãodo parasitismo apartirde 200 ovosdohospedeiro. Infere-se que a criaçãoem laboratório de T. remus requer cuidados que limitem a perda do potencial para controle biológico. Avaliaçõessubsequentes de qualidade bem como ametodologia atual de criação precisam ser revistas.O presente estudo resultou numimportante aporte para auxiliar na implementação de programas de controle biológico para a lagarta-do-cartucho.Mass rearing in laboratory conditions affects the activity and vigor of parasitoids and consequentlytheir potentialas biological agents. In Brazil, Telenomus remus was introduced in 1986 and high levels of parasitism on Spodoptera frugiperda were obtained in laboratory tests. However, theselevels were notobtained infield conditions. Thus, tobroaden thegeneticbases of laboratorymaintained strains and to determine possible differencesin activity and vigor, this study aimed to:(1) introduce a new strain ofT. remus from Venezuela in Brazil;(2) compare the biology of two strains of T.remus (one collected in maizefields and introduced, and the other, maintained by over 600generations in laboratory conditions) by evaluatingreproductive parameters and fertilitylife tables, (3)compare the functional responses; (4) evaluate thequality ofthestrains using flightacitivity and emergence as criteria. The introduced species was confirmed by a taxonomist and their specificity for S. frugiperda was confirmed.Both strains demonstrated genetic similarity in restriction patterns for the 16S and ITS1 regions, although the imported strain showed superior quality as biological control agent. The fertility parameters showed thattheintroduced strain has a greater potentialfor population increaseand is inherently more aggressive. The two strains exhibited type IIIfunctional response, with stabilization of parasitism at 200 hosteggs. It is inferred that the laboratory rearingof T. remus requires efforts toprevent lossof biological control potential. Further evaluations of quality must be made and the currentmass rearing methodology should bere-designed. This study resulted in an important contribution that could aid the implementation of biological control programs for fall armyworm

Evaluation of the incidence of Aerotransported microorganisms by the horizontal rain of Salto del Tequendama (Cundinamarca, Colombia) on the microbiota of the adjacent soil to the fall of water

El proyecto de investigación consistió en caracterizar los microorganismos aerotransportados y sedimentados en el suelo, provenientes del río Bogotá por acción de la lluvia horizontal generada en la caída de agua del Salto del Tequendama y evaluar su posible incidencia sobre las comunidades microbianas y sobre el equilibrio microbiológico edáfico adyacente al Salto. Para lo anterior se muestrearon los componentes ambientales agua, aire y suelo en cinco (5) estaciones, tres (3) representativas del área de estudio y dos (2) como puntos de control aguas arriba y aguas abajo, aislando, identificando y empleando así, en ensayos antagónicos, seis (6) bacterias de interés por ser ubicuas, permitiendo detectar los cambios en su concentración, y/o su relación directa con la contaminación del río: Salmonella typhimurium, Shigella sp., Escherichia coli, Pseudomona aeruginosa, Proteus mirabilis y Staphylococcus aureus; y cinco (5) géneros fúngicos que por sus características macroscópicas y microscópicas se pudieron aislar e identificar: Fusarium sp., Penicillium sp., Verticillium sp., Trichoderma sp., y Aspergillus sp., que presentaron algún porcentaje de inhibición del crecimiento micelial al enfrentarse a las bacterias patógenas aerotransportadas. Igualmente, se reportaron las UFC de microorganismos encontradas en total por estación de muestreo para los 3 componentes ambientales, obteniendo una relación directa entre la distancia del Salto del Tequendama y la concentración microbiológica en el aire, que tiende a modificarse con la acción de variables meteorológicas, geomorfológicas y forestales en el área de estudio. Así mismo, al comparar dichas concentraciones en aire con las presentes en agua y suelo se evidencian los procesos de aerotransporte y sedimentación que soportan los microorganismos provenientes del río Bogotá. De la información anterior recolectada, procesada y analizada, se infirieron preliminarmente los posibles impactos ambientales sobre la microbiota del suelo y los efectos ambientales sobre el ecosistema de bosque de niebla y áreas con vocación agrícola, siendo el impacto más significativo la alteración de la productividad de ecosistemas y cultivos.The research proyect lied in characterizing the airborne and sedimented microorganisms on the soil, that comes from the Bogota river by action of the horizontal rain generated in the Salto del Tequendama waterfall and evaluating its possible effect on the microbial communities and the edaphic microbiological equilibrium adjacent to the Salto. For the above were sampled the environmental components water, air and soil in five (5) stations, three (3) representative the area of study, among them two (2) upstream and downstream as check point, isolating, identifying and using thus, in antagonistic trials, 6 bacterias of interest because of their ubiquity, allowing to detect the changes in their concentration, and their direct relationship with the river contamination: Salmonella typhimurium, Shigella sp., Escherichia coli, Pseudomona aeruginosa, Proteus mirabilis and Staphylococcus aureus; and 5 fungus that by their macroscopic and microscopic characteristics they could be isolated and identified: Fusarium sp., Penicillium sp., Verticillium sp., Trichoderma sp., and Aspergillus sp., that presented some percentage inhibition of the micelial growth to be faced with the airborne pathogenic bacterias. Also, it were reported the UFC of microorganisms found in total by sampling station for each of the 3 environmental components, getting a direct relationship between the distance of the Salto del Tequendama and microbial concentration in the air that tends to change with the action of forest, geomorphological and meteorological variables in the study area. Likewise, when comparing these concentrations in air with the present in water and soil are evident the aerotransport and the sedimentation processes that support the microorganisms from the Bogota river. From the above recollected information, processed and analyzed, were inferred preliminarily the possible environmental impacts on the microbiota of the soil and the environmental effects on the fog forest ecosystem and the agricultural coverage, being the most significant impact the alteration of ecosystems and crops productivity

Increase the consumer acceptance of insect based food in western European countries: A German and Dutch market study

Insects could prove to be a sustainable solution to feeding the growing human population. While insects are already consumed in many countries, the acceptance of insect-based foods is very low in Western European countries. This cross-border study examined how the acceptance of German and Dutch consumers can be increased through marketing measures. To this end, the main factors influencing the assumption were identified. Market research and expert interviews were then carried out. According to the results of this research, consumers prefer insect-based foods in which the insects are not visible. Preference is given to foods that taste like and resemble known products. Disgust and food neophobia were identified as the largest negative factors affecting acceptance. Factors such as the willingness to experiment and positive taste experiences when consuming insects for the first time have been identified as potential drivers for higher acceptance. Based on the results of this work, recommendations for operational marketing measures are discussed