Organizing health care: an ethical perspective

Indexación: Web of Science; Scielo.Health Care at population level is a complex problem. Having this in mind, the purpose of this paper is to focus on the goods that are ethically relevant in the process of caring for health at this level. We briefly analyze some of the Chilean health statistics that, although they show important improvements along the years, demonstrate that certain conditions are to be deemed as inadequate by both healthcare providers and patients. Ethics is a central component to determine how to structure and organize health care systems and how they should operate. We emphasize Human Dignity as an ethical corner stone of the Health Care System, along with other important values such as Justice and Humanization, under the scope of the Ends of Medicine, and other components such as technical competence of providers and the financing of the whole process. We conclude that as far as a health care system is organized in a way that medical practice is well ordered, primarily and fundamentally according the Ends of Medicine and the good of persons, such a health care system is ethically adequate.http://ref.scielo.org/9bt3z

Algunas amenazas actuales a la confidencialidad en medicina

Social, technical and legal conditions of the current practice of medicine make it necessary to insist on certain actions and circumstances that may jeopardize the confidentiality of information, offered by patients to their health providers. Therefore, some effects of the current Chilean law are analyzed in this respect, regarding access to data from the clinical record of a patient. Also, the risks of putting certain data on social networking sites are analyzed, as well as some of its effects on clinical practice. The reasons because of mandatory reporting of diseases, meaning danger to public health, is allowed, are mentioned. We also discuss the difficulties involved in managing the results of preventative health screenings and its knowledge by third parties, as well as some possible violations of personal privacy, regarding dissemination of some people health information and its further mention or figuration in mass media. We conclude that it is a must for both physicians and other health team members, to safeguard confidentiality of data to which they have had access, as well as the need to know the relevant law, in order to respect human dignity of patients, each one as a person. We address the attention to the possibility that, practicing in a different way, it could endanger the reliability of clinical records, also impairing the quality of people’s health care. (Rev Med Chile 2015; 143: 358-366) Key words: Access to Information; Confidentiality; Information Dissemination; Medical Records; Social Networkin

Respecting patient intimacy

Indexación: Web of Science; Scielo.Transparency as a general rule for all our professional acts casts doubts about the statement of the Hippocratic Oath that says "Whatever I see or hear in the lives of my patients, I will keep secret, as considering all such things to be private". Medical secrecy protects the intimacy of patients, who reveal to their physicians their most hidden secrets aiming to recover their health. Therefore, physicians should receive those secrets with reverence and care, as servers and not as their owners. The values associated with the respect for personal intimacy are the anthropological basis of medical confidentiality. A medical act is performed by definition between two equally honorable individuals. Therefore, the professional honors the trust of his patient, maintaining strict confidence of what is revealed. Therefore, medical secrecy must be strengthened rather than weakened, pursuing common wealth and dignity.http://ref.scielo.org/cf3mx

An ethical and medical perspective on the voluntary termination of pregnancy

Indexación: Web of Science; Scielo.“Voluntary termination of pregnancy” can refer to actions intended to make a delivery easier, to provide medical care to the fetus, or to protect the life or health of the mother. All of these are proper medical actions and are by definition voluntary. In other cases, the expression denotes a termination of pregnancy before the embryo or fetus is viable, leading to the death of the latter. This action is constitutive of abortion under current Chilean law. The product of conception living being, who develops in the womb during pregnancy, is an individual, both in the sense that it is different from its mother and father, and in that it is a biological individual. For these reasons, such living being constitutes another patient in itself. The free and voluntary medical action of health care professionals is geared toward disease prevention or health recovery and medical terminations of pregnancy, as distinguished from abortion, are not criminalized in our country. Therefore, the idea of legalizing abortive terminations of pregnancy so that they become “legitimate health care services” is a call to the medical community, which should engage in a debate about the meaning and consequences of an eventual mandate of the State that would be at odds with the Hippocratic tradition. A woman can feel that her health is at risk due to her pregnancy, and she certainly has the right to request medical help. Health professionals should care both at the medical and emotional level for all those who require their services, especially when such persons are undergoing situations of vulnerability and distress. When requested to perform an abortion, the physician faces dilemmas that should be addressed in line with the present state of the medical art.http://ref.scielo.org/c4ypf

A Neutrophil Timer Coordinates Immune Defense and Vascular Protection

Neutrophils eliminate pathogens efficiently but can inflict severe damage to the host if they over-activate within blood vessels. It is unclear how immunity solves the dilemma of mounting an efficient anti-microbial defense while preserving vascular health. Here, we identify a neutrophil-intrinsic program that enabled both. The gene Bmal1 regulated expression of the chemokine CXCL2 to induce chemokine receptor CXCR2-dependent diurnal changes in the transcriptional and migratory properties of circulating neutrophils. These diurnal alterations, referred to as neutrophil aging, were antagonized by CXCR4 (C-X-C chemokine receptor type 4) and regulated the outer topology of neutrophils to favor homeostatic egress from blood vessels at night, resulting in boosted anti-microbial activity in tissues. Mice engineered for constitutive neutrophil aging became resistant to infection, but the persistence of intravascular aged neutrophils predisposed them to thrombo-inflammation and death. Thus, diurnal compartmentalization of neutrophils, driven by an internal timer, coordinates immune defense and vascular protection.We thank all members of the Hidalgo Lab for discussion and insightful comments; J.M. Ligos, R. Nieto, and M. Viton for help with sorting and cytometric analyses; I. Ortega and E. Santos for animal husbandry; D. Rico, M.J. Gomez, C. Torroja, and F. Sanchez-Cabo for insightful comments and help with transcriptomic analyses; V. Labrador, E. Arza, A.M. Santos, and the Microscopy Unit of the CNIC for help with microscopy; S. Aznar-Benitah, U. Albrecht, Q.-J. Meng, B. Staels, and H. Duez for the generous gift of mice; J.A. Enriquez and J. Avila for scientific insights; and J.M. Garcia and A. Diez de la Cortina for art. This study was supported by Intramural grants from A* STAR to L.G.N., BES-2013-065550 to J.M.A., BES-2010-032828 to M.C.-A, and JCI-2012-14147 to L.A.W (all from Ministerio de Economia, Industria y Competitividad; MEIC). Additional MEIC grants were SAF2014-61993-EXP to C.L.-R.; SAF2015-68632-R to M.A.M. and SAF-2013-42920R and SAF2016-79040Rto D.S. D.S. also received 635122-PROCROP H2020 from the European Commission and ERC CoG 725091 from the European Research Council (ERC). ERC AdG 692511 PROVASC from the ERC and SFB1123-A1 from the Deutsche Forschungsgemeinschaft were given to C.W.; MHA VD1.2/81Z1600212 from the German Center for Cardiovascular Research (DZHK) was given to C.W. and O.S.; SFB1123-A6 was given to O.S.; SFB914-B08 was given to O.S. and C.W.; and INST 211/604-2, ZA 428/12-1, and ZA 428/13-1 were given to A.Z. This study was also supported by PI12/00494 from Fondo de Investigaciones Sanitarias (FIS) to C.M.; PI13/01979, Cardiovascular Network grant RD 12/0042/0054, and CIBERCV to B.I.; SAF2015-65607-R, SAF2013-49662-EXP, and PCIN-2014-103 from MEIC; and co-funding by Fondo Europeo de Desarrollo Regional (FEDER) to A.H. The CNIC is supported by the MEIC and the Pro CNIC Foundation and is a Severo Ochoa Center of Excellence (MEIC award SEV-2015-0505).S

Orogenias paleozoicas en los Andes de Argentina y Chile y en la Península Antártica

Congreso Geológico Argentino (20º. 2017. San Miguel de Tucumán, Argentina). Simposio de Téctonica pre-andinaDurante el Neoproterozoico y Paleozoico, los Andes de Argentina y Chile, y desde fines del Paleozoico también la Península Antártica, formaron parte del margen SO de Gondwana. Durante este tiempo se acrecionaron a dicho margen varios fragmentos continentales de tamaño y aloctonía variable; denominados de N a S: Antofalla, Chi-Cu, Patagonia Occidental y Antártida Occidental. Estos fragmentos formaban parte de placas litosféricas, en ocasiones divididas en subplacas. La colisión de dichos fragmentos continentales con Gondwana y una última subducción bajo dicho margen, dieron lugar a 6 orogenias de extensión temporal y espacial limitada.Instituto Geológico y Minero de España, EspañaDepartamento de Geología, Universidad de Oviedo, EspañaUniversidad de Río Negro, ArgentinaServicio Geológico y Minero Argentino, ArgentinaInstituto De Bio y Geociencias Del NOA, Consejo Nacional de Investigaciones Científicas y Técnicas, ArgentinaInstituto De Bio y Geociencias Del NOA, Universidad Nacional de Salta, ArgentinaDepartamento de Geodinámica, Universidad del País Vasco, EspañaFacultad de Geología, Universidad de Barcelona, EspañaDepartamento de Geología, Universidad de Chile, ChileUniversidad Andrés Bello, ChileUnidad de Tectónica, Consejo Nacional de Investigaciones Científicas y Técnicas, ArgentinaFacultad de Geología, Universidad de Buenos Aires, ArgentinaÁrea de Geología, Universidad Rey Juan Carlos, EspañaUniversidad de Salta, ArgentinaInstituto de Investigación en Paleobiología y Geología, Universidad de Río Negro, ArgentinaInstituto de Investigación en Paleobiología y Geología, Consejo Nacional de Investigaciones Científicas y Técnicas, ArgentinaCentro de Investigaciones Geológicas, Universidad de La Plata, ArgentinaUniversidad de San Juan, ArgentinaPeer reviewe

Producción de semillas de alfalfa (Medicago sativa) en el VBRC. Mitigación de la contaminación con transgenes

La contaminación de las semillas de alfalfa con variedades transgénicas o genéticamente modificadas (GM) preocupa a los semilleros instalados en el Valle Bonaerense del río Colorado (VBRC). En función de los últimos diagnósticos realizados, resultará muy difícil lograr que las semillas se encuentren completamente libres de impurezas GM. En este informe se describen las posibles fuentes de contaminación, para delinear estrategias de manejo a nivel de lote y de gestión a escala predial para evitar o minimizar la contaminación con transgenes. Se propone emplear un método de detección fenotípico/proteico específico desarrollado en el INTA Hilario Ascasubi para realizar controles de contaminación en diferentes instancias del entramado productivo comercial. El enfoque de organización por “barrios de producción” requiere una participación colaborativa de los actores de la cadena, pero a su vez presenta una oportunidad única para la valorización de la producción generada en la región. Se recomienda el establecimiento de umbrales de tolerancia de contaminantes GM para la producción de semilla de alfalfa convencional.EEA Hilario AscasubiFil: Renzi Pugni, Juan Pablo. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Hilario Ascasubi; ArgentinaFil: Renzi Pugni, Juan Pablo. Universidad Nacional del Sur. Departamento de Agronomía; ArgentinaFil: Garcia, Flavia Carina. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Hilario Ascasubi; ArgentinaFil: Crisanti, Paola Andrea. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Hilario Ascasubi; ArgentinaFil: Rodriguez, Graciela Adriana. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Hilario Ascasubi; ArgentinaFil: Bruna, Matias Nicolas. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Hilario Ascasubi; ArgentinaFil: Quintana, Matias. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Hilario Ascasubi; ArgentinaFil: Reinoso, Omar Juan. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Hilario Ascasubi; ArgentinaFil: Vanzolini, Juan Ignacio. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Hilario Ascasubi; ArgentinaFil: Vanzolini, Juan Ignacio. Universidad Nacional del Sur. Departamento de Agronomía; ArgentinaFil: Coito, Carlos. Southern Seeds S.A.; ArgentinaFil: Ancia, V. Southern Seeds S.A.; ArgentinaFil: Guasch, P. Guasch Semillas; ArgentinaFil: Arditti, S. Guasch Semillas; ArgentinaFil: Gaido, E. Municipalidad de Patagones; ArgentinaFil: Cantamutto, Miguel Angel. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Hilario Ascasubi; ArgentinaFil: Cantamutto, Miguel Angel. Universidad Nacional del Sur. Departamento de Agronomía; ArgentinaFil: Cantamutto, Miguel Angel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Centro de Recursos Naturales Renovables de la Zona Semiarida; ArgentinaFil: Cantamutto, Miguel Angel. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiarida; Argentin

A Neutrophil Timer Coordinates Immune Defense and Vascular Protection

Neutrophils eliminate pathogens efficiently but can inflict severe damage to the host if they over-activate within blood vessels. It is unclear how immunity solves the dilemma of mounting an efficient anti-microbial defense while preserving vascular health. Here, we identify a neutrophil-intrinsic program that enabled both. The gene Bmal1 regulated expression of the chemokine CXCL2 to induce chemokine receptor CXCR2-dependent diurnal changes in the transcriptional and migratory properties of circulating neutrophils. These diurnal alterations, referred to as neutrophil aging, were antagonized by CXCR4 (C-X-C chemokine receptor type 4) and regulated the outer topology of neutrophils to favor homeostatic egress from blood vessels at night, resulting in boosted anti-microbial activity in tissues. Mice engineered for constitutive neutrophil aging became resistant to infection, but the persistence of intravascular aged neutrophils predisposed them to thrombo-inflammation and death. Thus, diurnal compartmentalization of neutrophils, driven by an internal timer, coordinates immune defense and vascular protection. Neutrophils display circadian oscillations in numbers and phenotype in the circulation. Adrover and colleagues now identify the molecular regulators of neutrophil aging and show that genetic disruption of this process has major consequences in immune cell trafficking, anti-microbial defense, and vascular health.This study was supported by Intramural grants from A∗STAR to L.G.N., BES-2013-065550 to J.M.A., BES-2010-032828 to M.C.-A, and JCI-2012-14147 to L.A.W (all from Ministerio de Economía, Industria y Competitividad; MEIC). Additional MEIC grants were SAF2014-61993-EXP to C.L.-R.; SAF2015-68632-R to M.A.M. and SAF-2013-42920R and SAF2016-79040Rto D.S. D.S. also received 635122-PROCROP H2020 from the European Commission and ERC CoG 725091 from the European Research Council (ERC). ERC AdG 692511 PROVASC from the ERC and SFB1123-A1 from the Deutsche Forschungsgemeinschaft were given to C.W.; MHA VD1.2/81Z1600212 from the German Center for Cardiovascular Research (DZHK) was given to C.W. and O.S.; SFB1123-A6 was given to O.S.; SFB914-B08 was given to O.S. and C.W.; and INST 211/604-2, ZA 428/12-1, and ZA 428/13-1 were given to A.Z. This study was also supported by PI12/00494 from Fondo de Investigaciones Sanitarias (FIS) to C.M.; PI13/01979, Cardiovascular Network grant RD 12/0042/0054, and CIBERCV to B.I.; SAF2015-65607-R, SAF2013-49662-EXP, and PCIN-2014-103 from MEIC; and co-funding by Fondo Europeo de Desarrollo Regional (FEDER) to A.H. The CNIC is supported by the MEIC and the Pro CNIC Foundation and is a Severo Ochoa Center of Excellence (MEIC award SEV-2015-0505)

The Role of Eye Gaze in Security and Privacy Applications: Survey and Future HCI Research Directions

For the past 20 years, researchers have investigated the use of eye tracking in security applications. We present a holistic view on gaze-based security applications. In particular, we canvassed the literature and classify the utility of gaze in security applications into a) authentication, b) privacy protection, and c) gaze monitoring during security critical tasks. This allows us to chart several research directions, most importantly 1) conducting field studies of implicit and explicit gaze-based authentication due to recent advances in eye tracking, 2) research on gaze-based privacy protection and gaze monitoring in security critical tasks which are under-investigated yet very promising areas, and 3) understanding the privacy implications of pervasive eye tracking. We discuss the most promising opportunities and most pressing challenges of eye tracking for security that will shape research in gaze-based security applications for the next decade