La objeción de conciencia en los servicios de salud a menores de edad: una mirada desde su constitucional fundamentación jurídica

El objeto del presente estudio es revisar, desde la realidad constitucional, el escenario que se presenta cuando, tratándose de menores de edad, la decisión de sus legítimos representantes imposibilita al personal médico de las instituciones de salud pública en México a actuar conforme a los protocolos, ante la objeción de conciencia por credo o religión y, la imposibilidad de dar cumplimiento a las obligaciones del Estado como garante de los derechos de los niños cuando hay colisión de derechos

Intestinal passive absorption of hydrosoluble compounds by sparrows: effect of molecular size and luminal nutrients

We tested predictions that: (1) absorption of water-soluble probes decreases with increasing molecular size, consistent with movement through effective pores in epithelia, and (2) absorption of probes is enhanced when measured in the presence of luminal nutrients, as predicted for paracellular solvent drag. Probes (L-arabinose, L-rhamnose, perseitol, lactulose; MW 150.1–342.3 Da) were gavaged in nonanesthetized House sparrows (Passer domesticus), or injected into the pectoralis, and serially measured in plasma. Bioavailability was calculated as F=AUC by gavage/AUC by injection, where AUC is the area under the curve of plasma probe concentration vs. time. Consistent with predictions, F declined with probe size by 75% from the smallest to the largest probe, and absorption of probes increased by 40% in the presence of luminal glucose or food compared to a mannitol control. Absorption of water-soluble probes by sparrows is much higher than in humans, which is much higher than in rats. These differences seem mainly attributable to differences in paracellular solvent flux and less to differences in effective paracellular pore size.Fil: Chediack, Juan Gabriel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis. Universidad Nacional de San Luis. Facultad de Ciencias Físico Matemáticas y Naturales. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis; ArgentinaFil: Caviedes Vidal, Enrique Juan Raul. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis. Universidad Nacional de San Luis. Facultad de Ciencias Físico Matemáticas y Naturales. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis; ArgentinaFil: Fasulo, Sara Veronica. Universidad Nacional de San Luis; ArgentinaFil: Yamin, L. J.. Universidad Nacional de San Luis; ArgentinaFil: Karasov, William. University of Wisconsin; Estados Unido

Violent bear it away : 12 artists respond to violence

Francis Tarwater awoke to find himself laying in the wake of unspeakable violence. When he arose, he found himself transformed—a prophet. His eyes, at last burned clean, began to see the world differently. This revelation brought a new calling and soon, a message that he must deliver to those still sleeping in the darkness. Much like Tarwater, Flannery O’Connor’s bourgeoning prophet from the novel The Violent Bear It Away, each of the artists in this exhibition have been struck by an awareness of violence, the scars of which are seen etched on bodies, inflicted upon the landscape, and cut into our memories. They now stand on the other side of their own awakening, unable to turn back, compelled to respond. The specific violence examined by each artist varies greatly: from the substantial physical cost of war to the abstract metaphysical violence of representation/ memory; and from the oppressive action of human institutions to the sublimely terrifying forces of nature. Jeff Rau - curator; We also sincerely appreciate the work of graphic designer Kaylin Johnson who has helped to translate this project into its present book form so that its impact live on beyond the walls of the gallery. Kabul Road - photography - Luc Delahaye; Taliban - photography - Luc Delahaye; Longing - sculptures - Sonny Assu; untitled (Banda Aceh tsunami - photography - Ira Lippke; Beautiful Terrible - film - Amanda Hamilton; If Your Daughter Ever - drawing - Nery Gabriel Lemus; Until the Day Breaks and the Shadows Flee - drawing - Nery Gabriel Lemus untitled (DV Series #’s 1-9) - drawing - Nery Gabriel Lemus; Backpack (Green) - soft sculpture - Margarita Cabrera; Cleaning Supplies - soft sculpture - Margarita Cabrera; Reconstructive Memory - drawing, video - Jes Schrom; 99 Names of God (AK-47 exploded view) - drawing - Sandow Birk & Elyse Pignolet; 99 Names of God (U.S.A.) - drawing - Sandow Birk & Elyse Pignolet; Geometries II - media - Samira Yamin; Geometries III - media - Samira Yamin; Geometries VI - media - Samira Yamin; Geometries V - media - Samira Yamin; Does Not Play Well With Others - painting - André Goeritz; It’s an Odd Fickle Cross - painting - André Goeritz; Ignore the Smoke and Smile - painting - André Goeritz; Wager - painting - André Goeritz; True Light Dynamic Image: For healing & unity in the world of art - fiber print - Lia Chavez; True Light Dynamic Image: For the future of performance art, 2:00 - 3:20am - fiber print - Lia Chavez; True Light: HEAL US/ HEAL U.S - print - Lia Chavez; Portraits of Tuol Sleng Genocide Museum - photography - Binh Danh; Iridescence of Life - photography - Binh Danh;https://digitalcommons.biola.edu/exhibit-catalogs/1007/thumbnail.jp

Effect of 12 mg vs 6 mg of Dexamethasone on the Number of Days Alive Without Life Support in Adults With COVID-19 and Severe Hypoxemia: The COVID STEROID 2 Randomized Trial.

Importance A daily dose with 6 mg of dexamethasone is recommended for up to 10 days in patients with severe and critical COVID-19, but a higher dose may benefit those with more severe disease. Objective To assess the effects of 12 mg/d vs 6 mg/d of dexamethasone in patients with COVID-19 and severe hypoxemia. Design, Setting, and Participants A multicenter, randomized clinical trial was conducted between August 2020 and May 2021 at 26 hospitals in Europe and India and included 1000 adults with confirmed COVID-19 requiring at least 10 L/min of oxygen or mechanical ventilation. End of 90-day follow-up was on August 19, 2021. Interventions Patients were randomized 1:1 to 12 mg/d of intravenous dexamethasone (n = 503) or 6 mg/d of intravenous dexamethasone (n = 497) for up to 10 days. Main Outcomes and Measures The primary outcome was the number of days alive without life support (invasive mechanical ventilation, circulatory support, or kidney replacement therapy) at 28 days and was adjusted for stratification variables. Of the 8 prespecified secondary outcomes, 5 are included in this analysis (the number of days alive without life support at 90 days, the number of days alive out of the hospital at 90 days, mortality at 28 days and at 90 days, and ≥1 serious adverse reactions at 28 days). Results Of the 1000 randomized patients, 982 were included (median age, 65 [IQR, 55-73] years; 305 [31%] women) and primary outcome data were available for 971 (491 in the 12 mg of dexamethasone group and 480 in the 6 mg of dexamethasone group). The median number of days alive without life support was 22.0 days (IQR, 6.0-28.0 days) in the 12 mg of dexamethasone group and 20.5 days (IQR, 4.0-28.0 days) in the 6 mg of dexamethasone group (adjusted mean difference, 1.3 days [95% CI, 0-2.6 days]; P = .07). Mortality at 28 days was 27.1% in the 12 mg of dexamethasone group vs 32.3% in the 6 mg of dexamethasone group (adjusted relative risk, 0.86 [99% CI, 0.68-1.08]). Mortality at 90 days was 32.0% in the 12 mg of dexamethasone group vs 37.7% in the 6 mg of dexamethasone group (adjusted relative risk, 0.87 [99% CI, 0.70-1.07]). Serious adverse reactions, including septic shock and invasive fungal infections, occurred in 11.3% in the 12 mg of dexamethasone group vs 13.4% in the 6 mg of dexamethasone group (adjusted relative risk, 0.83 [99% CI, 0.54-1.29]). Conclusions and Relevance Among patients with COVID-19 and severe hypoxemia, 12 mg/d of dexamethasone compared with 6 mg/d of dexamethasone did not result in statistically significantly more days alive without life support at 28 days. However, the trial may have been underpowered to identify a significant difference. Trial Registration ClinicalTrials.gov Identifier: NCT04509973 and ctri.nic.in Identifier: CTRI/2020/10/028731