Improvement of Inter-Professional Collaborative Work Abilities in Mexican Medical and Nursing Students: A Longitudinal Study

Background: Inter-professional and interpersonal relationships in collaborative work environments can prove to be critical elements in healthcare practice. When implementers fail to understand the importance of a collaborative perspective, this can lead to communication problems which ultimately harm the users. Objectives: To improve the inter-professional collaborative work skills of Mexican students in their first year of medical and nursing degrees through the use of a training program geared toward development of interpersonal skills and interdisciplinary work. Results: The control group of medical students showed a deterioration in the development of collaborative work skills (p < 0.01), whereas in the experimental group this deterioration was not present. In the experimental group of nursing students, a significant increase in the development of collaborative work skills (p < 0.05) was observed. The differences were clearly due to the professional area of study (p < 0.001). Conclusion: There are differences in collaborative work skill development among different professional areas. These differences can be reduced through the implementation of a program aimed at developing collaborative work and interpersonal skills in the early stages of training.This study was supported by the Rioja Salud Foundation (FRS), Spain, and by a grant from the Instituto de Salud Carlos III (Pi16/01934), co-financed by Operational Program of the European Regional Development Fund (FEDER-La Rioja) in Spain (6FRS-ABC-012)

Urinary tract physiological conditions promote ciprofloxacin resistance in low-level-quinolone-resistant Escherichia coli

Escherichia coli isolates carrying chromosomally encoded low-level-quinolone-resistant (LLQR) determinants are frequently found in urinary tract infections (UTIs). LLQR mutations are considered the first step in the evolutionary pathway producing high-level fluoroquinolone resistance. Therefore, their evolution and dissemination might influence the outcome of fluoroquinolone treatments of UTI. Previous studies support the notion that low urine pH decreases susceptibility to ciprofloxacin (CIP) in E. coli. However, the effect of the urinary tract physiological parameters on the activity of ciprofloxacin against LLQR E. coli strains has received little attention. We have studied the activity of ciprofloxacin under physiological urinary tract conditions against a set of well-characterized isogenic E. coli derivatives carrying the most prevalent chromosomal mutations (ΔmarR, gyrA-S83L, gyrA-D87N, and parC-S80R and some combinations). The results presented here demonstrate that all the LLQR strains studied became resistant to ciprofloxacin (according to CLSI guidelines) under physiological conditions whereas the control strain lacking LLQR mutations did not. Moreover, the survival of some LLQR E. coli variants increased up to 100-fold after challenge with a high concentration of ciprofloxacin under UTI conditions compared to the results seen with Mueller-Hinton broth. These selective conditions could explain the high prevalence of LLQR mutations in E. coli. Furthermore, our data strongly suggest that recommended methods for MIC determination produce poor estimations of CIP activity against LLQR E. coli in UTIs.Fondo de Investigación Sanitaria PI13/0006

Genetic analysis of pre-Columbian human remains from Lower Magdalena suggests a migratory route and matrilineal genetic continuity in Northern South America

El análisis del ADN en restos de poblaciones prehispánicas ha permitido aproximarse al origen genético de una proporción importante de los habitantes de la actual Colombia. Los resultados arqueológicos de la tradición de Malambo, cuyo origen se remonta a 3.000 años A.P. en el bajo Magdalena, se complementaron con estudios genéticos de cuatro individuos asociados con esta población. Para ello se extrajo ADN de muestras de dientes y huesos. El ADN extraído se purificó y se amplificó por PCR para su posterior secuenciación y análisis filogenético. El haplogroupo B2j se identificó y se caracterizó mediante la mutación G16361A, así como la deleción de 9pb y las mutaciones diagnósticas del haplogrupo B. Este mismo haplogrupo fue descrito recientemente en un individuo en Venezuela, lo que sugiere la filiación genética matrilineal y su continuidad en el norte de SuraméricaDNA analysis in pre-Hispanic populations remains has allowed approaching the genetic origins of inhabitants in present-day Colombia. In this work, we complemented the archaeological results on the Malambo tradition, originated 3000 years B.P. in Lower Magdalena, with genetic studies of bone remains of four individuals associated with this population. We extracted DNA from bone samples and purified and amplified them by PCR for further sequencing and phylogenetic analysis. We identified the B2j haplogroup in all individuals as characterized by a G16361A mutation, as well as a 9-pb deletion and diagnostic mutations of haplogroup B. This same haplogroup was recently described in an individual in Venezuela suggesting genetic maternal filiation and continuity in northern South AmericaN/

Calculation of Response matrix of a BSS with 6LiI scintillator

The response matrix of a Bonner sphere spectrometer was calculated using MCNP 4C and MCNPX 2.4.0 codes. As thermal neutron detector a 0.4 cm £; 0.4 cm 6LiI which is located at the center of a set of polyethylene spheres. The response was calculated for 0, 2, 3, 5, 8, 10, and 12 inches-diameter polyethylene spheres for neutrons whose energy goes from 2.50E(-8) to 100 MeV. The response matrix was calculated for 23 neutron energies, the response functions were energy-interpolated to 51 neutron energies and were compared with a matrix response reported in the literature, in this comparison both response matrices are in agreement. The main differences were found in the bare detector and are attributed to the irradiation conditions and cross sections, for the other detectors the differences are due to the cross sections libraries

Environmental Assessment of Olive Mill Solid Waste Valorization via Anaerobic Digestion Versus Olive Pomace Oil Extraction

Anaerobic digestion is a promising alternative to valorize agrifood wastes, which is gaining interest under an environmental sustainability overview. The present research aimed to compare anaerobic digestion with olive pomace oil extraction, by using life cycle assessment, as alternatives for the valorization of the olive mill solid waste generated in the centrifugation process with a two-outlet decanter from oil mills. In the case of olive pomace oil extraction, two cases were defined depending on the type of fuel used for drying the wet pomace before the extraction: natural gas or a fraction of the generated extracted pomace. The anaerobic digestion alternative consisted of the production of biogas from the olive mill solid waste, heat and electricity cogeneration by the combustion of the generated biogas, and composting of the anaerobic digestate. The life cycle assessment showed that anaerobic digestion was the best alternative, with a global environmental impact reduction of 88.1 and 85.9% respect to crude olive pomace oil extraction using natural gas and extracted pomace, respectively, as fuel.Ministerio de Economía y Competitividad CTM2014-55095-

Generalized synchronization in relay systems with instantaneous coupling

We demonstrate the existence of generalized synchronization in systems that act as mediators between two dynamical units that, in turn, show complete synchronization with each other. These are the so-called relay systems. Specifically, we analyze the Lyapunov spectrum of the full system to elucidate when complete and generalized synchronization appear. We show that once a critical coupling strength is achieved, complete synchronization emerges between the systems to be synchronized, and at the same point, generalized synchronization with the relay system also arises. Next, we use two nonlinear measures based on the distance between phase-space neighbors to quantify the generalized synchronization in discretized time series. Finally, we experimentally show the robustness of the phenomenon and of the theoretical tools here proposed to characterize it

Insuficiencia mitral de etiología poco usual

We communicate a case of a 8-month breastfed sent by her pediatrician to cardiology consultation after finding a heart murmur on physical examination. Echocardiography showed left ventricle dilatation with severe mitral regurgitation due to restricted posterior leaflet movement, together with a diastolic flow on pulmonary artery suggestive of anomaly of coronary arterial origin. CT coronary angiogram confirmed diagnosis. The patient underwent surgery with left coronary artery reimplantation on ascending aorta, mitral valve plication, and posterior leaflet closure of pseudo-cleft of posterior leaflet evidenced during intervention, with good results.Se presenta un caso de lactante de 8 meses, que fue enviado por su pediatra para una consulta cardiovascular después de auscultar un soplo en el examen físico. La ecocardiografía demostró el ventrículo izquierdo dilatado con regurgitación mitral grave debido a movimiento restringido de la valva posterior, junto a un flujo diastólico en la arteria pulmonar sugestivo de una anomalía con origen en la arteria coronaria. La angiografía coronaria por tomografía computarizada confirmó el diagnóstico. El paciente fue sometido a cirugía de reimplante de la arteria coronaria izquierda a la aorta ascendente, más plicatura de valva mitral y cierre de la hendidura de la valva posterior evidenciado ya durante la intervención buenos resultados

Multicenter evaluation of BioFire JI panel related to improved microbiological diagnostics on acute osteoarticular infections

Microbiological diagnosis of osteoarticular infections (OI) is crucial for a successful treatment. A prospective multicenter study including 262 synovial fluids with suspicion of acute OI was performed between July 2021 and October of 2022. BioFire Joint Infection Panel multiplex-PCR test was performed and results were compared with conventional cultures of synovial fluid specimens. In total, 136 microorganisms were detected, and fourteen samples were positive for more than one microorganism. In monomicrobial infections (n = 87) agreement with culture was 69%. In 26 samples, the multiplex PCR yield an additional positive result when culture result was negative. It helped in the detection of fastidious microorganisms as K. kingae and N. gonorrhoeae. This multiplex PCR has proven to be a useful technique that can be used for patients with high suspicion of acute OI in a rapid and automated manner

Improvement of Inter-Professional Collaborative Work Abilities in Mexican Medical and Nursing Students: A Longitudinal Study

Background: Inter-professional and interpersonal relationships in collaborative work environments can prove to be critical elements in healthcare practice. When implementers fail to understand the importance of a collaborative perspective, this can lead to communication problems which ultimately harm the users.Objectives: To improve the inter-professional collaborative work skills of Mexican students in their first year of medical and nursing degrees through the use of a training program geared toward development of interpersonal skills and interdisciplinary work.Methods: The sample was composed of 162 students (62 males and 99 females) from the School of Healthcare Sciences of the Autonomous University of Coahuila, Mexico. The main measures used were the Jefferson Scale of Empathy (JSE); the Jefferson Scale of Attitudes toward Inter-Professional Collaborative Work between Medical and Nursing Professionals (JSAPNC); and the Jefferson Scale of Lifelong Learning (JeffSPLL). The entire sample was divided into two groups (experimental and control groups). Both groups attended an extra-curricular program using a coaching methodology. In the first case the topic focused on attitudes toward inter-professional collaborative work. In the second case, the program focused on addiction. Both programs ran for 4 months. Psychometric instruments were applied at the beginning and at the end of both programs. After analyzing the reliability of the instruments, an ANOVA test was performed.Results: The control group of medical students showed a deterioration in the development of collaborative work skills (p &lt; 0.01), whereas in the experimental group this deterioration was not present. In the experimental group of nursing students, a significant increase in the development of collaborative work skills (p &lt; 0.05) was observed. The differences were clearly due to the professional area of study (p &lt; 0.001).Conclusion: There are differences in collaborative work skill development among different professional areas. These differences can be reduced through the implementation of a program aimed at developing collaborative work and interpersonal skills in the early stages of training

Glutaminase and MMP-9 downregulation in cortex and hippocampus of LPA1 receptor null mice correlate with altered dendritic spine plasticity

Lysophosphatidic acid (LPA) is an extracellular lipid mediator that regulates nervous system development and functions acting through G protein-coupled receptors (GPCRs). Here we explore the crosstalk between LPA1 receptor and glutamatergic transmission by examining expression of glutaminase (GA) isoforms in different brain areas isolated from wild-type (WT) and KOLPA1 mice. Silencing of LPA1 receptor induced a severe down-regulation of Gls-encoded long glutaminase protein variant (KGA) (glutaminase gene encoding the kidney-type isoforms, GLS) protein expression in several brain regions, particularly in brain cortex and hippocampus. Immunohistochemical assessment of protein levels for the second type of glutaminase (GA) isoform, glutaminase gene encoding the liver-type isoforms (GLS2), did not detect substantial differences with regard to WT animals. The regional mRNA levels of GLS were determined by real time RT-PCR and did not show significant variations, except for prefrontal and motor cortex values which clearly diminished in KO mice. Total GA activity was also significantly reduced in prefrontal and motor cortex, but remained essentially unchanged in the hippocampus and rest of brain regions examined, suggesting activation of genetic compensatory mechanisms and/or post-translational modifications to compensate for KGA protein deficit. Remarkably, Golgi staining of hippocampal regions showed an altered morphology of glutamatergic pyramidal cells dendritic spines towards a less mature filopodia-like phenotype, as compared with WT littermates. This structural change correlated with a strong decrease of active matrix-metalloproteinase (MMP) 9 in cerebral cortex and hippocampus of KOLPA1 mice. Taken together, these results demonstrate that LPA signaling through LPA1 influence expression of the main isoenzyme of glutamate biosynthesis with strong repercussions on dendritic spines maturation, which may partially explain the cognitive and learning defects previously reported for this colony of KOLPA1 mice