Search

ABSTRACT Objective: Many biologic agents cause some degree of immunosuppression, which can increase the risk of reactivation of tuberculosis infection (TBI). This risk is variable between individual biologics. We aimed to assess current (and recommended) clinical practice of TBI screening and treatment among patients initiating treatment with biologic agents. Methods: An online questionnaire was distributed via email to members of the Global Tuberculosis Network and associated professional organisations to seek insights into the screening for and treatment of TBI in patients treated with biologics. Results: A total of 163 respondents in 27 countries answered at least one question. For all biologics described in the questionnaire, respondents advised increasing screening relative to current practice. Observed and supported TBI screening rates in patients treated with TNF-a inhibitors were high, especially for older TNF-a inhibitors. Most participants supported TBI screening in patients treated with B- or T-cell inhibitors but not in those treated with interleukin inhibitors. Guideline awareness was higher for TNF-a inhibitors than for other biologic classes (79% vs. 34%). Conclusions: Although respondents stated that TBI screening rates are lower than what they consider ideal, there was a tendency to recommend TBI screening in patients treated with biologics not known to be associated with an increased risk of TBI. As a result, there is a potential risk of over-screening and over-treatment of TBI, potentially causing harm, in patients treated with biologics other than TNF-a inhibitors. There is a need to research the risk of TBI associated with biologics and for guidelines to address the spectrum of TBI risk across all types of biologics.

Durante los Siglos de Oro, la relación hipertextual que existe entre las imitaciones y continuaciones de La Celestina y su modelo se puede describir en términos architextuales. En cambio, en la época contemporánea se ha desarrollado un imaginario celestinesco aún más complejo por ser transmediático. En este trabajo se analizarán las modalidades propiamente novelescas de las reescrituras celestinescas contemporáneas (1990-2023) a la luz del concepto de serialidad: cada texto de tema celestinesco producido y leído en la actualidad moviliza lógicas de personajes, así como dispositivos paratextuales, intertextuales y metaficcionales que crean un verdadero pacto de lectura celestinesco, basado en una enciclopedia particular del lector. Después de un examen panorámico de las prácticas de serialidad evidenciadas en las reescrituras de la Tragicomedia de Calisto y Melibea publicadas desde 1990, este estudio examinará cómo se articulan dichas prácticas en la novela La mujer de la escalera (2018), de Pedro González Moreno.

La región latinoamericana ha sido pionera en la implementación del etiquetado frontal de advertencia nutricional (EFAN), mismo que ha demostrado su eficacia y efectividad para identificar correctamente cuando un producto contiene cantidades excesivas de nutrientes asociados a Enfermedades no transmisibles (ENT). Sin embargo, ningún país del Sistema de la Integración Centroamericana (SICA); que incluye a Belice, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panamá y República Dominicana, lo ha adoptado. Por esta razón, el Instituto de Nutrición de Centro América y Panamá, convocó a un grupo de expertos de la academia y la sociedad civil con el objetivo de establecer una postura técnica, basada en la mejor evidencia científica, en relación al etiquetado frontal para los nutrientes críticos de alimentos y bebidas pre- envasados en la región centroamericana. Se presenta evidencia específica de la región del SICA que demuestran la superioridad del EFAN frente a otros etiquetados como las Guías Diarias de Alimentación (GDA), el semáforo y el Nutriscore para seleccionar opciones más saludables. Dentro del marco de los derechos de la niñez y de los consumidores, se brindan argumentos y se hace un llamado a los gobiernos para la pronta adopción del EFAN como una política costo-efectiva para la prevención de ENT. Además, se proveen recomendaciones para su monitoreo y evaluación, así como recomendaciones de otras políticas costo-efectivas como la regulación de la publicidad de alimentos no saludables dirigido a la niñez y adolescencia, entre otros, para la prevención de las ENT y la creación de ambientes y sistemas alimentarios más saludables y sostenibles.

The ethos of the journalist is based on his representations of the public space. Updated in the discourse, they participate in the construction of citizen identity. This is what we show through an enunciative analysis of editorials from the daily “Le Monde” during the Covid-19 pandemic crisis. The analysis highlights an increasingly marked identity divide during the crisis.

Resumo A saúde planetária vem se consolidando como área transdisciplinar do conhecimento, fundamentada na caracterização e mitigação dos impactos antropogênicos sobre a saúde do ser humano e dos sistemas terrestres. O estilo de vida em sociedades capitalistas impulsiona a degradação ambiental e suas consequências (como emergência climática e perda de biodiversidade), relacionando-se também à alta prevalência de doenças crônicas não transmissíveis. No entanto, essas questões não costumam receber a atenção necessária no processo de ensino e aprendizagem dos profissionais de saúde. Assim, este ensaio objetiva contribuir para sistematização das informações que correlacionam os fatores ambientais e a saúde humana na perspectiva do pensamento sistêmico, destacando a importância de se pensar a saúde sistêmica no âmbito das profissões da saúde. Observa-se que o profissional de saúde, sendo ponte entre o conhecimento científico e a sociedade, pode desempenhar os papéis de mediador do cuidado integral e curador do conhecimento. Além disso, é preciso incentivar o pensamento sistêmico no processo formativo em saúde para que esses papéis sejam alcançados, tanto em atitudes individuais quanto coletivas.

The present essay analyses the resemantisation of the character of the go-between presented by Sancho de Muñón in his Tragicomedia de Lisandro y Roselia. Analysing, in its characterological dimension but also in its functional aspect, the portrait of Elisa-Celestina built in this work allows to understand more precisely one of the components of the Celestinian tradition, of which Muñón participated in the incipient elaboration, but also to clarify the transfictional techniques which ensure the connection between the go-between of the sequel and the Celestina of its model

O objetivo do presente estudo foi avaliar o conhecimento popular e automedicação com plantas medicinais em gestantes do município de Juazeiro do Norte, Ceará, Brasil. Trata-se de uma pesquisa exploratória com abordagem quali-quantitativa. As informações foram coletadas por meio de um questionário semiestruturado e um grupo focal de gestantes. Em relação ao conhecimento e uso de plantas de medicinais, afirma-se que as gestantes utilizam plantas medicinais. Na análise dos riscos, todas plantas relatadas apresentavam toxicidade fetal, com exceção da cebola branca. Nota-se que as gestantes utilizam plantas medicinais por influência da cultura familiar. As gestantes acreditam que as plantas medicinais ingeridas na gestação não causam efeitos nocivos por serem de origem natural, o que contribui para a automedicação. Destaca-se a importância do diálogo entre o saber popular e o conhecimento científico na construção de uma educação terapêutica que previna problemas relacionados ao uso de produtos terapêuticos na gestação.

Objetivo: revisar na literatura as possibilidades reabilitadoras para pacientes com erosão dental. Método: screeningda literatura que seguiu os princípios do check listSANRA. A pesquisa foi realizada nas bases de dados da BVS (LILACS e BBO), Scielo, Cochrane Library e via buscador de pesquisa PubMed. Foram incluídos estudos na língua inglesa, relatos de casos clínicos disponíveis na íntegra. Foram realizadas buscas por artigos publicados até fevereiro de 2022 e sem restrição cronológica. Resultados:entre44 artigos identificados, 10 foram selecionados. A maioria dos estudos (40%) foram publicados no Brasil, seguido dos Estados Unidos (20%) e Itália (20%). As possibilidades de reabilitação identificadas foram o uso de coroas de cerâmica, laminados cerâmicos e restauração direta com resina composta. Conclusão:foi possível verificar que a reabilitação dos elementos dentários com materiais diretos (resinas compostas) ou indiretos (cerâmica ou cerômeros) tem demonstrado resultados satisfatórios,conforme os casos clínicos investigados.

Propos recueillis par Sandrine Lévêque, entretien annoté par Sandrine Lévêque et Denis Ruellan

Resumen Les élèves du secondaire ont beaucoup de difficultés avec le respect du code linguistique. Pour arriver à les surmonter, ils ont accès à leurs connaissances explicites sur la langue, qu’ils peuvent exploiter sous forme de réflexions métalinguistiques. Nous avons fait écrire une séquence descriptive à 100 élèves de 12-13 ans du secondaire québécois, avec verbalisation concurrente à la tâche. L’analyse des textes a confirmé que leErreurs linguistiques, réflexions métalinguistiques, textes descriptifs, syntaxe, orthographe grammaticales élèves avaient des difficultés d’orthographe grammaticale et lexicale nombreuses, mais que celles en structure de la phrase et en ponctuation étaient aussi considérables. Parallèlement, la très grande majorité des réflexions métalinguistiques portent sur l’orthographe, et les aspects syntaxiques sont résiduels. Face à ce constat, nous proposons quelques pistes didactiques, notamment relativement à l’importance d’articuler l’enseignement de la syntaxe aux pratiques d’écriture. Abstract High school students, with french as a first language, have plenty difficulties with french grammar. To overcome them, they have access to their explicit knowledge of the language, which they can exploit in the form of metalinguistic reflections. 100 high school students (12-13 years old) from Quebec written a descriptive sequence, with verbalization competing with the task. The analysis of the texts confirmed that the pupils had numerous difficulties with grammatical and lexical spelling, but also with sentence structure and punctuation. At the same time, the vast majority of metalinguistic reflections focus on spelling, and syntactic aspects are neglicted. Thus, we propose some didactic approaches, in particular with regard to the importance of linking together the teaching of syntax and of writing competencies.

Rootstock cuttings infected with latent Grapevine Trunk Diseases (GTD’s) pathogens are a major problem for nurseries. These fungal pathogens include several species of the genera Phaeoacremonium, Phaeomoniella, Cadophora, Dactylonectria, Ilyonectria, Diaporthe and the family Botryosphaeriaceae. Infected rootstock cuttings can cause losses of up to 60 % during propagation and post planting, and can be a reservoir of disease in the vineyard. This article presents a protocol for sanitary production of rootstock cuttings and is a guide to improving health of the grafted vine, and the profitability of nurseries and vineyards.

Com apoio em Goodman e Genette, o autor desenvolve dois conceitos centrais previamente cunhados pelo primeiro – autografia e alografia – para ajudar a responder se a oposição entre filme e TV está relacionada com diferenças na qualidade artística, um debate exacerbado pelo ingresso da Netflix em festivais de cinema. Usando também uma comparação com partituras musicais, o artigo indaga se o espectador do trabalho interativo pode ser chamado de operador, executante, ator ou intérprete.

Chile Central (30° - 37°S), concentra cerca del 75% de la población total del país, lo cual se traduce en una enorme demanda hídrica. Gran parte del agua disponible del área en cuestión proviene de la nieve estacional y los glaciares ubicados en la alta cordillera. En este contexto, el cambio climático se emplaza como una amenaza para la seguridad hídrica, mediante la disminución en las precipitaciones y la aceleración del derretimiento de las nieves. Se hace necesario contar con robustos sistemas de monitoreo de la variabilidad espacio temporal de los patrones de nieve de manera de poder cuantificar efectos y zonificar áreas afectadas para desarrollar sistemas de pronósticos y preparar planes de contingencia. El presente trabajo establece la relación entre cobertura nival y el caudal, determinando la variabilidad espaciotemporal entre el año 2000-2020 de subcuencas de los Andes extratropicales de Chile (29°-37°S), mediante imágenes satelitales MODIS y variables climáticas utilizando Google Earth Engine. Los resultados, dan cuenta a la caracterización del régimen hidrológico y el patrón estacional de la nieve de las subcuencas estudiadas, siendo de régimen nival las ubicadas en la porción central del área de estudio (30,5°-35° S), y las mixtas en los bordes (29° y 36° S). Esta configuración, repercute en la dinámica anual de los caudales en donde se aprecia un periodo de desfase entre el máximo de precipitación sólida y el máximo del caudal. Asimismo, se observó una disminución constante en la cobertura de nieves durante los últimos 20 años, siendo apreciable que en la porción central del área de estudio (i.e. 33° - 35°S) este proceso ocurre de forma más severa. La experiencia obtenida en función al análisis y resultados en este trabajo, indica la factibilidad de utilizar aproximaciones asociadas a la teledetección satelital a fin de estimar variaciones en el patrón de cobertura de nieve y caracterizar de mejor manera los regímenes hidrológicos de cuencas con datos meteorológicos limitados con el propósito de apoyar el monitoreo hídrico para la sustentabilidad de la criósfera y para la seguridad hídrica de los territorios.

ABSTRACT In view of the exponential growth in the volume of data that is considered in intelligent decision-making, hyperspectral remote sensing (HRS) has, without doubt, brought greater dominance over agricultural crops as it goes beyond the paradigm of little information being available about the targets. In this review of the state of the art of HRS, complementary views on the use of sensors and analytical techniques in agriculture over the last decade are grouped together. State-of-the-art technologies, and research trends associated with each level of data collection are cited. There is still a long way to go in the agricultural sciences; however, specialists in precision agriculture are devotees of the valuable insights offered with the increased availability of hyperspectral data. In this respect, this review is organised as follows: Section 1 helps the reader to contextualise and conceptualise the basics of remote sensing; the second section discusses the types of sensors and their resolutions; section 3 presents four subsections that show recent applications of these technologies according to their level of acquisition; finally, the fourth section offers the reader a discussion on the positive trends achieved in managing vegetation, soils and waterbodies over the last ten years, as well as the needs and challenges of the next decade.

En el estado de Michoacán, México, se desarrollan principalmente actividades productivas en los sectores primario y secundario, esta dinámica ha favorecido la intensificación en el uso del terreno y agudizado la deforestación. En este trabajo, se plantea una propuesta metodológica que permite explicar el proceso de deforestación mediante el uso de herramientas estadísticas aplicadas en gabinete y métodos descriptivos, a partir de la observación en campo. Los resultados señalan que en ocasiones factores biofísicos, sociales, económicos y de política pública, favorecen el desmonte de los bosques y en otras, su conservación. Esta premisa puede ser la base para identificar regiones con necesidades específicas y plantear objetivos, planes de acción y/o recomendaciones, para atenderlas.

The Medicine students need to increase their research skills. Therefore, there is a main goal to train the fifth year students in epidemiological analysis methods during educational activities in work hours. In the Tula Aguilera Health Area, the fifth year Medicine students conducted a control-case study, where they applied a 14 questions survey to 69 persons sick with infectious diarrhea during June to December 2013. The results were compared to those of 131 healthy persons. The survey collected demographic, environmental and lifestyle variables. For each factor found, odd ratios (OR) were determined and the behavior of the analyzed variables was compared in both groups with the logistic regression technique. The basic reproductive number (Ro) was determined considering its impact and a simulation was compared with the usual historical dispersion of those diseases. Among the results, the students were trained to gather information and to transfer data to Excel Worksheets to analyze causal relationships. The students, after analyzing, were able to establish that the surveyed population had a low risk perception, they were also able to establish and calculate differences between sick and healthy people; for instance, people who don’t cover solid wastes and become sick have nearly three times more risk (OR=2.81; IC 1.34-6.03), moreover the students were able to demonstrate the presence of environmental hazards. They found that the survey was reliable and became familiar with the usage of the basic reproductive number and derived simulations. We conclude that the designed training allowed the students to increase their skills during the educational practices at work regarding the learning by doing research methodology. The trainig strategy is valid, sustainable, updated and of great value in the Medicine students instruction.

The nutritional value of browse foliage from the Thorny Kalahari Dune Bush veld of South Africa is not characterized. Most of this browse species is rich in tannin, but still palatable, and is consumed by ruminants during the dry season, as well as having a role to play in mitigating enteric methane emission from ruminants. In this study, the rumen methane mitigation potential of 19 browse species foliage collected from the Thorny Kalahari Dune Bush veld, was analyzed in terms of chemical composition, in vitro fermentation, digestibility and methane production. In vitro gas and methane production and organic matter digestibility (IVOMD) were determined by using rumen fluid collected, strained and anaerobically prepared. A semi-automated system was used to measure gas production (GP) from each browse species by incubating 400 mg samples in a shaking incubator at 39 °C with or without inclusion of 400 mg of polyethylene glycol (PEG). Data for all the parameters collected were statistically analyzed using the SAS (9.0) general linear model (GLM) procedure, and differences between foliage species were determined using Duncan’s multiple-range test. Acacia luederitziiand Monechma incanumshowed the best potential for decreasing methane production by up to 90 % after 48 h of incubation. The secondary components (mainly tannins) of the browse species appeared to have a significant effect on volatile fatty acids (VFA), methane and gas production as judged by the comparison of samples incubated with or without PEG inclusion. The substantial amount of crude protein (CP) content coupled with their anti-methanogenic effect during fermentation would make these browses a potential mitigation option for small scale farmers and pastoralists in sub-Sahara Africa. However, it is also very important that systematic and strategic supplementation in a mixed diet should be looked at as the way forward in terms of best utilization.

Le numéro entier, Full Issue, Edição completa.

ABSTRACT Grapevine production by classical grafting methods and in commercial scale emerged over 130 years. This system remained handmade until the mid-1950s, when the first international certification programs aimed at obtaining mother plants with high viral sanity emerged. The necessity to increase the scale of production on industrial model and plant material production based on minimum morphological standards appeared at the end of the 1960s. Along the 1970s, research unlocked knowledge on semi-automated grafting, process hygiene, use of plant growth regulators and understanding of physiological events of rootstock-scion compatibility, callus formation and rooting. So, until the mid-2000s, certification schemes and propagation processes advanced little in technical standard. However, grapevine growing areas were expanded and demands for plant material increased, and new diseases emerged from contaminated nurseries. These new diseases (new viral complexes, phytoplasmas, bacteria and grapevine trunk diseases) were discovered by high-sensitivity diagnostic methods. Today, there is a new discussion on the nursery segment worldwide. The propagation techniques have been reviewed from the perspective of reducing the incidence of new diseases and minimum physiological damage of nursery plants during the production stages. Therefore, technological innovations regarding equipment, practices and production inputs have been incorporated in new certification schemes. However, despite these advantages, these schemes have become more complex and multidisciplinary than previous ones, bringing difficulties in adaptation of nurserymen.

Le numéro entier, Full Issue, Edição completa.

Este artículo examina un documento en gran parte desconocido y conservado en los archivos del Instituto Valencia de Don Juan en Madrid. Este documento –un breve memorial escrito por el obispo portugués Andrés de Noronha en la década de 1580 y probablemente destinado a uno de los secretarios reales o tal vez el propio Felipe II– revela nueva información acerca de la creencia de que los judíos o conversos judaizantes en la Península Ibérica comunicaban con sus correligionarios en el Imperio otomano y conspiraban con el objetivo de infiltrar la sociedad cristiana y destruir a las monarquías ibéricas. Dando un informe de una conversación entre el obispo y un inquisidor español que habría tenido lugar en 1566 o 1567, el memorial se refiere a la Carta de los judíos de Constantinopla, una infame falsificación que se convirtió en la piedra angular de esta poderosa teoría conspirativa antisemita. A través de un análisis del texto, este artículo aclara el modo en que la Carta de los judíos de Constantinopla circuló y fue diseminada, tanto en España como en Portugal, así como su papel en la creación en 1568 de becas discriminatorias reservadas para cristianos viejos que deseaban estudiar medicina en la Universidad de Coimbra.

Leticia: Ministerio del Interior y de Justicia, Agencia Nacional de Hidrocarburos, FONADE , Organización de los Pueblos Indígenas de la Amazonía Colombiana – OPIAC , Universidad Nacional de Colombia, sede Amazonía. 2012. Volumen 1: 122 páginas; Volumen 2: 155 páginas.

This paper is based on the observation that fifth year Medicine students do not have enough skills in statistics, IT, or information management to adequately prepare and implement research projects. Therefore, the aim of this paper is to describe the experiences obtained by using the cooperative learning method and to present the results obtained by students in their research projects. In order to meet the proposed objectives the cooperative learning method was applied to several topics of the Public Health course in the Medical Program. Consequently, students were divided into five groups to interact with health care specialists and workers, workers from other sectors, and the general public. They identified the most urgent health problems in a participative manner and conducted a research project. The students’ acceptance of the method was evaluated using an exploratory statistical technique. As a result, students analyzed data, drew conclusions, and participated in debates having the professor as the facilitator and coordinator. All groups successfully presented the results of their research projects, which included 2 projects on the control of Dengue and the Aedes aegypti mosquito and 3 on potential maternal mortality risks. Surveys reflected acceptance of the method. The experiences obtained by using the cooperative learning technique and the results obtained by students in their projects are described; this experience should be systematized.

Cultural consonance is the degree to which individuals approximate prototypes encoded in cultural models. Low cultural consonance is associated with higher psychological distress. Religion may moderate the association between cultural consonance and psychological distress. Brazil, with substantial variation in religion, is an important society for the examination of this hypothesis. Research was conducted in Ribeirão Preto, Brazil, using a mixed-methods design. Measures of cultural consonance were derived using ethnographic methods and then applied in a survey of 271 individuals drawn from four distinct social strata. Low cultural consonance was associated with higher psychological distress in multiple regression analysis ( B = -.430, p < .001). Members of Pentecostal Protestant churches reported lower psychological distress independently of the effect of cultural consonance ( B = -.409, p < .05). There was no buffering effect of religion. Implications of these results for the study of religion and health are discussed.

This theoretical essay is to clarify what could be a deeper approach to education and its characteristics. The deep approach is a broad phenomenon that encompasses several domains. It manifest a turning point in the way we reflect on a variety of disciplines such as ecology, economy, engineering, mathematics, cross-cultural communication, psychology, and languages. The trend is influenced by semiotics—the science of meaningful signs—as an overarching discipline, process philosophy and complexity theory to address ontological dualism. The deep approach is an applied trend that is revolutionizing the ways we think about what should be accomplished in Education and Teacher Education, and how it should be done.It defines a move towards deeper conceptions of curricula in any disciplines and towards curriculum interconnectedness.

Sumário - Summary - Sommaire

Sommaire- Sumário- Summary

Se examina la génesis y el fundamento del análisis de políticas públicas y la producción de las mismas, caracteriza, a partir de ejemplos franceses ampliamente analizados, el rol "clave" que cumplen unos actores que él llama los "mediadores" en la formulación y la puesta en marcha de dichas políticas.

Le numéro entier, Full Issue, Edição completa.

Sommaire- Sumário- Summary

Este artículo aborda la répica y respuesta de Gianni Vattimo a una publicación de Emmanuel Faye; en la misma, Vattimo asume la postura deconstructivista que lo caracteriza para elogiar la voluntad de Heidegger y reconocer el mérito de sus acciones y pensamientos durante su participación en el partido nazi, reivindicándolo como la víctima de un juicio póstumo. Vattimo expone su propia perspectiva de política y cómo ésta ha sido practicada en tiempos posteriores a 1945, no obstante, las doctrinas trabajadas por Heidegger que implícitamente llevan el racismo y el exterminio, son complacientes con la violencia, por lo que minan el vigor crítico de la filosofía y terminan por carecer de validez.