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El virus de la Necrosis Hipodérmica y Hematopoyética Infecciosa es responsable en los últimos 30 años del decrecimiento productivo y la baja supervivencia de algunas especies de camarones penaeidos cultivados. En la actualidad esta enfermedad es tema de discusión y análisis en numerosos foros internacionales, debido a su incremento en los últimos cinco años. A pesar de que la enfermedad no se encuentra presente en Cuba, existe una gran preocupación por parte de las autoridades competentes del país debido a los movimientos de organismos vivos y refrigerados que se realizan, dentro y desde fuera de la nación. El presente estudio se realizó con el objetivo de determinar líneas de bioseguridad específicas para este virus en el cultivo del camarón Penaeus vannamei. Aunque los métodos matriciales son comunes en los análisis de riesgo biológico, el de matriz de riesgo tridimensional, resulta más abarcador por incluir el rol de las defensas en las secuencias accidentales que representan la introducción y propagación de la enfermedad. Para aplicar el método se empleó el código SECURE-MR-FMEA. Los resultados identifican los riesgos más contribuyentes para la camaronicultura en el escenario de Cuba, basados en la degradación de las defensas que caracterizan las buenas prácticas en un caso ideal, así como describen las medidas de defensa más trascendentes en dichas condiciones. El empleo del método y sus resultados constituyen una novedad en el campo de las investigaciones de bioseguridad. La investigación contribuye a la preparación de una estrategia de bioseguridad específica para esta patología del camarón, que constituye un importante riesgo económico para este rubro productivo. Recibido: 21.02.2023 Aceptado: 22.07.2023 Editor: Laida Ramos Trujillo

IntroductionEpidemiological studies around the world on acute leukemia (AL) and risk factors in infants are scarce. Infant AL has been proposed to originate in utero, which facilitates its study by establishing a short exposure time in pregnant women to environmental and dietary factors that could contribute to the risk of or protection against leukemia. We hypothesized that maternal diet during pregnancy may be an important factor involved in AL in offspring.MethodsWe conducted a hospital-based case-control study from 2010 to 2019 on maternal diet during pregnancy in nine high-specialty public hospitals of different health institutions that diagnose and offer treatment to children with AL in Mexico City. Cases (n=109) were children ≤24 months of age with de novo diagnosis of AL, and controls (n=252) were children obtained in hospitals from second-level medical care matched for age, sex, and health institution. Maternal diet during pregnancy was obtained by a semiquantitative food frequency questionnaire. Unconditional logistic regression models were used to assess the association between food groups and infant AL. Potential confounders were assessed by constructing directed acyclic graphs (DAGs) with Dagitty software in which adjusted options were identified for the construction of unconditional logistic regression models.ResultsCases were slightly predominantly female (52.3%). The years of education of the mother in cases and controls was 0-9 on average, and those who reported smoking cigarettes and consuming alcohol during pregnancy did so at a low frequency. Regarding the mother’s diet, the main findings were that the consumption of allium vegetables during pregnancy was inversely associated with AL for medium and high consumption (OR=0.26, 95% CI 0.14-0.46; P-trend< 0.001). In contrast, the high consumption of high-fat dairy products had a positive association with AL (OR=2.37, 95% CI 1.30-4.34; P-trend

There is scarce evidence on sociodemographic and lifestyle characteristics that may explain adherence to different dietary patterns (DPs) during pregnancy. Our aims were to identify dietary patterns in a sample of pregnant Mexican women and to describe their association with selected sociodemographic and lifestyle characteristics. This is a secondary cross-sectional analysis of 252 mothers of children that participated as controls in a hospital-based case–control study of childhood leukemia. We obtained parents’ information about selected sociodemographic characteristics, as well as alcohol and tobacco consumption. We also obtained dietary information during pregnancy. We identified DPs using cluster and factor analyses and we estimated their association with characteristics of interest. We identified two DPs using cluster analysis, which we called “Prudent” and “Non healthy”, as well as three DPs through factor analysis, namely “Prudent”, “Processed foods and fish”, and “Chicken and vegetables”. Characteristics associated with greater adherence to “Prudent” patterns were maternal education, older paternal age, not smoking, and being a government employee and/or uncovered population. Likewise, the “Processed foods and fish” pattern was associated with greater maternal and paternal education, as well as those with less household overcrowding. We did not identify sociodemographic variables related to the “Chicken and Vegetables” pattern. Our results may be useful to identify target populations that may benefit from interventions aimed to improve individual dietary decisions during pregnancy.

IntroductionGood syndrome (GS) is a rare adult-onset immunodeficiency first described in 1954. It is characterized by the coexistence of a thymoma and hypogammaglobulinemia, associated with an increased susceptibility to infections and autoimmunity. The classification and management of GS has been long hampered by the lack of data about the underlying immune alterations, a controversy existing on whether it is a unique diagnostic entity vs. a subtype of Common Variable Immune Deficiency (CVID).MethodsHere, we used high-sensitive flow cytometry to investigate the distribution of up to 70 different immune cell populations in blood of GS patients (n=9) compared to age-matched CVID patients (n=55) and healthy donors (n=61).ResultsAll 9 GS patients displayed reduced B-cell counts -down to undetectable levels (

BackgroundChildhood cancer is the leading cause of disease-related mortality among children aged 5–14 years in Mexico, with acute leukemia being the most common cancer among infants. Examining the overall dietary patterns allows for a comprehensive assessment of food and nutrient consumption, providing a more predictive measure of disease risk than individual foods or nutrients. This study aims to evaluate the association between maternal dietary patterns during pregnancy and the risk of acute leukemia in Mexican infants.MethodsA hospital-based case–control study was conducted, comparing 109 confirmed acute leukemia cases with 152 age-matched controls. All participants (≤24 months) were identified at hospitals in Mexico City between 2010 and 2019. Data on a posteriori dietary patterns and other relevant variables were collected through structured interviews and dietary questionnaires. Multivariate logistic regression was employed to estimate the association between maternal dietary patterns during pregnancy and the risk of acute leukemia in infants.ResultsThe “Balanced & Vegetable-Rich” pattern, characterized by a balanced consumption of various food groups and higher vegetable intake, exhibited a negative association with acute leukemia when compared to the “High Dairy & Cereals” Pattern (adjusted odds ratio [OR] = 0.51; 95% confidence interval [CI]: 0.29, 0.90). We observed that mothers who gave birth to girls and adhered to a healthy dietary pattern during pregnancy exhibited significantly lower odds of their children developing AL compared to those who gave birth to boys [OR = 0.32 (95% CI 0.11, 0.97)]. Our results underscore the significance of maternal nutrition as a modifiable factor in disease prevention and the importance of prenatal health education.

BackgroundMultiparameter flow cytometry (FC) immunophenotyping is a key tool for detailed identification and characterization of human blood leucocytes, including B-lymphocytes and plasma cells (PC). However, currently used conventional data analysis strategies require extensive expertise, are time consuming, and show limited reproducibility.ObjectiveHere, we designed, constructed and validated an automated database-guided gating and identification (AGI) approach for fast and standardized in-depth dissection of B-lymphocyte and PC populations in human blood.MethodsFor this purpose, 213 FC standard (FCS) datafiles corresponding to umbilical cord and peripheral blood samples from healthy and patient volunteers, stained with the 14-color 18-antibody EuroFlow BIgH-IMM panel, were used.ResultsThe BIgH-IMM antibody panel allowed identification of 117 different B-lymphocyte and PC subsets. Samples from 36 healthy donors were stained and 14 of the datafiles that fulfilled strict inclusion criteria were analysed by an expert flow cytometrist to build the EuroFlow BIgH-IMM database. Data contained in the datafiles was then merged into a reference database that was uploaded in the Infinicyt software (Cytognos, Salamanca, Spain). Subsequently, we compared the results of manual gating (MG) with the performance of two classification algorithms -hierarchical algorithm vs two-step algorithm- for AGI of the cell populations present in 5 randomly selected FCS datafiles. The hierarchical AGI algorithm showed higher correlation values vs conventional MG (r2 of 0.94 vs. 0.88 for the two-step AGI algorithm) and was further validated in a set of 177 FCS datafiles against conventional expert-based MG. For virtually all identifiable cell populations a highly significant correlation was observed between the two approaches (r2>0.81 for 79% of all B-cell populations identified), with a significantly lower median time of analysis per sample (6 vs. 40 min, p=0.001) for the AGI tool vs. MG, respectively and both intra-sample (median CV of 1.7% vs. 10.4% by MG, p

IntroductionMaternal dietary consumption during pregnancy has been inconclusively associated with acute leukemia (AL) in infants, probably because epidemiological evidence has emerged mainly from the analysis of one-by-one nutrient, which is not a real-life scenario. Our objective was to evaluate the association between AL in Mexican children under 2 years of age and their mothers’ nutrients concomitant intake during pregnancy, as well as to explore whether there are differences between girls and boys.MethodsWe conducted a study of 110 cases of AL and 252 hospital-based controls in the Mexico City Metropolitan area from 2010 to 2019. We obtained information on maternal intake of 32 nutrients by a food frequency questionnaire and used weighted quantile sum regression to identify nutrient concomitant intakes.ResultsWe found a concomitant intake of nutrients negatively associated with AL (OR 0.17; CI95% 0.03,0.88) only among girls; and we did not find a nutrient concomitant intake positively associated with AL.DiscussionThis is the first study that suggests nutrients that have been individually associated with AL are not necessarily the same in the presence of other nutrients (concomitant intake); as well as that maternal diet might reduce AL risk only in girls.

La existencia de agentes biológicos como el virus de la peste porcina clásica para la producción de vacunas veterinarias, entre otros de igual importancia para nuestro país y la región en general, justifica una buena gestión de la seguridad biológica, ya que el desconocimiento del riesgo por parte del personal que labora en estas vacunas puede provocar contaminaciones de graves consecuencias medio ambientales, en el proceso de producción y a nivel personal si son causantes de accidentes fatales. El objetivo de la investigación fue realizar un análisis de la percepción de riesgo existente en el personal responsable del proceso de producción de la vacuna contra la peste porcina clásica. La aplicación del RISKPERCEP en el personal de la instalación de producción de la vacuna de la peste porcina clásica mostró como resultados el comportamiento de diferentes variables que hacen evidente la alta subestimación del riesgo existente en el personal evaluado y que existe la necesidad de profundizar en la formación en bioseguridad para todo el personal que labora en el proceso. Finalmente, se relacionan estos temas y su importancia para mejorar la calidad de la producción en estos procesos, así como incrementar el conocimiento acerca del riesgo biológico a todos los niveles.

La importancia que tienen para la avicultura cubana el virus de la enfermedad infecciosa de la bolsa (Gumboro) y el virus de la viruela aviar, así como la producción de vacunas que permitan controlar las enfermedades producidas por estos agentes biológicos, justifican la necesidad del establecimiento de una buena gestión de la bioseguridad, ya que el desconocimiento de los peligros y riesgos del personal que labora en estas vacunas puede provocar accidentes de consecuencias indeseables para el producto, escapes de estos microorganismos durante sus procesos productivos y la consecuente contaminación del medio ambiente. El objetivo de la presente investigación fue realizar un análisis de la percepción de riesgo existente en el personal responsable del proceso de producción de dos vacunas aviares. Para ello se utilizó el software RISKPERCEP en una instalación de producción de vacunas aviares; su aplicación mostró variables que demostraron subestimación del riesgo por el personal expuesto y variables con tendencia a la sobrestimación, asociadas fundamentalmente al incorrecto diseño de la instalación. Se concluye que existe la necesidad de una buena capacitación y que se impartan cursos de actualización de bioseguridad donde se tengan en cuenta todos los aspectos del diseño del laboratorio que puedan solucionarse.

BackgroundThe trematode Fasciola hepatica is the most widespread causative agent of fasciolosis, a parasitic disease that mainly affects humans and ruminants worldwide. During F. hepatica infection, newly excysted juveniles (FhNEJ) emerge in the duodenum of the mammalian host and migrate towards their definitive location, the intra-hepatic biliary ducts. Understanding how F. hepatica traverses the intestinal wall and migrates towards the liver is pivotal for the development of more successful strategies against fasciolosis. The central enzyme of the mammalian fibrinolytic system is plasmin, a serine protease whose functions are exploited by a number of parasite species owing to its broad spectrum of substrates, including components of tissue extracellular matrices. The aim of the present work is to understand whether FhNEJ co-opt the functions of their host fibrinolytic system as a mechanism to facilitate trans-intestinal migration.Methodology/principal findingsA tegument-enriched antigenic extract of FhNEJ (FhNEJ-Teg) was obtained in vitro, and its capability to bind the zymogen plasminogen (PLG) and enhance its conversion to the active protease, plasmin, were analyzed by a combination of enzyme-linked immunosorbent, chromogenic and immunofluorescence assays. Additionally, PLG-binding proteins in FhNEJ-Teg were identified by bidimensional electrophoresis coupled to mass spectrometry analysis, and the interactions were validated using FhNEJ recombinant proteins.Conclusions/significanceOur results show that FhNEJ-Teg contains proteins that bind PLG and stimulate its activation to plasmin, which could facilitate the traversal of the intestinal wall by FhNEJ and contribute to the successful establishment of the parasite within its mammalian host. Altogether, our findings contribute to a better understanding of host-parasite relationships during early fasciolosis and may be exploited from a pharmacological and/or immunological perspective for the development of treatment and control strategies against this global disease.

Introducción: La COVID-19 ha planteado un reto a las actividades laborales en el mundo, favoreciendo la modalidad de trabajo a distancia, como alternativa para evitar la presencia en el puesto y con ello el incremento de la transmisión del SARS-CoV-2. Los comportamientos sociales de trabajadores y administraciones están relacionados con la percepción de riesgo respecto a la COVID-19. Objetivo: Cuantificar la percepción de riesgo asociada a la pandemia y establecer su relación con el comportamiento social derivado, a través de un estudio comparativo en una muestra multinacional de trabajadores. Métodos: Se utilizó un código preparado para evaluar la percepción de riesgo, unido al diseño y aplicación vía Internet de una herramienta destinada al estudio. Se midió la percepción empleando variables politómicas ordinales, en una encuesta aplicada a 927 trabajadores. Las salidas del estudio se presentan en forma analítica y gráfica. Resultados: Hubo una ligera subestimación del riesgo global en las muestras estudiadas. Esta se debió, esencialmente, a la baja comprensión del riesgo, poco temor a la pandemia, desbalance riesgo-beneficio y baja identidad de las víctimas. Se compararon los resultados con otros estudios. Se incluyeron recomendaciones para adecuar la percepción de riesgo y la estrategia de afrontamiento. Conclusión: Los resultados permiten comprender diferencias respecto al enfrentamiento de la pandemia, sus dificultades en cada escenario y el rol de la sociedad y las instituciones en cada caso Introduction: COVID-19 has posed a challenge to labor activities in the world favoring the modality of online work, as an alternative to avoid being present and thus increasing the transmission of SAR-COV-2. The social behaviors of workers and administrations are associated with the risk perception regarding COVID-19. Objective: To quantify the perception of risk associated with the pandemic and establish its relationship with the derived social behavior, through a comparative study in a multinational sample of workers. Methods: A code prepared to assess risk perception was used, together with the design and application via the Internet of a tool for the study. Perception was measured using ordinal polytomous variables, in a survey applied to 927 workers. The outputs of the study are presented analytically and graphically. The results showed a slight underestimation of the global risk in the studied samples. Results: This was due, essentially, to a low understanding of risk, little fear of the pandemic, risk-benefices unbalance and low identity of the victims. The results were compared with other studies. Recommendations were included to adapt the perception of risk and the coping strategy. Conclusion: The results allow us to understand differences regarding the confrontation of the pandemic, its difficulties in each scenario and the role of society and institutions in each case

Fundamento: el procesamiento de imágenes es clave en la planificación de tratamientos de radioterapia con haces externos. En su ejecución pueden ocurrir errores humanos y fallos de equipos, que conllevan, entre otros efectos, a interpretaciones erróneas de imágenes diagnósticas, errores de contorneo de blancos, sobredosis a tejidos sanos o subdosis a tejidos tumorales, lo cual significa poner en riesgo a los pacientes sometidos a estas prácticas.Objetivo: caracterizar los riesgos asociados a los factores tecnológicos y humanos relacionados con el procesamiento de imágenes que pueden afectar a los pacientes sometidos a tratamientos de radioterapia con haces externos.Métodos: como base de estudio se empleó la práctica de radioterapia de intensidad modulada. Para caracterizar los iniciadores y las medidas de defensa relacionados con este procesamiento, se emplearon modelos de riesgo basados en análisis de modos y efectos de fallo y matriz de riesgo de la práctica de referencia, que fueron procesados con el software SECURE-MR-FMEA. Resultados: los análisis de sensibilidad sobre los modelos de radioterapia de intensidad modulada mostraron los efectos sobre el riesgo de los fallos asociados al procesamiento de imágenes.Conclusiones: se confirmó la importancia de aplicar el análisis de riesgo en el procesamiento de imágenes para elevar la seguridad de los pacientes durante los tratamientos de radioterapia con haces externos.

Introducción: Las dificultades asociadas a las evaluaciones de riesgo exigidas por la normativa cubana de seguridad y salud en el trabajo, por desconocimiento de muchos de sus aspectos, provocan improvisaciones en su realización y problemas de calidad de sus documentos, que derivan en el cumplimiento formal de dichas evaluaciones. La evidencia de estos problemas impulsó el diseño y programación de un sistema de evaluación de seguridad y salud en el trabajo. Objetivo: Mostrar el proceso de informatización y aplicación de un sistema cubano de gestión de riesgos laborales. Método: Se desarrolló el código SECURE-SST Ver. 1.0 con capacidades analíticas y gráficas que permiten cumplir, de manera automatizada, los requerimientos de identificación, evaluación y redacción de los planes generales de prevención de riesgos laborales y la generación de mapas de proceso y mapas de riesgo. El enriquecimiento del programa con bases de referencia relativas a tipos de riesgos, situaciones peligrosas y medidas preventivas constituye una de las capacidades más trascendentes con las cuales se ha potenciado el programa, respecto a los métodos de partida. Resultados: La herramienta es un sistema con enfoque proactivo para la gestión de riesgos y toma de decisiones en la seguridad y salud en el trabajo. Se muestra un ejemplo práctico detallado, Conclusiones: SECURE-SST Ver. 1.0 se ofrece con un curso de capacitación asociado. Queda instalado en las PC de los usuarios junto a su manual de usuario y archivos tutoriales. El código permite la documentación en detalle de cada una de sus opciones. Introduction: The difficulties associated with the risk assessments required by the Cuban regulations on safety and health at work, due to ignorance of many of its aspects, cause improvisations in its implementation and problems of quality of its documents, which result in the formal fulfillment of these evaluations. The awareness of these problems prompted the design and programming of an occupational safety and health evaluation system. Objective: To show the process of computerization and application of a Cuban occupational risk management system. Methods: The code SECURE-SST Ver. 1.0 is developed with analytical and graphic capabilities that allow to fulfill, in an automated way, the requirements of identification, evaluation, and drafting of the general plans of prevention of occupational risks and the generation of process maps and risk maps. The enrichment of the program with reference bases related to types of risks, dangerous situations, and preventive measures constitutes one of the most important capacities with which the program has been strengthened, with respect to the starting methods. Results: The tool is a system with a proactive approach to risk management and decision-making in occupational health and safety. A detailed practical example is shown. Conclusions: SECURE-SST Ver. 1.0 is offered with an associated training course. It is installed on users' PCs along with their user manual and tutorial files. The code allows detailed documentation of each of its options.

Introducción: El transporte de material radiactivo (TMR) en Cuba es realizado principalmente por el Centro de Isótopos y el Centro de Protección e Higiene de las Radiaciones. Objetivo: Analizar los riesgos radiológicos para la salud de los trabajadores del TMR en Cuba. Material y método: Se determinaron los riesgos inherente y residual, las etapas del proceso y las medidas más importantes, así como las consecuencias. La matriz de riesgo se convirtió en el análisis de los modos y efectos de fallo. Se establecieron las sinergias entre estos y el sistema de aprendizaje de incidentes. Los modos de fallo, etapas y causas básicas más contribuyentes fueron identificados. Se utilizó el código cubano SECURE MR-FMEA 3.0. Resultados: Se obtuvo un nivel medio de riesgo, pero existieron secuencias accidentales con consecuencias muy altas. La transportación al aeropuerto y la conformación de los bultos radiactivos fueron las de mayor aporte. Las medidas preventivas relevantes son la capacitación del personal del transporte y la inspección técnica del vehículo. Las consecuencias altas para público fueron del 16 %, y las medias para trabajadores del 34,7 %. La contaminación transitoria en las superficies externas y el blindaje deficiente de las fuentes radiactivas selladas en los bultos tienen mayor coincidencia con el reporte. El incumplimiento de lo establecido es la causa básica de fallo predominante. Conclusiones: Se facilita la toma de decisiones para el control del riesgo radiológico del transporte de material radiactivo en Cuba a partir del empleo de la metodología que se propone en esta investigación. Introduction: There is the transport of radioactive material (TMR) in Cuba carried out mainly by the Isotope Center and the Radiation Protection and Hygiene Center. Objective: To analyze the radiological risks for the workers´ health of transport of radioactive material in Cuba. Material y method: Inherent and residual risks, process stages, and most important measures, as well as consequences, were determined. The risk matrix became the analysis of failure modes and effects. Synergies between these and the incident learning system were established. The most contributing identified were among failure modes, stages, and root causes. There used the Cuban code SECURE MR-FMEA 3.0. Results: There obtained a medium level of risk, but there were accidental sequences with very high consequences. The transportation to the airport and the confirmation of the radioactive packages were the ones with the greatest contribution. The relevant preventive measures are the training of transport personnel and the technical inspection of the vehicle. The high consequences for the public are 16 % and the average for workers 34.7 %. Transient contamination on external surfaces and poor shielding of sealed radioactive sources in packages are more consistent with the report. Non-compliance with the established is the predominant basic cause of failure. Conclusions: This paper allows the decision-making to control the radiological risk of the transport of radioactive material in Cuba increased from the use of the methodology proposed in this research.

Durante los últimos años, los análisis de riesgo han encontrado aplicación en múltiples sectores de la tecnología y la sociedad. El artículo propone un sistema integrado de análisis de riesgo aplicado a los estudios de sostenibilidad energética. En este contexto se enmarcan los estudios de percepción de riesgo o riesgo subjetivo sobre cambio climático, los análisis de impacto por empleo de fuentes renovables de energía en los riesgos objetivos asociados al calentamiento global y las evaluaciones de confiabilidad tecnológica aplicados a fuentes sostenibles de energía. El sistema propuesto se ha implementado a través de códigos informáticos específicos (RISKPERCEP, SIMENI-CC, MOSEG), los que atienden cada uno de los frentes referidos a los análisis de riesgo esbozados. Se presentan ejemplos de aplicaciones de análisis de riesgo que consideran el empleo de fuentes renovables de energía como alternativa para la sostenibilidad energética.

Resumen Introducción: La percepción del riesgo biológico ha ido ganando terreno como mecanismo regulador de la seguridad laboral en instalaciones de salud, ya que está asociada a la ocurrencia y prevención de accidentes laborales. Para las diferentes instituciones de salud es fundamental conocer este fenómeno, favoreciendo así la implementación de estrategias de prevención, que permitan que el trabajador realice una correcta valoración del peligro y, entre otros factores, contribuir a la disminución de accidentes laborales. Objetivos: Compilar estudios realizados sobre percepción del riesgo biológico en el personal de la salud en instalaciones pertenecientes al sector y analizar el comportamiento de las variables relacionadas con la percepción del riesgo biológico. Métodos: Se realizó un estudio explicativo transversal que aplicó el método de evaluación de la percepción del riesgo en el personal biológicamente expuesto, de siete instituciones hospitalarias y el programa RISKPERCEP. Resultados: Las variables familiaridad, comprensión del riesgo, demanda laboral, voluntariedad de exposición al riesgo, pánico y beneficios no fueron percibidas adecuadamente por parte del personal y resulta un problema a resolver que pudiera relacionarlas con la realización de actos inseguros que guardaran alguna relación con accidentes laborales. Conclusión: Existe una alta subestimación del riesgo por el personal expuesto que labora en las áreas estudiadas. Abstract Introduction: Biological risk perception has been gaining ground as a regulatory mechanism for occupational safety in health facilities, since it is associated with the occurrence and prevention of occupational accidents. For the different health institutions, it is essential to know this phenomenon, thus favoring the implementation of prevention strategies that allow the worker to make a correct assessment of the danger and, among other factors, contribute to the reduction of occupational accidents. Objectives: To gather studies about biological risk perception among the health personnel from facilities belonging to this sector and to analyze the behavior of the variables related to biological risk perception. Methods: A cross-sectional and explanatory study was carried out using the risk perception assessment method in biologically exposed personnel from seven hospital institutions and the RISKPERCEP program. Results: The variables familiarity, understanding of risk, occupational demand, willingness to risk exposure, panic and benefits were not adequately perceived by the personnel, a problem to be solved that could be related to doing unsafe activities somehow related to occupational accidents. Conclusion: There is a high underestimation of risk by the exposed personnel working in the areas studied.

Introducción: La percepción de riesgo es un tema que cada día adquiere mayor importancia, pues su correcta interpretación permite enfrentar diversos comportamientos humanos. El profesional veterinario vinculado al cautiverio de aves queda expuesto al riesgo biológico. Estas aves son reservorio de numerosos microorganismos que pueden ser zoonóticos y ocasionar enfermedades profesionales. Objetivo: Evaluar la percepción de riesgo biológico entre el personal veterinario encargado del manejo de aves en cautiverio mediante el empleo del programa propio RISKPERCEP. Material y método: La investigación se realizó en un centro dedicado al manejo de aves en cautiverio en Cuba en el período comprendido entre diciembre de 2018 y octubre de 2019. La evaluación subjetiva del riesgo se fundamentó en el algoritmo de Evaluación de Percepción de Riesgo Ocupacional, que constituye la base del código RISKPERCEP utilizado para la cuantificación. Para la evaluación se diseñó una encuesta específica con preguntas cerradas y ordenadas en tres gradaciones. Las interrogantes se relacionaron con las variables de estudio clasificadas en tres tipos: las de carácter individual, las relacionadas con la naturaleza del riesgo o riesgo físico y las vinculadas con la gestión del riesgo o riesgo gestionado. Resultados: El personal encuestado manifestó una elevada diversidad de opiniones en 10 de las variables introducidas en el programa. De ahí la necesidad de realizar acciones inmediatas para la homogeneización de conocimientos. Conclusión: Existe una baja percepción de riesgo biológico, lo que evidencia un desconocimiento de aspectos esenciales de la bioseguridad. Introduction: The perception of risk is a topic that now acquires great importance, whereas its correct interpretation leads us to the confrontation of human diverse behaviors. The veterinary professional related to the captivity of birds is exposed to biological risk. These birds are reservoirs of microorganisms that can be zoonotic and may cause professional illnesses. Objective: To evaluate the perception of biological risk with the developed program RISKPERCEP. Material and method: The research was carried in a center dedicated to the management of birds in captivity in Cuba in the period of December 2018 to October 2019. The subjective risk assessment was based on the Occupational Risk Perception Assessment (EPRO) algorithm that constitutes the basis of the RISKPERCEP code used for the quantification of risk perception. For the evaluation of the perception of biological risk, a specific survey for research was conceived in three gradations, closed, and ordered questions. The questions were related to the variables´ study classified into three types: those of an individual character, those related to the nature of the risk or physical risk, and those related to risk management or risk management. Results: A high dispersion of opinions for ten variables introduced in the program was observed, this implies the necessity to carry out immediate actions for the homogenization of knowledge. Conclusion: The study revealed that exits a low perception of biological risk is linked directly to a high familiarity with the danger, this evidences inexperience in critical aspects of biosafety.

Fasciola hepatica is the main causative agent of fasciolosis, a zoonotic parasitic disease of growing public health concern. F. hepatica metacercariae are ingested by the host and excyst in the intestine, thereby releasing the newly excysted juveniles (FhNEJ), which traverse the gut wall and migrate towards the biliary ducts. Since blocking F. hepatica development is challenging after crossing of the intestinal wall, targeting this first step of migration might result in increased therapeutic success. The intestinal extracellular matrix (ECM) is constituted by a network of structural proteins, including laminin (LM) and fibronectin (FN), that provide mechanical support while acting as physical barrier against intestinal pathogens. Here, we employed ELISA and immunofluorescent assays to test for the presence of LM- and FN-binding proteins on a tegument-enriched antigenic fraction of FhNEJ, and further determined their identity by two-dimensional electrophoresis coupled to mass spectrometry. Additionally, we performed enzymatic assays that revealed for the first time the capability of the juvenile-specific cathepsin L3 to degrade LM, and that LM degradation by FhNEJ proteins is further potentiated in the presence of host plasminogen. Finally, a proteomic analysis showed that the interaction with LM triggers protein changes in FhNEJ that may be relevant for parasite growth and adaptation inside the mammalian host. Altogether, our study provides valuable insights into the molecular interplay between FhNEJ and the intestinal ECM, which may lead to the identification of targetable candidates for the development of more effective control strategies against fasciolosis.

Introducción: El análisis de riesgo en la gestión de la calidad y seguridad permite la mejora continua de los servicios médicos en Cuba. En Medicina Nuclear Terapéutica es requisito regulador que permite la continuidad de estos servicios a la población.Objetivo: Analizar los riesgos radiológicos con enfoque integrador dirigido a causas básicas de fallo en la práctica citada.Material y métodos: Se revisó y adaptó el modelo genérico de riesgo para cada caso de estudio. Los métodos prospectivos de matriz de riesgo y análisis de modos y efectos de fallo y reactivo de aprendizaje de las lecciones de sucesos registrados fueron utilizados con el código cubano SECURE MR-FMEA versión 3.0. Se determinó el riesgo inherente, su tratamiento y el riesgo residual por práctica. Se identificaron las etapas del proceso, las medidas y las causas básicas más contribuyentes.Resultados: No se obtuvo riesgo superior al del nivel alto. La radiosinoviortesis y el tratamiento radiactivo de la policitemia vera tuvieron la mayor cantidad de modificaciones al modelo genérico. Las etapas más significativas son prescripción clínica, preparación del radiofármaco y administración. Las medidas preventivas de mayor importancia son mantener una carga de trabajo moderada para el personal, las capacitaciones de los médicos nucleares y del técnico que realiza la administración.Conclusiones: Existe una no uniformidad en el nivel de calidad y seguridad entre los servicios analizados. Para el cambio, la adopción de decisiones se ve beneficiada en su eficacia y eficiencia, al integrarse los métodos prospectivos y reactivos de análisis de riesgo.

Los procesos de hemodiálisis son una alternativa de sobrevida para los pacientes con insuficiencia renal crónica, sin embargo, por su proceder invasivo resultan una de las prácticas médicas con mayores riesgos para los mismos. También resulta riesgosa la práctica para los trabajadores ocupacionalmente expuestos, dados los peligros biológicos por el manejo de fluidos y la existencia de patógenos, con los que estos se ven involucrados. El método de “matriz de riesgo tridimensional” es utilizado comúnmente como herramienta para establecer prioridades en la gestión del riesgo de muchas prácticas médicas con radiaciones ionizantes, a partir del análisis combinado de los escenarios de riesgo que pueden aparecer en esta práctica. El objetivo de este estudio es evaluar, utilizando de manera novedosa este método, el riesgo biológico en una sala de hemodiálisis. Para ello se aplicó el código SECURE-MR-FMEA, el cual informatiza el método de matriz de riesgo. Se detectó que el riesgo en este proceso es muy alto debido, esencialmente, a la no existencia de local para el almacenamiento de desechos biológicos peligrosos. Otros contribuyentes importantes son el uso inadecuado de los medios de protección individual y buenas prácticas y procedimientos.

Introduction: In Cuba, there are plans to conduct patient-specific therapy for hyperthyroidism. A methodology and computational tools have been developed for this purpose. Risk analysis will allow us to undertake this practice with quality and safety. Objective: To analyze the radiological risks in the patient –specific therapy for hyperthyroidism in Cuba. Material and Methods: The generic patient-specific Nuclear Medicine model was reviewed and adapted. Inherent and residual risk were determined with the Cuban code SECURE MR-FMEA version 3.0; the stages of the process, the initiating events, the most contributing measures and causes, and the consequences for the exposed groups were identified. Results: A high level of risk was obtained, which was controlled with additional measures. The most significant stages are the acquisition of pre- and post-treatment images, and the preparation of the radiopharmaceutical. The most important preventive measures are: maintaining a moderate workload of the staff, and the training of the medical physicist and the specialists who perform the project reviews at the stages in service design. Patients have very high consequences in 10,7 % of accidental sequences. However, the workers and the public show average consequences at 29 % and 16 %, respectively. Non-compliance with practices, protocols, procedures or standards is the predominant underlying cause of failure. Conclusions: Decision-making for the implementation of patient-specific therapy for hyperthyroidism in Cuba, based on the use of the methodology proposed in this research, is facilitated.

Introducción: En Cuba, se prevé realizar la terapia paciente específica del hipertiroidismo. Se han desarrollado una metodología y herramientas computacionales con este propósito. El análisis del riesgo permitirá acometer con calidad y seguridad dicha práctica. Objetivo: Analizar los riesgos radiológicos en la terapia paciente específica del hipertiroidismo en Cuba. Material y Métodos: Se revisó y adaptó el modelo genérico de Medicina Nuclear paciente específica. Con el código cubano SECURE MR-FMEA versión 3.0 se determinaron el riesgo inherente y el residual, se identificaron las etapas del proceso, los sucesos iniciadores, las medidas y causas más contribuyentes, así como las consecuencias para los grupos expuestos. Resultados: Se obtuvo un nivel alto de riesgo que se controló con las medidas adicionadas. Las etapas más significativas son: la adquisición de imágenes pre- y post- tratamiento y la preparación del radiofármaco. Las medidas preventivas más importantes son: mantener una carga de trabajo moderada para el personal, las capacitaciones del físico médico y de los especialistas que realizan las revisiones del proyecto en la etapa de diseño del servicio. Los pacientes tienen consecuencias muy altas en 10,7 % de las secuencias accidentales. Sin embargo, los trabajadores y el público presentan consecuencias medias en 29 % y 16 %, respectivamente. El incumplimiento de prácticas, protocolos, procedimientos o normas es la causa básica de fallo predominante. Conclusiones: Se facilita la toma de decisiones para la implementación del tratamiento paciente específico del hipertiroidismo en Cuba, a partir del empleo de la metodología que se propone en esta investigación.

BackgroundChronic kidney disease (CKD) predispose to viral coinfections in patients submitted to renal replacement therapy (RRT); nevertheless, few reports have been performed to elucidate the current epidemiology within this population in Mexico.AimTo estimate the prevalence of HBV, HCV, and HIV coinfection and to explore factors associated with prevalent coinfection in patients living with renal failure undergoing to RRT.MethodsA multicenter cross-sectional recruitment across 21 units at the Mexican Institute of Social Security (IMSS) at the State of Mexico was performed during 2019. A standardized clinical questionnaire was performed to elucidate individual and relatives-related conditions. A treatment facility questionnaire was applied to the chief responsible of each unit to explore treatment facility variables. Serological testing, clinical, biochemical, and anthropometrical parameters were extracted from clinical records.ResultIn 1,304 patients (57.5% male, mean age 45.5 (SD: 15.6) years, and 95.8% in hemodialysis), the prevalence of any viral coinfection was 3.14% (95% CI: 2.32%-4.23%). The highest viral coinfection prevalence were for HCV, HBV, and HIV, in which men and subjects diagnosed after 2010's had the highest rates. We identify that being submitted to peritoneal dialysis, being treated in a surrogated dialysis center and living with a close relative with prior hepatitis coinfection were associated factors for any viral coinfection.ConclusionIn patients submitted to RRT, the prevalence of viral coinfection remains high compared with general population. Screening strategies, medical awareness and targeted public healthcare policies should prioritize better care practices within patients submitted to RRT in Mexico.

BackgroundAcute lymphoblastic leukemia (ALL) is characterized by an abnormal proliferation of immature lymphocytes, in whose development involves both environmental and genetic factors. It is well known that single nucleotide polymorphisms (SNPs) in coding and noncoding genes contribute to the susceptibility to ALL. This study aims to determine whether SNPs in miR-146a, miR-196a-2, miR-499a, and miR-612 genes are associated with the risk to ALL in pediatric Mexican population.MethodsA multicenter case-control study was carried out including patients with de novo diagnosis of ALL and healthy subjects as control group. The DNA samples were obtained from saliva and peripheral blood, and the genotyping of rs2910164, rs12803915, rs11614913, and rs3746444 was performed using the 5′exonuclease technique. Gene-gene interaction was evaluated by the multifactor dimensionality reduction (MDR) software.ResultsmiR-499a rs3746444 showed significant differences among cases and controls. The rs3746444G allele was found as a risk factor to ALL (OR, 1.6 [95% CI, 1.05–2.5]; p = 0.028). The homozygous GG genotype of rs3746444 confers higher risk to ALL than the AA genotype (OR, 5.3 [95% CI, 1.23–23.4]; p = 0.01). Moreover, GG genotype highly increases the risk to ALL in male group (OR, 17.6 [95% CI, 1.04–298.9]; p = 0.00393). In addition, an association in a gender-dependent manner among SNPs located in miR-146a and miR-196a-2 genes and ALL susceptibility was found.ConclusionOur findings suggest that SNP located in miR-499a, miR-146a, and miR-196a-2 genes confer risk to ALL in Mexican children. Experimental analysis to decipher the role of these SNPs in human hematopoiesis could improve our understanding of the molecular mechanism underlying the development of ALL.

There is scarce evidence on sociodemographic and lifestyle characteristics that may explain adherence to different dietary patterns (DPs) during pregnancy. Our aims were to identify dietary patterns in a sample of pregnant Mexican women and to describe their association with selected sociodemographic and lifestyle characteristics. This is a secondary cross-sectional analysis of 252 mothers of children that participated as controls in a hospital-based case–control study of childhood leukemia. We obtained parents' information about selected sociodemographic characteristics, as well as alcohol and tobacco consumption. We also obtained dietary information during pregnancy. We identified DPs using cluster and factor analyses and we estimated their association with characteristics of interest. We identified two DPs using cluster analysis, which we called "Prudent" and "Non healthy", as well as three DPs through factor analysis, namely "Prudent", "Processed foods and fish", and "Chicken and vegetables". Characteristics associated with greater adherence to "Prudent" patterns were maternal education, older paternal age, not smoking, and being a government employee and/or uncovered population. Likewise, the "Processed foods and fish" pattern was associated with greater maternal and paternal education, as well as those with less household overcrowding. We did not identify sociodemographic variables related to the "Chicken and Vegetables" pattern. Our results may be useful to identify target populations that may benefit from interventions aimed to improve individual dietary decisions during pregnancy. [ABSTRACT FROM AUTHOR]

The Sargassum have become a cyclical phenomenon that generates ecological, economic, and social problems in the Caribbean. The situation becomes more serious in a context of voluntary acceptance of the problem, which generates difficulties regarding the behaviors to control it. This research addresses the phenomenon from the perspective of risk perception concerning Sargassum invasions in the Dominican Republic, using a tool that includes perceptual and behavioral questions. The results show an underestimation of the risk of Sargassum blooms attributed to its interpretation as a natural and inevitable phenomenon, with an insignificant effect. This underestimation does not notably affect the health or standard of living of the population involved but has not been sufficiently addressed by scientific institutions and the Dominican government. The alert about some erroneous beliefs regarding the phenomenon, as shown by these perceptions, can contribute to designing successful policies for the control and management of massive influx of Sargassum. This transformation can turn them from an environmental problem into an opportunity for sustainable development. Based on the risk analysis, actions are suggested to guarantee the sustainable management of Sargassum blooms in the Dominican Republic. [ABSTRACT FROM AUTHOR]

La aplicación de métodos de análisis de riesgo combinados, para medicina con radiaciones ionizantes, permite identificar de manera proactiva debilidades en las etapas del proceso, lo que se traduce en el diseño de un plan de acciones de mejora. Muchos de estos análisis han sido ejecutados en base a matriz de riesgo (MR). Este enfoque emplea medidas de defensa, sin abordar las causas. Por otra parte, el análisis de modos y efectos de fallo (FMEA, por sus siglas en inglés), determina las causas de fallo, lo que aporta un enfoque más profundo a los análisis. Por ello, la tarea de transformación de MR a FMEA resulta de particular interés. Se presenta la aplicación de una metodología que facilita esta conversión con el código SECURE-MR-FMEA 3.0, obteniéndose resultados coherentes por ambos métodos. Igualmente se adapta el patrón de FMEA a la práctica de medicina nuclear para pacientes, trabajadores y público. Con objetivos ilustrativos, se muestra la transformación a un patrón de FMEA para los estudios de diagnóstico, desde su correspondiente modelo de MR. En el marco de la transformación se prevé el trabajo de expertos, los que deben convertir a causas básicas de fallo estandarizadas, las sugerencias originales de la conversión informatizada. Los resultados de la conversión se validan a través de un método conservador disponible en el sistema. La investigación de las causas de los incidentes estudiados se privilegia con la metodología propuesta, así como con la facilidad para la identificación de las medidas de defensa que evitan su recurrencia.

El estado del arte de la temática de clasificación de causas de fallos aplicada a los incidentes, ya sean ocurridos o potenciales, en prácticas médicas con radiaciones ionizantes, muestra enfoques parcializados y la no cobertura de todas las posibles áreas de influencia en los sucesos.La conformación de un listado estandarizado de causas de fallos para el análisis de riesgo en estas prácticas médicas facilita la adopción de medidas de mejora en el sistema de gestión de la calidad y de la seguridad. Su aplicación en el marco de la técnica de análisis de modos y efectos de fallas (FMEA por sus siglas en inglés) como método proactivo, así como durante el empleo de un método reactivo dentro de una base de datos de incidentes,facilita la determinación de la importancia de los errores humanos, las falla de equipos, la falta de cultura de seguridad, etc., que se presentancomo causas, así como la definición más efectiva de las acciones a adoptar por los gestores. Por otro lado, tal aplicación también facilita la homogenización de la terminología en la identificación de las causas básicas y el acoplamiento entre métodos de análisis. Se presenta una relación de causas básicas por área de influencia de uso internacional, pero ampliada y adaptada a las prácticas médicas de referencia, siguiendo la codificación numérica utilizada en bases de datos de sucesos adversos y potenciales. Se ilustra su empleo por los expertos en el análisis de riesgo a través del código SECURE-MR-FMEA 3.0.

En el estado del arte de la aplicación de la gestión de riesgos a la optimización de la garantía de calidad de las prácticas médicas con radiaciones ionizantes (PMCRI) está el AAPM-TG100, en el que se combinan capacidades de herramientas como diagramas de Ishikawa, evaluaciones con análisis de modos y efectos de fallos (FMEA por sus siglas en inglés) y árboles de fallos. Un aspecto distintivo de este documento es la diversidad de códigos empleados para lograr esta aplicación. El código SECURE-MR-FMEA, ofrece, entre otras capacidades la posibilidad de generar mapas de procesos, en forma de diagramas de Ishikawa, realizar evaluaciones basadas en FMEA y generar árboles de fallos de los subprocesos y de las causas que generan los modos de fallos (MF) de cada uno. El documento es amplio en la ilustración de tales capacidades y en el enfoque crítico del estado del arte de estas tareas aplicadas a PMCRI, planteando el desarrollo de nuevos indicadores y facilidades gráficas a nivel de subproceso, etapa, MF y causa, lo que ayuda a la implementación de las medidas de defensa que se aplican a los contribuyentes más importantes tras este análisis sistemático, lo que permite ganar en eficacia y eficiencia en la toma de decisiones, para la mejora de la calidad y seguridad en dichas prácticas.

A partir de una revisión de la bibliográfica y fuentes metodológicas de análisis de la percepción del riesgo, el artículo expone el resultado del estudio realizado en trabajadores que ocupan puestos de alto riesgo, en la División Territorialde la Empresade Telecomunicaciones de Cuba S. A. (Etecsa) en la ciudad de Sancti Spíritus. Material y método: Como instrumento de medición se utilizó la metodología de evaluación de percepción de riesgo ocupacional (Epro) desarrollada en Cuba en 2009 y contenida en el software Riskpercep. Resultado: El análisis de los resultados obtenidos en las diferentes variables estableció que las más influyentes como factores condicionantes de las violaciones registradas en materia de seguridad vial y del trabajo fueron: baja percepción de riesgos determinadas por la baja comprensión del riesgo, actitudes temerarias y negligentes, los altos beneficios recibidos en términos de bienes, servicios e ingresos monetarios; así como su relación con la alta demanda (intensidad) de trabajos. Conclusiones: Finalmente se propone desarrollar un programa de capacitación adecuado para el incremento de la percepción del riesgo en los trabajadores.

The most useful prospective methods to risk analysis in ionizing radiation medicine are the risk matrix and the failure mode and effect analysis. In another hand, at the world level developed various systems for reactive risk analysis, for example ROSIS, SAFRON and ARIR. In the research will follow to development and use an integration methodology of these methods. This approach was introduced in the Cuban code SECURE MR-FMEA version 3.0. A specific taxonomy for the incident data base (IDB) coupled with the code was developed and it was created the correspondence analysis of studied models for radiotherapy for allows the selection by expert criteria. The result of this matching allows the validation of the risk patterns by risk matrix or FMEA approach, through the coverage or representative studies in the incident data base. The most representative risk patterns in the incident data base are the linear accelerator and cobalt therapy. The comparison between the results of the investigation and other similar studies are available in the paper. The IDB incorporated de radionuclide therapy and transport of radioactive materials events.This research facilitates the decision-making in improvements of safety and culture in the ionizing radiation medicine.

Background: Acute lymphoblastic leukemia (ALL) is the main type of cancer in children. In Mexico and other Hispanic populations, the incidence of this neoplasm is one of the highest reported worldwide. Functional polymorphisms of various enzymes involved in the metabolism of xenobiotics have been associated with an increased risk of developing ALL, and the risk is different by ethnicity. The aims of the present study were to identify whether NQO1, CYP2E1, and NAT2 polymorphisms or some genotype-environmental interactions were associated with ALL risk in Mexican children.Methods: We conducted a case-control study including 478 pediatric patients diagnosed with ALL and 284 controls (children without leukemia). Ancestry composition of a subset of cases and controls was assessed using 32 ancestry informative markers. Genetic-environmental interactions for the exposure to hydrocarbons were assessed by logistic regression analysis.Results: The polymorphisms rs1801280 (OR 1.54, 95% CI 1.21–1.93), rs1799929 (OR 1.96, 95% CI 1.55–2.49), and rs1208 (OR 1.44, 95% CI 1.14–1.81) were found to increase the risk of ALL; being the risks higher under a recessive model (OR 2.20, 95% CI 1.30–1.71, OR 3.87, 95% CI 2.20–6.80, and OR 2.26, 95% CI 1.32–3.87, respectively). Gene-environment interaction analysis showed that NAT2 rs1799929 TT genotype confers high risk to ALL under exposure to fertilizers, insecticides, hydrocarbon derivatives, and parental tobacco smoking. No associations among NQO1, CYP2E1, and ALL were observed.Conclusion: Our study provides evidence for the association between NAT2 polymorphisms/gene-environment interactions, and the risk of childhood ALL in Mexican children.

Pertussis is a vaccine-preventable disease caused by the bacterium Bordetella pertussis. Over the past years, the incidence and mortality of pertussis increased significantly. A possible cause is the switch from whole-cell to acellular pertussis vaccines, although other factors may also contribute. Here, we applied high-dimensional flow cytometry to investigate changes in B cells in individuals of different ages and distinct priming backgrounds upon administration of an acellular pertussis booster vaccine. Participants were divided over four age cohorts. We compared longitudinal kinetics within each cohort and between the different cohorts. Changes in the B-cell compartment were correlated to numbers of vaccine-specific B- and plasma cells and serum Ig levels. Expansion and maturation of plasma cells 7 days postvaccination was the most prominent cellular change in all age groups and was most pronounced for more mature IgG1+ plasma cells. Plasma cell responses were stronger in individuals primed with whole-cell vaccine than in individuals primed with acellular vaccine. Moreover, IgG1+ and IgA1+ plasma cell expansion correlated with FHA-, Prn-, or PT- specific serum IgG or IgA levels. Our study indicates plasma cells as a potential early cellular marker of an immune response and contributes to understanding differences in immune responses between age groups and primary vaccination backgrounds.

Context: The Institute of Oncology and Radiobiology (INOR) is the leading institution for the diagnosis, treatment and follow up of cancer in Cuba. Cancer treatment is mainly by three methods: surgery, radiotherapy and chemotherapy. Pharmacological treatments involve the use of dangerous substances such as cytostatics, the handling of which threat the health of the occupationally exposed staff. Aims: To evaluate a biomarker of genotoxicity indicative of DNA damage in the biomonitoring of occupational risks associated with the administration of antineoplastic drugs to hospitalized patients. Methods: The determination of the frequency of micronuclei, in cells of the exfoliated oral mucosa was determined (Micronucleus test) in subjects who administer cytostatic drugs at the institute and a control group formed by administrative personal. Results: Present results evidenced that all exposed subjects possess the same DNA damage that non-exposed-ones. Such results are in concordance with the proper use of primary protection barriers and the adhesion to normalized operational procedures. Conclusions: The frequency of micronuclei is a useful biomarker for assessing DNA damage associated with the administration of antineoplastic drugs. The risk perception analysis (RISKPERCEP) in occupationally exposed subjects complements the occupational safety monitoring.

Introduction: in view of the high incidence of skin cancer, where treatments with ionizing radiation are used, particularly with SENSUS SRT-100TM equipment at Oncology Patient Care Center of Pinar del Río, and the known need to improve the prevention of incidents and accidents related to this practice, an advanced risk-analysis approach, similar to that proposed by the American Association of Physicists in Medicine, was applied using the SECURE MR-FMEA code. Objective: to develop a risk study for superficial radiotherapy with SENSUS SRT 100TM that identifies the modes and causes of failures associated with the treatment, which allow the use of applications that optimize the safety and quality of the practice. Methods: the prospective method of failure modes and effect analysis, regarding superficial treatments with SENSUS SRT-100TM through the applications developed by means of the SECURE MR-FMEA code. Results: the process map was designed with its sub-processes and respective stages by a multidisciplinary team created at Oncology Patient Care Center in Pinar del Río, assisting the global comprehension of the activity and determining the risk profile and specific failure trees (supported by the benefits of the SECURE MR-FMEA program), to create defense measures and developing activities that decreased the risk after the application of the reassessment. Conclusions: the risk study carried out in superficial radiotherapy made possible to strengthen the safety and quality of the treatments delivered at the Oncology Patient Care Center of Pinar del Río, allowing the future assessments

O presente trabalho foi dedicado à avaliação de árvores de falhas mediante uma planilha EXCEL. A determinação dos Cortes Mínimos (CM) foi realizada formando todas as combinações possíveis dos eventos básicos que integram a árvore. O método impede que o cálculo colapse por explosão combinatória. A memória disponível nunca constitui uma limitação. Foi aplicada a fatoração de eventos não repetidos, um método recursivo para a formação das combinações de eventos e um ordenamento dos componentes que da prioridade aos mais repetidos e próximos do portão topo. A planilha EXCEL determina os CM mais importantes, a probabilidade de falha do sistema e as medidas de importância dos componentes. Também são possíveis análises de indisponibilidade instantânea. São apresentados os resultados para duas árvores de falhas representativas que foram resolvidas em tempos razoáveis, mostrando um desempenho adequado para aplicações industriais de moderada complexidade.

Technetium-99m is the most commonly used radionuclide in the field of nuclear medicine. The National Center for Nuclear Safety (NCNS), as the regulatory body of Cuba, requires the carrying out of risk analysis for facilities with associated radiological hazard potential and, preferably, that these analyzes be performed using the risk matrix method. Although there are several qualitative or quantitative methods to perform these studies, the existence of basis risk starting and analysis codes and simplicity of use has been privileged the risk matrix as a predominant semi-quantitative method. The paper presents the results of the application of this method for the evaluation of the risks associated with the production of Molybdenum-99/Technetium-99m generators, which is carried out at the Isotope Center (Centis). Using the SECURE – MR Ver. 2.0 code a detailed risk analysis of its practice was carried out. Three accidental sequences of high-level risks were identified and the importance of barriers and reducers related to human factors associated to sufficiency and staff training was determined. Among the derived applications novel analysis capacities as well as risk monitoring possibilities are reported. The risk model developed for the production process of Molybdenum-99/Technetium-99m generators, joined with the ability to review, analyze and all the documentation provided by the tool, allow obtaining a completely and coherent document with the model, which constitutes an effective basis the safety of the facility. risk assessment, radioisotope generators, molybdenum 99, technetium 99, safety

The kilovoltage radiotherapy is a recently re-implemented practice in the National Institute of Oncology and Radiology of Cuba to treat patients. One of the problems to approve its use is the assessment of risks associated to this practice. The present paper shows a summary of the pattern of accidental sequences proposed for this practice and its risk is quantified by using the risk matrix methodology. The SECURE-MR code has been used as the tool selected to implement such a practice. In addition to customary analysis facilities, this code has some other novel characteristics allowing us to establish the contributors’ priorities. The global results of the risk assessment for the proposed pattern, as well as some particular optimization practices are included in this paper.

Introduction: Good syndrome (GS) is a rare adult-onset immunodeficiency first described in 1954. It is characterized by the coexistence of a thymoma and hypogammaglobulinemia, associated with an increased susceptibility to infections and autoimmunity. The classification and management of GS has been long hampered by the lack of data about the underlying immune alterations, a controversy existing on whether it is a unique diagnostic entity vs. a subtype of Common Variable Immune Deficiency (CVID). Methods: Here, we used high-sensitive flow cytometry to investigate the distribution of up to 70 different immune cell populations in blood of GS patients (n=9) compared to age-matched CVID patients (n=55) and healthy donors (n=61). Results: All 9 GS patients displayed reduced B-cell counts -down to undetectable levels (<0.1 cells/mL) in 8/9 cases-, together with decreased numbers of total CD4+ T-cells, NK-cells, neutrophils, and basophils vs. age-matched healthy donors. In contrast, they showed expanded TCRgd+ T-cells (p ≤ 0.05). Except for a deeper Bcell defect, the pattern of immune cell alteration in blood was similar in GS and (agematched) CVID patients. In depth analysis of CD4+ T-cells revealed significantly decreased blood counts of naïve, central memory (CM) and transitional memory (TM) TCD4+ cells and their functional compartments of T follicular helper (TFH), regulatory T cells (Tregs), T helper (Th)2, Th17, Th22, Th1/Th17 and Th1/Th2 cells. In addition, GS patients also showed decreased NK-cell, neutrophil, basophil, classical monocyte and of both CD1c+ and CD141+ myeloid dendritic cell counts in blood, in parallel to an expansion of total and terminal effector TCRgd+ T-cells. Interestingly, those GS patients who developed hypogammaglobulinemia several years after the thymoma presented with an immunological and clinical phenotype which more closely resembled a combined immune humoral and cellular defect, with poorer response to immunoglobulin replacement therapy, as compared to those in whom the thymoma and hypogammaglobulinemia were simultaneously detected. Discussion: Our findings provide a more accurate definition of the immune cell defects of GS patients and contribute to a better discrimination among GS patients between those with a pure B-cell defect vs. those suffering from a combined immunodeficiency with important consequences on the diagnosis and management of the disease. [ABSTRACT FROM AUTHOR]

Risk assessment methods vary and have been applied to areas such as environmental, technological, and occupational safety, adapting to the complexities of the subjects under study. The objective of this work is to conduct a risk analysis of a domestic wastewater treatment system based on constructed wetlands (CW) and to evaluate actions to reduce the operational risk of the studied installation. The approach used is the three-dimensional risk matrix, which is a simplified version of the probabilistic risk evaluation method, making it more accessible and allowing for broader application. To apply the risk matrix method to a wastewater system based on CW, it was necessary to modify a risk model. This modification involved creating a process map and identifying accidental scenarios or sequences within each stage, including their initiating events, defenses, and consequences. The results enabled the identification of the most critical initiating events and defenses. Notably, human factors emerged as the primary contributors to the risk associated with wetland operation. The findings from this study can be used to enhance wetland security, including the prioritization of controls for the most critical defenses identified in this research. [ABSTRACT FROM AUTHOR]

Background: Multiparameter flow cytometry (FC) immunophenotyping is a key tool for detailed identification and characterization of human blood leucocytes, including B-lymphocytes and plasma cells (PC). However, currently used conventional data analysis strategies require extensive expertise, are time consuming, and show limited reproducibility. Objective: Here, we designed, constructed and validated an automated database-guided gating and identification (AGI) approach for fast and standardized in-depth dissection of B-lymphocyte and PC populations in human blood. Methods: For this purpose, 213 FC standard (FCS) datafiles corresponding to umbilical cord and peripheral blood samples from healthy and patient volunteers, stained with the 14-color 18-antibody EuroFlow BIgH-IMM panel, were used. Results: The BIgH-IMM antibody panel allowed identification of 117 different Blymphocyte and PC subsets. Samples from 36 healthy donors were stained and 14 of the datafiles that fulfilled strict inclusion criteria were analysed by an expert flow cytometrist to build the EuroFlow BIgH-IMM database. Data contained in the datafiles was then merged into a reference database that was uploaded in the Infinicyt software (Cytognos, Salamanca, Spain). Subsequently, we compared the results of manual gating (MG) with the performance of two classification algorithms -hierarchical algorithm vs two-step algorithm-for AGI of the cell populations present in 5 randomly selected FCS datafiles. The hierarchical AGI algorithm showed higher correlation values vs conventional MG (r2 of 0.94 vs. 0.88 for the two-step AGI algorithm) and was further validated in a set of 177 FCS datafiles against conventional expert-based MG. For virtually all identifiable cell populations a highly significant correlation was observed between the two approaches (r2>0.81 for 79% of all B-cell populations identified), with a significantly lower median time of analysis per sample (6 vs. 40 min, p=0.001) for the AGI tool vs. MG, respectively and both intra-sample (median CV of 1.7% vs. 10.4% by MG, p<0.001) and inter-expert (median CV of 3.9% vs. 17.3% by MG by 2 experts, p<0.001) variability. Conclusion: Our results show that compared to conventional FC data analysis strategies, the here proposed AGI tool is a faster, more robust, reproducible, and standardized approach for in-depth analysis of B-lymphocyte and PC subsets circulating in human blood. [ABSTRACT FROM AUTHOR]

The use of simulators is good practice for teaching or training in the operation of complex processes. This is the case of climate change, the one associated with multiple phenomena that cannot be played as isolated laboratory practices. The experts themselves of the Intergovernmental Panel on Climate Change (IPCC) have suggested qualitative indicators tomeasure the components of this risk (hazard, vulnerability and exposure) and still, its complexity is remarkable for the multi, inter and transdisciplinary knowledge necessary for evaluation. One of the most important challenges of teaching these topics is the multiplicity of combinations that can occur for a variety of inputs of tax risk factors in each area of the world studied. Therefore, the presentation of an interdependent matrix system that maps the global and regional variables concerning the risks of climate change and a recursive system for evaluation are the basis of the simulator proposed in this paper. The same has been tested with global and regional scenarios, which have been incorporated into computercode developed for the preparation of prewritten didactic exercises and a recommendation for the implementation of new case studies.

Las energías renovables, en particular la eólica, ocuparán un lugar importante en las próximas décadas, marcadas por el agotamiento de las fuentes de combustible fósil. En Cuba se prevé un crecimientoconsiderable en la utilización de estas fuentes energéticas. De ahí la importancia de crear las bases del uso de tecnologías confiables que garantice tal misión futura. El artículo se propone como objetivo central,realizar el análisis de confiabilidad del parque eólico Gibara 2 partiendo del empleo de la metodología de árbol de fallos y recomendar algunas posibles aplicaciones de sus resultados. Un paso esencial en la investigación es la determinación de los componentes que participarán en el árbol de fallos y elprocesamiento de la base de datos disponible en el parque Gibara 2. El documento tributa esencialmente a la identificación de los contribuyentes principales a la indisponibilidad de los parques y a la optimización dela política de mantenimiento.Renewable energy, particularly wind, will occupy an important place in the coming decades, marked by the depletion of fossil fuel sources. In Cuba significant growth in the use of these energy sourcesis forecasted.For this reason is importantthe creation of reliable technology to ensure that future mission. The paper proposes as its central objective, the analysis of reliability of Wind Farm Gibara 2 starting from its representation based on the methodology of fault tree and to recommend some possible applications of the results. An essential step in the research is the determination of participating components in the fault tree and processing of the available reliability database at the Wind Farm Gibara 2. The document essentiallyhelpsin the identification of the main contributors to the unavailability of facilities and optimizing maintenance policy.