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BACKGROUND: The first waves of the COVID-19 pandemic had a negative impact on health systems and health professionals, due to the high number of cases and a lack of preparation. The aim of this study was to understand how nurses working in hospital units and in intensive care perceived the performance of nurse managers and senior hospital management during the first two waves of the pandemic. METHODS: The phenomenological approach proposed by Giorgi was used to investigate perceptions of the performance of nurse managers and senior hospital management during the first two waves of the COVID-19 pandemic in Spain. Fourteen clinical nurses who worked on the front line in inpatient units or intensive care units of the Health Services of Extremadura and Madrid in the first (March-April 2020) and second (October-November 2020) waves of the COVID-19 pandemic participated in this study. The data was collected through semi-structured interviews, following a script of themes, in a theoretical sample of nurses who were worked during the pandemic. RESULTS: Two main themes emerged from the analysis of the data: (1) perceptions about the performance of nurse managers and senior hospital managers during the first and second waves of the pandemic (health system failure; belief that senior hospital management professionals could have managed the pandemic better; recognizing the efforts of middle management (nursing supervisors); insufficient institutional support) and (2) strategies employed by nurses to compensate for the weaknesses in pandemic management. CONCLUSIONS: The clinical nurses perceived that the nurse managers demonstrated better management of the pandemic than the hospital's senior management, which they attribute to their proximity, empathy, accessibility, and ability to mediate between them and the senior management. The nurses also believe that the senior management of the hospitals was to blame for organisational failures and the poor management of the pandemic.

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Using mathematical models of physiological systems in medicine has allowed for the development of diagnostic, treatment, and medical educational tools. However, their complexity restricts, in most cases, their application for predictive, preventive, and personalized purposes. Although there are strategies that reduce the complexity of applying models based on fitting techniques, most of them are focused on a single instant of time, neglecting the effect of the system's temporal evolution. The objective of this research was to introduce a dynamic fitting strategy for physiological models with an extensive array of parameters and a constrained amount of experimental data. The proposed strategy focused on obtaining better predictions based on the temporal trends in the system's parameters and being capable of predicting future states. The study utilized a cardiorespiratory model as a case study. Experimental data from a longitudinal study of healthy adult subjects undergoing aerobic exercise were used for fitting and validation. The model predictions obtained in a steady state using the proposed strategy and the traditional single-fit approach were compared. The most successful outcomes were primarily linked to the proposed strategy, exhibiting better overall results regarding accuracy and behavior than the traditional population fitting approach at a single instant in time. The results evidenced the usefulness of the dynamic fitting strategy, highlighting its use for predictive, preventive, and personalized applications.

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The historical and geographical properties of the archipelagos allow a detailed study of species diversification, and phenotypic traits can indicate the extent of such processes. Eupelmus pulchriceps (Cameron, 1904) is an exotic species to the Galapagos archipelago, and generalist parasitoid that attacks a beetle species that consumes the seeds of the invasive shrub Leucaena leucocephala (Lam.) de Wit. Despite extensive sampling, the wasp is recorded only in Santa Cruz and San Cristobal islands of the Galapagos archipelago. Thus, using 112 female wasps, we compare body size, proportion, and allometric differentiations within and between the two islands. There were no body size differences between islands. A PerMANOVA indicates differences between the islands and a single differentiation between two localities of one island. Allometric differences between islands were not the same for all structures. These results are consistent with the greater distance between islands than between localities and suggest a differentiation process. The variables with allometric differentiation are associated with wings and ovipositor, possibly responding to different ecological pressures. It is interesting that this parasitoid, recently arrived at the archipelago, is already showing differentiation. Also, it is essential to monitor the behavior of these wasps in the archipelago, given their potential to access other species affecting the trophic interactions of the local biota.

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The pseudoscorpion family Withiidae is widely distributed around the world, with most of its diversity in tropical areas. Five new species and a new genus from Colombia are described: Cystowithiusflorezisp. nov., Parawithiusbromelicolasp. nov., Oligowithiusachaguasp. nov., and the genus Paciwithiusgen. nov. with two species Paciwithiusvalduparensissp. nov. and Paciwithiuschimbilacussp. nov. A reassessment of the subgenus Dolichowithius (Oligowithius) Beier, 1936 allows the elevation to a full generic level, and the transfer of the only known species to Oligowithius, forming the new combination Oligowithiusabnormis (Beier, 1936), comb. nov.

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Applying complex mathematical models of physiological systems is challenging due to the large number of parameters. Identifying these parameters through experimentation is difficult, and although procedures for fitting and validating models are reported, no integrated strategy exists. Additionally, the complexity of optimization is generally neglected when the number of experimental observations is restricted, obtaining multiple solutions or results without physiological justification. This work proposes a fitting and validation strategy for physiological models with many parameters under various populations, stimuli, and experimental conditions. A cardiorespiratory system model is used as a case study, and the strategy, model, computational implementation, and data analysis are described. Using optimized parameter values, model simulations are compared to those obtained using nominal values, with experimental data as a reference. Overall, a reduction in prediction error is achieved compared to that reported for model building. Furthermore, the behavior and accuracy of all the predictions in the steady state were improved. The results validate the fitted model and provide evidence of the proposed strategy's usefulness.

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The use of physiological models in medicine allows the evaluation of new hypotheses, development of diagnosis and clinical treatment applications, and development of training and medical education tools, as well as medical device design. Although several mathematical models of physiological systems have been presented in the literature, few of them are able to predict the human cardiorespiratory response under physical exercise stimulus adequately. This paper aims to present the building and comparison of an integrated cardiorespiratory model focused on the prediction of the healthy human response under rest and aerobic exercise. The model comprises cardiovascular circulation, respiratory mechanics, and gas exchange system, as well as cardiovascular and respiratory controllers. Every system is based on previously reported physiological models and incorporates reported mechanisms related to the aerobic exercise dynamics. Experimental data of 30 healthy male volunteers undergoing a cardiopulmonary exercise test and simulated data from two of the most current and complete cardiorespiratory models were used to evaluate the performance of the presented model. Experimental design, processing, and exploratory analysis are described in detail. The simulation results were compared against the experimental data in steady state and in transient regime. The predictions of the proposed model closely mimic the experimental data, showing in overall the lowest prediction error (10.35%), the lowest settling times for cardiovascular and respiratory variables, and in general the fastest and similar responses in transient regime. These results suggest that the proposed model is suitable to predict the cardiorespiratory response of healthy adult humans under rest and aerobic exercise conditions.NEW & NOTEWORTHY This paper presents a new cardiorespiratory model focused on the prediction of the healthy human response under rest and aerobic dynamic exercise conditions. Simulation results of cardiorespiratory variables are compared against experimental data and two of the most current and complete cardiorespiratory models.

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Assuntos

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Stenocorse is a monotypic genus with wide distribution and a large range of beetle hosts. We analyzed the morphological variation of 346 specimens from the USA south to Brasil. We studied 15 morphometric and 30 discrete characters using principal component (PCA) and discriminant function analyses (DFA) to assess character informativeness and the influence of geographic distribution and host source to detect differentiation. Mexican samples were studied according to location and biogeographic provinces. Specimens from Colombia were studied according to the plant where the host was recorded. Three measurements show group differentiation whereas four were redundant. Three groups of individuals were supported by continuous and discrete characters: one found in the USA, Mexico, Nicaragua and Costa Rica, a second from Mexico, and a third from Colombia and Brazil. These groups showed poor agreement with the differentiation of its common beetle host populations. This could be a consequence of the large number of sympatric host species feeding on a large number of plant species. This research shed light on other sources of evidence for building a sound taxonomy for Stenocorse.

Assuntos

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Transcranial direct current stimulation (tDCS) is a reemerged noninvasive cerebral therapy used to treat patients with epilepsy, including focal cortical dysplasia, with controversial results. We present a case of a 28-year-old female with left frontal cortical dysplasia refractory to antiepileptic drugs, characterized by 10-15 daily right tonic hemi-body seizures. The patient received a total of seven sessions of cathodal tDCS (2 mA, 30 min). The first three sessions were applied over three consecutive days, and the remaining four sessions of tDCS were given each at 2-week intervals. At the 1-year follow-up, the patient reported to have a single seizure per month and only mild adverse events.