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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">jmm</journal-id>
<journal-title-group>
<journal-title>Journal of Medicine and Movies</journal-title>
<trans-title-group xml:lang="es">
<trans-title>Revista de Medicina y Cine</trans-title>
</trans-title-group>
<abbrev-journal-title abbrev-type="publisher">J. Med. Mov. / Rev. Med. Cine</abbrev-journal-title>
</journal-title-group>
<issn pub-type="epub">1885-5210</issn>
<publisher>
<publisher-name>Ediciones Universidad de Salamanca</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">rmc.31185</article-id>
<article-id pub-id-type="doi">10.14201/rmc.31185</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Art&#x00ED;culos</subject>
</subj-group>
</article-categories>
<title-group>
<article-title><italic>THE THING</italic> (1982): UN PRIMER MODELO DE PREDIAGN&#x00D3;STICO PARA LAS INFECCIONES Y ALTERACIONES DE LA FISIOLOG&#x00CD;A</article-title>
<trans-title-group>
<trans-title xml:lang="en">The Thing <italic>(1982): A First Prediagnostic Model for Infections and Alterations of Physiology</italic></trans-title>
</trans-title-group>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>PRIETO-G&#x00D3;MEZ</surname>
<given-names>Isabel</given-names>
</name>
<xref ref-type="aff" rid="aff-es-1"><sup>1</sup></xref>
<bio>
<fig>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-1-31185.jpg"/>
</fig>
<p>Isabel Prieto G&#x00F3;mez. Catedr&#x00E1;tica de Fisiolog&#x00ED;a del Departamento de Ciencias de la Salud. Facultad de Ciencias Experimentales de la Universidad de Ja&#x00E9;n. Responsable del grupo de investigaci&#x00F3;n Endocrinolog&#x00ED;a y Nutrici&#x00F3;n en la Universidad de Ja&#x00E9;n (Neuroendocrinolog&#x00ED;a y Nutrici&#x00F3;n, BIO-221).</p>
</bio>
</contrib>
<contrib contrib-type="author">
<name>
<surname>RAM&#x00CD;REZ-S&#x00C1;NCHEZ</surname>
<given-names>Manuel</given-names>
</name>
<xref ref-type="aff" rid="aff-es-1"><sup>1</sup></xref>
<bio>
<fig>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-2-31185.jpg"/>
</fig>
<p>Manuel Ram&#x00ED;rez S&#x00E1;nchez. Catedr&#x00E1;tico de Fisiolog&#x00ED;a del Departamento de Ciencias de la Salud. Facultad de Ciencias Experimentales de la Universidad de Ja&#x00E9;n. Responsable del grupo de investigaci&#x00F3;n PAI CVI-221 (P&#x00E9;ptidos y Peptidasas).</p>
</bio>
</contrib>
<contrib contrib-type="author">
<name>
<surname>SEGARRA-ROBLES</surname>
<given-names>Ana Bel&#x00E9;n</given-names>
</name>
<xref ref-type="aff" rid="aff-es-1"><sup>1</sup></xref>
<bio>
<fig>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-3-31185.jpg"/>
</fig>
<p>Ana Bel&#x00E9;n Segarra Robles. Doctora en Ciencias Biol&#x00F3;gicas por la Universidad de Ja&#x00E9;n. Profesora Ayudante Doctor en la Universidad de Ja&#x00E9;n y miembro en activo del grupo BIO-221 (Neuroendocrinolog&#x00ED;a y Nutrici&#x00F3;n).</p>
</bio>
</contrib>
<contrib contrib-type="author">
<name>
<surname>SULEIMAN-MARTOS</surname>
<given-names>Nora</given-names>
</name>
<xref ref-type="aff" rid="aff-es-2"><sup>2</sup></xref>
<bio>
<fig>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-4-31185.jpg"/>
</fig>
<p>Nora Suleiman-Martos. Doctora en Psicolog&#x00ED;a por la Universidad de Granada. Actualmente es profesora ayudante doctor en la Facultad de Ciencias de la Salud de la Universidad de Granada, donde imparte docencia asociada al mismo departamento utilizando una metodolog&#x00ED;a de gamificaci&#x00F3;n y recursos de innovaci&#x00F3;n docente entre ellos el uso del Cine como recurso educativo docente. Su l&#x00ED;nea de investigaci&#x00F3;n se centra en el &#x00E1;mbito de la salud p&#x00FA;blica y problemas psicosociales en el &#x00E1;mbito sanitario.</p>
</bio>
</contrib>
<contrib contrib-type="author">
<name>
<surname>GARC&#x00CD;A-C&#x00D3;ZAR</surname>
<given-names>Francisco</given-names>
</name>
<xref ref-type="aff" rid="aff-es-3"><sup>3</sup></xref>
<bio>
<fig>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-5-31185.jpg"/>
</fig>
<p>Francisco Jos&#x00E9; Garc&#x00ED;a C&#x00F3;zar. Catedr&#x00E1;tico de Inmunolog&#x00ED;a del Departamento de Biomedicina, Biotecnolog&#x00ED;a y Salud P&#x00FA;blica de la Universidad de C&#x00E1;diz. Doctor por la Universidad de C&#x00F3;rdoba con la tesis &#x00AB;Estudio funcional de mol&#x00E9;culas implicadas en activaci&#x00F3;n de c&#x00E9;lulas T humanas&#x00BB;. Responsable del grupo de investigaci&#x00F3;n CTS-498 (Gen&#x00F3;mica Funcional del Sistema Inmune. Alteraci&#x00F3;n Inmunol&#x00F3;gica de la Reproducci&#x00F3;n y la Anestesia).</p>
</bio>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>DOM&#x00CD;NGUEZ-V&#x00CD;AS</surname>
<given-names>Germ&#x00E1;n</given-names>
</name>
<xref ref-type="aff" rid="aff-es-4"><sup>4</sup></xref>
<xref ref-type="corresp" rid="c1-es"/>
<bio>
<fig>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-6-31185.jpg"/>
</fig>
<p>Germ&#x00E1;n Dom&#x00ED;nguez-V&#x00ED;as. Doctor en Ciencias de la Salud por la Universidad de C&#x00E1;diz y Doctor en Seguridad de los Alimentos por la Universidad de Ja&#x00E9;n. Actualmente es profesor contratado doctor en la Facultad de Ciencias de la Salud (Campus de Ceuta) de la Universidad de Granada, donde imparte docencia asociada al departamento de fisiolog&#x00ED;a en el grado de enfermer&#x00ED;a, e implementa el Cine como recurso educativo dentro del curr&#x00ED;culo. Su l&#x00ED;nea de investigaci&#x00F3;n se centra en la neurodegeneraci&#x00F3;n y la regulaci&#x00F3;n de la presi&#x00F3;n arterial.</p>
</bio>
</contrib>
<aff id="aff-es-1">
<label><sup>1</sup></label>
<institution content-type="original">&#x00C1;rea de Fisiolog&#x00ED;a, Facultad de Ciencias Experimentales. Universidad de Ja&#x00E9;n (Espa&#x00F1;a).</institution>
<institution content-type="orgname">&#x00C1;rea de Fisiolog&#x00ED;a, Facultad de Ciencias Experimentales</institution>
<institution content-type="orgdiv1">Universidad de Ja&#x00E9;n</institution>
<country country="ES">Espa&#x00F1;a</country>
</aff>
<aff id="aff-es-2">
<label><sup>2</sup></label>
<institution content-type="original">Departamento de Enfermer&#x00ED;a, Facultad de Ciencias de la Salud de Granada. Universidad de Granada (Espa&#x00F1;a).</institution>
<institution content-type="orgname">Departamento de Enfermer&#x00ED;a, Facultad de Ciencias de la Salud de Granada</institution>
<institution content-type="orgdiv1">Universidad de Granada</institution>
<country country="ES">Espa&#x00F1;a</country>
</aff>
<aff id="aff-es-3">
<label><sup>3</sup></label>
<institution content-type="original">&#x00C1;rea de Inmunolog&#x00ED;a, Facultad de Medicina. Universidad de C&#x00E1;diz (Espa&#x00F1;a).</institution>
<institution content-type="orgname">&#x00C1;rea de Inmunolog&#x00ED;a, Facultad de Medicina</institution>
<institution content-type="orgdiv1">Universidad de C&#x00E1;diz</institution>
<country country="ES">Espa&#x00F1;a</country>
</aff>
<aff id="aff-es-4">
<label><sup>4</sup></label>
<institution content-type="original">Departamento de Fisiolog&#x00ED;a, Facultad de Ciencias de la Salud de Ceuta. Universidad de Granada (Espa&#x00F1;a).</institution>
<institution content-type="orgname">Departamento de Fisiolog&#x00ED;a, Facultad de Ciencias de la Salud de Ceuta</institution>
<institution content-type="orgdiv1">Universidad de Granada</institution>
<country country="ES">Espa&#x00F1;a</country>
</aff>
</contrib-group>
<author-notes>
<corresp id="c1-es"><email>germandv@ugr.es</email></corresp>
</author-notes>
<pub-date publication-format="electronic" date-type="pub">
<day>01</day>
<month>12</month>
<year>2023</year>
</pub-date>
<pub-date publication-format="electronic" date-type="collection">
<year>2023</year>
</pub-date>
<volume>19</volume>
<issue>4</issue>
<fpage>345</fpage>
<lpage>354</lpage>
<history>
<date date-type="received">
<day>31</day>
<month>01</month>
<year>2023</year>
</date>
<date date-type="accepted">
<day>06</day>
<month>02</month>
<year>2023</year>
</date>
</history>
<permissions>
<copyright-statement>&#x00A9; 2023 Ediciones Universidad de Salamanca</copyright-statement>
<copyright-year>2023</copyright-year>
    <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es" xml:lang="es">
        <license-p>CC BY-NC-SA Atribuci&#x00F3;n-NoComercial-CompartirIgual 4.0 Internacional</license-p>
    </license>
</permissions>
<abstract>
<title><bold>Resumen</bold></title>
<p><italic>The Thing</italic> / <italic>La cosa (El enigma de otro mundo)</italic> (1982) de John Carpenter, supone un reto audiovisual para pensar en el descubrimiento de claves para la detecci&#x00F3;n temprana de infecciones hostiles. La b&#x00FA;squeda de t&#x00E9;cnicas r&#x00E1;pidas y sencillas para la resoluci&#x00F3;n de casos supone la diferencia entre la supervivencia y mantenerse en la desconfianza para un grupo que trata de descubrir quienes de ellos est&#x00E1;n infectados, y no terminar transformados en &#x00AB;otra cosa&#x00BB;. Este trabajo permitir&#x00E1; al estudiantado conocer los cambios en el equilibrio homeost&#x00E1;tico que supondr&#x00ED;a la relaci&#x00F3;n con los microorganismos de distinta naturaleza presentes en la sangre.</p>
</abstract>
<trans-abstract xml:lang="en">
<title><bold>Abstract</bold></title>
<p><italic>The Thing</italic> (1982) by John Carpenter represents an audiovisual challenge to think about the discovery of keys for the early detection of hostile infections. The search for quick and easy techniques for solving cases means the difference between survival and remaining suspicious for a group that tries to discover which of them are infected, and not end up transformed into &#x00AB;something else&#x00BB;. This work will allow the student body to know the changes in the homeostatic balance that the relationship with microorganisms of different nature present in the blood would imply.</p>
</trans-abstract>
<kwd-group xml:lang="es">
<title><bold>Palabras clave:</bold></title>
<kwd>fisiolog&#x00ED;a</kwd>
<kwd>homeostasis</kwd>
<kwd>microbioma</kwd>
<kwd>zoonosis</kwd>
<kwd>infecci&#x00F3;n</kwd>
<kwd>imitador</kwd>
</kwd-group>
<kwd-group xml:lang="en">
<title><bold>Keywords:</bold></title>
<kwd>physiology</kwd>
<kwd>homeostasis</kwd>
<kwd>microbiome</kwd>
<kwd>zoonosis</kwd>
<kwd>infection</kwd>
<kwd>mimic</kwd>
</kwd-group>
</article-meta>
</front>
<body>
<sec id="sec-1-31185-es">
<title><bold>Ficha t&#x00E9;cnica</bold></title>
<p><bold>T&#x00ED;tulo original:</bold> <italic>La cosa (El enigma de otro mundo).</italic></p>
<p><bold>Pa&#x00ED;s:</bold> Estados Unidos.</p>
<p><bold>A&#x00F1;o:</bold> 1982.</p>
<p><bold>Director:</bold> John Carpenter.</p>
<p><bold>M&#x00FA;sica:</bold> Ennio Morricone.</p>
<p><bold>Fotograf&#x00ED;a:</bold> Dean Cundey.</p>
<p><bold>Montaje:</bold> Todd C. Ramsay.</p>
    <p><bold>Guión:</bold> Bill Lancaster. Novela: John W. Campbell.</p>
<p><bold>Int&#x00E9;rpretes:</bold> Kurt Russell, Wilford Brimley, Keith David, David Clennon, Richard Dysart, Donald Moffat, Richard Masur, T.K. Carter, Charles Hallahan, Peter Maloney, Joel Polis, Thomas G. Waites.</p>
<p><bold>Color:</bold> Color.</p>
<p><bold>Duraci&#x00F3;n:</bold> 109 minutos.</p>
<p><bold>G&#x00E9;nero:</bold> Terror, fantas&#x00ED;a, misterio, ciencia ficci&#x00F3;n. Pel&#x00ED;cula de culto.</p>
<p><bold>Idioma original:</bold> ingl&#x00E9;s, noruego.</p>
<p><bold>Productora:</bold> Universal Pictures, Turman-Foster Company, Province of BC, Ministry of Tourism, Film Promotion Office.</p>
<p><bold>Sinopsis:</bold> En una estaci&#x00F3;n de investigaci&#x00F3;n estadounidense en la Ant&#x00E1;rtida, a principios del invierno de 1982, observan la aparici&#x00F3;n de un helic&#x00F3;ptero de la cercana estaci&#x00F3;n de investigaci&#x00F3;n noruega que sobrevuela la base americana tratando de matar a un perro de trineo. Despu&#x00E9;s de la destrucci&#x00F3;n del helic&#x00F3;ptero noruego, los miembros del equipo estadounidense vuelan a la base noruega, solo para descubrir a todos sus ocupantes muertos o desaparecidos. Encuentran los restos de una extra&#x00F1;a criatura que los noruegos quemaron. Los estadounidenses lo llevan a su base y deducen que se trata de una forma de vida extraterrestre. Cuando acogen al perro, &#x00E9;ste ataca brutalmente tanto a los seres humanos como a los caninos del campamento, y descubren que la bestia, de origen desconocido, puede asumir la forma de sus v&#x00ED;ctimas. Despu&#x00E9;s de un tiempo, es evidente que el extraterrestre puede hacerse cargo y asimilarse a otras formas de vida, incluidos los humanos, y puede propagarse como un virus. Esto significa que cualquiera en la base podr&#x00ED;a estar habitado por &#x00AB;La Cosa&#x00BB;, y las tensiones aumentan.</p>
<p><bold>Nominada a los Premios:</bold></p>
<p>1982, Saturn Awards: Mejor Pel&#x00ED;cula de Terror, Mejores Efectos Especiales (Rob Bottin);</p>
<p>1983, Premios Razzie: Peor banda sonora (Ennio Morricone).</p>
<p><bold>Disponibilidad:</bold> <italic>La cosa (The Thing)</italic> (Blu-Ray). Universal Pictures Iberia, S.L.; 2008.</p>
<p><bold>Enlaces:</bold></p>
<p><ext-link ext-link-type="uri" xlink:href="https://www.filmaffinity.com/es/film313264.html">https://www.filmaffinity.com/es/film313264.html</ext-link> <ext-link ext-link-type="uri" xlink:href="https://www.imdb.com/title/tt0084787/?ref_=ttfc_ql">https://www.imdb.com/title/tt0084787/?ref_=ttfc_ql</ext-link></p>
<p><bold>Tr&#x00E1;iler en espa&#x00F1;ol:</bold></p>
<p><ext-link ext-link-type="uri" xlink:href="https://www.filmaffinity.com/es/evideos.php?movie_id=313264">https://www.filmaffinity.com/es/evideos.php?movie_id=313264</ext-link></p>
<p><bold>Tr&#x00E1;iler Internacional (VO):</bold></p>
<p><ext-link ext-link-type="uri" xlink:href="https://www.imdb.com/video/vi2298151193/?playlistId=tt0084787&#x0026;ref_=tt_ov_vi">https://www.imdb.com/video/vi2298151193/?playlistId=tt0084787&#x0026;ref_=tt_ov_vi</ext-link></p>
<fig id="fig-1-31185-es">
<caption><title>Cartel espa&#x00F1;ol</title></caption>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-7-31185-es.jpg"/>
</fig>
</sec>
<sec id="sec-2-31185-es" sec-type="intro">
<title><bold>Introducci&#x00F3;n</bold></title>
<p><italic>La Cosa (El enigma de otro mundo) / The Thing</italic> (1982) de John Carpenter es una de las mejores obras maestras del terror y de la ciencia ficci&#x00F3;n (Posici&#x00F3;n en rankings: IMDb Top 153/250; Filmaffinity Espa&#x00F1;a 37/1000) que aborda la contaminaci&#x00F3;n microbiol&#x00F3;gica y las modificaciones de la biolog&#x00ED;a celular humana. En la pel&#x00ED;cula se palpa la tensi&#x00F3;n al descubrir que las c&#x00E9;lulas de un ser proveniente del espacio exterior tienen la capacidad de asimilar c&#x00E9;lulas terrestres y organismos vivos, digiri&#x00E9;ndolas e imitando su forma, habilidades y conocimientos (<xref ref-type="fig" rid="fig-2-31185-es">Foto 1</xref>). Este hecho marca un ritmo de suspense fren&#x00E9;tico por la desconfianza que supone convivir con alguien que puede que sea la imitaci&#x00F3;n de un compa&#x00F1;ero.</p>
<fig id="fig-2-31185-es">
<label><bold>Foto 1.</bold></label>
<caption><title>Estudio celular del microorganismo ex&#x00F3;geno no identificado (<italic>La Cosa</italic>). Descubren que tiene la habilidad de asimilar (A - E) las c&#x00E9;lulas de los perros de trineo y de cualquier ser vivo, e imitar (F) la c&#x00E9;lula asimilada, as&#x00ED; como cualquier otra forma de vida</title></caption>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-8-31185.jpg"/>
</fig>
<p>Ante una lesi&#x00F3;n celular o tisular, las c&#x00E9;lulas sufren mecanismos de adaptaci&#x00F3;n hasta el fin del cese del est&#x00ED;mulo, o sucumben por apoptosis o necrosis ante la imposibilidad de adaptarse. Ejemplos de adaptaciones a la lesi&#x00F3;n o al ambiente estresor son los cambios en tama&#x00F1;o de la c&#x00E9;lula (atrofia/hipertrofia), n&#x00FA;mero (hiperplasia, metaplasia - displasia) y/o forma. La sangre es un medio que se considera en principio est&#x00E9;ril hasta la llegada de una infecci&#x00F3;n sist&#x00E9;mica, sin embargo, en condiciones fisiol&#x00F3;gicas tambi&#x00E9;n es f&#x00E1;cilmente detectable c&#x00E9;lulas o ADN ex&#x00F3;geno sin manifestar signos y s&#x00ED;ntomas de una patolog&#x00ED;a. En este estudio planteamos los cambios fisiol&#x00F3;gicos que pueden ocurrir ante una septicemia o, desde otro punto de vista, ante una alteraci&#x00F3;n en el equilibrio del microbioma en sangre o disbiosis, refiri&#x00E9;ndose este a un cambio en la composici&#x00F3;n de las comunidades microbianas simbi&#x00F3;ticas o comensales.</p>
<p>Esta pel&#x00ED;cula plantea una forma interesante de detectar agentes microbianos a trav&#x00E9;s de una recolecci&#x00F3;n de muestra de sangre sobre una placa de Petri, para despu&#x00E9;s aplicar un est&#x00ED;mulo de calor con un cable calentado al fuego de un lanzallamas (<xref ref-type="fig" rid="fig-3-31185-es">Foto 2</xref>). La reacci&#x00F3;n ante un agente estresor o lesivo provocar&#x00ED;a la detecci&#x00F3;n y retirada inmediata del agente infeccioso.</p>
<fig id="fig-3-31185-es">
<label><bold>Foto 2.</bold></label>
<caption><title>Protocolo improvisado de recolecci&#x00F3;n de muestras de sangre y est&#x00ED;mulo de calor (A - B). Las muestras de sangre de sujetos sanos desprenden vapor (C &#x2013; E), sin embargo, la muestra contaminada se revela ante el est&#x00ED;mulo da&#x00F1;ino (F)</title></caption>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-9-31185.jpg"/>
</fig>
</sec>
<sec id="sec-3-31185-es" sec-type="results|discussion">
<title><bold>Resultados y discusi&#x00F3;n</bold></title>
<p>Dado que tradicionalmente se ha considerado que el torrente sangu&#x00ED;neo es un entorno b&#x00E1;sicamente est&#x00E9;ril, que contiene solo c&#x00E9;lulas sangu&#x00ED;neas, plaquetas y plasma, la detecci&#x00F3;n de microbios en la sangre humana se interpret&#x00F3; sistem&#x00E1;ticamente como un indicativo de infecci&#x00F3;n. Sin embargo, aunque es un concepto pol&#x00E9;mico, la evidencia de la existencia de un microbioma sangu&#x00ED;neo humano saludable se acumula constantemente<sup><xref ref-type="bibr" rid="ref-1-31185-Es">1</xref></sup>. La controversia sobre la incidencia de c&#x00E9;lulas extra&#x00F1;as en la sangre humana se remonta a 1969<sup><xref ref-type="bibr" rid="ref-2-31185-Es">2</xref></sup>, al describirse la presencia de bacterias metab&#x00F3;licamente activas en la sangre de sujetos humanos sanos. Espec&#x00ED;ficamente, el aumento de la absorci&#x00F3;n de nucle&#x00F3;sidos y amino&#x00E1;cidos en las suspensiones de eritrocitos los llev&#x00F3; a plantear la hip&#x00F3;tesis de la presencia de microorganismos bacterianos en la sangre de individuos sin signos y s&#x00ED;ntomas de enfermedad<sup><xref ref-type="bibr" rid="ref-2-31185-Es">2</xref></sup>. Otros estudios desmantelan estos resultados planteando que las bacterias pleom&#x00F3;rficas identificadas en la sangre de humanos sanos no eran m&#x00E1;s que micropart&#x00ED;culas derivadas de eritrocitos desintegrados, en concreto ves&#x00ED;culas de membrana y prote&#x00ED;nas sangu&#x00ED;neas refringentes capturadas por microscop&#x00ED;a de campo oscuro<sup><xref ref-type="bibr" rid="ref-3-31185-Es">3</xref>, <xref ref-type="bibr" rid="ref-4-31185-Es">4</xref></sup>. Todav&#x00ED;a sigue siendo un misterio la filogenia microbiana transmitida por la sangre, as&#x00ED; como los or&#x00ED;genes, las identidades y el papel funcional de estos microorganismos tan inesperados. Aun as&#x00ED; se van conociendo muchos estudios recientes que sugieren que la presencia de bacterias en la sangre es consecuencia de la translocaci&#x00F3;n desde otros sitios del cuerpo: piel y boca, materno por cord&#x00F3;n umbilical, pero particularmente el tracto gastrointestinal sin estar comprometida la membrana epitelial intestinal<sup><xref ref-type="bibr" rid="ref-5-31185-Es">5</xref>-<xref ref-type="bibr" rid="ref-7-31185-Es">7</xref></sup>. A pesar de las continuas evidencias de taxones bacterianos que conforman el microbioma sangu&#x00ED;neo saludable en humanos, se desconoce de la presencia de otros microorganismos, como virus, arqueas y hongos en la sangre de humanos sanos<sup><xref ref-type="bibr" rid="ref-1-31185-Es">1</xref></sup>.</p>
<p>La presencia de microorganismos extra&#x00F1;os en la sangre humana no equivale necesariamente a una infecci&#x00F3;n o a un estado de enfermedad. En estado de disbiosis, aunque el microbioma bacteriano que se transmite por la sangre es inocuo, el elevado n&#x00FA;mero puede provocar un estado de trastornos complejos y alteraciones fisiol&#x00F3;gicas. En situaciones reales, el an&#x00E1;lisis de rutina de los controles de laboratorio determina las caracter&#x00ED;sticas taxon&#x00F3;micas y metab&#x00F3;licas de taxones contaminantes derivados del medio ambiente. Hay que considerar que muchos microorganismos que se encuentran naturalmente en la sangre humana pueden estar en estado latente<sup><xref ref-type="bibr" rid="ref-1-31185-Es">1</xref></sup>. Por esta raz&#x00F3;n los m&#x00E9;todos basados en cultivos no son fiables para respaldar la existencia de un microbioma sangu&#x00ED;neo humano. Adem&#x00E1;s, si bien el n&#x00FA;mero de microorganismos y su concentraci&#x00F3;n de ADN en la sangre suele ser muy baja, las t&#x00E9;cnicas anal&#x00ED;ticas sensibles como la PCR cuantitativa en tiempo real (qPCR) y las t&#x00E9;cnicas de secuenciaci&#x00F3;n masiva (Next Generation Sequencing [NGS]) dirigida a loci espec&#x00ED;ficos de enfermedad, pueden corroborar la evidencia actual de la presencia de taxones bacterianos inocuos en la sangre de humanos sanos<sup><xref ref-type="bibr" rid="ref-5-31185-Es">5</xref></sup>. Otras de las t&#x00E9;cnicas que se utilizan son la microscop&#x00ED;a electr&#x00F3;nica de transmisi&#x00F3;n (TEM), la microscop&#x00ED;a de campo oscuro (DFM) y la hibridaci&#x00F3;n fluorescente in situ (FISH). En el caso del filme, &#x00AB;La Cosa&#x00BB; supone un agente zoon&#x00F3;tico con acci&#x00F3;n contaminante en los fluidos y tejidos humanos que facilita su digesti&#x00F3;n, asimilaci&#x00F3;n y mimetismo. Para que la sangre contaminada reaccione ante el da&#x00F1;o por calor, la disbiosis en el ser humano deber ser muy significativa, hecho constatado en el filme al representar cada individuo como una r&#x00E9;plica que imita y sustituye al original. En relaci&#x00F3;n al mimetismo, existe literatura que evidencia que determinados microorganismos se adaptan e imitan a las c&#x00E9;lulas inmunitarias para regular procesos fisiol&#x00F3;gicos o que pueden llegar a imitar a moduladores de los procesos inflamatorios y otras enfermedades autoinmunes<sup><xref ref-type="bibr" rid="ref-8-31185-Es">8</xref>-<xref ref-type="bibr" rid="ref-10-31185-Es">10</xref></sup>. Por ejemplo, la homeostasis inmunitaria en el intestino est&#x00E1; estrechamente controlada por las c&#x00E9;lulas T reguladoras (Treg) FOXP3<sup>+</sup>, cuyos defectos est&#x00E1;n relacionados con el desarrollo de enfermedades cr&#x00F3;nicas, como la enfermedad inflamatoria intestinal. Como mecanismo de evasi&#x00F3;n inmunitaria, el par&#x00E1;sito intestinal <italic>Heligmosomoides polygyrus</italic> potencia la actividad de las Treg al secretar una mol&#x00E9;cula (Hp-TGM) que imita la capacidad del TGF-&#x03B2; para inducir la expresi&#x00F3;n de FOXP3 en las c&#x00E9;lulas T CD4<sup>+</sup> <sup><xref ref-type="bibr" rid="ref-8-31185-Es">8</xref></sup>. La fisiolog&#x00ED;a de &#x00AB;La Cosa&#x00BB; se adapta a las caracter&#x00ED;sticas reales de los pat&#x00F3;genos, que durante milenios han aprendido a coevolucionar junto con sus hu&#x00E9;spedes para adquirir la capacidad de interceptar, interrumpir, imitar y usurpar numerosas v&#x00ED;as de se&#x00F1;alizaci&#x00F3;n de esos anfitriones; entre ellas encontramos las rutas moleculares mediadas por tirosina quinasa y Rho guanosina trifosfatasa de sus anfitriones para lograr una entrada, replicaci&#x00F3;n y salida eficientes durante sus ciclos infecciosos<sup><xref ref-type="bibr" rid="ref-9-31185-Es">9</xref></sup>. Adem&#x00E1;s, es conocido que el microbioma intestinal es un regulador central de la hipertensi&#x00F3;n<sup><xref ref-type="bibr" rid="ref-11-31185-Es">11</xref></sup> y del metabolismo lip&#x00ED;dico del hu&#x00E9;sped<sup><xref ref-type="bibr" rid="ref-12-31185-Es">12</xref></sup>, integra entradas ambientales, como la dieta<sup><xref ref-type="bibr" rid="ref-13-31185-Es">13</xref>-<xref ref-type="bibr" rid="ref-15-31185-Es">15</xref></sup>, con se&#x00F1;ales gen&#x00E9;ticas e inmunitarias para afectar el metabolismo, la inmunidad y la respuesta a la infecci&#x00F3;n del hu&#x00E9;sped<sup><xref ref-type="bibr" rid="ref-16-31185-Es">16</xref></sup>.</p>
<p>Con respecto a la ubicaci&#x00F3;n precisa de los microorganismos dentro de la sangre humana, la literatura m&#x00E1;s reciente sugiere que los taxones bacterianos pueden sobrevivir dentro de los hemat&#x00ED;es, plaquetas y linfocitos con un 93,74 % del ADN bacteriano integrado<sup><xref ref-type="bibr" rid="ref-5-31185-Es">5</xref>, <xref ref-type="bibr" rid="ref-17-31185-Es">17</xref>, <xref ref-type="bibr" rid="ref-18-31185-Es">18</xref></sup>. Ejemplos de bacterias intracelulares son la <italic>Chlamydia pneumoniae</italic> (causante de la neumon&#x00ED;a), habita en c&#x00E9;lulas mononucleares de sangre perif&#x00E9;rica en individuos sanos<sup><xref ref-type="bibr" rid="ref-19-31185-Es">19</xref></sup>. Los gl&#x00F3;bulos blancos pueden actuar como recept&#x00E1;culos o &#x00AB;caballos de Troya&#x00BB; al ofrecer protecci&#x00F3;n contra los anticuerpos humanos, facilitando la met&#x00E1;stasis de <italic>Staphylococcus aureus</italic> a diferentes sitios del cuerpo<sup><xref ref-type="bibr" rid="ref-20-31185-Es">20</xref></sup>. Esta estrategia es similar a la seguida en esta pel&#x00ED;cula, introduci&#x00E9;ndose dentro del organismo para atrapar las c&#x00E9;lulas hu&#x00E9;sped (<xref ref-type="fig" rid="fig-4-31185-es">Foto 3, A</xref>), introducirse dentro hasta asimilarla e imitar las funciones b&#x00E1;sicas de la fisiolog&#x00ED;a (nutrici&#x00F3;n, reproducci&#x00F3;n y relaci&#x00F3;n). Las probabilidades de contagio con &#x00AB;La Cosa&#x00BB; son elevadas, hasta un 75 % entre los compa&#x00F1;eros del campamento base (<xref ref-type="fig" rid="fig-4-31185-es">Foto 3, B</xref>), siendo capaz de infectar a la poblaci&#x00F3;n mundial en 27.000 horas (3,08 a&#x00F1;os) (<xref ref-type="fig" rid="fig-4-31185-es">Foto 3, C</xref>).</p>
<fig id="fig-4-31185-es">
<label><bold>Foto 3.</bold></label>
<caption><title>Proceso de una c&#x00E9;lula imitadora atrapando a una c&#x00E9;lula hospedadora para su asimilaci&#x00F3;n (A). Probabilidad de riesgo en el campamento base (B) y tiempo para infectar a toda la poblaci&#x00F3;n mundial (C)</title></caption>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-10-31185.jpg"/>
</fig>
<p>La epidemiolog&#x00ED;a siempre va a depender de la interacci&#x00F3;n entre la ecolog&#x00ED;a del pat&#x00F3;geno y del hu&#x00E9;sped<sup><xref ref-type="bibr" rid="ref-21-31185-Es">21</xref></sup>. Para el par&#x00E1;sito se eval&#x00FA;a el modo de transmisi&#x00F3;n y circulaci&#x00F3;n, su origen, invasi&#x00F3;n y persistencia. Por otro lado, en la ecolog&#x00ED;a del hu&#x00E9;sped se tiene en cuenta el resultado de la infecci&#x00F3;n dentro de diferentes escalas geogr&#x00E1;ficas y de tiempo: a) el impacto en la densidad de poblaci&#x00F3;n y las comunidades dentro de la escala de tiempo del observador, b) el efecto de la infecci&#x00F3;n en la coevoluci&#x00F3;n de los hu&#x00E9;spedes y pat&#x00F3;genos dentro de la escala de tiempo evolutiva. Muchos par&#x00E1;sitos provocan una disminuci&#x00F3;n en el tama&#x00F1;o de la poblaci&#x00F3;n y un mayor riesgo de extinci&#x00F3;n para las especies amenazadas<sup><xref ref-type="bibr" rid="ref-22-31185-Es">22</xref></sup>.</p>
</sec>
<sec id="sec-4-31185-es" sec-type="conclusions">
<title><bold>Conclusiones</bold></title>
<p>Este recurso docente profundiza en la necesidad de investigar las herramientas que permitan la detecci&#x00F3;n de agentes microbianos o del microbioma &#x00FA;nico en la sangre humana, con el objetivo de facilitar tanto el diagn&#x00F3;stico como una mejor comprensi&#x00F3;n de la aparici&#x00F3;n de numerosas enfermedades humanas. Adem&#x00E1;s, es necesario comprender el v&#x00ED;nculo entre el comportamiento del hu&#x00E9;sped y la transmisi&#x00F3;n de enfermedades para la gesti&#x00F3;n sanitaria. Con este estudio se consideran planteamientos epidemiol&#x00F3;gicos entre la intersecci&#x00F3;n del comportamiento, la ecolog&#x00ED;a y la transmisi&#x00F3;n de par&#x00E1;sitos, que abarcan un amplio n&#x00FA;mero de microorganismos.</p>
</sec>
</body>
<back>
<ref-list>
<title><bold>Referencias</bold></title>
<ref id="ref-1-31185-Es"><label>1.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Castillo</surname> <given-names>DJ</given-names></name> <name><surname>Rifkin</surname> <given-names>RF</given-names></name> <name><surname>Cowan</surname> <given-names>DA</given-names></name> <name><surname>Potgieter</surname> <given-names>M</given-names></name></person-group> <article-title>The Healthy Human Blood Microbiome: Fact or Fiction?</article-title> <source>Front. Cell. Infect. Microbiol.</source> <year>2019</year><volume>9</volume><fpage>148</fpage> <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519389/pdf/fcimb-09-00148.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519389/pdf/fcimb-09-00148.pdf</ext-link></element-citation>
<mixed-citation>1. Castillo DJ, Rifkin RF, Cowan DA, Potgieter M. The Healthy Human Blood Microbiome: Fact or Fiction? Front. Cell. Infect. Microbiol. 2019;9:148. <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519389/pdf/fcimb-09-00148.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519389/pdf/fcimb-09-00148.pdf</ext-link></mixed-citation></ref>
<ref id="ref-2-31185-Es"><label>2.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tedeschi</surname> <given-names>GG</given-names></name> <name><surname>Amici</surname> <given-names>D</given-names></name> <name><surname>Paparelli</surname> <given-names>M</given-names></name></person-group> <article-title>Incorporation of nucleosides and amino-acids in human erythrocyte suspensions: possible relation with a diffuse infection of mycoplasms or bacteria in the L form</article-title> <source>Nature</source> <year>1969</year><volume>222</volume><issue>5200</issue><fpage>1285</fpage><lpage>6</lpage> <pub-id pub-id-type="doi">10.1038/2221285a0</pub-id></element-citation>
<mixed-citation>2. Tedeschi GG, Amici D, Paparelli M. Incorporation of nucleosides and amino-acids in human erythrocyte suspensions: possible relation with a diffuse infection of mycoplasms or bacteria in the L form. Nature. 1969;222(5200):1285-6. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1038/2221285a0">https://doi.org/10.1038/2221285a0</ext-link></mixed-citation></ref>
<ref id="ref-3-31185-Es"><label>3.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Mitchell</surname> <given-names>AJ</given-names></name> <name><surname>Gray</surname> <given-names>WD</given-names></name> <name><surname>Schroeder</surname> <given-names>M</given-names></name> <name><surname>Yi</surname> <given-names>H</given-names></name> <name><surname>Taylor</surname> <given-names>JV</given-names></name> <name><surname>Dillard</surname> <given-names>RS</given-names></name> <etal/></person-group> <article-title>Pleomorphic Structures in Human Blood Are Red Blood Cell-Derived Microparticles, Not Bacteria</article-title> <source>PLoS One</source> <year>2016</year><volume>11</volume><issue>10</issue><elocation-id>e0163582</elocation-id> <ext-link ext-link-type="uri" xlink:href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0163582">https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0163582</ext-link></element-citation>
<mixed-citation>3. Mitchell AJ, Gray WD, Schroeder M, Yi H, Taylor JV, Dillard RS, et al. Pleomorphic Structures in Human Blood Are Red Blood Cell-Derived Microparticles, Not Bacteria. PLoS One. 2016;11(10):e0163582. <ext-link ext-link-type="uri" xlink:href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0163582">https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0163582</ext-link></mixed-citation></ref>
<ref id="ref-4-31185-Es"><label>4.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Martel</surname> <given-names>J</given-names></name> <name><surname>Wu</surname> <given-names>CY</given-names></name> <name><surname>Huang</surname> <given-names>PR</given-names></name> <name><surname>Cheng</surname> <given-names>WY</given-names></name> <name><surname>Young</surname> <given-names>JD</given-names></name></person-group> <article-title>Pleomorphic bacteria-like structures in human blood represent non-living membrane vesicles and protein particles</article-title> <source>Sci. Rep.</source> <year>2017</year><volume>7</volume><issue>1</issue><fpage>10650</fpage> <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587737/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587737/</ext-link></element-citation>
<mixed-citation>4. Martel J, Wu CY, Huang PR, Cheng WY, Young JD. Pleomorphic bacteria-like structures in human blood represent non-living membrane vesicles and protein particles. Sci. Rep. 2017;7(1):10650. <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587737/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587737/</ext-link></mixed-citation></ref>
<ref id="ref-5-31185-Es"><label>5.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Pa&#x00EF;ss&#x00E9;</surname> <given-names>S</given-names></name> <name><surname>Valle</surname> <given-names>C</given-names></name> <name><surname>Servant</surname> <given-names>F</given-names></name> <name><surname>Courtney</surname> <given-names>M</given-names></name> <name><surname>Burcelin</surname> <given-names>R</given-names></name> <name><surname>Amar</surname> <given-names>J</given-names></name> <etal/></person-group> <article-title>Comprehensive description of blood microbiome from healthy donors assessed by 16S targeted metagenomic sequencing</article-title> <source>Transfusion</source> <year>2016</year><volume>56</volume><issue>5</issue><fpage>1138</fpage><lpage>1147</lpage> <pub-id pub-id-type="doi">10.1111/trf.13477</pub-id></element-citation>
<mixed-citation>5. Pa&#x00EF;ss&#x00E9; S, Valle C, Servant F, Courtney M, Burcelin R, Amar J, et al. Comprehensive description of blood microbiome from healthy donors assessed by 16S targeted metagenomic sequencing. Transfusion. 2016;56(5):1138-1147. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1111/trf.13477">https://doi.org/10.1111/trf.13477</ext-link></mixed-citation></ref>
<ref id="ref-6-31185-Es"><label>6.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Cogen</surname> <given-names>AL</given-names></name> <name><surname>Nizet</surname> <given-names>V</given-names></name> <name><surname>Gallo</surname> <given-names>RL</given-names></name></person-group> <article-title>Skin microbiota: a source of disease or defence?</article-title> <source>Br. J. Dermatol.</source> <year>2008</year><volume>158</volume><issue>3</issue><fpage>442</fpage><lpage>455</lpage> <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2746716/pdf/nihms91877.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2746716/pdf/nihms91877.pdf</ext-link></element-citation>
<mixed-citation>6. Cogen AL, Nizet V, Gallo RL. Skin microbiota: a source of disease or defence? Br. J. Dermatol. 2008;158(3):442-455. <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2746716/pdf/nihms91877.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2746716/pdf/nihms91877.pdf</ext-link></mixed-citation></ref>
<ref id="ref-7-31185-Es"><label>7.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Funkhouser</surname> <given-names>LJ</given-names></name> <name><surname>Bordenstein</surname> <given-names>SR</given-names></name></person-group> <article-title>Mom knows best: the universality of maternal microbial transmission</article-title> <source>PLoS. Biol.</source> <year>2013</year><volume>11</volume><issue>8</issue><elocation-id>e1001631</elocation-id> <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747981/pdf/pbio.1001631.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747981/pdf/pbio.1001631.pdf</ext-link></element-citation>
<mixed-citation>7. Funkhouser LJ, Bordenstein SR. Mom knows best: the universality of maternal microbial transmission. PLoS. Biol. 2013;11(8):e1001631. <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747981/pdf/pbio.1001631.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747981/pdf/pbio.1001631.pdf</ext-link></mixed-citation></ref>
<ref id="ref-8-31185-Es"><label>8.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Cook</surname> <given-names>L</given-names></name> <name><surname>Reid</surname> <given-names>KT</given-names></name> <name><surname>H&#x00E4;kkinen</surname> <given-names>E</given-names></name> <name><surname>de Bie</surname> <given-names>B</given-names></name> <name><surname>Tanaka</surname> <given-names>S</given-names></name> <name><surname>Smyth</surname> <given-names>DJ</given-names></name> <etal/></person-group> <article-title>Induction of stable human FOXP3+ Tregs by a parasite-derived TGF-&#x03B2; mimic</article-title> <source>Immunol. Cell. Biol.</source> <year>2021</year><volume>99</volume><issue>8</issue><fpage>833</fpage><lpage>847</lpage> <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453874/pdf/IMCB-99-833.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453874/pdf/IMCB-99-833.pdf</ext-link></element-citation>
<mixed-citation>8. Cook L, Reid KT, H&#x00E4;kkinen E, de Bie B, Tanaka S, Smyth DJ, et al. Induction of stable human FOXP3+ Tregs by a parasite-derived TGF-&#x03B2; mimic. Immunol. Cell. Biol. 2021;99(8):833-847. <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453874/pdf/IMCB-99-833.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453874/pdf/IMCB-99-833.pdf</ext-link></mixed-citation></ref>
<ref id="ref-9-31185-Es"><label>9.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>M&#x00FC;nter</surname> <given-names>S</given-names></name> <name><surname>Way</surname> <given-names>M</given-names></name> <name><surname>Frischknecht</surname> <given-names>F</given-names></name></person-group> <article-title>Signaling during pathogen infection</article-title> <source>Sci. STKE.</source> <year>2006</year><volume>2006</volume><issue>335</issue><elocation-id>re5</elocation-id> <pub-id pub-id-type="doi">10.1126/stke.3352006re5</pub-id></element-citation>
<mixed-citation>9. M&#x00FC;nter S, Way M, Frischknecht F. Signaling during pathogen infection. Sci. STKE. 2006;2006(335):re5. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1126/stke.3352006re5">https://doi.org/10.1126/stke.3352006re5</ext-link></mixed-citation></ref>
<ref id="ref-10-31185-Es"><label>10.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chen</surname> <given-names>X</given-names></name> <name><surname>Zhou</surname> <given-names>Q</given-names></name> <name><surname>Liu</surname> <given-names>J</given-names></name> <name><surname>Zhou</surname> <given-names>B</given-names></name> <name><surname>Wu</surname> <given-names>X</given-names></name> <name><surname>Long</surname> <given-names>L</given-names></name></person-group> <article-title>Autoimmune manifestations of visceral leishmaniasis in Chinese patients</article-title> <source>Ann. Palliat. Med.</source> <year>2021</year><volume>10</volume><issue>12</issue><fpage>12699</fpage><lpage>12705</lpage> <ext-link ext-link-type="uri" xlink:href="https://apm.amegroups.com/article/view/86099/pdf">https://apm.amegroups.com/article/view/86099/pdf</ext-link></element-citation>
<mixed-citation>10. Chen X, Zhou Q, Liu J, Zhou B, Wu X, Long L. Autoimmune manifestations of visceral leishmaniasis in Chinese patients. Ann. Palliat. Med. 2021;10(12):12699-12705. <ext-link ext-link-type="uri" xlink:href="https://apm.amegroups.com/article/view/86099/pdf">https://apm.amegroups.com/article/view/86099/pdf</ext-link></mixed-citation></ref>
<ref id="ref-11-31185-Es"><label>11.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Richards</surname> <given-names>EM</given-names></name> <name><surname>Li</surname> <given-names>J</given-names></name> <name><surname>Stevens</surname> <given-names>BR</given-names></name> <name><surname>Pepine</surname> <given-names>CJ</given-names></name> <name><surname>Raizada</surname> <given-names>MK</given-names></name></person-group> <article-title>Gut Microbiome and Neuroinflammation in Hypertension</article-title> <source>Circ. Res.</source> <year>2022</year><volume>130</volume><issue>3</issue><fpage>401</fpage><lpage>417</lpage> <ext-link ext-link-type="uri" xlink:href="https://www.ahajournals.org/doi/epub/10.1161/CIRCRESAHA.121.319816">https://www.ahajournals.org/doi/epub/10.1161/CIRCRESAHA.121.319816</ext-link></element-citation>
<mixed-citation>11. Richards EM, Li J, Stevens BR, Pepine CJ, Raizada MK. Gut Microbiome and Neuroinflammation in Hypertension. Circ. Res. 2022;130(3):401-417. <ext-link ext-link-type="uri" xlink:href="https://www.ahajournals.org/doi/epub/10.1161/CIRCRESAHA.121.319816">https://www.ahajournals.org/doi/epub/10.1161/CIRCRESAHA.121.319816</ext-link></mixed-citation></ref>
<ref id="ref-12-31185-Es"><label>12.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Schoeler</surname> <given-names>M</given-names></name> <name><surname>Caesar</surname> <given-names>R</given-names></name></person-group> <article-title>Dietary lipids, gut microbiota and lipid metabolism</article-title> <source>Rev. Endocr. Metab. Disord.</source> <year>2019</year><volume>20</volume><issue>4</issue><fpage>461</fpage><lpage>472</lpage> <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938793/pdf/11154_2019_Article_9512.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938793/pdf/11154_2019_Article_9512.pdf</ext-link></element-citation>
<mixed-citation>12. Schoeler M, Caesar R. Dietary lipids, gut microbiota and lipid metabolism. Rev. Endocr. Metab. Disord. 2019;20(4):461-472. <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938793/pdf/11154_2019_Article_9512.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938793/pdf/11154_2019_Article_9512.pdf</ext-link></mixed-citation></ref>
<ref id="ref-13-31185-Es"><label>13.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>And&#x00FA;jar-Tenorio</surname> <given-names>N</given-names></name> <name><surname>Prieto</surname> <given-names>I</given-names></name> <name><surname>Cobo</surname> <given-names>A</given-names></name> <name><surname>Mart&#x00ED;nez-Rodr&#x00ED;guez</surname> <given-names>AM</given-names></name> <name><surname>Hidalgo</surname> <given-names>M</given-names></name> <name><surname>Segarra</surname> <given-names>AB</given-names></name> <etal/></person-group> <article-title>High fat diets induce early changes in gut microbiota that may serve as markers of ulterior altered physiological and biochemical parameters related to metabolic syndrome. Effect of virgin olive oil in comparison to butter</article-title> <source>PLoS. One.</source> <year>2022</year><volume>17</volume><issue>8</issue><elocation-id>e0271634</elocation-id> <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9380944/pdf/pone.0271634.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9380944/pdf/pone.0271634.pdf</ext-link></element-citation>
<mixed-citation>13. And&#x00FA;jar-Tenorio N, Prieto I, Cobo A, Mart&#x00ED;nez-Rodr&#x00ED;guez AM, Hidalgo M, Segarra AB, et al. High fat diets induce early changes in gut microbiota that may serve as markers of ulterior altered physiological and biochemical parameters related to metabolic syndrome. Effect of virgin olive oil in comparison to butter. PLoS. One. 2022;17(8):e0271634. <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9380944/pdf/pone.0271634.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9380944/pdf/pone.0271634.pdf</ext-link></mixed-citation></ref>
<ref id="ref-14-31185-Es"><label>14.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Mart&#x00ED;nez</surname> <given-names>N</given-names></name> <name><surname>Prieto</surname> <given-names>I</given-names></name> <name><surname>Hidalgo</surname> <given-names>M</given-names></name> <name><surname>Segarra</surname> <given-names>AB</given-names></name> <name><surname>Mart&#x00ED;nez-Rodr&#x00ED;guez</surname> <given-names>AM</given-names></name> <name><surname>Cobo</surname> <given-names>A</given-names></name> <etal/></person-group> <article-title>Refined versus Extra Virgin Olive Oil High-Fat Diet Impact on Intestinal Microbiota of Mice and Its Relation to Different Physiological Variables</article-title> <source>Microorganisms</source> <year>2019</year><volume>7</volume><issue>2</issue><fpage>61</fpage> <ext-link ext-link-type="uri" xlink:href="https://www.mdpi.com/2076-2607/7/2/61">https://www.mdpi.com/2076-2607/7/2/61</ext-link></element-citation>
<mixed-citation>14. Mart&#x00ED;nez N, Prieto I, Hidalgo M, Segarra AB, Mart&#x00ED;nez-Rodr&#x00ED;guez AM, Cobo A, et al. Refined versus Extra Virgin Olive Oil High-Fat Diet Impact on Intestinal Microbiota of Mice and Its Relation to Different Physiological Variables. Microorganisms. 2019;7(2):61. <ext-link ext-link-type="uri" xlink:href="https://www.mdpi.com/2076-2607/7/2/61">https://www.mdpi.com/2076-2607/7/2/61</ext-link></mixed-citation></ref>
<ref id="ref-15-31185-Es"><label>15.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Prieto</surname> <given-names>I</given-names></name> <name><surname>Hidalgo</surname> <given-names>M</given-names></name> <name><surname>Segarra</surname> <given-names>AB</given-names></name> <name><surname>Mart&#x00ED;nez-Rodr&#x00ED;guez</surname> <given-names>AM</given-names></name> <name><surname>Cobo</surname> <given-names>A</given-names></name> <name><surname>Ram&#x00ED;rez</surname> <given-names>M</given-names></name> <etal/></person-group> <article-title>Influence of a diet enriched with virgin olive oil or butter on mouse gut microbiota and its correlation to physiological and biochemical parameters related to metabolic syndrome</article-title> <source>PLoS. One.</source> <year>2018</year><volume>13</volume><issue>1</issue><elocation-id>e0190368</elocation-id> <ext-link ext-link-type="uri" xlink:href="https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0190368&#x0026;type=printable">https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0190368&#x0026;type=printable</ext-link></element-citation>
<mixed-citation>15. Prieto I, Hidalgo M, Segarra AB, Mart&#x00ED;nez-Rodr&#x00ED;guez AM, Cobo A, Ram&#x00ED;rez M, et al. Influence of a diet enriched with virgin olive oil or butter on mouse gut microbiota and its correlation to physiological and biochemical parameters related to metabolic syndrome. PLoS. One. 2018;13(1):e0190368. <ext-link ext-link-type="uri" xlink:href="https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0190368&#x0026;type=printable">https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0190368&#x0026;type=printable</ext-link></mixed-citation></ref>
<ref id="ref-16-31185-Es"><label>16.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Thaiss</surname> <given-names>CA</given-names></name> <name><surname>Zmora</surname> <given-names>N</given-names></name> <name><surname>Levy</surname> <given-names>M</given-names></name> <name><surname>Elinav</surname> <given-names>E</given-names></name></person-group> <article-title>The microbiome and innate immunity</article-title> <source>Nature</source> <year>2016</year><volume>535</volume><issue>7610</issue><fpage>65</fpage><lpage>74</lpage> <pub-id pub-id-type="doi">10.1038/nature18847</pub-id></element-citation>
<mixed-citation>16. Thaiss CA, Zmora N, Levy M, Elinav E. The microbiome and innate immunity. Nature. 2016;535(7610):65-74. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1038/nature18847">https://doi.org/10.1038/nature18847</ext-link></mixed-citation></ref>
<ref id="ref-17-31185-Es"><label>17.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>M&#x00FC;ller</surname> <given-names>TH</given-names></name> <name><surname>Mohr</surname> <given-names>H</given-names></name> <name><surname>Montag</surname> <given-names>T</given-names></name></person-group> <article-title>Methods for the detection of bacterial contamination in blood products</article-title> <source>Clin Chem Lab Med.</source> <year>2008</year><volume>46</volume><issue>7</issue><fpage>933</fpage><lpage>46</lpage> <pub-id pub-id-type="doi">10.1515/CCLM.2008.154</pub-id></element-citation>
<mixed-citation>17. M&#x00FC;ller TH, Mohr H, Montag T. Methods for the detection of bacterial contamination in blood products. Clin Chem Lab Med. 2008;46(7):933-46. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1515/CCLM.2008.154">https://doi.org/10.1515/CCLM.2008.154</ext-link></mixed-citation></ref>
<ref id="ref-18-31185-Es"><label>18.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>El Mehdaoui</surname> <given-names>F</given-names></name> <name><surname>Benajiba</surname> <given-names>M</given-names></name> <name><surname>Boulahdid</surname> <given-names>S</given-names></name> <name><surname>El Hattimy</surname> <given-names>F</given-names></name> <name><surname>Soulaymani</surname> <given-names>A</given-names></name> <name><surname>Alami</surname> <given-names>R</given-names></name></person-group> <article-title>Skin flora and bacterial contamination of diversion pouch and recovered platelet components in Moroccan blood donors</article-title> <source>Transfus. Med.</source> <year>2020</year><volume>30</volume><issue>5</issue><fpage>384</fpage><lpage>390</lpage> <pub-id pub-id-type="doi">10.1111/tme.12704</pub-id></element-citation>
<mixed-citation>18. El Mehdaoui F, Benajiba M, Boulahdid S, El Hattimy F, Soulaymani A, Alami R. Skin flora and bacterial contamination of diversion pouch and recovered platelet components in Moroccan blood donors. Transfus. Med. 2020;30(5):384-390. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1111/tme.12704">https://doi.org/10.1111/tme.12704</ext-link></mixed-citation></ref>
<ref id="ref-19-31185-Es"><label>19.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Yamaguchi</surname> <given-names>H</given-names></name> <name><surname>Yamada</surname> <given-names>M</given-names></name> <name><surname>Uruma</surname> <given-names>T</given-names></name> <name><surname>Kanamori</surname> <given-names>M</given-names></name> <name><surname>Goto</surname> <given-names>H</given-names></name> <name><surname>Yamamoto</surname> <given-names>Y</given-names></name> <etal/></person-group> <article-title>Prevalence of viable <italic>Chlamydia pneumoniae</italic> in peripheral blood mononuclear cells of healthy blood donors</article-title> <source>Transfusion</source> <year>2004</year><volume>44</volume><issue>7</issue><fpage>1072</fpage><lpage>1078</lpage> <pub-id pub-id-type="doi">10.1111/j.1537-2995.2004.04005.x</pub-id></element-citation>
<mixed-citation>19. Yamaguchi H, Yamada M, Uruma T, Kanamori M, Goto H, Yamamoto Y, et al. Prevalence of viable <italic>Chlamydia pneumoniae</italic> in peripheral blood mononuclear cells of healthy blood donors. Transfusion. 2004;44(7):1072-1078. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1111/j.1537-2995.2004.04005.x">https://doi.org/10.1111/j.1537-2995.2004.04005.x</ext-link></mixed-citation></ref>
<ref id="ref-20-31185-Es"><label>20.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Thwaites</surname> <given-names>GE</given-names></name> <name><surname>Gant</surname> <given-names>V</given-names></name></person-group> <article-title>Are bloodstream leukocytes Trojan Horses for the metastasis of <italic>Staphylococcus aureus</italic>?</article-title> <source>Nat. Rev. Microbiol.</source> <year>2011</year><volume>9</volume><issue>3</issue><fpage>215</fpage><lpage>222</lpage> <pub-id pub-id-type="doi">10.1038/nrmicro2508</pub-id></element-citation>
<mixed-citation>20. Thwaites GE, Gant V. Are bloodstream leukocytes Trojan Horses for the metastasis of <italic>Staphylococcus aureus</italic>? Nat. Rev. Microbiol. 2011;9(3):215-222. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1038/nrmicro2508">https://doi.org/10.1038/nrmicro2508</ext-link></mixed-citation></ref>
<ref id="ref-21-31185-Es"><label>21.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Artois</surname> <given-names>M</given-names></name></person-group> <article-title>Epidemiology of contagious diseases, ecology of mammals, health, management and conservation biology: concluding remarks</article-title> <source>Rev. Sci. Tech.</source> <year>1993</year><volume>12</volume><issue>1</issue><fpage>203</fpage><lpage>234</lpage> <ext-link ext-link-type="uri" xlink:href="https://doc.woah.org/dyn/portal/digidoc.xhtml?statelessToken=OVYe2CFPMsTtKSR-E2RufNW54vKLbB-ZjBXuY2AtlkQ=&#x0026;actionMethod=dyn%2Fportal%2Fdigidoc.xhtml%3AdownloadAttachment.openStateless">https://doc.woah.org/dyn/portal/digidoc.xhtml?statelessToken=OVYe2CFPMsTtKSR-E2RufNW54vKLbB-ZjBXuY2AtlkQ=&#x0026;actionMethod=dyn%2Fportal%2Fdigidoc.xhtml%3AdownloadAttachment.openStateless</ext-link></element-citation>
<mixed-citation>21. Artois M. Epidemiology of contagious diseases, ecology of mammals, health, management and conservation biology: concluding remarks. Rev. Sci. Tech. 1993;12(1):203-234. <ext-link ext-link-type="uri" xlink:href="https://doc.woah.org/dyn/portal/digidoc.xhtml?statelessToken=OVYe2CFPMsTtKSR-E2RufNW54vKLbB-ZjBXuY2AtlkQ=&#x0026;actionMethod=dyn%2Fportal%2Fdigidoc.xhtml%3AdownloadAttachment.openStateless">https://doc.woah.org/dyn/portal/digidoc.xhtml?statelessToken=OVYe2CFPMsTtKSR-E2RufNW54vKLbB-ZjBXuY2AtlkQ=&#x0026;actionMethod=dyn%2Fportal%2Fdigidoc.xhtml%3AdownloadAttachment.openStateless</ext-link></mixed-citation></ref>
<ref id="ref-22-31185-Es"><label>22.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Herrera</surname> <given-names>J</given-names></name> <name><surname>Nunn</surname> <given-names>CL</given-names></name></person-group> <article-title>Behavioural ecology and infectious disease: implications for conservation of biodiversity</article-title> <source>Phil. Trans. R. Soc. B.</source> <year>2019</year><volume>374</volume><issue>1781</issue><elocation-id>20180054</elocation-id> <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6710567/pdf/rstb20180054.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6710567/pdf/rstb20180054.pdf</ext-link></element-citation>
<mixed-citation>22. Herrera J, Nunn CL. Behavioural ecology and infectious disease: implications for conservation of biodiversity. Phil. Trans. R. Soc. B. 2019;374(1781):20180054. <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6710567/pdf/rstb20180054.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6710567/pdf/rstb20180054.pdf</ext-link></mixed-citation></ref>
</ref-list>
</back>
<sub-article article-type="translation" xml:lang="en" id="S1">
<front-stub>
<article-id pub-id-type="publisher-id">rmc.31185</article-id>
<article-id pub-id-type="doi">10.14201/rmc.31185</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Art&#x00ED;culos</subject>
</subj-group>
</article-categories>
<title-group>
<article-title><italic>THE THING</italic> (1982): A FIRST PREDIAGNOSTIC MODEL FOR INFECTIONS AND ALTERATIONS OF PHYSIOLOGY</article-title>
<trans-title-group>
<trans-title xml:lang="es"><bold>The Thing <italic>(1982): un primer modelo de prediagn&#x00F3;stico para las infecciones y alteraciones de la fisiolog&#x00ED;a</italic></bold></trans-title>
</trans-title-group>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>PRIETO-G&#x00D3;MEZ</surname>
<given-names>Isabel</given-names>
</name>
<xref ref-type="aff" rid="aff-en-1"><sup>1</sup></xref>
<bio>
<fig>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-1-31185.jpg"/>
</fig>
<p>Isabel Prieto G&#x00F3;mez. Professor of Physiology of the Department of Health Sciences. Faculty of Experimental Sciences of the University of Ja&#x00E9;n. Head of the Endocrinology and Nutrition research group at the University of Ja&#x00E9;n (Neuroendocrinology and Nutrition, BIO-221).</p>
</bio>
</contrib>
<contrib contrib-type="author">
<name>
<surname>RAM&#x00CD;REZ-S&#x00C1;NCHEZ</surname>
<given-names>Manuel</given-names>
</name>
<xref ref-type="aff" rid="aff-en-1"><sup>1</sup></xref>
<bio>
<fig>
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<p>Manuel Ram&#x00ED;rez S&#x00E1;nchez. Professor of Physiology of the Department of Health Sciences. Faculty of Experimental Sciences of the University of Ja&#x00E9;n. Head of the research group PAI CVI-221 (Peptides and Peptidases).</p>
</bio>
</contrib>
<contrib contrib-type="author">
<name>
<surname>SEGARRA-ROBLES</surname>
<given-names>Ana Bel&#x00E9;n</given-names>
</name>
<xref ref-type="aff" rid="aff-en-1"><sup>1</sup></xref>
<bio>
<fig>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-3-31185.jpg"/>
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<p>Ana Bel&#x00E9;n Segarra Robles. PhD in Biological Sciences from the University of Ja&#x00E9;n. PhD Assistant Professor at the University of Ja&#x00E9;n and active member of the BIO-221 group (Neuroendocrinology and Nutrition).</p>
</bio>
</contrib>
<contrib contrib-type="author">
<name>
<surname>SULEIMAN-MARTOS</surname>
<given-names>Nora</given-names>
</name>
<xref ref-type="aff" rid="aff-en-2"><sup>2</sup></xref>
<bio>
<fig>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-4-31185.jpg"/>
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<p>Nora Suleiman-Martos. PhD in Psychology from the University of Granada. She is currently a PhD assistant professor at the Faculty of Health Sciences of the University of Granada, where she teaches associated with the same department using a gamification methodology and teaching innovation resources, including the use of Cinema as a teaching educational resource. Her line of research focuses on the field of public health and psychosocial problems in the health field.</p>
</bio>
</contrib>
<contrib contrib-type="author">
<name>
<surname>GARC&#x00CD;A-C&#x00D3;ZAR</surname>
<given-names>Francisco</given-names>
</name>
<xref ref-type="aff" rid="aff-en-3"><sup>3</sup></xref>
<bio>
<fig>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-5-31185.jpg"/>
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<p>Francisco Jos&#x00E9; Garc&#x00ED;a C&#x00F3;zar. Professor of Immunology at the Department of Biomedicine, Biotechnology and Public Health of the University of C&#x00E1;diz. He has a PhD from the University of C&#x00F3;rdoba with the thesis &#x00AB;Functional study of molecules involved in the activation of human T cells&#x00BB;. Head of the CTS-498 research group (Functional Genomics of the Immune System. Immunological Alteration of Reproduction and Anesthesia).</p>
</bio>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>DOM&#x00CD;NGUEZ-V&#x00CD;AS</surname>
<given-names>Germ&#x00E1;n</given-names>
</name>
<xref ref-type="aff" rid="aff-en-4"><sup>4</sup></xref>
<xref ref-type="corresp" rid="c1-en"/>
<bio>
<fig>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-6-31185.jpg"/>
</fig>
<p>Germ&#x00E1;n Dom&#x00ED;nguez-V&#x00ED;as. Doctor in Health Sciences from the University of C&#x00E1;diz and Doctor in Food Safety from the University of Ja&#x00E9;n. He is currently a PhD associate professor at the Faculty of Health Sciences (Ceuta Campus) of the University of Granada, where he teaches associated with the department of physiology in the nursing degree, and implements Cinema as an educational resource within the curriculum. His line of research focuses on neurodegeneration and the regulation of blood pressure.</p>
</bio>
</contrib>
<aff id="aff-en-1">
<label><sup>1</sup></label>
<institution content-type="original">Physiology Area, Faculty of Experimental Sciences. University of Ja&#x00E9;n (Spain).</institution>
<institution content-type="orgname">Physiology Area, Faculty of Experimental Sciences</institution>
<institution content-type="orgdiv1">University of Ja&#x00E9;n</institution>
<country country="ES">Spain</country>
</aff>
<aff id="aff-en-2">
<label><sup>2</sup></label>
<institution content-type="original">Department of Nursing, Faculty of Health Sciences of Granada. University of Granada (Spain).</institution>
<institution content-type="orgname">Department of Nursing, Faculty of Health Sciences of Granada</institution>
<institution content-type="orgdiv1">University of Granada</institution>
<country country="ES">Spain</country>
</aff>
<aff id="aff-en-3">
<label><sup>3</sup></label>
<institution content-type="original">Immunology Area, Faculty of Medicine. University of C&#x00E1;diz (Spain).</institution>
<institution content-type="orgname">Immunology Area, Faculty of Medicine</institution>
<institution content-type="orgdiv1">University of C&#x00E1;diz</institution>
<country country="ES">Spain</country>
</aff>
<aff id="aff-en-4">
<label><sup>4</sup></label>
<institution content-type="original">Department of Physiology, Faculty of Health Sciences of Ceuta. University of Granada (Spain).</institution>
<institution content-type="orgname">Department of Physiology, Faculty of Health Sciences of Ceuta</institution>
<institution content-type="orgdiv1">University of Granada</institution>
<country country="ES">Spain</country>
</aff>
</contrib-group>
<author-notes>
<corresp id="c1-en"><email>germandv@ugr.es</email></corresp>
</author-notes>
<pub-date publication-format="electronic" date-type="pub">
<day>01</day>
<month>09</month>
<year>2023</year>
</pub-date>
<pub-date publication-format="electronic" date-type="collection">
<year>2023</year>
</pub-date>
<volume>19</volume>
<issue>4</issue>
<fpage>345</fpage>
<lpage>354</lpage>
<history>
<date date-type="received">
<day>31</day>
<month>01</month>
<year>2023</year>
</date>
<date date-type="accepted">
<day>06</day>
<month>02</month>
<year>2023</year>
</date>
</history>
<permissions>
<copyright-statement>&#x00A9; 2023 Ediciones Universidad de Salamanca</copyright-statement>
<copyright-year>2023</copyright-year>
    <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es" xml:lang="es">
        <license-p>CC BY-NC-SA Atribuci&#x00F3;n-NoComercial-CompartirIgual 4.0 Internacional</license-p>
    </license>
</permissions>
<abstract>
<title><bold>Abstract</bold></title>
<p><italic>The Thing</italic> (1982) represents an audiovisual challenge to think about the discovery of keys for the early detection of hostile infections. The search for quick and easy techniques for solving cases means the difference between survival and remaining suspicious for a group that tries to discover which of them are infected, and not end up transformed into &#x00AB;something else&#x00BB;. This work will allow the student body to know the changes in the homeostatic balance that the relationship with microorganisms of different nature present in the blood would imply.</p>
</abstract>
<trans-abstract xml:lang="es">
<title><bold>Resumen</bold></title>
<p><italic>The Thing</italic> / <italic>La cosa (El enigma de otro mundo)</italic> (1982) de John Carpenter, supone un reto audiovisual para pensar en el descubrimiento de claves para la detecci&#x00F3;n temprana de infecciones hostiles. La b&#x00FA;squeda de t&#x00E9;cnicas r&#x00E1;pidas y sencillas para la resoluci&#x00F3;n de casos supone la diferencia entre la supervivencia y mantenerse en la desconfianza para un grupo que trata de descubrir quienes de ellos est&#x00E1;n infectados, y no terminar transformados en &#x00AB;otra cosa&#x00BB;. Este trabajo permitir&#x00E1; al estudiantado conocer los cambios en el equilibrio homeost&#x00E1;tico que supondr&#x00ED;a la relaci&#x00F3;n con los microorganismos de distinta naturaleza presentes en la sangre.</p>
</trans-abstract>
<kwd-group xml:lang="en">
<title><bold>Keywords:</bold></title>
<kwd>physiology</kwd>
<kwd>homeostasis</kwd>
<kwd>microbiome</kwd>
<kwd>zoonosis</kwd>
<kwd>infection</kwd>
<kwd>mimic</kwd>
</kwd-group>
<kwd-group xml:lang="es">
<title><bold>Palabras clave:</bold></title>
<kwd>fisiolog&#x00ED;a</kwd>
<kwd>homeostasis</kwd>
<kwd>microbioma</kwd>
<kwd>zoonosis</kwd>
<kwd>infecci&#x00F3;n</kwd>
<kwd>imitador</kwd>
</kwd-group>
</front-stub>
<body>
<sec id="sec-1-31185-en">
<title><bold>Technical details</bold></title>
<p><bold>Original title:</bold> The Thing.</p>
<p><bold>Country:</bold> United States.</p>
<p><bold>Year:</bold> 1982.</p>
<p><bold>Director:</bold> John Carpenter.</p>
<p><bold>Music:</bold> Ennio Morricone.</p>
<p><bold>Photography:</bold> Dean Cundey.</p>
<p><bold>Film editor:</bold> Todd C. Ramsay.</p>
<p><bold>Screenwriter:</bold> Bill Lancaster. Novela: John W. Campbell.</p>
<p><bold>Cast:</bold> Kurt Russell, Wilford Brimley, Keith David, David Clennon, Richard Dysart, Donald Moffat, Richard Masur, T.K. Carter, Charles Hallahan, Peter Maloney, Joel Polis, Thomas G. Waites.</p>
<p><bold>Color:</bold> Color.</p>
<p><bold>Duration:</bold> 109 min.</p>
<p><bold>Genre:</bold> Horror, fantasy, mystery, science fiction. Cult film.</p>
<p><bold>Original language:</bold> english, norwegian.</p>
<p><bold>Production Company:</bold> Universal Pictures, Turman-Foster Company, Province of BC, Ministry of Tourism, Film Promotion Office.</p>
<p><bold>Synopsis:</bold> At an American research station in Antarctica, in the early winter of 1982, they observe the appearance of a helicopter from the nearby Norwegian research station flying over the American base trying to kill a sled dog. After the destruction of the Norwegian helicopter, members of the American team fly to the Norwegian base, only to discover all of its occupants dead or missing. They find the remains of a strange creature that the Norwegians burned. The Americans take it to their base and deduce that it is an alien life form. When they take the dog in, it viciously attacks both the humans and canines in the camp, and they discover that the beast, of unknown origin, can assume the form of its victims. After a while, it becomes apparent that the alien can take over and assimilate with other life forms, including humans, and can spread like a virus. This means that anyone on the base could be inhabited by &#x00AB;The Thing&#x00BB;, and tensions rise.</p>
<p><bold>Awards Nominee:</bold></p>
<p>1982, Saturn Awards: Best Horror Film, Best Special Effects (Rob Bottin);</p>
<p>1983, Razzie Awards: Worst Musical Score (Ennio Morricone).</p>
<p><bold>Availability:</bold> The Thing (Blu-Ray). Universal Pictures Home Entertainment.</p>
<p><bold>Links:</bold></p>
<p><ext-link ext-link-type="uri" xlink:href="https://pro.imdb.com/title/tt0084787/?rf=cons_tt_atf&#x0026;ref_=cons_tt_atf">https://pro.imdb.com/title/tt0084787/?rf=cons_tt_atf&#x0026;ref_=cons_tt_atf</ext-link></p>
<p><ext-link ext-link-type="uri" xlink:href="https://www.imdb.com/title/tt0084787/?ref_=ttfc_ql">https://www.imdb.com/title/tt0084787/?ref_=ttfc_ql</ext-link></p>
<p><bold>Original trailer versions:</bold></p>
<p><ext-link ext-link-type="uri" xlink:href="https://www.imdb.com/video/vi2298151193/?playlistId=tt0084787&#x0026;ref_=tt_ov_vi">https://www.imdb.com/video/vi2298151193/?playlistId=tt0084787&#x0026;ref_=tt_ov_vi</ext-link></p>
<fig id="fig-1-31185-en">
<caption><title>American poster version</title></caption>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-7-31185-en.jpg"/>
</fig>
</sec>
<sec id="sec-2-31185-en" sec-type="intro">
<title><bold>Introduction</bold></title>
<p><italic>The Thing</italic> (1982) by John Carpenter is one of the best masterpieces of horror and science fiction (Position in rankings: IMDb Top 153/250; Filmaffinity Spain 37/1000) that deals with microbiological contamination and modifications of human cell biology. In the film, the tension is palpable when discovering that the cells of a being from outer space have the capacity to assimilate terrestrial cells and living organisms, digesting them and imitating their shape, abilities and knowledge (<xref ref-type="fig" rid="fig-2-31185-en">Photo 1</xref>). This fact sets a pace of frantic suspense due to the mistrust of living with someone who may be the imitation of a partner.</p>
<fig id="fig-2-31185-en">
<label><bold>Photo 1.</bold></label>
<caption><title>Cellular study of the unidentified exogenous microorganism (The Thing). They discover that it has the ability to assimilate (A - E) the cells of sled dogs and any living being, and imitate (F) the assimilated cell, as well as any other form of life</title></caption>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-8-31185.jpg"/>
</fig>
<p>In the face of cell or tissue injury, cells undergo adaptation mechanisms until the end of the cessation of the stimulus, or succumb by apoptosis or necrosis due to the impossibility of adapting. Examples of adaptations to injury or the stressful environment are changes in cell size (atrophy/hypertrophy), number (hyperplasia, metaplasia - dysplasia) and/or shape. Blood is a medium that is considered sterile until the arrival of a systemic infection, however, under physiological conditions it is also easily detectable cells or exogenous DNA without manifesting signs and symptoms of a pathology. In this study we propose the physiological changes that can occur in the face of sepsis or, from another point of view, in the face of an alteration in the balance of the microbiome in the blood or dysbiosis, referring to a change in the composition of symbiotic or commensal microbial communities.</p>
<p>This film presents an interesting way to detect microbial agents through a blood sample collection on a Petri dish, to later apply a heat stimulus with a heated wire to the fire of a flamethrower (<xref ref-type="fig" rid="fig-3-31185-en">Photo 2</xref>). The reaction to a stressor or injurious agent would cause the detection and immediate withdrawal of the infectious agent.</p>
<fig id="fig-3-31185-en">
<label><bold>Photo 2.</bold></label>
<caption><title>Improvised protocol for blood sample collection and heat stimulation (A - B). Blood samples from healthy subjects give off vapor (C &#x2013; E), however, the contaminated sample is revealed by the harmful stimulus (F)</title></caption>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-9-31185.jpg"/>
</fig>
</sec>
<sec id="sec-3-31185-en" sec-type="results|discussion">
<title><bold>Results and Discussion</bold></title>
<p>Since the bloodstream has traditionally been considered to be a basically sterile environment, containing only blood cells, platelets, and plasma, the detection of microbes in human blood has been consistently interpreted as indicative of infection. However, while a controversial concept, evidence for the existence of a healthy human blood microbiome is constantly accumulating<sup><xref ref-type="bibr" rid="ref-1-31185-En">1</xref></sup>. The controversy over the incidence of foreign cells in human blood dates back to 1969<sup><xref ref-type="bibr" rid="ref-2-31185-En">2</xref></sup>, when the presence of metabolically active bacteria was described in the blood of healthy human subjects. Specifically, the increased uptake of nucleosides and amino acids into erythrocyte suspensions led them to hypothesize the presence of bacterial microorganisms in the blood of individuals without signs and symptoms of disease<sup><xref ref-type="bibr" rid="ref-2-31185-En">2</xref></sup>. Other studies dismantle these results by stating that the pleomorphic bacteria identified in the blood of healthy humans were nothing more than microparticles derived from disintegrated erythrocytes, specifically membrane vesicles and refractive blood proteins captured by dark-field microscopy<sup><xref ref-type="bibr" rid="ref-3-31185-En">3</xref>, <xref ref-type="bibr" rid="ref-4-31185-En">4</xref></sup>. The blood-borne microbial phylogeny, as well as the origins, identities, and functional role of these highly unexpected microorganisms, remain a mystery. Even so, many recent studies are becoming known that suggest that the presence of bacteria in the blood is a consequence of translocation from other parts of the body: skin and mouth, maternal umbilical cord, but particularly the gastrointestinal tract without compromising the intestinal epithelial membrane<sup><xref ref-type="bibr" rid="ref-5-31185-En">5</xref>-<xref ref-type="bibr" rid="ref-7-31185-En">7</xref></sup>. Despite continuing evidence of bacterial taxa that make up the healthy blood microbiome in humans, the presence of other microorganisms, such as viruses, archaea, and fungi in the blood of healthy humans, are unknown<sup><xref ref-type="bibr" rid="ref-1-31185-En">1</xref></sup>.</p>
<p>The presence of foreign microorganisms in human blood does not necessarily equate to an infection or disease state. In a state of dysbiosis, although the blood-borne bacterial microbiome is harmless, the high numbers can lead to a state of complex disorders and physiological disturbances. In real situations, the routine analysis of laboratory controls determines the taxonomic and metabolic characteristics of polluting taxa derived from the environment. It must be considered that many microorganisms found naturally in human blood may be in a latent state<sup><xref ref-type="bibr" rid="ref-1-31185-En">1</xref></sup>. For this reason, culture-based methods are not reliable in supporting the existence of a human blood microbiome. In addition, although the number of microorganisms and their DNA concentration in the blood is usually very low, sensitive analytical techniques such as quantitative real-time PCR (qPCR) and Next Generation Sequencing (NGS) techniques target to specific disease loci, may corroborate current evidence for the presence of harmless bacterial taxa in the blood of healthy humans<sup><xref ref-type="bibr" rid="ref-5-31185-En">5</xref></sup>. Other techniques used are transmission electron microscopy (TEM), dark field microscopy (DFM) and fluorescence in situ hybridization (FISH). In the case of the film, &#x00AB;The Thing&#x00BB; is a zoonotic agent with a contaminating action on human fluids and tissues that facilitates their digestion, assimilation and mimicry. In order for contaminated blood to react to heat damage, the dysbiosis in humans must be very significant, a fact confirmed in the film by representing each individual as a replica that imitates and replaces the original. In relation to mimicry, there is literature that shows that certain microorganisms adapt and imitate immune cells to regulate physiological processes or that they can imitate modulators of inflammatory processes and other autoimmune diseases<sup><xref ref-type="bibr" rid="ref-8-31185-En">8</xref>-<xref ref-type="bibr" rid="ref-10-31185-En">10</xref></sup>. For example, immune homeostasis in the gut is tightly controlled by FOXP3<sup>+</sup> regulatory T cells (Tregs), whose defects are linked to the development of chronic diseases, such as inflammatory bowel disease. As an immune evasion mechanism, the intestinal parasite <italic>Heligmosomoides polygyrus</italic> enhances Treg activity by secreting a molecule (Hp-TGM) that mimics the ability of TGF-&#x03B2; to induce FOXP3 expression in CD4<sup>+</sup> T cells<sup><xref ref-type="bibr" rid="ref-8-31185-En">8</xref></sup>. The physiology of &#x00AB;The Thing&#x00BB; is adapted to the actual characteristics of pathogens, which over millennia have learned to co-evolve with their hosts to acquire the ability to intercept, disrupt, mimic, and usurp numerous signaling pathways from those hosts; among them we find the molecular pathways mediated by tyrosine kinase and Rho guanosine triphosphatase of their hosts to achieve efficient entry, replication and exit during their infectious cycles<sup><xref ref-type="bibr" rid="ref-9-31185-En">9</xref></sup>. In addition, it is known that the gut microbiome is a central regulator of hypertension<sup><xref ref-type="bibr" rid="ref-11-31185-En">11</xref></sup> and host lipid metabolism<sup><xref ref-type="bibr" rid="ref-12-31185-En">12</xref></sup>, integrating environmental inputs, such as diet<sup><xref ref-type="bibr" rid="ref-13-31185-En">13</xref>-<xref ref-type="bibr" rid="ref-15-31185-En">15</xref></sup>, with genetic and immune signals to affect host metabolism, immunity, and infection response<sup><xref ref-type="bibr" rid="ref-16-31185-En">16</xref></sup>.</p>
<p>Regarding the precise location of microorganisms within human blood, the most recent literature suggests that bacterial taxa can survive within red blood cells, platelets, and lymphocytes with 93,74 % integrated bacterial DNA<sup><xref ref-type="bibr" rid="ref-5-31185-En">5</xref>, <xref ref-type="bibr" rid="ref-17-31185-En">17</xref>, <xref ref-type="bibr" rid="ref-18-31185-En">18</xref></sup>. Examples of intracellular bacteria are <italic>Chlamydia pneumoniae</italic> (causing pneumonia), which inhabits peripheral blood mononuclear cells in healthy individuals<sup><xref ref-type="bibr" rid="ref-19-31185-En">19</xref></sup>. White blood cells can act as receptacles or &#x00AB;Trojan horses&#x00BB; by offering protection against human antibodies, facilitating metastasis of <italic>Staphylococcus aureus</italic> to different sites in the body<sup><xref ref-type="bibr" rid="ref-20-31185-En">20</xref></sup>. This strategy is similar to the one followed in this film, entering the organism to trap the host cells (<xref ref-type="fig" rid="fig-4-31185-en">Photo 3, A</xref>), entering until assimilating it and imitating the basic functions of physiology (nutrition, reproduction and relationship). The probabilities of contagion with &#x00AB;The Thing&#x00BB; are high, up to 75 % among the companions of the base camp (<xref ref-type="fig" rid="fig-4-31185-en">Photo 3, B</xref>), being capable of infecting the world population in 27,000 hours (3.08 years) (<xref ref-type="fig" rid="fig-4-31185-en">Photo 3, C</xref>).</p>
<fig id="fig-4-31185-en">
<label><bold>Photo 3.</bold></label>
<caption><title>Process of a mimic cell trapping a host cell for its assimilation (A). Risk probability at the base camp (B) and time to infect the entire world population (C)</title></caption>
<graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="fig-10-31185.jpg"/>
</fig>
<p>Epidemiology will always depend on the interaction between the ecology of the pathogen and the host<sup><xref ref-type="bibr" rid="ref-21-31185-En">21</xref></sup>. For the parasite, the mode of transmission and circulation, its origin, invasion and persistence are evaluated. Host ecology, on the other hand, takes into account the outcome of infection within different geographic and time scales: a) the impact on population density and communities within the observer time scale, b) the effect of infection in the coevolution of hosts and pathogens within the evolutionary time scale. Many parasites cause a decrease in population size and an increased risk of extinction for threatened species<sup><xref ref-type="bibr" rid="ref-22-31185-En">22</xref></sup>.</p>
</sec>
<sec id="sec-4-31185-en" sec-type="conclusions">
<title><bold>Conclusions</bold></title>
<p>This teaching resource delves into the need to investigate the tools that allow the detection of microbial agents or the unique microbiome in human blood, with the aim of facilitating both diagnosis and a better understanding of the appearance of numerous human diseases. In addition, an understanding of the link between host behavior and disease transmission is necessary for health management. With this study, epidemiological approaches are considered between the intersection of behavior, ecology and parasite transmission, covering a wide number of microorganisms.</p>
</sec>
</body>
<back>
<ref-list>
<title><bold>References</bold></title>
<ref id="ref-1-31185-En"><label>1.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Castillo</surname> <given-names>DJ</given-names></name> <name><surname>Rifkin</surname> <given-names>RF</given-names></name> <name><surname>Cowan</surname> <given-names>DA</given-names></name> <name><surname>Potgieter</surname> <given-names>M</given-names></name></person-group> <article-title>The Healthy Human Blood Microbiome: Fact or Fiction?</article-title> <source>Front. Cell. Infect. Microbiol.</source> <year>2019</year><volume>9</volume><fpage>148</fpage> <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519389/pdf/fcimb-09-00148.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519389/pdf/fcimb-09-00148.pdf</ext-link></element-citation>
<mixed-citation>1. Castillo DJ, Rifkin RF, Cowan DA, Potgieter M. The Healthy Human Blood Microbiome: Fact or Fiction? Front. Cell. Infect. Microbiol. 2019;9:148. <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519389/pdf/fcimb-09-00148.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519389/pdf/fcimb-09-00148.pdf</ext-link></mixed-citation></ref>
<ref id="ref-2-31185-En"><label>2.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tedeschi</surname> <given-names>GG</given-names></name> <name><surname>Amici</surname> <given-names>D</given-names></name> <name><surname>Paparelli</surname> <given-names>M</given-names></name></person-group> <article-title>Incorporation of nucleosides and amino-acids in human erythrocyte suspensions: possible relation with a diffuse infection of mycoplasms or bacteria in the L form</article-title> <source>Nature</source> <year>1969</year><volume>222</volume><issue>5200</issue><fpage>1285</fpage><lpage>6</lpage> <pub-id pub-id-type="doi">10.1038/2221285a0</pub-id></element-citation>
<mixed-citation>2. Tedeschi GG, Amici D, Paparelli M. Incorporation of nucleosides and amino-acids in human erythrocyte suspensions: possible relation with a diffuse infection of mycoplasms or bacteria in the L form. Nature. 1969;222(5200):1285-6. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1038/2221285a0">https://doi.org/10.1038/2221285a0</ext-link></mixed-citation></ref>
<ref id="ref-3-31185-En"><label>3.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Mitchell</surname> <given-names>AJ</given-names></name> <name><surname>Gray</surname> <given-names>WD</given-names></name> <name><surname>Schroeder</surname> <given-names>M</given-names></name> <name><surname>Yi</surname> <given-names>H</given-names></name> <name><surname>Taylor</surname> <given-names>JV</given-names></name> <name><surname>Dillard</surname> <given-names>RS</given-names></name> <etal/></person-group> <article-title>Pleomorphic Structures in Human Blood Are Red Blood Cell-Derived Microparticles, Not Bacteria</article-title> <source>PLoS One</source> <year>2016</year><volume>11</volume><issue>10</issue><elocation-id>e0163582</elocation-id> <ext-link ext-link-type="uri" xlink:href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0163582">https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0163582</ext-link></element-citation>
<mixed-citation>3. Mitchell AJ, Gray WD, Schroeder M, Yi H, Taylor JV, Dillard RS, et al. Pleomorphic Structures in Human Blood Are Red Blood Cell-Derived Microparticles, Not Bacteria. PLoS One. 2016;11(10):e0163582. <ext-link ext-link-type="uri" xlink:href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0163582">https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0163582</ext-link></mixed-citation></ref>
<ref id="ref-4-31185-En"><label>4.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Martel</surname> <given-names>J</given-names></name> <name><surname>Wu</surname> <given-names>CY</given-names></name> <name><surname>Huang</surname> <given-names>PR</given-names></name> <name><surname>Cheng</surname> <given-names>WY</given-names></name> <name><surname>Young</surname> <given-names>JD</given-names></name></person-group> <article-title>Pleomorphic bacteria-like structures in human blood represent non-living membrane vesicles and protein particles</article-title> <source>Sci. Rep.</source> <year>2017</year><volume>7</volume><issue>1</issue><fpage>10650</fpage> <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587737/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587737/</ext-link></element-citation>
<mixed-citation>4. Martel J, Wu CY, Huang PR, Cheng WY, Young JD. Pleomorphic bacteria-like structures in human blood represent non-living membrane vesicles and protein particles. Sci. Rep. 2017;7(1):10650. <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587737/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587737/</ext-link></mixed-citation></ref>
<ref id="ref-5-31185-En"><label>5.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Pa&#x00EF;ss&#x00E9;</surname> <given-names>S</given-names></name> <name><surname>Valle</surname> <given-names>C</given-names></name> <name><surname>Servant</surname> <given-names>F</given-names></name> <name><surname>Courtney</surname> <given-names>M</given-names></name> <name><surname>Burcelin</surname> <given-names>R</given-names></name> <name><surname>Amar</surname> <given-names>J</given-names></name> <etal/></person-group> <article-title>Comprehensive description of blood microbiome from healthy donors assessed by 16S targeted metagenomic sequencing</article-title> <source>Transfusion</source> <year>2016</year><volume>56</volume><issue>5</issue><fpage>1138</fpage><lpage>1147</lpage> <pub-id pub-id-type="doi">10.1111/trf.13477</pub-id></element-citation>
<mixed-citation>5. Pa&#x00EF;ss&#x00E9; S, Valle C, Servant F, Courtney M, Burcelin R, Amar J, et al. Comprehensive description of blood microbiome from healthy donors assessed by 16S targeted metagenomic sequencing. Transfusion. 2016;56(5):1138-1147. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1111/trf.13477">https://doi.org/10.1111/trf.13477</ext-link></mixed-citation></ref>
<ref id="ref-6-31185-En"><label>6.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Cogen</surname> <given-names>AL</given-names></name> <name><surname>Nizet</surname> <given-names>V</given-names></name> <name><surname>Gallo</surname> <given-names>RL</given-names></name></person-group> <article-title>Skin microbiota: a source of disease or defence?</article-title> <source>Br. J. Dermatol.</source> <year>2008</year><volume>158</volume><issue>3</issue><fpage>442</fpage><lpage>455</lpage> <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2746716/pdf/nihms91877.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2746716/pdf/nihms91877.pdf</ext-link></element-citation>
<mixed-citation>6. Cogen AL, Nizet V, Gallo RL. Skin microbiota: a source of disease or defence? Br. J. Dermatol. 2008;158(3):442-455. <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2746716/pdf/nihms91877.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2746716/pdf/nihms91877.pdf</ext-link></mixed-citation></ref>
<ref id="ref-7-31185-En"><label>7.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Funkhouser</surname> <given-names>LJ</given-names></name> <name><surname>Bordenstein</surname> <given-names>SR</given-names></name></person-group> <article-title>Mom knows best: the universality of maternal microbial transmission</article-title> <source>PLoS. Biol.</source> <year>2013</year><volume>11</volume><issue>8</issue><elocation-id>e1001631</elocation-id> <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747981/pdf/pbio.1001631.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747981/pdf/pbio.1001631.pdf</ext-link></element-citation>
<mixed-citation>7. Funkhouser LJ, Bordenstein SR. Mom knows best: the universality of maternal microbial transmission. PLoS. Biol. 2013;11(8):e1001631. <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747981/pdf/pbio.1001631.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747981/pdf/pbio.1001631.pdf</ext-link></mixed-citation></ref>
<ref id="ref-8-31185-En"><label>8.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Cook</surname> <given-names>L</given-names></name> <name><surname>Reid</surname> <given-names>KT</given-names></name> <name><surname>H&#x00E4;kkinen</surname> <given-names>E</given-names></name> <name><surname>de Bie</surname> <given-names>B</given-names></name> <name><surname>Tanaka</surname> <given-names>S</given-names></name> <name><surname>Smyth</surname> <given-names>DJ</given-names></name> <etal/></person-group> <article-title>Induction of stable human FOXP3+ Tregs by a parasite-derived TGF-&#x03B2; mimic</article-title> <source>Immunol. Cell. Biol.</source> <year>2021</year><volume>99</volume><issue>8</issue><fpage>833</fpage><lpage>847</lpage> <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453874/pdf/IMCB-99-833.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453874/pdf/IMCB-99-833.pdf</ext-link></element-citation>
<mixed-citation>8. Cook L, Reid KT, H&#x00E4;kkinen E, de Bie B, Tanaka S, Smyth DJ, et al. Induction of stable human FOXP3+ Tregs by a parasite-derived TGF-&#x03B2; mimic. Immunol. Cell. Biol. 2021;99(8):833-847. <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453874/pdf/IMCB-99-833.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453874/pdf/IMCB-99-833.pdf</ext-link></mixed-citation></ref>
<ref id="ref-9-31185-En"><label>9.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>M&#x00FC;nter</surname> <given-names>S</given-names></name> <name><surname>Way</surname> <given-names>M</given-names></name> <name><surname>Frischknecht</surname> <given-names>F</given-names></name></person-group> <article-title>Signaling during pathogen infection</article-title> <source>Sci. STKE.</source> <year>2006</year><volume>2006</volume><issue>335</issue><elocation-id>re5</elocation-id> <pub-id pub-id-type="doi">10.1126/stke.3352006re5</pub-id></element-citation>
<mixed-citation>9. M&#x00FC;nter S, Way M, Frischknecht F. Signaling during pathogen infection. Sci. STKE. 2006;2006(335):re5. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1126/stke.3352006re5">https://doi.org/10.1126/stke.3352006re5</ext-link></mixed-citation></ref>
<ref id="ref-10-31185-En"><label>10.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chen</surname> <given-names>X</given-names></name> <name><surname>Zhou</surname> <given-names>Q</given-names></name> <name><surname>Liu</surname> <given-names>J</given-names></name> <name><surname>Zhou</surname> <given-names>B</given-names></name> <name><surname>Wu</surname> <given-names>X</given-names></name> <name><surname>Long</surname> <given-names>L</given-names></name></person-group> <article-title>Autoimmune manifestations of visceral leishmaniasis in Chinese patients</article-title> <source>Ann. Palliat. Med.</source> <year>2021</year><volume>10</volume><issue>12</issue><fpage>12699</fpage><lpage>12705</lpage> <ext-link ext-link-type="uri" xlink:href="https://apm.amegroups.com/article/view/86099/pdf">https://apm.amegroups.com/article/view/86099/pdf</ext-link></element-citation>
<mixed-citation>10. Chen X, Zhou Q, Liu J, Zhou B, Wu X, Long L. Autoimmune manifestations of visceral leishmaniasis in Chinese patients. Ann. Palliat. Med. 2021;10(12):12699-12705. <ext-link ext-link-type="uri" xlink:href="https://apm.amegroups.com/article/view/86099/pdf">https://apm.amegroups.com/article/view/86099/pdf</ext-link></mixed-citation></ref>
<ref id="ref-11-31185-En"><label>11.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Richards</surname> <given-names>EM</given-names></name> <name><surname>Li</surname> <given-names>J</given-names></name> <name><surname>Stevens</surname> <given-names>BR</given-names></name> <name><surname>Pepine</surname> <given-names>CJ</given-names></name> <name><surname>Raizada</surname> <given-names>MK</given-names></name></person-group> <article-title>Gut Microbiome and Neuroinflammation in Hypertension</article-title> <source>Circ. Res.</source> <year>2022</year><volume>130</volume><issue>3</issue><fpage>401</fpage><lpage>417</lpage> <ext-link ext-link-type="uri" xlink:href="https://www.ahajournals.org/doi/epub/10.1161/CIRCRESAHA.121.319816">https://www.ahajournals.org/doi/epub/10.1161/CIRCRESAHA.121.319816</ext-link></element-citation>
<mixed-citation>11. Richards EM, Li J, Stevens BR, Pepine CJ, Raizada MK. Gut Microbiome and Neuroinflammation in Hypertension. Circ. Res. 2022;130(3):401-417. <ext-link ext-link-type="uri" xlink:href="https://www.ahajournals.org/doi/epub/10.1161/CIRCRESAHA.121.319816">https://www.ahajournals.org/doi/epub/10.1161/CIRCRESAHA.121.319816</ext-link></mixed-citation></ref>
<ref id="ref-12-31185-En"><label>12.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Schoeler</surname> <given-names>M</given-names></name> <name><surname>Caesar</surname> <given-names>R</given-names></name></person-group> <article-title>Dietary lipids, gut microbiota and lipid metabolism</article-title> <source>Rev. Endocr. Metab. Disord.</source> <year>2019</year><volume>20</volume><issue>4</issue><fpage>461</fpage><lpage>472</lpage> <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938793/pdf/11154_2019_Article_9512.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938793/pdf/11154_2019_Article_9512.pdf</ext-link></element-citation>
<mixed-citation>12. Schoeler M, Caesar R. Dietary lipids, gut microbiota and lipid metabolism. Rev. Endocr. Metab. Disord. 2019;20(4):461-472. <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938793/pdf/11154_2019_Article_9512.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938793/pdf/11154_2019_Article_9512.pdf</ext-link></mixed-citation></ref>
<ref id="ref-13-31185-En"><label>13.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>And&#x00FA;jar-Tenorio</surname> <given-names>N</given-names></name> <name><surname>Prieto</surname> <given-names>I</given-names></name> <name><surname>Cobo</surname> <given-names>A</given-names></name> <name><surname>Mart&#x00ED;nez-Rodr&#x00ED;guez</surname> <given-names>AM</given-names></name> <name><surname>Hidalgo</surname> <given-names>M</given-names></name> <name><surname>Segarra</surname> <given-names>AB</given-names></name> <etal/></person-group> <article-title>High fat diets induce early changes in gut microbiota that may serve as markers of ulterior altered physiological and biochemical parameters related to metabolic syndrome. Effect of virgin olive oil in comparison to butter</article-title> <source>PLoS. One.</source> <year>2022</year><volume>17</volume><issue>8</issue><elocation-id>e0271634</elocation-id> <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9380944/pdf/pone.0271634.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9380944/pdf/pone.0271634.pdf</ext-link></element-citation>
<mixed-citation>13. And&#x00FA;jar-Tenorio N, Prieto I, Cobo A, Mart&#x00ED;nez-Rodr&#x00ED;guez AM, Hidalgo M, Segarra AB, et al. High fat diets induce early changes in gut microbiota that may serve as markers of ulterior altered physiological and biochemical parameters related to metabolic syndrome. Effect of virgin olive oil in comparison to butter. PLoS. One. 2022;17(8):e0271634. <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9380944/pdf/pone.0271634.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9380944/pdf/pone.0271634.pdf</ext-link></mixed-citation></ref>
<ref id="ref-14-31185-En"><label>14.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Mart&#x00ED;nez</surname> <given-names>N</given-names></name> <name><surname>Prieto</surname> <given-names>I</given-names></name> <name><surname>Hidalgo</surname> <given-names>M</given-names></name> <name><surname>Segarra</surname> <given-names>AB</given-names></name> <name><surname>Mart&#x00ED;nez-Rodr&#x00ED;guez</surname> <given-names>AM</given-names></name> <name><surname>Cobo</surname> <given-names>A</given-names></name> <etal/></person-group> <article-title>Refined versus Extra Virgin Olive Oil High-Fat Diet Impact on Intestinal Microbiota of Mice and Its Relation to Different Physiological Variables</article-title> <source>Microorganisms</source> <year>2019</year><fpage>7</fpage><issue>2</issue><fpage>61</fpage> <ext-link ext-link-type="uri" xlink:href="https://www.mdpi.com/2076-2607/7/2/61">https://www.mdpi.com/2076-2607/7/2/61</ext-link></element-citation>
<mixed-citation>14. Mart&#x00ED;nez N, Prieto I, Hidalgo M, Segarra AB, Mart&#x00ED;nez-Rodr&#x00ED;guez AM, Cobo A, et al. Refined versus Extra Virgin Olive Oil High-Fat Diet Impact on Intestinal Microbiota of Mice and Its Relation to Different Physiological Variables. Microorganisms. 2019;7(2):61. <ext-link ext-link-type="uri" xlink:href="https://www.mdpi.com/2076-2607/7/2/61">https://www.mdpi.com/2076-2607/7/2/61</ext-link></mixed-citation></ref>
<ref id="ref-15-31185-En"><label>15.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Prieto</surname> <given-names>I</given-names></name> <name><surname>Hidalgo</surname> <given-names>M</given-names></name> <name><surname>Segarra</surname> <given-names>AB</given-names></name> <name><surname>Mart&#x00ED;nez-Rodr&#x00ED;guez</surname> <given-names>AM</given-names></name> <name><surname>Cobo</surname> <given-names>A</given-names></name> <name><surname>Ram&#x00ED;rez</surname> <given-names>M</given-names></name> <etal/></person-group> <article-title>Influence of a diet enriched with virgin olive oil or butter on mouse gut microbiota and its correlation to physiological and biochemical parameters related to metabolic syndrome</article-title> <source>PLoS. One.</source> <year>2018</year><volume>13</volume><issue>1</issue><elocation-id>e0190368</elocation-id> <ext-link ext-link-type="uri" xlink:href="https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0190368&#x0026;type=printable">https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0190368&#x0026;type=printable</ext-link></element-citation>
<mixed-citation>15. Prieto I, Hidalgo M, Segarra AB, Mart&#x00ED;nez-Rodr&#x00ED;guez AM, Cobo A, Ram&#x00ED;rez M, et al. Influence of a diet enriched with virgin olive oil or butter on mouse gut microbiota and its correlation to physiological and biochemical parameters related to metabolic syndrome. PLoS. One. 2018;13(1):e0190368. <ext-link ext-link-type="uri" xlink:href="https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0190368&#x0026;type=printable">https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0190368&#x0026;type=printable</ext-link></mixed-citation></ref>
<ref id="ref-16-31185-En"><label>16.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Thaiss</surname> <given-names>CA</given-names></name> <name><surname>Zmora</surname> <given-names>N</given-names></name> <name><surname>Levy</surname> <given-names>M</given-names></name> <name><surname>Elinav</surname> <given-names>E</given-names></name></person-group> <article-title>The microbiome and innate immunity</article-title> <source>Nature</source> <year>2016</year><volume>535</volume><issue>7610</issue><fpage>65</fpage><lpage>74</lpage> <pub-id pub-id-type="doi">10.1038/nature18847</pub-id></element-citation>
<mixed-citation>16. Thaiss CA, Zmora N, Levy M, Elinav E. The microbiome and innate immunity. Nature. 2016;535(7610):65-74. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1038/nature18847">https://doi.org/10.1038/nature18847</ext-link></mixed-citation></ref>
<ref id="ref-17-31185-En"><label>17.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>M&#x00FC;ller</surname> <given-names>TH</given-names></name> <name><surname>Mohr</surname> <given-names>H</given-names></name> <name><surname>Montag</surname> <given-names>T</given-names></name></person-group> <article-title>Methods for the detection of bacterial contamination in blood products</article-title> <source>Clin Chem Lab Med.</source> <year>2008</year><volume>46</volume><issue>7</issue><fpage>933</fpage><lpage>46</lpage> <pub-id pub-id-type="doi">10.1515/CCLM.2008.154</pub-id></element-citation>
<mixed-citation>17. M&#x00FC;ller TH, Mohr H, Montag T. Methods for the detection of bacterial contamination in blood products. Clin Chem Lab Med. 2008;46(7):933-46. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1515/CCLM.2008.154">https://doi.org/10.1515/CCLM.2008.154</ext-link></mixed-citation></ref>
<ref id="ref-18-31185-En"><label>18.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>El Mehdaoui</surname> <given-names>F</given-names></name> <name><surname>Benajiba</surname> <given-names>M</given-names></name> <name><surname>Boulahdid</surname> <given-names>S</given-names></name> <name><surname>El Hattimy</surname> <given-names>F</given-names></name> <name><surname>Soulaymani</surname> <given-names>A</given-names></name> <name><surname>Alami</surname> <given-names>R</given-names></name></person-group> <article-title>Skin flora and bacterial contamination of diversion pouch and recovered platelet components in Moroccan blood donors</article-title> <source>Transfus. Med.</source> <year>2020</year><volume>30</volume><issue>5</issue><fpage>384</fpage><lpage>390</lpage> <pub-id pub-id-type="doi">10.1111/tme.12704</pub-id></element-citation>
<mixed-citation>18. El Mehdaoui F, Benajiba M, Boulahdid S, El Hattimy F, Soulaymani A, Alami R. Skin flora and bacterial contamination of diversion pouch and recovered platelet components in Moroccan blood donors. Transfus. Med. 2020;30(5):384-390. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1111/tme.12704">https://doi.org/10.1111/tme.12704</ext-link></mixed-citation></ref>
<ref id="ref-19-31185-En"><label>19.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Yamaguchi</surname> <given-names>H</given-names></name> <name><surname>Yamada</surname> <given-names>M</given-names></name> <name><surname>Uruma</surname> <given-names>T</given-names></name> <name><surname>Kanamori</surname> <given-names>M</given-names></name> <name><surname>Goto</surname> <given-names>H</given-names></name> <name><surname>Yamamoto</surname> <given-names>Y</given-names></name> <etal/></person-group> <article-title>Prevalence of viable <italic>Chlamydia pneumoniae</italic> in peripheral blood mononuclear cells of healthy blood donors</article-title> <source>Transfusion</source> <year>2004</year><volume>44</volume><issue>7</issue><fpage>1072</fpage><lpage>1078</lpage> <pub-id pub-id-type="doi">10.1111/j.1537-2995.2004.04005.x</pub-id></element-citation>
<mixed-citation>19. Yamaguchi H, Yamada M, Uruma T, Kanamori M, Goto H, Yamamoto Y, et al. Prevalence of viable <italic>Chlamydia pneumoniae</italic> in peripheral blood mononuclear cells of healthy blood donors. Transfusion. 2004;44(7):1072-1078. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1111/j.1537-2995.2004.04005.x">https://doi.org/10.1111/j.1537-2995.2004.04005.x</ext-link></mixed-citation></ref>
<ref id="ref-20-31185-En"><label>20.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Thwaites</surname> <given-names>GE</given-names></name> <name><surname>Gant</surname> <given-names>V</given-names></name></person-group> <article-title>Are bloodstream leukocytes Trojan Horses for the metastasis of <italic>Staphylococcus aureus</italic>?</article-title> <source>Nat. Rev. Microbiol.</source> <year>2011</year><volume>9</volume><issue>3</issue><fpage>215</fpage><lpage>222</lpage> <pub-id pub-id-type="doi">10.1038/nrmicro2508</pub-id></element-citation>
<mixed-citation>20. Thwaites GE, Gant V. Are bloodstream leukocytes Trojan Horses for the metastasis of <italic>Staphylococcus aureus</italic>? Nat. Rev. Microbiol. 2011;9(3):215-222. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1038/nrmicro2508">https://doi.org/10.1038/nrmicro2508</ext-link></mixed-citation></ref>
<ref id="ref-21-31185-En"><label>21.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Artois</surname> <given-names>M</given-names></name></person-group> <article-title>Epidemiology of contagious diseases, ecology of mammals, health, management and conservation biology: concluding remarks</article-title> <source>Rev. Sci. Tech.</source> <year>1993</year><volume>12</volume><issue>1</issue><fpage>203</fpage><lpage>234</lpage> <ext-link ext-link-type="uri" xlink:href="https://doc.woah.org/dyn/portal/digidoc.xhtml?statelessToken=OVYe2CFPMsTtKSR-E2RufNW54vKLbB-ZjBXuY2AtlkQ=&#x0026;actionMethod=dyn%2Fportal%2Fdigidoc.xhtml%3AdownloadAttachment.openStateless">https://doc.woah.org/dyn/portal/digidoc.xhtml?statelessToken=OVYe2CFPMsTtKSR-E2RufNW54vKLbB-ZjBXuY2AtlkQ=&#x0026;actionMethod=dyn%2Fportal%2Fdigidoc.xhtml%3AdownloadAttachment.openStateless</ext-link></element-citation>
<mixed-citation>21. Artois M. Epidemiology of contagious diseases, ecology of mammals, health, management and conservation biology: concluding remarks. Rev. Sci. Tech. 1993;12(1):203-234. <ext-link ext-link-type="uri" xlink:href="https://doc.woah.org/dyn/portal/digidoc.xhtml?statelessToken=OVYe2CFPMsTtKSR-E2RufNW54vKLbB-ZjBXuY2AtlkQ=&#x0026;actionMethod=dyn%2Fportal%2Fdigidoc.xhtml%3AdownloadAttachment.openStateless">https://doc.woah.org/dyn/portal/digidoc.xhtml?statelessToken=OVYe2CFPMsTtKSR-E2RufNW54vKLbB-ZjBXuY2AtlkQ=&#x0026;actionMethod=dyn%2Fportal%2Fdigidoc.xhtml%3AdownloadAttachment.openStateless</ext-link></mixed-citation></ref>
<ref id="ref-22-31185-En"><label>22.</label> <element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Herrera</surname> <given-names>J</given-names></name> <name><surname>Nunn</surname> <given-names>CL</given-names></name></person-group> <article-title>Behavioural ecology and infectious disease: implications for conservation of biodiversity</article-title> <source>Phil. Trans. R. Soc. B.</source> <year>2019</year><volume>374</volume><issue>1781</issue><elocation-id>20180054</elocation-id> <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6710567/pdf/rstb20180054.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6710567/pdf/rstb20180054.pdf</ext-link></element-citation>
<mixed-citation>22. Herrera J, Nunn CL. Behavioural ecology and infectious disease: implications for conservation of biodiversity. Phil. Trans. R. Soc. B. 2019;374(1781):20180054. <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6710567/pdf/rstb20180054.pdf">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6710567/pdf/rstb20180054.pdf</ext-link></mixed-citation></ref>
</ref-list>
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