Recurrent Achilles Tendon Rupture in Multiple Sites as a Primary Manifestation of Systemic Lupus Erythematosus in a 32-Year-Old Patient: A Case Report.

The Achilles tendon is vital for walking and running, but it's also the most frequently ruptured tendon. Ruptures often occur without direct trauma and present with acute posterior ankle/heel pain. Various factors like age, biomechanical properties, degeneration, and mechanical factors influence susceptibility to rupture. Mechanisms of injury vary, including weight-bearing forefoot pushing off and sudden dorsiflexion of the ankle. Management goals focus on minimizing morbidity, swift recovery, and preventing complications through tailored interventions. Systemic lupus erythematosus (SLE) can also contribute to tendon rupture, especially with prolonged corticosteroid use. A 32-year-old female presented to the ER after injuring her left foot during a basketball game. She was diagnosed with an Achilles tendon rupture and underwent surgery to repair it. However, she experienced delayed wound closure and needed a skin graft. Two months later, she suffered another rupture in a different location, requiring a tendon transfer surgery. She was finally diagnosed with SLE after tests by the Rheumatology Department. Treatment commenced, and she began rehabilitation four weeks post-surgery. Surgical management of ruptured Achilles tendon involves techniques like open repair, percutaneous repair, mini-open repair, and augmentative repair. Open repair involves a direct approach with a posteromedial incision to align tendon stumps using various stitching techniques. Conservative treatment involves immobilization and non-weight-bearing for at least four weeks post surgery. For rare cases of Achilles tendon rupture caused by lupus, treatment focuses on managing the underlying disease with medications like hydroxychloroquine and glucocorticosteroids. Comprehensive evaluation, including musculoskeletal assessment, is crucial for lupus patients. SLE needs to be considered as a potential cause, especially in cases of recurrent ruptures or additional musculoskeletal symptoms. Surgical management should be tailored to individual patient needs, while also considering surgeon proficiency and preferences.

Gene variants rs5182, rs2074192, and rs4343 in the renin-angiotensin-aldosterone system are associated with symptom severity, higher odds of hospitalization, and death in COVID-19.

OBJECTIVES: To analyze the gene variants of the renin-angiotensin-aldosterone system and determine their association with the severity and outcome of COVID-19. METHODS: A total of 104 patients were included in the study: 34 asymptomatic patients with COVID-19 as controls and 70 symptomatic patients as cases. The genetic variants ACE rs4343, ACE2 rs2074192, AGTR1 rs5182, and AGT rs4762 were identified using TaqMan genotyping tests. RESULTS: Patients with the T/T genotype of AGTR1 rs5182 have a higher probability of developing symptomatic COVID-19 (odds ratio [OR] 12.25, 95% confidence interval [CI] 1.34-111.9, P ≤0.001) and a higher risk of hospitalization because of disease (OR 14.00, 95% CI 1.53-128.49, P = 0.012). The haplotype CTG (AGTR1 rs5182, ACE2 rs2074192, ACE rs4343) decreased the odds of death related to COVID-19 in the study population (OR 0.03, 95% CI 0.0-0.06, P = 0.026). CONCLUSIONS: The T/T genotype of the AGTR1 rs5182 variant increased the probability of symptomatic COVID-19 and hospitalization, whereas the haplotype CTG (consisting of AGTR1 rs5182, ACE2 rs2074192, and ACE rs4343) decreased the odds of death related to COVID-19 by 97% in the hospitalized patients with COVID-19. These results support the participation of renin-angiotensin-aldosterone system gene variants as modifiers of the severity of symptoms associated with SARS-CoV-2 infection and the outcome of COVID-19.

Temporal Dynamics of Adverse Effects across Five Sessions of Transcranial Direct Current Stimulation.

(1) Background: Transcranial direct current stimulation (tDCS) is a safe intervention, only producing mild and transient adverse effects (AEs). However, there is no detailed analysis of the pattern of adverse effects in an application transferable to the clinic. Therefore, our objective is to describe the AEs produced by tDCS and its temporal evolution. (2) Methods: A total of 33 young volunteers were randomized into a tDCS or sham group. Participants performed a hand dexterity task while receiving the tDCS or sham intervention (20 min and 1 mA), for five consecutive days. AEs were assessed daily after each intervention and classified as somatosensory, pain, or other effects. (3) Results: The number of AEs was generally increased by tDCS intervention. Specifically, tDCS led to more frequent somatosensory discomfort, characterized by sensations like itching and tingling, alongside painful sensations such as burning, compared to the sham intervention. Additionally, certain adverse events, including neck and arm pain, as well as dizziness and blurry vision, were exclusive to the tDCS group. Interestingly, tDCS produced similar AEs across the days; meanwhile, the somatosensory AEs in the sham group showed a trend to decrease. (4) Conclusions: tDCS produces mild and temporary somatosensory and pain AEs during and across sessions. The different evolution of the AEs between the tDCS and sham protocol could unmask the blinding protocol most used in tDCS studies. Potential solutions for improving blinding protocols for future studies are discussed.

Gene Variants of the OAS/RNase L Pathway and Their Association with Severity of Symptoms and Outcome of SARS-CoV-2 Infection.

INTRODUCTION: The interferon pathway plays a critical role in triggering the immune response to SARS-CoV-2, and these gene variants may be involved in the severity of COVID-19. This study aimed to analyze the frequency of three gene variants of OAS and RNASEL with the occurrence of COVID-19 symptoms and disease outcome. METHODS: This cross-sectional study included 104 patients with SARS-CoV-2 infection, of which 34 were asymptomatic COVID-19, and 70 were symptomatic cases. The variants rs486907 (RNASEL), rs10774671 (OAS1), rs1293767 (OAS2), and rs2285932 (OAS3) were screened and discriminated using a predesigned 5'-nuclease assay with TaqMan probes. RESULTS: Patients with the allele C of the OAS2 gene rs1293767 (OR = 0.36, 95% CI: 0.15-0.83, p = 0.014) and allele T of the OAS3 gene rs2285932 (OR = 0.39, 95% CI: 0.2-0.023, p = 0.023) have lower susceptibility to developing symptomatic COVID-19. The genotype frequencies (G/G, G/C, and C/C) of rs1293767 for that comparison were 64.7%, 29.4%, and 5.9% in the asymptomatic group and 95.2%, 4.8%, and 0% in severe disease (p < 0.05). CONCLUSIONS: Our data indicate that individuals carrying the C allele of the OAS2 gene rs1293767 and the T allele of the OAS3 gene rs2285932 are less likely to develop symptomatic COVID-19, suggesting these genetic variations may confer a protective effect among the Mexican study population. Furthermore, the observed differences in genotype frequencies between asymptomatic individuals and those with severe disease emphasize the potential of these variants as markers for disease severity. These insights enhance our understanding of the genetic factors that may influence the course of COVID-19 and underscore the potential for genetic screening in identifying individuals at increased risk for severe disease outcomes.

Adaptation and Validation of the Perception of Anomie Scale in Chilean University Students.

The Perception of Anomie Scale (PAS) is a measure used to evaluate the state of society and whether it is disintegrated and deregulated. Although widely used, the psychometric properties of reliability, validity, and measurement invariance according to sex have not been studied in the Chilean university population. To explore these properties, a cross-sectional study was carried out with 383 students from public (45.7%) and private (54.3%) universities, with a mean age of 21.5 years (SD = 3.3). A CFA and ESEM were performed, which confirmed the two-factor correlated structure, achieving better goodness-of-fit indices by eliminating five items (RMSEA = 0.09; CFI = 0.98; TLI = 0.95). This also provided evidence of reliability and measurement invariance according to sex. This study provides evidence of the psychometric quality of the PAS scale, thus allowing its use in the Chilean university context.

Combination of different noninvasive brain stimulation treatments for upper limb recovery in stroke patients: A systematic review.

We report a review of Pubmed (Medline), CENTRAL, Web of Science, and Scopus to test the effectiveness of the combined application of repetitive transcranial magnetic stimulation and transcranial direct current stimulation in the improvement of different functional variables of the upper limb in people with stroke. Two independent reviewers assessed eligibility and evaluated the quality of the studies. Five articles were included in the final review according to the inclusion criteria: Most show statistically significant differences in motor function improvement in favor of the experimental group, but not in activity. Due to the heterogeneity of the observed studies, the results should be interpreted with caution-more high-quality studies are needed to investigate the effectiveness of these interventions in different stages of stroke patients.

Does patella lowering as part of multilevel surgery improve knee kinematics in children with cerebral palsy and crouch gait? A meta-analysis of comparative studies.

Purpose: To evaluate differences in knee kinematic outcomes of patellar-lowering surgery, specifically patellar tendon advancement or patellar tendon shortening, compared with no-patellar-lowering surgery in multilevel surgery for children with cerebral palsy and crouch gait. Methods: Four databases were searched to retrieve studies published from inception until 2023. Three reviewers independently screened for studies with observational or randomized control designs, comparing two groups of patients with cerebral palsy and crouch gait who underwent multilevel surgery (with patellar-lowering surgery versus no-patellar-lowering surgery), where various gait analysis outcomes were reported (CRD42023450692). The risk of bias was assessed with the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tool. Results: Seven studies (249 patients and 368 limbs) met the eligibility criteria. Patients undergoing patellar-lowering surgery demonstrated statistically significant improvements in knee flexion at initial contact (mean difference = -6.39; 95% confidence interval = [-10.4, -2.75]; p = 0.0006; I2 = 84%), minimum knee flexion in stance (mean difference = -14.27; 95% confidence interval = [-18.31, -10.23]; p < 0.00001; I2 = 89%), and clinical knee flexion contracture (mean difference = -5.6; 95% confidence interval = [-9.59, -1.6]; p = 0.006; I2 = 95%), with a significant increase in anterior pelvic tilt (mean difference = 2.97; 95% confidence interval = [0.58, 5.36]; p = 0.01; I2 = 15%). However, improvements in gait deviation index and decrease in peak knee flexion in swing did not reach statistical significance. Subgroup analysis reduced heterogeneity and revealed (1) greater improvement using patellar tendon shortening versus patellar tendon advancement techniques; (2) lack of knee flexion contracture improvement in high-quality or longer-term studies; (3) longer-term improvement only in minimum knee flexion in stance, with a decrease in peak knee flexion in swing; and (4) an inability to assess the potential benefit of rectus femoris procedure and hamstring preservation. Conclusions: Overall, the combination of patellar-lowering surgery with multilevel surgery demonstrated superior improvements in stance-phase knee kinematics compared with multilevel surgery alone, despite an increase in anterior pelvic tilt and a longer-term knee flexion reduction during the swing phase. Level of evidence: Level III, Systematic review of level III studies.

New approach for early and specific Alzheimer disease diagnosis from different plasma biomarkers.

BACKGROUND: Alzheimer Disease (AD) is a complex pathology, in which several biochemical pathways could be involved. Therefore, the development of clinical studies combining different nature biomarkers in an AD diagnosis approach is required. Specifically, the present study evaluated blood biomarkers from different molecular pathways (epigenomics, lipid metabolism, lipid peroxidation), to obtain an early and specific AD diagnosis approach. METHODS: The participants were classified into early AD (n = 53), and non-AD (healthy controls, other dementias) (n = 83). Blood samples were collected and biochemical determinations (microRNAs, lipids, lipid peroxidation compounds) were carried out by quantitative PCR and liquid chromatography coupled to mass spectrometry, respectively. Then, a logistic regression model with a Bayesian variable selection procedure was developed. RESULTS: The Bayesian variable selection procedure for microRNAs did not show any relevant variable. Therefore, microRNA biomarkers were excluded. So, the developed model considered only lipids and lipid peroxidation compounds. The corresponding selected variables were age, 18:0 LPC, PGE2, isoprostanes and, isofurans. The validated model (by leave-one-out cross-validation) provided satisfactory diagnosis indexes (AUC 0.83, Sensitivity 87 %, Specificity 79 %). CONCLUSION: The developed model included biomarkers from different pathways (lipid metabolism, oxidative stress), achieving a promising approach to early, specific and, minimally invasive AD diagnosis. Nevertheless, further work to validate clinically these preliminary results with an external cohort is required. Also, the integration of different compounds coming from several biochemical pathways could constitute a relevant research field for the development of AD therapeutic targets.

Motor imagery ability in children and adolescents with cerebral palsy: a systematic review and evidence map.

Background: Cerebral palsy (CP) refers to a group of permanent movement and posture disorders. Motor imagery (MI) therapy is known to provide potential benefits, but data on MI ability in children and adolescents with CP is lacking. Objective: A systematic review was performed to explore MI abilities in children and adolescents with CP compared to typically developed (TD) subjects. Methods: We searched on PubMed, Web of Science (WOS), EBSCO, Google Scholar, and PEDro including observational studies. Methodological quality was assessed with the modified Newcastle-Ottawa Scale and evidence map was created to synthesize the evidence qualitatively and quantitatively. Results: Seven cross-sectional studies were selected, which included 174 patients with CP and 321 TD subjects. Three studies explored explicit MI, two MI-execution synchrony, and four implicit MI domains. Methodological quality ranged from 6 to 8 stars. Moderate evidence supported the absence of differences in vividness between the groups. As there was only limited evidence, establishing a clear direction for the results was not possible, especially for the capacity to generate MI, mental chronometry features, and MI-execution synchrony domains. Moderate evidence supported a lower efficiency in cases for hand recognition, derived from a lower accuracy rate, while reaction time remained similar between the two groups. Moderate evidence indicated that patients with CP and TD controls showed similar features on whole-body recognition. Conclusion: Moderate evidence suggests that patients with CP present a reduced ability in hand recognition, which is not observed for whole-body recognition compared to healthy controls. Severe limitations concerning sample size calculations and validity of assessment tools clearly limits establishing a direction of results, especially for explicit MI and MI-Execution synchrony domains. Further research is needed to address these limitations to enhance our comprehension of MI abilities in children, which is crucial for prescribing suitable MI-based therapies in this child population.

Gender-based differences in the impact of Dark Triad traits on academic dishonesty: The mediating role of moral disengagement in college students.

This study explores whether gender differences influence the components of the Dark Triad of personality and moral disengagement on the manifestations of dishonest academic behavior in Peruvian university students. Moreover, it evaluates how moral disengagement mediates the effect that the Dark Triad components have on academic dishonesty. The participants were 591 university students, aged between 18 and 40 years (women = 71.7 %; Mage = 21.5; SDage = 3.60), to whom the Dirty Dozen Dark Triad, the Propensity to Morally Disengage Scale, and the Scale of Academic Dishonesty, which has 3 dimensions (cheating on exams, plagiarism, and falsification) were applied. The results reveal that only Machiavellianism has a significant and consistent influence on all dimensions of academic dishonesty, in both men and women, while psychopathy influences the dimension of plagiarism in both men and women and falsification only in men. In addition, moral disengagement affects falsification in both groups, cheating on exams only in the men's group, and plagiarism in the women's group. Finally, the mediating role of moral disengagement between the effect of the Dark Triad and the manifestations of academic dishonesty was not demonstrated.

Psychometric properties of the Teachers' Sense of Efficacy Scale in a sample of Chilean public school teachers.

The Teachers' Sense of Efficacy Scale (TSES) has demonstrated suitable levels of reliability and validity for its use on the teacher population in several countries, and it is the most used scale to assess teachers' beliefs in their efficacy. However, few psychometric studies exist on its applicability to elementary teachers in public schools. This study analyzed the psychometric properties of the TSES in teachers who work in elementary education. The sample comprised 1,406 Chilean teachers, mainly women (77.2%), from various Chilean public and subsidized schools. The results obtained from three confirmatory factor analyses demonstrated that the model that best fit the data was bifactor exploratory structural equation modeling (B-ESEM) for 24 items, one general factor, and three residual factors. The results of the factorial invariance analysis indicate that the TSES remains stable up to the strict level of invariance for the variable sex. These results imply that the TSES can be used on Chilean teachers. The results are discussed based on the theoretical and empirical evidence available.

Development and validation of the dizziness fear-avoidance behaviours and beliefs inventory for patients with vestibular disorders.

The purpose of this study is to present the development and analysis of the factorial structure and psychometric properties of a new self-administered questionnaire (Dizziness Fear-Avoidance Behaviours and Beliefs Inventory (D-FABBI)) designed to measure fear-avoidance behaviors and cognitions related to dizziness disability. A mixed-method design combining a qualitative study with an observational and cross-sectional study was employed to develop (content validity) and psychometrically validate (construct validity, reliability, and convergent/discriminant validity) a new instrument. A total of 198 patients with vestibular disorders (acute vestibular syndrome (AVS), 23.2%; chronic vestibular syndrome (CVS), 35.4%; and episodic vestibular syndrome (EVS) 41.4%) were recruited. Sociodemographic characteristics, the Dizziness Handicap Inventory (DHI) and the Hospital Anxiety and Depression Scale (HADS) and D-FABBI were evaluated. The final version of the D-FABBI consists of 17 items distributed across two subscales: activities of daily living fear-avoidance and movement fear-avoidance. The D-FABBI showed high internal consistency (Cronbach α = 0.932; 95% CI [0.91-0.94]) and so did the subscales (Cronbach α > 0.8). The exploratory structural equation model and confirmatory factor analysis provided better fit results, with a comparative fit index and root mean square error of approximation values of 0.907 to 0.081. No floor or ceiling effects were identified. There was a positive, significant, and moderate-strong magnitude correlation with the total DHI (r = 0.62) and low-moderate with respect to the HADS depression (r = 0.35) and HADS anxiety subscales (r = 0.26). The patients with CVS had a higher D-FABBI score than those with AVS or EVS. The D-FABBI appears to be a valid and reliable instrument for measuring the fear-avoidance behaviors and cognition related to dizziness disability of patients with vestibular disorders.

Psychometric Validation of the Adult Prosocialness Behavior Scale in a Professional Teaching Context.

For the teaching profession, prosociality is a relevant skill. From this perspective, the present study aimed to examine the psychometric properties of the Adult Prosocialness Behavior Scale (APBS) in a professional setting of primary school Chilean teachers (n = 1404; mean age = 41.4; SD = 10.8; 77.4% women). ESEM and CFA were applied to evaluate its factor structure, internal consistency, factorial reliability, and invariance. The results supported a bifactor ESEM model in which prosociality was represented by a general latent factor and four specific factors (helping, sharing, caring, and empathy). A predominance of the unidimensional component of the APBS was observed (general factor, ECV = 0.938; ωh = 0.945), with adequate reliability (α = 0.932; ω of the factor general = 0.968) and invariance of the measurement in terms of gender. Its adequacy was confirmed by a good level of fit (RMSEA = 0.042 90%CI [0.036-0.049]; SRMR = 0.012; CFI = 0.995; TLI = 0.988). It is concluded that the APBS is a suitable instrument to measure prosociality in the professional setting studied. Its general and specific dimensions are relevant to the prosocial behaviors currently required of teachers. Future studies could contribute evidence of the transcultural validation of the APBS in other educational contexts in order to undertake comparative studies.

Psychometric Properties of the SV-RES60 Resilience Scale in a Sample of Chilean Elementary School Teachers.

The concept of resilience, identified as a crucial variable due to its association with several beneficial outcomes in adulthood, is of particular interest in the teaching field. Specifically, teachers work in a demanding, challenging, and stressful context that requires a remarkable ability to adapt; therefore, resilience is important in the field of teaching and training, as it plays a fundamental role in children's cognitive, social, and emotional development. This study sought to analyze the psychometric properties of the SV-RES60 Resilience Scale in a sample of Chilean elementary school teachers from first to eighth grade (N = 1406; mean age = 41.4; SD = 10.8). ESEM and bifactor ESEM analyses were performed to evaluate its factor structure, internal consistency, and reliability. The results supported a bifactor structure in which resilience was represented by one general latent factor and twelve specific factors (RMSEA = 0.032; 90%CI [0.030, 0.033]; SRMR = 0.012; CFI = 0.986; TLI = 0.977). A predominance of the unidimensional components of the SV-RES60 (general factor, ECV = 0.812; ωh = 0.975) and a high reliability (α = 0.981; ω of the general factor = 0.991) were observed. In conclusion, the SV-RES60 Resilience Scale is a suitable instrument for measuring the general factor of resilience in the investigated teaching environment. Future studies could contribute towards evidence of a reduced scale and transcultural validation to conduct comparative studies.

Lipoinjection with Adipose Stem Cells for Nasal Modeling: Rhino Cell, a Highly Versatile Alternative.

It is undeniable that a significant number of patients who want to improve their facial appearance is increasingly interested in nonsurgical procedures. Without a doubt, the use of autologous fat could not be left out as a magnificent alternative for nasal modeling simply because of four influential factors: ease of collection, compatibility, the temporality of the results, and safety. This work describes an innovative alternative technique for nasal modeling using micrografts enriched with adipose-derived mesenchymal stem cells (ASCs). With this technique, fat was collected and divided into two samples, nanofat and microfat. Nanofat was used to isolate the ASCs; microfat was enriched with ASCs and used for nasal modeling. Lipoinjection was performed in a supraperiosteal plane on the nasal dorsum. Through a retrolabial access, the nasal tip and base of the columella were lipoinjected. We consider that nonsurgical nasal modeling using micrografts enriched with ASCs can be an attractive and innovative alternative. This technique will never be a substitute for surgical rhinoplasty. It can be performed in a minor procedure area with rapid recovery and return to the patient's daily activities the next day. If necessary, the procedure can be repeated.

Psychometric Analysis of Two Brief Versions of the CERQ in the Argentinean Population: CERQ-18 and CERQ-27.

Background: Emotion Regulation (ER) involves any explicit or implicit process that may alter the emotion felt, its duration and expression, and is a transdiagnostic factor of vulnerability involved in the etiology and maintenance of different emotional disorders. The Cognitive Emotion Regulation Questionnaire (CERQ) assesses nine cognitive strategies involved in ER and is a valuable tool. Its popularity and wide use led to the development of two abbreviated versions: a version with 18 items (two items per factor) and a 27-item version (three items per factor). Objective: To analyze the psychometric properties of both versions in the Argentinean population. Design: The research design was instrumental. The factor structure of the CERQ-18 and CERQ-27 as well as the reliability of the scores and the construct of each dimension were evaluated. In addition, we gathered validity evidence for its relationship with other variables by associating the CERQ scores with Difficulties in Emotion Regulation Scale (DERS) scores. Results: The CERQ-18 presented more consistent evidence regarding its internal structure (adequate fit indices and factor loadings of moderate magnitude) and reliability. Given that the association of the two versions with the DERS is similar, we recommend that the 18-item version be used. Conclusion: The CERQ-18 has quite similar psychometric properties to the CERQ-27 in the general population of Argentina and the findings contribute to an understanding of its internal structure.

Circulating and Endometrial Tissue microRNA Markers Associated with Endometrial Cancer Diagnosis, Prognosis, and Response to Treatment.

In developed countries, endometrial cancer (EC) is one of the most common neoplasms of the female reproductive system. MicroRNAs (miRs) are a class of single-stranded noncoding RNA molecules with lengths of 19-25 nucleotides that bind to target messenger RNA (mRNA) to regulate post-transcriptional gene expression. Although there is a large amount of research focused on identifying miRs with a diagnostic, prognostic, or response to treatment capacity in EC, these studies differ in terms of experimental methodology, types of samples used, selection criteria, and results obtained. Hence, there is a large amount of heterogeneous information that makes it difficult to identify potential miR biomarkers. We aimed to summarize the current knowledge on miRs that have been shown to be the most suitable potential markers for EC. We searched PubMed and Google Scholar without date restrictions or filters. We described 138 miRs with potential diagnostic, prognostic, or treatment response potential in EC. Seven diagnostic panels showed higher sensitivity and specificity for the diagnosis of EC than individual miRs. We further identified miRs up- or downregulated depending on the FIGO stage, precursor lesions, and staging after surgery, which provides insight into which miRs are expressed chronologically depending on the disease stage and/or that are modulated depending on the tumor grade based on histopathological evaluation.

Prescription of therapeutic exercise in migraine, an evidence-based clinical practice guideline.

The main objective of this clinical practice guideline is to provide a series of recommendations for healthcare and exercise professionals, such as neurologists, physical therapists, and exercise physiologists, regarding exercise prescription for patients with migraine.This guideline was developed following the methodology and procedures recommended in the Appraisal of Guidelines for Research and Evaluation (AGREE). The quality of evidence and strength of recommendations were evaluated with the Scottish Intercollegiate Guidelines Network (SIGN). A systematic literature review was performed and an established appraisal process was employed to rate the quality of relevant scientific research (Grading of Recommendations Assessment, Development, and Evaluation methodology).The evaluation of the current evidence, the elaboration of the grades of recommendation, and their validation show a B grade of recommendation for aerobic exercise, moderate-continuous aerobic exercise, yoga, and exercise and lifestyle recommendations for the improvement of symptoms, disability, and quality of life in patients with migraine. Relaxation techniques, high-intensity interval training, low-intensity continuous aerobic exercise, exercise and relaxation techniques, Tai Chi, and resistance exercise obtained a C grade of recommendation for the improvement of migraine symptoms and disability.

Invarianza factorial de dos versiones breves de la Escala de Resiliencia de Connor-Davidson (CD-RISC) en estudiantes universitarios de Arequipa / Factorial Invariance of two Short Versions of the Connor-Davidson Resilience Scale (CD-RISC) in Arequipa University Students

Resumen La resiliencia es una característica individual que posibilita el reajuste biopsicosocial y espiritual que ayuda al bienestar psicológico y al desenvolvimiento académico de los estudiantes universitarios. El objetivo de esta investigación fue analizar la invarianza de medición según el sexo, de dos versiones breves de la Escala de Resiliencia de Connor-Davidson (CD-RISC) y determinar si existen diferencias entre hombres y mujeres. Se evaluó con la CD-RISC-10, que incluye la CD-RISC-7, a una muestra de 491 universitarios arequipeños (312 mujeres; 179 hombres) con edad promedio de 20.56 años (DE = 3.18), de una institución privada. Inicialmente se realizó un análisis factorial multigrupo con cada versión para valorar el grado de invarianza de medición alcanzado, y luego de ello se compararon las medias latentes de resiliencia entre hombres y mujeres. En cuanto a los resultados, la CD-RISC-7 presentó indicadores estructurales más favorables (e.g., λ > .50; en mujeres: CFI = .981, RMSEA = .087, WRMR = 0.683; en hombres: CFI = .966, RMSEA = .124, WRMR = 0.783), que la CD-RISC-10 (e.g., λ < .50, índices de ajuste en mujeres: CFI = .974, RMSEA = .073, WRMR = 0.774; en hombres: CFI = .960, RMSEA = .095, WRMR = 0.803) incluyendo la invarianza de medición (invarianza estricta: ΔCFI = .003; ARMSEA = .001), y al comparar las medias latentes fueron halladas diferencias significativas a favor de los hombres (d = .471). Finalmente, se discuten las implicancias teóricas y metodológicas de los hallazgos, así como la necesidad de ampliar los estudios considerando otros aspectos relevantes para una mejor comprensión del constructo resiliencia.

Abstract Resilience is an individual trait that enables biopsychosocial and spiritual readjustment, helping the psychological well-being and academic performance of university students. The objective of this research was to analyze the measurement invariance by sex of two short versions of the Connor - Davidson Resilience Scale (CD-RISC), and to determine if there are differences between men and women. A sample of 491 Arequipa university students (63.5% women), with an average age of 20.56 years-old (SD = 3.18), from a private institution in Arequipa-Peru was evaluated with the CD-RISC-10, which includes the CD-RISC-7. First, a multi-group factor analysis was carried out with each version to assess the degree of measurement invariance achieved, and then the latent means of resilience between men and women were compared. Regarding the results, the cD-Risc-7 presented more favorable structural indicators (e.g., λ > .50; in women: CFI= .981, RMSEA= .087, WRMR = 0.683; in men: CFI= .966, RMSEA= .124, WRMR= 0.783), than THE CD-RISC-10 (e.g., λ < .50, fit indices in women: CFI = .974, RMSEA = .073, WRMR = 0.774; in men: CFI = .960, RMSEA = .095, WRMR = 0.803), including measurement invariance (strict invariance: ΔCFI= .003; ARMSEA = .001), and when comparing latent means, significant differences in favor of men were found (d = .471). Finally, the theoretical and methodological implications of the findings are discussed, as well as the need to extend the studies considering other relevant aspects for a better understanding of the resilience construct.