Ránula cervical gigante: a propósito de un caso / Huge plunging ranula: about a case

La ránula es una lesión pseudoquística causada por la retención de contenido salival de la glándula sublingual en el tejido conjuntivo subyacente, siendo la patología más frecuente de esta glándula. Su localización es a nivel del suelo de la boca, pudiendo en ocasiones extenderse a través del músculo milohioideo hacia la región submaxilar o cervical (ránula plunging o cervical), presentándose clínicamente como una tumoración laterocervical de crecimiento lento. El apoyo de imágenes mediante ecografía, tomografía computarizada, o RM (resonancia magnética) es fundamental para un correcto diagnóstico. Respecto al tratamiento, el procedimiento más aceptado y con menos tasas de recurrencia es la escisión de la ránula cervical por abordaje laterocervical, asociada a la extirpación de la glándula sublingual implicada vía transoral. Aquí presentamos el caso clínico de un varón de 25 años quien presenta una masa laterocervical derecha de seis meses de evolución de crecimiento progresivo e indoloro. La ecografía y RM confirman una ránula cervical gigante de 62x45x101 mm, que se localiza en espacio submandibular derecho, alcanzando el espacio parafaríngeo en su vertiente más craneal. Debido a las características de la lesión y su anatomía se decide tratamiento quirúrgico.

The ranula is a pseudocystic lesion caused by the retention of salivary content of the sublingual gland in the underlying connective tissue, being the most frequent pathology of this gland. Its location is at the level of the floor of the mouth and can sometimes extend through the mylohyoid muscle towards the submaxillary or cervical region (plunging or cervical ranula), clinically presenting as a slow-growing laterocervical tumor. The support of images by ultrasound, computed tTomography or MRI (magnetic resonance imaging) is essential for a correct diagnosis. Regarding treatment, the most accepted procedure, and with the lowest recurrence rates is excision of the cervical ranula by the laterocervical approach, associated with the transoral removal of the involved sublingual gland. Here, we present the clinical case of a 25-year-old man who presented a six-month-old right laterocervical mass of progressive and painless growth. Ultrasound and MRI confirmed a giant cervical ranula measuring approximately 62x45x101 mm, located in the right submandibular space, reaching the parapharyngeal space in its most cranial aspect. Due to the characteristics of the injury and its anatomy, surgical treatment was decided.

Experimental comparison of DSB and CS-DSB mmW formats over a hybrid fiber and FSO fronthaul network for 5G.

The telecommunication world is experiencing the 5th generation (5G) networks deployment including the use of millimeter wave (mmW) frequency bands to satisfy capacity demands. This leads to the extensive use of optical communications, especially the optical fiber connectivity at the last mile access and the edge networks. In this paper we outline fiber and free space optics (FSO) technologies for use as part of the 5G optical fronthaul network. We investigate two different mmW transmission schemes based on (i) the conventional analog radio over fiber transmission using one Mach-Zehnder modulator (MZM) with double sideband (DSB) optical modulation, and (ii) an optical-based frequency doubling with one MZM biased at the null point to introduce carrier suppression DSB (CS DSB) transmission and second MZM used for data modulation. Both systems are assessed in terms of the error vector magnitude, signal-to-noise ratio, dynamic range and phase noise. We consider a configuration for the fronthaul network in the frequency range 2 (FR2) at 27 and 39 GHz with the scale of bandwidth up to 400 MHz with M-quadrature amplitude modulation and quadrature phase shift keying. Results are also shown for FR1 at 3.5 GHz. Moreover, we investigate for the first time the 5G new radio signal transmission under strong turbulence conditions and show the turbulence-induced FSO link impairment. We finally demonstrate the CS DSB scheme performs well under chromatic dispersion-induced fading for the frequency up to 40 GHz and single mode fiber length of 30 km, whereas the DSB format seems more appropriate for an antenna seamless transmission.

Ten-year assessment of a cancer fast-track programme to connect primary care with oncology: reducing time from initial symptoms to diagnosis and treatment initiation.

BACKGROUND: Cancer is the second leading cause of mortality worldwide. Integrating different levels of care by implementing screening programmes, extending diagnostic tools and applying therapeutic advances may increase survival. We implemented a cancer fast-track programme (CFP) to shorten the time between suspected cancer symptoms, diagnosis and therapy initiation. PATIENTS AND METHODS: Descriptive data were collected from the 10 years since the CFP was implemented (2009-2019) at the Clinico-Malvarrosa Health Department in Valencia, Spain. General practitioners (GPs), an oncology coordinator and 11 specialists designed guidelines for GP patient referral to the CFP, including criteria for breast, digestive, gynaecological, lung, urological, dermatological, head and neck, and soft tissue cancers. Patients with enlarged lymph nodes and constitutional symptoms were also considered. On identifying patients with suspected cancer, GPs sent a case proposal to the oncology coordinator. If criteria were met, an appointment was quickly made with the patient. We analysed the timeline of each stage of the process. RESULTS: A total of 4493 suspected cancer cases were submitted to the CFP, of whom 4019 were seen by the corresponding specialist. Cancer was confirmed in 1098 (27.3%) patients: breast cancer in 33%, urological cancers in 22%, gastrointestinal cancer in 19% and lung cancer in 15%. The median time from submission to cancer testing was 11 days, and diagnosis was reached in a median of 19 days. Treatment was started at a median of 34 days from diagnosis. CONCLUSIONS: The findings of this study show that the interval from GP patient referral to specialist testing, cancer diagnosis and start of therapy can be reduced. Implementation of the CFP enabled most patients to begin curative intended treatment, and required only minimal resources in our setting.

Circulating miR-30b-5p levels in plasma as a novel potential biomarker for early detection of breast cancer.

BACKGROUND: Recently, microRNAs have been demonstrated to be potential non-invasive biomarkers for diagnosis, prognosis assessment or prediction of response to treatment in cancer. In this study, we evaluate the potential of miR-30b-5p as a biomarker for early diagnosis of breast cancer (BC) in tissue and plasma. METHODS: Expression of miR-30b-5p was determined in a series of 112 BC and 40 normal breast tissues. Circulating miR-30b-5p levels in plasma samples were determined in a discovery cohort of 38 BC patients and 40 healthy donors and in a validation cohort of 83 BC patients and 83 healthy volunteers. miR-30b-5p expression was measured by quantitative real-time PCR and receiver operating characteristics curve analysis was carried out. RESULTS: The miR-30b-5p expression was significantly lower in BC tissue than in healthy breast samples. In contrast, circulating miR-30b-5p levels were significantly higher in BC patients compared with healthy donors. Furthermore, circulating miR-30b-5p levels were significantly higher in patients with positive axillary lymph node and de novo metastatic patients. Receiver operating characteristics curve analysis demonstrated a good diagnostic potential of miR-30b-5p to detect BC even at an early stage of the disease. CONCLUSION: Thus, we highlight the potential of miR-30b-5p as a non-invasive, fast, reproducible and cost-effective diagnostic biomarker of BC.

[Assessment of creative thinking among medical students]. / Determinación de pensamiento creativo en estudiantes de medicina de una universidad chilena.

BACKGROUND: Creativity is a highly valued quality in different fields. Despite this, it is rarely included in the curricula of medical careers. AIM: To assess creative thinking among undergraduate medical students. MATERIAL AND METHODS: Sixty-seven students aged 18 to 31 years (45% women) from the first (16), third (26) and seventh year (25) of medical school answered a sociodemographic questionnaire and the Torrance Test of Creative Thinking (TTCT). RESULTS: Median creativity index according to age was in percentile 52 (range 2-99). Percentiles for fluency, originality, elaboration, abstraction of titles and resistance for premature closure were 31, 32, 79, 53 and 17 respectively. There were no significant differences between students of different levels (p = 0.73). CONCLUSIONS: In this group of students, there is a high performance in elaboration and a low score in Resistance to premature closure.

Determinación de pensamiento creativo en estudiantes de medicina de una universidad chilena / Assessment of creative thinking among medical students

Background: Creativity is a highly valued quality in different fields. Despite this, it is rarely included in the curricula of medical careers. Aim: To assess creative thinking among undergraduate medical students. Material and Methods: Sixty-seven students aged 18 to 31 years (45% women) from the first (16), third (26) and seventh year (25) of medical school answered a sociodemographic questionnaire and the Torrance Test of Creative Thinking (TTCT). Results: Median creativity index according to age was in percentile 52 (range 2-99). Percentiles for fluency, originality, elaboration, abstraction of titles and resistance for premature closure were 31, 32, 79, 53 and 17 respectively. There were no significant differences between students of different levels (p = 0.73). Conclusions: In this group of students, there is a high performance in elaboration and a low score in Resistance to premature closure.

Graphene catalyzes the reversible formation of a C-C bond between two molecules.

Carbon deposits are well-known inhibitors of transition metal catalysts. In contrast to this undesirable behavior, here we show that epitaxial graphene grown on Ru(0001) promotes the reversible formation of a C-C bond between -CH2CN and 7,7,8,8-tetracyano-p-quinodimethane (TCNQ). The catalytic role of graphene is multifaceted: First, it allows for an efficient charge transfer between the surface and the reactants, thus favoring changes in carbon hybridization; second, it holds the reactants in place and makes them reactive. The reaction is fully reversible by injecting electrons with an STM tip on the empty molecular orbitals of the product. The making and breaking of the C-C bond is accompanied by the switching off and on of a Kondo resonance, so that the system can be viewed as a reversible magnetic switch controlled by a chemical reaction.

[The most frequent causative agents of Guillain-Barre syndrome in a Mexican general hospital]. / Agentes causales mas frecuentes del sindrome de Guillain-Barre en un hospital de Veracruz, Mexico.

INTRODUCTION: After Zika virus outbreak and the increase in the incidence of Guillain-Barre syndrome (GBS), the causal relationship has been studied, however a full etiological correlation has not been found. PATIENTS AND METHODS: From January 1 to December 31, 2017, patients with GBS were included. In addition to the basic serologies, enterovirus, herpes, Campylobacter, hepatitis B and C, TORCH, HIV, Brucella and Salmonella were requested. RESULTS: Cohort of seven male patients. Five patients analyzed cerebrospinal fluid reporting normal; all of them underwent brain scan, reporting normal. Neuroconduction was performed, resulting in acute inflammatory demyelinating polyneuropathy in four cases and acute motor axonal neuropathy in one case. All received intravenous immunoglobulins, five cases had a good prognosis and two deaths. No positive cases were reported to Zika virus. A positive case was reported to dengue and another to chikungunya. Five positive cases were reported to Campylobacter. One case positive to enterovirus. Dengue + Campylobacter coinfections were reported in one case and chikungunya + Campylobacter in another case. CONCLUSIONS: The present cohort shows that it was not possible to establish a causal relationship between GBS and Zika virus, but other viral and bacterial causal agents were identified, such as dengue, chikungunya and enterovirus, with the identification of Campylobacter cases even more remarkable.

TITLE: Agentes causales mas frecuentes del sindrome de Guillain-Barre en un hospital de Veracruz, Mexico.Introduccion. Con posterioridad a la oleada del virus del Zika y el incremento en la incidencia de sindrome de Guillain-Barre (SGB), se ha estudiado la relacion causal, pero no se ha encontrado una plena correlacion etiologica. Pacientes y metodos. Del 1 de enero al 31 de diciembre de 2017, se incluyeron pacientes con SGB. Ademas de las serologias basicas, se solicitaron determinaciones de enterovirus, virus del herpes, Campylobacter, hepatitis B y C, TORCH, virus de la inmunodeficiencia humana, Brucella y Salmonella. Resultados. Cohorte de siete pacientes de sexo masculino. A cinco pacientes se les analizo el liquido cefalorraquideo, que era normal. A todos se les realizo una tomografia encefalica, tambien normal, y se realizo neuroconduccion, que mostro polineuropatia inflamatoria desmielinizante aguda en cuatro casos y neuropatia motora axonal aguda en uno. Todos recibieron inmunoglobulinas intravenosas; tuvieron buen pronostico cinco casos y hubo dos defunciones. No se informo de casos positivos al virus del Zika. Hubo un caso positivo al dengue, uno al chikungunya, cinco a Campylobacter y uno a enterovirus. Se informo de coinfecciones de dengue + Campylobacter en un caso y de chikungunya + Campylobacter en otro. Conclusiones. La presente cohorte demuestra que no fue posible establecer una relacion causal entre el SGB y el virus del Zika, pero se identificaron otros agentes causales viricos y bacterianos, como dengue, chikungunya y enterovirus, y fue aun mas destacable la identificacion de los casos de Campylobacter.

Satisfacción de estudiantes de enfermería con su formación teórico-práctica. Universidad de Panamá, Sede Azuero / Satisfaction of nursing students regarding their theoretical-practical formation. University of Panama, Sede Azuero / Satisfação de estudantes de enfermagem com sua formação teórico-prática. Universidad de Panamá, Sede Azuero

La universidad contemporánea tiene como misión formar profesionales competentes, que les permitan contribuir al desarrollo de la sociedad, por lo que se hace indispensable evaluar continuamente la calidad del proceso docente educativo y la eficiencia de los programas académicos vigentes, donde el estudiante es un factor clave. Objetivo Analizar el grado de satisfacción de los graduandos con la formación teórico-práctica recibida en la Facultad de Enfermería en el Centro Regional Universitario de Azuero. Material y Métodos Se realizó un estudio descriptivo de corte transversal, en el que se evaluó la satisfacción de los graduandos en relación a dos componentes: la formación teórico-práctica durante la carrera y la práctica profesional como opción para obtención del grado de Licenciados en Enfermería. Resultados Los estudiantes están satisfechos con la formación teórico-práctica y tienen una percepción del docente entre excelente y buena en un 87% al 95%. Los criterios con puntuaciones regulares 10% fueron obtenidos por: el horario de atención, la capacidad de interacción virtual del docente y el apoyo en la formulación y análisis de problemas. Las competencias adquiridas durante la práctica profesional como opción de grado fueron ponderadas con valores positivos en un 98% al 100%. Conclusiones Los estudiantes graduandos tienen un alto grado de satisfacción con la formación teórico-práctica y destacan la práctica profesional como una buena experiencia en el fortalecimiento de competencias profesionales.

Contemporary universities have the mission to form competent professionals who can contribute to the development of society. Because of this, it is necessary to continually assess the quality of the teaching process and the efficiency of the current academic programs. Objective To analyze the degree of satisfaction of graduate nursing students regarding their theoretical-practical formation at the Nursing Faculty of the Universitarian Regional Center in Azuero, Panama. Material and Methods This is a descriptive and transversal study assessing the satisfaction of graduates according to two components: the theoretical-practical formation during the education stage, and the professional practice as an option to obtain the title of Baccalaureate in Nursing. Results Students are satisfied with their theoretical-practical formation and they have an excellent-good impression of the teachers (87% to 95%). The low or regular scores were found in the areas of: attention schedule, virtual interaction capability, and support in elaborating and analyzing problems. Acquired competencies resulting from the professional practice as a graduating option turned out to be positive (98% to 100%). Conclusions Graduate students have a high level of satisfaction with their theoretical-practical formation, at the same time highlighting professional practice as a good experience for the strengthening of professional competencies.

A universidade contemporânea tem como missão formar professionais competentes, que lhes permitam contribuir ao desenvolvimento da sociedade, pelo que se faz indispensável avaliar continuamente a qualidade do processo docente educativo e a eficiência dos programas académicos vigentes, onde o estudante é um fator chave. Objetivo Analisar o grau de satisfação dos formandos com a formação teórico-prática recebida na Faculdade de Enfermagem no Centro Regional Universitário de Azuero. Material e Métodos Realizou-se um estudo descritivo de corte transversal, no que se avaliou a satisfação dos formandos em relação à dos componentes: a formação teórico-prática durante a carreira e a prática profissional como opção para obtenção do grau de Licenciados em Enfermagem. Resultados Os estudantes estão satisfeitos com a formação teórico-prática e têm uma percepção do docente entre excelente e boa em um 87% ao 95%. Os critérios com pontuações regulares de 10% foram obtidos pelo: horário de atenção, pela capacidade de interação virtual do docente e pelo apoio na formulação e análise de problemas. As competências adquiridas durante a prática profissional como opção de grau foram ponderadas com valores positivos em um 98% ao 100%. Conclusões Os estudantes graduandos têm um alto grau de satisfação com a formação teórico-prática e destacam a prática profissional como uma boa experiência no fortalecimento de competências profissionais.

Fast and stable gratings inscription in POFs made of different materials with pulsed 248 nm KrF laser.

This paper presents fiber Bragg grating (FBG) inscription with a pulsed 248 nm UV KrF laser in polymer optical fibers (POFs) made of different polymers, namely polymethyl methacrylate (PMMA), cyclic-olefin polymer and co-polymer, and Polycarbonate. The inscribed gratings and the corresponding inscription parameters are compared with grating inscribed in POFs made of the aforementioned materials but with the hitherto most used laser for inscription, which is a continuous wave 325 nm UV HeCd laser. Results show a reduction of the inscription time of at least 16 times. The maximum time reduction is more than 130 times. In addition, a reflectivity and a bandwidth close to or higher than the ones with the 325 nm laser were obtained. The polymer optical fiber Bragg gratings (POFBGs) inscribed with the 248 nm laser setup present high stability with small variations in their central wavelength, bandwidth, and reflectivity after 40 days.

[The educational context to train health care professionals. A qualitative approach]. / Condiciones del contexto educativo para ejercer el rol docente en Ciencias de la Salud. Un enfoque cualitativo.

BACKGROUND: There are differences in the educational context in Health Sciences, between clinical and non-clinical teachers. Therefore, the didactic and reflexive peculiarities of both educational scenarios should be analyzed. AIM: To describe the conditions of the educational context in Health Sciences for the practice of the teaching role in a Chilean university. MATERIAL AND METHODS: Qualitative study, performed according to Grounded Theory of Strauss and Corbin. Thirty one teachers from six health sciences programs were selected according to Patton's maximum variation criterion and contacted personally, after an informed consent process. Semi-structured interviews and focus group were performed, analyzed by open coding, using the constant comparison method, with the Atlas-ti 7.5.2 software. RESULTS: Six conditions of the educational context that can support the teaching role in these careers emerged. Namely, a clinical field suited for patient attention and teaching, classrooms designed for the new educational models, number of students in the classrooms and clinical settings, insertion programs for teachers' training, teachers' coordination and economic resources of the program. CONCLUSIONS: Health Sciences programs are developed in a complex educational context, having to articulate diverse elements to train professionals. Therefore, it is fundamental to understand the conditions of the educational context that can favor the practice of the teaching role, thus generating improvements in teaching-learning process.

Condiciones del contexto educativo para ejercer el rol docente en Ciencias de la Salud: un enfoque cualitativo / The educational context to train health care professionals: a qualitative approach

Background: There are differences in the educational context in Health Sciences, between clinical and non-clinical teachers. Therefore, the didactic and reflexive peculiarities of both educational scenarios should be analyzed. Aim: To describe the conditions of the educational context in Health Sciences for the practice of the teaching role in a Chilean university. Material and Methods: Qualitative study, performed according to Grounded Theory of Strauss and Corbin. Thirty one teachers from six health sciences programs were selected according to Patton's maximum variation criterion and contacted personally, after an informed consent process. Semi-structured interviews and focus group were performed, analyzed by open coding, using the constant comparison method, with the Atlas-ti 7.5.2 software. Results: Six conditions of the educational context that can support the teaching role in these careers emerged. Namely, a clinical field suited for patient attention and teaching, classrooms designed for the new educational models, number of students in the classrooms and clinical settings, insertion programs for teachers' training, teachers' coordination and economic resources of the program. Conclusions: Health Sciences programs are developed in a complex educational context, having to articulate diverse elements to train professionals. Therefore, it is fundamental to understand the conditions of the educational context that can favor the practice of the teaching role, thus generating improvements in teaching-learning process.

Características nutricionales de los escolares afrodescendientes de la costa pacífica Colombiana / Nutritional characteristics of afro-descendant schoolchildren of Colombian pacific southwest coast

This paper provides a current diagnosis on the nutritional status of schoolchildren of pacific coast of Cauca in Colombia. A secondary analysis of publicly available anthropometric data was performed. BMI/Age and H/Age indices, nutritional classification and their association with gender, ethnicity, age and geographical area of 6793 students aged 5 to 18 years of the municipalities of Guapi, Lopez de Micay and Timbiquí were determined. Normality was the prevalent nutritional status in the three municipalities for schoolchildren of all ages according to BMI and height (65.7% and 59.3 %, respectively); Guapi was found to be the main contributor. There was no significant differences of BMI and region among males and females. Adolescents between 12 and 14 years old had percentages of stunting significantly higher than other age ranges. Results highlight the need to identify, measure and monitor indicators of health, food habits and sociodemographic aspects of schoolchildren in this region to strictly explore whether Colombian black children fit WHO patterns and to provide specific information for successful national nutrition policy planning for this population.

El presente artículo proporciona un diagnóstico sobre el estado nutricional de los escolares de la costa pacífica del Cauca en Colombia. Se realizó un análisis secundario de datos antropométricos públicos que están disponibles. Se determinaron los índices IMC/edad y talla/edad, la clasificación nutricional y su asociación con el género, etnia, edad y área geográfica de 6793 estudiantes de 5 a 18 años de los municipios de Guapi, López de Micay y Timbiquí. La normalidad fue el estado nutricional prevalente en los tres municipios para escolares de todas las edades de acuerdo al BMI y la talla (65.7% y 59.3 %, respectivamente); Guapi resultó ser el principal contribuyente. No hubo diferencias significativas de IMC y región entre hombres y mujeres. Los adolescentes entre 12 y 14 años tuvieron porcentajes de retraso en el crecimiento significativamente más elevados que los de otros rangos de edad. Los resultados destacan la necesidad de identificar, medir y monitorear los indicadores de salud, hábitos alimentarios y aspectos sociodemográficos de los escolares en esta región para explorar si los niños afrodescendientes se ajustan a los patrones de la OMS y para proveer información específica para un exitoso planeamiento de una política de nutrición nacional para esta población.

[Motivation and self-directed learning among medical students]. / Aspectos motivacionales involucrados en el aprendizaje autodirigido en estudiantes de medicina. Un enfoque cualitativo.

BACKGROUND: Motivation is an essential aspect in the training process of medical students. The association that motivation can have with learning self-regulation is of utmost importance for the design of curriculum, teaching methods and evaluation. AIM: To describe the motivational aspects of self-directed learning among medical students from a traditional Chilean University. MATERIAL AND METHODS: A qualitative, descriptive study based on grounded theory of Strauss and Corbin. Twenty 4th and 5th year medical students were selected using a maximum variation sampling technique. After obtaining an informed consent, semi-structured interviews and field notes were carried out. Data were analyzed to the level of open coding through Atlas-ti 7.5.2. RESULTS: From the student point of view, personal motivational aspects are linked to the search for information, constant updating, the perception of the physician-patient relationship and interest in subject matters. From the scope of teachers, a main issue is related to their ability to motivate students to develop independent study skills. CONCLUSIONS: Personal motivational aspects facilitate the development of independent study skills, specifically in the search of information. The role of teachers is crucial in promoting these skills and the perception of medical students from their learning process.

Gene Interactions Provide Evidence for Signaling Pathways Involved in Cleft Lip/Palate in Humans.

Nonsyndromic cleft lip with or without cleft palate (NSCL/P) is a common craniofacial birth defect that has a complex etiology. Genome-wide association studies have recently identified new loci associated with NSCL/P, but these loci have not been analyzed in a Mexican Mestizo population. A complex etiology implies the presence of genetic interactions, but there is little available information regarding this in NSCL/P, and no signaling pathway has been clearly implicated in humans. Here, we analyzed the associations of 24 single nucleotide polymorphisms (SNPs) with NSCL/P in a Mexican Mestizo population (133 cases, 263 controls). The multifactorial dimensionality reduction method was used to examine gene-gene and gene-folic acid consumption interactions for the 24 SNPs analyzed in this study and for 2 additional SNPs that had previously been genotyped in the same study population. Six SNPs located in paired box 7, ventral anterior homeobox 1, sprouty RTK signaling antagonist 2, bone morphogenetic protein 4, and tropomyosin 1 genes were associated with higher risks of NSCL/P (P = 0.0001 to 0.04); 2 SNPs, 1 each in netrin 1 and V-maf avian musculoaponeurotic fibrosarcoma oncogene homolog B, were associated with a lower risk of NSCL/P (P = 0.013 to 0.03); and 2 SNPs, 1 each in ATP binding cassette subfamily A member 4 (ABCA4) and noggin, showed associations with NSCL/P that approached the threshold of significance (P = 0.056 to 0.07). In addition, 6 gene-gene interactions (P = 0.0001 to 0.001) and an ABCA4-folic acid consumption interaction (P < 0.0001) were identified. On the basis of these results, combined with those of previous association studies in the literature and biological characterizations of murine models, we propose an interaction network in which interferon regulatory factor 6 plays a central role in the etiology of NSCL/P.

Aspectos motivacionales involucrados en el aprendizaje autodirigido en estudiantes de medicina. un enfoque cualitativo / Motivation and self-directed learning among medical students

Background: Motivation is an essential aspect in the training process of medical students. The association that motivation can have with learning self-regulation is of utmost importance for the design of curriculum, teaching methods and evaluation. Aim: To describe the motivational aspects of self-directed learning among medical students from a traditional Chilean University. Material and Methods: A qualitative, descriptive study based on grounded theory of Strauss and Corbin. Twenty 4th and 5th year medical students were selected using a maximum variation sampling technique. After obtaining an informed consent, semi-structured interviews and field notes were carried out. Data were analyzed to the level of open coding through Atlas-ti 7.5.2. Results: From the student point of view, personal motivational aspects are linked to the search for information, constant updating, the perception of the physician-patient relationship and interest in subject matters. From the scope of teachers, a main issue is related to their ability to motivate students to develop independent study skills. Conclusions: Personal motivational aspects facilitate the development of independent study skills, specifically in the search of information. The role of teachers is crucial in promoting these skills and the perception of medical students from their learning process.

[An assessment of the Dundee Ready Education Environment Measure (DREEM) in Chilean university students]. / Estructura factorial de la escala DREEM en estudiantes de medicina chilenos.

BACKGROUND: The entry to a University requires an adaptation process that not all students solve with the same kind of success. Even though students social adaptation and emotional skills are essential, the educational environmental that they perceive has a significant influence in their academic life. AIM: To describe the changes in the perception about academic environment that medical students experience during the first three years of undergraduate career. MATERIAL AND METHODS: The Dundee Ready Education Environment Measure (DREEM) scale was applied to 525 first to third year medical students and an exploratory factorial analysis was made. RESULTS: Four factors were identified: Academic Perception: academic quality that students attribute to the process in which they take part, as well as to the assessment that they do of their learning outcomes (coefficient ± = 0.85); Academic Experience: refers to positive emotions that students experience during the career such as confidence, pleasure and energy (coefficient ± = 0.76); Atmosphere Perception, comfort and calm that students experiment during their academic activities (coefficient ± = 0.79); Teachers Perception: the perception that students have of teachers about their interest and disposition towards students (coefficient ± = 0.50). CONCLUSIONS: The assessment of academic environment quality is inversely associated with the lapse that the students have spent in their undergraduate careers.

[Factors associated with self-directed learning among medical students]. / Predictores afectivos y académicos del aprendizaje autodirigido en estudiantes de medicina.

BACKGROUND: Self-directed learning is a skill that must be taught and evaluated in future physicians. AIM: To analyze the association between self-directed learning, self-esteem, self-efficacy, time management and academic commitment among medical students. MATERIAL AND METHODS: The self-directed learning, Rosemberg self-esteem, general self- efficacy, time management and Utrecht work engagement scales were applied to 297 first year medical students. RESULTS: A multiple regression analysis showed a significant association between self-efficacy, time management and academic commitment with self-directed learning. Self-esteem and satisfaction with studies did not enter in the model. CONCLUSIONS: self-esteem, academic commitment and a good time management were associated with self-directed learning in these students.

Estructura factorial de la escala DREEM en estudiantes de medicina chilenos

Background: The entry to a University requires an adaptation process that not all students solve with the same kind of success. Even though students social adaptation and emotional skills are essential, the educational environmental that they perceive has a significant influence in their academic life. Aim: To describe the changes in the perception about academic environment that medical students experience during the first three years of undergraduate career. Material and Methods: The Dundee Ready Education Environment Measure (DREEM) scale was applied to 525 first to third year medical students and an exploratory factorial analysis was made. Results: Four factors were identified: Academic Perception: academic quality that students attribute to the process in which they take part, as well as to the assessment that they do of their learning outcomes (coefficient ± = 0.85); Academic Experience: refers to positive emotions that students experience during the career such as confidence, pleasure and energy (coefficient ± = 0.76); Atmosphere Perception, comfort and calm that students experiment during their academic activities (coefficient ± = 0.79); Teachers Perception: the perception that students have of teachers about their interest and disposition towards students (coefficient ± = 0.50). Conclusions: The assessment of academic environment quality is inversely associated with the lapse that the students have spent in their undergraduate careers.