Evaluation of the impact of an online video game as an educational intervention on sexual health and the prevention, diagnosis, and treatment of sexually transmitted infection: A randomized controlled trial protocol.

BACKGROUND: The incidence of sexually transmitted infections (STIs) is increasing, especially among young people. Tools are needed to increase knowledge about sex education and STI prevention and treatment. Gamification can be a good training tool for both young people and health professionals. The primary objective of this study is to assess the impact of a training intervention on STI prevention, detection, and treatment in primary care professionals. METHODS/DESIGN: Multicentre cluster randomized controlled trial. Groups of primary care professionals will receive an intervention (online video game on sex education and STIs [SEXIT]) and will be compared with control groups that will not receive the intervention. Group assignments will be randomized by clusters. The study will consist of a pre-post evaluation of the intervention: a knowledge test will be administered before and after the intervention and 3 months after the intervention. This test will also be carried out on the same time sequence in the control groups. The impact of the training intervention will be assessed over a 6-month period, focusing on various variables associated with the clinical management of STIs. This evaluation entails the clinical records of diagnostic tests and antibiotic prescriptions related to the clinical approach to STIs. The required sample size is 262 (131 per group). DISCUSSION: Compared with those in the control group, improvements in knowledge and clinical behavioural outcomes after the intervention are expected for participants in the intervention groups. We plan to develop an educational video game to increase the knowledge about sexuality, STIs and violence. Protocol registered at ISRCTN with reference number ISRCTN17783607.

Adenoma detection rate and tolerability of two ultra-low volume bowel preparations in screening: a noninferiority randomized controlled trial.

BACKGROUND AND AIMS: The adenoma detection rate (ADR), recognized as a surrogate marker for colorectal cancer incidence and mortality reduction, is closely linked to the efficacy of bowel cleansing. However, there is a dearth of evidence examining the impact on ADR when employing two distinct very low-dose bowel cleansing products. This study sought to compare ADR in a fecal immunochemical occult blood testing (iFOBT) based organized screening program by utilizing 1L polyethylene glycol plus ascorbate (1L-PEGA) versus magnesium citrate plus picosulphate (SPMC), both administered in a split-dose regimen. METHODS: We conducted a comparative, parallel, randomized, noninferiority, and low-intervention clinical trial, the study targeted individuals from a population colorectal cancer screening program aged 50-69 with a positive iFOBT result scheduled for a work-up colonoscopy in the morning. Participants were randomized to either 1L-PEGA or SPMC for bowel cleansing. Main outcome was ADR. Secondary outcomes were bowel preparation quality, individuals' safety, tolerability and satisfaction. RESULTS: A total of 1,002 subjects were included, 501 in each group. There were no differences between groups with respect to pooled ADR (SPMC, 56.5% [52.1-60.8]; 1L-PEGA, 53.7% [49.3-58.0]; RR 0.95 [0.85-1.06]); therefore, SPMC demonstrated noninferiority in ADR compared to 1L-PEGA (difference, 2.8%; 2-sided 95% lower confidence limit (LCL), -3.4). In addition, there were no significant differences in mean lesions regardless of size and location between arms. Bowel preparation favored 1L-PEGA (96.2% vs. 89.2%; p<0.001) whereas SPMC exhibited significantly higher safety and tolerability, as evidenced by fewer non-serious treatment-emergent adverse events CONCLUSIONS: SPMC emerged as a noninferior laxative compared to 1L-PEGA concerning ADR. Despite the superior bowel preparation quality associated with 1L-PEGA, the safety, tolerability and overall satisfaction of participants were higher with SPMC. This trial was registered at ClinicalTrials.gov (EudraCT: 2019-003186-18) on March 18, 2019.

Estrés, ansiedad y depresión en estudiantes de obstetricia de una universidad pública durante la pandemia por la COVID-19

Introducción: La pandemia por la COVID-19 ha generado repercusiones importantes en los estudiantes de educación superior. Su impacto ha permitido el desarrollo de afecciones en el aspecto académico y de salud, especialmente en la salud mental. Objetivo: Identificar el nivel de estrés, ansiedad y depresión durante la pandemia por la COVID-19 en los estudiantes de obstetricia de una universidad pública. Métodos: Estudio descriptivo y transversal, que se realizó en una muestra de 212 estudiantes de obstetricia quienes se seleccionaron de forma no probabilística. Se aplicaron 3 instrumentos: la escala de percepción global de estrés (EPGE), la escala de medición del desorden de ansiedad generalizada (GAD-7) y el cuestionario de salud del paciente (PHQ-9), todos con elevada confiabilidad. Se estimaron frecuencias absolutas y relativas. Resultados: La mayor proporción de los estudiantes era de sexo femenino (95,8 %) y tenía entre 21 y 25 años (66 %). Además, el 37,2 % se encontraba en cuarto año de la carrera y 6,1 % vivía solo. El eustrés moderado (85,8 %) y el alto distrés (66 %) se presentaron con mayor frecuencia. El 18,9 % tuvo un nivel grave de ansiedad, la preocupación (81,1 %) y la incapacidad para relajarse (80,7 %) fueron los síntomas más frecuentes. El 31,1 % y 11,8 % tuvo depresión leve y grave, respectivamente. Conclusión: Durante la pandemia por la COVID-19 la mayor parte de los estudiantes de obstetricia presentan niveles altos de estrés, depresión leve y ansiedad grave.

Introduction: The COVID-19 pandemic has generated significant repercussions in higher education students. Its impact has led to the development of academic and health conditions, especially in mental health. Objective: To identify the level of stress, anxiety and depression during the COVID-19 pandemic in midwifery students of a public university. Methods: Descriptive and cross-sectional study, which was carried out in a sample of 212 midwifery students who were selected in a non-probabilistic way. Three instruments were applied: the global perception of stress scale (EPGE), the generalized anxiety disorder measurement scale (GAD-7) and the patient health questionnaire (PHQ-9), all with high reliability. Absolute and relative frequencies were estimated. Results: The highest proportion of the students was female (95,8 %) and aged between 21 and 25 years (66%). In addition, 37,2% were in their fourth year and 6,1% lived alone. Moderate eustress (85,8%) and high distress (66%) occurred more frequently. 18,9% had a severe level of anxiety and worry (81,1%), and inability to relax (80,7%) were the most frequent symptoms. 31,1% and 11,8% had mild and severe depression, respectively. Conclusion: During the COVID-19 pandemic, most of the midwifery students present high levels of stress, mild depression and severe anxiety.

Origen y evolución de una vía aérea permeable / The origin and evolution of a permeable airway

Resumen: A través de los siglos hemos descubierto la importancia de mantener permeable y segura la vía aérea. Desde Hipócrates en la antigua Grecia, hasta el siglo XX en oriente y occidente, se ha continuado con el desarrollo de herramientas que faciliten esta cotidiana tarea por lo que, con esta revisión sistemática, se establecieron como objetivos exponer el origen y los antecedentes del tubo endotraqueal, cánula orofaríngea y laringoscopio, así como discutir su utilidad en la práctica anestésica-quirúrgica, a través del tiempo hasta hoy en día.

Abstract: Over the centuries, we have discovered the importance of preserving a safe permeable airway. From Hippocrates in ancient Greece to the 20th century in the East and West, the development of multiple tools that enable this task continues through time, which is why with this systematic review we aim to uncover the origin and historical background of the endotracheal tube, the oropharyngeal cannula and the laryngoscope, discussing their effectiveness in the anesthetic-surgical practice over years to the present day.

Microplastics transport in a low-inflow estuary at the entrance of the Gulf of California.

Microplastics (MPs) are recognized as a global emergent pollution impact, which can affect all food chains. Estimating MPs transport pathways in coastal ecosystems is needed to assess their likely effects. Here, we studied MPs accumulation and transport pathways in the Estero de Urias lagoon system (low-inflow estuary) using field data and a 3D particle model. Field results showed that the MPs present similar abundances throughout the study area during the dry and rainy seasons. Model simulations indicated that i) morphology and tidal currents caused the MPs discharged in the lagoon to remain inside, and ii) wind-induced currents caused the MPs in the coastal area to be transported to the southwest. These transport processes may be responsible for homogenizing MPs concentrations through the studied area. In addition, model simulations suggested that EUL-dense waters can export MPs from the coastal area to the sea bottom.

TetraSOD®, a Unique Marine Microalgae Ingredient, Promotes an Antioxidant and Anti-Inflammatory Status in a Metabolic Syndrome-Induced Model in Rats.

Increased oxidative stress has been linked to the pathogenic process of obesity and can trigger inflammation, which is often linked with the risk factors that make up metabolic syndrome (MetS), including obesity, insulin resistance, dyslipidaemia and hypertension. TetraSOD®, a natural marine vegan ingredient derived from the microalgae Tetraselmis chuii that is high in the antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) has recently demonstrated in vitro increased activity of these key antioxidant enzymes. In the present study, the potential bioactive effects of three dietary dosages of TetraSOD® in enhancing antioxidant and anti-inflammatory mechanisms to combat the metabolic disturbances that compose MetS were assessed in rats given a cafeteria (CAF) diet. Chronic supplementation with 0.17, 1.7, and 17 mg kg-1 day-1 of TetraSOD® for 8 weeks ameliorated the abnormalities associated with MetS, including oxidative stress and inflammation, promoting endogenous antioxidant defence mechanisms in the liver (GPx and GSH), modulating oxidative stress and inflammatory markers in plasma (NOx, oxLDL and IL-10), and regulating genes involved in antioxidant, anti-inflammatory and immunomodulatory pathways in the liver, mesenteric white adipose tissue (MWAT), thymus, and spleen. Overall, TetraSOD® appears to be a potential therapeutic option for the management of MetS.

Metabolic pathways for biosynthesis and degradation of starch in Tetraselmis chui during nitrogen deprivation and recovery.

Tetraselmis chui is known to accumulate starch when subjected to stress. This phenomenon is widely studied for the purpose of industrial production and process development. Yet, knowledge about the metabolic pathways involved is still immature. Hence, in this study, transcription of 27 starch-related genes was monitored under nitrogen deprivation and resupply in 25 L tubular photobioreactors. T. chui proved to be an efficient starch producer under nitrogen deprivation, accumulating starch up to 56% of relative biomass content. The prolonged absence of nitrogen led to an overall down-regulation of the tested genes, in most instances maintained even after nitrogen replenishment when starch was actively degraded. These gene expression patterns suggest post-transcriptional regulatory mechanisms play a key role in T. chui under nutrient stress. Finally, the high productivity combined with an efficient recovery after nitrogen restitution makes this species a suitable candidate for industrial production of high-starch biomass.

Relación morfológica entre el hueso hioides y la mandíbula en una muestra de esqueletos estudiados / Morphological relationship between the hyoid bone and the mandible in a sample of skeletons studied

Introducción: El crecimiento de los tejidos esqueléticos constituye una respuesta secundaria, compensatoria y mecánicamente obligada a cambiar las matrices funcionales. Cuando por alguna razón las matrices funcionales se ven afectadas en su crecimiento, los tejidos esqueléticos responden también con un grado de afectación dependiendo del momento en que esta se produzca. Entonces la mandíbula como parte del viscerocráneo debe presentar esa relación con el hueso hioides de forma directa. Objetivos: Asociar el comportamiento morfológico del hueso hioides con variables morfológicas de la mandíbula y verificar sí la morfología de los huesos pertenecientes a los esqueletos estudiados está determinada por el conjunto de tejidos blandos que los rodea y marcan el ritmo del proceso de remodelación de crecimiento. Material y Métodos: Se realizó la continuación del estudio osteológico en una muestra ósea de 82 esqueletos con mediciones morfométricas del hueso hioides y la mandíbula. Para evaluar la relación de la morfología del hueso hioides con respecto a la mandíbula, se utilizaron matrices de coeficiente de correlación lineal de Pearson en SPSS versión 22 de Window. Resultados: Se corrobora la relación de la morfología del hueso hioides con el crecimiento del viscerocráneo, debido a la correlación positiva y significativa entre varias variables morfológicas del hioides que se obtuvo, -tanto a nivel de su cuerpo como sus astas o cuernos mayores-, con la mandíbula. Conclusiones: Existe una asociación de la morfología del hueso hioides con respecto a la morfología de la mandíbula(AU)

Introduction: The growth of skeletal tissues constitutes a secondary, compensatory and mechanically obliged response to change the functional matrixes. When the growth of functional matrixes is affected for any reason, the skeletal tissues also respond with a degree of affectation depending on the moment in which it occurs. Then the mandible, as part of the viscerocranium, must present that relationship with the hyoid bone directly. Objective: To associate the morphological behavior of the hyoid bone with the morphological variables of the mandible and verify if the morphology of the bones belonging to the skeletons studied is determined by the set of soft tissues that surround them and set the pace of the growth remodeling process. Material and Methods: The continuation of the osteological study was carried out in a bone sample of 82 skulls by performing morphometric measurements of the hyoid bone and the mandible. Pearson's linear correlation coefficient matrices in SPSS Version 22 were used to evaluate the relationship between the morphology of the hyoid bone and the bones of the mandible. Results: The relationship between the morphology of the hyoid bone and the growth of the viscerocranium is corroborated by the positive and significant correlation between several morphological variables of the hyoid bone obtained - both at the level of its body and its greater horns -, and the mandible. Conclusions: These findings corroborate the association between the morphology of the hyoid bone and the growth of the mandible(AU)

Relación morfológica entre el hueso hioides y el viscerocráneo en una muestra de esqueletos / Morphologic relationship between the hyoid bone and the viscerocranium in a sample of skeletons

Introducción: El movimiento corporal, obedece y produce actividad del músculo esquelético para lo cual debe existir un equilibrio muscular estático, a partir del cual se genere el desplazamiento de los elementos anatómicos, involucrados en él, ya sea como respuesta a la volición o a la percepción inconsciente al estímulo que lo demande. Objetivo: Asociar el comportamiento morfológico del hioides con ciertas variables morfológicas del viscerocráneo de esqueletos (excepto la mandíbula). Material y Métodos: Se realizó estudio osteológico en una muestra ósea de 82 esqueletos mediante mediciones morfométricas del hueso hioides y huesos del viscerocráneo. Se utilizaron matrices de coeficiente de correlación lineal de Pearson en SPSS 22 para evaluar la relación de la morfología del hioides con respecto a la morfología de los huesos de la cara. Variables morfológicas del viscerocráneo como ancho bicigomático (abc), ancho transversal externo del paladar óseo (pote), ancho sagital externo del paladar óseo (pose) y la altura del tercio medio de la cara (tmed). Resultados: Se obtuvo una gran correlación positiva y significativa de distintas variables morfológicas del hioides, -tanto de su cuerpo como de sus astas o cuernos mayores- con las variables morfológicas del viscerocráneo. Conclusiones: Se corrobora la asociación de la morfología del hueso hioides con el crecimiento de los huesos del viscerocráneo(AU)

Introduction: Body movement obeys and produces activity in the skeletal muscle for which there must be a static muscle equilibrium that produces the movement of the anatomic elements involved in it, either as a result of volition or as the unconscious perception of a stimulus. Objective: To associate the morphological behavior of the hyoid bone with some morphological variables of the viscerocranium of skeletons (except the jaw). Material and Methods: An osteological study was carried out in a bone sample of 82 skulls by performing morphometric measurements of the hyoid bone and the bones of the viscerocranium. Pearson's correlation coefficient and SPSS Version 22 were used to evaluate the relationship between the morphology of the hyoid bone and the facial bones. Morphological variables of the viscerocranium include: bizygomatic width (BW), external transverse width of the hard palate (ETWHP), external sagittal width of the hard palate (ESWHP), and the height of the middle third of the face (MTF). Results: A very strong positive correlation between different morphological variables of the hyoid bone, -both at the level of its antlers or greater horns- and the morphological variables of the viscerocranium was obtained. Conclusions: These findings corroborate the association between the hyoid bone and the growth of facial bones(AU)