In Utero Exposure to Alcohol and Tobacco and Electroencephalogram Power During Childhood.

Importance: Prenatal alcohol exposure (PAE) and prenatal tobacco exposure (PTE) are risk factors associated with adverse neurobehavioral and cognitive outcomes. Objective: To quantify long-term associations of PAE and PTE with brain activity in early and middle childhood via electroencephalography (EEG). Design, Setting, and Participants: This cohort study included participants enrolled in the Safe Passage Study (August 2007 to January 2015), from which a subset of 649 participants were followed up in the Environmental Influences on Child Health Outcomes Program. From September 2018 through November 2022, EEG recordings were obtained at ages 4, 5, 7, 9, or 11 years. Data were analyzed from November 2022 to November 2023. Exposures: Maternal self-reported consumptions of alcohol and tobacco during pregnancy were captured at the recruitment interview and at up to 3 visits during pregnancy (20-24, 28-32, and ≥34 weeks' gestation). Classifications of PAE (continuous drinking, quit-early drinking, and nondrinking) and PTE (continuous smoking, quit-early smoking, and nonsmoking) were previously obtained. Main Outcomes and Measures: EEG band powers (theta, alpha, beta, gamma) were extracted from the EEG recordings. Linear regression models were used to estimate the associations of PAE and PTE with EEG estimates. Results: The final sample included 649 participants (333 [51.3%] female) aged 4, 5, 7, 9, or 11 years. Children whose mothers were in the quit-early drinking cluster had increased alpha power (0.116 [95% CI, 0.023 to 0.209] µV2; P = .02) compared with individuals without PAE. The magnitude of this increase was approximately double for children exposed to continuous drinking (0.211 [95% CI, 0.005 to 0.417] µV2; P = .04). Children whose mothers were in the continuous smoking cluster had decreased beta power (-0.031 [95% CI, -0.059 to -0.003] µV2; P = .03) and gamma power (-0.020 [95% CI, -0.039 to -0.000] µV2; P = .04) compared with the nonsmoking cluster. In exploratory sex-stratified models, male participants in the quit-early PAE cluster had greater EEG power in the alpha band (0.159 [95% CI, 0.003 to 0.315] µV2; P = .04) compared with those with no PAE, and the difference was approximately double for male participants with continuous PAE (0.354 [95% CI, 0.041 to 0.667] µV2; P = .03). Male participants in the continuous PTE cluster had decreased beta (-0.048 [95% CI, -0.090 to - 0.007] µV2; P = .02) and gamma (-0.032 [95% CI, -0.061 - 0.002] µV2; P = .04) power compared with those with no PTE. Conclusions and Relevance: These findings suggest that even low levels of PAE and PTE were associated with long-term alterations of brain activity.

Importancia del VO2máx y la capacidad de recuperación de los futbolistas

El consumo máximo de oxígeno se considera un indicador directamente relacionado con la resistencia aeróbica, por lo que dicha capacidad se hace determinante en el rendimiento del futbolista. Conocer los criterios teóricos nacionales que sustentaron la importancia del VO2máx en la capacidad de recuperación en el fútbol constituyó un paso previo hacia conformar estrategias prospectivas de intervención directa para la toma de decisiones. En tal sentido, se planteó como objetivo de la investigación determinar, por consulta de especialistas, los criterios existentes de la importancia del VO2máx en la capacidad de recuperación de los futbolistas. La investigación fue descriptiva-correlacional de orientación exploratoria; se encuestaron a 13 especialistas que emitieron criterios sobre cinco indicadores. La importancia de la resistencia aeróbica en el entrenamiento del fútbol obtuvo un puntaje de (X4.62) y en relación al resto de las capacidades físicas aplicadas al fútbol un (X3.23); la importancia del VO2máx en el proceso de dirección un (X4.46); la correlación entre VO2máx y la recuperación un (X4.54) y la necesidad de perfeccionar la resistencia aeróbica en el fútbol ecuatoriano un (X4). El índice de concordancia entre especialistas obtuvo un nivel aceptable (w=0.527). Todos los indicadores de análisis obtuvieron una cualificación entre alta y muy alta, por lo que la investigación resaltó la importancia teórica brindada por los especialistas sobre el consumo máximo de oxígeno como indicador directamente relacionado con la resistencia aeróbica y el vínculo entre este y la capacidad de recuperación de los futbolistas.

SÍNTESE O consumo máximo de oxigênio é considerado um indicador diretamente relacionado à resistência aeróbica, tornando esta capacidade um fator determinante no desempenho de um jogador de futebol. Conhecer os critérios teóricos nacionais que sustentavam a importância do VO2max na capacidade de recuperação no futebol foi um passo anterior para a formação de estratégias prospectivas de intervenção direta para a tomada de decisões. Neste sentido, o objetivo da pesquisa foi determinar, consultando especialistas, os critérios existentes sobre a importância do VO2max na capacidade de recuperação dos jogadores de futebol. A pesquisa foi descritivo-correlacional com uma orientação exploratória; 13 especialistas foram pesquisados e deram critérios sobre cinco indicadores. A importância da resistência aeróbica no treinamento de futebol obteve uma pontuação de (X4,62) e em relação ao resto das capacidades físicas aplicadas ao futebol a (X3,23); a importância do VO2max no processo de gerenciamento a (X4,46); a correlação entre VO2max e recuperação a (X4,54) e a necessidade de aperfeiçoar a resistência aeróbica no futebol equatoriano a (X4). O índice de concordância entre especialistas obteve um nível aceitável (w=0,527). Todos os indicadores de análise obtiveram uma qualificação entre alto e muito alto, portanto a pesquisa destacou a importância teórica dada pelos especialistas sobre o consumo máximo de oxigênio como um indicador diretamente relacionado à resistência aeróbica e a ligação entre esta e a capacidade de recuperação dos jogadores de futebol.

The maximum oxygen consumption is considered an indicator directly related to aerobic endurance, so this capacity becomes decisive in the performance of the soccer player. Knowing the national theoretical criteria that supported the importance of VO2max in the recovery capacity in soccer was a previous step towards shaping prospective strategies of direct intervention for decision making. In this sense, the objective of the research was to determine, by consulting specialists, the existing criteria of the importance of VO2max in the recovery capacity of soccer players. The research was descriptive-correlational with an exploratory orientation; 13 specialists were surveyed who issued criteria on five indicators. The importance of aerobic endurance in soccer training obtained a score of (X 4.62) and in relation to the rest of the physical capacities applied to soccer a (X3.23); the importance of VO2max in the direction process a X 4.46); the correlation between VO2max and recovery a (X 4.54) and the need to improve aerobic endurance in Ecuadorian soccer a (X 4). The concordance index between specialists obtained an acceptable level (w=0.527). All the analysis indicators obtained a qualification between high and very high, so the research highlighted the theoretical importance provided by specialists on maximum oxygen consumption as an indicator directly related to aerobic endurance and the link between this and the ability to recovery of footballers.

Entrenamiento sistemático de defensa personal en la Escuela Superior Naval / Formação sistemática em autodefesa na Escola Secundária Naval / Systematic self-defense training at the Naval High School

RESUMEN La defensa personal en la Fuerza Naval es una de las competencias fundamentales del profesional militar, el perfeccionamiento del proceso de maestría en las artes marciales mixtas requiere de diagnósticos sistemáticos, evidencia alcances y limitaciones y, por ende, la toma de decisiones acertadas para mejorar el proceso. En tal sentido, se planteó como propósito de la investigación: diagnosticar necesidades en la defensa personal sistemática de la Escuela Superior Naval. La Investigación es exploratoria con enfoque descriptivo-explicativo y correlacional; se realiza selección bajo un muestreo intencional de 20 oficiales navales. Estos responden a encuestas cerradas que justificarán el diseño prospectivo de un proceso de intervención a futuro. La autoevaluación de los especialistas demuestra que el 40 % posee una calificación Buena en el dominio de técnicas de karate-do, boxeo y judo y el 30 % una calificación mala. Estos valores indican que son similares durante la aplicación correcta de técnicas de karate-do (45 %: bueno; 15 %: malo), boxeo (65 %: bueno; 0 %: malo) y judo (40 %: bueno; 25 %: malo), mientras que los indicadores pertinencia (4.30 puntos), factibilidad (3.40 puntos), prioridad (4.55 puntos) e integralidad. (4.40 puntos). Estos valores justificaron la necesidad de implementar un proceso de intervención para perfeccionar la defensa personal en marinos. En el estudio, prevalece una concordancia aceptable entre los especialistas (0.526). La consulta a especialistas muestra la necesidad de implementar un proceso de entrenamiento sistemático de defensa personal en la Escuela Superior Naval. Se presentan como positivos los indicadores de pertinencia, factibilidad, prioridad e integralidad, en el diseño de un proceso prospectivo para brindar superación profesional al personal naval ecuatoriano en el aspecto de la defensa personal.

RESUMO A autodefesa na Força Naval é uma das competências fundamentais do profissional militar. A melhoria do processo de domínio nas artes marciais mistas requer diagnósticos sistemáticos, provas de alcances e limitações e, portanto, a tomada de decisões corretas para melhorar o processo. Neste sentido, o objectivo da investigação era diagnosticar as necessidades em autodefesa sistemática na Escola Superior Naval. A investigação é exploratória com uma abordagem descritiva-explicativa e correlativa; foi selecionada uma amostra propositada de 20 oficiais navais. Responderam a inquéritos fechados que justificarão a concepção prospectiva de um futuro processo de intervenção. A auto avaliação dos especialistas mostra que 40% têm uma boa classificação no domínio do Karate-do, boxe e técnicas de judô e 30% uma má classificação. Estes valores indicam que são semelhantes durante a aplicação correta do Karate-do (45 %: bom; 15 %: mau), do boxe (65 %: bom; 0 %: mau) e do judô (40 %: bom; 25 %: mau) técnicas, enquanto que os indicadores relevância (4,30 pontos), viabilidade (3,40 pontos), prioridade (4,55 pontos) e abrangência (4,40 pontos). Estes valores justificaram a necessidade de implementar um processo de intervenção para melhorar a autodefesa dos marítimos. No estudo, prevalece um acordo aceitável entre os especialistas (0,526). A consulta com especialistas mostra a necessidade de implementar um processo sistemático de formação em autodefesa na Academia Naval. Os indicadores de relevância, viabilidade, prioridade e abrangência são apresentados como positivos na concepção de um processo prospectivo para proporcionar desenvolvimento profissional ao pessoal naval equatoriano na área da autodefesa.

ABSTRACT Self-defense in the Naval Force is one of the fundamental competencies of the military professional, the improvement of the mastery process in mixed martial arts requires systematic diagnoses, evidence of scope and limitations and, therefore, making the right decisions to improve the process. In this sense, it was proposed as the purpose of the research: to diagnose needs in the systematic self-defense of the Higher Naval School. The research is exploratory with a descriptive-explanatory and correlational approach; selection is made under an intentional sampling of 20 naval officers. These respond to closed surveys that will justify the prospective design of a future intervention process. The self-assessment of the specialists shows that 40% have a Good rating in mastering karate-do, boxing and judo techniques and 30 % a Bad rating. These values indicate that they are similar during the correct application of karate-do techniques (45 %: Good; 15 %: Bad), Boxing (65 %: Good; 0%: Bad) and Judo (40 %: Good; 25 %: Bad), while the indicators Relevance (4.30 points), Feasibility (3.40 points), Priority (4.55 points) and Comprehensiveness. (4.40 points). These values justified the need to implement an intervention process to improve self-defense in sailors. In the study, an acceptable concordance prevails among the specialists (0.526). Consultation with specialists shows the need to implement a systematic self-defense training process at the Naval High School. The indicators of relevance, feasibility, priority and comprehensiveness are presented as positive in the design of a prospective process to provide professional improvement to Ecuadorian naval personnel in the aspect of self-defense.

Preparación física para mujeres militares de la Fuerza Naval en período de poslactancia / Preparação física das mulheres militares da Força Naval no período pós-lactação / Physical preparation for military women of the Naval Force in post-lactation period

RESUMEN La preparación físico-militar incluye numerosos supuestos que regulan el apresto operacional del personal militar, establecen los estándares básicos para toda la vida activa. Dentro de las acciones de trabajo para mejorar o mantener la condición física, se deben tener presente las condiciones del militar, donde el entrenamiento del período poslactancia de las mujeres deben condicionarse a sus necesidades biológicas. En tal sentido, se planteó como propósito de la investigación implementar un plan de entrenamiento para mejorar la condición física de mujeres militares de la Fuerza Naval para el periodo de poslactancia. Bajo un muestreo intencional, se intervienen a siete mujeres (31-36 años) de la Fuerza Naval ecuatoriana, en proceso de lactancia, ellas son insertadas a un plan de ejercicios especializados para acondicionarlas físicamente. De aquí se genera un estudio en dos momentos de la preparación de su resistencia aeróbica, velocidad y potencia local muscular. Todas las pruebas de valoración presentaron un menor rendimiento medio en la primera valoración. Desde este resultado, se superan sus indicadores como parte del postest, test de velocidad: 17:56s-17:00s (p=0.018), test de Cooper: 16:38min-16:12min (p=0.712), Test de Abdominales: ≈36rep-≈41rep (p=0.000) y test de flexiones de codo: 25rep-30rep (p=0.000). Durante el proceso de intervención, no se presentaron lesiones ni otras dificultades que provoquen abandono del programa. El plan de intervención propuesto mejoró y acondicionó la preparación física en las mujeres militares de la Fuerza Naval ecuatoriana en estado de poslactancia; así mejoró significativamente las capacidades de velocidad y fuerza muscular local, lo cual acondicionó la capacidad de resistencia aeróbica.

RESUMO A preparação físico-militar inclui numerosos pressupostos que regulam a prontidão operacional do pessoal militar, estabelecem as normas básicas para toda a vida ativa. No âmbito das ações de trabalho para melhorar ou manter a condição física, devem ser tidas em conta as condições dos militares, onde a formação das mulheres no período pós-lactação deve ser condicionada às suas necessidades biológicas. Neste sentido, o objectivo da investigação era implementar um plano de formação para melhorar a condição física das mulheres militares na Força Naval para o período de pós-parto. Sob uma amostragem propositada, sete mulheres (31-36 anos) da Força Naval equatoriana, no processo de amamentação, foram envolvidas num plano de exercício especializado para as condicionar fisicamente. A partir disto, é gerado um estudo em dois momentos da preparação da sua resistência aeróbica, velocidade e potência muscular local. Todos os testes de avaliação mostraram um desempenho médio inferior na primeira avaliação. A partir deste resultado, os seus indicadores são excedidos como parte do teste de velocidade: 17:56s-17:00s (p=0,018), teste de Cooper: 16:38min-16:12min (p=0,712), teste abdominal: ≈36rep-≈41rep (p=0,000) e teste de flexão do cotovelo: 25rep-30rep (p=0,000). Durante o processo de intervenção, não houve feridos ou outras dificuldades que levassem ao abandono do programa. O plano de intervenção proposto melhorou e condicionou a preparação física das mulheres militares pós-lactação da Força Naval equatoriana; melhorou significativamente as capacidades de velocidade e força muscular local, o que condicionou a capacidade de resistência aeróbica.

ABSTRACT Physical-military preparation includes numerous assumptions that regulate the operational readiness of military personnel, establish the basic standards for all active life. Within the work actions to improve or maintain physical condition, the conditions of the military must be taken into account, where the training of the post- lactation period of women must be conditioned to their biological needs. In this sense, the purpose of the research was to implement a training plan to improve the physical condition of military women of the naval force for the post -lactation period. Under an intentional sampling, seven women (31-36 years old) of the Ecuadorian naval force, in the process of breastfeeding, are inserted into a specialized exercise plan to condition them physically. From here, a study is generated in two moments of the preparation of their aerobic endurance, speed and local muscle power. All the assessment tests presented a lower mean performance in the first assessment. From this result, their indicators are exceeded as part of the post -test, Speed Test: 17:56-17:00 (p=0.018), Cooper Test: 16:38-16:12 (p=0.712), Abdominal Test:≈ 36rep-≈ 41rep (p=0.000) and elbow flexion test: 25rep-30rep (p=0.000). During the intervention process, there were no injuries or other difficulties that caused abandonment of the program. The proposed intervention plan improved and conditioned the physical training of military women of the Ecuadorian naval force in a post -lactation state; thus, it significantly improved speed capabilities and local muscle strength, which conditioned aerobic endurance capacity.

Caracterización del tipo de sensibilidad dental de pacientes con periodontitis y su respuesta a los dentífricos / Characterization of the type of dental sensitivity of patients with periodontitis and their response to dentifrices

La hipersensibilidad de la dentina surge ante la exposición de esta y en respuesta a estímulos de diverso tipo, fundamentalmente de origen térmico, evaporativo, táctil, osmótico o químico. Se realizó una investigación abocada a caracterizar la hipersensibilidad dental de pacientes atendidos en consulta de odontología y la respuesta a determinado dentífrico utilizado. En el análisis de estimulación dental se tomaron 308 mediciones de la sensibilidad dental para todos los participantes (n=22), con 7 factores de tiempo (T0 antes del uso del producto, T3 días, T5 días, T8 días, T22 días y T29 días después del uso del dentífrico). Se realizó la prueba paramétrica regresión lineal simple para identificar la tendencia y el ajuste de los datos, al considerar dichas variables como una serie temporal. Se utilizaron 22 tratamientos. Casi el 91,0% expreso que el dentífrico había cumplido sus expectativas, fundamentalmente por la reducción de la hipersensibilidad a corto plazo, mientras que aproximadamente 91,0% de los casos afirmó que compraría el dentífrico (20 casos, IC 95%: 72,2% y 97,5%), respectivamente(AU)

Dentin hypersensitivity arises when exposed to it and in response to various types of stimuli, mainly of thermal, tactile evaporative, osmotic or chemical origin. An investigation was carried out aimed at characterizing the dental hypersensitivity of patients seen in the dental office and the response to a certain toothpaste used. In the dental stimulation analysis, 308 measurements of tooth sensitivity were taken for all participants (n = 22), with 7 time factors (T0 before use of the product, T3 days, T5 days, T8 days, T22 days and T29 days after using the toothpaste). The simple linear regression parametric test was performed to identify the trend and the fit of the data, considering these variables as a time series. 22 treatments were used. Almost 91.0% believed that the toothpaste had met their expectations, mainly due to the reduction in hypersensitivity in the short term, while approximately 91.0% of the cases stated that they would buy the toothpaste (20 cases, 95% CI: 72 , 2% and 97.5%), respectively(AU)

Entrenamiento interválico de resistencia aeróbica en el rendimiento de las pruebas físicas del personal militar

La resistencia aérobica es la capacidad de realizar una actividad física en el mayor tiempo posible; esta es una capacidad determinante para muchos deportes y una necesidad para el personal militar activo, para lo cual se establecen estrategias especializadas en función de su potenciación como la aplicación del modelo interválico, considerado un entrenamiento basado en la repetición de periodos de trabajo de alta intensidad. En tal sentido, se planteó como objetivo de la investigación potenciar la resistencia aeróbica en soldados de la Escuela de Infantería del Ejército (EIE) a partir de un entrenamiento interválico HIIT. Se implementó una investigación descriptiva-correlacional. Se analizaron 75 soldados del curso de perfeccionamiento de la Escuela de Infantería del Ejército. Se evalúo su capacidad aeróbica e incluyó el índice de masa corporal antes y después de implementar un entrenamiento interválico durante ocho semanas. El promedio del índice de masa corporal fue de 23,91kg (normal; pretest), y de 23,38kg (normal; postest). Se muestreó significativamente diferente (p=0.000), mientras que el tiempo promedio en el test de dos millas fue de13´39min/s (pretest) y de 12´48min/s (postest), se mejora, para un -51s. El Vo2máx fue de 47,64 (ml/kg/min. pretest) y de 52,65ml/Kg/min (postest), un aumento de+5.01 ml/Kg/min, correspondiente a un 10,51 % de incremento del VO2máx. El entrenamiento interválico, se enfatiza en el extensivo-medio e intensivo-corto e incide positivamente en el desarrollo de la resistencia aeróbica a corto plazo, indica que es una alternativa para mejorar indicadores de resistencia aeróbica en soldados con un rango etario entre 23-28 años.

A resistência aeróbica é a capacidade de realizar uma atividade física no maior tempo possível; esta é uma capacidade determinante para muitos esportes e uma necessidade de pessoal militar ativo, para o qual são estabelecidas estratégias especializadas em termos de seu aperfeiçoamento, como a aplicação do modelo interválico, considerado um treinamento baseado na repetição de períodos de trabalho de alta intensidade. Neste sentido, o objetivo da pesquisa era melhorar a resistência aeróbica nos soldados da Escola de Infantaria do Exército (EIE) através do treinamento interválico HIIT. Uma pesquisa descritivo-correlacional foi implementada. Setenta e cinco soldados da Escola de Infantaria do Exército foram analisados no curso de treinamento avançado. Sua capacidade aeróbica foi avaliada e incluiu o índice de massa corporal antes e depois da implementação do treinamento interválico por oito semanas. O índice médio de massa corporal era de 23,91kg (normal; pré-teste), e 23,38kg (normal; pós-teste). A amostra foi significativamente diferente (p=0,000), enquanto o tempo médio no teste de duas milhas foi de 13'39min/s (pré-teste) e 12'48min/s (pós-teste), é melhorado, para um -51s. O Vo2max foi de 47,64 (ml/kg/min pré-teste) e 52,65ml/kg/min (pós-teste), um aumento de +5,01 ml/kg/min, correspondendo a um aumento de 10,51 % no VO2max. O treinamento interválico, enfatizado no intensivo-médio e intensivo-curto e tem um impacto positivo no desenvolvimento da resistência aeróbica de curto prazo, indica que é uma alternativa para melhorar os indicadores de resistência aeróbica em soldados com uma faixa etária entre 23-28 anos.

Aerobic resistance is the capacity to perform physical activity for as long as possible, being a determining capacity for many sports and a need for active military personnel, for which specialized strategies are established for its enhancement such as the interval model application, considered a training based on the repetition periods of high intensity load. In this sense, the research objective is to promote aerobic endurance in soldiers of the Escuela de Infantería del Ejército (EIE) from a HIIT interval training. A descriptive-co relational investigation is implemented, analyzing 75 soldiers from the improvement course of the Escuela de Infantería del Ejército, evaluating their aerobic capacity, including the Body Mass Index before and after implementing interval training for 8 weeks. The average body mass index was 23.91kg (Normal; Pretest), and 23.38kg (Normal; Posttest), being significantly different (p = 0.000), while the average time in the 2-mile test was 13'39min / s (Pretest) and 12'48 min / s (Posttest), improving -51s. The VoMax2 was 47.64 (ml / kg / min. Pretest) and 52.65 ml / Kg / min (Posttest), an increase of +5.01 ml / Kg / min, corresponding to a 10.51% increase of VO2max. Interval training, emphasizing the extensive-medium and intensive-short, positively affects the development of short-term aerobic endurance, being an alternative to improve aerobic endurance indicators in soldiers with an age range between 23-28 years.

Efectividad de sustancias químicas en el clareamiento y biopelícula dental aplicado en el consultorio y ambulatorio / Effectiveness of chemical substances in bleaching and dental biofilm applied in the office and outpatient

El blanqueamiento dental está considerado como pieza fundamental en el embellecimiento de los seres humanos, ya que permite la restauración de la "sonrisa perfecta". Este proceso en sí, es poco invasivo y juega como un gran papel como aliado en la restauración satisfactoria de la sonrisa y autoestima del paciente. Es un procedimiento que debe ser aplicado cuidadosamente para lograr los efectos positivos del mismo. El fundamento de esta técnica es aclarar la tonalidad que han sufrido los dientes por diversos factores: extrinsecos, intrínsecos y decoloraciones internas. Durante el procedimiento, es usual el uso de peróxido de hidrógeno (H2O2) en concentraciones que van del 10 al 32 % en volumen o el peróxido de carbamida, un compuesto conformado por peróxido de hidrógeno y urea concentraciones del 10 al 22 %. El uso de peróxido de hidrógeno se lleva a cabo fundamentalmente en los consultorios, mientras que el uso del peróxido de carbamida es un procedimiento doméstico. A pesar de los excelentes resultados que se obtiene al usar ambos blanqueadores, su uso puede ocasionar erosiones dentales y sensibilidad dentaria. El primer caso, puede llevar a la adherencia de bacterias cariogénicas como el Strepctococus mutans responsable de caries. Los resultados obtenidos, demostraron que el peróxido de hidrógeno es un agente más agresivo que el peróxido de carbamida, lo cual origina mayor sensibilidad dentaria y un mayor control bacteriano; en cambio el peróxido de carbamida fue mejor blanqueador y originó menor sensibilidad dental(AU)

Tooth whitening is considered a fundamental piece in the beautification of human beings, since it allows the restoration of the "perfect smile". This process itself is minimally invasive and plays a great role as an ally in the satisfactory restoration of the patient's smile and self-esteem. It is a procedure that must be carefully applied to achieve its positive effects. The basis of this technique is to clarify the shade that the teeth have suffered due to various factors: extrinsic, intrinsic and internal discoloration. During the procedure, the use of hydrogen peroxide (H2O2) in concentrations ranging from 10 to 32% by volume or carbamide peroxide, a compound made up of hydrogen peroxide and urea concentrations of 10 to 22%, is usual. The use of hydrogen peroxide is mainly carried out in offices, while the use of carbamide peroxide is a home procedure. Despite the excellent results obtained by using both whiteners, their use can cause dental erosion and tooth sensitivity. The first case can lead to the adherence of cariogenic bacteria such as Streptococcus mutans responsible for caries. The results obtained showed that hydrogen peroxide is a more aggressive agent than carbamide peroxide, which causes greater dental sensitivity and greater bacterial control; On the other hand, carbamide peroxide was a better whitener and caused less dental sensitivity(AU)

International Neurotrauma Training Based on North-South Collaborations: Results of an Inter-institutional Program in the Era of Global Neurosurgery.

Objective: Shortage of general neurosurgery and specialized neurotrauma care in low resource settings is a critical setback in the national surgical plans of low and middle-income countries (LMIC). Neurotrauma fellowship programs typically exist in high-income countries (HIC), where surgeons who fulfill the requirements for positions regularly stay to practice. Due to this issue, neurosurgery residents and medical students from LMICs do not have regular access to this kind of specialized training and knowledge-hubs. The objective of this paper is to present the results of a recently established neurotrauma fellowship program for neurosurgeons of LMICs in the framework of global neurosurgery collaborations, including the involvement of specialized parallel education for neurosurgery residents and medical students. Methods: The Global Neurotrauma Fellowship (GNTF) program was inaugurated in 2015 by a multi-institutional collaboration between a HIC and an LMIC. The course organizers designed it to be a 12-month program based on adapted neurotrauma international competencies with the academic support of the Barrow Neurological Institute at Phoenix Children's Hospital and Meditech Foundation in Colombia. Since 2018, additional support from the UK, National Institute of Health Research (NIHR) Global Health Research in Neurotrauma Project from the University of Cambridge enhanced the infrastructure of the program, adding a research component in global neurosurgery and system science. Results: Eight fellows from Brazil, Venezuela, Cuba, Pakistan, and Colombia have been trained and certified via the fellowship program. The integration of international competencies and exposure to different systems of care in high-income and low-income environments creates a unique environment for training within a global neurosurgery framework. Additionally, 18 residents (Venezuela, Colombia, Ecuador, Peru, Cuba, Germany, Spain, and the USA), and ten medical students (the United Kingdom, USA, Australia, and Colombia) have also participated in elective rotations of neurotrauma and critical care during the time of the fellowship program, as well as in research projects as part of an established global surgery initiative. Conclusion: We have shown that it is possible to establish a neurotrauma fellowship program in an LMIC based on the structure of HIC formal training programs. Adaptation of the international competencies focusing on neurotrauma care in low resource settings and maintaining international mentoring and academic support will allow the participants to return to practice in their home-based countries.

Obesidad, intervención escolar, actividad física y estilos de vida saludable en niños españoles / Obesity, School Intervention; Physical Activity and Healthy Lifestyles in Spanish Children

Introducción: El sobrepeso y la obesidad en la infancia y la adolescencia se han incrementado a nivel mundial durante las últimas décadas. Este hecho se asocia, principalmente, con la falta de actividad física, hábitos de vida y comportamientos alimenticios poco saludables. Objetivo: Analizar la efectividad de diferentes estudios de intervención escolar llevados a cabo en España para prevenir y tratar la obesidad en niños y niñas. Métodos: Se realizó una estrategia de búsqueda electrónica utilizando las bases de datos PubMed, Medline y SPORTdiscus y los términos school-based intervention, Spain, healthy lifestyle, obesity prevention, physical activity y nutrition childhood obesity y children obesity. Se identificaron 124 artículos y solo 11 cumplieron los criterios de inclusión. Conclusiones: Las intervenciones realizadas por el entorno escolar no fueron eficaces o significativas para cambiar los indicadores antropométricos de los niños, niñas y adolescentes españoles. Sin embargo, las intervenciones escolares unidas a la implicación familiar, pueden ser eficaces para modificar cambios en los hábitos nutricionales, nivel de actividad física y hábitos de vida saludable en la etapa infantojuvenil, ya que son los principales determinantes de obesidad en la infancia. Por último, la consolidación de un adecuado estilo de vida en etapas tempranas puede prevenir la obesidad y sobrepeso en la adultez(AU)

Introduction: Overweight and obesity in childhood and adolescence have increased worldwide in recent decades. This fact is associated mainly with a lack of physical activity, unhealthy lifestyle habits and eating behaviors. Objective: To analyze the effectiveness of different school intervention studies carried out in Spain to prevent and treat obesity in boys and girls. Methods: An electronic search strategy was carried out using the PubMed, Medline and SPORTdiscus databases, under the terms school-based intervention, Spain, healthy lifestyle, obesity prevention, physical activity, nutrition, childhood obesity and children obesity. 124 articles were identified and only 11 met the inclusion criteria. Conclusions: The interventions carried out by school were not effective or significant to change the anthropometric indicators of Spanish children and adolescents. However, school interventions, together with family involvement, can be effective in modifying changes in nutritional habits, level of physical activity and healthy lifestyle habits in the infant-juvenile stage, since they are the main determinants of obesity in childhood. Finally, establishing an adequate lifestyle early can prevent obesity and overweight in adulthood(AU)

Clinical, radiological and laboratory characteristics of pediatric patients with COVID-19: Living systematic review / Características clínicas, radiológicas y de laboratorio en pacientes pediátricos con COVID-19. Revisión sistemática viva

Abstract Introduction: Since the first COVID-19 cases were reported, the disease's clinical and epidemiological characteristics have continuously been studied, although they have not been yet defined. Objective: To estimate the epidemiological profile of pediatric patients with COVID-19, as well as their clinical, laboratory and radiological characteristics. Materials and methods: A living systemic review was conducted in the PubMed, Scopus and SciELO databases. Observational studies describing clinical, radiological, and laboratory characteristics of pediatric patients with COVID-19 and published between January 1, 2020, and July 20, 2020, were considered for the search; there were no language restrictions. Government, epidemiological, and pre-print papers were also considered. Meta-analyses of single proportion (frequentist approach) and two proportions (Bayesian method) were carried out. The study registration and protocol are available at https://osf.io/y43wm and https://osf.io/r8ktv, respectively. Results: 13 studies, with a total of 9 152 patients, were retrieved. The Bayesian meta-analysis reported that males are more affected by the disease: OR 1.24 (HDI95%: 1.09-1.4). The proportion results calculated by means of the frequentist meta-analysis are: 52% cough (95%CI: 50-55), 0% death (95%CI: 0-0.1), 16% high aspartate transaminase levels (95%CI: 13-19), and 60% lung changes observed in chest X-ray (95%CI: 57-64). Conclusions: Based on the current data, it is not possible to describe accurately the clinical and epidemiological characteristics of COVID-19 in the pediatric population. However, evidence suggests that males are more affected by the disease and that lung alterations in imaging studies are more frequent than clinical signs such as cough and fever. Laboratory test results are not conclusive and show that different organs and systems of the human body may be affected by SARS-CoV-2. The results reported here must be compared to prospective controlled studies conducted in larger samples and a more rigorous design.

Resumen Introducción. Desde que se reportaron los primeros casos de COVID-19, sus características clínicas y epidemiológicas han sido constantemente estudiadas, pero aún no han sido definidas. Objetivo. Estimar el perfil epidemiológico, así como las características clínicas, radiológicas y de laboratorio en pacientes pediátricos con COVID-19. Materiales y métodos. Se realizó una revisión sistemática viva en las bases de datos PubMed, Scopus y SciELO; para la búsqueda se consideraron estudios observacionales publicados entre enero 1 de 2020 y julio 20 de 2020, sin restricción de idioma, que describieran características clínicas, radiológicas y de laboratorio en población pediátrica con COVID-19; también se incluyeron reportes gubernamentales y epidemiológicos, y artículos publicados en formato pre-print. Se realizaron metaanálisis de proporción única (método frecuentista) y de dos proporciones (método bayesiano). El registro y el protocolo del estudio están disponibles en https://osf.io/y43wm y https://osf.io/r8ktv, respectivamente. Resultados. Se encontraron 13 estudios, con un total de 9 152 pacientes. El metaanálisis bayesiano reportó una mayor afectación del sexo masculino: OR: 1.2 (HDI95%: 1.09-1.4). Los resultados de la proporción calculada por el metaanálisis frecuentista fueron: tos 52% (IC95%: 50-55), muerte 0% (IC95%: 0-0.1), niveles elevados de aspartato aminotransferasa 16% (IC95%: 13-19) y alteraciones pulmonares evidenciadas mediante estudios de imagen 60% (IC95%: 57-64). Conclusiones. Con los datos actuales no es posible describir con exactitud las características clínicas y epidemiológicas de la COVID-19 en población pediátrica. Sin embargo, existen indicios de una mayor afectación al sexo masculino, y de que las anormalidades pulmonares detectadas en radiografías y tomografías del tórax son más frecuentes que signos clínicos como la tos y la fiebre. Los resultados de laboratorio no son concluyentes y reflejan que diferentes órganos y sistemas son afectados por el SARS-CoV-2. Los hallazgos del presente estudio deben ser contrastados con estudios prospectivos controlados, con un mayor número de pacientes y un diseño más riguroso.

Variables del rendimiento de los bateadores del béisbol cubano utilizando el sensor Blast Motion Baseball / Variáveis do desempenho dos batedores do basebol cubano utilizando o Sensor de Basebol de Movimento de Explosão / Variables in the Cuban baseball batter's performance using the Blast Motion Baseball sensor

Resumen La introducción de las nuevas tecnologías en el béisbol ha optimizado los sistemas para el registro y análisis de información, tanto en el entrenamiento como en el juego, contribuyendo a un control más exacto del rendimiento de un jugador. En el presente trabajo, se aplica el sensor Blast Motion Baseball cuyo objetivo es identificar las variables significativamente influyentes en el rendimiento de los bateadores en el béisbol cubano. Se eligieron bateadores (N=24) pertenecientes a la Serie Nacional de béisbol LIX debido a que constituye el evento nacional de mayor nivel del béisbol cubano. La información fue registrada en prácticas de bateo, mientras el bateador ejecutaba la tarea de conectar bolas lanzadas por el entrenador de frente (front toss), por encima del brazo a una distancia de 30 pies y a una velocidad inferior a las 50 mph. Posteriormente, se compararon los resultados del Blast Motion Baseball con las estadísticas oficiales de la Serie Nacional de Béisbol LIX. Se demostró que los bateadores con mayor velocidad del bate, mayor velocidad máxima de las manos y mayor potencia lograron un mayor rendimiento ofensivo. Por tanto, conocer en tiempo real estas características del swing contribuyen a perfeccionar el proceso de entrenamiento y predecir el rendimiento deportivo de un bateador.

Resumo A introdução de novas tecnologias no basebol otimizou os sistemas de gravação e análise de informação, tanto no treino como no jogo, contribuindo para um controlo mais preciso do desempenho de um jogador. No presente trabalho, é aplicado o Sensor de basebol Blast Motion. O seu objetivo é identificar as variáveis que influenciam significativamente o desempenho dos batedores no basebol cubano. Os batedores (N=24) pertencentes à Série Nacional de basebol LIX foram escolhidos porque constitui o evento nacional de mais alto nível do basebol cubano. A informação foi registada durante o treino de batedores, enquanto o batedor executava a tarefa de ligar bolas lançadas pelo treinador a partir do lançamento frontal, sobre o braço a uma distância de 30 pés e a uma velocidade inferior a 50 mph. Os resultados do Blast Motion Baseball foram então comparados com as estatísticas oficiais da Série Nacional de Basebol LIX. Foi demonstrado que batedores com maiores velocidades de taco, maiores velocidades de mão superior, e mais potência alcançaram um maior desempenho ofensivo. Portanto, conhecer estas características do balanço em tempo real ajuda a refinar o processo de treino e a prever o desempenho atlético de um batedor.

Abstract The introduction of new technologies in baseball has optimized the systems for recording and analyzing information, both in training and in the game, contributing to a more accurate control of a player's performance. In this work, it is applied the Blast Motion Baseball sensor which objective is to identify the variables significantly influencing the performance of batters in Cuban baseball. There were chosen batters (N=24) belonging to the National Baseball Series LIX because it constitutes the national event of higher level in Cuban baseball. The information was recorded during batting practice, while the batter was performing the task of connecting balls thrown by the coach from the front toss, over the arm at a distance of 30 feet and at a speed of less than 50 mph. The results of Blast Motion Baseball were then compared with the official statistics of the LIX National Baseball Series. It was shown that batters with higher bat speed, higher top hand speed and more power achieved greater offensive performance. Therefore, knowing these characteristics of the swing in real time helps to perfect the training process and predict the sports performance of a batter.

Differences in Parent and Child Report on the Screen for Child Anxiety-Related Emotional Disorders (SCARED): Implications for Investigations of Social Anxiety in Adolescents.

Social anxiety typically emerges by adolescence and is one of the most common anxiety disorders. Many clinicians and researchers utilize the Screen for Child Anxiety Related Disorders (SCARED) to quantify anxiety symptoms, including social anxiety, throughout childhood and adolescence. The SCARED can be administered to both children and their parents, though reports from each informant tend to only moderately correlate. Here, we investigated parent-child concordance on the SCARED in a sample of adolescents (N = 360, Mage = 13.2) using a multi-trait multi-method (MTMM) model. Next, in a selected sample of the adolescents, we explored relations among child report, parent report, and latent social anxiety scores with two laboratory tasks known to elicit signs of social anxiety in the presence of unfamiliar peers: a speech task and a "Get to Know You" task. Findings reveal differences in variance of the SCARED accounted for by parent and child report. Parent report of social anxiety is a better predictor of anxiety signs elicited by a structured speech task, whereas child report of social anxiety is a better predictor of anxiety signs during the naturalistic conversation with unfamiliar peers. Moreover, while latent social anxiety scores predict both observed anxiety measures, parent report more closely resembles latent scores in relation to the speech task, whereas child report functions more similarly to latent scores in relation to the peer conversation. Thus, while latent scores relate to either observed anxiety measure, parent and child report on the SCARED each provide valuable information that differentially relate to naturalistic social anxiety-related behaviors.

La corrección-compensación en niños sordociegos con alteraciones motrices a través de actividades físicas adaptadas / Correction-compensation in the deafblind children with motor alterations through adapted physical activities

Introducción: La sordoceguera es una discapacidad doble que implica problemas en el campo auditivo y visual, provoca problemas comunicativos y motrices únicos. Por lo que es necesario trazar estrategias docente-educativas especiales y personalizadas. Objetivo: Proponer actividades físicas adaptadas como parte de la terapia ocupacional para la corrección-compensación de las alteraciones motrices presentadas en niños sordociegos que estudian en el Instituto Especial Mariana de Jesús. Métodos: La muestra estuvo conformada por 20 niños, entre los 6-10 años de edad con problemas visuales y auditivos parciales provocados por diferentes padecimientos. La investigación se inició con el diagnóstico realizado a 11 especialistas, que estaban implicados directamente en el proceso docente-educativo. Se delimitaron las variables de investigación antes de la implementación de la estrategia. Se diseñaron 10 juegos adaptados a las individualidades y necesidades de la muestra estudiada, y aplicados durante el curso docente 2016-2017. Resultados: Con la aplicación de las 7 pruebas motrices antes y después de implementada la mejora, se obtuvieron progresos significativos en las habilidades motrices de los sujetos, aumentando el porcentaje de evaluados de bien, según se demostró estadísticamente al calcular las proporciones para muestras relacionadas. Conclusiones: Las actividades físicas adaptadas, dentro de estrategias lúdicas como terapia ocupacional, permiten mejorar el trabajo correctivo-compensativo y las capacidades motrices de niños sordociegos. Estas estrategias deben desarrollarse bajo los principios de una ética humanista e inclusiva y sobre la base de una atención personalizada(AU)

Visual field, and causes unique communicative and motor problems. So, it is necessary to draw special and customised educational-teaching strategies. Objective: To propose adapted physical activities as part of the occupational therapy for the correction-compensation of motor alterations presented in deafblind children studying in Mariana de Jesus Special Institute. Methods: The sample consisted of 20 children in the ages from 6 to10 years old with visual and auditory problems caused by different diseases. The investigation began with a diagnosis to 11 specialists whom were directly involved in the educational process. The research variables were defined prior to the implementation of the strategy. There were designed ten games adapted to the individualities and needs of the sample studied, and those were used during the school year 2016-2017. Results: With the implementation of the 7 motor tests before and after the implementation of the improvement, significant breakthroughs in the motor skills of the subjects were achieved, and with it an increase in the percentage of subjects evaluated as well, as demonstrated statistically when calculating the proportions for related samples. Conclusions: The adapted physical activities, within playful strategies as occupational therapy, improve the corrective-compensative work and the motor abilities of deafblind children. These strategies should be developed under the principles of a humanist and inclusive ethics and on the basis of a personalized attention(AU)

Efectos de las plataformas vibratorias en la salud ósea en mujeres posmenopáusicas / Effects of Vibratory Platforms on Bone Health in Postmenopausal Women

Estudios recientes han sugerido que los estímulos mecánicos (vibraciones) de alta frecuencia y baja magnitud pueden ejercer un efecto positivo sobre la morfología ósea y beneficiar su cantidad y calidad. La plataforma vibratoria es una máquina popular que se introdujo en la última década como una nueva promesa contra el tratamiento de la osteoporosis. Actualmente, en el mundo hay más de 200 millones de mujeres posmenopáusicas que sufren osteoporosis. Esta enfermedad es una de las más comunes y costosas de la salud pública. El ejercicio físico complementado con el tratamiento vibratorio puede que sea considerado como una estrategia efectiva para la prevención y tratamiento de la osteoporosis posmenopáusica. Esta revisión ofrece una visión general de cuestiones significativas relacionadas con la terapia con la plataforma vibratoria para la prevención y tratamiento de la osteoporosis en mujeres postmenopáusicas. El objetivo de esta revisión ha sido conocer los últimos avances de entrenamiento con plataformas vibratorias para la mejoría de la masa ósea en mujeres posmenopáusicas. Existe una gran discrepancia respecto al uso de estas como tratamiento osteoporósico, uso de diferentes tipos de plataformas, distintas frecuencias, amplitud, aceleración o duración del tratamiento. La escasa literatura estableció que la plataforma vibratoria Galileo es la que más se utiliza en dicha población, pero se necesitan más intervenciones para concretar los beneficios y daños de este tratamiento en mujeres postmenopáusicas(AU)

Recent studies have suggested that mechanical stimuli (vibrations) of high frequency and low magnitude can exert a positive effect on bone morphology and benefit quantity and quality. The vibrating platform is a popular machine introduced in the last decade as a new promise against the treatment of osteoporosis. Currently, there are more than 200 million postmenopausal women in the world suffering from osteoporosis. This disease is one of the most common and expensive in public health. Physical exercise supplemented with vibrational treatment may be considered an effective strategy for the prevention and treatment of postmenopausal osteoporosis. This review offers an overview of significant issues related to therapy with the vibration platform for the prevention and treatment of osteoporosis in postmenopausal women. The objective of this review is to know the latest advances in vibratory platforms training for the improvement of bone mass in postmenopausal women. There is a great discrepancy regarding the use of vibratory platforms as osteoporosis treatment, the use of different types of platforms, different frequencies, amplitude, acceleration or duration of treatment. The limited literature established that Galileo vibration platform is the most used in this population, but more interventions are needed to grasp the benefits and harms of this treatment in postmenopausal women(AU)

Las propiedades mecánicas del accionar del cuerpo humano. Su manifestación en las técnicas del aikido / The mechanical properties of the human body actions. Its manifestation in aikido techniques

Los movimientos de las partes del cuerpo humano son desplazamientos en el espacio y el tiempo, que se ejecutan en muchas articulaciones simultánea y consecutivamente. Precisamente el Aikido se caracteriza por provocar la pérdida del equilibrio y el derribo de un oponente mediante el accionar sobre las articulaciones. Atendiendo a esto, se concibe este trabajo dirigido a ofrecer una oportuna explicación sobre el accionar de los diferentes miembros que componen el cuerpo humano y su incidencia en una correcta ejecución técnica en aikido. Cuestiones de gran interés como: las uniones de los miembros, las cadenas cinemáticas, los grados de libertad de los movimientos y las particularidades dinámicas de los movimientos humanos; así como aspectos distintivos del equilibrio, tanto estático como dinámico son tratados en el presente trabajo con adecuada sencillez y precisión.

The parts of the human body movements are movements in space and time, running in many joints simultaneously and consecutively. Aikido is precisely characterized by cause the loss of balance and the demolition of an opponent through the actions applied to the joints. Attending this is conceived this work aimed to offer a timely explanation of the actions of the different members that make up the human body and its impact in a proper technical execution in aikido. Issues of great interest such as: the joints of the limbs, kinematic chains, the degrees of freedom of movement and dynamic peculiarities of the human movements; as well as distinctive balance, both static and dynamic aspects are dealt with in the present work with appropriate simplicity and precision.

Diseño y validación de un cuestionario para el diagnóstico de riesgos psicosociales en empresas ecuatorianas / Design and validation of a questionnaire for the diagnosis of psychosocial risks in Ecuatorian companies

OBJETIVO: presentar el diseño, construcción y validación de un cuestionario para el diagnóstico de riesgos psicosociales en Ecuador, conformado por 58 ítems que evalúan el riesgo psicosocial a través de 8 dimensiones. Diseño: estudio transversal en 2 fases: (i) diseño del marco conceptual y construcción del cuestionario y; (ii) valoración de la validez y consistencia interna aplicado en una muestra de 3.225 trabajadores de empresas ecuatorianas. Resultados: El cuestionario posee una alta fiabilidad en términos de consistencia interna (Alfa de Cronbach = 0,968) y una adecuación satisfactoria de los datos a la matriz factorial (KMO = 0,980; Bartlett = 93818,0, <0,05). Conclusiones: se recomienda el uso de este cuestionario como instrumento para el diagnóstico preliminar, permitiendo el diseño e implementación de futuros programas de prevención de riesgos psicosociales en empresas de más de 10 trabajadores en el país.

Abstract: Objective: to present the design, construction and validation of a questionnaire for the diagnosis of psychosocial risks in Ecuador, consisting of 58 items that assess psychosocial risk through 8 dimen sions. Design: cross-sectional study in 2 phases: (i) design of the conceptual framework and construction of the questionnaire and; (ii) assessment of the validity and internal consistency applied to a sample of 3.225 workers from ecuadorian companies. Results: The questionnaire has a high reliability in terms of internal consistency (Cronbach's alpha = 0,968) and a satisfactory adaptation of the data to the factorial matrix (KMO = 0,980; Bartlett = 93818,0, <0,05). Conclusions: the use of this questionnaire is recommended as an instrument for preliminary diagnosis, allowing the design and imple mentation of future psychosocial risk prevention programs in com panies with more than 10 workers in the country.

Los programas de actividad física para combatir la obesidad y el sobrepeso en adolescentes

La obesidad y el sobrepeso son dos de los problemas de salud más acuciantes en la sociedad actual, y están aumentando hasta niveles preocupantes en los adolescentes. La actividad física es una de las herramientas que se pueden utilizar para mejorar la situación. Diversos países han puesto en marcha programas, en los que la actividad física juega un papel primordial, con el objetivo de reducir el porcentaje de grasa corporal en los jóvenes. En este trabajo se realiza una revisión bibliográfica de los estudios que analizan esos programas.

Obesity and overweight are two of the most pressing health problems in today's society, and those are increasing to worrying levels in adolescents. Physical activity is one of the tools that can be used to improve the situation. Several countries have launched programs in which physical activity plays a key role, with the aim of reducing the percentage of body fat in young people. In this work, a bibliographic review of the studies that analyze these programs is carried out.