Double Myelomeningocele Repair by Fetal Surgery with a Single Micro-Hysterotomy.

INTRODUCTION: Open spina bifida (OSB) is the most common congenital anomaly of the central nervous system. It is associated with severe neurodevelopmental delay, motor impairment, hydrocephalus, and bowel and bladder dysfunction. In selected cases, intrauterine spina bifida repair has been shown to improve neonatal outcomes. Rarely, the spine can have a double defect compromising two different segments and there is a lack of evidence on the feasibility and benefits of intrauterine repair in these cases. CASE PRESENTATION: We present a case with both cervicothoracic and lumbosacral myelomeningocele, Arnold-Chiari malformation type II and bilateral ventriculomegaly, that was treated successfully at 25 weeks with open micro-neurosurgery. Double myelomeningocele was successfully treated through a single 2-cm micro-hysterotomy, by performing external versions to sequentially expose and repair both defects. Weekly postoperative follow-up showed no progression of ventriculomegaly or complications attributable to the procedure. Preterm rupture of membranes prompted a conventional cesarean delivery at 32 weeks of gestation. Neurodevelopmental outcome at 20 months was within normal ranges, having achieved ambulation without orthopedic support and with no need for ventriculoperitoneal shunting. CONCLUSION: This report demonstrates for the first time the feasibility of double OSB repair through a single 2-cm micro-hysterotomy, suggesting that selected isolated cases of double myelomeningocele could be candidates for fetal intervention. Further prospective studies should be carried out to assess the potential benefit of double OSB intrauterine open repair.

Effectiveness of fosfomycin trometamol as oral step-down therapy for bacteraemic urinary tract infections due to MDR Escherichia coli: a post hoc analysis of the FOREST randomized trial.

BACKGROUND: Fosfomycin is a potentially attractive option as step-down therapy for bacteraemic urinary tract infections (BUTI), but available data are scarce. Our objective was to compare the effectiveness and safety of fosfomycin trometamol and other oral drugs as step-down therapy in patients with BUTI due to MDR Escherichia coli (MDR-Ec). METHODS: Participants in the FOREST trial (comparing IV fosfomycin with ceftriaxone or meropenem for BUTI caused by MDR-Ec in 22 Spanish hospitals from June 2014 to December 2018) who were stepped-down to oral fosfomycin (3 g q48h) or other drugs were included. The primary endpoint was clinical and microbiological cure (CMC) 5-7 days after finalization of treatment. A multivariate analysis was performed using logistic regression to estimate the association of oral step-down with fosfomycin with CMC adjusted for confounders. RESULTS: Overall, 61 patients switched to oral fosfomycin trometamol and 47 to other drugs (cefuroxime axetil, 28; amoxicillin/clavulanic acid and trimethoprim/sulfamethoxazole, 7 each; ciprofloxacin, 5) were included. CMC was reached by 48/61 patients (78.7%) treated with fosfomycin trometamol and 38/47 (80.9%) with other drugs (difference, -2.2; 95% CI: -17.5 to 13.1; P = 0.38). Subgroup analyses provided similar results. Relapses occurred in 9/61 (15.0%) and 2/47 (4.3%) of patients, respectively (P = 0.03). The adjusted OR for CMC was 1.11 (95% CI: 0.42-3.29, P = 0.75). No relevant differences in adverse events were seen. CONCLUSIONS: Fosfomycin trometamol might be a reasonable option as step-down therapy in patients with BUTI due to MDR-Ec but the higher rate of relapses would need further assessment.

Traditional and cyber dating violence among adolescents: Profiles, prevalence, and short-term associations with peer violence.

There is a paucity of studies on dating violence profiles that incorporate the forms of cyber and sexual dating violence. Moreover, the results on the predictive role of peer violence on dating violence are inconsistent. Our aim was to identify dating violence profiles and to study the predictive value of peer violence profiles on dating violence profiles using a short-term longitudinal design. The sample consisted of 498 adolescents with current or past romantic relationship (42.8% boys), aged 12-18 years (M = 14.22; SD = 1.39). Four dating violence profiles were identified with an overlap between traditional and cyberdating violence. Peer violence profiles were associated with dating violence profiles 4 months later. The results suggest the need to prevent all forms of dating violence at an early age, starting with the improvement of interpersonal relationships between peers.

Management of Late Twin-to-Twin Transfusion Syndrome beyond 26 Weeks: Comparison between Fetoscopic Laser Therapy versus Traditional Management.

INTRODUCTION: A proportion of monochorionic diamniotic (MCDA) twin pregnancies complicated by twin-to-twin transfusion syndrome (TTTS) can present after 26 weeks of gestation. The aim of this study was to compare perinatal outcomes of late TTTS treated by fetoscopic laser coagulation versus traditional management with amniodrainage and/or emergency preterm cesarean delivery (CD). METHODS: Retrospective cohort from January 2012 to January 2023 of consecutive MCDA twin pregnancies complicated by TTTS after 26 weeks and evaluated in our referring centers. We analyzed perinatal outcomes of cases treated with fetoscopic laser surgery at our national referral fetal surgery center in Queretaro, Mexico, and compared them with those managed with traditional management (amniodrainage and/or emergency preterm CD). The primary outcome was survival at discharge and the secondary outcome was gestational age (GA) at birth. RESULTS: Among the study population, 46 TTTS cases were treated by fetoscopy at 27+6 (26+0-31+0) weeks+days and were compared with a group of 39 cases who underwent emergency preterm CD. In comparison to the group who underwent traditional management, the group treated by laser fetoscopy showed a significantly higher GA at birth (32+3 vs. 29+1 weeks+days, p < 0.001), lower frequency of preterm delivery below 37 weeks (91.3% vs. 100%, p = 0.06), 34 weeks (63.0% vs. 100%, p < 0.001), 32 weeks (50% vs. 74.4%, p = 0.02), or 30 weeks (28.3% vs. 53.8%, p = 0.01), and significantly higher perinatal survival (89.1% vs. 71.8%, p < 0.05 of at least one twin; and 65.2% vs. 38.5%, p = 0.01 of both twins, respectively). CONCLUSION: MCDA twins complicated with TTTS can be treated with fetoscopic laser surgery between 26 and 31 weeks of gestation, which is a feasible and safe option, and such cases are associated with a higher GA at birth and better perinatal survival than those managed with amniodrainage and/or emergency preterm CD.

The role of mindfulness in associations among depression symptoms, sleep duration, and insulin resistance in adolescents.

Sleep difficulties may be one explanatory factor in the association between depression and insulin resistance; yet, explicit tests of this hypothesis are lacking. We determined if there was an indirect effect of depression symptoms on insulin resistance through sleep duration in adolescents at risk for excess weight gain. We also investigated whether dispositional mindfulness moderated the interconnections among depression, sleep, and insulin resistance. Ninety adolescents (14.2 ± 1.6y; 50% female) at risk for excess weight gain (body mass index [BMI, kg/m2] z score 1.6 ± 0.6) participated in the cross-sectional, baseline phase of a health behaviors study. Depression was assessed with the Center for Epidemiologic Studies-Depression Scale, sleep duration with the Sleep Habits Survey, and mindfulness with the Mindful Attention and Awareness Scale. Homeostatic model assessment of insulin resistance was determined from fasting insulin and glucose. The product-of-coefficients method was used to test the indirect effect of depression on insulin resistance through sleep duration, accounting for age, sex, BMIz, puberty, and socioeconomic status (SES). Dispositional mindfulness was tested as a moderator of the associations among depression, sleep, and insulin resistance. There was a significant indirect effect of depression on insulin resistance through sleep duration, controlling for age, sex, BMIz, puberty, and SES, 95%CI [0.001, 0.05]. Dispositional mindfulness moderated the association between sleep duration and insulin resistance, such that lower sleep duration related to greater insulin resistance only among adolescents with lower mindfulness (p < .001). Short sleep may be one explanatory factor in the depression-insulin resistance connection in adolescents at risk for excess weight gain. Adolescents with poorer mindfulness and short sleep are at highest risk for insulin resistance, whereas higher mindfulness may be protective.

Associations of adverse childhood experiences with stress physiology and insulin resistance in adolescents at risk for adult obesity.

Adverse childhood experiences (ACEs) heighten the risk for adult obesity and cardiometabolic disease, but physiological factors underlying this connection are not well understood. We determined if ACEs were associated with physiological stress response and insulin resistance in adolescents at risk for adult obesity. Participants were 90 adolescents 12.0-17.5 years (50% female, 30% Hispanic/Latinx), at risk for adult obesity by virtue of above-average body mass index (BMI; kg/m2 ≥ 70th percentile) or parental obesity (BMI ≥ 30 kg/m2 ). ACEs were determined as presence (vs. absence) based upon the Schedule for Affective Disorders and Schizophrenia for School-Aged Children. Physiological stress response was measured as heart rate/blood pressure response to the Trier Social Stress Test. Homeostatic model assessment of insulin resistance was determined from fasting glucose/insulin. Sixty-one percent of adolescents reported positive ACE history. The presence of ACEs predicted greater heart rate (p < .001) and diastolic blood pressure (p = .02) response to stress, controlling for age, sex, race/ethnicity, puberty, and BMI standard score. Systolic blood pressure and insulin resistance did not differ by ACE history (p-values > .08). Findings suggest heightened sympathetic stress response in adolescence could be explanatory in how ACEs increase the risk for later cardiometabolic disease. Future studies should characterize ACEs in relationship to day-to-day variations in adolescents' stress physiology and glucose homeostasis.

Can Virtual Reality be Used for the Prevention of Peer Sexual Harassment in Adolescence? First Evaluation of the Virtual-PRO Program.

Objective: The present study analyzed the Virtual-PRO program's efficacy in preventing peer sexual harassment by promoting the bystanders' active intervention and incorporating a virtual reality (VR) component. The impact of the program on sexist attitudes, moral disengagement, the intention to intervene as bystanders, and the involvement in sexual aggression and victimization was tested. Method: Virtual-PRO is a VR-enhanced sexual harassment curricular prevention program of six one-hour sessions. The evaluation comprised a pre-test, a post-test after the intervention, and a follow-up measure at three months. In the study, 579 Spanish adolescent students aged between 12 and 17 years (M = 14.76, SD = 0.88; 47.1% boys) were randomly grouped into experimental (n = 286) and control (n = 293) conditions. Results: The Virtual-PRO program effectively controlled participants' levels of sexism and reduced moral disengagement in the experimental group compared to the control group three months after the intervention. The program also showed positive results in changing bystander behavior, increasing the intention to intervene when the victim was not a friend. Finally, visual/verbal and online victimization decreased in the experimental group and increased in the control group. No differences were found for physical sexual victimization and sexual aggression. Conclusions: The first trial of the Virtual-PRO program is promising and highlights the use of VR as a sexual harassment prevention tool. Follow-up measures are essential to determine the impact of interventions accurately.

Objetivo: El presente estudio analiza la eficacia del programa Virtual-PRO en la prevención del acoso sexual entre iguales promoviendo la intervención activa de los espectadores mediante el uso de la realidad virtual (RV). Se comprobó el impacto del programa en las actitudes sexistas, la desconexión moral, la intención de intervenir como espectadores y la implicación en agresión y victimización sexual. Método: Virtual-PRO es un programa curricular compuesto por seis unidades que incorpora la RV para mejorar la prevención del acoso sexual. La evaluación incluyó una medida pre-test, un post-test después de la intervención y una medida de seguimiento a los tres meses. En el estudio participaron 579 estudiantes españoles de entre 12 y 17 años (M = 14.76, DT = 0.88, 47.1% chicos), agrupados aleatoriamente en grupo experimental (n = 286) y control (n = 293). Resultados: El programa Virtual-PRO controló eficazmente los niveles de sexismo y redujo la desconexión moral en el grupo experimental en comparación con el grupo de control tres meses después de la intervención. También mostró resultados positivos en el cambio del comportamiento de los espectadores, mejorando la intención de intervenir cuando la víctima no era amigo o amiga. Por último, la victimización visual/verbal y online disminuyó en el grupo experimental y aumentó en el grupo control. No se encontraron diferencias en victimización sexual física y agresión sexual. Conclusiones: El primer ensayo del programa Virtual-PRO es prometedor y pone de relieve el uso de la RV como herramienta eficaz para la prevención del acoso sexual. Las medidas de seguimiento son esenciales para determinar con precisión el efecto de las intervenciones.

Universal prenatal screening: a initiative from Guanajuato, Mexico to improve equity in perinatal healthcare.

The prenatal approach from a preventive perspective is necessary to reduce perinatal complications. A perinatal care model with a holistic and horizontal approach is required. Mexico is currently considered an emerging market economy with inequality and an economic gap that impacts the accessibility and distribution of healthcare services. Guanajuato is one of the 32 states of Mexico and represents 1.6% of the country's surface. Strategies during the prenatal approach allow prediction, diagnosis, and anticipation of the principal causes of morbidity and mortality. Combining data from maternal characteristics and history with findings of biophysical and biochemical tests at 11 to 13 weeks of gestation can define the patient-specific risk for a large spectrum of complications that include miscarriage and fetal death, preterm delivery, preeclampsia, congenital disorders, and fetal growth abnormalities. We aim to describe the care model designed and implemented in the State Center for Timely Prenatal Screening of the Maternal and Child Hospital of Leon, Guanajuato, Mexico. Previous research showed there is a lack of information for low and middle-income countries regarding how to integrate prenatal screening strategies in the absence of resources to perform cell-free fetal DNA or biochemical serum markers in countries with emergent economies. This care model is carried out through horizontal processes where the screening is provided by trained and certified general practitioners who identify the population at risk in a timely manner for specialized care, and could help guide other Mexican states, and other countries with emergent economies with limited financial, professional, and infrastructural resources to improve prenatal care with a sense of equity, equality, and social inclusion as well as the timely evaluation of specialized perinatal care of high-risk patients.

Monitoring physicochemical modifications in beef steaks during dry salting using contact and non-contact ultrasonic techniques.

In conventional ultrasonic techniques, the necessary contact between the sensor and the product has constrained the implementation of ultrasound for quality control purposes in the meat industry. The use of novel air-coupled ultrasonic technologies provides multiple advantages linked to contactless inspection. Therefore, this study aims to compare the feasibility of contact (C; 1 MHz) and non-contact (NC; 0.3 MHz) ultrasonic techniques for monitoring the physicochemical modifications undergone by beef steaks during dry salting after different times (0, 1, 4, 8 and 24 hours). Experimental results showed that the ultrasonic velocity increased during salting, which was linked to the reduction in Time-of-Flight ratio (RTOF) and sample shrinkage (velocity C: R2 = 0.99; velocity NC: R2 = 0.93 and RTOF C: R2 = 0.98; RTOF NC: R2 = 0.95). In terms of the compositional changes provoked by salting, the velocity variation (△V) increased linearly (C: R2 = 0.97; NC: R2 = 0.95) with the salt content. As for textural parameters, hardness (C: R2 = 0.99; NC: R2 = 0.97) and relaxation capacity (C: R2 = 0.96; NC: R2 = 0.94) were well correlated with the △V through power equations. Experimental results reflected that the performance of the non-contact ultrasonic technique was similar to that of the contact technique as regards the monitoring of the physicochemical changes undergone by beef steaks during dry salting.

Cyber Dating Violence Instrument for Teens (CyDAV-T): Dimensional Structure and Relative Item Discrimination

BACKGROUND: Validated measures of cyber dating violence are scarce and have barely explored the sexual dimension. The present study advanced this line of research by developing a new instrument that differentiates between sexual, verbal and control dimensions. METHOD: The instrument was created in four phases: literature review, focus groups with young people, expert review, and creation of the final scale. This instrument was administered to 600 students from high schools in Seville and Córdoba, aged between 14 and 18 ( M = 15.54; SD = 1.22). RESULTS: A three-factor latent structure was confirmed for the aggression and victimization scales: verbal/emotional, control, and sexual. Using Item Response Theory, a refined version of the scales resulted in 19 items for both aggression and victimisation. Prevalence analysis showed that verbal/emotional forms were the most frequent, followed by control and sexual. CONCLUSIONS: The CyDAV-T instrument can be considered a valid instrument for assessing cyber dating violence in the adolescent population.

Analysis of the Structural Validity of the Reduced Version of Metacognitive Awareness of Reading Strategies Inventory.

The application of metacognitive strategies is considered a basic skill of the student at any educational level. In the present study, we evaluate the reduced version of the Metacognitive Awareness of Reading Strategies Inventory (MARSI-R) in Spanish, a self-report instrument designed to measure the metacognitive awareness of students and their perception of the strategies that they use while they are reading school materials. MARSI-R is formed by three subscales: (a) global reading strategies (GRS), (b) problem-solving strategies, and (c) strategies to support reading. We conducted a confirmatory factor analysis (CFA) in a Spanish student sample (N = 570) and the results shown relative inadequate fit for the proposed theoretical three-factor model. More important, the three subscales presented a high level of inter-correlation, which raises the need to assess to what extent the construct should be considered as unidimensional. We conducted two additional CFA models: a unidimensional model and a bifactor S-1 model, and the results indicated the presence of a strong general factor related to the GRS subscale. These results have important implications, since they imply that it is more appropriate to use the total score of the instrument derived of the S-1 model instead of the scores derived from each subscale. The bifactor S-1 model has allowed us to develop a closer approximation between the psychometric model and the theoretical model.

Is This WhatsApp Conversation Aggressive? Adolescents' Perception of Cyber Dating Aggression.

This study investigated adolescents' understanding of cyber dating aggression in terms of frequency and aggressiveness: how prevalent they perceived cyber dating aggression among adolescents and how aggressive they perceived such behaviors to be. To do so, different WhatsApp scenarios were presented to adolescents, controlling for the typology of cyber dating aggression (verbal/emotional, controlling, or sexual) and its publicity (public or private cyber dating aggression). The moderating effect of gender and moral disengagement (MD) was also analyzed. A total of 262 adolescents (56.5% girls; mean age of 14.46 years) participated in the study and answered a computer-based questionnaire. General linear models revealed that adolescents consider cyber dating aggression to be present in most adolescent romantic relationships. Controlling online behavior was perceived as the most frequent and the least aggressive behavior. Adolescents rated private cyber aggression as more frequent and less aggressive than public cyber aggressions. Controlling for gender, girls reported that cyber dating aggression was more common and more severe than boys. Moreover, participants with high levels of MD perceived cyber dating aggressions to be less aggressive than participants with medium-low MD. This study reveals the significance of the type of cyber dating aggression, the public/private dimension, gender, and MD as variables that influence adolescent understanding of cyber dating aggression. These results have implications not only for the design of cyber dating aggression prevention programs but also for future research on cyber dating aggression.

Violence among adolescents: A study of overlapping of bullying, cyberbullying, sexual harassment, dating violence and cyberdating violence.

BACKGROUND: Face-to-face and virtual violence among adolescents could lead to polyvictimisation and polyaggression. More studies are needed to simultaneously analyse various types of violence to understand the extent of involvement in violence during adolescence. OBJECTIVE: This study explores the overlap of bullying, cyberbullying, sexual harassment, dating violence, and cyber dating violence, considering dating experience, gender, and stage of adolescence. PARTICIPANTS AND SETTING: This study involved 2514 Spanish middle school students (49.8 % girls) aged 11-19 years (M = 13.97, SD = 1.40). METHODS: The design of this study was cross-sectional. Data were collected through a survey. RESULTS: Among adolescents with no dating experience, 39.7 % were not victims, and 55.9 % were not aggressors. By contrast, among adolescents with dating experience, 7.1 % were not victims, and 10.5 % were not aggressors. Gender differences in poly-involvement were found between adolescents with and without dating experience. Girls were significantly less involved than boys as polyvictims and polyaggressors when they had no dating experience. They were significantly more involved than boys as polyvictims (9.7 %) and polyaggressors (23.9 %) in dating violence and cyber dating violence when they had dating experience. Age differences in poly-involvement were found only in adolescents with dating experience. Adolescents were more polyinvolved late than early adolescence, especially in dating violence, sexual harassment, and cyber dating violence as polyvictims (22.8 %) and polyaggressors (26.7 %). CONCLUSIONS: Experiences of poly-involvement are diverse according to dating experience, gender, and stage of adolescence. More comprehensive peer and dating violence prevention strategies need to be designed.

Assessment of Textural Properties of Puffed Corn Cakes during Storage at Different Relative Humidity.

Moisture adsorption is considered a critical factor during production and shelf-life of puffed corn cakes (PCC). This study aims to develop and validate an instrumental method and a mathematical model for the characterization of the textural modifications caused by the moisture adsorption in PCC. For that purpose, PCC were stored at different relative humidities to achieve a wide range of water activities (from 0.1 to 0.8 at 22 ± 1 °C). A flexion-compression test was successfully validated in order to characterize the average textural properties of a PCC batch. A mathematical model considering consecutive elastic and plastic zones satisfactorily fitted (average VAR 99.65% and MRE 3.29%) the average stress-strain profiles of PCC and reported useful textural parameters, such as the deformability modulus (E), critical strain (εc), and n curvature parameter. The structural modifications caused by moisture adsorption led to the reduction in E and n and the increase in εc. Even minor changes on the PCC moisture content involve remarkable modifications of the textural properties, which has to be considered for industry and retail distribution.

Analysis of the Effects of Melanin Depigmentation on Immunohistochemical Staining.

Heavily pigmented lesions are difficult to evaluate histologically, as melanin obscures cellular details. Several classic laboratory techniques aim to clear melanin and allow evaluation. Most of them are old and appeared before immunohistochemistry (IHC) use. Many laboratories perform IHC with aminoethylcarbazole instead of diaminobenzidine (DAB) in heavily pigmented lesions, as red-stained is easy to interpret despite pigmentation. Nevertheless, many laboratories lack alternatives to DAB. The aim of this study is to compare 6 different tissue bleaching techniques and evaluate which is the best for immunohistochemical staining with DAB. In the present study we have selected a case with gross pigmentation because of the high grade of melanin deposition. We have performed 6 different bleaching techniques and subsequently performed 2 different IHC stains, frequently used in melanoma: SOX10 (nuclear) and Melan-A (cytoplasmic). Five different pathologists, 2 of them with expertise in dermatopathology, have blindly reviewed and scored the staining quality. Our results indicate a high grade of interobserver concordance in the evaluation of IHC results between pathologists. All the bleaching techniques that included a sulfuric acid led to tissue detachment from the slide. The best method for SOX10 was that based in potassium permanganate, with a high quality of staining (4 over 5), while the best method for Melan-A was the 1 based in peroxide hydrogen (4 over 5). We consider this study can be quite useful for those laboratories lacking aminoethylcarbazole for IHC techniques, allowing the use of DAB for IHC of heavily pigmented lesions.

Identification of Facilitators and Barriers of Healthy Living and Type 2 Diabetes Prevention Among Latinx Families.

Youth-onset type 2 diabetes (T2D) is on the rise and may be associated with more adverse health outcomes than adult onset. Latinx adolescents are disproportionately at risk for T2D yet are underrepresented in prevention efforts. Extant interventions to prevent T2D in Latinx adolescents show limited effectiveness. Comprehensive understanding of Latinx adolescent/family needs is lacking, but necessary for cultural tailoring of T2D prevention. Researchers conducted focus groups with 32 Latinx adolescents (age 10-18 years) from Northern Colorado and 31 Spanish-speaking parents/caregivers, with 2.5-hr semistructured youth-specific and parent-specific discussions, respectively. No participants included in this study had T2D. Qualitative data were analyzed for emergent themes about barriers/facilitators of healthy living and T2D prevention preferences. Thematic content analysis yielded eight themes within three categories: barriers to healthy living, facilitators of healthy living, and program preferences. Barriers to healthy living included individual motivational factors/food preferences; financial cost and time demands of healthy eating/exercise; negative emotions; and external/relational factors such as parent feeding pressure and peer pressure/bullying. Facilitators of healthy living included individual motivational factors/enjoyment of healthy living and supportive family structure. Program preferences were for family-based programming with adolescent breakout sessions and for facilitation by culturally competent facilitators. T2D is recognized as a serious health concern among Latinx families. There is a need for culturally tailored prevention programming that, in order to be acceptable, should address cultural and socioeconomic considerations, provide coping skills for adolescent-specific psychosocial stressors, and utilize a family-based programming framework with adolescent breakout sessions and culturally competent facilitators.

La diabetes tipo 2 (DT2) que comienza en la juventud está en aumento y esta asociada con peores resultados en comparación con los de la edad adulta. Los adolescentes Latinx tienen un riesgo desproporcionado de DT2 sin embargo, no están representados en los esfuerzos de prevención. Las intervenciones existentes muestran una eficacia limitada. La comprensión sobre las necesidades de los adolescentes y las familias Latinx son escasas, pero son necesarias para prevenir DT2. Se realizaron grupos de enfoque con 32 adolescentes Latinx (de 10 a 18 añ3os) del Norte de Colorado y 31 padres de habla hispana, con sesiones de 2.5 horas para jóvenes y para padres. Ningún participante en este estudio tenía DT2. Se analizaron datos cualitativos que identificaron barreras/facilitadores para una vida sana y preferencias de programas para prevenir DT2. Las barreras incluyeron factores individuales; el costo y el tiempo para tener alimentación/ejercicio sano; emociones negativas; y factores externos como la presión de los padres/compañeros. Los facilitadores incluyeron factores individuales/disfrute de la salud y el apoyo familiar. Las preferencias fueron basada en la familia, con grupos de adolescentes y con facilitadores culturalmente competentes. La DT2 es un grave problema entre las familias Latinx. Se necesitan programas de prevención que consideren la cultura y factores socioeconómicos. También se deben proporcionar habilidades de afrontamiento de los estresores psicosociales para adolescentes, a través de facilitadores culturalmente competentes y utilizar programación basada en la familia, con actividades culturales para adolescentes.

Intrauterine transfusion of a hydropic fetus with anemia due to a giant chorioangioma: A case report.

Giant chorioangiomas are a potentially life-threatening condition that may require intrauterine therapy. We describe a case of a large chorioangioma (>4cm) diagnosed at 30 weeks of gestation causing severe fetal anemia and hydrops. An intrauterine blood transfusion was performed at 31 weeks with reversal of the anemia and hydrops. The neonate was born at 37 weeks showing respiratory distress syndrome that required neonatal intensive care unit admission but was discharged at 30 days of life. Further evaluation at two months of age showed no signs of abnormal neurodevelopment. When timely indicated, intrauterine transfusion of a hydropic fetus with anemia due to a giant chorioangioma is a potentially life-saving therapy that shows good neurodevelopment of the surviving fetus.

Maternal Death by COVID-19 Associated with Elevated Troponin T Levels.

Cardiomyocyte injury and troponin T elevation has been reported within COVID-19 patients and are associated with a worse prognosis. Limited data report this association among COVID-19 pregnant patients. OBJECTIVE: We aimed to analyze the association between troponin T levels in severe COVID-19 pregnant women and risk of viral sepsis, intensive care unit (ICU) admission, or maternal death. METHODS: We performed a prospective cohort of all obstetrics emergency admissions from a Mexican National Institute. All pregnant women diagnosed by reverse transcription-polymerase chain reaction (RT-qPCR) for SARS-CoV-2 infection between October 2020 and May 2021 were included. Clinical data were collected, and routine blood samples were obtained at hospital admission. Seric troponin T was measured at admission. RESULTS: From 87 included patients, 31 (35.63%) had severe COVID-19 pneumonia, and 6 (6.89%) maternal deaths. ROC showed a significant relationship between troponin T and maternal death (AUC 0.979, CI 0.500-1.000). At a cutoff point of 7 ng/mL the detection rate for severe pneumonia was 83.3% (95%CI: 0.500-0.100) at 10% false-positive rate. CONCLUSION: COVID-19 pregnant women with elevated levels of troponin T present a higher risk of death and severe pneumonia.

The impact of the COVID-19 pandemic on depression and stress levels in pregnant women: a national survey during the COVID-19 pandemic in Mexico.

BACKGROUND: COVID-19 outbreak has been associated with a wide variety of psychiatric manifestations such as panic, anxiety, and depression. We aim to assess the impact of the COVID - 19 pandemic on the levels of stress and depression of pregnant women in Mexico. METHODS: A cross-sectional web survey was carried out in pregnant women in 10 states of the Mexican Republic during the COVID-19 pandemic among public and private hospitals. The perception of stress was assessed using the Perceived Stress Scale, while depressive symptoms were evaluated using the Edinburgh Postnatal Depression Scale. RESULTS: A total of 549 surveys were applied, of which 96.1% (n = 503) were included in the data analysis. The mean participant's age was 28.1 years old. The mean perceived stress scale score was 24. 33.2% (n = 167) of participants had a score equal to 27 points or more and were considered highly stressed. The mean depression score was 9. A total of 17.5% (n = 88) participants had more than 14 points on the Edinburgh's depression scale, and were considered depressed. Stress levels were higher at later gestational ages (p = .008). CONCLUSIONS: COVID-19 pandemic has caused mental health issues in pregnant women reflected by high perceived stress levels and depression.

Evaluating reading and metacognitive deficits in children and adolescents with attention deficit hyperactivity disorder.

The reading achievement of children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) has scarcely been explored in research conducted in the Spanish language and when it has, the results have been contradictory. The focus of the present research is to analyze participants' reading competency and metacognitive strategies as they carry out reading comprehension tasks. The sample was comprised of 187 Argentine schoolchildren aged 9 to 13 years old. 94 constituted the control group and the clinical group consisted of 93 schoolchildren diagnosed with ADHD. The metacognitive assessment was made up of two metacognitive tests, the Reading Awareness Scale (ESCOLA; acronym in Spanish) and a Spanish adaptation of Metacognitive Awareness of Reading Strategies Inventory (MARSI), and one test of reading comprehension, the Evaluation of Reading Processes for Secondary Education Students (PROLEC-SE; acronym in Spanish). Students with ADHD had lower achievement on tests o reading comprehension compared to the control group. Nevertheless, our results suggest their difficulties did not stem from readin comprehension problems, but rather from alterations in their Executive Functions, because when subjects' reading comprehensio was equalized, students with ADHD still exhibited a lower level of Metacognition, particularly when it came to planning.