Underlying and proximate drivers of biodiversity changes in Mesoamerican biosphere reserves.

Protected areas are of paramount relevance to conserving wildlife and ecosystem contributions to people. Yet, their conservation success is increasingly threatened by human activities including habitat loss, climate change, pollution, and species overexploitation. Thus, understanding the underlying and proximate drivers of anthropogenic threats is urgently needed to improve protected areas' effectiveness, especially in the biodiversity-rich tropics. We addressed this issue by analyzing expert-provided data on long-term biodiversity change (last three decades) over 14 biosphere reserves from the Mesoamerican Biodiversity Hotspot. Using multivariate analyses and structural equation modeling, we tested the influence of major socioeconomic drivers (demographic, economic, and political factors), spatial indicators of human activities (agriculture expansion and road extension), and forest landscape modifications (forest loss and isolation) as drivers of biodiversity change. We uncovered a significant proliferation of disturbance-tolerant guilds and the loss or decline of disturbance-sensitive guilds within reserves causing a "winner and loser" species replacement over time. Guild change was directly related to forest spatial changes promoted by the expansion of agriculture and roads within reserves. High human population density and low nonfarming occupation were identified as the main underlying drivers of biodiversity change. Our findings suggest that to mitigate anthropogenic threats to biodiversity within biosphere reserves, fostering human population well-being via sustainable, nonfarming livelihood opportunities around reserves is imperative.

Mutation of AtPME2, a pH-Dependent Pectin Methylesterase, Affects Cell Wall Structure and Hypocotyl Elongation.

Pectin methylesterases (PMEs) modify homogalacturonan's chemistry and play a key role in regulating primary cell wall mechanical properties. Here, we report on Arabidopsis AtPME2, which we found to be highly expressed during lateral root emergence and dark-grown hypocotyl elongation. We showed that dark-grown hypocotyl elongation was reduced in knock-out mutant lines as compared to the control. The latter was related to the decreased total PME activity as well as increased stiffness of the cell wall in the apical part of the hypocotyl. To relate phenotypic analyses to the biochemical specificity of the enzyme, we produced the mature active enzyme using heterologous expression in Pichia pastoris and characterized it through the use of a generic plant PME antiserum. AtPME2 is more active at neutral compared to acidic pH, on pectins with a degree of 55-70% methylesterification. We further showed that the mode of action of AtPME2 can vary according to pH, from high processivity (at pH8) to low processivity (at pH5), and relate these observations to the differences in electrostatic potential of the protein. Our study brings insights into how the pH-dependent regulation by PME activity could affect the pectin structure and associated cell wall mechanical properties.

Chronic disease prevalence in a population with structural hemoglobin disorders undergoing diabetes diagnosis: A bayesian approach.

Background: Structural disorders of hemoglobin are a group of rare and fatal genetic diseases that disrupt the transport and exchange of oxygen in the blood, causing tissue damage and ultimately leading to chronic conditions. The hemoglobin (Hb) S variant predominantly impacts individuals of Afro-descendant heritage. A significant concentration of the Afro-descendant population in Colombia, notably 12.5 %, is found in the city of Cali. Previous research has identified this city's structural hemoglobin disorders prevalence rate of 3.78 %. The aim of this study was to determine the prevalence of HbC, HbS, HbF, and HbA2 variants within a population who underwent HbA1c testing, as well as the prevalence of chronic diseases among patients with these hemoglobin alterations, at a high-complexity hospital in the city of Cali from 2015 to 2019. Methods: A descriptive observational study was conducted, involving a study population that comprised patients with both suspected and monitored diagnoses of diabetes. The cohort was selected from a high-complexity hospital in Cali. A total of 15,608 patients were included in the analysis, all of whom underwent HbA1C measurement through capillary electrophoresis, which also offers an indirect diagnosis of certain structural disorders of hemoglobin. Bayesian methods were employed for frequency analysis. Results: Among the 15,608 patients assessed, 63.6 % (n = 9920) were women. The overall prevalence of structural hemoglobin disorders was 1.98 % (n = 287, 95 % CI = 1.77 %-2.21 %). The co-occurrence of diabetes and kidney disease emerged as the most prevalent combination of pathologies observed in individuals with HbC, for both men and women across various age groups: 18-42 (58.3 % and 50.0 % respectively), 43-55 (50.0 % for both), 56-65 (50.0 % and 37.5 % respectively), and >65 years (66.7 % and 57.1 % respectively). Conclusions: The observed prevalence of the studied variants exceeded 1 %, a threshold underscored by the World Health Organization (WHO) as epidemiologically significant. Among HbC and HbS-positive patients, the elevated prevalence of diabetes and kidney disease is a guiding factor in developing proactive prevention strategies.

Variables académicas y de calidad de vida en estudiantes universitarios mexicanos / Academic and quality of life variables in mexican university students

Resumen. Objetivo. Analizar el efecto de las expectativas y metas de progreso académicas en las dimensiones de la calidad de vida de estudiantes universitarios mexicanos. Método. El tipo de investigación es cuantitativa con un diseño transversal, abierto, observacional con alcances descriptivos y predictivos. Las técnicas estadísticas utilizadas fueron estadística descriptiva, coeficiente de correlación y análisis de senderos con el método GLS. El muestreo fue no probabilístico por conveniencia, con un total de 465 participantes. Resultados. Se demostró que, para el modelo explicativo resultante, la variable metas de progreso académicas es un predictor directo de la dimensión función física. Asimismo, las expectativas académicas de resultado son un predictor de las dimensiones rol emocional y la función física. Respecto a los componentes de la salud física y mental, este último presentó la puntuación más baja.

Abstract. Objective. To analyze the effect of expectations and goals of academic progress on the dimensions of the quality of life of Mexican university students. Method. The research was quantitative with a cross-sectional, open, observational design with descriptive and predictive scopes. The statistical techniques used were descriptive statistics, correlation coefficient and path analysis with the GLS method. Sampling was non-probabilistic for convenience, with a total of 465 participants. Results. For the resulting explanatory model the variable academic progress goals is a direct predictor of the physical function dimension. And academic expectations of outcome are a predictor of the emotional role and physical function dimensions.

Intrahepatic cholestasis due to Treponema pallidum in an immunocompetent patient / Colestasis intrahepática por Treponema pallidum en paciente inmunocompetente

Hepatitis due to Treponema pallidum is a rare entity and its diagnosis represents a clinical challenge. Treponema pallidum should be considered as a presumptive etiology in all patients with acute liver disease, when other frequent causes have been ruled out. We present the case of a young, immunocompetent patient with elevated values in his liver tests, a cholestatic pattern, and maculopapular lesions on his palms and soles. Given his clinical picture, diagnostic tests, and response to the antimicrobial therapy, a diagnosis of cholestasis due to secondary syphilis has been established. It is important to include secondary syphilis within the possible causes of acute liver disease.

La hepatitis por Treponema pallidum es una entidad poco frecuente y su diagnóstico representa un reto clínico. Treponema pallidum debe considerarse como etiología presuntiva en todo paciente con enfermedad hepática aguda, en el cual se hayan descartado otras causas más frecuentes. Se presenta el caso de un paciente joven,  inmunocompetente, quien presentó elevación de los valores de las pruebas hepáticas con patrón colestásico y lesiones maculopapulares en palmas y plantas. Dado su cuadro clínico, las pruebas diagnósticas y la respuesta a la terapia antimicrobiana instaurada, se estableció el diagnóstico de colestasis por una sífilis secundario sifilítiao. Es importante incluir la sífilis secundaria entre las posibles causas de enfermedad hepática aguda.

Colestasis intrahepática por Treponema pallidum en paciente inmunocompetente / Intrahepatic cholestasis due to Treponema pallidum in an immunocompetent patient

La hepatitis por Treponema pallidum es una entidad poco frecuente y su diagnóstico representa un reto clínico. Treponema pallidum debe considerarse como etiología presuntiva en todo paciente con enfermedad hepática aguda, en el cual se hayan descartado otras causas más frecuentes. Se presenta el caso de un paciente joven, inmunocompetente, quien presentó elevación de los valores de las pruebas hepáticas con patrón colestásico y lesiones maculopapulares en palmas y plantas. Dado su cuadro clínico, las pruebas diagnósticas y la respuesta a la terapia antimicrobiana instaurada, se estableció el diagnóstico de colestasis por una sífilis secundario sifilítiao. Es importante incluir la sífilis secundaria entre las posibles causas de enfermedad hepática aguda.

Hepatitis due to Treponema pallidum is a rare entity and its diagnosis represents a clinical challenge. Treponema pallidum should be considered as a presumptive etiology in all patients with acute liver disease, when other frequent causes have been ruled out. We present the case of a young, immunocompetent patient with elevated values in his liver tests, a cholestatic pattern, and maculopapular lesions on his palms and soles. Given his clinical picture, diagnostic tests, and response to the antimicrobial therapy, a diagnosis of cholestasis due to secondary syphilis has been established. It is important to include secondary syphilis within the possible causes of acute liver disease.

Effect of manipulating the vergence/accommodation and image size mismatches of the ±2D flipper test on the frequency and precision of accommodative facility.

PURPOSE: The ±2.00 D accommodative facility test presents several limitations, including the lack of objective information and inherent characteristics such as vergence/accommodative conflict, change in apparent size of the image, subjective criteria for judging blur and motor reaction time. By using free-space viewing conditions and an open-field autorefractor to monitor the refractive state, we examined the impact of manipulating these factors on the qualitative and quantitative assessment of accommodative facility. METHODS: Twenty-five healthy young adults (24.5 ± 4.5 years) took part in this study. Participants performed three accommodative facility tests (adapted flipper, 4D free-space viewing and 2.5D free-space viewing) under both monocular and binocular conditions in random order. A binocular open-field autorefractor was used to assess the accommodative response continuously, and these data were used to characterise accommodative facility quantitatively and qualitatively. RESULTS: There were statistically significant differences between the three testing methods both quantitatively (p < 0.001) and qualitatively (p = 0.02). For the same accommodative demand, a lower number of cycles was obtained for the adapted flipper condition in comparison with the 4D free-space viewing test (corrected p-value < 0.001, Cohen's d = 0.78). However, this comparison did not reach statistical significance for qualitative measures of accommodative facility (corrected p-value = 0.82, Cohen's d 0.05). CONCLUSIONS: These data provide evidence that the qualitative assessment of accommodative facility is not influenced by the inherent limitations of the ±2.00 D flipper test. The use of qualitative outcomes by incorporating an open-field autorefractor allows examiners to increase the validity of the accommodative facility test in both clinical and research settings.

Modelo explicativo del autocuidado, la regulación emocional y el burnout en psicólogas en condición de aislamiento por COVID-19 / Explanatory model of self-care, emotional regulation and burnout in psychologists in isolation due to COVID-19

Resumen Los efectos negativos en la salud mental de la población mundial derivados de la pandemia por coronavirus 2019 (COVID-19) han incrementado la demanda de los servicios de atención psicológica. Por ello resulta importante estudiar también el bienestar emocional de este grupo de profesionales. El objetivo de este estudio fue analizar los procesos de autorregulación emocional y autocuidado como factores protectores frente a la presencia del burnout en un grupo de psicólogas mexicanas. Para esto, se utilizó un diseño cuantitativo transversal con alcance explicativo, en una muestra por voluntarios de 226 psicólogas con trabajo clínico. Los datos se recolectaron en formato electrónico, y para su obtención se aplicó la Escala de Conductas de Autocuidado para Psicólogos Clínicos (APC), el Cuestionario de Regulación Emocional (ERQ) y el Inventario Maslach de Burnout (MBI-HS). Para el análisis, se obtuvieron estadísticos descriptivos para cada una de las escalas y subes-calas, se estimaron coeficientes de correlación de Pearson, se ajustaron modelos de regresión lineal simple y múltiple para las subescalas del MBI-HS, y se ajustó un modelo de senderos mediante el método GLS. Los resultados indican un bajo nivel de burnout, que se asocia al autocuidado como factor protector frente al agotamiento emocional, a la realización personal, a un mayor uso de la supresión emocional como estrategia de autorregulación, y a la reevaluación cognitiva como factor protector ante la despersonalización. El estudio subraya la importancia fomentar el uso de conductas de autocuidado para disponer del mayor número de psicólogas en las mejores condiciones posibles para hacer frente a los efectos a largo plazo de la pandemia por COVID-19.

Abstract The negative effects on the mental health of the world's population from the 2019 coronavirus pandemic has increased the demand for psychological care services, which is why it is important to study the emotional well-being of this group of professionals. The objective of the study was to analyze the processes of emotional self-regulation and self-care as protective factors against the presence of burnout in a group of Mexican psychologists. To this end, a cross-sectional quantitative design with explanatory scopes was used. An intentional sample of 226 female psychologists who were conducting clinical work was used. Data were collected by means of an electronic format. The Clinical Psychologist Self-Care Conduct Scale (EAP), the Emotional Regulation Questionnaire (ERQ) and the Burnout Maslach Inventory (MBI) were applied. Descriptive statistics were obtained for each of the scales and subscales; Pearson correlation coefficients were estimated, and single and multiple linear regression models were adjusted for the MBI subscales. A path analysis was later adjusted using the GLS method. The results indicated a low level of burnout, demonstrating self-care as a protective factor against emotional exhaustion; personal fulfillment and increased use of emotional suppression, as a self-regulation strategy, and cognitive reevaluation, as a protective factor against depersonalization. The study underlines the importance of encouraging the use of self-care behaviors to have as many psychologists as possible in the best possible conditions to cope with the long-term effects of the pandemic.

Experience of the Hybrid technique for breast cancer planning in an oncology care center in Lima-Peru.

OBJECTIVE: To investigate, describe and evaluate the dosimetric parameters of the hybrid technique as a combination of the 3D Irregular Surface Compensator (3D-ISC) technique and modulated volumetric arc therapy (VMAT) for breast cancer planning. METHODS: The study involved planning a patient with left breast cancer. Planning was carried out with 3D-ISC, VMAT and Hybrid techniques. The 3 techniques were compared with respect to the target volume (PTV), coverage, gradient and protection of organs at risk (OARs). The Eclipse version 13.6 planning system was used and the prescription of the dose obeyed the hypofractionated scheme of 40.05Gy in 15 sessions (267 cGy per fraction) followed by a 13.35Gy boost in 5 sessions. RESULTS: The tangential field technique was the one with the lowest dose values delivered to healthy organs. However, with respect to the gradient, the VMAT technique was better. The Hybrid technique was the balance between the 3D-ISC and VMAT technique because after the evaluation of dosimetric parameters for both the OARs and the PTV coverage, values were found within the limits allowed according to the RTOG. CONCLUSION: The hybrid 3D-ISC and VMAT technique can be considered as a viable option for breast planning, achieving better control in OARs without losing priority over PTV coverage in addition to obtaining a good plan quality.

Is Dairy Effluent an Alternative for Maize Crop Fertigation in Semiarid Regions? An Approach to Agronomic and Environmental Effects.

The reuse of effluents from intensive dairy farms combined with localized irrigation techniques (fertigation) has become a promising alternative to increase crop productivity while reducing the environmental impact of waste accumulation and industrial fertilizers production. Currently, the reuse of dairy effluents through fertigation by subsurface drip irrigation (SDI) systems is of vital importance for arid regions but it has been poorly studied. The present study aimed to assess the greenhouse gas (GHG) emissions, soil properties, and crop yield of a maize crop fertigated with either treated dairy effluent or dissolved granulated urea applied through an SDI system at a normalized N application rate of 200 kg N ha-1. Fertilizer application was divided into six fertigation events. GHG fluxes were measured during fertigation (62-day) using static chambers. Soil properties were measured previous to fertilizer applications and at the harvest coinciding with crop yield estimation. A slight increase in soil organic matter was observed in both treatments for the 20-60 cm soil depth. Both treatments also showed similar maize yields, but the dairy effluent increased net GHG emissions more than urea during the fertigation period. Nevertheless, the net GHG emissions from the dairy effluent were lower than the theoretical CO2eq emission that would have been emitted during urea manufacturing or the longer storage of the effluent if it had not been used, showing the need for life-cycle assessments. Local-specific emission factors for N2O were determined (0.07%), which were substantially lower than the default value (0.5%) of IPCC 2019. Thus, the subsurface drip irrigation systems can lead to low GHG emissions, although further studies are needed.

Thermogravimetry coupled with mass spectrometry successfully used to quantify polyethylene and polystyrene microplastics in organic amendments.

The global consumption of plastic is growing year by year, producing small plastic pieces known as microplastics (MPs) that adversely affect ecosystems. The use of organic amendments (compost and manure) polluted with MPs affects the quality of agricultural soils, and these MPs can be incorporated into the food chain and negatively impact human health. Current European legislation only considers large plastic particles in organic amendments. There is no information regarding MP pollution. Thus, the development of a methodology to support future legislation ensuring the quality of agricultural soils and food safety is necessary. This proposed methodology is based on thermogravimetry coupled with mass spectrometry to quantify polyethylene and polystyrene (PE and PS) MPs through their mass spectrometry signal intensity of characteristic PE (m/z 41, 43 and 56) and PS (m/z 78 and 104) ions. This method has been validated with several organic amendments where the MP content ranged from 52.6 to 4365.7 mg kg-1 for PE-MPs and from 1.1 to 64.3 mg kg-1 for PS-MPs. The proposed methodology is a quick and robust analytical method to quantify MPs in organic amendments that could support new legislation.

Ansiedad, desesperanza y afrontamiento ante el COVID-19 en usuarios de atención psicológica

Objetivo. Identificar los niveles de síntomas de ansiedad y desesperanza, así como, las estrategias de afrontamiento durante la pandemia de COVID-19 en usuarios de servicios de atención psicológica en línea. Método. Se utilizó un diseño de tipo transversal predictivo, con una muestra de 78 personas voluntarias. Se aplicó la Escala de estrategias de afrontamiento frente a riesgos extremos, Inventario de Ansiedad de Beck (BAI) y la Escala de Desesperanza de Beck (BHS). Resultados. Al existir un alto nivel de ansiedad en las personas participantes, se tiende a manifestar mayor nivel de indefensión y de conductas de afrontamiento orientadas hacia la evitación y de naturaleza pasiva.

Objective. The main goal was to identify the levels of symptoms of anxiety and hopelessness, as well as the coping strategies during the COVID-19 pandemic in users of online psychological care services. Method. A predictive cross-sectional design was used, with a sample of 78 volunteers. The scale of coping strategies in the face of extreme risks, the Beck Anxiety Inventory (BAI) and the Beck Hopelessness Scale (BHS) were applied. Results. The results indicated that since there is an elevated level of anxiety in the participants, they tend to manifest a higher level of helplessness and coping behaviors oriented towards avoidance and passive nature.

A protocol for Chenopodium quinoa pollen germination.

BACKGROUND: Quinoa is an increasingly popular seed crop frequently studied for its tolerance to various abiotic stresses as well as its susceptibility to heat. Estimations of quinoa pollen viability through staining methods have resulted in conflicting results. A more effective alternative to stains is to estimate pollen viability through in vitro germination. Here we report a method for in vitro quinoa pollen germination that could be used to understand the impact of various stresses on quinoa fertility and therefore seed yield or to identify male-sterile lines for breeding. RESULTS: A semi-automated method to count germinating pollen was developed in PlantCV, which can be widely used by the community. Pollen collected on day 4 after first anthesis at zeitgeber time 5 was optimum for pollen germination with an average germination of 68% for accession QQ74 (PI 614886). The optimal length of pollen incubation was found to be 48 h, because it maximizes germination rates while minimizing contamination. The pollen germination medium's pH, boric acid, and sucrose concentrations were optimized. The highest germination rates were obtained with 16% sucrose, 0.03% boric acid, 0.007% calcium nitrate, and pH 5.5. This medium was tested on quinoa accessions QQ74, and cherry vanilla with 68%, and 64% germination efficiencies, respectively. CONCLUSIONS: We provide an in vitro pollen germination method for quinoa with average germination rates of 64 and 68% on the two accessions tested. This method is a valuable tool to estimate pollen viability in quinoa, and to test how stress affects quinoa fertility. We also developed an image analysis tool to semi-automate the process of counting germinating pollen. Quinoa produces many new flowers during most of its panicle development period, leading to significant variation in pollen maturity and viability between different flowers of the same panicle. Therefore, collecting pollen at 4 days after first anthesis is very important to collect more uniformly developed pollen and to obtain high germination rates.

Heat stress changes mineral nutrient concentrations in Chenopodium quinoa seed.

Quinoa is a popular seed crop, often consumed for its high nutritional quality. We studied how heat stress in the roots or the shoots of quinoa plants affected the concentrations of 20 elements (aluminum, arsenic, boron, calcium, cadmium, cobalt, copper, iron, potassium, magnesium, manganese, molybdenum, sodium, nickel, phosphorous, rubidium, sulfur, selenium, strontium, and zinc) in quinoa seed. Elemental concentrations in quinoa seed were significantly changed after an 11-day heat treatment during anthesis. The type of panicle (main, secondary, and tertiary) sampled and the type of heat treatment (root only, shoot only, or whole plants) significantly affected elemental profiles in quinoa seed. Plants were also divided into five sections from top to bottom to assess the effect of panicle position on seed elemental profiles. Plant section had an effect on the concentrations of arsenic, iron, and sodium under control conditions and on copper with heat treatment. Overall, the time of panicle development in relation to the time of heat exposure had the largest effect on seed elemental concentrations. Interestingly, the quinoa plants were exposed to heat only during anthesis of the main panicle, but the elemental concentrations of seeds produced after heat treatment ended were still significantly changed, indicating that heat stress has long-lasting effects on quinoa plants. These findings demonstrate how the nutritional quality of quinoa seeds can be changed significantly even by relatively short heat spells.

La medición de soledad en personas adultas mayores: estructura interna de la escala ESTE en una muestra del norte de México / Loneliness measurement in older adults: internal structure of the ESTE scale in a sample of northern Mexico

Resumen El objetivo de este trabajo fue identificar la estructura interna de la escala de medición de la soledad ESTE, creada en España y aplicada en población de adultos mayores de la ciudad de Saltillo, Coahuila, México. El estudio fue de corte cuantitativo con un diseño instrumental. Se evaluó la estructura interna y propiedades métricas del instrumento a través del Análisis Factorial Exploratorio (AFE), el Análisis Paralelo (AP) y el Análisis Factorial Confirmatorio (AFC) en una muestra por conveniencia de 396 adultos mayores 55.8 % mujeres y 44.2 % hombres de 60 a 95 años (M = 69.81, DE = 6.96) que asistían a los servicios de consulta externa en el Centro Estatal del Adulto Mayor (CEAM) y en los programas de la Comisión de Derechos Humanos del Estado de Coahuila, México. En el AFE se obtuvo una solución de cuatro factores que explicó el 53.45 % de la varianza y en el Análisis Paralelo la varianza explicada total fue de 57.3 %. Los factores que más varianza explicaron son soledad social (24.31 %), soledad familiar (12.13 %) y crisis existencial (10.18 %). El factor soledad conyugal fue el componente con menor explicación (6.81 %). El coeficiente alfa ordinal resultó con alta fiabilidad (ω = .920). Se obtuvieron cuatro factores con 22 indicadores. En el Análisis Confirmatorio se obtuvieron índices de bondad de ajuste adecuados. La escala validada para población mexicana es una herramienta útil para medir el nivel de soledad. Con este estudio, se obtuvo evidencia de la validez de la estructura interna de la escala y se estimó la confiabilidad de la escala de soledad ESTE adaptada a población mexicana.

Abstract The objective was to identify the internal structure of the measurement scale of the loneliness ESTE, created in Spain and applied in the population of older adults in the city of Saltillo, Coahuila, México. Loneliness has been conceptualized as perceived social isolation and has been described as a condition that can become serious, however, it has been seen as a subjective experience of lack of affection, intimacy, and closeness with family and/or friendships, as well as the difference between the preferred level and the actual level of social contact a person has. Lack of support networks and cohabitation in the homes of older adults generate conditions of vulnerability, which results in a weakness in the health issue, as well as being exposed to greater fragility that prevents maintaining the usual pace of life. The study was quantitative with instrumental design. We assessed the internal structure of the instrument through exploratory factor analysis (AFE) and confirmatory factorial analysis (AFC) in a convenience sample of 396 adults 55.8 % women and 44.2 % men from 60 to 95 years (M = 69.81, DE = 6.96) attending medical service in the State Center of the Elderly and in the programs of the Commission of Human Rights of the state of Coahuila, Mexico. The EAST scale measuring loneliness in older adults was used, with 34 items grouped into four factors: family loneliness, marital loneliness, social loneliness, and existential crisis. The response format is ordinal with five options ranging from Never to Always. In addition, three questions were included regarding the perception of health. The McDonald's coefficient for instrument reliability was estimated for each of the dimensions. The analysis of the data was an Exploratory Factor Analysis (EFA) and the Confirmatory Factor Analysis (CFA). 79.8 % believe that their health is good health, this percentage being higher than those who consider their health to be bad and lousy. Compared to a person their age, 62.4 % of older adults are considered equal, 30.3 % feel better, and 6.8 % consider themselves worse, with differences in these three response groups. In conclusion, they were asked if they were satisfied with their lives, to which 94.4 % said yes. The four-factor solution explained 53.45 % of the variance and in the parallel analysis the total explained variance was 57.3 %. The factors that most variance explained are social loneliness (24.31 %) family solitude (12.13 %) and existential crisis (10.18 %). The marital loneliness factor was the least explained component (6.81 %). The ordinal alpha coefficient resulted with high reliability (ω = .920). Four factors were obtained with 22 indicators. According to the indicators, the model with correlated factors presented a close approximation between the hypothetical model and the data, this according to the value obtained in the RMSEA, which was .050, which is of good adjustment, the CFI presented a good fit since a value of .974 was reported, values between .950 and .990 are considered appropriate. The GFI and AGFI had values greater than .90, which represent good adjustment. Additionally, the performance of variables from sociodemographic groups showed no significant differences in totals estimates per factor. The validated scale for Mexican population is a useful tool to measure the level of loneliness. This study obtained evidence of the validity of the internal structure of the scale and estimated the reliability of the ESTE loneliness scale adapted to the Mexican population.

Análisis confirmatorio de la Escala de Autoevaluación Breve de Bienestar y Autonomía en Adultos Mayores de Coahuila y Yucatán, México / Confirmatory Analysis of the Short Self-Assessment of Wellbeing and Autonomy Scale in Older Adults in Coahuila and Yucatán, Mexico

Resumen El objetivo de este trabajo fue realizar un Análisis Factorial Confirmatorio de la Escala de Bienestar y Autonomía específica para adultos mayores en dos muestras mexicanas, lo que permitió determinar la validez del constructo medido. Se utilizó un diseño cuantitativo, transversal con alcances explicativos. Se analizó una muestra incidental de 895 adultos mayores, de los cuales 59.8 % eran habitantes de la ciudad de Saltillo, Coahuila, México y 40.2 % de Tizimín, Yucatán, México. Se utilizó la Escala de Autoevaluación Breve de Bienestar y Autonomía para Adultos Mayores. Se procesó el Análisis Factorial Exploratorio, Paralelo y Confirmatorio con el método de Mínimos Cuadrados Generalizados, además de obtener la confiabilidad y los estadísticos descriptivos de las dimensiones. La estructura que se identificó presentó indicadores de ajuste estadístico adecuado. Originalmente, la estructura consideraba dos dimensiones: la autonomía y el bienestar, sin embargo, los resultados mostraron la separación en tres dimensiones de la medición de bienestar.

Abstract The objective of this work was to carry out a Confirmatory Factorial Analysis of the Scale of Wellbeing and Specific Autonomy for Older Adults in two Mexican samples, which allowed to establish the validity of the measured construct. A quantitative, transversal design with explanatory scopes was used. An incidental sample of 895 aging adults was obtained, from which 59.8% were inhabitants of the Saltillo city, Coahuila, Mexico, and 40.2%, of Tizimín city, Yucatán, Mexico. We used the Short SelfAssessment of Wellbeing and Autonomy for Older Adults. The Exploratory, Parallel and Confirmatory Factor Analysis was processed with the Generalized Least Squares Method, in addition to obtaining the reliability and descriptive statistics of dimensions. The identified structure showed adequate statistical adjustment indicators. Initially, the structure considered two dimensions: autonomy and wellbeing; however, the results showed the separation in three dimensions of the wellbeing measurement.

Clinically significant prostate cancer detection and segmentation in low-risk patients using a convolutional neural network on multi-parametric MRI.

OBJECTIVES: To develop an automatic method for identification and segmentation of clinically significant prostate cancer in low-risk patients and to evaluate the performance in a routine clinical setting. METHODS: A consecutive cohort (n = 292) from a prospective database of low-risk patients eligible for the active surveillance was selected. A 3-T multi-parametric MRI at 3 months after inclusion was performed. Histopathology from biopsies was used as reference standard. MRI positivity was defined as PI-RADS score ≥ 3, histopathology positivity was defined as ISUP grade ≥ 2. The selected cohort contained four patient groups: (1) MRI-positive targeted biopsy-positive (n = 116), (2) MRI-negative systematic biopsy-negative (n = 55), (3) MRI-positive targeted biopsy-negative (n = 113), (4) MRI-negative systematic biopsy-positive (n = 8). Group 1 was further divided into three sets and a 3D convolutional neural network was trained using different combinations of these sets. Two MRI sequences (T2w, b = 800 DWI) and the ADC map were used as separate input channels for the model. After training, the model was evaluated on the remaining group 1 patients together with the patients of groups 2 and 3 to identify and segment clinically significant prostate cancer. RESULTS: The average sensitivity achieved was 82-92% at an average specificity of 43-76% with an area under the curve (AUC) of 0.65 to 0.89 for different lesion volumes ranging from > 0.03 to > 0.5 cc. CONCLUSIONS: The proposed deep learning computer-aided method yields promising results in identification and segmentation of clinically significant prostate cancer and in confirming low-risk cancer (ISUP grade ≤ 1) in patients on active surveillance. KEY POINTS: • Clinically significant prostate cancer identification and segmentation on multi-parametric MRI is feasible in low-risk patients using a deep neural network. • The deep neural network for significant prostate cancer localization performs better for lesions with larger volumes sizes (> 0.5 cc) as compared to small lesions (> 0.03 cc). • For the evaluation of automatic prostate cancer segmentation methods in the active surveillance cohort, the large discordance group (MRI positive, targeted biopsy negative) should be included.

Loneliness in older people from Spain and Mexico: a comparative analysis / Soledad en personas mayores de España y México: un análisis comparativo

Abstract It has been found that suffering loneliness increases the probability of anxiety and depression. The importance of studying loneliness is due to the negative consequences that this phenomenon can generate on the mental and physical health of elderly people. The objective of this study was to analyze the influence of loneliness in old age and their form of coexistence, and determine whether there are differences depending on the cultural group analyzed, Spain or Mexico. A quantitative design with a comparative scope was used. A total number of 691 older adults (40.2% men and 59.8% women) age 60 years-old or older from Spain (42.7%) and Mexico (57.3%) were selected to take part in this study through convenience sampling. Instruments included a sociodemographic data section, consisting of questions about age, sex, education, marital status and with whom the participants lived. Also the ESTE scale of loneliness was used, which measures the existing deficits in the support of the individual at family, marital and social level, as well as the feelings resulting from such deficits. Hypothesis tests were processed using the χ2 coefficient, the contingency coefficient and the t-test for independent samples, with a significance level of p ≤. 050. Results showed that cultural differences according to the country of origin have weight on the prevalence of situations of loneliness in the elderly. Evidence was found that in both samples, demographic characteristics such as sex, education, and marital status, make a difference in the characterization of loneliness, and that there is a relationship between the demographic factors of elderly people and the onset of loneliness. The study underlines the importance that cultural background and demographic characteristics have on loneliness and how these aspects should be considered as risk factors for the development of loneliness in the older adults.

Resumen Se ha encontrado evidencia de que la soledad incrementa la probabilidad de presentar problemas de ansiedad y depresión en personas mayores, razón por la cual se hace importante el estudio de las consecuencias negativas de este fenómeno sobre la salud mental y física de estas personas. El objetivo de este trabajo fue analizar la influencia de la soledad en la vejez y en la forma de convivencia de los adultos mayores, así como determinar si existen diferencias en función del grupo cultural analizado (España y México). Para esto, se utilizó un diseño cuantitativo con alcances comparativos, en el que participaron 691 adultos mayores (hombres = 40.2 %, mujeres = 59.8 %) de 60 o más años (M = 71.49, DE = 7.41), residentes de España (42.7 %) o México (57.3 %), seleccionados por medio de un muestreo por conveniencia. Para el análisis, por medio de la aplicación de un apartado sobre datos sociodemográficos y la escala ESTE de soledad -que mide los déficits existentes en el soporte del sujeto a nivel familiar, conyugal y social, así como los sentimientos resultantes de tales déficits-, se procesaron pruebas de hipótesis con el coeficiente χ2, el coeficiente de contingencia y la prueba t para muestras independientes -con un nivel de p ≤ .050-. Los resultados demostraron que las diferencias culturales según el país de pertenencia tienen peso sobre la prevalencia de situaciones de soledad en el adulto mayor; que en ambas submuestras las características demográficas hacen diferencia en la caracterización de la soledad; y que hay evidencia de una relación entre los factores sociodemográficos de las personas mayores y la aparición de la soledad. El estudio subraya la importancia del entorno cultural y de las características demográficas sobre la soledad, elementos que se deben tener en cuenta como factores de riesgo para el desarrollo de soledad en las personas mayores.

Development and Performance of Dengue Diagnostic Clinical Algorithms in Colombia.

Diagnosing dengue in endemic areas remains problematic because of the low specificity of the symptoms and lack of accurate diagnostic tests. This study aimed to develop and prospectively validate, under routine care, dengue diagnostic clinical algorithms. The study was carried out in two phases. First, diagnostic algorithms were developed using a database of 1,130 dengue and 918 non-dengue patients, expert opinion, and literature review. Algorithms with > 70% sensitivity were prospectively validated in a single-group quasi-experimental trial with an adaptive Bayesian design. In the first phase, the algorithms that were developed with the continuous Bayes formula and included leukocytes and platelet counts, in addition to selected signs and symptoms, showed the highest sensitivities (> 80%). In the second phase, the algorithms were applied on admission to 1,039 consecutive febrile subjects in three endemic areas in Colombia of whom 25 were laboratory-confirmed dengue, 307 non-dengue, 514 probable dengue, and 193 undetermined. Including parameters of the hemogram consistently improved specificity without affecting sensitivity. In the final analysis, considering only confirmed dengue and non-dengue cases, an algorithm with a sensitivity and specificity of 65.4% (95% credibility interval 50-83) and 40.1% (34.7-45.7) was identified. All tested algorithms had likelihood ratios close to 1, and hence, they are not useful to confirm or rule out dengue in endemic areas. The findings support the use of hemograms to aid dengue diagnosis and highlight the challenges of clinical diagnosis of dengue.