Coalition for Health and Gender Equity (CHANGE)-a protocol for a global cross-sectional survey of health and gender equity in rheumatology.

Objectives: The primary aim of the CHANGE survey is to determine the current state of gender equity within rheumatology, and secondarily, to review the physician perspective on bullying, harassment and equipoise of opportunities within rheumatology. Methods: The CHANGE e-survey is a cross-sectional self-reported questionnaire adapted from EULAR's gender equity in academic rheumatology task force. The survey was launched in January 2023; it is available in six languages and distributed widely via rheumatology organizations and social media. Eligible participants include rheumatologist physicians and rheumatology health-care professionals. Survey responses will undergo descriptive analysis and inter-group comparison aiming to explore gender-based discrimination using logistic regression, with subgroup analyses for country/continent variations. Conclusion: This e-survey represents a comprehensive global initiative led by an international consortium, aimed at exploring and investigating the gender-related disparities and obstacles encountered by rheumatologists and rheumatology health-care professionals across diverse communities and health-care environments. By pursuing this initiative, we aim to take the broader rheumatology community a step closer to understanding the underlying origins of inequities and their determinants. Such insights are pivotal in identifying viable interventions and strategies to foster gender equity within the field. Ultimately, our collective objective is to ensure equitable access to opportunities for every individual, irrespective of gender, thereby promoting inclusivity and fairness across the entire spectrum of professional practice and career development.

Experiencias de las mujeres con el proceso de atención del parto: revisión integrativa / Women's Experiences in the Childbirth Care Process: An Integrative Review / Experiências das mulheres no processo de assistência ao parto: uma revisão integrativa

Introdução: o parto é reconhecido como um processo fisiológico que alude à procriação e ao desenvolvimento entre as sociedades; entretanto, pouco se tem falado sobre a assistência humanizada ao parto. Portanto, é necessário identificar a experiência das mulheres durante o parto normal a fim de gerar práticas que garantam uma melhor qualidade de atendimento. Objetivo: caracterizar as evidências científicas relacionadas às experiências das mulheres durante a assistência ao parto normal. Materiais e método: foi realizada uma revisão integrativa, segundo Cooper, e revisadas seis bases de dados: Cochrane, PubMed, Science Direct, Springer, Scopus e Cinahl, com os descritores em espanhol, inglês e português, "parto normal", "parto humanizado", "humanização da assistência", "violência obstétrica", "pesquisa qualitativa", limitados ao período de 2010 a 2023, com os seguintes critérios de inclusão/exclusão: artigos qualitativos em texto completo sobre partos normais, com pontuação maior ou igual a 8 segundo o Critical Appraisal Skills Programme em espanhol (CASPe). Resultados: emergiram seis unidades temáticas: microagressões e macroimpactos: parto ­ entre a dor e o medo; agindo com respeito ­ o parto como um processo natural; silenciar, calar e suportar; meu parto, minha escolha; tornando visível o invisível ­ normalizando a violência durante o parto; e o rito do parto ­ a dignidade da mulher. Conclusões: as experiências de parto das mulheres são moldadas pelo contexto cultural em que elas vivem; os modelos biomédico e tradicional colidem e impactam a vida das mulheres. É necessário que as mulheres estejam cientes de seus direitos reprodutivos para contribuir com a humanização do parto.

Introducción: el parto es reconocido como un proceso fisiológico que alude a la procreación y al desarrollo entre las sociedades; no obstante, poco se ha habla sobre la atención humanizada del mismo. Por lo anterior, es necesario identificar la experiencia de las mujeres durante la atención del parto vaginal para generar prácticas que garanticen una mejor calidad en la atención. Objetivo: caracterizar la evidencia científica relacionada con las experiencias de las mujeres durante la atención del parto vaginal. Materiales y Método: se realizó una revisión integrativa, según Cooper; se revisaron seis bases de datos Cochrane, PubMed, Science Direct, Springer, Scopus y Cinahl, con los descriptores: Parto Normal; Parto Humanizado; Humanización de la Atención; Violencia Obstétrica e Investigación Cualitativa, en idioma español, inglés y portugués, limitada al periodo 2010-2023, con los siguientes criterios de inclusión/exclusión: artículos cualitativos en texto completo sobre partos vaginales, con puntuación mayor o igual a 8 según CASPe. Resultados: se obtuvieron seis unidades temáticas: microagresiones y macro-impactos: el parto: entre el dolor y el miedo; actuar con respeto: el parto como proceso natural; silenciar, callar y soportar; mi parto, mi elección; haciendo visible lo invisible: normalizando la violencia durante el parto; y el rito de parir: dignidad de la mujer. Conclusiones: las experiencias de las mujeres durante el parto están moldeadas por el contexto cultural en el que viven; el modelo biomédico y el tradicional chocan e impactan la vida de la mujer. Es necesario que las mujeres conozcan sus derechos reproductivos para contribuir con la humanización del parto.

Introduction: Childbirth is recognized as a physiological process essential to procreation and societal development. Nevertheless, it often lacks adequate discussion on humanized care practices. Therefore, it is necessary to identify women's experiences during vaginal birth care to create practices that ensure better quality care. Objective: To characterize scientific evidence related to women's experiences during vaginal birth care. Materials and Methods: An integrative review was conducted following Cooper's methodology; six databases were reviewed: Cochrane, PubMed, Science Direct, Springer, Scopus, and Cinahl, using the descriptors: Normal Birth; Humanized Birth; Humanization of Care; Obstetric Violence; Qualitative Research, in Spanish, English, and Portuguese, limited to the 2010-2023 period, with the following inclusion/exclusion criteria: Qualitative full-text articles on vaginal births with a score of 8 or higher according to CASPe. Results: Six thematic units emerged: microaggressions and macro-impacts: childbirth: between pain and fear; acting with respect: childbirth as a natural process; silencing, enduring, and bearing; my birth, my choice; making the invisible visible: normalizing violence during childbirth; and the ritual of childbirth: women's dignity. Conclusions: Women's childbirth experiences are influenced by the cultural contexts in which they live; the biomedical model and traditional practices clash and impact women's lives. Women must know their reproductive rights to contribute to a humanized childbirth.

Interpersonal protective factors for LGBTQ+ youth at multiple intersecting social identities and positions.

Interpersonal supports are protective against multiple negative health outcomes for youth such as emotional distress and substance use. However, finding interpersonal support may be difficult for youth exposed to intersecting racism, heterosexism, and cisgenderism, who may feel they are "outsiders within" their multiple communities. This study explores disparities in interpersonal supports for youth at different sociodemographic intersections. The 2019 Minnesota Student Survey includes data from 80,456 high school students, including measures of four interpersonal supports: feeling cared about by parents, other adult relatives, friends, and community adults. Exhaustive Chi-square Automatic Interaction Detection analysis was used to examine all interactions among four social identities/positions (racialized/ethnic identity, sexual identity, gender identity, sex assigned at birth) to identify groups who report different rates of caring from each source (Bonferroni adjusted p<.05). In the overall sample, 69.24% perceived the highest level of caring ("very much") from parents, 50.09% from other adult relatives, 39.94% from friends, and 15.03% from community adults. Models identified considerable differences in each source of support. For example, more than 72% of straight, cisgender youth reported their parents cared about them very much, but youth who identified as LGBQ and TGD or gender-questioning were much less likely to report high parent caring (less than 36%) across multiple racialized/ethnic identities and regardless of sex assigned at birth. Findings highlight the importance of better understanding the ways interpersonal support might differ across groups, and underscore a need for intersectionality-tailored interventions to develop protective interpersonal supports for LGBTQ+ youth, rather than one-size-fits-all approaches.

Exploring floral morphoanatomy and embryology in wild populations of Chrysolaena flexuosa (Vernonia, Asteraceae): a contribution to understanding its ornamental potential.

Chrysolaena flexuosa (Sims.) H. Rob. is a South American species in the tribe Vernonieae, with potential ornamental value: it has attractive inflorescences, is suitable for pot cultivation, and its cypselae are useful for dried flower arrangements. Apart from studies on the growth dynamics of this species under cultivation, chromosome number, DNA content, ploidy level, size, pollen viability, and the characterization of phenotypic and genetic variability, it is noteworthy that other aspects regarding the floral architecture, reproductive mode, and gametophyte formation of C. flexuosa have not yet been studied. For this reason, our study encompasses a floral morphoanatomical survey and a comprehensive assessment of gametophyte development in the species. As a result of this study, we report new floral morphotypes, confirming that the morphological variability of the species might be greater than speculated. The morphoanatomy of the androecium and gynoecium and the male and female gametophyte developmental characteristics are uniform in all the populations studied despite the different ploidy levels. Chrysolaena flexuosa has five tetrasporangiate stamens of the dicotyledonous type of development; all the populations studied displayed a unilocular inferior ovary with a single anatropous, unitegumented, and tenuinucellar ovule. Given that all the embryo sacs observed were of the Polygonum-type development regardless of the ploidy level, we infer that the populations analyzed are fertile and undergo sexual reproduction. Our results not only contribute further research in the field of breeding systems and propagation of this species, but also promote the successful introduction of C. flexuosa to the plant ornamental market.

Seed removal by the squirrel Notocitellus adocetus (Rodentia: Sciuridae) in Western México

Introduction: Seed dispersal and seed predation have important impacts on plant diversity and community structure. Rodents participate in both of these types of interactions. Objectives: To evaluate the removal of the seeds of Crescentia alata, Randia capitata, and Zea mays by the squirrel Notocitellus adocetus to determine how it affects these plant species, by dispersing or preying on their seeds. Methods: We studied 14 individuals for C. alata, 24 for R. capitata, and for Z. mays 35 individuals. We observed foraging and used camera traps to determine the part of the fruit (seed and/or pulp) consumed by the squirrels and the amount of fruit or seed consumed. We also placed fine sand traps (FST) to measure the percentage of seed removal. We quantified the fruits produced by the plant species studied and the percentage of damage caused by N. adocetus throughout the plots. Results: Notocitellus adocetus feeds on the seeds and pulp of C. alata and Z. mays. The species with the highest removal rate and the highest percentage of damage was C. alata. Zea mays was the plant species that had the highest percentage of removal from FST, the largest number of fruits, and the lowest percentage of damage. On FST, R. capitata had the lowest seed remotion. Conclusions: Notocitellus adocetus is considered a seed predator; however, due to its behavior and the characteristics of the fruits of C. alata and R. capitata, this rodent could make the seeds available to secondary seed dispersers.

Introducción: La dispersión y depredación de semillas tienen efectos importantes en la diversidad de plantas y estructura de las comunidades. Los roedores participan en estos tipos de interacciones. Objetivos: Evaluar la remoción de semillas de Crescentia alata, Randia capitata y Zea mays por la ardilla Notocitellus adocetus, para determinar su efecto en estas especies de plantas, dispersando o depredando semillas. Métodos: Estudiamos 14 individuos de C. alata, 24 para R. capitata y 35 individuos para Z. mays. Observamos el forrajeo y usamos cámaras trampas para determinar la parte del fruto (semilla y/o pulpa) consumida y la intensidad de consumo por las ardillas. También colocamos trampas de arena fina (FST) para medir el porcentaje de remoción de semillas. Cuantificamos los frutos producidos por las especies estudiadas y el porcentaje de daño ocasionado por N. adocetus, mediante parcelas. Resultados: Notocitellus adocetus se alimenta de las semillas y pulpa de C. alata y Z. mays. La especie que tuvo mayor tasa de remoción y mayor porcentaje de daño fue C. alata. La especie con mayor porcentaje de remoción, mayor número de frutos y menor daño en las FST fue Z. mays. En las trampas de arena fina, R. capitata tuvo la menor remoción de semillas. Conclusiones: Notocitellus adocetus es considerada depredadora de semillas, no obstante, por su comportamiento y las características de los frutos de C. alata y R. capitata, este roedor podría dejar disponibles las semillas a dispersores secundarios de semillas.

Application of an intersectional lens to bias-based bullying among LGBTQ+ youth of color in the United States.

Bias-based bullying influences health, academic success, and social wellbeing. However, little quantitative work takes an intersectional perspective to understand bias-based bullying among youth with marginalized social positions, which is critical to prevention. This paper describes the application of exhaustive chi-square automatic interaction detection (CHAID) to understand how prevalence of race-, gender-, and sexual orientation-based bullying varies for youth with different intersecting social positions. We used two datasets - the 2019 Minnesota Student Survey (MSS; N=80,456) and the 2017-2019 California Healthy Kids Survey (CHKS; N=512,067). Students self-reported sex assigned at birth, sexual orientation, gender identity, race/ethnicity, and presence of any race-, gender-, and sexual orientation-based bullying (MSS: past 30 days, CHKS: past 12 months). Exhaustive CHAID with a Bonferroni correction, a recommended approach for large, quantitative intersectionality research, was used for analyses. Exhaustive CHAID analyses identified a number of nodes of intersecting social positions with particularly high prevalences of bias-based bullying. Across both datasets, with varying timeframes and question wording, and all three forms of bias-based bullying, youth who identified as transgender, gender diverse, or were questioning their gender and also held other marginalized social positions were frequent targets of all forms of bias-based bullying. More work is needed to understand how systems of oppression work together to influence school-based bullying experiences. Effective prevention programs to improve the health of youth with marginalized social positions must acknowledge the complex and overlapping ways bias and stigma interact.

Waist circumference cut-off points to identify major cardiovascular events and incident diabetes in Latin America: findings from the prospective Urban rural epidemiology study Colombia.

Background: Abdominal obesity (AO) indirectly represents visceral adiposity and can be assessed by waist circumference (WC) measurement. In Latin America, cut-off points for the diagnosis of AO are based on Asian population data. We aim to establish the WC cut-off points to predict major cardiovascular events (MACE) and incident diabetes. Methods: We analyzed data from the cohort PURE study in Colombia. WC cut-off points were defined according to the maximum Youden index. Multivariate logistic regression was used to obtain associations between WC and MACE, diabetes, and cumulative incidence of outcomes visualized using Kaplan-Meier curves. Results: After a mean follow-up of 12 years, 6,580 individuals with a mean age of 50.7 ± 9.7 years were included; 64.2% were women, and 53.5% were from rural areas. The mean WC was 85.2 ± 11.6 cm and 88.3 ± 11.1 cm in women and men, respectively. There were 635 cases of the MACE composite plus incident diabetes (5.25 events per 1,000 person-years). Using a cut-off value of 88.85 cm in men (sensitivity = 0.565) and 85.65 cm in women (sensitivity = 0.558) resulted in the highest value for the prediction of the main outcome. These values were associated with a 1.76 and 1.41-fold increased risk of presenting the composite outcome in men and women, respectively. Conclusions: We defined WC cut-off points of 89 cm in men and 86 cm in women to identify the elevated risk of MACE and incident diabetes. Therefore, we suggest using these values in cardiovascular risk assessment in Latin America.

Hoarding behaviour: special features and complications in real-world clinical practice.

OBJECTIVE: Hoarding behaviour is a common but poorly characterised problem in real-world clinical practice. Although hoarding behaviour is the key component of Hoarding Disorder (HD), there are people who exhibit hoarding behaviour but do not suffer from HD. The aim of the present study was to characterise a clinical sample of patients with clinically relevant hoarding behaviour and evaluate the differential characteristics between patients with and without HD. METHODS: This study included patients who received treatment at the home visitation program in Barcelona (Spain) from January 2013 through December 2020, and scored ≥ 4 on the Clutter Image Rating scale. Sociodemographic, DSM-5 diagnosis, clinical data and differences between patients with and without an HD diagnosis were assessed. RESULTS: A total of 243 subjects were included. Hoarding behaviour had been unnoticed in its early stages and the median length in the sample was 10 years (IQR 15). 100% of the cases had hoarding-related complications. HD was the most common diagnosis in 117 patients (48.1%). CONCLUSIONS: The study found several differential characteristics between patients with and without HD diagnosis. Alcohol use disorder could play an important role among those without HD diagnosis. Home visitation programs could improve earlier detection, preventing hoarding-related complications.

Benefits of the Polypill on Medication Adherence in the Primary and Secondary Prevention of Cardiovascular Disease: A Systematic Review.

Background: Higher medication adherence reduces the risk of new cardiovascular events. However, there are individual and health system barriers that lead to lower adherence. The polypill has demonstrated benefits in cardiovascular morbidity and mortality mainly driven by an increase in adherence. We aim to evaluate the impact of the polypill on adherence to cardiovascular medication, its efficacy and safety in cardiovascular disease (CVD) prevention. Methods: A systematic review following PRISMA guidelines was conducted. Databases were searched from January 2003 to December 2022. We included randomized, pragmatic, or real-world clinical trials and observational studies. The primary outcome was medication adherence, secondary outcomes were efficacy in cardiovascular disease in primary and secondary prevention and safety. Results: From the 490 publications screened, 13 met the inclusion criteria and were incorporated into a comparative table Of those included, 70% were randomized controlled trials (RCTs) and 53.8% focused on secondary prevention. Most of the studies received a high and moderate quality rating. Self-report, pill counting and, the Morisky scale were the most frequent methods to evaluate adherence (84.6%). Compared with standard medication, the polypill improved overall medication adherence by 13%, with percentages ranging from 7.6% to 34.9%. Moreover, a potential benefit was also observed in reducing Major Adverse Cardiovascular Events (MACE), particularly in secondary prevention studies, with hazard ratios ranged between 0.43 to 0.76. Compared to standard care, the profile of side effects was similar. Conclusion: The polypill is an effective, safe, and practical strategy to improve adherence in people at risk of CVD. Although there is a demonstrated benefit in reducing MACE, predominantly in secondary prevention, there are still gaps in its efficacy in primary prevention and reducing total mortality. Therefore, the importance of obtaining long-term results of the polypill effect and how this strategy can be implemented in real practice.

Experienced vs. Novice Participants Perception of Overall Quality and Intention to Join in Future Sport Trials: Case European Duathlon Championship.

Even though athletes' experience has been ascertained to shape the perception of quality in sports events, scarce studies have addressed this issue jointly with the intent to join in upcoming comparable sports challenges. (1) Background: The present research investigates how the experience determines the evaluation of the championship and future intentions. (2) Methods: The PLS (SEM) method was evaluated specifically for both novice and experienced duathlon participants, and secondly, the fsQCA methodology was applied with the intention to estimate combinatorial net effects to confirm the hypothesis proposed. (3) Results reveal that the overall quality is equally important for novice and experienced individuals as a determinant of future intentions. However, novices tend to value more positively all the dimensions analyzed, while experienced ones noted higher levels of demand. (4) These findings highlight the importance of designing adequate management strategies for the participants with different levels of performance.

[Translated Article] Disease-modifying treatments for patients with multiple sclerosis in Spain.

Multiple sclerosis is a chronic demyelinating disease of the central nervous system and long-term disabling. Different disease-modifying treatments are available. These patients, despite being generally young, have high comorbidity and risk of polymedication due to their complex symptomatology and disability. OBJECTIVE PRIMARY: To determine the type of disease-modifying treatment in patients seen in Spanish hospital pharmacy departments. SECONDARY OBJECTIVES: to determine concomitant treatments, determine the prevalence of polypharmacy, identify the prevalence of interactions and analyze pharmacotherapeutic complexity. METHOD: Observational, cross-sectional, multicentre study. All patients with a diagnosis of multiple sclerosis and active disease-modifying treatment who were seen in outpatient clinics or day hospitals during the second week of February 2021 were included. Modifying treatment, comorbidities and concomitant treatments were collected to determine multimorbidity pattern, polypharmacy, pharmacotherapeutic complexity (Medication Regimen Complexity Index) and drug-drug interactions. RESULTS: 1407 patients from 57 centres in 15 autonomous communities were included. The most frequent form of disease presentation was the relapsing remitting form (89.3%). The most prescribed disease-modifying treatment was dimethyl fumarate (19.1%), followed by teriflunomide (14.0%). Of the parenteral disease-modifying treatments, the two most prescribed were glatiramer acetate and natalizumab with 11.1% and 10.8%. 24.7% of the patients had 1 comorbidity and 39.8% had at least 2 comorbidities. 13.3% belonged to at least one of the defined patterns of multimorbidity and 16.5% belonged to 2 or more patterns. The concomitant treatments prescribed were psychotropic drugs (35.5%); antiepileptic drugs (13.9%) and antihypertensive drugs and drugs for cardiovascular pathologies (12.4%). The presence of polypharmacy was 32.7% and extreme polypharmacy 8.1%. The prevalence of interactions was 14.8%. Median pharmacotherapeutic complexity was 8.0 (IQR: 3.3-15.0). CONCLUSIONS: We have described the disease-modifying treatment of patients with multiple sclerosis seen in Spanish pharmacy services and characterized concomitant treatments, the prevalence of polypharmacy, interactions, and their complexity.

Disease-modifying treatments for patients with multiple sclerosis in Spain. / Tratamientos modificadores de la enfermedad en pacientes con esclerosis múltiple en España.

Multiple sclerosis is a chronic demyelinating disease of the central nervous system and long-term disabling. Different disease-modifying treatments are available. These patients, despite being generally young, have high comorbidity and risk of polymedication due to their complex symptomatology and disability. OBJECTIVE PRIMARY: To determine the type of disease-modifying treatment in patients seen in Spanish hospital pharmacy departments. SECONDARY OBJECTIVES: To determine concomitant treatments, determine the prevalence of polypharmacy, identify the prevalence of interactions and analyse pharmacotherapeutic complexity. METHOD: Observational, cross-sectional, multicentre study. All patients with a diagnosis of multiple sclerosis and active disease-modifying treatment who were seen in outpatient clinics or day hospitals during the second week of February 2021 were included. Modifying treatment, comorbidities and concomitant treatments were collected to determine multimorbidity pattern, polypharmacy, pharmacotherapeutic complexity (Medication Regimen Complexity Index) and drug-drug interactions. RESULTS: 1,407 patients from 57 centres in 15 autonomous communities were included. The most frequent form of disease presentation was the relapsing remitting form (89.3%). The most prescribed disease-modifying treatment was dimethyl fumarate (19.1%), followed by teriflunomide (14.0%). Of the parenteral disease-modifying treatments, the two most prescribed were glatiramer acetate and natalizumab with 11.1% and 10.8%. 24.7% of the patients had one comorbidity and 39.8% had at least 2 comorbidities. 13.3% belonged to at least one of the defined patterns of multimorbidity and 16.5% belonged to 2 or more patterns. The concomitant treatments prescribed were psychotropic drugs (35.5%); antiepileptic drugs (13.9%) and antihypertensive drugs and drugs for cardiovascular pathologies (12.4%). The presence of polypharmacy was 32.7% and extreme polypharmacy 8.1%. The prevalence of interactions was 14.8%. Median pharmacotherapeutic complexity was 8.0 (IQR: 3.3 -- 15.0). CONCLUSIONS: We have described the disease-modifying treatment of patients with multiple sclerosis seen in Spanish pharmacy services and characterised concomitant treatments, the prevalence of polypharmacy, interactions, and their complexity.

Improved Phenolic Profile, Sensory Acceptability, and Storage Stability of Strawberry Decoction Beverages Added with Blueberry Decoctions.

Blueberries are rich in polyphenols, anthocyanins, and proanthocyanidins; however, they are expensive. In contrast, strawberries have a lower cost and are rich in ellagitannins. Therefore, a strawberry-blueberry blend decoction could produce a low-cost beverage with a rich and diverse phytochemical profile. In this study, we developed three berry-based beverages: blend strawberry-blueberry (SBB), strawberry (SB), and blueberry (BB). The polyphenol profile of the beverages was characterized by UPLC-ESI-Q-ToF MSE, an acceptability test was carried out with potential consumers, and a stability analysis was performed under commercial storage conditions (4, 25, and 34 °C). The SBB exhibited a good sensorial preference (score of 81.3) and showed high contents and a diverse composition of anthocyanins and proanthocyanidins, which were up to 3.0- and 1.2-fold higher compared to the SB, respectively. Regarding the storage stability, the SBB showed better retention of lightness (97.9%) and red color (66.7%) at the end of the storage under refrigerated conditions (4 °C) compared to the SB. Therefore, these results demonstrate that using blended berry fruits leads to the creation of a functional beverage that has higher nutraceutical potential than single-berry-based beverages.

Strawberry, Blueberry, and Strawberry-Blueberry Blend Beverages Prevent Hepatic Steatosis in Obese Rats by Modulating Key Genes Involved in Lipid Metabolism.

There is an increasing interest in developing natural herb-infused functional beverages with health benefits; therefore, in this study, we aimed to evaluate the effect of strawberry, blueberry, and strawberry-blueberry blend decoction-based functional beverages on obesity-related metabolic alterations in high-fat and high-fructose diet-fed rats. The administration of the three berry-based beverages for eighteen weeks prevented the development of hypertriglyceridemia in obese rats (1.29-1.78-fold) and hepatic triglyceride accumulation (1.38-1.61-fold), preventing the development of hepatic steatosis. Furthermore, all beverages significantly down-regulated Fasn hepatic expression, whereas the strawberry beverage showed the greatest down-regulation of Acaca, involved in fatty acid de novo synthesis. Moreover, the strawberry beverage showed the most significant up-regulation of hepatic Cpt1 and Acadm (fatty acid ß-oxidation). In contrast, the blueberry beverage showed the most significant down-regulation of hepatic Fatp5 and Cd36 (fatty acid intracellular transport). Nevertheless, no beneficial effect was observed on biometric measurements, adipose tissue composition, and insulin resistance. On the other hand, several urolithins and their derivatives, and other urinary polyphenol metabolites were identified after the strawberry-based beverages supplementation. In contrast, enterolactone was found significantly increase after the intake of blueberry-based beverages. These results demonstrate that functional beverages elaborated with berry fruits prevent diet-induced hypertriglyceridemia and hepatic steatosis by modulating critical genes involved in fatty acid hepatic metabolism.

Critical Perspectives on Expanding Racial/Ethnic Diversity in the HIV Research Workforce: Comorbidities and Mentoring.

HIV-related comorbidities in underrepresented minority populations are reframed to include the co-occurring problems of systemic and structural barriers, within the mentoring context as a buffer and as action-oriented. This framework is discussed to improve racial and ethnic minority diversity in the research workforce from the perspectives of HIV comorbidities and mentoring. An integrated and coordinated approach to HIV-related comorbidities and inequities may be helpful when combined with research on the social-structural contributions as drivers to diversify the research workforce. We emphasize how these key research issues (a) provide a platform for training and retraining a highly motivated, diverse workforce and (b) facilitate the empowerment of these trained individuals to conduct rigorous scientific research on social-structural factors to mitigate the effects of these comorbidities. We conclude that a diverse research workforce is necessary but insufficient for improving training-related outcomes or reducing comorbidity effects. Additional considerations are warranted that include systemic approaches and changes at the structural and institutional levels.

Risk Factors for Working Pregnant Women and Potential Adverse Consequences of Exposure: A Systematic Review.

Objective: To assess the risk factors perceived as stressors by pregnant women in the work environment and the possible adverse consequences of such exposure for the normal development of pregnancy. Methods: Systematic review, guided by the PRISMA guidelines, and using Pubmed, Web of Science, Dialnet, SciELO, and REDIB databases. Methodological quality was assessed using the critical appraisal tools for non-randomised studies of the Joanna Briggs Institute. Results: A total of 38 studies were included. The main risk factors found in the work environment of pregnant women were chemical, psychosocial, physical-ergonomic-mechanical factors, and other work-related factors. The main adverse consequences of exposure to these factors include low birth weight, preterm birth, miscarriage, hypertension and pre-eclampsia, as well as various obstetric complications. Conclusion: During pregnancy, working conditions that are considered acceptable in normal situations may not be so during this stage due to the major changes that occur during pregnancy. Many obstetric effects may have an important impact in the mother's psychological status; therefore, it is important to optimise working conditions during this stage and to reduce or eliminate possible risks.

Resilience and Its Limits: The Roles of Individual Resilience, Social Capital, Racial Discrimination, and Binge Drinking on Sexual Behavior Among Black Heterosexual Men.

In response to the increased recognition of racism as a public health crisis, we assessed links between racial discrimination and HIV-related risk behavior for Black men. Specifically, using survey data from 530 Black heterosexual men (18-44 years old, M = 31.0, SD = 7.8), we tested two moderated-mediation models: (1) a protective model, in which resilience and social capital protected against the indirect effect of racial discrimination on alcohol-related sexual behavior via binge drinking, and (2) a bounded model, in which racial discrimination limited the indirect effects of resilience and social capital on alcohol-related sexual behavior via binge drinking. We found support for the bounded model only. Specifically, resilience was indirectly associated with decreased alcohol-related sexual behavior via lower binge drinking when racial discrimination was low to moderately high, but not when racial discrimination was at its highest levels. Resilience was not directly associated with alcohol-related sexual behavior. Social capital was directly related to lower odds of alcohol-related sexual behavior. At high levels of racial discrimination, however, social capital was indirectly related to increased alcohol-related sexual behavior via binge drinking. High levels of racial discrimination limit beneficial effects of resilience on alcohol-related sexual behavior. Social capital maintains a beneficial effect if social bonds are not associated with binge-drinking norms or behaviors. Results highlight the limitations of individual-level resilience and the need to conceptualize and support resilience as a social-structural resource.

Quinta arremetida de COVID-19 y el uso de mascarillas en espacios abiertos y cerrados / Fifth peak of COVID-19 and use of masks in open and enclosed spaces

Introduction: COVID-19 pandemic requires permanent adaptations in management depending on the epidemiological situation. Objective: To analyze the epidemiological behavior of COVID-19 in Cali (Colombia) after ending the face mask mandate in open and enclosed spaces between March 1 and July 11 of 2022. Materials and methods: An observational descriptive study of COVID-19 cases and cumulative incidence (CI) for 7 days with two temporary milestones: refusal of the obligatory use of face masks in open and enclosed environments, using data published by the National Institute of Health. The temporary tendency was evaluated with the Mann-Kendall non parametric test. Results: Differences were found between the first and second milestone; 922 cases in 75 days vs. 12,037 in 59 days; Tau=-0.22 vs. 0.57, S=-608 vs. 968, Var(S)=47,574.66 versus 233,280.66; Sen slope=-0.10 (IC95%: -0.18 and -0.03) versus 7.39 (IC95%: 5.23 and 8.88). After the second milestone, the CI increased with a positive tendency (S=23, p=0.006). Conclusions: The significant increases of COVID-19 cases and the CI coincided with the ending of the face mask mandate in enclosed spaces. Therefore, it is advisable to return to the use of face masks in enclosed spaces, strengthen infodemic management, promote vaccination, and improve natural ventilation.

Introducción: La pandemia COVID-19 demanda permanentes adaptaciones en la gestión según la situación epidemiológica. Objetivo: Analizar el comportamiento epidemiológico de COVID-19 en Cali (Colombia) post levantamiento de obligatoriedad de usar mascarillas en ambientes abiertos y cerrados, entre marzo 1 y julio 11/2022. Materiales y métodos: Estudio observacional descriptivo de casos de COVID-19 e incidencia acumulada (IA) para 7 días, con dos hitos temporales: desistimiento del uso mandatorio de mascarillas en ambientes abiertos y cerrados, usando datos publicados por el Instituto Nacional de Salud. Se evaluó la tendencia temporal con la prueba no paramétrica Mann-Kendall. Resultados: Se demostraron diferencias entre el primer y segundo hito: 922 casos en 75 días versus 12.037 en 59 días; Tau=-0,22 versus 0,57, S=-608 versus 968, Var(S)=47.574,66 versus 233.280,66; pendiente de Sen=-0,10 (IC95%: -0,18 y -0,03) versus 7,39 (IC95%: 5,23 y 8,88). Luego del segundo hito, la IA aumentó con tendencia positiva (S=23, p=0,006). Conclusiones: El aumento significativo de casos de COVID-19 y de IA coincidió con el levantamiento de la medida de usar mascarillas en espacios cerrados. Por tanto, se apoya el regresar al uso de mascarillas en espacios cerrados, reforzar la gestión infodémica, promover la vacunación y acrecentar la ventilación natural.