Teaching Population Panel Management: A Patient Outreach Activity in a Family Medicine Clerkship.

BACKGROUND AND OBJECTIVES: The delivery of population health education in medical school can be challenging. We developed a patient outreach activity for third-year students to teach them the role of population panel management in primary care. METHODS: The family medicine undergraduate medical education and population health teams collaborated to develop an educational patient outreach toolkit. After an orientation, family medicine clerkship students were assigned to call patients on their faculty adviser's patient panel to discuss care gaps and identify barriers and potential strategies to improve care. After the experience, students completed reflection questions, which we analyzed. RESULTS: From February to August 2022, 82 third-year medical students participated in the patient outreach activity during their 6-week clerkship. Of the 1,235 total attempted calls, 24% of the patients scheduled their appointments afterward. After analyzing the reflective student feedback, we identified six main takeaways, which focused on the importance of population health, the identification of barriers to care, positive and negative feelings that students experienced when making calls, student self-identified areas of growth, and the fragmentation/inefficiency of the health care system. CONCLUSIONS: An opportunity exists to continue to teach students about how to communicate with patients about their health and how to address and improve social determinants of health. This curricular activity can be a step toward efforts to align population health and clinical practice and a way for medical students to add value by educating patients.

Maltrato a estudiantes de medicina del Paraguay en 2022: encuesta multicéntrica

Introducción: los estudiantes de medicina son propensos a recibir maltratos de sus colegas, personal administrativo y pacientes. Objetivo: determinar las características del maltrato a estudiantes de medicina del Paraguay en 2022. Metodología: se aplicó un diseño observacional, de corte transversal. Se incluyó a estudiantes de medicina, de ambos sexos, que aceptaban participar de la encuesta telemática. El muestreo fue por conveniencia. Se midieron variables demográficas. La percepción del maltrato fue evaluada según cuatro componentes (psicológico, físico, académico y sexual) utilizando el cuestionario de Munayco-Guillén F et al, previamente validado. El estudio contó con la aprobación del Comité de ética de la Universidad Privada del Este, Paraguay. Resultados: el cuestionario fue contestado por 214 estudiantes, siendo 146 mujeres (edad media 24 ± 3 años) y 68 varones (edad media 25 ± 5 años). La mayoría reside en Asunción (29,4%) y asiste a universidades privadas (92%). La media ± DE del maltrato psicológico fue 1,89 ± 1,02, la del físico fue 1,64 ± 0,89, la del académico fue 2,01 ± 1,11 y la del sexual fue 1,4 ± 0,83. Aplicando puntos de corte en los percentiles 60 y 70, el maltrato fue leve en 126 estudiantes (58,9%), moderado en 24 (11,2%) y grave en 64 (29,9%). El motivo principal para no denunciarlo fue el miedo a ser señalado por los demás o recibir represalias (17,3%). Discusión: se detectó maltrato leve en 58,9%, moderado en 11,2% y grave en 29,9% de los estudiantes de medicina. Se requiere aplicar medidas de prevención y contención de los maltratos.

Introduction: medical students are prone to mistreatment from their colleagues, administrative staff, and patients. Objective: to determine the characteristics of the mistreatment of medical students in Paraguay in 2022. Method: an observational, cross-sectional design was applied. Medical students of both sexes who agreed to participate in the online survey were included. Sampling was for convenience. Demographic variables were measured. The perception of abuse was evaluated according to four components (psychological, physical, academic, and sexual) using the previously validated questionnaire by Munayco-Guillén F et al. The study was approved by the Ethics Committee of the Universidad Privada del Este, Paraguay. Results: the questionnaire was answered by 214 students, 146 being women (mean age 24 ± 3 years) and 68 men (mean age 25 ± 5 years). The majority reside in Asunción (29.4%) and attend private universities (92%). The mean ± SD of psychological abuse was 1.89 ± 1.02, physical abuse was 1.64 ± 0.89, academic abuse was 2.01 ± 1.11, and sexual abuse was 1.4 ± 0. 83. Applying cut-off points at the 60th and 70th percentiles, the abuse was mild in 126 students (58.9%), moderate in 24 (11.2%), and severe in 64 (29.9%). The main reason for not reporting it was fear of being singled out by others or receiving reprisals (17.3%). Discussion: mild abuse was detected in 58.9%, moderate in 11.2%, and severe in 29.9% of medical students. It is necessary to apply measures to prevent and contain abuse.

Cerebellar Hemangioblastoma with Leptomeningeal Spread and a Fatal Outcome: A Rare Case Report with MDM2 and EGFR Alterations.

Hemangioblastoma (HB) is a Central Nervous System (CNS) tumor with a generally favorable behavior and prognosis, classified as WHO grade 1. Sporadic HB is not related to any inherited disease, and it usually appears in a single location. Sporadic or VHL-related HBs show variable patterns of growth velocity. Cases of growing HB can cause mild symptoms such as headache, but some cases develop serious complications such as accumulation of cerebrospinal fluid in the brain with secondary neurological damage sometimes being irreversible when early treatment is not started. Our case showed some clinical characteristics more frequently observed in VHL-related HB rather than sporadic HB, and the presence of alterations in MDM2 and EGFR that could be related to the oncogenesis of these tumors. Even when the treatment of choice for HB is surgery, the presence of these genetic alterations could open a new window for research aimed at assessing the possibility of new therapies with TKIs-EGFR and anti-MDM2 inhibitors in those HB cases with multifocal recurrences or cases with an adverse clinical behavior.

Transition metal (Ti, Cu, Zn, Pt) single-atom modified graphene/AS2 (A = Mo, W) van der Waals heterostructures for removing airborne pollutants.

Air pollution is a worldwide issue that affects human health and the environment. The scientific community tries to control it through different approaches, from experimental to theoretical assessments. Here, we perform DFT calculations to describe CO2, NO2, and SO2 detection on a single-atom (Ti, Cu, Zn, Pt) graphene supported on 2D molybdenum disulfide (MoS2) and tungsten disulfide (WS2). Transition metal single atoms on graphene improve the monolayer reactivity by generating an effective way to remove airborne pollutants. Results indicate that SO2 and NO2 chemically adsorb on all tested transition metals, whereas CO2 stands on top of the incorporated atoms through van der Waals interactions. Since strong Ti-O interactions appear, the Ti single-atom graphene/MoS2(WS2) systems efficiently remove CO2 from the environment. Compared to pristine graphene, our proposed heterostructures improve the SO2, NO2, and CO2 adsorption energies. The heterostructures' electronic properties change once the molecules interact with the transition metals, generating sensible and selective pollutant molecule detection and removal.

Cultural Adaptation, Validation and Evaluation of the Psychometric Properties of an Obstetric Violence Scale in the Spanish Context.

Obstetric violence refers to dehumanized or derogative treatment of women in their pregnancy, childbirth or postpartum periods and may be manifested in different ways. Currently, there is no tool validated in Spain to measure women's perception of obstetric violence. The objective of this study was to carry out the cultural adaptation and validation of an existing 14-item obstetric violence scale in the Spanish context and to evaluate its psychometric properties. The research was conducted in two phases: first, a methodological study designed to evaluate content validity, through assessments by eight experts (calculating the Aiken V coefficient) and face validity in a sample of 20 women; second, a cross-sectional study to evaluate construct validity (through confirmatory factor analysis and Rasch analysis), divergent validity against a scale of birth satisfaction, known-groups validity and, finally, reliability. In Phase 1, Aiken V values higher than 0.71 were obtained for all items. Phase 2 was conducted on a sample of 256 women and the fit values for the unidimensional model were RMSEA: 0.070 (95% CI: 0.059-0.105) and GFI: 0.982 (95% CI: 0.823-0.990). The Rasch analysis indicated poor performance of item 2, which was removed. The Omega and Cronbach's Alpha coefficients were 0.863 and 0.860, respectively. A final 13-item version of the Obstetric Violence Scale was produced, with a total score ranging from 0 (no obstetric violence perception) to 52 (maximum obstetric violence perception). The Obstetric Violence Scale is a reliable and useful tool to measure women's perception of obstetric violence. This study was not registered.

Demographic Characteristics and Career Plans of First-Generation Medical Students at a Single Medical School in the United States.

Introduction: Recruitment of first-generation medical students is essential to improving diversity and inclusion in US medical colleges. First-generation students offer unique experiential insights that foster empathy and cultural competency in the learning environment and improve health outcomes for patients. However, little is known about their demographic characteristics or career goals. It is important to identify these factors to provide insight on ways to better support first-generation students. Methods: This exploratory pilot study aimed to describe background, demographic characteristics, and goals of students. We administered a secondary analysis of a quality improvement and health disparities survey to third-year medical students at a large, private medical school in Philadelphia, Pennsylvania. Measures included demographic information, interest in loan forgiveness programs, and other career goal items. We conducted χ2 goodness-of-fit tests to examine differences by first-generation status. Results: Thirteen percent of respondents identified as first-generation medical students (n=26). First-generation medical students were more likely to be male, aged 21-26 years, White, and non-Hispanic/Latino. First-generation students were significantly more likely to report wanting to care for underserved populations during their career and enter loan forgiveness programs, with Department of Education's Public Service Loan Forgiveness program most often cited. Conclusion: This study provides an exploratory profile of characteristics of first-generation medical students and their career intentions. Our results suggests that enrollment of first-generation students may increase the number of physicians who are willing to serve underserved populations. However, first-generation students may also need more financial support through loan forgiveness programs which has important implications for medical education.

Anti-Hla Donor-Specific Antibodies Are Associated to Infection and Not to the Engraftment Rate in Outpatient Haploidentical Hematopoietic Cell Transplantation

ABSTRACT Background: Recipients of a related haploidentical stem cell transplant (haplo-SCT) can have preformed antibodies to HLA donor's antigens. Objective: The aim of the study was to evaluate the engraftment rate and major clinical associations of anti-HLA donor-specific antibodies (DSA) at two mean fluorescence intensity (MFI) thresholds in recipients of an outpatient haplo-SCT. Methods: Seventy haplo-HCT recipients were analyzed. A virtual crossmatch was performed using the donor HLA typing and the recipient's anti-HLA DSA test results. Data for anti-HLA-A, -B, -C, and -DR were analyzed. Recipients with DSA ≥ 500 MFI were considered positive, and those with < 500 were considered negative; the same was adopted for MFI ≥ 1000. Results: Post-transplant infection was higher in recipients with DSA ≥ 500 MFI (84.6%, p = 0.041). First-year mortality was higher in DSA-positive patients ≥ 500 MFI, p = 0.004, and DSA ≥ 1000 MFI, p = 0.022, than in DSA-negative recipients. Graft failure in the first 100 days was not associated with DSA ≥ 500 or ≥ 1000 MFI. There was no difference in acute (a-GVHD) or chronic (c-GVHD) graft versus host disease between DSA-positive and negative patients. Conclusions: There was no association of anti-HLA DSA at MFI ≥ 500 and ≥ 1000 with graft failure, however, increased infection and 1st-year mortality were documented in related haplo-HCT at the MFI cutoffs studied. (REV INVEST CLIN. 2023;75(5):249-58)

CO to formaldehyde transformation study on pristine and Au-modified BaTiO3(001) through DFT calculations.

CONTEXT: BaTiO3 is one of the most important ferroelectric oxides in electronic applications. Also, it has attractive properties for catalysis that could be used for reducing contamination levels, especially carbon monoxide, CO. CO is one of the main gaseous pollutants generally released from the combustion of fossil fuel. In this work, the CO transformation on pristine and Au-modified BaTiO3 perovskite for H2CO obtention is studied. The CO adsorption and hydrogenation on pristine BaTiO3 leads to formaldehyde synthesis as the most stable product through two possible routes. Furthermore, hydrogenation stages are less probable on pristine BaTiO3. On Au-modified BaTiO3 formaldehyde is the principal product too but Au adatom generates H2CO competition with HCOH. After BaTiO3 modification with Au unpaired electrons were generated. These unpaired electrons are related to the adatom reactivity. According to the obtained results, pristine and Au-modified BaTiO3 can adsorb and hydrogenate CO generating formaldehyde as the principal product. BaTiO3 modifications with Au increase the reactivity of the perovskite in the CO hydrogenation reactions. CO hydrogenation process on Au suggests that further hydrogenation stages beyond formaldehyde are possible. METHODS: The study was performed through ab initio calculations using the periodic spin-polarized Density Functional Theory (DFT) as implemented in Quantum ESPRESSO. DFT calculations were carried out using the Plane Wave self-consistent field (PWscf). Spin density difference allows us to identify reactive regions related to dangling bonds and unpaired electrons. A plane wave basis set was used to represent the electron states. Vanderbilt pseudopotentials with nonlinear core correction were used to model the ionic cores and valence electrons interaction. Exchange-correlation energies were treated within the generalized gradient approximation (GGA) with the Perdew-Burke-Ernzerhof (PBE) parameterization.

Potential benefits of microalgae intake against metabolic diseases: beyond spirulina-a systematic review of animal studies.

CONTEXT: Microalgae are a diverse source of bioactive molecules, such as polyphenols, carotenoids, and omega-3 fatty acids, with beneficial properties in biomarkers of metabolic diseases. Unlike the rest of the microalgae genera, Arthrospira sp., commonly called spirulina, has been widely studied. OBJECTIVE: This review aims to describe the current knowledge about microalgae, besides spirulina, focusing on their beneficial properties against metabolic diseases. DATA SOURCES: A systematic research of MEDLINE (via PubMed), Cochrane, and Scopus databases was conducted to identify relevant studies published after January 2012. In vivo animal studies including microalgae consumption, except for spirulina, that significantly improved altered biomarkers related to metabolic diseases were included. These biomarkers included body weight/composition, glucose metabolism, lipid metabolism, oxidative damage, inflammation markers, and gut microbiota. DATA EXTRACTION: After the literature search and the implementation of inclusion and exclusion criteria, 37 studies were included in the revision out of the 132 results originally obtained after the application of the equation on the different databases. DATA ANALYSIS: Data containing 15 microalgae genera were included reporting on a wide range of beneficial results at different levels, including a decrease in body weight and changes in plasma levels of glucose and lipoproteins due to molecular alterations such as those related to gene expression regulation. The most reported beneficial effects were related to gut microbiota and inflammation followed by lipid and glucose metabolism and body weight/composition. CONCLUSIONS: Microalgae intake improved different altered biomarkers due to metabolic diseases and seem to have potential in the design of enriched foodstuffs or novel nutraceuticals. Nevertheless, to advance to clinical trials, more thorough/detailed studies should be performed on some of the microalgae genera included in this review to collect more information on their molecular mechanisms of action.

Nanocatalytic performance of pectinase immobilized over in situ prepared magnetic nanoparticles.

Immobilization of enzymes is one of the protein engineering methods used to improve their thermal and long-term stabilities. Immobilized pectinase has become an essential biocatalyst for optimization in the food processing industry. Herein, nanostructured magnetic nanoparticles were prepared in situ for use as supports to immobilize pectinase. The structural, morphological, optical and magnetic features and the chemical compositions of the nanoparticles were characterized. Nanoparticle agglomeration and low porosity were observed due to the synthetic conditions. These nanoparticles exhibited superparamagnetic behavior, which is desirable for biotechnological applications. The maximum retention rate for the enzyme was observed at pH 4.5 with a value of 1179.3 U/mgNP (units per milligram of nanoparticle), which was equivalent to a 65.6% efficiency. The free and immobilized pectinase were affected by the pH and temperature. The long-term instability caused 40% and 32% decreases in the specific activities of the free and immobilized pectinase, respectively. The effects of immobilization were analyzed with kinetic and thermodynamic studies. These results indicated a significant affinity for the substrate, a decreased reaction rate, and improved thermal stability of the immobilized pectinase. The reusability of the immobilized pectinase was preserved effectively during cycling, with only a 21.2% decrease in activity observed from the first to the last use. Therefore, alternative magnetic nanoparticles are presented for immobilizing and maintaining the thermostability of pectinase.

The Impact of Liquid Biopsies Positive for EGFR Mutations on Overall Survival in Non-Small Cell Lung Cancer Patients.

In recent years, non-small cell lung cancer treatment has been revolutionized. EGFR tyrosine kinase inhibitors and our improved understanding of its alterations have driven new diagnostic strategies. Liquid biopsies have emerged as a useful tool in these contexts, showing potential utility in early diagnosis combined with low-dose CT scans, as well as potential in monitoring treatment response and predicting the development of patients. We studied the circulating tumor DNA (ctDNA) of 38 EGFR-mutated non-small cell lung cancer patients at diagnosis in different moments of their disease by liquid biopsy techniques. Our results show that mean overall survival was significantly lower when a liquid biopsy was positive for the detection of EGFR mutations compared with wild-type patients in their liquid biopsy in both univariate (29 ± 4 vs. 104 ± 19 months; p = 0.004) and multivariate analysis (p = 0.008). Taking this into consideration, liquid biopsies could be key to improving the control of this disease.

3D Optical Coherence Thermometry Using Polymeric Nanogels.

In nanothermometry, the use of nanoparticles as thermal probes enables remote and minimally invasive sensing. In the biomedical context, nanothermometry has emerged as a powerful tool where traditional approaches, like infrared thermal sensing and contact thermometers, fall short. Despite the strides of this technology in preclinical settings, nanothermometry is not mature enough to be translated to the bedside. This is due to two major hurdles: the inability to perform 3D thermal imaging and the requirement for tools that are readily available in the clinics. This work simultaneously overcomes both limitations by proposing the technology of optical coherence thermometry (OCTh). This is achieved by combining thermoresponsive polymeric nanogels and optical coherence tomography (OCT)-a 3D imaging technology routinely used in clinical practice. The volume phase transition of the thermoresponsive nanogels causes marked changes in their refractive index, making them temperature-sensitive OCT contrast agents. The ability of OCTh to provide 3D thermal images is demonstrated in tissue phantoms subjected to photothermal processes, and its reliability is corroborated by comparing experimental results with numerical simulations. The results included in this work set credible foundations for the implementation of nanothermometry in the form of OCTh in clinical practice.

Supplementation with a New Standardized Extract of Green and Black Tea Exerts Antiadipogenic Effects and Prevents Insulin Resistance in Mice with Metabolic Syndrome.

Insulin resistance is one of the main characteristics of metabolic syndrome (MetS) and the main cause of the development of type II diabetes. The high prevalence of this syndrome in recent decades has made it necessary to search for preventive and therapeutic agents, ideally of natural origin, with fewer side effects than conventional pharmacological treatments. Tea is widely known for its medicinal properties, including beneficial effects on weight management and insulin resistance. The aim of this study was to analyze whether a standardized extract of green and black tea (ADM® Complex Tea Extract (CTE)) prevents the development of insulin resistance in mice with MetS. For this purpose, C57BL6/J mice were fed for 20 weeks with a standard diet (Chow), a diet with 56% kcal from fat and sugar (HFHS) or an HFHS diet supplemented with 1.6% CTE. CTE supplementation reduced body weight gain, adiposity and circulating leptin levels. Likewise, CTE also exerted lipolytic and antiadipogenic effects in 3T3-L1 adipocyte cultures and in the C. elegans model. Regarding insulin resistance, CTE supplementation significantly increased plasma adiponectin concentrations and reduced the circulating levels of insulin and the HOMA-IR. Incubation of liver, gastrocnemius muscle and retroperitoneal adipose tissue explants with insulin increased the pAkt/Akt ratio in mice fed with Chow and HFHS + CTE but not in those fed only with HFHS. The greater activation of the PI3K/Akt pathway in response to insulin in mice supplemented with CTE was associated with a decrease in the expression of the proinflammatory markers Mcp-1, IL-6, IL-1ß or Tnf-α and with an overexpression of the antioxidant enzymes Sod-1, Gpx-3, Ho-1 and Gsr in these tissues. Moreover, in skeletal muscle, mice treated with CTE showed increased mRNA levels of the aryl hydrocarbon receptor (Ahr), Arnt and Nrf2, suggesting that the CTE's insulin-sensitizing effects could be the result of the activation of this pathway. In conclusion, supplementation with the standardized extract of green and black tea CTE reduces body weight gain, exerts lipolytic and antiadipogenic effects and reduces insulin resistance in mice with MetS through its anti-inflammatory and antioxidant effects.

Ab initio study of the adsorption of SO2 on single-atom Cu-decorated ZnO(0001) surface.

CONTEXT: The World Health Organization has cataloged sulfur dioxide (SO2) as harmful for the human health and the environment. It also contributes to generate acid rain, which affects the ecosystems. To reduce its negative effects, new strategies to control the emissions are required. New and engineered materials are investigated to detect, capture, and eradicate toxic gases from the environment. Zinc oxide is considered a promising candidate. Here, we investigate the Cu-decorated ZnO(0001) surfaces as a single-atom catalyst (SAC) to reduce SO2 by first-principles calculations. We propose a two-step reduction mechanism. First, one of the S-O bonds is broken on the pristine surface, with a calculated activation energy of 14.76 kcal/mol, 1.84 kcal/mol larger than the one obtained in the Cu SAC. In the second step, the SO reduction is viable only for Cu SAC, with calculated activation energy of 29.28 kcal/mol. Our results point that Cu SAC improves the SO2 reduction, pointing it as a potentially efficient device to eradicate such harmful pollutant from the environment. METHODS: The calculations were performed using the density functional theory, as implemented in quantum ESPRESSO package. The exchange-correlation energy was calculated within the generalized gradient approximation with the Perdew-Burke-Ernzerhof parameterization. Van der Waals dispersion-corrected interactions were considered. Spin-polarization was considered for studying dangling bonds in transition states. The minimum energy pathways were calculated by using the climbing image nudged elastic band.

Impact of the COVID-19 Pandemic on Medical Students' Perceptions of Health Care for Vulnerable Populations.

BACKGROUND AND OBJECTIVES: The COVID-19 pandemic highlighted the shortcomings of our health care delivery system for vulnerable populations and created a need to rethink health disparity education in medical training. We examined how the early COVID-19 pandemic impacted third-year medical students' attitudes, perceptions, and sense of responsibility regarding health care delivery for vulnerable populations. METHODS: Third-year family medicine clerkship students at a large, private medical school in Philadelphia, Pennsylvania responded to a reflection assignment prompt asking how the COVID-19 pandemic impacted their thoughts about health care delivery for vulnerable populations in mid-2020 (N=59). Using conventional content analysis, we identified three main themes across 24 codes. RESULTS: Students recognized homeless individuals and Black, indigenous, and persons of color (BIPOC) as vulnerable populations impacted by the pandemic. Students reported causes of vulnerability that focused heavily on social determinants of health, increased risk for contracting COVID-19 infections, and difficulty adhering to COVID-19 prevention guidelines. Notable action-oriented approaches to addressing these disparities included health care reform and community health intervention. CONCLUSIONS: Our findings describe an educational approach to care for vulnerable populations based on awareness, attitudes, and social action. Medical education must continue to teach students how to identify ways to mitigate disparities in order to achieve health equity.

Meaningless gestures or pathway to healing and reconciliation? Comparing the perspectives on political apologies in victim and non-victim communities in El Salvador, the Republic of Korea and the United Kingdom.

Political apologies have been theorized to play an important role in healing and reconciliation processes in post-conflict settings. Whether they actually fulfil this function, however, remains unclear as the voices and perspectives of victim communities have largely been underrepresented in research. To address this, we examined the role of apologies that were offered for the El Mozote massacre (El Salvador), the Jeju 4.3 massacres (Republic of Korea) and Bloody Sunday (United Kingdom), according to members of these communities and the broader public. Although we anticipated that victim community members should find the apology more valuable and meaningful and should, therefore, be more positive about its role in healing and reconciliation processes, we found that this varies across countries. This variation could be explained by people's trust in the country's institutions. Across the samples, we found that the apology was seen as a relatively important gesture. For the apology to be perceived as impactful, however, it had to be seen as a meaningful (i.e. sincere) gesture. Our findings suggest that apologies have a role to play in the aftermath of human rights violations, but that it is essential to take the broader context into account.

Digital Quality Resources Resulting from Standardized Program for Rubric Training in Medical Residents.

INTRODUCTION: In the health care area, tuition is an essential part to provide the instrument that proves the graduates have acquired the necessary skills in their specialties. OBJECTIVE: Evaluation of the improvement in quality of resources for residents after standardized digital training program with rubrics. METHODS: Prospective observational study of first year medical residents in seven medical specialties in four different training centers. Five dimensions were considered to scale the quality of medical resident research: Validation of rubric in investigation methodology topics for each block in b-learning mode; initial and ending evaluation; colloquium investigation rubric; results of final investigation; satisfaction survey of 360 degrees. The instruments were validated using the delphi method with a minimum agreement of 0.8. We considered global values greater than 80 points as good quality. RESULTS: 85 medical residents participated and obtained a final average of 80.62 (±9.59), and the satisfaction of the course was qualified as excellent/good in 82.5%. A positive relation was observed between the scope of the evaluation and the level of satisfaction. Mean quality score for the course was good. There is no relationship between the research experience of the students and the final average r = 0.123 (p = 0.291). CONCLUSIONS: The implementation of research seminars in b-learning mode results in improving the education program for health residents after a training program with a rubric system and their acquiring research skills, and, as a consequence, the final product also showed better quality, even when the student did not have any experience in a scientific publication.

Epidemiological Study of Prostate Cancer in the Province of Salamanca (2006-2015).

OBJECTIVES: Knowing the incidence of prostate cancer in Salamanca and its evolution, as well as the age at diagnosis and its evolution. In addition, analyzing the mortality from prostate cancer in the province of Salamanca. METHODS: Descriptive and analytical, longitudinal and retrospective observational study. From the collection of data from the Pathological Anatomy service and the Clinical Documentation service of the Hospital Complex of Salamanca a database was developed for the calculation of incidence rates. The information collected on mortality was obtained through the National Institute of Statistics. For regression analysis, segmented "jointpoint" models were developed. RESULTS: 2676 males diagnosed with prostate cancer were recorded in the province of Salamanca (period 2006-2015). The risk of prostate cancer up to age 74 in 2006 was 6.23%, almost double in 2010. The evolution of mortality rates adjusted to the European population in the province of Salamanca during the period 2006-2015 showed a slight decrease. CONCLUSIONS: In general, Prostate cancer incidence rates increased progressively over the years studied, similar to Spain's overall rates. These rates increased as age progressed. In general, our incidence rates were lower than those reported by the provinces of northern Spain (except Vizcaya) and higher than those recorded by the provinces of southern Spain. In Europe, our rate was surpassed by countries in northern and western Europe and lower than countries in southern and eastern Europe, and part of central Europe. Countries like U.S.A had rates higher than ours, while Canada accounted for a similar rate. On the other hand, mortality rates remained stable during the middle of the study period, suffering from then on a non-statistically significant anual decrease.

Epidemiological Study of Prostate Cancer in the Province of Salamanca (2006-2015)

Objectives: Knowing the incidence of prostate cancer in Salamanca and its evolution, as well as the age at diagnosis and its evolution. In addition, analyzing the mortality from prostate cancer in the province of Salamanca. Methods: Descriptive and analytical, longitudinal and retrospective observational study. From the collection of data from the Pathological Anatomy service and the Clinical Documentation service of the Hospital Complex of Salamanca a database was developed for the calculation of incidence rates. The information collected on mortality was obtained through the National Institute of Statistics. For regression analysis, segmented “jointpoint” models were developed. Results: 2676 males diagnosed with prostate cancer were recorded in the province of Salamanca (period 2006-2015). The risk of prostate cancer up to age 74 in 2006 was 6.23%, almost double in 2010. The evolution of mortality rates adjusted to the European population in the province of Salamanca during the period 2006-2015 showed a slight decrease. Conclusions: In general, Prostate cancer incidence rates increased progressively over the years studied, similar to Spain’s overall rates. These rates increased as age progressed. In general, our incidence rates were lower than those reported by the provinces of northern Spain (except Vizcaya) and higher than those recorded by the provinces of southern Spain. In Europe, our rate was surpassed by countries in northern and western Europe and lower than countries in southern and eastern Europe, and part of central Europe. Countries like U.S.A had rates higher than ours, while Canada accounted for a similar rate. On the other hand, mortality rates remained stable during the middle of the study period, suffering from then on a non-statistically significant anual decrease (AU)

Supplementation with Two New Standardized Tea Extracts Prevents the Development of Hypertension in Mice with Metabolic Syndrome.

Hypertension is considered to be both a cardiovascular disease and a risk factor for other cardiovascular diseases, such as coronary ischemia or stroke. In many cases, hypertension occurs in the context of metabolic syndrome (MetS), a condition in which other circumstances such as abdominal obesity, dyslipidemia, and insulin resistance are also present. The high incidence of MetS makes necessary the search for new strategies, ideally of natural origin and with fewer side effects than conventional pharmacological treatments. Among them, the tea plant is a good candidate, as it contains several bioactive compounds such as caffeine, volatile terpenes, organic acids, and polyphenols with positive biological effects. The aim of this study was to assess whether two new standardized tea extracts, one of white tea (WTE) and the other of black and green tea (CTE), exert beneficial effects on the cardiovascular alterations associated with MetS. For this purpose, male C57/BL6J mice were fed a standard diet (Controls), a diet high in fats and sugars (HFHS), HFHS supplemented with 1.6% WTE, or HFHS supplemented with 1.6% CTE for 20 weeks. The chromatography results showed that CTE is more concentrated on gallic acid, xanthines and flavan-3-ols than WTE. In vivo, supplementation with WTE and CTE prevented the development of MetS-associated hypertension through improved endothelial function. This improvement was associated with a lower expression of proinflammatory and prooxidant markers, and-in the case of CTE supplementation-also with a higher expression of antioxidant enzymes in arterial tissue. In conclusion, supplementation with WTE and CTE prevents the development of hypertension in obese mice; as such, they could be an interesting strategy to prevent the cardiovascular disorders associated with MetS.