Calidad de vida relacionada con la salud y los estados de ánimo en estudiantes de instituciones educativas de Antioquia, Colombia / Quality of life related to the health and mood states of students in educational institutions from Antioquia, Colombia / Qualidade de vida relacionada à saúde e ao humor em estudantes de instituições de ensino em Antioquia, Colômbia

Introducción: La calidad de vida relacionada con la salud (CVRS) y los estados de ánimo son indicadores cruciales del bienestar en adolescentes, pero su relación con estudiantes de Antioquia, Colombia, no ha sido ampliamente estudiada. Objetivo: Determinar la CVRS y los estados de ánimo en escolares de Antioquia-Colombia. Materiales y métodos: Estudio transversal con 1957 escolares de 9 a 20 años. Se aplicaron mediciones de CVRS, ansiedad, depresión, hostilidad y alegría, actividad física, comportamiento sedentario, apoyo social de padres y nivel socioeconómico. Resultados: La calidad de vida alta (CVA) es más elevada en hombres, personas con alegría, estudiantes con apoyo de padres, activos físicamente y personas de nivel socioeconómico alto y medio. AL aumentar un año de edad, disminuye en un 15 % la CVA, y al aumentar la depresión, la ansiedad y el comportamiento sedentario disminuye la CVA. Además, los niveles de depresión y ansiedad son mayores en mujeres, estudiantes mayores, sin apoyo de los padres y personas sedentarias. Conclusiones: La CVRS se asocia con estados de ánimo, actividad física, comportamiento sedentario y apoyo de los padres; mientras que los estados de ánimo se asocian con el sexo, el apoyo de los padres, la CVS y el sedentarismo.

Introduction: Even though health-related quality of life (HRQL) and mood states are key indicators of the well-being of adolescents, their relationship has not been analyzed in students from Antioquia, Colombia. Objective: To determine HRQL and mood states in schoolchildren from Antioquia. Materials and methods: A cross-sectional study was conducted on 1,957 schoolchildren and adolescents aged between 9 and 20 years. Measurements of HRQL, anxiety, depression, hostility and happiness, physical activity, sedentary behavior, parental social support, and socioeconomic status were applied. Results: A high quality of life (HQL) was observed more frequently in male participants, students with parental support, physically active, and those belonging to medium and high socioeconomic status. HQL decreased 15% as their age increased by one year. Also, HQL was reduced when depression, anxiety, and sedentary behavior increased. Furthermore, depression and anxiety levels were higher in women, older students, as well as in those without parental control and with sedentary behavior. Conclusions: HRQL is associated with mood states, physical activity, sedentary behavior, and parental support. In contrast, mood states are related to gender, parental support, HQL, and sedentary lifestyle.

Introdução: A qualidade de vida relacionada à saúde (CVRS) e os estados de humor são indicadores cruciais de bem-estar em adolescentes, mas sua relação com estudantes de Antioquia, Colômbia, não foi amplamente estudada. Objetivo: Determinar a CVRS e os estados de humor em escolares de Antioquia-Colômbia. Materiais e métodos: Estudo transversal com 1.957 escolares de 9 a 20 anos. Foram aplicadas medidas de QVRS, ansiedade, depressão, hostilidade e felicidade, atividade física, comportamento sedentário, apoio social dos pais e nível socioeconômico. Resultados: A alta qualidade de vida (CVA) é maior em homens, pessoas com alegria, estudantes com apoio parental, fisicamente ativos e pessoas de nível socioeconômico alto e médio. À medida que a idade aumenta em um ano, diminui em 15% o CVA, e ao aumentar a depressão, a ansiedade e o comportamento sedentário aumentam, o CVA diminui. Além disso, os níveis de depressão e ansiedade são mais elevados nas mulheres, nos estudantes mais velhos, sem apoio dos pais e nas pessoas sedentárias. Conclusões: A QVRS está associada a estados de humor, atividade física, comportamento sedentário e apoio parental; enquanto os estados de humor estão associados ao sexo, apoio parental, CVS e estilo de vida sedentário.

Mecánica y energética durante la marcha en cinta caminadora en adultos uruguayos saludables: efecto del IMC y la edad / Mechanics and energy during treadmill walking in healthy uruguayan adults: effect of BMI and age / Mecânica e energia durante a caminhada em esteira em adultos uruguaios saudáveis: efeito do IMC e Idade

La evaluación de la marcha en cinta caminadora puede resultar relevante para la toma de decisiones clínicas. No obstante, factores demográficos como la edad y el IMC pueden alterar la interpretación de los resultados. Nuestro objetivo fue obtener variables espacio- temporales, energéticas y costo de transporte durante la velocidad autoseleccionada en cinta caminadora para una muestra representativa de adultos uruguayos (n=28) y evaluar si diferentes rangos de edades e IMC pueden ser factores a tener en cuenta en pruebas clínicas donde se consideren dichas variables. Participaron 17 hombres y 11 mujeres (39,3 ± 14,8 años, 75,9 ± 12,5 kg, 1,74 ± 0,09 m, IMC 25,2 ± 4,06). Se realizó una reconstrucción 3D del movimiento en forma sincronizada con el consumo energético. Se obtuvieron valores de referencia y luego de agrupar los participantes según su IMC y rango de edad se compararon los datos mediante test de t (p≤0.05). Los resultados revelaron discrepancias significativas en las medidas espacio-temporales y energéticas de los adultos uruguayos al caminar en cinta con respecto a la literatura. La marcha difiere entre adultos jóvenes y de mediana edad en su velocidad autoseleccionada (p=0,03), longitud de zancada (p=0,01), trabajo mecánico externo (<0,001) y recuperación de energía mecánica (0,009), destacando la importancia de considerar la edad en evaluaciones clínicas. El IMC no influyó significativamente en estas variables. Estos hallazgos subrayan la necesidad de ajustar las interpretaciones de las pruebas clínicas de la marcha sobre cinta caminadora en adultos uruguayos de mediana edad (45 a 65 años).

Treadmill gait assessment can be relevant for clinical decision-making. However, demographic factors such as age and BMI may alter result interpretation. Our aim was to obtain spatiotemporal, energetic, and cost of transport variables during self-selected treadmill walking speed for a representative sample of Uruguayan adults (n=28) and to assess if different age ranges and BMI could be factors to consider in clinical tests involving these variables. Seventeen men and eleven women participated (39.3 ± 14.8 years, 75.9 ± 12.5 kg, 1.74 ± 0.09 m, BMI 25.2 ± 4.06). A synchronized 3D motion reconstruction was performed with energy consumption. Reference values were obtained and data were compared using t-tests (p≤0.05), after grouping participants by BMI and age range. Results revealed significant discrepancies in spatiotemporal and energetic measures of Uruguayan adults walking on the treadmill, compared to the literature. Gait differed between young and middle-aged adults in their self-selected speed (p=0.03), stride length (p=0.01), external mechanical work (p<0.001), and mechanical energy recovery (0.009), emphasizing the importance of considering age in clinical evaluations. BMI did not significantly influence these variables. These findings underscore the need to adjust interpretations of treadmill gait clinical tests in middle-aged Uruguayan adults (45 to 65 years).

A avaliação da marcha na esteira pode ser relevante para a tomada de decisões clínicas. No entanto, fatores demográficos como idade e IMC podem alterar a interpretação dos resultados. Nosso objetivo foi obter variáveis espaço-temporais, energéticas e custo de transporte durante a velocidade de caminhada autoselecionada na esteira para uma amostra representativa de adultos uruguaios (n = 28) e avaliar se diferentes faixas etárias e IMC podem ser fatores a serem considerados em testes clínicos que envolvam essas variáveis. Dezessete homens e onze mulheres participaram (39,3 ± 14,8 anos, 75,9 ± 12,5 kg, 1,74 ± 0,09 m, IMC 25,2 ± 4,06). Foi realizada uma reconstrução tridimensional do movimento sincronizada com o consumo de energia. Foram obtidos valores de referência e os dados foram comparados usando testes t (p≤0,05), após agrupar os participantes por IMC e faixa etária. Os resultados revelaram discrepâncias significativas nas medidas espaço-temporais e energéticas dos adultos uruguaios ao caminhar na esteira, em comparação com a literatura. A marcha diferiu entre adultos jovens e de meia-idade em sua velocidade autoselecionada (p=0,03), comprimento da passada (p=0,01), trabalho mecânico externo (<0,001) e recuperação de energia mecânica (0,009), destacando a importância de considerar a idade em avaliações clínicas. O IMC não influenciou significativamente essas variáveis. Esses achados destacam a necessidade de ajustar as interpretações dos testes clínicos de marcha na esteira em adultos uruguaios de meia- idade (45 a 65 anos).

Prevalencia de urticaria crónica: un estudio en población pediátrica de un hospital general / Prevalence of chronic urticaria: A study in the pediatric population of a general hospital

Introducción. La urticaria crónica es una afección inflamatoria de la piel caracterizada por presencia de habones evanescentes y/o angioedema, que ocurren durante un período ≥ 6 semanas. Objetivo. Determinar la prevalencia de esta enfermedad y describir características clínicas en niños y adolescentes menores de 19 años de un hospital general. Población y métodos. Estudio corte transversal, realizado entre el 2015 y el 2020, en una población de niños y adolescentes de un sistema de salud privado. Resultados. Se revisaron 1567 historias clínicas de pacientes con urticaria atendidos durante el período de estudio. Se identificaron 36 pacientes con urticaria crónica; se estableció una prevalencia del 0,16 % (IC95% 0,11-0,22). Conclusión. La prevalencia de urticaria crónica en niños y adolescentes fue del 0,16 %. Se observó mayor frecuencia en el sexo femenino y adolescentes.

Introduction. Chronic urticaria is an inflammatory skin condition characterized by the presence of evanescent wheals or angioedema that last for ≥ 6 weeks. Objective. To determine the prevalence of urticaria and describe its clinical characteristics in children and adolescents under 19 years of age in a general hospital. Population and methods. This was a cross-sectional study carried out between 2015 and 2020 in a population of children and adolescents seen at a private healthcare facility. Results. A total of 1567 medical records of patients with urticaria seen during the study period were reviewed. Thirty-six patients with chronic urticaria were identified; the prevalence was 0.16% (95% CI: 0.11­0.22). Conclusion. The prevalence of chronic urticaria in children and adolescents was 0.16%. A higher frequency was observed among girls and adolescents.

Referencias argentinas de perímetro cefálico desde el nacimiento hasta los 19 años / Argentine reference charts for head circumference from birth to 19 years of age

Introducción. El perímetro cefálico (PC) es un indicador del crecimiento cerebral y es necesario contar con referencias de crecimiento que permitan determinar variaciones normales o patológicas. Objetivos. Presentar las primeras referencias argentinas de perímetro cefálico entre el nacimiento y los 19 años, y compararlas con las referencias de Nellhaus, utilizadas en nuestro país hasta la actualidad. Población y métodos. Para la construcción de estas referencias, se combinaron datos de la Encuesta Nacional de Nutrición y Salud 2018 y estudios transversales realizados entre 2004 y 2007 en las provincias de Buenos Aires y La Pampa, que incluyeron 8326 niños, niñas y adolescentes sanos. Las curvas de crecimiento fueron ajustadas con el método LMS. Para evaluar la magnitud de las diferencias entre estas referencias y las de Nellhaus, a diferentes edades, se graficaron los centilos 2, 50 y 98. Resultados. El PC mostró un incremento de tamaño variable con la edad, de mayor magnitud en los primeros años de vida, y un ligero incremento en la pubertad. Los valores del centilo 98 de las referencias argentinas fueron mayores que los de Nellhaus en todas las edades. Los valores del centilo 2 de la referencia nacional fueron menores que los de Nellhaus durante los primeros 2 años de vida, similares entre los 3 y 7 años, y mayores a partir de esta edad. Conclusiones. Las curvas argentinas describen adecuadamente el patrón de crecimiento del PC. Las diferencias halladas con la referencia de Nellhaus pueden atribuirse a cambios seculares.

Introduction. Head circumference (HC) is an indicator of brain growth; growth charts are necessary to determine normal or pathological variations. Objectives. To present the first Argentine HC reference charts between birth and 19 years of age and to compare them with the Nellhaus charts, which have been used in our country to date. Population and methods. These references were developed based on combined data from the National Survey on Nutrition and Health of 2018 and cross-sectional studies conducted between 2004 and 2007 in the provinces of Buenos Aires and La Pampa, which included 8326 healthy children and adolescents. Growth curves were adjusted using the LMS method. To assess the differences between these reference charts and the Nellhaus charts, at different ages, the 2nd, 50th, and 98th percentiles were plotted. Results. HC showed a variable increase in size with age, which was greater in the first years of life, and a slight increase at puberty. The values for the 98th percentile of the Argentine reference charts were higher than those of the Nellhaus charts at all ages. The values for the 2 nd percentile of the national reference were lower than those of the Nellhaus charts during the first 2 years of life, similar between 3 and 7 years of age, and higher after this age. Conclusions. The Argentine curves adequately describe the growth pattern of HC. The differences found with the Nellhaus charts may be attributed to secular changes.

Planejamento e Políticas de Saúde na Amazônia / Health Planning and Policies in the Amazon

Na Amazônia, a política de saúde se encontra com um território de vida específico, caracterizado por um tecido social diverso, dinâmico e imigrante, transitando pelas águas e florestas. Nesse cenário, a vida é pujante, que vibra e faz acontecer um sistema de saúde amazônico, plural étnica e socialmente, biodiverso e culturalmente específico. Assim, é imperativo construirmos referencial teórico da saúde coletiva regional, bem como refletirmos e contextualizarmos o SUS com "DNA amazônico". Compreendemos ser esta uma referência para colaborar com o campo das ciências gerenciais que compõe o campo da saúde coletiva no Brasil, sem dissociar do desafio de realizar a gestão e as práticas das políticas de saúde por pesquisadores gestores da Amazônia. O 'fator amazônico' aqui apresentado roteiriza os desafios de se fazer saúde nessas diversas amazônias. Cenários de experiências promissoras no campo das políticas e planejamento aqui expressos podem contribuir com a comunicação entre gestore(a)s, pesquisadore(a)s e membros do controle social a vislumbrarem métodos e oportunidades de mudanças sistêmicas nas práticas assistenciais e nos modos de gerir a saúde na Amazônia.

Is gender primacy universal?

Emerging evidence suggests that gender is a defining feature of personhood. Studies show that gender is the primary social category individuals use to perceive humanness and the social category most strongly related to seeing someone-or something-as human. However, the universality of gender's primacy in social perception and its precedence over other social categories like race and age have been debated. We examined the primacy of gender perception in the Mayangna community of Nicaragua, a population with minimal exposure to Western influences, to test whether the primacy of gender categorization in humanization is more likely to be a culturally specific construct or a cross-cultural and potentially universal phenomenon. Consistent with findings from North American populations [A. E. Martin, M. F. Mason, J. Pers. Soc. Psychol. 123, 292-315 (2022)], the Mayangna ascribed gender to nonhuman objects more strongly than any other social category-including age, race, sexual orientation, disability, and religion-and gender was the only social category that uniquely predicted perceived humanness (i.e., the extent to which a nonhuman entity was seen as "human"). This pattern persisted even in the most isolated subgroup of the sample, who had no exposure to Western culture or media. The present results thus suggest that gender's primacy in social cognition is a widely generalizable, and potentially universal, phenomenon.

Cost-effectiveness and health impact of screening and treatment of Mycobacterium tuberculosis infection among formerly incarcerated individuals in Brazil: a Markov modelling study.

BACKGROUND: Individuals who were formerly incarcerated have high tuberculosis incidence, but are generally not considered among the risk groups eligible for tuberculosis prevention. We investigated the potential health impact and cost-effectiveness of Mycobacterium tuberculosis infection screening and tuberculosis preventive treatment (TPT) for individuals who were formerly incarcerated in Brazil. METHODS: Using published evidence for Brazil, we constructed a Markov state transition model estimating tuberculosis-related health outcomes and costs among individuals who were formerly incarcerated, by simulating transitions between health states over time. The analysis compared tuberculosis infection screening and TPT, to no screening, considering a combination of M tuberculosis infection tests and TPT regimens. We quantified health effects as reductions in tuberculosis cases, tuberculosis deaths, and disability-adjusted life-years (DALYs). We assessed costs from a tuberculosis programme perspective. We report intervention cost-effectiveness as the incremental costs per DALY averted, and tested how results changed across subgroups of the target population. FINDINGS: Compared with no intervention, an intervention incorporating tuberculin skin testing and treatment with 3 months of isoniazid and rifapentine would avert 31 (95% uncertainty interval 14-56) lifetime tuberculosis cases and 4·1 (1·4-5·8) lifetime tuberculosis deaths per 1000 individuals, and cost US$242 per DALY averted. All test and regimen combinations were cost-effective compared with no screening. Younger age, longer incarceration, and more recent prison release were each associated with significantly greater health benefits and more favourable cost-effectiveness ratios, although the intervention was cost-effective for all subgroups examined. INTERPRETATION: M tuberculosis infection screening and TPT for individuals who were formerly incarcerated appears cost-effective, and would provide valuable health gains. FUNDING: National Institutes of Health. TRANSLATION: For the Portuguese translation of the abstract see Supplementary Materials section.

Development of coparenting during the transition to parenthood: Integrating parents' representations with observed interactions.

The transition to parenthood is a significant period of transformation and adjustment for all members of a new family, reshaping relational dynamics that often endure throughout the initial years of a child's life. This qualitative and longitudinal study aimed to explore coparenting representations held by both partners in a parental couple, along with observations of their family interactions, at three distinct points in time, with the aim to better understand the interaction between these representational and behavioral observations. In-depth interviews were conducted with 17 heterosexual, first-time parents in Santiago de Chile, during pregnancy and at two different times during the first year of their child's life. Family interactions were assessed using the Lausanne Trilogue Play task (LTP) on all occasions. Three main coparenting representation categories emerged: traditional, ambiguous, and co-responsible. On observation, approximately half of the couples showed cooperative coparenting interactions, while the other half had conflictual interactions. Couples generally followed stable trajectories over time. Cooperative couples demonstrated co-responsibility and open dialogue, while conflictual couples tended to follow traditional gender roles with tacit communication styles. This study highlights the importance of promoting co-responsibility and dialogue for fostering cooperative relational dynamics during the critical transition to parenthood.

La transición a la paternidad/maternidad es un período significativo de transformación y ajuste para todos los miembros de una nueva familia, dándole nueva forma a las dinámicas de relación que a menudo se sobrellevan a lo largo de los años iniciales de la vida del niño. Este estudio cualitativo y longitudinal se propuso explorar las representaciones en la crianza compartida que tienen ambos miembros de una pareja de padres, junto con observaciones de sus interacciones familiares, en tres puntos distintivos en el tiempo, con el propósito de comprender mejor la interacción entre estas observaciones representacionales y de comportamiento. Se llevaron a cabo entrevistas profundas con 17 padres primerizos, heterosexuales, en Santiago de Chile, durante el embarazo y en dos momentos diferentes durante el primer año de vida de sus niños. Se evaluaron las interacciones de familia usando la tarea del Juego Tripartito de Lausanne (LTP) en todas las ocasiones. Tres principales categorías representacionales de crianza compartida surgieron: tradicional, ambigua y de responsabilidad compartida. Bajo observación, aproximadamente la mitad de las parejas mostró interacciones cooperadoras de crianza compartida, mientras que la otra mitad tuvo interacciones conflictivas. Las parejas generalmente siguieron trayectorias estables a lo largo del tiempo. Las parejas cooperadoras demostraron responsabilidad compartida y diálogo abierto, mientras que las parejas conflictivas tendieron a seguir papeles tradicionales de género con estilo de comunicación tácitos. Este estudio subraya la importancia de promover la responsabilidad compartida y el diálogo para cultivar relaciones dinámicas de cooperación durante la crucial transición a la paternidad/maternidad.

Ethnic-racial disparities in poisoning cases: analysis of drugs of abuse, medicines and pesticides in Brazil.

In Brazil, ethnic-racial inequalities exist in all fields, obstructing access to goods, services, and opportunities, including healthcare services. However, there are no apparent studies that assess, at a national level, ethnic-racial disparities in poisoning cases, emphasizing skin color as a determining factor. The study aimed to examine the relationship between race/ethnicity and general poisoning cases, by medications, pesticides, and drug of abuse in Brazilian states. Poisoning cases data were extracted for the years 2017, 2018, and 2019. Notification data for general poisoning cases and toxic agents were collected: medications, pesticides, and drugs of abuse. Data were categorized between whites and non-whites (blacks, browns, and indigenous) and without information on skin color/ethnicity. Rates of poisonings amongst ethnic-racial groups and cases of not declared skin color as well as relative risk (RR) of poisoning among non-whites were calculated. All states in the North, Northeast (states with the worst Human Development Index), Midwest, and 2 states in the Southeast exhibited higher rates of poisoning cases per 100,000 inhabitants among non-whites. The RR values for nonwhite individuals were higher in the North and Northeast regions for all types of poisonings. The type of poisoning cases that presented the highest RR for non-whites over the 3 years was drugs of abuse (2-2.44), when compared to other types of poisonings from pesticides (2-2.33) and medications (1.5-1.91). The spatial distribution of poisoning cases rates and RR of nonwhite population support public policies to reduce socioeconomic and environmental inequalities.

Sex-Related Glycemic and Cardiovascular Responses After Continuous and Interval Aerobic Sessions in Patients With Type 1 Diabetes: A Randomized Crossover Study.

We aimed to investigate sex-related glycemic and cardiovascular responses after intensity- (moderate) and duration- (30 minutes) matched interval aerobic exercise (IAE) and continuous (CAE) aerobic exercise sessions in patients with type 1 diabetes mellitus (T1DM). A total of 19 volunteers (10 women) participated in 2 randomized and crossover sessions (1:1). Heart rate, systolic and diastolic blood pressure, double product, and blood glucose (BG) levels were measured before (PRE), immediately after (POST-0), and 20 minutes after (POST-20) each session. The rates of perceived exertion (RPE) and enjoyment levels (ELs) were assessed after each session. Generalized estimating equations were used to analyze the data (condition × time × sex). Regarding sex-related changes, men showed BG reductions at POST-0 and POST-20 after CAE (∆: -3.7 and -3.7 mmol/L, respectively) and only at POST-0 after IAE (∆: -1.6 mmol/L), with 1 episode of hypoglycemia occurring in the latter group. In contrast, women showed reduced BG values only after CAE at both time points (∆: -1.4 and -1.7 mmol/L) compared with PRE values. The decrease in BG levels at both time points was higher for men after CAE than IAE. Cardiovascular responses, RPEs, and ELs were similar between exercise sessions, except for blood pressure, which showed higher values in men. In conclusion, lower BG levels were observed after CAE, with greater reductions in men. Similar cardiovascular, RPE, and EL responses were found across sexes and sessions. Consideration of sex-specific recommendations may be warranted when prescribing aerobic exercise, particularly, for men with irregular physical activity levels.

Detection of Mycobacterium tuberculosis transrenal DNA in urine samples among adults in Peru.

Diagnosis of pulmonary tuberculosis (TB) relies on a sputum sample, which cannot be obtained from all symptomatic individuals. Mycobacterium tuberculosis (Mtb) transrenal DNA (trDNA) has been detected in urine, an easily obtainable, noninvasive, alternative sample type. However, reported sensitivities have been variable and likely depend on collection and assay procedures and aspects of trDNA biology. We analyzed three serial urine samples from each of 75 adults with culture-confirmed pulmonary TB disease in Lima, Peru for detection of trDNA using short-fragment real-time PCR. Additionally, we examined host, urine, and sampling factors associated with detection. Overall per-sample sensitivity was 38 % (95 % Confidence Interval [CI] 30-45 %). On an individual level (i.e., any of the three samples positive), sensitivity was 73 % (95 % CI: 62-83 %). Sensitivity was highest among samples from patients with smear-positive TB, 92 % (95 % CI: 62-100 %). Specificity from a single sample from each of 10 healthy controls was 100 % (95 % CI: 69-100 %). Adjusting our assay positivity threshold increased individual-level sensitivity to 88 % (95 % CI: 78-94 %) overall without affecting the specificity. We did not find associations between Mtb trDNA detection and individual characteristics or urine sample characteristics. Overall, our results support the potential of trDNA detection for TB diagnosis.

Test-retest reliability and minimal detectable change in pelvis and lower limb coordination during running assessed with modified vector coding.

The objective of this study was to evaluate the reliability of Modified Vector Coding in assessing the coordination and coordination variability of the lower limbs and pelvis during running and to determine the Minimal Detectable Change (MDC). Twenty-five healthy runners participated in a biomechanical analysis of treadmill running using a motion capture system. Modified vector coding was applied to assess the three-dimensional coordination among various pelvis and lower limb segmental couplings. Reliability was assessed using the Intraclass Correlation Coefficient (ICC), Standard Error of Measurement (SEM), MDC, and Bland-Altman analysis to ascertain measurement consistency, agreement, and the smallest clinically meaningful change that exceeds measurement error. The test-retest reliability for 33 of 42 segmental couplings analyzed was good to excellent, with ICC values ranging from 0.613 to 0.928 (p <0.05), which substantiates the robustness of modified vector coding in running biomechanics. However, nine couplings, particularly femur-tibia in the sagittal plane during midstance and foot in the frontal plane-tibia in the transverse plane during late stance, exhibited poor to moderate reliability. These findings underscore the need for cautious interpretation due to significant proportional bias (p <0.05). SEM and MDC provided insights into the precision and minimal clinically significant changes for each coupling. The findings confirm the reliability of modified vector coding for biomechanical analysis in running, with most couplings demonstrating consistent high reliability. Nevertheless, specific couplings should be interpreted with caution due to potential measurement errors. The application of MDC highlights the precision of modified vector coding in biomechanical analyses and emphasizes the importance of careful interpretation to improve clinical and research outcomes in running-related injuries.

Life-course influences of poverty on violence and homicide: 30-year Brazilian birth cohort study.

BACKGROUND: Homicide is the leading cause of death among young people in Latin America, one of the world's most violent regions. Poverty is widely considered a key cause of violence, but theories suggest different effects of poverty, depending on when it is experienced in the life-course. Longitudinal studies of violence are scarce in Latin America, and very few prospective data are available worldwide to test different life-course influences on homicide. METHODS: In a prospective birth cohort study following 5914 children born in southern Brazil, we examined the role of poverty at birth, in early childhood, and in early adulthood on violence and homicide perpetration, in criminal records up to age 30 years. A novel Structured Life Course Modelling Approach was used to test competing life-course hypotheses about 'sensitive periods', 'accumulation of risk', and 'downward mobility' regarding the influence of poverty on violence and homicide. RESULTS: Cumulative poverty and poverty in early adulthood were the most important influences on violence and homicide perpetration. This supports the hypothesis that early adulthood is a sensitive period for the influence of poverty on lethal and non-lethal violence. Results were replicable using different definitions of poverty and an alternative outcome of self-reported fights. CONCLUSION: Cumulative poverty from childhood to adulthood was an important driver of violence and homicide in this population. However, poverty experienced in early adulthood was especially influential, suggesting the importance of proximal mechanisms for violence in this context, such as unemployment, organized crime, drug trafficking, and ineffective policing and justice systems.

Understanding Health Care Students' Perceptions, Beliefs, and Attitudes Toward AI-Powered Language Models: Cross-Sectional Study.

BACKGROUND: ChatGPT was not intended for use in health care, but it has potential benefits that depend on end-user understanding and acceptability, which is where health care students become crucial. There is still a limited amount of research in this area. OBJECTIVE: The primary aim of our study was to assess the frequency of ChatGPT use, the perceived level of knowledge, the perceived risks associated with its use, and the ethical issues, as well as attitudes toward the use of ChatGPT in the context of education in the field of health. In addition, we aimed to examine whether there were differences across groups based on demographic variables. The second part of the study aimed to assess the association between the frequency of use, the level of perceived knowledge, the level of risk perception, and the level of perception of ethics as predictive factors for participants' attitudes toward the use of ChatGPT. METHODS: A cross-sectional survey was conducted from May to June 2023 encompassing students of medicine, nursing, dentistry, nutrition, and laboratory science across the Americas. The study used descriptive analysis, chi-square tests, and ANOVA to assess statistical significance across different categories. The study used several ordinal logistic regression models to analyze the impact of predictive factors (frequency of use, perception of knowledge, perception of risk, and ethics perception scores) on attitude as the dependent variable. The models were adjusted for gender, institution type, major, and country. Stata was used to conduct all the analyses. RESULTS: Of 2661 health care students, 42.99% (n=1144) were unaware of ChatGPT. The median score of knowledge was "minimal" (median 2.00, IQR 1.00-3.00). Most respondents (median 2.61, IQR 2.11-3.11) regarded ChatGPT as neither ethical nor unethical. Most participants (median 3.89, IQR 3.44-4.34) "somewhat agreed" that ChatGPT (1) benefits health care settings, (2) provides trustworthy data, (3) is a helpful tool for clinical and educational medical information access, and (4) makes the work easier. In total, 70% (7/10) of people used it for homework. As the perceived knowledge of ChatGPT increased, there was a stronger tendency with regard to having a favorable attitude toward ChatGPT. Higher ethical consideration perception ratings increased the likelihood of considering ChatGPT as a source of trustworthy health care information (odds ratio [OR] 1.620, 95% CI 1.498-1.752), beneficial in medical issues (OR 1.495, 95% CI 1.452-1.539), and useful for medical literature (OR 1.494, 95% CI 1.426-1.564; P<.001 for all results). CONCLUSIONS: Over 40% of American health care students (1144/2661, 42.99%) were unaware of ChatGPT despite its extensive use in the health field. Our data revealed the positive attitudes toward ChatGPT and the desire to learn more about it. Medical educators must explore how chatbots may be included in undergraduate health care education programs.

The structure of depressive symptoms using CES-D and ZDS in outpatients in a general hospital in Lima, Peru.

BACKGROUND: Depression represents one of the leading causes of disability due to illness worldwide. Previous studies have demonstrated the significant heterogeneity of the diagnosis of depression, making it necessary to develop new diagnostic approaches. Network analysis is a perspective that considers symptoms as constituents of the psychiatric disorder itself. The objective was to determine the structure of depressive symptoms using the CES-D and ZDS depression scales. METHODS: Cross-sectional study of secondary analysis of 194 patients using the CES-D and ZDS scales. Correlation matrices and regularised partial correlation networks were constructed from the database. Centrality measures were estimated, and a network stability analysis was performed. RESULTS: On the CES-D scale, the most central item was "Sad"; while on the ZDS scale, the most central items were "Sad" and "Live". On the CES-D scale, the connection between "Enjoy" and "Happy" was the strongest. On the ZDS scale, the strongest connection was between the items "Live" with "Useful". The item "Morning" was the least connected on the ZDS. CONCLUSIONS: The most central symptom from the CES-D scale was sadness, while from the ZDS scale, was sadness and anhedonia.

Medical conditions, symptoms of anxiety, and depression during the COVID-19 pandemic in a population sample of Lima, Peru.

INTRODUCTION: This study aims to determine differences between the number of underlying medical conditions, depression, and anxiety, when controlling for the covariates of age, sex, and completed education. METHODS: Participants (n = 484) indicated the number of medical conditions present during the survey, also including the PHQ-9 and GAD-7, to assess depression and anxiety, respectively. RESULTS: Differences were found between groups of medical conditions and the combined values of PHQ-9 and GAD-7 after controlling for the covariates mentioned above (F4,954 = 5.78; Wilks' Λ = 0.95; P < 0.0005). The univariate tests showed differences for PHQ-9 (F2,478 = 8.70; P < 0.0005) and GAD-7 (F2,478 = 11.16; P < 0.0005) between the 3 groups. Finally, post-hoc analysis showed differences between participants with one medical condition and with no medical condition (PHQ-9: MD = 1.82; 95%CI, 0.25-3.40; GAD-7: MD = 1.73; 95%CI, 0.55-2.91), and between participants with more than one medical condition and participants with no medical condition (PHQ-9: MD = 3.10; 95%CI, 1.11-5.10; GAD-7: MD = 2.46; 95%CI, 0.97-3.95). CONCLUSIONS: Our results suggest that people who had a medical condition during the COVID-19 pandemic were more prone to developing severe symptoms of anxiety and depression.

Description of a telehealth mental health programme in the framework of the COVID-19 pandemic in Colombia.

BACKGROUND: A telehealth mental health programme was designed at the LivingLab of the Faculty of Medicine of the Universidad de Antioquia [University of Antioquia]. OBJECTIVES: To describe the development and operation of the programme and evaluate the satisfaction of the patients treated during the COVID-19 pandemic in 2020 and 2021. METHODS: Descriptive study that details the development of the programme. Data were extracted from medical records to describe the patients who were treated. A satisfaction scale was applied to a random sample and the data were summarised with descriptive statistics. RESULTS: In March 2020 and August 2021, 10,229 patients were treated, with 20,276 treated by telepsychology and 4,164 by psychiatry, 1,808 by telepsychiatry and 2,356 by tele-expertise, with a total of 6,312 visits. The most frequent diagnoses were depressive (36.8%), anxiety (12.0%), and psychotic (10.7%) disorders. Respondents were satisfied to the point that more than 93% would recommend it to another person. CONCLUSIONS: The LivingLab telehealth mental health programme allowed for the care of patients with mental health problems and disorders in Antioquia during the first two years of the COVID-19 pandemic, and there was a high degree of satisfaction among the beneficiaries. Therefore it could be adopted in mental health care.

Effect of music on hemodynamic fluctuations in women during induction of general anesthesia: A prospective randomized controlled multicenter trial.

BACKGROUND: The authors aim to investigate the effect of music on hemodynamic fluctuations during induction of general anesthesia and reducing preoperative anxiety for women who underwent elective non-cardiac surgery. METHODS: It is a multicenter, double-blind, randomized, parallel-group clinical trial. Patients were randomized 1:1 to either a Music Intervention group (MI) or a Control group (Control). The MI participants listened to their preferred music for more than 30 minutes in the waiting area. The State-Trait Anxiety Inventory (STAI) was used to measure anxiety levels in the groups, and hemodynamic parameters (Heart Rate [HR], Mean Arterial Pressure [MAP]) were continuously recorded before induction (T0), at loss of consciousness (T1), immediately before intubation (T2), and after intubation (T3). Intubation-related adverse events were also recorded. The primary outcome was the incidence of MAP changes more than 20 % above baseline during T0-T2. RESULTS: A total of 164 patients were included in the final analyses. The incidence of MAP instability during T0-T2 was lower in the MI, and the 95 % Confidence Interval for the rate difference demonstrated the superiority of MI. HR instability was less frequent in MI participants both in T0-T2 and T2-T3. The overall incidence of preoperative anxiety was 53.7 % (88/164). After the music intervention, the mean score of STAI was significantly lower in the MI than in the Control, with a between-group difference of 8.01. CONCLUSIONS: Preoperative music intervention effectively prevented hemodynamic instability during anesthesia induction and significantly reduced preoperative anxiety in women undergoing elective non-cardiac surgery.

[Repeatability of spirometrys expiratory flows]. / Repetitividad de los flujos espiratorios de la espirometría.

Background: The quality of the spirometry is estimated with criteria of acceptability and repeatability. The repeatability criteria accepted by consensus is < 0.150 L. Objective: To know the repeatability in quality A spirometry. Material and methods: Analytical cross-sectional design. The demographic variables and the 3 best spirometry curves with normal, suggestive of restriction and bronchial obstruction profiles were obtained from consecutive subjects of both genders from 18 to 80 years of age. The repeatability was analyzed with the mean difference (bias) and the intraclass correlation coefficient. Results: 630 curves from 210 subjects were accepted. Group age 60 ± 15 years. Female predominance 113 (53.8%), occupation: domestic services 61 (29%), and diagnosed with chronic obstructive pulmonary disease: 70 (33.4%). The differences in the curves were < 0.150 L. The mean difference (bias) and the intraclass correlation coefficient (95% confidence interval, 95% CI) of the forced expiratory volume in the first second were 1 vs. 2 maneuver: -0.01 (0.13, -0.14), 0.997 (95% CI 0.996, 0.998); 2 vs. 3 maneuver: 0.00 (0.13, -0.13), 0.997 (95% CI 0.996, 0.998), and maneuver 1 vs. 3: -0.00 (0.16, -0.17), 0.995 (95% CI 0.994, 0.996). Forced vital capacity: 1 vs. 2 maneuver: -0.01 (0.17, -0.18), 0.996 (95% CI 0.995, 0.997); 2 vs. 3 maneuver: 0.01 (0.17, -0.16), 0.997 (95% CI 0.0.996, 0.998), and maneuver 1 vs. 3: -0.00 (0.18, -0.19), 0.996 (95% CI 0.995, 0.997). Conclusion: The repeatability obtained in spirometry with quality A validates the use of the repeatability criterion of 0.150 L.

Introducción: la calidad de la espirometría se estima con criterios de aceptabilidad y repetitividad. La repetitividad aceptada por consenso es < 0.150 L. Objetivo: conocer la repetitividad en espirometrías de calidad A. Material y métodos: diseño transversal analítico. Se obtuvieron las variables demográficas y las 3 mejores curvas de espirometría con perfil normal, que sugiriera restricción y obstrucción bronquial de sujetos consecutivos de ambos géneros de 18 a 80 años. La repetitividad se analizó con la diferencia de medias (sesgo) y el coeficiente de correlación intraclase. Resultados: se aceptaron 630 curvas de 210 sujetos. Edad grupal 60 ± 15 años. Predominio femenino 113 (53.8%), ocupación: servicios domésticos 61 (29%) y con enfermedad pulmonar obstructiva crónica 70 (33.4%). Las diferencias en las curvas fueron < 0.150 L. Las diferencias medias (sesgo) y el coeficiente de correlación intraclase (intervalo de confianza al 95%, IC 95%) del volumen espiratorio forzado en el primer segundo fueron: maniobra 1 frente a 2: −0.01 (0.13, −0.14), 0.997 (IC 95% 0.996, 0.998); maniobra 2 frente a 3: 0.00 (0.13, −0.13), 0.997 (IC 95% 0.996, 0.998), y maniobra 1 frente a 3: −0.00 (0.16, −0.17), 0.995 (IC 95% 0.994, 0.996). La capacidad vital forzada: maniobra 1 frente a 2: −0.01 (0.17, −0.18), 0.996 (IC 95% 0.995, 0.997); maniobra 2 frente a 3: 0.01 (0.17, −0.16), 0.997 (IC 95% 0.0.996, 0.998), y maniobra 1 frente a 3: −0.00 (0.18, −0.19), 0.996 (IC 95% 0.995, 0.997). Conclusión: la repetitividad obtenida en espirometrías con calidad A valida el uso del criterio de repetitividad de 0.150 L.

Efficacy of a buccal and lingual at-home bleaching protocol-A randomized, split-mouth, single-blind controlled trial.

OBJECTIVE: To compare the color change, the risk and intensity of tooth sensitivity (TS), and gingival irritation (GI) of at-home bleaching applied on the buccal surface only or the buccal and lingual surfaces. MATERIALS AND METHODS: Sixty patients with canines A2 or darker were selected and their superior arches were randomized in two groups: at-home bleaching on the buccal-only or on the buccal and lingual surfaces, with 7.5% hydrogen peroxide, for 1 h daily/2 weeks. The color change was evaluated at baseline, 7, 14 days, and 1 month after bleaching using shade guides scales (ΔSGU) and a spectrophotometer (ΔEAB, ΔE00, and ΔWID). Risk and intensity of TS and GI were recorded daily using visual analogic scale (0-10). Patient satisfaction was evaluated with the orofacial esthetics. Paired t-test, McNemar's, and Wilcoxon signed-rank test were used for data analysis (α = 5%). RESULTS: Neither the color change nor the risk/intensity of TS was statistically different between groups (p > 0.05). Patient satisfaction increased after bleaching for both groups (p < 0.05). CONCLUSION: The addition of one contact surface does not result in an increased whitening degree compared to bleaching applied solely on the buccal surface. CLINICAL SIGNIFICANCE: Understanding the influence of surfaces interacting with the bleaching agent is crucial for comprehending the bleaching mechanism and avoiding unnecessary material expenses. Notably, employing the buccal-only technique is sufficient to achieve the desired efficacy.