COVID-19 patient satisfaction and associated factors in telemedicine and hybrid system.

Background: The quality assessment of the home-based isolation and care program (HBIC) relies heavily on patient satisfaction and length of stay. COVID-19 patients who were isolated and received HBIC were monitored through telephone consultations (TC), in-person TC visits, and a self-reporting application. By evaluating patient satisfaction and length of stay in HBIC, healthcare providers could gauge the effectiveness and efficiency of the HBIC program. Methods: A cross-sectional study design enrolled 444 HBIC patients who answered a structured questionnaire. A binary logistic regression model assessed the association between independent variables and patient satisfaction. The length of stay in HBIC was analyzed using Cox regression analysis. The data collection started on April (1-30), 2022, in Addis Ababa, Ethiopia. Results: The median age was 34, and 247 (55.6%) were females. A greater proportion (313, 70.5%) of the participants had high satisfaction. Higher frequency of calls (>3 calls) (AOR = 2.827, 95% CI = 1.798, 4.443, p = 0.000) and those who were symptomatic (AOR = 2.001, 95% CI = 1.289, 3.106, p = 0.002) were found to be significant factors for high user satisfaction. Higher frequency of calls (>3 calls) (AHR = 0.537, 95% CI = 0.415, 0.696, p = 0.000) and more in-person visits (>1 visit) (AHR = 0.495, 95% CI = 0.322, 0.762, p = 0.001) had greater chances to reduce the length of stay in the COVID-19 HBIC. Conclusion: 70.5% of the participants had high satisfaction with the system, and frequent phone call follow-ups on patients' clinical status can significantly improve their satisfaction and length of recovery. An in-person visit is also an invaluable factor in a patient's recovery.

Acne treatment challenges - Recommendations of Latin American expert consensus.

BACKGROUND: Acne is a chronic inflammatory disorder of the pilosebaceous unit that is associated with a negative impact on quality of life, causing anxiety, depression, and poor self-esteem. The treatment of acne is not simple and presents some new challenges. This article addresses important issues faced by dermatologists on their daily, some of them specific for Latin America. OBJECTIVE: To discuss daily practice recommendations when managing acne patients. METHODS: A literature review was conducted by a group of eight experts with extensive experience in the field of acne. The results of the data review were presented at an initial kick-off meeting to align the consensus topics. Two e-surveys using the Delphi methodology and an interim group webinar meeting were held. RESULTS: The expert panel reached a consensus on all proposed key statements, providing scientific support to help dermatologists and healthcare providers make acne management decisions on topics that can be challenging in the everyday practice of dermatology, such as the characteristics of Generation Z or the importance of the maintenance phase of adult acne treatment. CONCLUSION: This article provides current recommendations for managing acne patients. The high level of agreement achieved based on the latest evidence supports the best acne therapeutic choices in both established topics and new important issues that have emerged in recent years, such as the impact of social media, Generation Z characteristics, and transgender male patient specifics.

Learning-oriented motivation: Examining the impact of teaching practices with motivational potential.

This study compares the predictive ability of nine different types of motivational practices on the motivational orientation toward learning. Given the nature of undergraduate studies, identifying the most predictive motivational variables on learning orientation allows us to focus our efforts on those motivational practices to guide students to deploy their cognitive resources by focusing on learning and not only on obtaining good grades. The study included Chilean university students from health (n = 398) and education (n = 365) programs. A Bayesian multiple regression was carried out in both groups. The results show strong evidence of a specific effect of motivational practices on motivational orientation towards learning. Although the impact on motivational orientation toward learning may vary slightly across different fields of study, the primary predictors consistently are practices that emphasize importance and foster autonomy. The effect of utility-focused motivational practices is observed only within the predictive model for the group of health students.

Comparative Study of the Removal Efficiency of Nalidixic Acid by Poly[(4-vinylbenzyl)trimethylammonium Chloride] and N-Alkylated Chitosan through the Ultrafiltration Technique and Its Approximation through Theoretical Calculations.

Emerging antibiotic contaminants in water is a global problem because bacterial strains resistant to these antibiotics arise, risking human health. This study describes the use of poly[(4-vinylbenzyl) trimethylammonium chloride] and N-alkylated chitosan, two cationic polymers with different natures and structures to remove nalidixic acid. Both contain ammonium salt as a functional group. One of them is a synthetic polymer, and the other is a modified artificial polymer. The removal of the antibiotic was investigated under various experimental conditions (pH, ionic strength, and antibiotic concentration) using the technique of liquid-phase polymer-based retention (LPR). In addition, a stochastic algorithm provided by Fukui's functions is used. It was shown that alkylated N-chitosan presents 65.0% removal at pH 7, while poly[(4-vinylbenzyl)trimethylammonium chloride] removes 75.0% at pH 9. The interaction mechanisms that predominate the removal processes are electrostatic interactions, π-π interactions, and hydrogen bonding. The polymers reached maximum retention capacities of 1605 mg g-1 for poly[(4-vinylbenzyl) trimethylammonium chloride] and 561 mg g-1 of antibiotic per gram for alkylated poly(N-chitosan). In conclusion, the presence of aromatic groups improves the capacity and polymer-antibiotic interactions.

Pharmacological activation of insulin-degrading enzyme improves insulin secretion and glucose tolerance in diet-induced obese mice.

AIM: To investigate the use of synthetic preimplantation factor (sPIF) as a potential therapeutic tool for improving glucose-stimulated insulin secretion (GSIS), glucose tolerance and insulin sensitivity in the setting of diabetes. MATERIALS AND METHODS: We used a preclinical murine model of type 2 diabetes (T2D) induced by high-fat diet (HFD) feeding for 12 weeks. Saline or sPIF (1 mg/kg/day) was administered to mice by subcutaneously implanted osmotic mini-pumps for 25 days. Glucose tolerance, circulating insulin and C-peptide levels, and GSIS were assessed. In addition, ß-cells (Min-6) were used to test the effects of sPIF on GSIS and insulin-degrading enzyme (IDE) activity in vitro. The effect of sPIF on GSIS was also tested in human islets. RESULTS: GSIS was enhanced 2-fold by sPIF in human islets ex vivo. Furthermore, continuous administration of sPIF to HFD mice increased circulating levels of insulin and improved glucose tolerance, independently of hepatic insulin clearance. Of note, islets isolated from mice treated with sPIF exhibited restored ß-cell function. Finally, genetic (shRNA-IDE) or pharmacological (6bK) inactivation of IDE in Min-6 abolished sPIF-mediated effects on GSIS, showing that both the protein and its protease activity are required for its action. CONCLUSIONS: We conclude that sPIF is a promising secretagogue for the treatment of T2D.

Healthy Behavior and Sports Drinks: A Systematic Review.

This review article aims to systematically identify the relationship between sports drinks and healthy behavior. This systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline criteria, and eligibility criteria were established using the PICOS tool (population, interventions, comparators, outcomes, and study) from about 1000 records of sports drinks articles identified in the various Web of Science Core Collection databases. The literature review stages determined a reduced set of 15 articles relating these drinkable supplements to healthy behavior. This study concludes that water consumption should be emphasized for non-athletes, sports drinks should be labeled to indicate water consumption and carry a warning label, and more randomized clinical trials should be considered to ensure conclusive results for health decision making.

Longitudinal trajectories of maternal TSH in healthy pregnant women in Catalonia.

Objective: Longitudinal evaluation of thyroid function throughout pregnancy in the same subject could offer precise information about its dynamics as a physiological mechanism of adaption to the requirements. In this study, we evaluated longitudinal trajectories of maternal thyroid function during pregnancy by a latent class growth analysis and explored their association with maternal-fetal outcomes. Methods: A prospective observational study was carried out, including 414 healthy pregnant women, from the first trimester to delivery. Thyroid function and autoimmunity were measured in the three trimesters. Clinical data during pregnancy were obtained. Longitudinal mixed model techniques were performed to explore trajectories of gestational thyroid function. Results: Three different longitudinal trajectories were obtained from maternal thyrotropin (TSH) levels: low-increasing TSH (class 1) in 86% of cases, high-increasing TSH (class 2) in 9.7%, and decreasing TSH (class 3) in 4.3%. No statistical differences in free thyroxine levels were found among the three classes. Differences in maternal age (P = 0.027) and initial maternal weight (P = 0.043) were observed among the groups. In logistic regression analysis, maternal age correlated with longitudinal trajectories. The three longitudinal classes remain when women with thyroid autoimmunity (TAI) are excluded. Multinomial logistic regression showed maternal age correlated with longitudinal trajectories independently of TAI status. Conclusions: Three differentiated TSH trajectories were found in healthy pregnant women living in Catalonia, as previously described. No association with obstetric outcomes was observed in these different chronological thyroid pathways, but maternal age might condition the longitudinal mechanism of thyroid function regulation throughout pregnancy.

Ética e integridad académica en la formación doctoral: el caso de los doctorados en educación en las universidades chilenas / Ethics and academic integrity in doctoral training: the case of doctorates in education in Chilean universities / Ética e integridade acadêmica na formação pós-graduada: o caso dos doutorados em educação nas universidades chilenas

El presente artículo analiza, a partir de una revisión documental de planes y programas de curso de los doctorados en Educación activos en Chile, en qué medida y cómo los programas de formación de futuros investigadores en educación doctoral abordan el desafío de integrar la educación ética en su diseño curricular. Mediante un análisis temático de la documentación oficial de los programas se identificaron y analizaron diversos elementos relacionados con ética de la investigación e integridad académica abordados en la formación doctoral, su enfoque prevalente (normativo o de discernimiento ético), su orientación (propositiva o de prevención) y la profundidad con que son tratados esos aspectos. Los resultados muestran que solo un tercio de los actuales programas abordan de manera explícita la formación ética en investigación, y que, en estos casos, su abordaje tiende a subrayar aspectos más formales que de fondo, acotados fundamentalmente al cumplimiento del protocolo de consentimiento informado.

This article analyzes to what extent and how training programs for future researchers in doctoral education address the challenge of integrating ethical training in their curricular design. Based on a documentary review of course plans and postgraduate programs in education active in Chile, the explicit presence of ethical aspects and academic integrity in their training plans was examined. Through a thematic analysis of the official documentation of the programs, we identified and analyzed various elements related to research ethics and academic integrity addressed in doctoral training, their prevalent approach normative or ethical discernment, their orientation proactive or preventive and the depth with which these aspects are treated. The results show that only one-third of the current programs explicitly address ethical training in research and that in these cases, their approach tends to emphasize more formal than substantive aspects, mainly limited to compliance with the informed consent protocol.

O presente artigo analisa, a partir de uma revisão documental de planos e programas de curso dos doutorados em Educação ativos no Chile, em que medida e como os programas de formação de futuros investigadores em educação pós-graduada abordam o desafio de integrar a educação ética em seu plano curricular. Mediante uma análise temática da documentação oficial dos programas se identificaram e analisaram diversos elementos relacionados com ética da investigação e integridade acadêmica abordados na formação pós-graduada, seu enfoque prevalente (normativo ou de discernimento ético), sua orientação (propositiva ou de prevenção) e a profundidade com que são tratados esses aspectos. Os resultados mostram que só um terço dos atuais programas abordam de maneira explícita a formação ética em investigação, e que, nestes casos, sua abordagem tende a ressaltar aspectos mais formais que substanciais, limitados fundamentalmente ao cumprimento do protocolo de consentimento informado.

Delays in commitment and treatment court proceedings worsen psychiatric and other medical conditions.

OBJECTIVE: Adversarial hearings in hospital commitment and de novo treatment proceedings, or court hearings, delay psychiatric treatment in many jurisdictions. In Massachusetts, the "treatment over objection" process requires a court petition. For state hospital patients, the delay to treatment is an initial 34 day waiting period in addition to continuances of court hearings that extend treatment delays. This study examined the frequency of adverse medical events due to delayed court hearings within a forensic state hospital in the US. METHODS: The study reviewed all (n = 355) treatment petitions filed by a Massachusetts forensic hospital from 2015 and 2016. The incidence and nature of adverse events (e.g. patient/staff assaults, milieu disruptions) and acute medical symptoms (e.g. catatonia, acute psychosis), before and after the Court granted a petition for treatment, were analyzed by two raters. Adverse events included patient and staff assaults, acute psychiatric symptoms, and milieu problems. RESULTS: 82.6 % of treatment petitions led to involuntary treatment, 16.6 % were withdrawn by the medical petition filer, and only 0.8 % petitions were denied by the judge. Adversarial hearings occasioned an average delay of 41 days from treatment petition filing to receipt of standing treatment in addition to statute required delays. Once treatment was court-approved, all types of adverse events were significantly reduced. CONCLUSIONS: Results established that the court treatment hearing scheme exacerbates health and safety risks to patients with serious mental illness. Increasing physician and court personnel awareness of these risks is likely key to enhancing a patient-focused, rights-oriented approach to these matters. This and other recommendations is proposed for jurisdictions that deal with this problem around the world.

Validation of a Measurement Scale on Technostress for University Students in Chile.

The main aim in this research was to validate a scale for measuring technostress in Chilean university students under the context of hybrid education. There were 212 university students as participants from the central-south zone of Chile. For measuring technostress manifestations, a technostress questionnaire for Chinese university professors and its adaptation for Spanish university students was used as a base instrument to adapt the scale. The exploratory and confirmatory factor analysis generated an adequacy of the psychometric scale by eliminating three items from the original scales but generated important changes by reordering the other 19 items into only three factors, establishing an important local difference with previous versions that contemplated five factors, but retaining as a central axis the stress produced by a misfit between the person and his or her environment. The resulting scale was based on factors such as Abilities-Demands Techno-Educational, Needs-Supplies Resources, and Person-People Factor. It also has a good internal consistency with a scale that allows for the continuation of technostress measurements in the local context; adding to studies on this topic which have already been carried out on diverse actors of the Chilean educational system; proposing a reliable and valid psychometric scale of technostress in Chilean university students; and giving researchers and academic managers the ability to know the adverse effects of the use of technologies and propose mitigation actions.

Infección por VIH y COVID 19 en un paciente pediátrico: reporte de un caso / HIV and COVID-19 infection in a pediatric patient: case report

El Virus de la Inmunodeficiencia Humana (V.I.H.) en etapas avanzadas confiere al portador la susceptibilidad para desarrollar infecciones oportunistas. Se sabe poco sobre el COVID-19 en pacientes con infección por el VIH, y a pesar de que la mayoría estos pacientes coinciden con los factores de riesgo de mal pronóstico cuando hay una coinfección con el COVID-19, se han informado muy pocos casos referentes al tema. En este artículo se presentamos un caso clínico de una paciente pediátrica, sin antecedentes patológicos de importancia, con diagnósticos iniciales de pénfigo y neumonía que, después de posteriores estudios pasó a diagnóstico de VIH-SIDA/ COVID 19.

The Human Immunodeficiency Virus (H.I.V.) in advanced stages confers the carrier susceptibility to develop opportunistic infections. Little is known about COVID 19 in patients with HIV infection, and although the majority of patients in this group coincide with risk factors for poor prognosis when coinfected with COVID 19, very few cases have been reported referring to the subject. In this article we present a clinical case of a pediatric patient, with no significant pathological history, which after further studies went on to a diagnosis of HIV-AIDS/COVID 19.

Impact of Techno-Creators and Techno-Inhibitors on Techno-Stress Manifestations in Chilean Kindergarten Directors in the Context of the COVID-19 Pandemic and Teleworking.

The research objective was to predict the impact of techno-creators and techno-inhibitors on the different manifestations of technostress in kindergarten directors in the context of the COVID-19 pandemic and telework. The participants were INTEGRA Foundation kindergarten directors, from a sample of 567 kindergartens in Chile. To measure the technostress manifestations, the RED-TIC questionnaire was used as an instrument, and concerning techno-creators and techno-inhibitors, those established in previous research were considered. The partial least squares structural equation modeling (PLS-SEM) methodology was used, and the model estimation was performed using SmartPLS version 3.0 software. It was obtained that techno-creators correlate positively and significantly with the technostress manifestations. A negative correlation was found between techno-inhibitors and technostress manifestations and techno-creators, but not significant for skepticism and inefficacy manifestations. Therefore, it is concluded that techno-creators lead to technostress manifestations, however, techno-inhibitors did not show a significant effect in reducing these manifestations in the sample studied.

Analysis of the mesh resolution of an .STL exported from an intraoral scanner file.

OBJECTIVES: This study aimed to provide information on the accuracy of exported digital files with the different resolutions available in the CEREC 4.6.2 software obtained by means of an intraoral scanner (IOS), in addition to establishing differences between materialized models with different exported resolutions, and how these different exported files can influence finite element analysis (FEA) simulations. MATERIALS AND METHODS: The upper complete arch of 10 patients was scanned through an IOS (CEREC Omnicam 1.0/Dentsply Sirona). Files of three resolution meshes digitalized by a CAD software (Cerec SW, 4.6.2) high, medium and low (IOSH, IOSM, and IOSL) were exported. Each file was evaluated by a software (NETFABB) about the number of triangles obtained and compared with the number announced by the manufacturer. Also, with a superimposition with a specialized software (GEOMAGIC X), the digital models were compared. The files of each resolution were printed (Sprintray 3D Printer), and the printed models were scanned with IOS (Omnicam 1.0) and compared with the control group (intraoral scanned high-resolution file, IOSH). FEA simulations were imported into COMSOL and analyzed under different loading conditions. RESULTS: The number of exported triangles coincided with that reported by the manufacturer. The digital models from files of different resolution did not show significant differences (less than 1.5 um) between each other. Models printed (H, M, L) from files of the same resolution mesh (H, M, L) did not show significant differences between them either in partial measures of the arch and neither in the complete arch. FEA showed significant differences in stress concentration between different exported models. CLINICAL SIGNIFICANCE: Digital models can be exported and printed in three resolutions of the mesh, without differences clinically significative. On the other hand, for future FEA applications further research should be performed in order to determine the optimal number of triangles.

Technostress of Chilean Teachers in the Context of the COVID-19 Pandemic and Teleworking.

This article shows the levels of technostress in primary and secondary education teachers in Chile, in the context of educational telework that Chile has adopted in connection with the health crisis by COVID-19. The information has been collected with the use of the RED-TIC scale, previously used in this country, whose validity and reliability of the instrument has been treated, for this case, with confirmatory factorial analysis (CFA) with a national coverage sample of 3006 teachers. The results show that 11% of teachers reveal techno anxiety and 7.2%, techno fatigue. Combining both manifestations, we find that 6.8% of teachers are techno stressed. Finally, fatigue and anxiety factors are higher for female teachers.

Reference Intervals of Thyroid Function Tests Assessed by Immunoassay and Mass Spectrometry in Healthy Pregnant Women Living in Catalonia.

BACKGROUND: Recent guidelines recommend establishing a local reference interval (RI) for thyroid function. We aimed to establish trimester-specific RIs for thyrotropin (TSH) and free thyroxine (FT4) in a cohort of healthy pregnant women in Catalonia (Spain). METHODS: A prospective observational study was conducted with 332 healthy pregnant women, from the first trimester (1T) to delivery. TSH was measured using an Architect® immunoassay (Abbott) and FT4 by two immunoassays, Architect® (Abbott) and Cobas® (Roche), in the three trimesters. FT4 was also measured by liquid chromatography mass spectrometry (LC/MS/MS) in the 1T. RESULTS: TSH (µUI/mL) increased throughout pregnancy (1T: 0.03-3.78; 2T: 0.51-3.53; 3T: 0.50-4.32; p < 0.0001) and FT4 (pmol/L) progressively decreased (Architect® 1T: 10.42-15.96; 2T: 8.37-12.74; 3T: 8.24-12.49; p < 0.0001; and Cobas®: 1T: 11.46-19.05; 2T: 9.65-14.67; 3T: 8.88-14.54; p < 0.0067). The FT4 RI during 1T determined LC/MS/MS was 8.75-18.27. Despite the 1T FT4 results measured by LC/MS/MS and with the two immunoassays being significantly correlated, the results obtained by the three methods were found to be non-interchangeable. CONCLUSIONS: We established trimester-specific RIs for TSH and for FT4 with immunoassays in our population. We also validated the 1T FT4 using LC/MS/MS to confirm the results of FT4 lower than the 2.5th percentile or higher than the 97.5th percentile.

Synthesis of Fluorogenic Arylureas and Amides and Their Interaction with Amines: A Competition between Turn-on Fluorescence and Organic Radicals on the Way to a Smart Label for Fish Freshness.

We describe the synthesis of fluorogenic arylureas and amides and their interaction with primary or secondary amines under air and light in organic-aqueous mixtures to give rise to a new class of persistent organic radicals, described on the basis of their electron paramagnetic resonance (EPR), as well as UV-vis, fluorescence, NMR, and quantum mechanics calculations, and their prospective use as multi-signal reporters in a smart label for fish freshness.

Teacher Technostress in the Chilean School System.

The expanded use of information technology in education has led to the emergence of technostress due to a lack of adaptation to the technological environment. The purpose of this study is to identify the levels of technostress in primary and secondary education in 428 teachers using a RED-TIC questionnaire, of which skepticism, fatigue, anxiety, and inefficiency are the main components. For the empirical analysis of the data, principal component analysis (PCA) and confirmatory factor analysis (CFA) were used. The results show that 12% of Chilean teachers participating in the study feel techno-fatigued, 13% feel techno-anxious, and 11% present both conditions. Male teachers show a higher incidence of techno-anxiety and techno-fatigue than their female peers. It can be concluded that the questionnaire used is a reliable tool to evaluate the presence of technostress, and it manifests itself importantly in its components of techno-anxiety and techno-fatigue in Chilean teachers.

Childhood abuse and externalizing behavior among immigrant high school students.

There is a current lack of data on the relation between childhood abuse and behavior problems in recently immigrated Latino youth and potential protective factors. This study sought to assess rates of abuse, explore relations between abuse and behavior problems, and examine peer attachment as a possible moderator in 76 recently immigrated high school students. High rates of prior abuse were observed: 36.84% emotional abuse, 22.37% physical abuse, and 9.21% sexual abuse. Emotional abuse was associated with conduct problems (B = 4.19, 95% CI [3.88, 9.39], t = 2.23, p = .028). In the context of physical abuse, peer attachment played a significant, mitigating role on conduct problems (B = -.02, 95% CI [-.05, .00], t = -1.10, p = .049). Results require replication but suggest a critical need for attention to immigrant youth as a highly victimized sample with a high risk for conduct problems.

Diseño de un modelo de asistencia personal breve para personas con discapacidad intelectual en Chile / Design of a short personal assistance model for people with intellectual disabilities in Chile

La asistencia personal para personas con discapacidad intelectual puede contribuir a la aplicación de los nuevos paradigmas de autodeterminación e inclusión social y a una mejora de la calidad de vida. Mediante revisión de la literatura y un análisis con expertos profesionales, expertos por experiencia y potenciales usuarios, se elaboró un modelo breve de asistencia personal para ser ejecutado por agentes comunitarios con supervisión profesional. El modelo considera actividades en los espacios habituales de las personas y sus familias, con apoyo para el uso de recursos formales e informales de la comunidad y el refuerzo de redes de apoyo que continúen operando una vez que termine la intervención. Con una duración de 9 meses, el modelo se desarrolla mediante un proceso de 3 etapas: 1) establecimiento de vínculo y elaboración de un plan individualizado, 2) implementación del plan y 3) refuerzo de los aprendizajes de los participantes y traspaso a redes de apoyo. Se discute la factibilidad de la aplicación del modelo en países latinoamericanos y la necesidad de realizar estudios que evalúen su implementación

Personal assistance for people with intellectual disabilities can contribute to the application of the new paradigms of self-determination and social inclusion and to an improvement in the quality of life. Through a literature review and analysis with professional experts, experts from experience and potential users, a brief model of personal assistance was developed to be executed by community agents with professional supervision. The model considers activities in the usual spaces of people and their families, with support for the use of community formal and informal resources and the reinforcement of social support networks that continue operating once the intervention ends. With duration of 9 months, the model is developed through a 3-stage process: 1) engagement and formulation of an individualized plan, 2) implementation of the plan, and 3) participants' learning reinforcement and transfer to support networks. The feasibility of the model in Latin American countries and the need for studies to evaluate its implementation are discussed

Chloroplast Dual Divergent Promoter Plasmid for Heterologous Protein Expression in Tetraselmis suecica (Chlorophyceae, Chlorodendrales).

The eukaryotic green microalga Tetraselmis suecica is commonly used for aquaculture purposes because of its high stress tolerance and ease of culture in a wide spectrum of environments; they are therefore suitable candidates for biotechnology applications. To date, no data are available regarding chloroplast transformation vectors based on specific endogenous promoters and homologous targeting regions. We report on the identification of Tetraselmis suecica genes encoding the ribulose bisphosphate carboxylase/oxygenase large subunit protein, the photosystem II D1 protein and the ATP synthase CF1-beta subunit protein together with their untranslated regions (5'UTR, 3'UTR). The full-length ORFs of the putative genes with their regulatory sequences were obtained. We were also able to identify the downstream 3' end of the large subunit ribosomal RNA gene (23S) along with the 5S RNA end-to-end with the psbA gene on the complementary strand. The intergenic region between these genes appears to be a good target site for the integration of target proteins. Moreover, we identified a back-to-back promoter region among the rbcL and atpB genes. To assess the bidirectionality activities of both promoters, a dual reporter vector was constructed for Tetraselmis suecica transformation containing the cat and TurboGFP genes driven by the 5'rbcL/5'atpB divergent promoter. The vector included the 23S-5S and psbA nucleotide sequences as flanking regions. These flanking regions provided suitable insertion sites within the chloroplast genome for cassette integration via homologous recombination. Simultaneous expression of the chloramphenicol-resistant conferring gene and the gene coding for TurboGFP driven by 5'rbcL/5'atpB showed a potent natural bidirectional promoter as a reliable genetic tool.