Concordance between LDL-C estimated by various formulas and directly measured LDL-C.

BACKGROUND: Although direct measurement of LDL cholesterol (LDL-C) in blood is possible, there are several formulas for its estimation. The performance and concordance of these formulas have not been evaluated in Colombia. OBJECTIVE: To determine the concordance between LDL-C directly measured using the enzymatic technique and existing methods to calculate it. METHODS: Study of diagnostic tests, and concordance. We analyzed complete lipid profile samples, which included direct measurement of LDL-C, from 2014 to 2022 at Hospital Universitario San Ignacio (Bogotá, Colombia). The direct LDL-C measurements were compared with estimations using the DeLong, Sampson, Friedewald, extended Martin/Hopkins, Anandaraja, and Cordova methods. Lin's concordance correlation coefficient (CCC) and Bland-Altman plots were employed, conducting subgroup analyses based on triglycerides (TG), and LDL-C levels. Kappa coefficients assessed agreement in LDL-C risk categories according to dyslipidemia guidelines. RESULTS: A total of 2144 samples were evaluated. The formulas with the best CCC were DeLong (0.971) and Sampson (0.969), with no relevant differences. The extended Martin/Hopkins formula (0.964) and the Friedewald formula (0.964) also performed well. The Anandaraja (0.921) and Cordova (0.881) equations exhibited inferior performance. For all formulas, a decrease in concordance was observed when triglycerides were ≥400 mg/dL or when LDL-C was <100 mg/dL. Most formulas demonstrated optimal agreement when assessed using risk categories according to dyslipidemia guidelines, except for Anandaraja and Cordova. CONCLUSIONS: The DeLong, Sampson, extended Martin/Hopkins, and Friedewald formulas show the best concordance with directly measured LDL-C, so in most cases the results can be considered interchangeable. However, the Anandaraja and Cordova formulas are not recommended.

Synergistic Effect between the APOE ε4 Allele with Genetic Variants of GSK3B and MAPT: Differential Profile between Refractory Epilepsy and Alzheimer Disease.

Temporal Lobe Epilepsy (TLE) is a chronic neurological disorder characterized by recurrent focal seizures originating in the temporal lobe. Despite the variety of antiseizure drugs currently available to treat TLE, about 30% of cases continue to have seizures. The etiology of TLE is complex and multifactorial. Increasing evidence indicates that Alzheimer's disease (AD) and drug-resistant TLE present common pathological features that may induce hyperexcitability, especially aberrant hyperphosphorylation of tau protein. Genetic polymorphic variants located in genes of the microtubule-associated protein tau (MAPT) and glycogen synthase kinase-3ß (GSK3B) have been associated with the risk of developing AD. The APOE ε4 allele is a major genetic risk factor for AD. Likewise, a gene-dose-dependent effect of ε4 seems to influence TLE. The present study aimed to investigate whether the APOE ɛ4 allele and genetic variants located in the MAPT and GSK3B genes are associated with the risk of developing AD and drug-resistant TLE in a cohort of the Mexican population. A significant association with the APOE ε4 allele was observed in patients with AD and TLE. Additional genetic interactions were identified between this allele and variants of the MAPT and GSK3B genes.

Problematic Internet Use and Personality Traits: Results in Working Age Adults.

INTRODUCTION: Problematic Internet use has become a growing problem worldwide; several factors, including personality, play an essential role in understanding this disorder. The Big Five personality traits and their association with problematic Internet use were examined in a large and diverse population. METHODS: A survey was applied to a total of 1,109 adults of working age. Each answered the Big Five Inventory and the Internet Addiction Test. RESULTS: Problematic Internet use was found in 10.6% of them (n=112). The personality traits extraversion and openness to experience were significantly associated with those with the disorder. With adjustment models, a positive association was found between these traits and being single and higher education. CONCLUSIONS: This study represents the largest of its kind in the Spanish-speaking population, highlighting the importance of recognising the factors involved in problematic Internet use.

Parenting practices as a buffer in the relationship between exposure to community violence and bullying in Mexican adolescents.

Multiple studies have shown that adolescents exposed to community violence are likely to engage in bullying behaviors. However, we still need to understand which variables can help reduce the influence of community violence exposure (CVE) on bullying. To investigate this question, a study was conducted with a sample of 568 Mexican adolescents, comprising 276 (48.6%) males and 292 (51.4%) females aged 12 to 16 years old (M age = 13.7 years, SD = 0.82). The study examined how parental support (PS) and parental induction to justice sensitivity (JS) can moderate the relationship between CVE and bullying. The study used structural equation modeling with latent variables. The results showed that CVE was positively associated with bullying, whereas PS and the induction to perpetrator JS were negatively associated. The moderation analysis suggests that the relationship between CVE and bullying was weaker among adolescents who received high PS. On the other hand, low and high parental induction to JS had the same moderating effect. Based on the findings, parental practices are critical when developing preventive programs to reduce the harmful effects of CVE on bullying behavior.

Use of portable single-lead electrocardiogram device as an alternative for QTc monitoring in critically ill patients.

PURPOSE: Acquired QT prolongation is frequent and leads to a higher mortality rate in critically ill patients. KardiaMobile 1L® (KM1L) is a portable, user-friendly single lead, mobile alternative to conventional 12-lead electrocardiogram (12-L ECG) that could be more readily available, potentially facilitating more frequent QTc assessments in intensive care units (ICU); however, there is currently no evidence to validate this potential use. METHODS: We conducted a prospective diagnostic test study comparing QT interval measurement using KM1L with conventional 12-L ECG ordered for any reason in patients admitted to an ICU. We compared the mean difference using a paired t-test, agreement using Bland-Altman analysis, and Lin's concordance coefficient, numerical precision (proportion of QT measurements with <10 ms difference between KM1L and conventional 12-L ECG), and clinical precision (concordance for adequate discrimination of prolonged QTc). RESULTS: We included 114 patients (61.4% men, 60% cardiovascular etiology of hospitalization) with 131 12-L ECG traces. We found no statistical difference between corrected QT measurements (427 ms vs. 428 ms, p = .308). Lin's concordance coefficient was 0.848 (95% CI 0.801-0.894, p = .001). Clinical precision was excellent in males and substantial in females (Kappa 0.837 and 0.781, respectively). Numerical precision was lower in patients with vasoactive drugs (-13.99 ms), QT-prolonging drugs (13.84 ms), antiarrhythmic drugs (-12.87 ms), and a heart rate (HR) difference of ≥5 beats per minute (bpm) between devices (-11.26 ms). CONCLUSION: Our study validates the clinical viability of KM1L, a single-lead mobile ECG device, for identifying prolonged QT intervals in ICU patients. Caution is warranted in patients with certain medical conditions that may affect numerical precision.

Restorative Parental Discipline and Types of Defending Bystander Intervention in Cyberbullying: The Mediate Role of Justice Sensitivity.

Parental socialization strategies are critical in explaining adolescents' online behavior. This study examined the relationships between parental restorative discipline, observed justice sensitivity, and cyber-bystander defender intervention (constructive and aggressive) in cyberbullying. The sample comprised 900 Mexican adolescents (40.2% male and 58.8% female), of which 450 were from secondary school (M age = 13.6, SD = 0.8) and 450 were from high school (M age = 15.4, SD = 1.3). Structural equation modeling with latent variables was performed. Overall, the results indicate that parental restorative discipline positively relates to the observer's justice sensitivity and the adoption of constructive interventions by cyber-bystander defenders. However, restorative discipline had no significant direct relationship with aggressive intervention. Observers' justice sensitivity mediates the association between restorative parenting discipline and aggressive or constructive defender interventions. Gender does not moderate the relationship proposed in the structural model. These findings suggest that parental restorative discipline explains constructive and aggressive cyber-bystander defender interventions in cyberbullying.

Adherence to Treatment Guidelines in Ambulatory Heart Failure Patients with Reduced Ejection Fraction in a Latin-American Country: Observational Study of the Colombian Heart Failure Registry (RECOLFACA).

INTRODUCTION: Although several guidelines recommend that patients with heart failure with reduced ejection fraction (HFrEF) be treated with angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEIs/ARBs) or angiotensin receptor-neprilysin inhibitors (ARNIs), beta-blockers, mineralocorticoid receptor antagonists (MRAs), and sodium-glucose cotransporter-2 inhibitor (SGLT2i), there are still several gaps in their prescription and dosage in Colombia. This study aimed to describe the use patterns of HFrEF treatments in the Colombian Heart Failure Registry (RECOLFACA). METHODS: Patients with HFrEF enrolled in RECOLFACA during 2017-2019 were included. Heart failure (HF) medication prescription and daily dose were assessed using absolute numbers and proportions. Therapeutic schemes of patients treated by internal medicine specialists were compared with those treated by cardiologists. RESULTS: Out of 2,528 patients in the registry, 1,384 (54.7%) had HFrEF. Among those individuals, 88.9% were prescribed beta-blockers, 72.3% with ACEI/ARBs, 67.9% with MRAs, and 13.1% with ARNIs. Moreover, less than a third of the total patients reached the target doses recommended by the European HF guidelines. No significant differences in the therapeutic schemes or target doses were observed between patients treated by internal medicine specialists or cardiologists. CONCLUSION: Prescription rates and target dose achievement are suboptimal in Colombia. Nevertheless, RECOLFACA had one of the highest prescription rates of beta-blockers and MRAs compared to some of the most recent HF registries. However, ARNIs remain underprescribed. Continuous registry updates can improve the identification of patients suitable for ARNI and SGLT2i therapy to promote their use in clinical practice.

Habilidades para la vida y percepción de riesgo en estudiantes universitarios de ciencias de la salud / Life skills and risk perception in university health sciences students

Objetivo: determinar el nivel de asertividad, resiliencia, autoestima y percepción en situaciones de riesgo en un grupo de estudiantes de ciencias de la salud. Métodos: estudio descriptivo de corte transversal, el muestreo fue aleatorio con 170 estudiantes. La consistencia interna de las pruebas fue: escala de autoestima (α=.66), cuestionario de confianza situacional (α=.99), cuestionario de asertividad (α=.66) y escala de resiliencia (α=.98). El proyecto fue avalado por el comité de ética del Hospital de San José, FUCS con carta expedita. Resultados: el 87.6% (n=149) eran mujeres, la mediana de la edad fue 20 años (RIQ=19 a 21), la autoestima fue elevada (Me: 34); nivel de asertividad contrariada (Me: 8); nivel de resiliencia alto (Me: 139.5); en cuanto a la percepción de riesgo en las 8 subescalas, el mayor puntaje se obtuvo en situaciones de control de consumo y presión social.

Objective: to determine the level of assertiveness, resilience, self-esteem, and risk perception in a group of health sciences students. Methods: a descriptive cross-sectional study was carried out in 170 randomly selected students. The tests included items of the self-esteem scale (α=.66), situational confidence questionnaire (α=.99), assertiveness questionnaire (α=.66) and resilience scale(α=.98). The project was endorsed by the ethics committee of Hospital de San José, FUCS, with an expedited letter. Results: 87.6% (n=149) were women, median age was 20 years (IQR=19 to 21), high self-esteem (Me: 34); thwarted level of assertiveness (Me: 8); high resilience (Me: 139.5); regarding risk perception, the highest score was obtained in control of consumption and social pressure situations, in the 8 subscales.

YouTube® as a source of information for Spanish-speaking patients with rheumatoid arthritis / YouTube® como fuente de información para pacientes hispanohablantes con artritis reumatoide

Introduction: Social media (SoMe) has reshaped access to health information, which may benefit patients with rheumatoid arthritis (RA), although an evaluation of the characteristics of contents for Spanish-speaking patients is lacking. We aimed to assess patient engagement, reliability, comprehensiveness, and quality of data uploaded to YouTube® for Spanish-speaking patients. Methods: We evaluated the videos uploaded to YouTube® in Spanish about RA. Information about video length, engagement (i.e., views, likes, popularity index), time online, and the source was retrieved; we appraised reliability (DISCERN), comprehensiveness (content score), and quality (Global Quality Score) using standardized scores. Results: We included 200 videos in the study and classified 67% of the videos as useful. These videos had a higher number of views (19,491 [10,132–61,162] vs. 11,208 [8183–20,538]), a longer time online (1156 [719–2254] vs. 832 [487–1708] days), and a shorter duration (6.3 [3.4–15.8] vs. 11.8 [7.4–20.3] min). Engagement parameters were similar between useful and misleading videos. Useful videos had higher reliability, comprehensiveness, and quality scores. Useful videos were mainly uploaded by independent users and government/news agencies; academic organizations offered only 15% of useful videos. Conclusions: Most of the information in YouTube® for Spanish-speaking patients with RA is useful; however, patient engagement is similar between useful and misleading content. More substantial involvement of academia in developing high-quality educational multimedia is warranted.(AU)

Introducción: Las redes sociales (ReSo) han redefinido el acceso a la información en salud, beneficiando a los pacientes con artritis reumatoide (AR). No se cuenta con una evaluación de las características de su contenido para pacientes hispanohablantes. Nuestro objetivo fue evaluar los parámetros de interacción, la confiabilidad, la exhaustividad y la calidad de la información disponible en YouTube® para pacientes hispanohablantes con AR. Métodos: Evaluamos los videos en español sobre AR disponibles en YouTube®. Se extrajo información sobre la duración del video, los parámetros de interacción (por ejemplo, vistas, likes, índice de popularidad), el tiempo en línea y la fuente generadora. Estimamos la confiabilidad (DISCERN), la exhaustividad (puntaje de contenido) y la calidad (Global Quality Score) utilizando puntajes estandarizados. Resultados: Incluimos 200 videos en el estudio y clasificamos a 67% como videos útiles. Estos videos tuvieron un mayor número de vistas (19.491 [10.132-61.162] vs. 11.208 [8.183-20.538]), un mayor tiempo en línea (1.156 [719-2.254] vs. 832 [487-1.708] días) y una menor duración (6,3 [3,4-15,8] vs. 11,8 [7,4-20,3] min). Los parámetros de interacción fueron similares entre los videos útiles y los no útiles. Los videos útiles presentaron puntajes mayores de confiabilidad, exhaustividad y calidad; en su mayoría fueron generados por usuarios independientes y por organizaciones gubernamentales/agencias de noticias. Las organizaciones académicas generaron únicamente 15% de los videos útiles. Conclusiones: La mayoría de la información en YouTube® para pacientes hispanohablantes con AR es útil. Sin embargo, los parámetros de interacción son similares entre los videos útiles y los no útiles. Se requiere una mayor participación de las organizaciones académicas en el desarrollo de multimedia educativo de alta calidad.(AU)

Seroprevalence and coprological prevalence of liver fluke Fasciola hepatica in cattle and sheep from Santander department, Colombia.

Fasciola hepatica is a parasite with a worldwide distribution that affects several mammals, including humans, and is considered a public health problem. Therefore, the aim of this study was to determine the prevalence of Fasciola hepatica in humans, cattle and sheep, as well as to evaluate factors associated with the prevalence. A total of 185 serum samples from sheep, 290 from cattle, and 114 from humans were collected and processed using an in-house developed ELISA to detect IgG antibodies against F. hepatica. Additionally, 185 stool samples from sheep and 290 from cattle were examined using a Dennis sedimentation technique. Risk factors were analyzed using epidemiological surveys. The overall seroprevalence was 46.5% (86/185) in sheep, 32.5% (94/289) in cattle, and no humans tested positive for the infection. The coprological prevalence was 47.7% (86/180) in sheep and 33.7% (98/290) in cattle. Female gender and cattle living with alternate grazing management showed 2.5 and 6.5 times higher probability of infection, respectively. Bovines coexisting with sheep exhibited a higher risk of infection (odds ratio [OR]=4.3) compared to those without sheep. We concluded that F. hepatica in cattle and sheep has an endemic behavior, and therefore represents a problem of public health for rural communities.

YouTube® as a source of information for Spanish-speaking patients with rheumatoid arthritis.

INTRODUCTION: Social media (SoMe) has reshaped access to health information, which may benefit patients with rheumatoid arthritis (RA), although an evaluation of the characteristics of contents for Spanish-speaking patients is lacking. We aimed to assess patient engagement, reliability, comprehensiveness, and quality of data uploaded to YouTube® for Spanish-speaking patients. METHODS: We evaluated the videos uploaded to YouTube® in Spanish about RA. Information about video length, engagement (i.e., views, likes, popularity index), time online, and the source was retrieved; we appraised reliability (DISCERN), comprehensiveness (content score), and quality (Global Quality Score) using standardized scores. RESULTS: We included 200 videos in the study and classified 67% of the videos as useful. These videos had a higher number of views (19,491 [10,132-61,162] vs. 11,208 [8183-20,538]), a longer time online (1156 [719-2254] vs. 832 [487-1708] days), and a shorter duration (6.3 [3.4-15.8] vs. 11.8 [7.4-20.3] min). Engagement parameters were similar between useful and misleading videos. Useful videos had higher reliability, comprehensiveness, and quality scores. Useful videos were mainly uploaded by independent users and government/news agencies; academic organizations offered only 15% of useful videos. CONCLUSIONS: Most of the information in YouTube® for Spanish-speaking patients with RA is useful; however, patient engagement is similar between useful and misleading content. More substantial involvement of academia in developing high-quality educational multimedia is warranted.

Análisis del programa de apoyo al paciente de evolocumab (Repatha®) para pacientes con enfermedades cardiovasculares en Colombia / Analysis of the evolocumab (Repatha®) patient support program for patients with cardiovascular disease in Colombia

Antecedentes: Las enfermedades cardiovasculares son la principal causa de muerte a nivel mundial. El objetivo es describir las características demográficas, los patrones de tratamiento, cumplimiento terapéutico y continuidad del tratamiento y explorar las variables relacionadas con la falta de adherencia de los pacientes inscritos en un programa de apoyo al paciente (PSP, por sus siglas en inglés) cardiovascular para al tratamiento con evolocumab en Colombia. Métodos: Estudio observacional-retrospectivo del registro de datos de los pacientes que ingresaron al programa PSP de evolocumab. Resultados: El análisis incluyó a 930 pacientes inscritos en el PSP (2017-2021). La edad media fue de 65,1 años (DE±1,1) y el 49,1% eran mujeres. La tasa media de cumplimiento del tratamiento con evolocumab fue del 70,5% (DE±21,8). Un total de 367 pacientes (40,5%) reportaron una tasa de cumplimiento superior al 80%. El análisis de continuidad incluyó a 739 pacientes (81,5%); el 87,8% de estos pacientes fueron considerados persistentes en el tratamiento. Un total de 871 pacientes (93,7%) reportaron al menos un evento adverso durante el período de seguimiento (en su mayoría no graves). Conclusión: Este es el primer estudio de la vida real sobre el tratamiento para la dislipidemia en un programa de apoyo a pacientes en Colombia. La adherencia encontrada fue superior al 70%, cifra similar a los hallazgos de otros estudios de vida real. Entre las causas del bajo cumplimiento se destacan las barreras administrativas y médicas para la suspensión o abandono del tratamiento con evolocumab. (AU)

Background: Cardiovascular diseases are considered the leading cause of death globally. This study describes the demographic characteristics, treatment patterns, self-reported compliance and persistence, and to explore variables related to non-adherence of patients enrolled in the cardiovascular patient support program (PSP) for evolocumab treatment in Colombia. Methods: This retrospective observational of the data registry of patients who entered the evolocumab PSP program. Results: The analysis included 930 patients enrolled in the PSP (2017-2021). Mean age was 65.1 (SD±13.1) and49.1% patients were female. The mean compliance rate to evolocumab treatment was 70.5% (SD±21.8). A total of 367 patients (40.5%) reported compliance higher than 80%. Persistence analysis included 739 patients (81.5%) where 87.8% of these patients were considered persistent to treatment. A total of 871 patients (93.7%) reported the occurrence of at least one adverse event during the follow-up period (mostly non-serious). Conclusion: This is the first real-life study describing patient characteristics, compliance and continuity of treatment for dyslipidemia in a patient support program in Colombia. The overall adherence found was higher than 70%; similar to findings reported in other real-life studies with iPCSK9. However, the reasons for low compliance were different, highlighting the high number of administrative and medical reasons for suspension or abandonment of treatment with evolocumab. (AU)

Development and psychometric evidence of the Academic Engagement Scale (USAES) in Mexican college students.

School engagement is considered an effective college dropout antidote; therefore, understanding the construct, its underpinnings, and its effects remains critical for scholars. Although several scholars have offered multiple scales to measure engagement, their use has been hindered by significant limitations. This study sought to develop a scale to measure academic engagement by unifying and improving existing work and theories that resulted in a three-dimensional measurement model (behavioral, emotional, and cognitive). The items included were validated by a group of experts who ensured that the wording of the items captured the uniqueness of the college experience. A sample of 992 Mexican college students was used to test the fit of a second-order three-dimensional factor model of school engagement. The sample was randomly split in two for model cross-validation. Confirmatory factor analyses confirmed that student engagement is a three-dimensional construct, with evidence that supports the hypothesized second-order engagement factor structure (behavioral, emotional, and cognitive). The stability of these models was confirmed by using an independent sample. Measurement invariance by gender was found in this model. Then, differences in latent factor means were analyzed. Finally, the scale showed discriminant and concurrent validity. These results indicate that the scale is theoretically and psychometrically grounded for measuring college students' school engagement.

Real-World Insights into Evolocumab Use in Patients with Hyperlipidemia Across Five Countries: Analysis from the ZERBINI Study.

INTRODUCTION: This study characterizes patients receiving evolocumab in clinical practice and assesses treatment effectiveness, safety and persistence outcomes across five countries. METHODS: This retrospective and prospective observational study enrolled patients initiated on evolocumab during August 2017 to July 2019 at 49 sites across Canada, Mexico, Colombia, Saudi Arabia and Kuwait. Medical records data were extracted within 6 months prior to (baseline) and every 3 months for 12 months post evolocumab initiation and reported as available. RESULTS: A total of 578 patients were enrolled (40.1% female, median age 60 [interquartile range (IQR) 51-68] years); 83.7% had atherosclerotic cardiovascular disease and/or familial hypercholesterolemia. Median low-density lipoprotein cholesterol (LDL-C) at baseline was 3.4 (IQR 2.7-4.2) mmol/L (131.5 [IQR 104.4-162.4] mg/dL), with 75.6% of patients receiving a statin (59.2% high intensity). Compared to baseline, the median lowest LDL-C was reduced by 70.2% and remained stable over 12 months of treatment. Guideline-recommended LDL-C thresholds < 1.8, < 1.4 and < 1.0 mmol/L (< 70, < 55 and < 40 mg/dL) were achieved by 75.3%, 63.6% and 47.4% of patients. LDL-C outcomes were consistent across high- and very high-risk patients. Background lipid-lowering therapy remained relatively stable. No serious treatment-emergent adverse events were reported, and persistence to evolocumab was 90.2% at 12 months. CONCLUSION: These findings provide real-world evidence that evolocumab use is in accordance with its international guideline-recommended place in dyslipidemia therapy, as well as confirmation of its effectiveness and safety in a heterogeneous population. Evolocumab can address a healthcare gap in the management of dyslipidemia by increasing the proportion of patients achieving LDL-C goals recommended to lower cardiovascular risk.

Implementing community based inclusive development for people with disability in Latin America: a mixed methods perspective on prioritized needs and lessons learned.

BACKGROUND: Research on the needs of people with disability is scarce, which promotes inadequate programs. Community Based Inclusive Development interventions aim to promote rights but demand a high level of community participation. This study aimed to identify prioritized needs as well as lessons learned for successful project implementation in different Latin American communities. METHODS: This study was based on a Community Based Inclusive Development project conducted from 2018 to 2021 led by a Columbian team in Columbia, Brazil and Bolivia. Within a sequential mixed methods design, we first retrospectively analyzed the project baseline data and then conducted Focus Group Discussions, together with ratings of community participation levels. Quantitative descriptive and between group analysis of the baseline survey were used to identify and compare sociodemographic characteristics and prioritized needs of participating communities. We conducted qualitative thematic analysis on Focus Group Discussions, using deductive main categories for triangulation: 1) prioritized needs and 2) lessons learned, with subcategories project impact, facilitators, barriers and community participation. Community participation was assessed via spidergrams. Key findings were compared with triangulation protocols. RESULTS: A total of 348 people with disability from 6 urban settings participated in the baseline survey, with a mean age of 37.6 years (SD 23.8). Out of these, 18 participated within the four Focus Group Discussions. Less than half of the survey participants were able to read and calculate (42.0%) and reported knowledge on health care routes (46.0%). Unemployment (87.9%) and inadequate housing (57.8%) were other prioritized needs across countries. Focus Group Discussions revealed needs within health, education, livelihood, social and empowerment domains. Participants highlighted positive project impact in work inclusion, self-esteem and ability for self-advocacy. Facilitators included individual leadership, community networks and previous reputation of participating organizations. Barriers against successful project implementation were inadequate contextualization, lack of resources and on-site support, mostly due to the COVID-19 pandemic. The overall level of community participation was high (mean score 4.0/5) with lower levels in Brazil (3.8/5) and Bolivia (3.2/5). CONCLUSION: People with disability still face significant needs. Community Based Inclusive Development can initiate positive changes, but adequate contextualization and on-site support should be assured.

Community Violence Exposure and Bullying in Mexican Adolescents. The Mediating Role of Moral Emotions.

Community characteristics can explain differences in bullying rates between schools. Underpinned by the social-ecological model, this study examined the relationships among community violence exposure (CVE), moral emotions (guilt and sympathy), and bullying in adolescents. We also explored the moderating role of gender in these relationships. The sample included 915 adolescents (48.6% female and 51.4% male) aged 11-16 (M age = 13.76, SD = 0.82). Students responded to the self-report measures. We used a latent variable structural equation modeling (SEM) approach to examine the relationships between variables. The SEM indicated that CVE was negatively associated with moral emotions (guilt and sympathy) and positively associated with bullying. In addition, CVE had a negative indirect association with bullying through their negative relationship with moral emotions. The structural model is equivalent for both genders, suggesting gender does not moderate these relationships. These findings indicate that CVE are associated with differences in school bullying rates.

Analysis of the evolocumab (Repatha®) patient support program for patients with cardiovascular disease in Colombia. / Análisis del programa de apoyo al paciente de evolocumab (Repatha®) para pacientes con enfermedades cardiovasculares en Colombia.

BACKGROUND: Cardiovascular diseases are considered the leading cause of death globally. This study describes the demographic characteristics, treatment patterns, self-reported compliance and persistence, and to explore variables related to non-adherence of patients enrolled in the cardiovascular patient support program (PSP) for evolocumab treatment in Colombia. METHODS: This retrospective observational of the data registry of patients who entered the evolocumab PSP program. RESULTS: The analysis included 930 patients enrolled in the PSP (2017-2021). Mean age was 65.1 (SD±13.1) and49.1% patients were female. The mean compliance rate to evolocumab treatment was 70.5% (SD±21.8). A total of 367 patients (40.5%) reported compliance higher than 80%. Persistence analysis included 739 patients (81.5%) where 87.8% of these patients were considered persistent to treatment. A total of 871 patients (93.7%) reported the occurrence of at least one adverse event during the follow-up period (mostly non-serious). CONCLUSION: This is the first real-life study describing patient characteristics, compliance and continuity of treatment for dyslipidemia in a patient support program in Colombia. The overall adherence found was higher than 70%; similar to findings reported in other real-life studies with iPCSK9. However, the reasons for low compliance were different, highlighting the high number of administrative and medical reasons for suspension or abandonment of treatment with evolocumab.

Effectiveness evaluation of online Mindfulness in mental health and alcohol consumption in medical students during the COVID-19 pandemic / Evaluación de la eficacia del Mindfulness online en la salud mental y el consumo de alcohol en estudiantes de medicina durante la pandemia de COVID-19

Abstract Introduction As a result of the COVID-19 pandemic, the prevalence of stress, anxiety, depression, and alcohol consumption has increased among medical students. Mindfulness is an intervention to decrease these psychopathologies and alcohol consumption; however, evidence has shown unclear results regarding its efficacy. Objective To evaluate the effectiveness of an online Mindfulness-based intervention (MBI) on stress, anxiety, and depression symptomatology levels, as well as on alcohol consumption and mindfulness status in medical students during the COVID-19 pandemic. Method A quasi-experimental study was conducted on 237 students, obtaining sociodemographic data. In addition the levels of psychopathology, alcohol consumption, and state of mindfulness: were measured pre-and post-intervention through the DASS-21, AUDIT, and MASS instruments. Eight online Mindfulness sessions were conducted once a week for approximately one hour each. Results MBI did not reduce levels of psychopathologies or alcohol consumption, nor did the mindfulness status improve. High levels of psychopathologies, dropout rate, and lack of voluntary participation were the main factors limiting the effectiveness of the online MBI. Discussion and conclusion The online MBI wasn't effective among the population under study: we recommend generation strategies where students are involved in and complete intervention programs. Results from this research will help enhance future online mindfulness interventions.

Resumen Introducción Derivado de la pandemia del COVID-19, la prevalencia de estrés, ansiedad, depresión y consumo de alcohol ha incrementado entre los estudiantes de medicina. La intervención por Mindfulness ha reportado disminuir estas psicopatologías y el consumo de alcohol; no obstante, la evidencia muestra resultados poco claros respecto a su eficacia. Objetivo Evaluar la eficacia de la intervención basada en Mindfulness online (IBM) sobre los niveles de sintomatología de estrés, ansiedad y depresión, así como en el consumo de alcohol y el estado de atención plena en estudiantes de medicina durante la pandemia por COVID-19. Método Se realizó una investigación cuasi-experimental en 237 estudiantes de medicina, de los cuales se obtuvieron datos sociodemográficos; además, se midieron los niveles de psicopatologías, consumo de alcohol, y el estado de atención plena pre y post intervención a través de los instrumentos DASS-21, AUDIT, y MASS. Se llevaron a cabo ocho sesiones de Mindfulness online, una vez por semana, de aproximadamente una hora cada una. Resultados La IBM no redujo los niveles de psicopatologías ni de consumo de alcohol ni mejoró el estado de atención plena. Los altos niveles de psicopatologías, la tasa de abandono y la falta de participación voluntaria, fueron los principales factores que limitan la eficacia del IBM online. Discusión y conclusión La IBM online no fue efectiva entre la población estudiada: se recomienda la generación de estrategias en las que los estudiantes se involucren y completen los programas de intervención, los resultados de esta investigación ayudarán a mejorar futuras intervenciones de mindfulness online.

Prolongation of the QTc Interval at Admission is Associated with Increased Mortality in Patients with SARS-COV-2 during Hospitalization. / O Prolongamento do Intervalo QTc na Admissão está Associado ao Aumento da Mortalidade em Pacientes com SARS-COV-2 durante a Hospitalização.

BACKGROUND: Cardiovascular involvement associated with SARS-COV-2 infection is related to unfavorable outcomes during hospitalization. Therefore, the measurement at the admission of the QTc interval on the 12-lead electrocardiogram may be a prognostic marker. OBJECTIVE: To identify the relationship between QTc prolongation at admission during hospitalization and mortality from SARS-COV-2. METHOD: Observational study based on a retrospective cohort of patients with confirmed SARS-COV-2 infection from San Ignacio University Hospital, Bogotá (Colombia), between March 19, 2020, and July 31, 2021. Mortality was compared in patients with prolonged and normal QTc at admission after controlling by clinical variables and comorbidities using bivariate and multivariate logistic regression models. A p-value <0.05 was considered statistically significant. RESULTS: 1296 patients were analyzed, and 127 (9.8%) had prolonged QTc. Mortality was higher in patients with prolonged QTc (39.4% vs 25.3%, p=0.001), as was hospital stay (median 11vs.8 days; p=0.002). In the multivariate analysis, mortality was associated with prolonged QTc (OR 1.61, 95% CI: 1.02; 2.54, p=0.038), age (OR 1.03, 95% CI 1.02; 1.05, p<0.001), male sex (OR 2.15, 95% CI 1.60; 2.90, p <0.001), kidney disease (OR 1.32, 95% CI 1.05; 1.66, p =0.018) and Charlson comorbidity index > 3 (OR 1.49, 95% CI 1.03; 2.17, p=0.035). CONCLUSIONS: Hospital mortality due to SARS-COV-2 is associated with prolonging the QTc interval at the time of admission, even after adjusting for age, sex, comorbidities, and basal severity of infection. Additional research is needed to establish whether these findings are related to cardiac involvement by the virus, hypoxia, and systemic inflammation.

FUNDAMENTO: O envolvimento cardiovascular associado à infecção por SARS-COV-2 está relacionado a desfechos desfavoráveis durante a internação. Portanto, a medida na admissão do intervalo QTc no eletrocardiograma de 12 derivações pode ser um marcador prognóstico. OBJETIVO: Identificar a relação entre o prolongamento do QTc na admissão durante a hospitalização e a mortalidade por SARS-COV-2. MÉTODO: Estudo observacional baseado em uma coorte retrospectiva de pacientes com infecção confirmada por SARS-COV-2 do Hospital Universitário San Ignacio, Bogotá (Colômbia), entre 19 de março de 2020 e 31 de julho de 2021. A mortalidade foi comparada em pacientes com QTc prolongado e normal na admissão e controle das variáveis clínicas e comorbidades por meio de modelos de regressão logística bivariada e multivariada. Um valor de p <0,05 foi considerado estatisticamente significativo. RESULTADOS: Foram analisados 1.296 pacientes e 127 (9,8%) apresentaram QTc prolongado. A mortalidade foi maior em pacientes com QTc prolongado (39,4% vs. 25,3%, p=0,001), assim como o tempo de internação (mediana 11 vs. 8 dias; p=0,002). Na análise multivariada, a mortalidade foi associada a QTc prolongado (OR 1,61, IC 95%: 1,02; 2,54, p=0,038), idade (OR 1,03, IC 95% 1,02; 1,05, p<0,001), sexo masculino (OR 2,15, IC 95% 1,60; 2,90, p<0,001), doença renal (OR 1,32, IC 95% 1,05; 1,66, p=0,018) e índice de comorbidade de Charlson > 3 (OR 1,49, IC 95% 1,03; 2,17, p=0,035). CONCLUSÕES: A mortalidade hospitalar por SARS-COV-2 está associada ao prolongamento do intervalo QTc no momento da admissão, mesmo após ajuste para idade, sexo, comorbidades e gravidade basal da infecção. Pesquisas adicionais são necessárias para estabelecer se esses achados estão relacionados ao envolvimento cardíaco pelo vírus, hipóxia e inflamação sistêmica.

O Prolongamento do Intervalo QTc na Admissão está Associado ao Aumento da Mortalidade em Pacientes com SARS-COV-2 durante a Hospitalização / Prolongation of the QTc Interval at Admission is Associated with Increased Mortality in Patients with SARS-COV-2 during Hospitalization

Resumo Fundamento O envolvimento cardiovascular associado à infecção por SARS-COV-2 está relacionado a desfechos desfavoráveis durante a internação. Portanto, a medida na admissão do intervalo QTc no eletrocardiograma de 12 derivações pode ser um marcador prognóstico. Objetivo Identificar a relação entre o prolongamento do QTc na admissão durante a hospitalização e a mortalidade por SARS-COV-2. Método Estudo observacional baseado em uma coorte retrospectiva de pacientes com infecção confirmada por SARS-COV-2 do Hospital Universitário San Ignacio, Bogotá (Colômbia), entre 19 de março de 2020 e 31 de julho de 2021. A mortalidade foi comparada em pacientes com QTc prolongado e normal na admissão e controle das variáveis clínicas e comorbidades por meio de modelos de regressão logística bivariada e multivariada. Um valor de p <0,05 foi considerado estatisticamente significativo Resultados Foram analisados 1.296 pacientes e 127 (9,8%) apresentaram QTc prolongado. A mortalidade foi maior em pacientes com QTc prolongado (39,4% vs. 25,3%, p=0,001), assim como o tempo de internação (mediana 11 vs. 8 dias; p=0,002). Na análise multivariada, a mortalidade foi associada a QTc prolongado (OR 1,61, IC 95%: 1,02; 2,54, p=0,038), idade (OR 1,03, IC 95% 1,02; 1,05, p<0,001), sexo masculino (OR 2,15, IC 95% 1,60; 2,90, p<0,001), doença renal (OR 1,32, IC 95% 1,05; 1,66, p=0,018) e índice de comorbidade de Charlson > 3 (OR 1,49, IC 95% 1,03; 2,17, p=0,035). Conclusões A mortalidade hospitalar por SARS-COV-2 está associada ao prolongamento do intervalo QTc no momento da admissão, mesmo após ajuste para idade, sexo, comorbidades e gravidade basal da infecção. Pesquisas adicionais são necessárias para estabelecer se esses achados estão relacionados ao envolvimento cardíaco pelo vírus, hipóxia e inflamação sistêmica.

Abstract Background Cardiovascular involvement associated with SARS-COV-2 infection is related to unfavorable outcomes during hospitalization. Therefore, the measurement at the admission of the QTc interval on the 12-lead electrocardiogram may be a prognostic marker. Objective To identify the relationship between QTc prolongation at admission during hospitalization and mortality from SARS-COV-2. Method Observational study based on a retrospective cohort of patients with confirmed SARS-COV-2 infection from San Ignacio University Hospital, Bogotá (Colombia), between March 19, 2020, and July 31, 2021. Mortality was compared in patients with prolonged and normal QTc at admission after controlling by clinical variables and comorbidities using bivariate and multivariate logistic regression models. A p-value <0.05 was considered statistically significant. Results 1296 patients were analyzed, and 127 (9.8%) had prolonged QTc. Mortality was higher in patients with prolonged QTc (39.4% vs 25.3%, p=0.001), as was hospital stay (median 11vs.8 days; p=0.002). In the multivariate analysis, mortality was associated with prolonged QTc (OR 1.61, 95% CI: 1.02; 2.54, p=0.038), age (OR 1.03, 95% CI 1.02; 1.05, p<0.001), male sex (OR 2.15, 95% CI 1.60; 2.90, p <0.001), kidney disease (OR 1.32, 95% CI 1.05; 1.66, p =0.018) and Charlson comorbidity index > 3 (OR 1.49, 95% CI 1.03; 2.17, p=0.035). Conclusions Hospital mortality due to SARS-COV-2 is associated with prolonging the QTc interval at the time of admission, even after adjusting for age, sex, comorbidities, and basal severity of infection. Additional research is needed to establish whether these findings are related to cardiac involvement by the virus, hypoxia, and systemic inflammation.