Virtual Clinical Simulation for Training Amongst Undergraduate Medical Students: A Pilot Randomised Trial (VIRTUE-Pilot).

BACKGROUND: Clinical virtual simulators are promising new technologies that might facilitate teaching clinical skills. OBJECTIVE: This study aimed to assess whether a virtual reality simulator might facilitate learning and improve adherence to current clinical guidelines. METHODOLOGY: A double-masked randomised trial was undertaken among fourth-year medical students at Universidad Andres Bello, Chile. Participants were randomised to a clinical virtual simulator (Body Interact®, Body Interact Inc., Austin, TX) or a small-group discussion session on the management of myocardial infarction. Main outcomes included performance in an objective structured clinical examination (OSCE) and adherence to clinical recommendations. Analyses were undertaken under the intention to treat principle by an independent statistician. RESULTS: Fifty students volunteered to participate. Most were female (30 students, 58.8%) and had a mean age of 23.0±2.7 years. Thirty-two participants (62.8%) had used virtual reality platforms before. Students allocated to the simulator showed better OSCE scores (mean difference: 2.8 points; 95% confidence interval (CI): -3.2 to +8.7 points, p=0.14) and were faster to implement diagnostic and therapeutic interventions, but not in a statistically significant way. DISCUSSION: Academic performance was slightly improved by the use the simulator, although the overall effect was smaller than expected. CONCLUSION:  This study examined the influence of a clinical virtual simulator on the academic performance and guideline adherence of undergraduate medical students, with small group discussions as a point of comparison. The findings revealed that there were no statistically significant distinctions between the two methods, potentially attributed to the selection of the comparator and the relatively brief intervention period.

Violence in fishing, hunting, and gathering societies of the Atacama Desert coast: A long-term perspective (10,000 BP-AD 1450).

In this study, we examine the long-term trajectory of violence in societies that inhabited the coast of the Atacama Desert in northern Chile using three lines of evidence: bioarchaeology, geoarchaeology and socio-cultural contexts (rock art, weapons, and settlement patterns). These millennia-old populations adopted a way of life, which they maintained for 10,000 years, based on fishing, hunting, and maritime gathering, complementing this with terrestrial resources. We analyzed 288 adult individuals to search for traumas resulting from interpersonal violence and used strontium isotopes 87Sr/86Sr as a proxy to evaluate whether individuals that showed traces of violence were members of local or non-local groups. Moreover, we evaluated settlement patterns, rock art, and weapons. The results show that the violence was invariant during the 10,000 years in which these groups lived without contact with the western world. During the Formative Period (1000 BC-AD 500), however, the type of violence changed, with a substantial increase in lethality. Finally, during the Late Intermediate Period (AD 1000-1450), violence and lethality remained similar to that of the Formative Period. The chemical signal of Sr shows a low frequency of individuals who were coastal outsiders, suggesting that violence occurred between local groups. Moreover, the presence of weapons and rock art depicting scenes of combat supports the notion that these groups engaged in violence. By contrast, the settlement pattern shows no defensive features. We consider that the absence of centralized political systems could have been a causal factor in explaining violence, together with the fact that these populations were organized in small-scale grouping. Another factor may have been competition for the same resources in the extreme environments of the Atacama Desert. Finally, from the Formative Period onward, we cannot rule out a certain level of conflict between fishers and their close neighbors, the horticulturalists.

Validation of the Spanish version of the Pediatric Symptom Checklist (PSC) to identify and assess psychosocial problems among early adolescents in Chile.

BACKGROUND: The high prevalence of mental disorders in early adolescents, and their consequences, encourage the need for validated instruments to identify and assess psychosocial problems. OBJECTIVES: i) To evaluate the psychometric properties of the Spanish version of the Pediatric Symptom Checklist (PSC) questionnaires (PSC-Y, 35 items, and PSC-17-Y) and its subscales (Attention, Internalizing and Externalizing subscales), including the assessment of the item structure, concurrent validity, and reliability; and ii) To assess possible associations between bullying experiences, school climate and school membership with psychological problems identified by the PSC questionnaire. METHODS: A cross-sectional study was carried out in 39 schools in Santiago, Chile. The sample consisted of 3,968 adolescents aged between 10 and 11 years. A descriptive analysis of the Pediatric Symptom Checklist was performed along with measures of dimensionality, reliability, and correlations with a validated questionnaire exploring similar constructs, the Strengths and Difficulties Questionnaire. Finally, associations of bullying, school climate, and school membership with the three subscales of the PSC were explored. RESULTS: Both versions of PSC had problems with item #7 (Act as if driven by motor), which did not load in any of the latent factors. It was removed from later analyses. The three-factor structure of PSC was confirmed. All remaining items had high factor loadings in their corresponded latent factors, and the reliability was high for the total scales (PSC-34-Y, ω = 0.78; PSC-16-Y, ω = 0.94) and the subscales of PSC-16-Y (Attention, ω = 0.77; Internalizing, ω = 0.79; Externalizing, ω = 0.78). The goodness of fit was adequate, and the correlation between PSC subscales and SDQ subscales was high. Victimization and perpetration were associated with all PSC subscales, and higher school climate and stronger school memberships were negatively associated with PSC symptoms. CONCLUSIONS: The current findings seem to demonstrate that the Spanish version of the PSC is a valid and reliable instrument for identifying and assessing psychosocial problems in early adolescents.

Mental training in dentistry: A scoping review.

INTRODUCTION: Clinical motor skills are essential to train dental students. There is evidence that imagery serves to acquire and improve motor skills, but there is scarce information on its application in dental education. In order to broadly map the available evidence and to detect knowledge gaps in the mental training used to develop motor skills in dentistry, a scoping review was conducted. MATERIALS AND METHODS: A structured search was conducted to identify relevant references from the Web of Science, Scopus and MEDLINE/PubMed databases for studies addressing mental training methods applied to develop motor skills in dentistry. RESULTS: A total of 758 articles were screened and four were selected, all of which were randomized clinical trials. Three studies investigated the effectiveness of visual imagery, and one investigated kinesthetic imagery. The research theme identified was motor skill acquisition. CONCLUSION: The reviewed studies indicate the usefulness of mental training for skill acquisition in dentistry. To improve the generalizability of the results, further research with standardized mental training on motor skills in dentistry is needed.

Desnutrición aguda en menores de cinco años en el Departamento de Boyacá (Colombia), 2017-2021 / Epidemiological surveillance of acute malnutrition in children under 5 years of age in the Department of Boyacá, Colombia, 2017 to 2021 / Desnutrição aguda em crianças com menos de cinco anos de idade no Departamento de Boyacá (Colômbia), 2017-2021

Introducción: La desnutrición es un problema de salud pública que afecta a los menores de cinco años. En Colombia, en 2021, se notificaron al Sistema de Vigilancia en Salud Pública 15 924 casos de desnutrición aguda, con una prevalencia de 0,41 por cada 100 niños menores de 5 años; mientras que el Departamento de Boyacá tuvo una prevalencia de 0,54 por cada 100 menores de 5 años. Por ello, es importante estudiar factores de riesgo de la des-nutrición para generar información que permita la toma de decisiones en el departamento. Objetivo: Describir el comportamiento epidemiológico de la desnutrición aguda en menores de cinco años en el Departamento de Boyacá durante el periodo 2017-2021. Materiales y métodos: Se realizó un estudio observacional descriptivo de corte trasversal analítico. Se calcularon fre-cuencias absolutas y porcentajes, medidas de tendencia central y dispersión y odds ratio como medida de asociación.Resultados: De los 2254 datos analizados, el 55,37 % correspondieron al sexo masculino, el 88,08 % pertenecía al régimen subsidiado, el 50,80 % vivía en áreas rurales dispersos y el estrato socioeconómico 1 aportó el 51,33 % de la información. Se identificaron como factores de riesgo de desnutrición aguda severa la lactancia materna menor a 6 meses (OR = 1,96; 1,61-2,39) y el inicio de la alimentación complementaria antes de los 6 meses (OR = 2,12; 1,72-2,59). Conclusión: Es importantefortalecer los programas y políticas en salud con el fin de velar por la atención integral y oportuna de los menores de cinco años.

Introduction: Malnutrition is a public health problem that affects children under five years of age. In Colombia in 2021, 15,924 cases of acute malnutrition were reported to the public health surveillance system, with a prevalence of 0.41 per 100 children under 5 years of age, while the department of Boyacá had a prevalence of 0.54 per every 100 children under 5 years of age. In this way, the impor-tance of studies of risk factors for malnutrition is determined to generate strategies that favor public health and improve the nutritional conditions of the child population. Objective: To describe the epidemiological behavior of acute malnutrition in children under 5 years of age in the department of Boyacá during the period 2017 to 2021. Materials and methods: An analytical cross-sectional descriptive observational study was carried out, absolute frequencies and percentages were calculated, measures central tendency and dispersion and OR as a measure of association. Results: Of the 2254 data analyzed, 55.37% were male, 88.08% are from the subsidized regime, 50.80% are dispersed rural area and socioeconomic stratum 1 contributed 51.33%. Breastfeeding for less than 6 months (OR = 1.96; 1.61-2.39) and the start of complementary feeding before 6 months (OR = 2.12; 1.72-2.59) were identified as risk factors for severe acute malnutrition. Conclusion: It is important to strengthen health programs and policies in order to ensure comprehensive and timely care for children under five years of age

Introdução: A desnutrição é um problema de saúde pública que afeta crianças com menos de cinco anos de idade. Na Colômbia, em 2021, 15.924 casos de desnutrição aguda foram notificados ao Sistema de Vigilância em Saúde Pública, com uma prevalência de 0,41 por 100 crianças com menos de 5 anos de idade, enquanto o Departamento de Boyacá teve uma prevalência de 0,54 por 100 crianças com menos de 5 anos de idade. Portanto, é importante estudar os fatores de risco para a desnutrição a fim de gerar informações para a tomada de decisões no Departamento. Objetivo: descrever o comportamento epidemiológico da desnutrição aguda em crianças com menos de cinco anos de idade no Departamento de Boyacá durante o período de 2017 a 2021. Materiais e métodos: Foi realizado um estudo observacional descritivo, transversal, analítico. Foram calculadas frequências absolutas e porcentagens, medidas de tendência central e dispersão e odds ratio como medida de associação. Resultados: Dos 2.254 dados analisados, 55,37% eram do sexo masculino, 88,08% pertenciam ao regime subsidiado, 50,80% viviam em áreas rurais dispersas e o estrato socioeconômico 1 representa-va 51,33% das informações. O aleitamento materno por menos de 6 meses (OR = 1,96; 1,61-2,39) e o início da alimentação complementar antes dos 6 meses (OR = 2,12; 1,72-2,59) foram identificados como fatores de risco para desnutrição aguda grave. Conclusão: É importante fortalecer os progra-mas e as políticas de saúde para garantir atendimento abrangente e oportuno para crianças menores de cinco anos

Novel Photo- and Thermo-Responsive Nanocomposite Hydrogels Based on Functionalized rGO and Modified SIS/Chitosan Polymers for Localized Treatment of Malignant Cutaneous Melanoma.

Melanoma is an aggressive type of skin cancer that accounts for over 75% of skin cancer deaths despite comprising less than 5% of all skin cancers. Despite promising improvements in surgical approaches for melanoma resection, the survival of undetectable microtumor residues has remained a concern. As a result, hyperthermia- and drug-based therapies have grown as attractive techniques to target and treat cancer. In this work, we aim to develop a stimuli-responsive hydrogel based on chitosan methacrylate (ChiMA), porcine small intestine submucosa methacrylate (SISMA), and doxorubicin-functionalized reduced graphene oxide (rGO-DOX) that eliminates microtumor residues from surgically resected melanoma through the coupled effect of NIR light-induced photothermal therapy and heat-induced doxorubicin release. Furthermore, we developed an in silico model to optimize heat and mass transport and evaluate the proposed chemo/photothermal therapy in vitro over melanoma cell cultures.

The Social Competence Promotion Program among Young Adolescents (SCPP-YA) in Chile ("Mi Mejor Plan") for substance use prevention among early adolescents: study protocol for a randomized controlled trial.

BACKGROUND: Substance use is highly prevalent among children and adolescents in Chile, and it is known how it impacts their health and social adjustment. The call for effective prevention of substance use among children adolescents has resulted in numerous school-based programs, and particularly, the Social Competence Promotion Program among Young Adolescents (SCPP-YA) has been proved to be successful for promoting social and problem-solving skills in addition to preventing substance abuse in the US population. The purpose of this study is to test the effectiveness of the Social Competence Promotion Program among Young Adolescents (SCPP-YA) in Chile ("Mi Mejor Plan"). METHODS: This is a cluster randomized controlled trial, parallel-group type, where "Mi Mejor Plan" is compared to standard school preventive curricula in control schools. A total of 10 schools and 600 adolescents are expected to be recruited and randomized with 1:1 allocation. During formative work, the SCPP-YA program was culturally adapted to Chile. The effectiveness of this program will be assessed using the European Drug Addiction Prevention Trial Questionnaire (EU-Dap), measuring substance use prevalence and risk and protective factors in baseline, post-intervention, and 4 months after the end of the intervention. DISCUSSION: The proposed study will be the first to test the effectiveness of the Social Competence Promotion Program among Young Adolescents (SCPP-YA) in Chile in a cluster randomized control trial and also the first study evaluating this program in Spanish-speaking Latin America. SCPP-YA has been implemented successfully in the USA. Thus, if the effects of the program are positive, wide implementation in Chile and Latin American countries is possible soon. TRIAL REGISTRATION: Clinical Trials NCT04236947 . Registered on January 22, 2020.

Effectiveness of the KiVa Antibullying Program with and without the Online Game in Chile: a Three-Arm Cluster Randomized Controlled Trial.

Bullying is a major health problem. The KiVa antibullying program has been evaluated in Finland and other European countries, showing preventive effects on self-reported bullying victimization and perpetration. No evaluations of this program have been conducted in Latin America. A cluster randomized controlled trial was conducted at socially vulnerable schools in Santiago, Chile, to assess the effectiveness of the KiVa antibullying program in grades 5 and 6 (aged 10-12 years). Schools were randomly assigned (1:1:1) to three groups: the full KiVa group (including the online game), the partial KiVa group (did not include the online game), and the control group in which the regular school curriculum was implemented. The primary outcome was self-reported bullying victimization, assessed before the intervention (baseline) at the end of the academic year (November 2016) and post-intervention, 12 months after the baseline assessment (November 2017). This trial is registered with ClinicalTrials.gov, number NCT02898324. A total of 39 schools (13 in each group) were included; no schools withdrew. The baseline survey included 5923 participants, and the endpoint survey included 3968 participants. Participants in the partial KiVa group had lower bullying victimization at the endpoint survey than those in the control group (OBVQ-R adjusted mean difference - 0.14; 95% CI, - 0.26 to - 0.01; effect size - 0.13, 95% CI - 0.24 to - 0.01, p = 0.035). There was no effect of the full KiVa group for bullying victimization compared with the control and partial KiVa groups. Compared to the control group, participants in the partial KiVa group had lower witnessing bullying at school (adjusted mean difference = - 0.25; 95% CI - 0.45 to - 0.05; effect size - 0.18, 95% CI, - 0.32 to - 0.04, p = 0.013). No effects were found for other secondary outcomes, including bullying perpetration in any comparisons between arms. The implementation of the KiVa antibullying program had mixed results in Chile. There was only a small effect on bullying victimization and witnessing when KiVa was delivered without the online game.

The Unplugged program in Chile ("Yo Sé Lo Que Quiero") for substance use prevention among early adolescents: study protocol for a randomized controlled trial.

BACKGROUND: Substance use is among the main contributors to disease among children and adolescents in the Americas region. The call for effective prevention of substance use among adolescents has resulted in numerous school-based programs, and particularly the Unplugged program has been proved to be successful in reducing the prevalence of different substances in seven European countries. The purpose of this study is to test the effectiveness of the Unplugged program in Chile ("Yo Sé Lo Que Quiero"). METHODS: This is a cluster randomized controlled trial, parallel-group type, where "Yo Sé Lo Que Quiero" is compared to standard school preventive curricula in control schools. A total of 70 schools and 8400 adolescents are expected to be randomized with 1:1 allocation. During formative work, the Unplugged program was culturally adapted to Chile, and the instrument to assess the primary and secondary outcomes was validated. The effectiveness of this program will be assessed using the European Drug Addiction Prevention Trial Questionnaire (EU-Dap), measuring substance use prevalence and risk and protective factors in baseline, post-intervention, and four months after the end of the intervention. DISCUSSION: The proposed study will be the first to test the effectiveness of a school-based substance use prevention program in Chile in a cluster randomized control trial and the first study evaluating the Unplugged program in Spanish-speaking Latin America. A model for disseminating the Unplugged program inside Europe already exists and has been implemented successfully in several countries. Thus, if the effects of the program are positive, wide implementation in Chile and Latin American countries is possible soon. TRIAL REGISTRATION: ClinicalTrials.gov NCT04236999 . Registered on January 17, 2020.

Recent Advances on Stimuli-Responsive Hydrogels Based on Tissue-Derived ECMs and Their Components: Towards Improving Functionality for Tissue Engineering and Controlled Drug Delivery.

Due to their highly hydrophilic nature and compositional versatility, hydrogels have assumed a protagonic role in the development of physiologically relevant tissues for several biomedical applications, such as in vivo tissue replacement or regeneration and in vitro disease modeling. By forming interconnected polymeric networks, hydrogels can be loaded with therapeutic agents, small molecules, or cells to deliver them locally to specific tissues or act as scaffolds for hosting cellular development. Hydrogels derived from decellularized extracellular matrices (dECMs), in particular, have gained significant attention in the fields of tissue engineering and regenerative medicine due to their inherently high biomimetic capabilities and endowment of a wide variety of bioactive cues capable of directing cellular behavior. However, these hydrogels often exhibit poor mechanical stability, and their biological properties alone are not enough to direct the development of tissue constructs with functional phenotypes. This review highlights the different ways in which external stimuli (e.g., light, thermal, mechanical, electric, magnetic, and acoustic) have been employed to improve the performance of dECM-based hydrogels for tissue engineering and regenerative medicine applications. Specifically, we outline how these stimuli have been implemented to improve their mechanical stability, tune their microarchitectural characteristics, facilitate tissue morphogenesis and enable precise control of drug release profiles. The strategic coupling of the bioactive features of dECM-based hydrogels with these stimulation schemes grants considerable advances in the development of functional hydrogels for a wide variety of applications within these fields.

Validation of the European Drug Addiction Prevention Trial Questionnaire (EU-Dap) for substance use screening and to assess risk and protective factors among early adolescents in Chile.

BACKGROUND: Substance use is highly prevalent among Chilean adolescents, and the damage it causes at the neurobiological, psychological, and social levels is known. However, there are no validated screening instruments that also assess risk and protective factors for this population in Chile, which is essential for evaluating future prevention interventions. OBJECTIVE: To determine the psychometric properties of the European Drug Addiction Prevention Trial Questionnaire (EU-Dap) questionnaire. METHODS: A cross-sectional study was carried out in 13 schools in the city of Santiago de Chile. The sample included 2261 adolescents ranging from 10 to 14 years old. Linguistic and cultural adaptation was assessed using focus groups with adolescents, the construct validity was evaluated using confirmatory factor analysis, and measures of its reliability were also determined. Furthermore, the associations regarding risk and protective factors with substance use were explored. RESULTS: Substance use questions were well understood and seemed to adequately capture the consumption of different drugs. Regarding the subscales of risk and protective factors, the analyses showed that most subscales had good psychometric properties, and few needed some degree of improvement (e.g., some items were removed). After the changes, most final subscales had good or adequate goodness of fit adjustments and good or acceptable internal consistency. Finally, the main associated factors with the substance use outcomes were: future substance use and school bonding for tobacco use; negative beliefs about alcohol, future substance use, school bonding and refusal skills for alcohol use; and negative beliefs about marihuana, positive attitudes towards drugs, risk perception, and substance abuse index for marihuana use. Normative beliefs increased the risk for all substances use. CONCLUSIONS: The current findings suggest that the EU-Dap is a valid and reliable instrument, and it may help to evaluate the effectiveness of drug use prevention interventions.

Lipase Assisted (S)-Ketoprofen Resolution from Commercially Available Racemic Mixture.

Ketoprofen is a commercially available drug sold as a racemic mixture that belongs to the family of non-steroidal anti-inflammatory drugs known as profens. It has been demonstrated (in vitro) that (S)-ketoprofen is around 160 times more potent than its enantiomer (R)-ketoprofen, while accumulation of (R)-ketoprofen can cause serious side effects, such as dyspepsia, gastrointestinal ulceration/bleeding, pain, salt and fluid retention, and hypertension. In this work, four commercially available lipases were systematically assessed. Parameters such as conversion, enantiomeric excess, and enantioselectivity were considered. Among them, and by evaluating lipase load, temperature, solvent, and alcohol, Candida rugosa lipase exhibited the best results in terms of enantioselectivity E = 185 ((S)-enantiopreference) with esterification conversions of c = 47% (out of 50%) and enantiomeric excess of 99%. The unreacted (R)-enantiomer was recovered by liquid-liquid extraction and racemized under basic media, which was recycled as starting material. Finally, the (S)-alkyl ketoprofen ester was successfully enzymatically hydrolyzed to the desired (S)-ketoprofen with c = 98.5% and 99% ee. This work demonstrated the benefit and efficiency of using Candida rugosa lipase to kinetically resolve racemic ketoprofen by an environmentally friendly protocol and with the recycling of the undesired (R)-ketoprofen.

Resultados de una capacitación sobre retroalimentación efectiva para tutores clínicos de internado de universidades chilenas / Results of a training activity about effective feedback for internship clinical preceptors in Chilean universities

Introducción: La retroalimentación es una competencia docente central en los procesos evaluativos, porque favorece aprendizajes de mejor calidad. Sin embargo, es necesario formar a los docentes para que logren desarrollarla. El presente estudio buscó analizar los resultados de una capacitación en línea en retroalimentación efectiva a tutores clínicos de internado de universidades chilenas pertenecientes a la Red Nacional de Unidades de Educación Médica y Ciencias de la Salud. Sujetos y métodos: Estudio cuantitativo, preexperimental, de corte transversal y con alcance analítico relacional. Los 29 participantes fueron elegidos con una estrategia de muestreo no probabilística y por voluntarios. Participaron en una capacitación en línea sobre retroalimentación efectiva. Antes y después de la capacitación, sus desempeños en retroalimentación se observaron con un estudiante simulado en una entrevista por videoconferencia. Para calificar su desempeño, se empleó la rúbrica de observación directa de retroalimentación de habilidades clínicas. Al final, también respondieron una encuesta de satisfacción de capacitación. Resultados: Todos los participantes mejoraron su desempeño realizando retroalimentación tanto en general como en ocho de los nueve criterios evaluados. Sólo el ítem de retroalimentación no presentó diferencias significativas y fue bien valorado en ambas evaluaciones. Además, los participantes evidenciaron un alto nivel de satisfacción con la intervención. Conclusiones: Una capacitación acotada en retroalimentación efectiva a tutores clínicos de internado, bien planificada, con objetivos de aprendizaje claros y utilizando diversas estrategias de enseñanza mejora su desempeño entregando retroalimentación y con un alto nivel de satisfacción de los participantes.(AU)

Introduction: Feedback is a central teaching competence in evaluation processes because it favors better quality learning. However, teachers need to be trained to develop it. This study aims to analyze the results of an online training in effective feedback to tutors of clinical practices of Chilean universities belonging to the National Network of Units of Medical Education and Health Sciences. Subjects and methods: A quantitative, pre-experimental, cross-sectional study with a relational analytical scope. The 29 participants were chosen with a non-probability sampling strategy and by volunteers. They participated in an online training on effective feedback. Before and after the training, their performance in feedback was observed with a simulated student in a video conference interview. The Direct Observation of Clinical Skills Feedback rubric was used to rate their performance. At the end, they also answered a Training Satisfaction Survey. Results: All participants improved their performance by providing feedback, with statistically significant results in 8 items (p < 0.001), only the item ‘Feedback was carried out in a respectful manner’ did not present significant differences (p = 0.569), being well valued in both evaluations. Furthermore, the participants showed a high level of satisfaction with the intervention. Conclusions: A limited training in effective feedback to clinical internship tutors, well planned, with clear learning objectives and using various teaching strategies, improves their performance by providing feedback and with a high level of satisfaction of the participants.(AU)

Validation of the Revised Olweus Bully/Victim Questionnaire (OBVQ-R) Among Adolescents in Chile.

Bullying is a phenomenon that affects children and adolescents worldwide, and it has major consequences for all participants involved in these situations. In Chile, researchers have validated several instruments used to investigate aggression between peers and school violence, but there is a lack of validation of instruments to investigate bullying. The purpose of this study was to provide evidence of the validity and reliability of the Olweus Bully/Victim Questionnaire-Revised version (OBVQ-R) in the Chilean context. The participants were 2,775 students from schools of low, medium, and high socioeconomic status. OBVQ-R is a self-report questionnaire with 42 items, which has been used in different countries, and has adequate psychometric properties to assess the prevalence of victimization and aggression and various forms of bullying worldwide. Results confirmed the two-factor structure of the OBVQ-R (victimization and perpetration subscales) and good reliability (ω = 0.81 and ω = 0.75, respectively). These dimensions seem to be correlated. Comparison between OBVQ-R with the School Violence between Peers Questionnaire and the Internet Experiences Questionnaire showed some degree of agreement. The Item Response Theory analysis showed that the item about verbal bullying, in both subscales, had the lowest-severity parameters, meaning that these forms of bullying were the most prevalent. The higher-severity parameter in the victimization scale was the cyberbullying item, and the sexual bullying item showed higher severity in the perpetration subscale. The differential item functioning analysis by gender showed a trend in which boys responded with lower-severity parameters than girls. In the victimization scale, the exception was the item about spreading rumors, and in the perpetration subscale, it was the item about racial bullying. We have provided evidence of the validation of OBVQ-R among school-age children and adolescents in Chile. This study is part of a trial registered at ClinicalTrials.gov, number NCT02898324.

Preparation and Characterization of an Injectable and Photo-Responsive Chitosan Methacrylate/Graphene Oxide Hydrogel: Potential Applications in Bone Tissue Adhesion and Repair.

As life expectancy continues to increase, the inevitable weakening and rupture of bone tissue have grown as concerns in the medical community, thus leading to the need for adhesive materials suitable for bone repair applications. However, current commercially available adhesives face certain drawbacks that prevent proper tissue repair, such as low biocompatibility, poor adhesion to wet surfaces, and the need for high polymerization temperatures. This work aims to develop an injectable and photo-responsive chitosan methacrylate/graphene oxide (ChiMA/GO) adhesive nanocomposite hydrogel of high biocompatibility that is easy to apply by simple extrusion and that offers the possibility for in situ polymer and physiological temperatures. The nanocomposite was thoroughly characterized spectroscopically, microscopically, rheologically, thermally, and through mechanical, textural, and biological assays to fully evaluate its correct synthesis and functionalization and its performance under physiological conditions that mimic those observed in vivo. In addition, a finite element analysis (FEA) simulation was used to evaluate its performance in femur fractures. Results suggest the material's potential as a bioadhesive, as it can polymerize at room temperature, shows superior stability in physiological media, and is capable of withstanding loads from body weight and movement. Moreover, the material showed remarkable biocompatibility as evidenced by low hemolytic and intermediate platelet aggregation tendencies, and high cytocompatibility when in contact with osteoblasts. The comprehensive studies presented here strongly suggest that the developed hydrogels are promising alternatives to conventional bone adhesives that might be further tested in vivo in the near future.

Efficacy of a cognitive stimulation programme using technology on older adults self-esteem, self-efficacy, and autonomy / Eficacia de un programa de estimulación cognitiva con tecnología en la autoestima, autoeficacia y autonomía de adultos mayores

Abstract The objective of this study was to verify the effectiveness of a cognitive stimulation programme using technology: PESCO MX in comparison to a traditional programme that used nontechnological recreational activities to improve levels of self-esteem, self-efficacy, and autonomy in older adults. In this quasi-experimental investigation, 63 participants were divided into three groups of older adults attending three different senior day-care centres. One group was treated with technology, another without technology, and the third group received no programme. All three groups were measured pre-test and post-test. The results show a significant difference in the three variables between the technology group and the control group; however, there is no difference in the pre-test results. Another finding shows significant differences between the three groups for the self-efficacy variable; differences were also found between the group that did not use technology and the control group. There was also a difference between the group without technology and the group that used the PESCO MX (the latter being higher). In general, a cognitive stimulation programme using technology benefitted self-esteem, self-efficacy, and autonomy, which indicates that this programme can contribute to improving the quality of life during old age. Finally, the theoretical and practical implications of this study were analysed.

Resumen El objetivo de este estudio fue comprobar la eficacia de un programa de estimulación cognitiva con tecnología: PESCO MX, frente a un programa tradicional con actividades lúdicas sin tecnología, para mejorar los niveles de autoestima, autoeficacia y autonomía en adultos mayores. En esta investigación cuasi-experimental 63 participantes fueron divididos en tres grupos de adultos mayores de tres diferentes estancias, a uno de ellos se le aplicó el programa con tecnología, a otro sin tecnología y el tercer grupo no se le suministró ningún programa; a los tres se les tomaron dos medidas pretest y postest. Los resultados muestran una diferencia significativa en las tres variables entre el grupo con tecnología y el grupo control, en el pretest no existe diferencia alguna. Otro hallazgo muestra diferencias significativas, para la variable de autoeficacia, entre los tres grupos; es decir, también se encontraron diferencias entre el grupo sin tecnología y el grupo control, además de entre el grupo sin tecnología y el grupo que utilizó el PESCO MX, siendo más alto este último. En general, la autoestima, autoeficacia y autonomía se vieron más beneficiadas a través de un programa de estimulación cognitiva con tecnología, lo que indica que este programa puede contribuir a mejorar la calidad de vida durante la vejez. Finalmente se analizaron las implicaciones teóricas y prácticas de este estudio.

Camelid husbandry in the Atacama Desert? A stable isotope study of camelid bone collagen and textiles from the Lluta and Camarones Valleys, northern Chile.

Management of camelids in the coastal valleys of the Andes has generated much debate in recent years. Zooarchaeological and isotopic studies have demonstrated that in the coastal valleys of northern and southern Peru there were locally maintained camelid herds. Because of the hyperarid conditions of the northern coast of Chile, this region has been assumed to be unsuitable for the raising of camelids. In this study we report stable carbon and nitrogen isotopic compositions of camelid bone collagen and textiles made from camelid fiber from Late Intermediate Period (LIP) and Late Horizon (LH) occupations in northern Chilean river valleys. The camelid bone collagen isotopic compositions are consistent with these animals originating in the highlands, although there is a significant difference in the camelids dating to the LIP and LH, possibly because of changes made to distribution and exchange networks by the Inca in the LH. There were no differences between the isotopic compositions of the camelid fibers sampled from textiles in the LIP and LH, suggesting that either the production of camelid fiber was unchanged by the Inca or the changes that were made do not present visible isotopic evidence. Several camelid fiber samples from both the LIP and LH present very high δ13C and δ15N values, comparable to human hair samples from one site (Huancarane) in the Camarones Valley. These data suggest that people in the northern valleys of Chile may have kept small numbers of animals specifically for fiber production. Overall, however, the vast majority of the textile samples have isotopic compositions that are consistent with an origin in the highlands. These data suggest that the hyperarid coastal river valleys of northern Chile did not support substantial camelid herds as has been interpreted for northern Peru.

Neurological soft signs as a marker of cognitive impairment severity in people living with HIV.

HIV-associated neurocognitive disorders (HAND) include asymptomatic neurocognitive impairment (ANI), mild neurocognitive disorder (MND) and HIV-associated dementia. Early recognition of HAND is crucial, and usually requires thorough neuropsychological testing. Neurological soft signs (NSS), i.e. minor motor and sensory changes, a common feature in severe psychiatric disorders, may facilitate early diagnosis. NSS were examined using the Heidelberg NSS Scale in 18 patients with ANI, 21 with MND, 28 HIV positive patients without HAND, and 39 healthy controls matched for age, gender, and education. The highest NSS scores were obtained in the MND patients (13.3 ±â€¯10.0, p < 0.0001) followed by those with ANI (11.7 ±â€¯10.6), the HIV positive subjects without neurocognitive deficits (8.0 ±â€¯4.1) and the healthy controls (3.8 ±â€¯3.2). This result was confirmed when age and years of school education were entered as covariates. No significant correlations between NSS and CD4 counts or any other clinical variables were found among the HIV positive groups. Our results demonstrate that NSS are frequently found in both ANI and MND but not HIV positive patients without neurocognitive deficits. NSS may facilitate the screening of HIV positive patients for ANI and MND as an easier and less expensive clinical tool.

Prehistoric polydactylism: Biological evidence and rock art representation from the Atacama Desert in northern Chile.

A review of the bioarchaeological collections from the site Morro de Arica in northern Chile allowed the identification of two cases of human polydactyly. Both cases are from the Chinchorro culture, hunters, fishers, and gatherers with a maritime orientation who inhabited the coast of the Atacama Desert (9000-3400 BP). Additionally, the analyses of 75 rock art sites in the area, from the Formative to Late Intermediate Periods (3000-550 BP), allowed the identification of hands and feet with six digits. Given the bioarchaeological record of polydactyly, it is highly probable that the rock art images were based on real individuals with polydactyly. However, the Sr chemical signal in a juvenile with polydactyly is the same as the Sr chemical signal in the rest of the individuals buried in the same site, proving that all the individuals were born and lived on the coast. We discuss the idea that, although these anomalies could have been the result of genetic mutations, endogamy and exposition to ecotoxic environments could also be at play within the Chinchorro groups.