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

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

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

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

Longitudinal relationship between posttraumatic cognitions and internalising symptoms in children and adolescents.

Background: Little is known about the naturalistic course of posttraumatic cognitions (PTCs) after exposure to a potentially traumatic event (PTE) in children and adolescents. Moreover, previous studies on the longitudinal associations of PTCs with internalising symptoms yielded mixed results.Objective: To explore the naturalistic courses and longitudinal associations of dysfunctional PTCs and functional PTCs with posttraumatic stress symptoms (PTSS), depression, and anxiety.Method: A total of 115 children and adolescents, aged 7-15 years, were assessed within 1 month, 3 months, and 6 months after exposure to an acute accidental PTE. Repeated measures analyses of variance were conducted to capture the naturalistic courses of PTCs and internalising symptoms. Cross-lagged panel analyses were applied to explore the longitudinal relationship between dysfunctional and functional PTCs, along with their longitudinal associations with PTSS, depression, and anxiety.Results: Dysfunctional PTCs and internalising symptoms decreased, whereas functional PTCs increased over time. Dysfunctional and functional PTCs were moderately inversely related, but no significant cross-lagged paths emerged among them. Dysfunctional PTCs were moderately to strongly associated with internalising symptoms, while functional PTCs were weakly to moderately inversely associated with internalising symptoms. Initial PTSS predicted later dysfunctional PTCs (ß = .31, p < .05), but not vice versa.Conclusions: Dysfunctional PTCs, functional PTCs, and internalising symptoms were entangled over time. Our findings support the cognitive scar model with initial PTSS predicting later dysfunctional PTCs. Future research complementing between-subject with within-subject analyses could offer additional insights into the longitudinal relationship between dysfunctional PTCs, functional PTCs, and psychological symptoms.

Dysfunctional posttraumatic cognitions and internalising symptoms naturally decreased, whereas functional posttraumatic cognitions naturally increased over a 6-month period following exposure to an acute accidental potentially traumatic event.Above the significant longitudinal associations of dysfunctional posttraumatic cognitions with internalising symptoms, functional posttraumatic cognitions were significantly inversely related to internalising symptoms over time.Posttraumatic stress symptoms assessed within 1 month after the potentially traumatic event predicted dysfunctional posttraumatic cognitions assessed 3 months after the potentially traumatic event, but not vice versa.

Meta-análisis: Intervalos de confianza e Intervalos de predicción / Meta-analysis: Confidence intervals and Prediction intervals

En los informes meta-analíticos se suelen reportar varios tipos de intervalos, hecho que ha generado cierta confusión a la hora de interpretarlos. Los intervalos de confianza reflejan la incertidumbre relacionada con un número, el tamaño del efecto medio paramétrico. Los intervalos de predicción reflejan el tamaño paramétrico probable en cualquier estudio de la misma clase que los incluidos en un meta-análisis. Su interpretación y aplicaciones son diferentes. En este artículo explicamos su diferente naturaleza y cómo se pueden utilizar para responder preguntas específicas. Se incluyen ejemplos numéricos, así como su cálculo con el paquete metafor en R.(AU)

Several types of intervals are usually employed in meta-analysis, a fact that has generated some confusion when interpreting them. Confidence intervals reflect the uncertainty related to a single number, the parametric mean effect size. Prediction intervals reflect the probable parametric effect size in any study of the same class as those included in a meta-analysis. Its interpretation and applications are different. In this article we explain in de-tail their different nature and how they can be used to answer specific ques-tions. Numerical examples are included, as well as their computation with the metafor Rpackage.(AU)

Differences in toxicology reports and hospital emergency care for patients suspected of experiencing drug-facilitated crimes: an analysis according to gender. / Atención de pacientes con sospecha de sumisión química en un servicio de urgencias hospitalario y resultados del análisis toxicológico: diferencias según el sexo.

OBJECTIVE: To analyze gender-related differences in patient and care characteristics and in toxicology findings in suspected cases of drug facilitated crime (DFC). METHODS: Observational cross-sectional study of all patients in suspected DFC cases attended in the emergency department of Hospital Clínico San Carlos and of their blood or urine samples analyzed by the National institute of Toxicology and Forensics in Madrid between March 1, 2015, and March 1, 2023. We analyzed variables from patient records and the toxicology reports according to gender. RESULTS: A total of 514 suspected DFC episodes were studied; 101 (19.6%) were proactive crimes, 61 (11.9%) opportunistic, and 352 (68.5%) mixed. The median (interquartile range) age was 25 years (21-34 years), and 370 (72%) were women. Eighty-three percent of the patients had amnesia, and 48% of the cases involved sexual assault or robbery. Toxicology identified substances in 78% of the patients (alcohol, 53%; street drugs, 37%; and/or psychopharmaceuticals or opioids, 23%). Independent variables associated with female gender in the multivariate analysis, according to adjusted odds ratio (aORs) were age less than 25 years (aOR, 2.73; 95% CI, 1.75 4.24; P < .001); physician-referred emergency (aOR, 1.77; 95% CI, 1.12-2.80; P = .03); robbery (aOR, 0.25; 95% CI, 0.15-0.41; P < .001); alcohol-positive test result (aOR, 1.91; 95% CI, 1.21-3.00; P = .01); and a drug-positive result (aOR, 0.43; 95% CI, 0.28-0.64; P < .001). Police and a forensic physician intervened in 13% of the cases, and in such cases the victim was more likely to be female (aOR, 3.97; 95% CI, 1.41-11.13; P < .001). Toxicology identified the presence of an unknown substance in 39%, and a woman was less likely to be involved in such cases (aOR, 0.43; 95% CI, 0.28-0.67; P < .001). CONCLUSIONS: The majority of victims of DFCs were female, and the crimes were mixed, involving involve alcohol, psychopharmaceuticals or street drugs. Female victims were more likely to be under the age of 25 years, be referred to the emergency service by a physician, be attended by a forensic physician for sexual assault, and have an alcoholpositive toxicology report. Women were also less likely to report a robbery or have a toxicology report identifying drugs or an unknown substance.

OBJETIVO: Analizar las diferencias en las características de los pacientes atendidos por sospecha de sumisión química (SQ) y en los resultados del análisis toxicológico (AT) en función del sexo. METODO: Estudio observacional transversal retrospectivo que incluyó a todos los casos con SQ atendidos en el servicio de urgencias del Hospital Clínico San Carlos y las muestras (sangre o orina) para el AT en el Instituto Nacional de Toxicología y Ciencias Forenses de Madrid entre el 1 de marzo de 2015 y el 1 de marzo de 2023. Se analizan variables de la historia clínica y del AT según el sexo. RESULTADOS: Se incluyeron 514 episodios con sospecha de SQ [101 (19,6%) proactiva, 61 (11,9%) oportunista y 352 (68,5%) mixta] en pacientes con una mediana de 25 años (RIC: 21-34), 370 (72%) de sexo femenino. El 83% presentó amnesia y el 48% asoció agresión sexual o robo. En el 78% se identificó alguna sustancia en el AT (53% alcohol etílico, 37% drogas y/o 23% psicofármaco u opiáceos). En el análisis multivariado las variables que se asociaron de manera independiente con el sexo femenino fueron la edad menor de 25 años con ORa de 2,73 (IC 95%: 1,75-4,24; p < 0,001), con médico deriva a urgencias con ORa de 1,77 (IC 95%: 1,12-2,80; p = 0,03), delito de robo con de ORa 0,25 (IC 95%: 0,15-0,41; p < 0,001), alcohol etílico en el AT con ORa 1,91 (IC 95%: 1,21-3,00; p = 0,01) y alguna droga en el AT con ORa 0,43 (IC 95%: 0,28-0,64; p < 0,001). En el 13% de casos hubo intervención policial y médico-forense y fue más probable que fuera a una mujer, con ORa 3,97 (IC 95%: 1,41-11,13; p < 0,001). En el 39% de AT se identificó alguna sustancia desconocida y fue menos probable que fuera mujer, con ORa de 0,43 (IC 95%: 0,28-0,67; p < 0,001). CONCLUSIONES: La mayoría de casos registrados fueron mujeres con sospecha de SQ mixta por alcohol, psicofármacos o drogas de abuso. Las mujeres presentaron mayor probabilidad de tener menos de 25 años, ser derivada a urgencias por un médico, de intervención médico-forense por agresión sexual y encontrar alcohol etílico en el AT.

Association between dietary patterns and glycemic control in type II diabetes mellitus patients.

OBJECTIVE: To assess the association between dietary patterns and glycemic control among patients with type II diabetes mellitus (T2DM). DESIGN: A cross-sectional study. SITE: The 2015-2018 National Health and Nutrition Examination Survey (NHANES). PARTICIPANTS: A total of 1646 T2DM patients were included, of whom 854 were hyperglycemia. METHODS: Main dietary patterns were identified using the sparse principal components analysis (SPCA). Logistic regression analysis was applied to investigate the association between each dietary pattern and the risk of hyperglycemia with odds ratios (OR) and 95% confidence intervals (CI). SPCA analysis yielded five significant principal components (PC), which represented five main dietary patterns. RESULTS: PC1, characterized by a high intake of sweets, red meat and processed meat, was associated with higher odds of hyperglycemia in patients who underwent hyperglycemic drug or insulin treatments (OR: 1.71, 95% CI: 1.10-2.64). PC5, characterized by high in red meat, while low in coffee, sweets, and high-fat dairy consumption. The relationship between the PC5 and hyperglycemia was marginal significance (OR: 0.63, 95% CI: 0.38-1.02). PC2 was characterized by a high consumption of green vegetables, other vegetables, and whole grains, and low intake of potatoes and processed meat. In patients with the hyperglycemic drug and insulin free, higher PC2 levels were related to lower odds of hyperglycemia (OR: 0.45, 95% CI: 0.21-0.96). CONCLUSIONS: High intake of sweets, red meat, and processed meat might be detrimental to glycemic control in patients with drug-treated T2DM. High in red meat, while low in coffee, sweets, and high-fat dairy consumption may be beneficial to glycemic control. In addition, high consumption of green vegetables, other vegetables, and whole grains, and low intake of potatoes and processed meat may be good for glycemic control in patients without drug-treated T2DM.

(Fire)fighting the pandemic: PTSD and depression symptom profiles and longitudinal correlates.

Background: Firefighters face regular exposure to potentially traumatic events, which is associated with the development of post-traumatic stress disorder (PTSD) and depression. Despite the high comorbidity, there remains limited understanding of the co-occurrence of PTSD and depression in terms of symptom patterns. Due to the unique stressors added by the COVID-19 pandemic, it is relevant to also understand this comorbidity in light of the impact of the COVID-19 pandemic.Objective: This study aimed to identify PTSD and depression symptom profiles in firefighters, and correlates thereof, using latent profile analysis (LPA).Method: 139 Dutch Firefighters (93% male) completed self-report surveys prior to the COVID-19 pandemic (T1) and after the outbreak COVID-19 pandemic (T2) on PTSD, depression, COVID-19 related stressors and other relevant correlates.Results: LPA demonstrated the best fit for a three-profile solution for PTSD and depression at T2 encompassing a low symptom profile (35%), a moderate symptom profile (46%), and an elevated symptom profile (19%). Profiles displayed mostly below clinical range scores for both PTSD and depression at T2. PTSD severity at T1, depression severity at T1, loneliness at T2, COVID-19-related stressors at T2 were significantly and positively related to PTSD and depression symptom profiles at T2.Conclusion: Our results shed light on the resilience of firefighters. Even in light of COVID-19 pandemic, firefighters seemed to maintain generally low levels of psychopathology. Despite firefighters' overall resilience, our findings highlight loneliness and the negative impact of the COVID-19 pandemic as potential risk factors for increased severity of PTSD and depression symptoms.

Three symptom profiles of PTSD and depression emerged in a sample of Dutch firefighters.Firefighters displayed mostly below clinical threshold PTSD and depression levels, emphasizing their resilience.Loneliness and COVID-19 stressors were identified as potential risk factors for PTSD and depression symptoms in firefighters.

Dynamic networks of complex posttraumatic stress disorder and depression among college students with childhood trauma: insights from cross-sectional and cross-lagged panel network analysis.

Background and Objective: There is a current research gap regarding the symptom structure and underlying causal relationships between complex posttraumatic stress disorder (CPTSD) and depressive symptoms. This longitudinal study used a cross-sectional network and cross-lag panel network (CLPN) to examine how CPTSD and depression symptoms interact over time in Chinese college students with childhood trauma.Methods: From 18,933 college students who took part in 2 surveys 12 months apart, 4006 participants (mean age: 20.07 ± 2.04) who reported childhood trauma were screened. Within this sample, there were 2354 (58.8%) males and 1652 (41.2%) females.Results: In the one-year interval CLPN model, it was found that depressive symptoms may precede other symptoms. Specifically, negative emotions and negative self-evaluations are more likely to predict subsequent symptoms. Conversely, in CPTSD, symptoms related to fear and anxiety, such as avoidance, intrusion, and hyperarousal, are more frequently activated by other symptoms, including negative emotionsConclusions: This finding offers a novel perspective on the interplay between CPTSD and depression, extending the existing theory. From a clinical standpoint, the points of intervention for comorbidity between depression and CPTSD who have experienced childhood trauma differ across different stages.

This study used network analysis to examine the evolving symptom structure of complex posttraumatic stress disorder (CPTSD) and depression, as well as the relationships between symptoms, in a large-scale longitudinal study among college students who have experienced childhood trauma.Symptoms such as emotional dysregulation and negative self-concept serve as stable central symptoms of both CPTSD and depression.Depression, tends to activate other symptoms, whereas CPTSD, is more frequently predicted by other symptoms.

Endovascular treatment of chronic subdural hematoma in a dual-trained neurosurgical unit: Results and proposal of a randomized controlled trial protocol.

INTRODUCTION: Chronic subdural hematoma (cSDH) is a prevalent neurosurgical condition with an increasing incidence due to the rising life expectancy and the widespread use of anticoagulant and antiplatelet therapies. Insights into the inflammatory origins of cSDH led to the exploration of Middle Meningeal Artery (MMA) embolization as a therapeutic strategy. In recent years the endovascular treatment of MMA has gained momentum. Herein we present the initial experience of a dual trained neurovascular unit implementing this therapeutic technique. METHODS: This single-center, prospective pilot study aimed to evaluate the feasibility, safety, and efficacy of MMA embolization in the treatment of cSDH. Following ethical approval and informed consent, demographic, clinical, and radiological data were collected. Patients requiring emergent surgical treatment were excluded. The study focused on assessing clinical outcomes, including the Modified Rankin Score (mRS) and volumetric analysis of cSDH, before and after embolization. RESULTS: Fifteen patients underwent MMA embolization, with a predominance of males (80%) and a mean age of 72.4 years. The most common presenting symptom was headache (53.3%). The average hospital stay was 3.9 days. Various embolization techniques were employed, with DMSO-EVOH being the most frequent. All procedures were successfully conducted without complications. Although not statistically significant, trends suggested better outcomes in patients with homogeneous cSDH on the CT scan, displaying the cotton wool sign on angiography and treated with EVOH-DMSO. CONCLUSION: MMA embolization for cSDH demonstrates promise as a safe and effective treatment, potentially reducing the need for surgical intervention and recurrence rates. This study lays the groundwork for a larger, randomized controlled trial which protocol is herein presented.

Distribution of homicides and production of space in a racially divided city / Distribución de homicidios y producción de espacio en una ciudad racialmente dividida. / Distribuição dos homicídios e produção do espaço em uma cidade racialmente cindida

Recife is one of the most violent and unequal cities in Brazil, especially when it comes to murders. The objective of this article is to analyze the effects of the production of a racially divided city on the distribution of homicides in the city of Recife. This is a cross-sectional and ecological study, whose study location was Recife, capital of the state of Pernambuco. The study period covered the years 2012 to 2021 and the study population were victims of homicides caused by gunshots. For the analyses, the study period was divided into two five-year periods. The determination of racism was observed in the profile of the victims: male (95%), black (86%), young (67%) and with low education (78%). The spatial analysis carried out demonstrated points of highest incidence of murders in Recife, census tracts with statistically significant highest risk in the city 2012-2016 (RR=5.7; p=0.031) and 2017-2021 (RR=1.8; p= 0.032) and protection 2012-2016 (RR= 0.3; p=0.001; 0.006 p=0.014) and 2017-2021 (RR=0.1; p=0.001; RR=0.1; p=0.001), and, the highest incidence of homicides in territories with the highest Social Deprivation Index (IPS).

O Recife constitui-se como uma das cidades mais violentas e desiguais do Brasil, sobretudo na ocorrência de assassinatos. O objetivo deste artigo é analisar os efeitos da produção de uma cidade racialmente cindida na distribuição da ocorrência de homicídios no município do Recife. Trata-se de um estudo transversal e ecológico, cujo local de estudo foi o Recife, capital do estado de Pernambuco. O período de estudo contemplou os anos de 2012 a 2021 e a população de estudo foram as vítimas de homicídios  provocados por disparo por arma de fogo. Para as análises, o período de estudo foi dividido em dois quinquênios. Observou-se a determinação do racismo no perfil das vítimas: pessoas do sexo masculino (95%), negras (86%), jovens (67%) e com baixa escolaridade (78%). A análise espacial realizada demonstrou pontos de maior incidência de assassinatos no Recife, setores censitários estatisticamente significante de maior risco de morte 2012-2016 (RR=5,7; p=0,031) e 2017-2021 (RR=1,8; p=0,032) e proteção 2012-2016 (RR= 0,3; p=0,001; 0,006 p=0,014) e 2017-2021 (RR=0,1; p=0,001; RR=0,1; p=0,001),  e, a maior incidência de homicídios nos territórios com maior Indice de Privação Social (IPS).

Primary tumor heterogeneity on pre-treatment [68Ga]Ga-PSMA PET/CT for the prediction of biochemical recurrence in prostate cancer.

PURPOSE: The aim of this study is to research the value of the texture analysis of primary tumors in pre-treatment [68Ga]Ga-PSMA PET in the prediction of the development of biochemical recurrence (BCR) in prostate cancer patients who underwent definitive therapies. METHODS: 51 patients with prostate adenocarcinoma who had a pre-treatment [68Ga]Ga-PSMA-11 PET/CT and underwent definitive radiotherapy (RT) or radical prostatectomy (RP) were included in the study. Demographics, clinicopathologic features, the presence of BCR, and the last follow-up date of patients were recorded. Textural and conventional PET parameters (maximum standardized uptake value (SUVmax), total lesion-PSMA (TL-PSMA), and PSMA-tumor volume (PSMA-TV)) were obtained from PET/CT images using LifeX program. Parameters were grouped using the Youden index in ROC analysis. Factors predicting the BCR were determined using Cox regression analyses. RESULTS: 29 (56.9%) patients have received primary curative RT, while the remaining 22 (43.1%) patients have undergone RP. 5 (22.7%) patients with RP and 3 (10.3%) patients with curative RT have developed BCR during the follow-up. INTENSITY-BASED-minimum grey level (P=.050), GLCM-sum variance (P=.019), and GLCM-cluster prominence (P=.050) were associated with BCR in univariate analysis. INTENSITY-BASED-minimum grey level (P=.009) and GLCM-sum variance (P=.004) were found as independent predictors of BCR in the multivariate analysis. CONCLUSION: Tumor heterogeneity on pre-treatment [68Ga]Ga-PSMA PET is associated with a high risk of BCR in PCa patients who underwent definitive therapies.

Latent transition analysis on post-traumatic stress and post-traumatic growth among firefighters.

Background: Firefighters, in the course of their professional responsibilities, confront an array of stressors contingent upon the distinctive characteristics of their duties.Objective: This study investigated the longitudinal impact of trauma incidents during duty on firefighters using latent transition analysis.Method: Data from 346 firefighters in South Korea who had experienced trauma events while on duty were utilized. Initially, latent groups were identified based on the relationship between post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG). Groups were labelled based on the analysis of differences in PTSD, mental health, and growth-related factors among classified groups. Subsequently, transition probabilities and patterns from Time 1 to Time 2 were examined, followed by an investigation into variances based on demographic factors (gender, age) and occupational factors (work experience, shift pattern) using variance analysis and multinomial logistic regression analysis.Results: First, at Time 2, a five-group model was classified into 'Growth,' 'Resilience or Numbness,' 'Struggle,' 'Partial Struggle,' and 'PTSD' groups. Second, upon examining the transition patterns between latent groups, four patterns emerged: 'continued distress,' 'growth,' 'adaptation,' and 'escalated distress.' Third, the 'Struggle' group showed a 0% probability of transitioning to the 'Growth' group, whereas it displayed the highest probability among the groups transitioning to the 'PTSD' group. Fourth, latent transition analysis results showed a strong tendency for the 'Growth' group and 'Resilience or Numbness' group to remain in the same category. Fifth, age was found to be a significant factor affecting the transition of latent groups.Conclusion: This research represents the inaugural attempt to longitudinally investigate the interplay between PTSD and PTG among firefighters.

Firefighters, in the course of their professional responsibilities, confront an array of stressors contingent upon the distinctive characteristics of their duties.The transition patterns of firefighters between latent groups revealed at Time 1 and Time 2 were examined, revealing four transition patterns: 'continued distress,' 'growth,' 'adaptation,' and 'escalated distress.'This research represents the inaugural attempt to longitudinally investigate the interplay between post-traumatic stress disorder and post-traumatic growth among firefighters.

Differential rates of induced abortion in Spain: educational attainment and age among native and immigrant women.

OBJECTIVE: Analyzing the variations in induced abortion (IA) rates across different subpopulations in Spain based on country of origin, while considering educational and age composition. METHOD: Using 2021 Voluntary Termination of Pregnancy register and 2021 Spanish Census microdata, we calculated crude IA rates and age-specific abortion rates. We used age-standardized IA rates (ASIAR) to account for the confounding effect of age composition. We compared seven subpopulations residing in Spain, taking into account simple ages and educational levels aggregated into four categories. RESULTS: Immigrant women, especially those from Sub-Saharan and Latin American countries, consistently had higher IA rates compared to native Spanish women. According to age-specific IA rates, university-educated women had considerably fewer abortions than women with other education levels at any age. Age-standardized rates stratified by migratory origin revealed that native Spanish women with primary education or less had higher IA rates than their immigrant counterparts. There was a clear non-linear, association between educational level and IA rates among immigrants. The highest propensity for IA was found among secondary school graduates, while university graduates had the lowest IA rate. CONCLUSIONS: The study demonstrated that variability in sociodemographic characteristics had an impact on IA rates. Young women with middle educational attainment and immigrant background had a higher likelihood of undergoing IA in Spain. The relationship between educational level and IA rates was complex, with variations observed among different groups and changes over time.

Analysis of medication errors in Neonatal Intensive Care: A systematic review.

Medication errors, potentially causing harm and causing harm, increase significantly in newborns cared for in intensive care settings. In this sense, this work carries out a systematic review to analyze the most current evidence in relation to medication errors in neonatal intensive care, discussing the topics that refer to health technology from smart pumps, cost-effectiveness of medications, the practice of nursing professionals on the medication administration process and quality improvement models. In this way, it could be considered a useful tool to promote quality and safety in neonatal intensive care.

Identificación de microorganismos entéricos en áreas de preparación y consumo de alimentos / Identification of enteric microorganisms in food preparation and consumption areas / Identificação de microrganismos entéricos em áreas de preparação e consumo de alimentos

La contaminación de las áreas de preparación al entrar en contacto con los alimentos crudos o cocinados, es por esto que una de las principales causas de la contaminación de las superficies inertes es la inadecuada manipulación de los alimentos a la hora de ser preparados. Con el objetivo de controlar la aplicación de normas de higiene en las áreas de preparación y consumo de alimentos mediante análisis microbiológicos para disminuir los riesgos de contaminación alimentaria. Esta investigación es de carácter descriptivo, en la cual se realizó una inspección visual del establecimiento con el propósito de evaluar las condiciones higiénicas sanitarias, mediante la aplicación de la Guía Técnica para el Análisis Microbiológico de Superficies en contacto con Alimentos y Bebidas. Para el análisis microbiológico de las muestras se emplearon las técnicas de inoculación, método de estriado, aislamiento bacteriano, tinción diferencial y utilización de las pruebas bioquímicas como: TSI, SIM, Citrato de Simmons, Urea, Lisina, Catalasa y Oxidasa, además de la utilización de medios de cultivo selectivo y diferencial como agar EMB y agar MacConkey para la identificación de bacterias entéricas como: E. coli, Salmonella, Klebsiella pneumoniae, Shigella, Pseudomona aeruginosa. Los resultados arrojaron que la frecuencia bacteriana de las superficies inertes de los restaurantes en el área de preparación de alimentos (mesón y tabla de picar) tienen presencia de bacterias: Salmonella con mayor frecuencia; E. coli, Klebsiella pneumoniae y Pseudomonas aeruginosa de mediana frecuencia y de baja para Shigella, y en el área de consumo de alimentos (mesas) la bacteria de mayor frecuencia es la E. coli y Shigella, la Klebsiella pneumoniae de mediana y Pseudomona aeruginosa se encuentra en baja frecuencia. Se llegó a la conclusión que las superficies inertes tanto en el área de preparación como en el área de consumo de alimentos se encuentran contaminados por lo que hay un riesgo de infección alimentaria para los comensales de la Universidad Técnica de Machala.

Contamination of preparation areas when coming into contact with raw or cooked foods, which is why one of the main causes of contamination of inert surfaces is inadequate handling of food when it is being prepared. With the aim of controlling the application of hygiene standards in the areas of food preparation and consumption through microbiological analysis to reduce the risks of food contamination. This research is descriptive in nature, in which a visual inspection of the establishment was carried out with the purpose of evaluating the sanitary and hygienic conditions, through the application of the Technical Guide for the Microbiological Analysis of Surfaces in Contact with Food and Beverages. For the microbiological analysis of the samples, inoculation techniques, streaking method, bacterial isolation, differential staining and use of biochemical tests such as: TSI, SIM, Simmons Citrate, Urea, Lysine, Catalase and Oxidase, in addition to use of selective and differential culture media such as EMB agar and MacConkey agar for the identification of enteric bacteria such as: E. coli, Salmonella, Klebsiella pneumoniae, Shigella, Pseudomona aeruginosa. The results showed that the bacterial frequency of the inert surfaces of the restaurants in the food preparation area (counter and cutting board) have the presence of bacteria: Salmonella more frequently; E. coli, Klebsiella pneumoniae and Pseudomonas aeruginosa of medium frequency and low frequency for Shigella, and in the food consumption area (tables) the most frequent bacteria are E. coli and Shigella, Klebsiella pneumoniae of medium and Pseudomona aeruginosa It is at low frequency. It was concluded that the inert surfaces in both the preparation area and the food consumption area are contaminated, so there is a risk of food infection for diners at the Technical University of Machala

Contaminação das áreas de preparo ao entrar em contato com alimentos crus ou cozidos, por isso uma das principais causas de contaminação de superfícies inertes é o manuseio inadequado dos alimentos no momento do preparo. Com o objetivo de controlar a aplicação de padrões de higiene nas áreas de preparação e consumo de alimentos através de análises microbiológicas para reduzir os riscos de contaminação alimentar. Esta pesquisa é de natureza descritiva, na qual foi realizada uma inspeção visual do estabelecimento com a finalidade de avaliar as condições sanitárias e higiênicas, por meio da aplicação do Guia Técnico para Análise Microbiológica de Superfícies em Contato com Alimentos e Bebidas. Para a análise microbiológica das amostras foram utilizadas técnicas de inoculação, método de estrias, isolamento bacteriano, coloração diferencial e utilização de testes bioquímicos como: TSI, SIM, Citrato de Simmons, Ureia, Lisina, Catalase e Oxidase, além de utilização de testes seletivos e diferenciais. meios de cultura como ágar EMB e ágar MacConkey para identificação de bactérias entéricas como: E. coli, Salmonella, Klebsiella pneumoniae, Shigella, Pseudomona aeruginosa. Os resultados mostraram que a frequência bacteriana das superfícies inertes dos restaurantes na área de preparo de alimentos (balcão e tábua de corte) apresentam com maior frequência a presença de bactérias: Salmonella; E. coli, Klebsiella pneumoniae e Pseudomonas aeruginosa de média frequência e baixa frequência para Shigella, e na área de consumo alimentar (tabelas) as bactérias mais frequentes são E. coli e Shigella, Klebsiella pneumoniae de média e Pseudomona aeruginosa Está em baixa frequência. Concluiu-se que as superfícies inertes tanto na área de preparação como na área de consumo de alimentos estão contaminadas, pelo que existe risco de infecção alimentar para os comensais da Universidade Técnica de Machala

Identificación de microorganismos entéricos en áreas de preparación y consumo de alimentos

La contaminación de las áreas de preparación al entrar en contacto con los alimentos crudos o cocinados, es por esto que una de las principales causas de la contaminación de las superficies inertes es la inadecuada manipulación de los alimentos a la hora de ser preparados. Con el objetivo de controlar la aplicación de normas de higiene en las áreas de preparación y consumo de alimentos mediante análisis microbiológicos para disminuir los riesgos de contaminación alimentaria. Esta investigación es de carácter descriptivo, en la cual se realizó una inspección visual del establecimiento con el propósito de evaluar las condiciones higiénicas sanitarias, mediante la aplicación de la Guía Técnica para el Análisis Microbiológico de Superficies en contacto con Alimentos y Bebidas. Para el análisis microbiológico de las muestras se emplearon las técnicas de inoculación, método de estriado, aislamiento bacteriano, tinción diferencial y utilización de las pruebas bioquímicas como: TSI, SIM, Citrato de Simmons, Urea, Lisina, Catalasa y Oxidasa, además de la utilización de medios de cultivo selectivo y diferencial como agar EMB y agar MacConkey para la identificación de bacterias entéricas como: E. coli, Salmonella, Klebsiella pneumoniae, Shigella, Pseudomona aeruginosa. Los resultados arrojaron que la frecuencia bacteriana de las superficies inertes de los restaurantes en el área de preparación de alimentos (mesón y tabla de picar) tienen presencia de bacterias: Salmonella con mayor frecuencia; E. coli, Klebsiella pneumoniae y Pseudomonas aeruginosa de mediana frecuencia y de baja para Shigella, y en el área de consumo de alimentos (mesas) la bacteria de mayor frecuencia es la E. coli y Shigella, la Klebsiella pneumoniae de mediana y Pseudomona aeruginosa se encuentra en baja frecuencia. Se llegó a la conclusión que las superficies inertes tanto en el área de preparación como en el área de consumo de alimentos se encuentran contaminados por lo que hay un riesgo de infección alimentaria para los comensales de la Universidad Técnica de Machala.

Contamination of preparation areas when coming into contact with raw or cooked foods, which is why one of the main causes of contamination of inert surfaces is inadequate handling of food when it is being prepared. With the aim of controlling the application of hygiene standards in the areas of food preparation and consumption through microbiological analysis to reduce the risks of food contamination. This research is descriptive in nature, in which a visual inspection of the establishment was carried out with the purpose of evaluating the sanitary and hygienic conditions, through the application of the Technical Guide for the Microbiological Analysis of Surfaces in Contact with Food and Beverages. For the microbiological analysis of the samples, inoculation techniques, streaking method, bacterial isolation, differential staining and use of biochemical tests such as: TSI, SIM, Simmons Citrate, Urea, Lysine, Catalase and Oxidase, in addition to use of selective and differential culture media such as EMB agar and MacConkey agar for the identification of enteric bacteria such as: E. coli, Salmonella, Klebsiella pneumoniae, Shigella, Pseudomona aeruginosa. The results showed that the bacterial frequency of the inert surfaces of the restaurants in the food preparation area (counter and cutting board) have the presence of bacteria: Salmonella more frequently; E. coli, Klebsiella pneumoniae and Pseudomonas aeruginosa of medium frequency and low frequency for Shigella, and in the food consumption area (tables) the most frequent bacteria are E. coli and Shigella, Klebsiella pneumoniae of medium and Pseudomona aeruginosa It is at low frequency. It was concluded that the inert surfaces in both the preparation area and the food consumption area are contaminated, so there is a risk of food infection for diners at the Technical University of Machala.

Contaminação das áreas de preparo ao entrar em contato com alimentos crus ou cozidos, por isso uma das principais causas de contaminação de superfícies inertes é o manuseio inadequado dos alimentos no momento do preparo. Com o objetivo de controlar a aplicação de padrões de higiene nas áreas de preparação e consumo de alimentos através de análises microbiológicas para reduzir os riscos de contaminação alimentar. Esta pesquisa é de natureza descritiva, na qual foi realizada uma inspeção visual do estabelecimento com a finalidade de avaliar as condições sanitárias e higiênicas, por meio da aplicação do Guia Técnico para Análise Microbiológica de Superfícies em Contato com Alimentos e Bebidas. Para a análise microbiológica das amostras foram utilizadas técnicas de inoculação, método de estrias, isolamento bacteriano, coloração diferencial e utilização de testes bioquímicos como: TSI, SIM, Citrato de Simmons, Ureia, Lisina, Catalase e Oxidase, além de utilização de testes seletivos e diferenciais. meios de cultura como ágar EMB e ágar MacConkey para identificação de bactérias entéricas como: E. coli, Salmonella, Klebsiella pneumoniae, Shigella, Pseudomona aeruginosa. Os resultados mostraram que a frequência bacteriana das superfícies inertes dos restaurantes na área de preparo de alimentos (balcão e tábua de corte) apresentam com maior frequência a presença de bactérias: Salmonella; E. coli, Klebsiella pneumoniae e Pseudomonas aeruginosa de média frequência e baixa frequência para Shigella, e na área de consumo alimentar (tabelas) as bactérias mais frequentes são E. coli e Shigella, Klebsiella pneumoniae de média e Pseudomona aeruginosa Está em baixa frequência . Concluiu-se que as superfícies inertes tanto na área de preparação como na área de consumo de alimentos estão contaminadas, pelo que existe risco de infecção alimentar para os comensais da Universidade Técnica de Machala.

Evaluation of Hand Morphometry in Healthy Young Individuals from Different Countries / Evaluación de la Morfometría de la Mano en Individuos Jóvenes Sanos de Diferentes Países

SUMMARY: This study aims to examine the hand morphometry of healthy young individuals from different countries and investigate the differences between countries in typing of hand based on the morphometric values obtained. In the study, 16 different parameters, including two surface areas and 14 lengths, were measured from the right hand of 579 volunteers (250 females, 329 males) from 7 different countries (Turkey, Chad, Morocco, Gabon, Kazakhstan, Senegal and Syria). Factor analysis was performed on the parameters, cluster analysis was performed according to the factor score obtained, and the hand types in the study were determined. As a result of the study, four different hand types were defined, and the distribution of these types according to countries was analyzed. All parameters showed significant differences between countries in both genders (p<0.05). According to the results of the study, there was a difference between male and female hand types between countries. In females, the type 1 hand type was found only in Gabon, the type 2 hand type was found only in Senegal, the type 3 hand type was found in Turkey, Morocco and Kazakhstan, while the type 4 hand type was significantly distributed in Senegal and Gabon (X2 =104.62; df=18, p<0.05). In males, type 1 hand type was found in Turkey, type 2 hand type in Senegal and Gabon, type 3 hand type in Turkey, while type 4 hand type was significantly distributed in Morocco and Kazakhstan (X2 =76.964; df=18, p<0.05).

Este estudio tuvo como objetivo examinar la morfometría de la mano de individuos jóvenes sanos de diferentes países e investigar las diferencias en la mecanografía de la mano entre países en función de los valores morfométricos obtenidos. En el estudio, se midieron 16 parámetros diferentes, incluidas dos superficies y 14 longitudes, de la mano derecha de 579 voluntarios (250 mujeres, 329 hombres) de 7 países diferentes (Turquía, Chad, Marruecos, Gabón, Kazajstán, Senegal y Siria). Se realizó un análisis factorial de los parámetros, un análisis de conglomerados según la puntuación factorial obtenida y se determinaron los tipos de manos en el estudio. Como resultado, se definieron cuatro tipos diferentes de manos y se analizó la distribución de estos tipos según países. Todos los parámetros mostraron diferencias significativas entre países en ambos sexos (p<0,05). Según los resultados del estudio, hubo una diferencia entre los tipos de manos de los hombres y de las mujeres entre países. En las mujeres, el tipo de mano tipo 1 se encontró solo en Gabón, el tipo de mano tipo 2 se encontró solo en Senegal, el tipo de mano tipo 3 se encontró en Turquía, Marruecos y Kazajstán, mientras que la mano tipo 4 se distribuyó significativamente en Senegal y Gabón (X2=104,62; gl=18, p<0,05). En los hombres, el tipo de mano tipo 1 se encontró en Turquía, el tipo de mano tipo 2 en Senegal y Gabón, el tipo de mano tipo 3 en Turquía, mientras que la mano tipo 4 se distribuyó significativamente en Marruecos y Kazajstán (X2=76,964; gl=18, p <0,05).

Determining Sex from Thai Radius: Discriminant Function Analysis Including the Dry Bone Weight as an Effective Variant / Determinación del Sexo a Partir del Radio Tailandés: Análisis de Función Discriminante que Incluye el Peso del Hueso Seco como Variante Eficaz

SUMMARY: In forensic anthropology, the radius bone has been shown to determine the sex of human remains in a number of different populations. The dry mass and growth of long bones, including the radius, are associated with sex hormone levels; however, the use of bone weight to determine sex has not been sufficiently investigated. The aim of this study was to apply bone morphometric parameters, including maximum length of radius (MLR), circumference at the midshaft of radius (CMR), and weight of radius (WR), to 400 sample radii from a Northeastern Thai population. Univariate and multivariate discriminant functions of all parameters were systemically applied. Equations for calculating sex classification were also determined. Descriptive data analysis showed significant sexual dimorphism in all variables (p < 0.05). The canonical correlation was highest in CMR (0.772) and the ratio of weight to length (0.747). Multivariate discriminant function analysis showed that the measured indices of the right radius were slightly greater than those of the left radius. The parameters demonstrating the highest values of the standardized canonical discriminant function coefficients were CMR (Rt. = 0.496, Lt. 0.431) and WR (Rt. = 0.681, Lt. = 0.715). Moreover, the results of the multivariable (stepwise method) indicated that the best accuracy rates for using combinations of CMR and WR were 94 % (right side) and 92 % (left side). In conclusion, the weight of the radius (rather than the length) is an effective parameter in determining sex.

En antropología forense, se ha demostrado que el hueso radio determina el sexo de los restos humanos en varias poblaciones diferentes. La masa seca y el crecimiento de los huesos largos, incluido el radio, están asociados con los niveles de hormonas sexuales; sin embargo, el uso del peso de los huesos para determinar el sexo no se ha investigado suficientemente. El objetivo de este estudio fue aplicar parámetros morfométricos óseos, incluida la longitud máxima del radio (LMR), la circunferencia en la mitad del radio (CMR) y el peso del radio (PR), a 400 radios de muestra de una población del noreste de Tailandia. Se aplicaron sistémicamente funciones discriminantes univariadas y multivariadas de todos los parámetros. También se determinaron ecuaciones para calcular la clasificación por sexo. El análisis descriptivo de los datos mostró un dimorfismo sexual significativo en todas las variables (p < 0,05). La correlación canónica fue mayor en CMR (0,772) y la relación peso-longitud (0,747). El análisis de función discriminante multivariante mostró que los índices del radio derecho eran ligeramente mayores que los del radio izquierdo. Los parámetros que demostraron los valores más altos de los coeficientes de la función discriminante canónica estandarizada fueron CMR (Rt. = 0,496, Lt. 0,431) y PR (Rt. = 0,681, Lt. = 0,715). Además, los resultados del método multivariable (método paso a paso) indicaron que las mejores tasas de precisión al usar combinaciones de CMR y PR fueron del 94 % (lado derecho) y del 92 % (lado izquierdo). En conclusión, el peso del radio (más que la longitud) es un parámetro eficaz para determinar el sexo.

Variaciones de la composición nutricional de la leche materna

La complejidad de la composición de la leche humana es aún motivo de estudio, tanto a nivel de macronutrientes (carbohidratos, proteínas y lípidos), como de micronutrientes (minerales y vitaminas), así como de los elementos no nutricionales que cumplen un sinnúmero de funciones (anticuerpos, oligosacáridos, microbiota, otros). La evidencia demuestra que la composición varía a través del tiempo de forma tal que se reconocen etapas en la producción de leche materna. También se han establecido variaciones interindividuales entre las madres de neonatos prematuros o madres que acuden a ordeñarse en los bancos de leche cuando su hijo se encuentra hospitalizado. Estas variaciones son motivo de intensas investigaciones para determinar su impacto en la salud del lactante y determinar la necesidad de intervenciones como la fortificación o la suplementación de la nutrición durante la hospitalización. De igual importancia es reconocer factores epidemiológicos que permitan identificar madres en riesgo de presentar variaciones negativas de la composición de la leche que producen. (provisto por Infomedic International)

The complexity of the composition of human milk is still under study, both at the level of macronutrients (carbohydrates, proteins and lipids) and micronutrients (minerals and vitamins), as well as non-nutritional elements that fulfill a number of functions (antibodies, oligosaccharides, microbiota, etc.). Evidence shows that the composition varies over time in such a way that stages in the production of breast milk can be recognized. Interindividual variations have also been established among mothers of premature infants or mothers who come to milk at milk banks when their infant is hospitalized. These variations are the subject of intensive research to determine their impact on infant health and to determine the need for interventions such as nutrition fortification or supplementation during hospitalization. Equally important is the recognition of epidemiological factors to identify mothers at risk for negative variations in the composition of the milk they produce. (provided by Infomedic International)

Spanish heart transplant registry. 35th official report of the Heart Failure Association of the Spanish Society of Cardiology.

INTRODUCTION AND OBJECTIVES: Our aim was to describe the characteristics and outcomes of heart transplants in Spain. METHODS: We analyzed trends in recipient and donor characteristics, recipient-donor interaction, surgical procedures, immunosuppression, and outcomes of patients included in the Spanish heart transplant registry from 2014 to 2023. Changes in survival were analyzed using the Kaplan-Meier method. RESULTS: In 2023, 325 cardiac transplants were performed (4.5% more than in the previous year), with a total of 2987 procedures from 2014 to 2023. There was a trend toward performing more transplants in women (29.2%), with etiologies other than cardiomyopathy (32.6%), and with better pretransplant status (less hepatic [12.5%], renal [glomerular filtration rate, 81.5mL/min/1.73 m2], and respiratory [8.7%] involvement). In 2023, the number of urgent transplants increased (44% of the total), especially those performed after circulatory support with extracorporeal membrane oxygenation (36% of total assistance), and transplants performed with donation after circulatory death (17.9%). Survival improved in the triennium from 2020 to 2022 compared with 2014 to 2016 (83.0% at 1 year from 2020-2022 vs 79.0% from 2014-2016). CONCLUSIONS: The number of transplants performed in Spain showed an upward trend, with recipients with better clinical status and an increasing use of donation after circulatory death. Survival improved in the last triennium.

Analysis of the image and corporate identity of the Colegio Mexicano de Reumatologia: Is it time to redefine it?

INTRODUCTION AND OBJECTIVES: The Colegio Mexicano de Reumatología (CMR) is a corporation whose brand has two elements-image and identity-that differentiate it from other corporations. We evaluated aspects of CMR's corporate image and identity. SUBJECTS AND METHODS: To assess corporate image, we designed a survey using proof-of-concept and discrete-choice-experiments approaches. It assessed which definition (orthopedist, rheumatologist, or rehabilitator) was most meaningful in four pain scenarios in healthy adults from the country's Western region. We used discourse analysis and five readability indices of the CMR website to assess corporate identity. RESULTS: In total, 700 respondents were included. For every rheumatologist chosen in the hand scenario, respondents chose 1.13 orthopedists and 0.70 rehabilitators. For every rheumatologist chosen in the knee scenario, respondents chose 2.36 orthopedists and 0.64 rehabilitators, whereas 0.85 orthopedists and 0.58 rehabilitators were chosen in the arthritis scenario. Only 38% of the respondents preferred the CMR's definition of a rheumatologist to describe a rheumatologist. The younger age group preferred orthopedists to rheumatologists (50% vs. 31%, p<0.001). In the arthritis scenario, the choice of rheumatologist increased from 27% in the elementary school group to 49% in the university group (p<0.001). Mother was the most influential in healthcare seeking. The discursive analysis revealed that the CMR is positioned as a "we" restricted to "colleagues;" the patient did not have agentive representation. The semiotic structure of the CMR's mission/vision was deemed imprecise and lacking in statements of value and purpose; the readability scores indicated that the text was challenging and dry. CONCLUSIONS: The CMR's corporate image does not differentiate it from other health providers. CMR's identity seems ambiguous with restricted directionality. It seems pertinent to redefine the CMR.