Fixed-bearing versus mobile-bearing total ankle replacement survivorship. A meta-analysis.

BACKGROUND: Main objective of this research is to know if there is a different survival rate between fixed bearing (FB) and mobile bearing (MB) total ankle replacement (TAR). We hypothesized that there are no differences between the survival rates of both implants. METHODS: A systematic search was performed in PubMed, Cochrane, EMBASE and ClinicalTrials.gov databases to identify published studies from August 2018 to September 2022 including results for FB and MB TAR survivorship. Inclusion criteria included 1) primary TAR in one or both feet in which implant could be identified , 2) a minimum of 20 procedures reported, 3) reported implant survivorship or calculable and 4) a minimum of 12 months follow-up for level 1-3 studies or 60 months for level 4 studies. RESULTS: 3902 ankles in 28 studies were included. 719 were FB and 3104 MB with an overall survivorship of 94% (95% CI [0.89; 0.97]) and 89% (95% CI [0.86; 0.92]) respectively. After subgroup analysis, we did not find differences among both groups (p =  0.429 ). Meta-regression analysis showed that longer follow-up was associated with lower survival rates in MB group (p = 0.000) while no other relationships were found with other factors (age, level of evidence or conflict of interests). CONCLUSIONS: No differences in survival rates between both groups were found. Age and other studied confounders were not found to be related with implant survivorship. However, longer follow-up was found to be related with lower survival rates. Studies with longer follow-up and higher level of evidence are needed to confirm results. LEVEL OF EVIDENCE: IV, systematic review of level I to IV studies.

Spanish Translation, Cross-Cultural Adaptation, and Validation of the Olerud-Molander Ankle Score (OMAS) for Ankle Fractures.

Background: The aim of this study was to translate and cross-culturally adapt the Olerud-Molander Ankle Score (OMAS) into Spanish and to assess its reliability and validity. Methods: The translation and adaptation to develop the Spanish version of the OMAS (OMAS-Sp) was performed according to current international guidelines. The OMAS-Sp was administered to 98 patients with a surgically treated ankle fracture, and it was repeated 7-14 days later to assess construct reliability of each question's score and the total score. Test-retest reliability and the internal consistency were calculated, and concurrent validity was assessed by comparing the OMAS-Sp with the Foot and Ankle Outcome Score (FAOS). The presence of floor and ceiling effects was also analyzed. Results: Adequate internal consistency was found with a Cronbach α of 0.821. Excellent test-retest reliability was demonstrated with an interclass correlation coefficient for the total score of 0.970 (95% CI 0.956-0.980; P < .001). Spearman correlation coefficients (r's) between the OMAS-Sp total score and the 5 FAOS subscales ranged from 0.944 to 0.951 (P < .001). No floor or ceiling effects were found. Conclusion: The OMAS-Sp demonstrated adequate psychometric properties and is a valid and reliable tool for assessing outcomes in Spanish-speaking patients with surgically treated ankle fractures. Level of Evidence: Level II, prospective cohort study.

Medio de enseñanza virtual sobre acupuntura con anatomía regional para internado vertical de Medicina Natural y Tradicional / Virtual teaching aid on acupuncture with regional anatomy for vertical internship of Natural and Traditional Medicine

RESUMEN Introducción: el uso de tecnologías de la información y la comunicación se ha generalizado en el proceso de enseñanza-aprendizaje para facilitar la continuidad de estudios en educandos universitarios, debido a la situación epidemiológica mundial. La medicina natural y tradicional constituye un pilar fundamental para el ejercicio de la práctica clínica, de ahí la necesidad del desarrollo de su internado vertical. Objetivo: diseñar un medio de enseñanza para el aprendizaje de la acupuntura y digitopuntura por los estudiantes del internado vertical. Materiales y métodos: se realizó un estudio transversal, de desarrollo tecnológico, en la Universidad de Ciencias Médicas de Matanzas, entre septiembre de 2021 y febrero de 2022. Se llevó a cabo el diseño y validación sobre una propuesta de medio de enseñanza digital para el internado vertical. Resultados: se trabajó de manera conjunta con áreas básicas clínicas, para dar salida al módulo de Acupuntura en el internado vertical de Medicina Natural y Tradicional, con el empleo de la anatomía humana. Se diseñó un medio de enseñanza al utilizar gráficos e información virtual, que fueron calificados de muy adecuados, tanto en pertinencia como en utilidad. Conclusiones: se confeccionó un medio de enseñanza que permite al estudiante del internado vertical de la carrera de Medicina, interactuar con los contenidos de Anatomía Humana y la Medicina Natural y Tradicional.

ABSTRACT Introduction: the use of information and communication technologies has become widespread in the teaching-learning process to facilitate the continuity of studies in university students, due to the global epidemiological situation. Natural and traditional medicine is a fundamental pillar for the exercise of clinical practice, hence the need for the development of its vertical internship. Objective: to design a teaching aid for the students of the vertical internship to learn acupuncture and digitopuncture. Materials and methods: a cross-sectional study of technological development was conducted at the Medical Sciences University of Matanzas, between September 2021 and February 2022. The design and validation on a proposal of digital teaching aid for the vertical internship was carried out. Results: the Acupuncture module was elaborated together with basic clinical areas for the vertical internship of Natural and Traditional Medicine, with the use of human anatomy. A teaching aid was designed using graphics and virtual information, which were qualified as very adequate, both in relevance and usefulness. Conclusions: a teaching aid was created that allows the student of the vertical internship of the Medicine studies to interact with the contents of Human Anatomy and Natural and Traditional Medicine.

Economic Costs of Pain in the Spanish Working Population.

OBJECTIVE: The objective of this paper is to provide an overview of the epidemiology of pain in the Spanish working population and to investigate the incremental costs of the different levels of pain on medical costs and productivity losses. METHODS: This is a cross-sectional study of costs of pain in the Spanish working population from a societal perspective using data from a national representative survey. RESULTS: Data from the 9919 respondents were analyzed. The prevalence of reported pain was 38.5%: 21.9% mild or very mild; 11.5% moderate; 5.1% severe or extreme. Increased self-reported pain was independently associated with significant increases in direct and indirect costs. Those reporting severe or extreme pain showed excess annual costs of €5118.97 per case, being 85% indirect costs. CONCLUSIONS: Spain is paying a heavy price for the high prevalence of pain in its working population.

Depth Data Denoising in Optical Laser Based Sensors for Metal Sheet Flatness Measurement: A Deep Learning Approach.

Surface flatness assessment is necessary for quality control of metal sheets manufactured from steel coils by roll leveling and cutting. Mechanical-contact-based flatness sensors are being replaced by modern laser-based optical sensors that deliver accurate and dense reconstruction of metal sheet surfaces for flatness index computation. However, the surface range images captured by these optical sensors are corrupted by very specific kinds of noise due to vibrations caused by mechanical processes like degreasing, cleaning, polishing, shearing, and transporting roll systems. Therefore, high-quality flatness optical measurement systems strongly depend on the quality of image denoising methods applied to extract the true surface height image. This paper presents a deep learning architecture for removing these specific kinds of noise from the range images obtained by a laser based range sensor installed in a rolling and shearing line, in order to allow accurate flatness measurements from the clean range images. The proposed convolutional blind residual denoising network (CBRDNet) is composed of a noise estimation module and a noise removal module implemented by specific adaptation of semantic convolutional neural networks. The CBRDNet is validated on both synthetic and real noisy range image data that exhibit the most critical kinds of noise that arise throughout the metal sheet production process. Real data were obtained from a single laser line triangulation flatness sensor installed in a roll leveling and cut to length line. Computational experiments over both synthetic and real datasets clearly demonstrate that CBRDNet achieves superior performance in comparison to traditional 1D and 2D filtering methods, and state-of-the-art CNN-based denoising techniques. The experimental validation results show a reduction in error than can be up to 15% relative to solutions based on traditional 1D and 2D filtering methods and between 10% and 3% relative to the other deep learning denoising architectures recently reported in the literature.

He Jiankui´s gene-editing experiment and the non-identity problem.

Genetic engineering has been a topic of discussion for over 50 years, but it is only recently that gene editing has become a reality. CRISPR biotechnologies have made gene editing much safer, precise and feasible. We have witnessed the first cases of human germline genetic modification resulting in live births, conducted by He Jiankui. In this paper, we will analyse He Jiankui's case in relation to one of the most difficult problems in procreative ethics (or the ethics of future generations): the non-identity problem. We believe that this analysis will help us to understand the ethics involved in gene editing and hopefully allow for a better, more philosophically grounded legislation on CRISPR and other gene-editing technologies.

A Multi Camera and Multi Laser Calibration Method for 3D Reconstruction of Revolution Parts.

This paper describes a method for calibrating multi camera and multi laser 3D triangulation systems, particularly for those using Scheimpflug adapters. Under this configuration, the focus plane of the camera is located at the laser plane, making it difficult to use traditional calibration methods, such as chessboard pattern-based strategies. Our method uses a conical calibration object whose intersections with the laser planes generate stepped line patterns that can be used to calculate the camera-laser homographies. The calibration object has been designed to calibrate scanners for revolving surfaces, but it can be easily extended to linear setups. The experiments carried out show that the proposed system has a precision of 0.1 mm.

Análisis comparativo de las pautas del consejo de organizaciones internacionales de ciencias médicas (CIOMS)2016. (Parte 3 de 3) / Comparative analysis of the standards of the council of international organizations of medical sciences (CIOMS)2016. (Part 3 of 3)

El este tercer trabajo se presenta el análisis comparativo de las últimas pautas de CIOMS 2016, realizado por estudiantes de la VI Cohorte de la Maestría en Bioética como parte de la evaluación de la asignatura Bioética e Investigación. En estas pautas se abordan de forma novedosa temas tan importantes como la investigación en grupos vulnerables, en situaciones de desastre y brotes de enfermedades de orden natural o creadas por el hombre e investigaciones con conglomerados, así como la compensación por daños, manejo de datos cuando se utiliza el entorno virtual y herramientas digitales y el conflicto de interés, lo cual proporcionará a los investigadores un aporte en su formación y una rápida adaptación a la nueva propuesta CIOMS(AU)

In this third work, the comparative analysis of the latest CIOMS 2016 guidelines, carried out by students of the VI Cohort of the Master in Bioethics, as part of the evaluation of the subject Bioethics and Research is presented. These guidelines deal in a novel way with important issues such as research in vulnerable groups in situations of disaster and outbreaks of natural or man-made diseases and investigations with clusters, as well as compensation for damages, data management when the virtual environment and digital tools and the conflict of interest are used, which will provide researchers with a contribution in their training and a rapid adaptation to the new CIOMS proposal(AU)

Optical Dual Laser Based Sensor Denoising for OnlineMetal Sheet Flatness Measurement Using Hermite Interpolation.

Flatness sensors are required for quality control of metal sheets obtained from steel coils by roller leveling and cutting systems. This article presents an innovative system for real-time robust surface estimation of flattened metal sheets composed of two line lasers and a conventional 2D camera. Laser plane triangulation is used for surface height retrieval along virtual surface fibers. The dual laser allows instantaneous robust and quick estimation of the fiber height derivatives. Hermite cubic interpolation along the fibers allows real-time surface estimation and high frequency noise removal. Noise sources are the vibrations induced in the sheet by its movements during the process and some mechanical events, such as cutting into separate pieces. The system is validated on synthetic surfaces that simulate the most critical noise sources and on real data obtained from the installation of the sensor in an actual steel mill. In the comparison with conventional filtering methods, we achieve at least a 41% of improvement in the accuracy of the surface reconstruction.

Occurrence of apomictic conspecifics and ecological preferences rather than colonization history govern the geographic distribution of sexual Potentilla puberula.

The geographic distribution of sexual-apomictic taxa (i.e., comprising individuals usually reproducing either sexually or asexually via seeds) is traditionally thought to be driven by their ecological preferences and colonization histories. Where sexuals and apomicts get into contact with each other, competitive and reproductive interactions can interfere with these factors, an aspect which hitherto received little attention in biogeographic studies. We disentangled and quantified the relative effects of the three factors on the distribution of tetraploid sexuals in Potentilla puberula in a latitudinal transect through the Eastern European Alps, in which they are codistributed with penta-, hepta-, and octoploid apomictic conspecifics. Effects were explored by means of binomial generalized linear regression models combining a single with a multiple predictor approach. Postglacial colonization history was inferred from population genetic variation (AFLPs and cpDNA) and quantified using a cost distance metric. The study was based on 235 populations, which were purely sexual, purely apomictic, or of mixed reproductive mode. The occurrence of apomicts explained most of the variation in the distribution of sexuals (31%). Specifically, the presence of sexual tetraploids was negatively related to the presence of each of the three apomictic cytotypes. Effects of ecological preferences were substantial too (7% and 12% of the total variation explained by ecological preferences alone, or jointly with apomicts' occurrence, respectively). In contrast, colonization history had negligible effects on the occurrence of sexuals. Taken together, our results highlight the potentially high impact of reproductive interactions on the geographic distribution of sexual and apomictic conspecifics and that resultant mutual exclusion interrelates to ecological differentiation, a situation potentially promoting their local coexistence.

Short-Term Effects of Anodal Transcranial Direct Current Stimulation on Endurance and Maximal Force Production. A Systematic Review and Meta-Analysis.

The purpose of the present systematic review and meta-analysis was to explore the effects of transcranial direct current stimulation (tDCS) on endurance (i.e., time to task failure (TTF)) and maximal voluntary contraction (MVC). Furthermore, we aimed to analyze whether the duration of stimulation, the brain region targeted for stimulation, and the task performed could also influence motor performance. We performed a systematic literature review in the databases MEDLINE and Web of Science. The short-term effects of anodal tDCS and sham stimulation (placebo) were considered as experimental and control conditions, respectively. A total of 31 interventions were included (MVC = 13; TTF = 18). Analysis of the strength-related tDCS studies showed small improvements in the MVC (SMD = 0.19; 95% CI = -0.02, 0.41; p = 0.08). However, the results of the endurance-related interventions indicated a moderate effect on TTF performance (SMD = 0.26; 95% CI = 0.07, 0.45; p = 0.008). Furthermore, the sub-analysis showed that anodal tDCS over M1 and stimulation durations longer than 10 min produced the best results in terms of TTF performance enhancement. Additionally, the effects of anodal tDCS were larger during full body exercises (i.e., cycling) when compared to uniarticular tasks. In conclusion, the current meta-analysis indicated that anodal tDCS leads to small and moderate effects on MVC and TTF, respectively.

Potential Application of h-BNC Structures in SERS and SEHRS Spectroscopies: A Theoretical Perspective.

In this work, the electronic and optical properties of hybrid boron-nitrogen-carbon structures (h-BNCs) with embedded graphene nanodisks are investigated. Their molecular affinity is explored using pyridine as model system and comparing the results with the corresponding isolated graphene nanodisks. Time-dependent density functional theory (TDDFT) analysis of the electronic excited states was performed in the complexes in order to characterize possible surface and charge transfer resonances in the UV region. Static and dynamic (hyper)polarizabilities were calculated with coupled-perturbed Kohn-Sham theory (CPKS) and the linear and nonlinear optical responses of the complexes were analyzed in detail using laser excitation wavelengths available for (Hyper)Raman experiments and near-to-resonance excitation wavelengths. Enhancement factors around 103 and 108 were found for the polarizability and first order hyperpolarizability, respectively. The quantum chemical simulations performed in this work point out that nanographenes embedded within hybrid h-BNC structures may serve as good platforms for enhancing the (Hyper)Raman activity of organic molecules immobilized on their surfaces and for being employed as substrates in surface enhanced (Hyper)Raman scattering (SERS and SEHRS). Besides the better selectivity and improved signal-to-noise ratio of pristine graphene with respect to metallic surfaces, the confinement of the optical response in these hybrid h-BNC systems leads to strong localized surface resonances in the UV region. Matching these resonances with laser excitation wavelengths would solve the problem of the small enhancement factors reported in Raman experiments using pristine graphene. This may be achieved by tuning the size/shape of the embedded nanographene structure.

Difference in reproductive mode rather than ploidy explains niche differentiation in sympatric sexual and apomictic populations of Potentilla puberula.

Apomicts tend to have larger geographical distributional ranges and to occur in ecologically more extreme environments than their sexual progenitors. However, the expression of apomixis is typically linked to polyploidy. Thus, it is a priori not clear whether intrinsic effects related to the change in the reproductive mode or rather in the ploidy drive ecological differentiation. We used sympatric sexual and apomictic populations of Potentilla puberula to test for ecological differentiation. To distinguish the effects of reproductive mode and ploidy on the ecology of cytotypes, we compared the niches (a) of sexuals (tetraploids) and autopolyploid apomicts (penta-, hepta-, and octoploids) and (b) of the three apomictic cytotypes. We based comparisons on a ploidy screen of 238 populations along a latitudinal transect through the Eastern European Alps and associated bioclimatic, and soil and topographic data. Sexual tetraploids preferred primary habitats at drier, steeper, more south-oriented slopes, while apomicts mostly occurred in human-made habitats with higher water availability. Contrariwise, we found no or only marginal ecological differentiation among the apomictic higher ploids. Based on the pronounced ecological differences found between sexuals and apomicts, in addition to the lack of niche differentiation among cytotypes of the same reproductive mode, we conclude that reproductive mode rather than ploidy is the main driver of the observed differences. Moreover, we compared our system with others from the literature, to stress the importance of identifying alternative confounding effects (such as hybrid origin). Finally, we underline the relevance of studying ecological parthenogenesis in sympatry, to minimize the effects of differential migration abilities.

Pollen precedence in sexual Potentilla puberula and its role as a protective reproductive barrier against apomictic cytotypes.

Cross-pollination is a major factor determining the demographic dynamics of mixed-ploidy populations. Typically, rare cytotypes are suppressed due to reduced female fertility by losing gametes in heteroploid crosses (i.e., through minority cytotype exclusion). In species with reproductive differentiation into sexual and apomictic cytotypes, sexuals might be reproductively suppressed by apomicts (or transformed due to introgression of apomixis genes). Pollen precedence potentially acts as a post-pollination pre-fertilization barrier protecting sexuals against their apomictic counterparts. We estimated the role of pollen precedence as a barrier against cross-fertilization of tetraploid sexuals by penta- and heptaploid gametophytic apomicts in Potentilla puberula (Rosaceae) by means of controlled crosses, and inference of the paternity through DNA ploidy estimation of embryos. Individuals from five regions spanning an elevational and biogeographic gradient were used to account for the variation in the relative frequencies of reproductive modes across the study area. We tested (1) whether the application of heteroploid pollen (sexual × apomictic) causes a reduction of seed yield compared to homoploid crosses (sexual × sexual), and (2) if so, whether pollen precedence recovers the seed yield in simultaneous applications of pollen from sexuals and apomicts (mixed-ploidy). Seed yield was significantly lower in hetero- than in homoploid crosses. We found clear evidence for precedence of homoploid pollen, despite a 13% to 15% of embryos experienced a change in ploidy due to heteroploid fertilizations. Thus, our study indicates that pollen precedence operates as a barrier against intercytotype fertilization in P. puberula, promoting the integrity of the sexual cytotype and their co-existence with apomictic individuals.

Sexual intraspecific recombination but not de novo origin governs the genesis of new apomictic genotypes in Potentilla puberula (Rosaceae).

Apomixis - asexual reproduction via seeds - might arise de novo following polyploidisation events, or via reproductive transfer of apomixis. Both processes can be obtained within species or via hybridisation. We aimed to determine the origin of apomictic genotypes in Potentilla puberula, a rosaceous species showing reproductive differentiation with ploidy: sexual tetraploids and apomictic penta- to octoploids, which regularly co-occur in sympatry. The study is based on 726 individuals, comprising all cytotypes, collected from 138 populations in the Eastern European Alps. We established relationships of cytotypes based on AFLP fingerprinting and cpDNA sequencing to test (1) whether the apomicts are of recurrent allopolyploid origin or originated from within the species via autopolyploidy, and (2) whether there are indications for reproductive transfer versus de novo origin of apomixis. Three principal pathways were identified which explain the origin of new apomictic genotypes, all involving at least one apomictic parent and thus compatible with the idea of reproductive transfer of the apomictic trait to the progeny: (1) self-fertilisation of unreduced egg cells in apomicts; (2) cross-fertilisation among apomicts; and (3) occasionally, heteroploid crosses among sexuals and apomicts. Autopolyploids derived from tetraploid sexuals were repeatedly observed, but did not express apomixis. Finally, our results suggest no role of other species in the origin of extant apomictic genotypes of P. puberula, although local hybrids with P. crantzii were identified. In conclusion, our results show that the formation of new apomictic genotypes required a genetic contribution from at least one apomictic parent. This finding is in accordance with the idea that apomixis is inheritable in P. puberula. On the contrary, lack of apomixis in penta- and hexaploids derived from sexual backgrounds did not support the hypothesis of a de novo origin of apomixis. Relatively high frequency of remnant sexuality in the apomicts involving different cytological pathways of seed formation can explain their high cytological and genotypic diversity. Finally, lack of global introgression from a third taxon is in support of P. puberula as a concise, although highly diverse, species.

Etapas del climaterio y función endotelial en mujeres de edad mediana / Climacteric stages and endothelial function in middle-aged women

Introducción: La disminución de los estrógenos durante el climaterio repercute negativamente en el endotelio vascular, y origina disfunción endotelial, cuyo significado clínico está aún por definir. Objetivo: determinar la frecuencia de disfunción endotelial en las etapas del climaterio. Métodos: estudio descriptivo transversal, en 133 mujeres de 40-59 años, sin factores de riesgo cardiovascular, seleccionadas en centros de los 3 niveles de atención del Sistema Nacional de Salud, entre mayo de 2012 y mayo de 2013. Se evaluó la función endotelial mediante la prueba de dilatación mediada por el flujo de la arteria braquial, y su relación con etapas del climaterio. Se exploró la asociación entre variables utilizando pruebas no paramétricas (Kruskal-Wallis). Resultados: en el 38 por ciento de las mujeres se encontró disfunción endotelial, más frecuente en la etapa temprana de la posmenopausia respecto a la tardía y a la perimenopausia (45,0 vs. 27,5 vs. 27,5 por ciento respectivamente [p< 0,05]). Conclusiones: la disfunción endotelial es un evento frecuente en las mujeres de edad mediana aparentemente sanas, y al parecer, el descenso inicial de los estrógenos en los primeros años de la posmenopausia, tiene mayor impacto negativo en el endotelio vascular que el tiempo de exposición al hipoestrogenismo(AU)

Introduction: Estrogen reduction during the climacteric has a negative effect on the vascular endothelium and causes endothelial dysfunction, whose clinical significance is still to be defined.Objective: determine the frequency of endothelial dysfunction in the different stages of climacteric. Methods: a descriptive cross-sectional study was conducted of 133 women aged 40-59 with no cardiovascular risk factors, selected from institutions of the three health care levels within the National Health System from May 2012 to May 2013. Endothelial function was evaluated using the brachial artery flow-mediated dilation test and its association with climacteric stages. The relationship between variables was analyzed using non-parametric tests (Kruskal-Wallis). Results: 38 percent of the women had endothelial dysfunction, which was more common in the early stage of post-menopause than in the late stage and in perimenopause (45.0 vs. 27.5 vs. 27.5 percent, respectively [p< 0.05]). Conclusions: endothelial dysfunction is a common event among seemingly healthy middle-aged women. It seems that the initial reduction in estrogens in the first years of post-menopause has a greater negative impact on the vascular endothelium than the time of exposure to hypoestrogenism(AU)

Etapas del climaterio y función endotelial en mujeres de edad mediana / Climacteric stages and endothelial function in middle-aged women

Introducción: la disminución de los estrógenos durante el climaterio repercute negativamente en el endotelio vascular, y origina disfunción endotelial, cuyo significado clínico está aún por definir.Objetivo: determinar la frecuencia de disfunción endotelial en las etapas del climaterio.Métodos: estudio descriptivo transversal, en 133 mujeres de 40-59 años, sin factores de riesgo cardiovascular, seleccionadas en centros de los 3 niveles de atención del Sistema Nacional de Salud, entre mayo de 2012 y mayo de 2013. Se evaluó la función endotelial mediante la prueba de dilatación mediada por el flujo de la arteria braquial, y su relación con etapas del climaterio. Se exploró la asociación entre variables utilizando pruebas no paramétricas (Kruskal-Wallis).Resultados: en el 38 por ciento de las mujeres se encontró disfunción endotelial, más frecuente en la etapa temprana de la posmenopausia respecto a la tardía y a la perimenopausia (45,0 vs. 27,5 vs. 27,5 por ciento respectivamente [p< 0,05]).Conclusiones: la disfunción endotelial es un evento frecuente en las mujeres de edad mediana aparentemente sanas, y al parecer, el descenso inicial de los estrógenos en los primeros años de la posmenopausia, tiene mayor impacto negativo en el endotelio vascular que el tiempo de exposición al hipoestrogenismo(AU)

Introduction: estrogen reduction during the climacteric has a negative effect on the vascular endothelium and causes endothelial dysfunction, whose clinical significance is still to be defined.Objective: determine the frequency of endothelial dysfunction in the different stages of climacteric.Methods: a descriptive cross-sectional study was conducted of 133 women aged 40-59 with no cardiovascular risk factors, selected from institutions of the three health care levels within the National Health System from May 2012 to May 2013. Endothelial function was evaluated using the brachial artery flow-mediated dilation test and its association with climacteric stages. The relationship between variables was analyzed using non-parametric tests (Kruskal-Wallis).Results: 38 percent of the women had endothelial dysfunction, which was more common in the early stage of post-menopause than in the late stage and in perimenopause (45.0 vs. 27.5 vs. 27.5 percent, respectively [p< 0.05]).Conclusions: endothelial dysfunction is a common event among seemingly healthy middle-aged women. It seems that the initial reduction in estrogens in the first years of post-menopause has a greater negative impact on the vascular endothelium than the time of exposure to hypoestrogenism(AU)

Science journalists' perceptions and attitudes to pseudoscience in Spain.

Using interviews and questionnaires, we explored the perceptions and attitudes of 49 Spanish science journalists regarding pseudoscience. Pseudoscience, understood as false knowledge that endeavours to pass as science, is a controversial and complex matter that potentially poses a risk to society. Given that concern over this issue has grown in recent years in Spain, our aim was to evaluate how pseudoscience operates in journalistic practice in Spanish media. Our data reveal not only a lack of editorial policies in regard to pseudoscience, but also the existence of a significant number of science journalists who make light of the potential threat implied by the pseudosciences in the media. Some journalists point to the lack of scientific training of editors and media managers as one of the reasons for the proliferation of the pseudosciences.