The TIRS trial: Enrollment procedures and baseline characterization of a pediatric cohort to quantify the epidemiologic impact of targeted indoor residual spraying on Aedes-borne viruses in Merida, Mexico.

Aedes mosquito-borne viruses (ABVs) place a substantial strain on public health resources in the Americas. Vector control of Aedes mosquitoes is an important public health strategy to decrease or prevent spread of ABVs. The ongoing Targeted Indoor Residual Spraying (TIRS) trial is an NIH-sponsored clinical trial to study the efficacy of a novel, proactive vector control technique to prevent dengue virus (DENV), Zika virus (ZIKV), and chikungunya virus (CHIKV) infections in the endemic city of Merida, Yucatan, Mexico. The primary outcome of the trial is laboratory-confirmed ABV infections in neighborhood clusters. Despite the difficulties caused by the COVID-19 pandemic, by early 2021 the TIRS trial completed enrollment of 4,792 children aged 2-15 years in 50 neighborhood clusters which were allocated to control or intervention arms via a covariate-constrained randomization algorithm. Here, we describe the makeup and ABV seroprevalence of participants and mosquito population characteristics in both arms before TIRS administration. Baseline surveys showed similar distribution of age, sex, and socio-economic factors between the arms. Serum samples from 1,399 children were tested by commercially available ELISAs for presence of anti-ABV antibodies. We found that 45.1% of children were seropositive for one or more flaviviruses and 24.0% were seropositive for CHIKV. Of the flavivirus-positive participants, most were positive for ZIKV-neutralizing antibodies by focus reduction neutralization testing which indicated a higher proportion of participants with previous ZIKV than DENV infections within the cohort. Both study arms had statistically similar seroprevalence for all viruses tested, similar socio-demographic compositions, similar levels of Ae. aegypti infestation, and similar observed mosquito susceptibility to insecticides. These findings describe a population with a high rate of previous exposure to ZIKV and lower titers of neutralizing antibodies against DENV serotypes, suggesting susceptibility to future outbreaks of flaviviruses is possible, but proactive vector control may mitigate these risks.

Pneumothorax, Pneumomediastinum, and Cervical and Facial Massive Emphysema Secondary to Colonoscopy: A Rare Complication of Colonoscopy.

Background: Colonoscopy is a resource used for the diagnosis, treatment, and monitoring of benign and malignant colorectal pathologies. The incidence of perforation is 0.03%-0.65% in diagnostic colonoscopy; however, the incidence can be up to 10 times higher in therapeutic interventions, such as polypectomies, increasing the risk of complications up to 0.07-2.1%. Materials and methods. Case report of a 71-year-old female who presents a rare complication due to a perforation in the sigmoid which developed pneumoperitoneum, pneumomediastinum, pneumothorax, and massive subcutaneous emphysema as a complication of a diagnostic colonoscopy where a biopsy of a friable lesion was performed. Results: A 71-year-old female that went to the emergency room due to acute generalized abdominal colic spasm pain with a duration of 7 hours, associated with significant abdominal distension, malaise, diaphoresis, progressive dyspnea, and massive subcutaneous emphysema that developed after performing panendoscopy and colonoscopy for diverticulosis follow-up. An abdominal CT scan with double contrast was performed, reporting suggestive data of hollow viscus perforation, pneumoperitoneum, pneumomediastinum, pneumothorax, and massive subcutaneous emphysema in the thorax, neck, and skull base. She underwent an exploratory laparotomy finding a perforation in the sigmoid for which sigmoidectomy was performed, and for the pneumothorax and pneumomediastinum, endopleural tubes were placed in both hemithoraxes. The massive subcutaneous emphysema subsided with observation and oxygen. Conclusion: A rare complication of the use of colonoscopy as a diagnostic and therapeutic method is presented. The purpose of presenting this case is for the doctor who performs these interventions to suspect this complication in a timely manner, not delaying the diagnosis and carrying out an urgent therapeutic approach as in this case with exploratory laparotomy, finding the perforation site and carrying out the corresponding surgical management. We demonstrated that massive subcutaneous emphysema can be managed with observation if there is no other alarm data evident that required another surgical approach.

The Complete Genome Sequences of 12 Species of Plants from the Yucatan Peninsula, Mexico.

We present the complete genome sequences of 12 species of plants from Campeche, Mexico and the greater Yucatan Peninsula: Agave americana, Agave angustifolia, Agave fourcroydes, Agave karwinskii, Agave potatorum, Agave tequiliana, Annona squamosa, Cedrela odorata, Pouteria campechiana, Pouteria glomerata, Trichilia hirta and Trichilia minutiflora.

[Características epidemiológicas de pacientes con viruela símica y su relación con eventos de hospitalización en Colombia]. / Epidemiological characteristics of patients with monkeypox and their relationship with hospitalization events in Colombia.

OBJECTIVE: Since the beginning of 2022, there has been an unusual outbreak of monkeypox in non-endemic countries that has alerted the international community. In Colombia, there are no recent studies on the epidemiology of patients in this new epidemic. Therefore, aim of this article was to establish the demographic and clinical characteristics of patients with monkeypox and their relationship with the frequency of hospitalization and other variables of clinical notification. METHODS: An observational, analytical, and cross-sectional study on monkeypox cases in Colombia between May and September 2022 was executed. Mann-Whitney U test was applied to contrast hypotheses between hospitalization and sociodemographic and quantitative notification variables; Fisher's exact test was used to contrast with the qualitative ones. RESULTS: Between May and September 2022, there were 1,260 cases of monkeypox reported in Colombia, 75% of the these were registered in Bogotá D.C. 99% (1,248) of those infected were male with a median age of 32.82% of the patients were from strata 2 and 3 (low to medium-low income). The source of infection was unknown in just over 80% of cases. Less than 1% belonged to ethnic groups. Only 3% required hospitalization. A significant statistically association was found between the frequency of hospitalization, being a woman (p=0.038), Afro-Colombian (p=0.024) and subsidized regime (p=0.009). No association of hospitalization was found with age, but it was found with the days from the onset of symptoms/rash to notification/diagnosis (p<0.05). CONCLUSIONS: Monkeypox cases are concentrated in the capital and other Andean departments of Colombia. Most of these progress without seriousness, without deaths. Men are the most affected population group. Women, afro-colombians and subsidized patients deserve special attention because they are more prone to hospitalization. Reducing the number of days from symptoms or rash to diagnosis and notification is key to avoiding serious cases.

OBJECTIVE: Desde inicio de 2022 se ha presentado un brote inusual de viruela símica en países no endémicos que ha alertado a la comunidad internacional. En Colombia, no existen trabajos recientes sobre la epidemiología de los pacientes en esta nueva epidemia. Por tanto, el objetivo del presente trabajo fue establecer las características epidemiológicas de pacientes con viruela símica y su relación con la frecuencia de hospitalización y otras variables de notificación clínica. METHODS: Se realizó un estudio observacional, analítico y transversal sobre los casos de viruela símica en Colombia entre mayo y septiembre de 2022. Se aplicó la prueba U de Mann-Whitney para el contraste de hipótesis entre hospitalización y variables sociodemográficas y de notificación cuantitativas; se usó la prueba exacta de Fisher para el contraste con las cualitativas. RESULTS: Entre mayo y septiembre de 2022 se presentaron 1.260 casos de viruela símica en Colombia, el 75% de estos se registraron en Bogotá D.C. El 99% (1.248) de los contagiados eran de sexo masculino, con mediana de 32 años. El 82% de los pacientes eran de estratos 2 y 3 (ingresos bajo a medio-bajo). La fuente de infección era desconocida en poco más del 80% de los casos. Menos del 1% pertenecían a grupos étnicos. Solo el 3% requirió hospitalización. Se encontró asociación estadística significativa entre frecuencia de hospitalización, ser mujer (p=0,038), afrocolombiano (p=0,024) y régimen subsidiado (p=0,009). No se encontró asociación de hospitalización con la edad, pero sí con los días desde el inicio de síntomas/exantema hasta la notificación/diagnóstico (p<0,05). CONCLUSIONS: Los casos de viruela símica se concentran en la capital y otros departamentos andinos de Colombia. La mayoría de estos cursan sin gravedad, sin fallecimientos. Los hombres son el grupo poblacional más afectado. Especial atención merecen las pacientes de sexo femenino, los afrocolombianos y los que se encuentran en régimen subsidiado por ser más proclives a hospitalización. Reducir el número de días desde los síntomas o exantema hasta el diagnóstico y notificación es clave para evitar casos graves.

Influence of management practices on water-related grain yield determinants.

Adequate management of N supply, plant density, row spacing, and soil cover has proved useful for increasing grain yields and/or grain yield stability of rainfed crops over the years. We review the impact of these management practices on grain yield water-related determinants: seasonal crop evapotranspiration (ET) and water use efficiency for grain production per unit of evapotranspired water during the growing season (WUEG,ET,s). We highlight a large number of conflicting results for the impact of management on ET and expose the complexity of the ET response to environmental factors. We analyse the influence of management practices on WUEG,ET,s in terms of the three main processes controlling it: (i) the proportion of transpiration in ET (T/ET), (ii) transpiration efficiency for shoot biomass production (TEB), and (iii) the harvest index. We directly relate the impact of management practices on T/ET to their effect on crop light interception and provide evidence that management practices significantly influence TEB. To optimize WUEG,ET,s, management practices should favor soil water availability during critical periods for seed set, thereby improving the harvest index. The need to improve the performance of existing crop growth models for the prediction of water-related grain yield determinants under different management practices is also discussed.

Hallazgos ultrasonográficos y laparoscópicos en pacientes con endometriosis profunda

Objetivo: Determinar los hallazgos ultrasonográficos y laparoscópicos en pacientes con endometriosis profunda en el Servicio de Ginecología del Complejo Hospitalario Dr. Arnulfo Arias Madrid, Caja de Seguro Social (CHMDAAM - CSS). Metodología: Estudio descriptivo observacional transversal retrospectivo donde se evaluaron mediante expedientes clínicos los hallazgos ultrasonográficos y laparoscópicos en 48 pacientes con endometriosis en el servicio de Ginecología del Complejo Hospitalario Dr. Arnulfo Arias Madrid. Resultados: La prevalencia de endometriosis fue mayor en el grupo etario de 31 a 40 años (58%). La mayoría de la sintomatología presentada fue en el grupo de 31 a 40 años. Siendo la dismenorrea el síntoma más frecuente. En los hallazgos ultrasonográficos, la mayoría se encontró en el comportamiento posterior, involucrando mayormente al recto. Los hallazgos laparoscópicos más frecuentes fueron en el comportamiento posterior. En nuestro estudio, 35 de 46 de las pacientes con hallazgos ultrasonográficos que demostraba endometriosis profunda, tenían en la laparoscopia endometriosis profunda. Es decir, el ultrasonido por mapeo de endometriosis fue capaz de predecir el 76% de los hallazgos por laparoscopia. Conclusiones: los hallazgos ultrasonográficos concuerdan en su mayoría con los hallazgos encontrados por laparoscopia, siendo el compartimiento posterior el más afectado, las lesiones en el recto fueron las más frecuentes encontradas. (provisto por Infomedic International)

Objective: To determine the ultrasonographic and laparoscopic findings in patients with deep endometriosis in the Gynecology Service of the Dr. Arnulfo Arias Madrid Hospital Complex, Caja de Seguro Social (CHMDAAM - CSS). Methodology: Retrospective cross-sectional observational descriptive study in which ultrasonographic and laparoscopic findings in 48 patients with endometriosis in the Gynecology Service of the Complejo Hospitalario Dr. Arnulfo Arias Madrid were evaluated by means of clinical records. Results: The prevalence of endometriosis was higher in the 31-40 years age group (58%). Most of the symptomatology presented was in the 31 to 40 years age group. Dysmenorrhea was the most frequent symptom. In the ultrasonographic findings, most were found in the posterior behavior, mostly involving the rectum. The most frequent laparoscopic findings were in the posterior behavior. In our study, 35 of 46 of the patients with ultrasonographic findings demonstrating deep endometriosis had deep endometriosis at laparoscopy. In other words, endometriosis mapping ultrasound was able to predict 76% of the laparoscopic findings. Conclusions: the ultrasonographic findings are mostly consistent with the findings found by laparoscopy, being the posterior compartment the most affected, lesions in the rectum were the most frequently found. (provided by Infomedic International)

Transcatheter resolution of an aneurism of the pulmonary trunk with residual ductus arteriosus after thoracoscopic clipping: a new approach.

Patent ductus arteriosus is the most common cardiac anomaly in our country. In the last few decades, there has been a lot of interest in developing less invasive techniques like video-assisted thoracoscopic clipping; nevertheless, this also has some complications. We present an 8-year-old female, which had been treated with video-assisted thoracoscopic clipping of patent ductus arteriosus. Five years later, she presented with a large aneurysm of the ductus arteriosus extending to the pulmonary trunk and a residual patent ductus arteriosus. A Cardia ASD occluder of 24 mm was placed in the aneurysm, and the residual ductus arteriosus was then closed with an Amplatzer Plug vascular II device of 10 mm, with a good outcome. The development of an aneurysm after video-assisted patent ductus arteriosus closure is apparently a non-reported complication; therefore, there are also no reports for its treatment. That is why we present this case as an option for its resolution.

Diagnóstico prenatal de enfermedad de canal atrio-ventricular, análisis epidemiológico y experiencia CERPO entre 2003 y 2021 / Prenatal diagnosis of atrio-ventricular canal disease, epidemiological analysis and CERPO experience between 2003 and 2021

Antecedentes: En Chile, la mitad de los casos de mortalidad perinatal son atribuibles a anomalías congénitas, y un tercio de estas corresponde a cardiopatías congénitas. Aproximadamente un 35% de estos últimos requerirán cirugía antes del año de vida, por lo que la pesquisa prenatal impacta profundamente en el pronóstico. Objetivo: Dar a conocer los resultados perinatales de pacientes con diagnóstico prenatal de canal atrio-ventricular controlados en el Centro de Referencia Perinatal Oriente (CERPO) entre los años 2003 y 2021, su asociación a otras anomalías, características demográficas y pronóstico a un año. Métodos: En este estudio se puede apreciar que tanto el pronóstico como el plan terapéutico posnatal dependerán de la presencia de otras alteraciones morfológicas y del estudio genético. De los factores estudiados, se puede concluir que tanto la presencia de anomalías cardiacas asociadas, como el grado de insuficiencia valvular y el tipo de canal no son predictores de la sobrevida perinatal. Conclusiones: Finalmente, en relación con la sobrevida posnatal, en este estudio, la sobrevida a un año de los recién nacidos vivos fue de un 52%, pero al desglosarlo en los niños con cariotipo euploide y trisomía 21, estos valores se tornan muy distintos, 44 y 81% respectivamente.

Background: In Chile, half of the perinatal mortality cases are attributable to congenital anomalies, and one third of these correspond to congenital heart disease. Approximately 35% of the later will require surgery before one year of life, so prenatal screening has a profound impact on the prognosis. Objective: To present the perinatal results of patients with a prenatal diagnosis of atrio-ventricular canal controlled at Centro de Referencia Perinatal Oriente CERPO) between 2003 and 2021, its association with other anomalies, demographic characteristics, and 1-year prognosis. Methods: In this study it can be seen that both the prognosis and the postnatal therapeutic plan will depend on the presence of other morphological alterations and the genetic study. From the factors studied, it can be concluded that the presence of associated cardiac anomalies, the degree of valvular insufficiency, and the type of canal are not predictors of perinatal survival. Conclusions: Finally, in relation to postnatal survival, in this study, the 1-year survival of live newborns was 52%, but when broken down into children with euploid karyotype and trisomy 21, these values become very different, 44 and 81% respectively.

Pilot trial using mass field-releases of sterile males produced with the incompatible and sterile insect techniques as part of integrated Aedes aegypti control in Mexico.

BACKGROUND: The combination of Wolbachia-based incompatible insect technique (IIT) and radiation-based sterile insect technique (SIT) can be used for population suppression of Aedes aegypti. Our main objective was to evaluate whether open-field mass-releases of wAlbB-infected Ae. aegypti males, as part of an Integrated Vector Management (IVM) plan led by the Mexican Ministry of Health, could suppress natural populations of Ae. aegypti in urbanized settings in south Mexico. METHODOLOGY/PRINCIPAL FINDINGS: We implemented a controlled before-and-after quasi-experimental study in two suburban localities of Yucatan (Mexico): San Pedro Chimay (SPC), which received IIT-SIT, and San Antonio Tahdzibichén used as control. Release of wAlbB Ae. aegypti males at SPC extended for 6 months (July-December 2019), covering the period of higher Ae. aegypti abundance. Entomological indicators included egg hatching rates and outdoor/indoor adult females collected at the release and control sites. Approximately 1,270,000 lab-produced wAlbB-infected Ae. aegypti males were released in the 50-ha treatment area (2,000 wAlbB Ae. aegypti males per hectare twice a week in two different release days, totaling 200,000 male mosquitoes per week). The efficacy of IIT-SIT in suppressing indoor female Ae. aegypti density (quantified from a generalized linear mixed model showing a statistically significant reduction in treatment versus control areas) was 90.9% a month after initiation of the suppression phase, 47.7% two months after (when number of released males was reduced in 50% to match local abundance), 61.4% four months after (when initial number of released males was re-established), 88.4% five months after and 89.4% at six months after the initiation of the suppression phase. A proportional, but lower, reduction in outdoor female Ae. aegypti was also quantified (range, 50.0-75.2% suppression). CONCLUSIONS/SIGNIFICANCE: Our study, the first open-field pilot implementation of Wolbachia IIT-SIT in Mexico and Latin-America, confirms that inundative male releases can significantly reduce natural populations of Ae. aegypti. More importantly, we present successful pilot results of the integration of Wolbachia IIT-SIT within a IVM plan implemented by Ministry of Health personnel.

A Novel Framework for Generating Personalized Network Datasets for NIDS Based on Traffic Aggregation.

In this paper, we addressed the problem of dataset scarcity for the task of network intrusion detection. Our main contribution was to develop a framework that provides a complete process for generating network traffic datasets based on the aggregation of real network traces. In addition, we proposed a set of tools for attribute extraction and labeling of traffic sessions. A new dataset with botnet network traffic was generated by the framework to assess our proposed method with machine learning algorithms suitable for unbalanced data. The performance of the classifiers was evaluated in terms of macro-averages of F1-score (0.97) and the Matthews Correlation Coefficient (0.94), showing a good overall performance average.

El día después: comportamientos de riesgo y protección ante el COVID-19 durante los comienzos de la cuarentena / The day after: risk and protection behaviours towards COVID-19 during the early quarantine

La declaración de la pandemia (Organización Mundial de la Salud, OMS, 2020) causada por el COVID-19 ha generado, a nivel global y en tiempo récord, investigaciones y publicaciones de evidencias preliminares. En este contexto, dentro de un diseño exploratorio, correlacional y comparativo, de corte transversal, se indaga comportamientos de riesgo y de protección (resiliencia, autoeficacia y afrontamiento) ante el COVID 19, percibidos individual y colectivamente, por los encuestados durante y post cuarentena. Participaron 1.134 encuestados, 31.48% hombres y 68.52% mujeres, con edad promedio de 30.18 años, el 94.4% residentes de Paraguay. Se destaca el acatamiento de normas de bioseguridad por parte de los participantes en el distanciamiento físico (62,17%), lavado regular de manos (89,8%), uso de tapabocas (81,13%). Existe acuerdo en la efectividad de la cuarentena para frenar el contagio (92,86%), pero una baja percepción de la capacidad para manejar el estrés individual en aislamiento (m=1.88; ds= .83), baja recurrencia a profesionales de la salud por ayuda (m= .86; s= 1.02), y un bajo nivel de afrontamiento en comparación a los otros factores preventivos (m= 10.61; ds=3.25). Importante seguir esta línea de investigación para las fases de confinamiento en proceso.

The declaration of the pandemic (WHO, 2020) caused by COVID-19 has generated, at a global level and in record time, investigations and publications of preliminary evidence. In this context, risk and protective behaviours (resilience, self-efficacy and coping) were investigated, perceived individually and collectively, by respondents during and after lockdown within an exploratory, correlational, and comparative, crosssectional design. The survey considered 1,134 respondents, with 31.48% men and 68.52% women, the average age was 30.18 years, and 94.4% were Paraguay residents. The study highlights the observance of biosafety regulations by the participants in terms of physical distance (62.17%), regular handwashing (89.8%) and use of face masks (81.13%). There is agreement on the effectiveness of lockdown to stop contagion (92.86%), but a low perception of the ability to handle individual stress in isolation (m = 1.88; ds = .83), low recurrence to health professionals for help (m = .86; s = 1.02), and a low level of coping compared to the other preventive factors (m = 10.61; ds = 3.25). It is important to follow this investigation line for the current lockdown phases.

Utilidad del apósito liofilizado de piel de cerdo en el manejo de cicatrización de úlcera de pie diabético / Usefulness of lyophilized pig skin dressings in wound healing as treatment for diabetic foot ulcer

Resumen Objetivo: Mostrar la utilidad del apósito liofilizado de piel de cerdo comparado con el manejo conservador con sulfadiazina de plata en el proceso de cicatrización de la úlcera de pie diabético. Materiales y Método: Estudio cuasiexperimental en pacientes con diagnóstico de pie diabético, se establecieron 2 grupos de estudio utilizando una relación 2:1, el grupo de exposición (10 pacientes) tratado con apósito liofilizado de piel de cerdo y el grupo de control (5 pacientes) manejado con sulfadiazina de plata. La utilidad se midió con la cicatrización en semanas de tratamiento. El análisis estadístico incluyó prueba de t, prueba de z, regresión logística simple y cálculo de la probabilidad del evento. Resultados: El tiempo de cicatrización fue más corto en el grupo manejado con apósito liofilizado de piel de cerdo (10,20 semanas) que en el grupo con manejo a base de sulfadiazina de plata (13,8 semanas). A las 9 semanas de iniciado el tratamiento, la mitad de las pacientes con apósito de piel de cerdo ya habían cicatrizado comparado con la cicatrización en el grupo manejado con sulfadiazina de plata (20%). La probabilidad de cicatrización a las 11 semanas en paciente manejados con sulfadiazina de plata es 20% y con apósito liofilizado de piel de cerdo 80%. Conclusión: El apósito liofilizado de piel de cerdo tuvo mejores resultados en el estudio, comparado con el manejo estándar con sulfadiazina de plata. Es necesario realizar un estudio aleatorizado para determinar la efectividad de este material como herramienta terapéutica.

Aim: To demonstrate the usefulness of lyophilized pig skin dressings versus usual management with silver sulfadiazine in wound healing treatment for diabetic foot ulcers. Materials and Method: In this quasi-experimental study, we included patients diagnosed with diabetic foot. We established two groups with a distribution (2:1), the exposure group treated with lyophilized pig skin dressings (10 patients) and the control group (5 patients), the standard of care with silver sulfadiazine. Usefulness was measured with wound healing in treatment weeks. Statistical analysis included t-test, z-test, simple logistic regression, and calculation of probability of an event. Results: Wound healing time was shorter in the group treated with lyophilized pig skin dressing (10.20 weeks) than in the group treated with silver sulfadiazine (13.8 weeks). At 9 weeks after treatment started, 50% of patients treated with lyophilized pig skin dressings had complete wound healing compared with the patients in the group managed with silver sulfadiazine. (20%). The probability of wound healing been completed at 11 weeks in a patient managed with silver sulfadiazine is 20%, compared to lyophilized pig skin dressings is 80%. Conclusion: Lyophilized pig skin dressings had better outcomes than silver sulfadiazine in wound healing treatment for diabetic foot ulcers inside the study. Is mandatory develop another study with a randomized design to determinate the effectiveness as a therapeutic alternative.

Gastrointestinal hemorrhage as the first manifestation of metastatic choriocarcinoma in a male patient.

INTRODUCTION: Choriocarcinoma is a malignant tumor, it is more frequent in the female sex, rarely reported in the male sex. CLINICAL CASE: A 19-year-old male patient who was admitted with hematochezia and melenic evacuations, panendoscopy and colonoscopy were performed without documenting the bleeding site, exploratory laparotomy was performed finding tumor lesion in the jejunum, the histopathological examination reported Choriocarcinoma. CONCLUSIONS: Gastrointestinal bleeding as a presentation of choriocarcinoma is sometimes the only symptom that the patient presents. Metastatic choriocarcinoma to the gastrointestinal tract is rare, which makes the suspected diagnosis poor.

INTRODUCCIÓN: El coriocarcinoma es un tumor maligno, más frecuente en el sexo femenino, raramente reportado en el sexo masculino. CASO CLÍNICO: Varón de 19 años que ingresa con hematoquecia y evacuaciones melénicas. Se realiza panendoscopia y colonoscopia, sin documentar el sitio de sangrado. Se realiza laparotomía exploradora y se encuentra una lesión tumoral en el yeyuno, cuyo examen histopatológico reportó coriocarcinoma. CONCLUSIONES: La hemorragia de tubo digestivo como presentación de un coriocarcinoma es en ocasiones el único síntoma que muestra un paciente. El coriocarcinoma metastásico al tracto gastrointestinal es raro, lo que hace que la sospecha diagnóstica sea pobre.

Mental health problems among healthcare workers involved with the COVID-19 outbreak

Objective: The mental health problems and perceived needs of healthcare workers involved with coronavirus disease (COVID-19) may vary due to individual and contextual characteristics. The objective of this study was to evaluate healthcare workers' mental health problems during the common COVID-19 exposure scenario in Mexico, comparing those on the frontline with other healthcare workers according to gender and profession, determining the main risk factors for the most frequent mental health problems. Methods: A cross-sectional online study was conducted with a non-probabilistic sample of 5,938 Mexican healthcare workers who completed brief screening measures of mental health problems and ad hoc questions about sociodemographic professional characteristics, conditions related to increased risk of COVID-19 infection, life stressors during the COVID-19 emergency, and perceived need to cope with COVID-19. Results: The identified mental health problems were insomnia, depression, and posttraumatic stress disorder (PTSD), all of which were more frequent in frontline healthcare workers (52.1, 37.7, and 37.5%, respectively) and women (47.1, 33.0 %, and 16.3%, respectively). A lack of rest time was the main risk factor for insomnia (OR = 3.1, 95%CI 2.6-3.7, p ≤ 0.0001). Mourning the death of friends or loved ones due to COVID-19 was the main risk factor for depression (OR = 2.2, 95%CI 1.8-2.7, p ≤ 0.0001), and personal COVID-19 status was the main risk factor for PTSD (OR = 2.2, 95%CI 1.7-2.9, p ≤ 0.0001). Conclusion: The most frequent mental health problems during the common exposure scenario for COVID-19 in Mexico included the short-term psychological consequences of intense adversity. A comprehensive strategy for preventing mental health problems should focus on individuals with cumulative vulnerability and specific risk factors.

Protective effect of house screening against indoor Aedes aegypti in Mérida, Mexico: A cluster randomised controlled trial.

OBJECTIVE: To evaluate the protective effect of house screening (HS) on indoor Aedes aegypti infestation, abundance and arboviral infection in Merida, Mexico. METHODS: In 2019, we performed a cluster randomised controlled trial (6 control and 6 intervention areas: 100 households/area). Intervention clusters received permanently fixed fiberglass HS on all windows and doors. The study included two cross-sectional entomologic surveys, one baseline (dry season in May 2019) and one post-intervention (PI, rainy season between September and October 2019). The presence and number of indoor Aedes females and blood-fed females (indoor mosquito infestation) as well as arboviral infections with dengue (DENV) and Zika (ZIKV) viruses were evaluated in a subsample of 30 houses within each cluster. RESULTS: HS houses had significantly lower risk for having Aedes aegypti female mosquitoes (odds ratio [OR] = 0.56, 95% CI 0.33-0.97, p = 0.04) and blood-fed females (OR = 0.53, 95% CI 0.28-0.97, p = 0.04) than unscreened households from the control arm. Compared to control houses, HS houses had significantly lower indoor Ae. aegypti abundance (rate ratio [RR] = 0.50, 95% CI 0.30-0.83, p = 0.01), blood-fed Ae. aegypti females (RR = 0.48, 95% CI 0.27-0.85, p = 0.01) and female Ae. aegypti positive for arboviruses (OR = 0.29, 95% CI 0.10-0.86, p = 0.02). The estimated intervention efficacy in reducing Ae. aegypti arbovirus infection was 71%. CONCLUSIONS: These results provide evidence supporting the use of HS as an effective pesticide-free method to control house infestations with Aedes aegypti and reduce the transmission of Aedes-transmitted viruses such as DENV, chikungunya (CHIKV) and ZIKV.

Motives of Students for or against the Practice of Physical Exercise and How They Are Related with the Climate in Physical Education Classes.

The main aim of the study was to investigate the reasons that motivate secondary school pupils to practise physical exercise, and how these motives are related to their perception of the climate in physical education classes. Participants: The sample consisted of 448 subjects, 36.8% girls and 63.2% boys, aged between 16 and 19 years (M = 17.61; SD = 0.96). The methodology was a descriptive cross-sectional study. Two instruments were applied: self-reporting by the pupils of their motives for practising physical exercise, and a questionnaire on their attitudes towards teachers' behaviour and the physical education programme. The results showed that the strongest motive for the practice of physical exercise was "Prevention and positive health" (M = 5.29; SD = 1.45). In conclusion, there is a weak correlation among the pupils' motives for practising physical exercise and their perception of the climate in class.

Características morfofuncionales de una muestra de futbolistas profesionales chilenos de primera B según posición de juego / Morfofunctional Characteristics of a Sample From First B Chilean Professional Football Players According to Playing Position

Resumen Objetivo: analizar el perfil morfofuncional de futbolistas profesionales chilenos según su posición de juego. Método: el diseño del estudio fue no experimental, con un alcance descriptivo-correlacional. Se evaluaron 29 futbolistas profesionales de la primera B. Para determinar el porcentaje graso se midieron cuatro pliegues cutáneos y se aplicó la ecuación de Durnin y Womersley; para las variables físicas se aplicó el test de 1 repetición máxima de sentadillas y se utilizó el método de Brzycki para proyectar la fuerza máxima; en fuerza explosiva se ejecutó el Test de Bosco que evalúa el salto Squat Jump (SJ); para la resistencia aeróbica se utilizó el Yoyo test nivel 1 de recuperación, con toma de frecuencia cardiaca (FC) al final y en recuperación (1 minuto). Resultados: se observan solo diferencias significativas en la talla entre arqueros y volantes (F=4.491; p=0.012), esto implica, que la edad, peso y Σ4 pliegues no inciden en la posición de juego. Conclusiones: se observa que, en cada posición de juego, los jugadores presentan una configuración morfofuncional distinta, lo cual permite inferir que el trabajo debe ser diferenciado.

Abstract Objective: to analyze the morphofunctional profile of Chilean professional soccer players according to their playing position. Method: the study design was non-experimental, with a descriptive-correlational scope. Twenty-nine professional soccer players belonging to the Valdivia Sports Club of Chile were evaluated. Fat percentage was established by measuring four skin folds and applying the Durnin and Womersley equation. For the physical variables, the maximum squat repetition test was applied, and the Brzycki method was used to project the maximum force in one repetition. In explosive force, the Bosco Test was performed; this test evaluates the squat jump (SJ). The level 1 recovery Yoyo Test was used for the aerobic resistance, with heart rate (HR) measurement at the end and in recovery (1 minute). Results: Only significant differences in height are observed between goalkeepers and midfielders (F =4.491;p= 0.012); this implies that age, weight, and Σ4 folds do not affect in the playing position. Conclusions: it is observed that, in each game position, the players present a different morphofunctional configuration, which allows inferring that the work must be differentiated.

Resumo Objetivo: analisar o perfil morfofuncional de jogadores profissionais chilenos de futebol segundo sua posição de jogo. Método: o desenho do estudo foi não experimental, de escopo descritivo-correlacional. Foram avaliados 29 jogadores de futebol profissional do primeiro B. Para determinar o percentual de gordura, foram medidas quatro dobras cutâneas e aplicada a equação de Durnin e Womersley; Para as variáveis físicas foi aplicado o teste de 1 repetição máxima de agachamento e utilizado o método de Brzycki para projetar a força máxima; Na força explosiva, foi realizado o Teste de Bosco, que avalia o Salto de Agachamento (SJ); Para a resistência aeróbia, foi utilizado o teste de recuperação Yoyo nível 1, com frequência cardíaca (FC) medida no final e na recuperação (1 minuto). Resultados: foram observadas apenas diferenças significativas na altura entre goleiros e petecas (F = 4,491; p = 0,012), isso implica que idade, peso e Σ4 dobras não interferem na posição de jogo. Conclusões: observa-se que, em cada posição de jogo, os jogadores apresentam uma configuração morfofuncional diferente, o que permite inferir que o trabalho deve ser diferenciado.