Co-design of a Virtual Reality Cognitive Remediation Program for Depression (bWell-D) With Patient End Users and Clinicians: Qualitative Interview Study Among Patients and Clinicians.

BACKGROUND: Major depressive disorder (MDD) is the leading cause of global disability; however, the existing treatments do not always address cognitive dysfunction-a core feature of MDD. Immersive virtual reality (VR) has emerged as a promising modality to enhance the real-world effectiveness of cognitive remediation. OBJECTIVE: This study aimed to develop the first prototype VR cognitive remediation program for MDD ("bWell-D"). This study gathered qualitative data from end users early in the design process to enhance its efficacy and feasibility in clinical settings. METHODS: Semistructured end-user interviews were conducted remotely (n=15 patients and n=12 clinicians), assessing the participants' perceptions and goals for a VR cognitive remediation program. Video samples of bWell-D were also shared to obtain feedback regarding the program. The interviews were transcribed, coded, and analyzed via thematic analysis. RESULTS: End users showed an optimistic outlook toward VR as a treatment modality, and perceived it as a novel approach with the potential of having multiple applications. The participants expressed a need for an engaging VR treatment that included realistic and multisensorial settings and activities, as well as customizable features. Some skepticism regarding its effectiveness was also reported, especially when the real-world applications of the practiced skills were not made explicit, as well as some concerns regarding equipment accessibility. A home-based or hybrid (ie, home and clinic) treatment modality was preferred. CONCLUSIONS: Patients and clinicians considered bWell-D interesting, acceptable, and potentially feasible, and provided suggestions to enhance its real-world applicability. The inclusion of end-user feedback is encouraged when developing future VR programs for clinical purposes.

Disordered Glucose Levels Are Associated with Xanthine Oxidase Activity in Overweight Type 2 Diabetic Women.

Oxidative stress plays an important role in vascular complications observed in patients with obesity and Type 2 Diabetes (T2D). Xanthine oxidase (XO) breaks down purine nucleotides into uric acid and contributes to the production of reactive oxygen species (ROS). However, the relationship between XO activity and glucose homeostasis in T2D subjects with obesity is unclear. We hypothesized that disordered glucose levels are associated with serum XO activity in overweight women and men with T2D and without hyperuricemia. We studied serum XO activity in women and men with and without T2D. Our results show that serum XO activity was greater in T2D patients with body mass index (BMI) ≥ 25 kg/m2 than in those with BMI < 25 kg/m2 (p < 0.0001). Sex-based comparative analyses of overweight T2D patients showed that serum XO activity correlated with homeostasis model assessment of ß-cell function (HOMA-ß), fasting plasma glucose (FPG), and hemoglobin A1C in overweight T2D women but not in overweight T2D men. In addition, as compared to overweight T2D men, women had higher high-sensitivity C-reactive protein (hs-CRP) levels. However, overweight T2D men had higher XO activity and uric acid levels than women. Our results suggest that XO activity is higher in overweight T2D patients, especially in men, but is more sensitive to disordered glucose levels in overweight women with T2D.

Reduction in Serum Magnesium Levels and Renal Function Are Associated with Increased Mortality in Obese COVID-19 Patients.

Several studies provide evidence that obesity is a significant risk factor for adverse outcomes in coronavirus disease 2019 (COVID-19). Altered renal function and disturbances in magnesium levels have been reported to play important pathophysiological roles in COVID-19. However, the relationship between obesity, renal function, circulating magnesium levels, and mortality in patients with COVID-19 remains unclear. In this retrospective cohort study, we characterized 390 hospitalized patients with COVID-19 that were categorized according to their body mass index (BMI). Patients were clinically characterized and biochemical parameters, renal function, and electrolyte markers measured upon admission. We found that in patients who died, BMI was associated with reduced estimated glomerular filtration rate (eGFR, Rho: −0.251, p = 0.001) and serum magnesium levels (Rho: −0.308, p < 0.0001). Multiple linear regression analyses showed that death was significantly associated with obesity (p = 0.001). The Cox model for obese patients showed that magnesium levels were associated with increased risk of death (hazard ratio: 0.213, 95% confidence interval: 0.077 to 0.586, p = 0.003). Thus, reduced renal function and lower magnesium levels were associated with increased mortality in obese COVID-19 patients. These results suggest that assessment of kidney function, including magnesium levels, may assist in developing effective treatment strategies to reduce mortality among obese COVID-19 patients.

The effects of biological sex and cardiovascular disease on COVID-19 mortality.

Cardiovascular disease (CVD) is a common comorbidity observed in patients with coronavirus disease 2019 (COVID-19), which is associated with increased severity and mortality. However, the effects of biological sex on CVD-associated mortality in patients with COVID-19 are poorly established, particularly among Hispanic/Latin Americans. We examined the association of preexisting CVD with COVID-19 mortality in hospitalized Latin American men and women. This multicenter study included Mexican patients hospitalized with a positive diagnosis of COVID-19. The main outcome was in-hospital mortality. Multivariable regression analyses were used to calculate the adjusted odds ratio with 95% confidence interval for mortality in women and men. Of 81,400 patients with a positive diagnosis for SARS-CoV-2 infection, 28,929 (35.54%) hospitalized patients were evaluated. Of these, 35.41% (10,243) were women. In-hospital death was higher in men than in women. In relation to CVD between the sexes, women had a higher incidence of CVD than men (4.69 vs. 3.93%, P = 0.0023). The adjusted logistic regression analyses showed that CVD was significantly associated with COVID-19 mortality in women but not men. We then stratified by sex according to age <52 and ≥52 yr old. Similar significant association was also found in prespecified analysis in women ≥52 yr old but not in men of similar age. We conclude that CVD's effect on mortality among patients hospitalized with COVID-19 is dependent on biological sex and age in this Latin American cohort. These results suggest that therapeutic strategies for Latin American women with CVD and COVID-19 should include particular attention to their cardiovascular health.NEW & NOTEWORTHY CVD's effect on COVID-19 mortality is dependent on biological sex and age. CVD in women but not men with COVID-19 is associated with significantly unfavorable outcomes.

Do patients' mood and gender affect the way we deliver CBT? An experimental, vignette-based study of the relevance of patient and clinician characteristics.

BACKGROUND AND OBJECTIVES: Clinicians often fail to deliver the best psychological treatments available, especially if they perceive their patients as fragile or vulnerable. This fragility might be interpreted by clinicians through their internalised gender stereotypes (e.g. female patients are less resilient to a demanding treatment) or according to their patients' emotional state (e.g. the patient is too delicate to endure the most stress-inducing aspects of therapy). The aim of this study was to test experimentally whether patients' characteristics influenced therapy delivery. Some clinician characteristics were also considered. METHODS: This was an experimental, vignette-based study that evaluated clinicians' likelihood of utilizing several techniques commonly used in CBT by manipulating patients' mood and gender. Clinicians' personality traits were also included as covariates. RESULTS: Anxious patients were the most likely to receive the techniques, especially exposure and other behavioural techniques. Therapists delivered more techniques to male patients, while angry and calm female patients were the least likely to receive the techniques. Therapists were more likely to deliver talking techniques to female patients. Clinicians' firmness and empathy had an effect on CBT delivery. LIMITATIONS: Future vignette-based studies should validate and pilot the vignettes. Technique clustering should also be based in factor analysis or similar methods. Direct observational methods might be more reliable than self-report. CONCLUSION: The findings suggest that clinicians treat their patients differently, either consciously or inadvertently. These differences are likely to be related to clinicians' own concerns and gender stereotypes about their patients.

Renal function, serum magnesium levels and mortality in COVID-19 patients with type 2 diabetes.

Patients with type 2 diabetes (T2D) and Latin American subjects in particular are at an increased risk of developing severe COVID-19 and mortality. Altered renal function and lower magnesium levels have been reported to play important roles in the pathophysiology of T2D. The aim of the study was to investigate the relationship between renal function, serum magnesium levels and mortality in T2D patients with COVID-19. In this retrospective study, we characterized 118 T2D and non-diabetic subjects hospitalized with COVID-19. Patients were clinically characterized and electrolyte, renal function and inflammatory markers were evaluated. Patients were grouped according to their estimated glomerular filtration rate (eGFR <60 mL/min per 1.73 m2). T2D patients had lower eGFR and serum magnesium levels when compared to non-diabetics (59.7 ± 32.8 vs. 78.4 ± 33.8 mL/min per 1.73 m2, P = 0.008 and 1.9 ± 0.3 vs. 2.1 ± 0.3 mEq/L, P = 0.012). Survival was worse in T2D patients with eGFR levels less than 60 mL/min per 1.73 m2 as estimated by Kaplan-Meier analyses (log-rank test <0.0001). The Cox model for T2D patients showed that eGFR (HR 0.970, 95% CI 0.949 to 0.991, P = 0.005) and magnesium (HR 8.025, 95% CI 1.226 to 52.512, P = 0.030) were associated with significantly increased risk of death. Reduced eGFR and magnesium levels were associated with increased mortality in our population. These results suggest that early assessment of kidney function, including magnesium levels, may assist in developing effective treatment strategies to reduce morbidity and mortality among Latin American COVID-19 patients with T2D.

Are we on the same page? A comparison of patients' and clinicians' opinions about the importance of CBT techniques.

Clinicians often omit or underuse several techniques while delivering therapy. These omissions can be due to unconscious factors (e.g., clinician's anxiety), or due to clinicians' deliberate decisions (e.g., modifying therapy believing that such modifications are on the patients' best interests). However, little is known about whether patients consider these modifications necessary. The main aim of this study was to explore the opinions about the important aspects of CBT according to both patients' and clinicians' perspectives. It also aimed to determine whether clinicians' anxiety influenced such preferences. To achieve these aims, two groups of participants were approached-CBT clinicians (n = 83) and CBT patients (n = 167). An online survey with a list of techniques commonly used in CBT was developed for each group, who indicated the importance they attributed to the techniques. Additionally, clinicians completed an anxiety measure. Results indicated that clinicians valued all "change-oriented" techniques and several "interpersonal engagement" techniques more than the patients. The only technique preferred by patients was "relaxation". Higher levels of clinician anxiety were associated with a lower preference for "behavioural experiments" and "exposure". In conclusion, clinicians are encouraged to plan therapy in collaboration with the patient, as well as to discuss the rationale for the implemented techniques.

Relación entre la eco-intensidad y el espesor muscular del cuádriceps con la potencia de salto vertical en niños escolares: una prueba piloto / Relationship between the eco-intensity and the muscular thickness of the quadriceps with the power of vertical jump in school children: a pilot study

OBJETIVO: Correlacionar la ecointensidad, el espesor muscular del recto femoral y el vasto intermedio (EVI) con la potencia del salto vertical y el porcentaje de fibras rápidas en niños en edad escolar. MÉTODO: Se evaluaron 47 niños entre 6 y 10 años. La ecointensidad y el espesor del muslo anterior (recto femoral y vasto intermedio) fueron medidos usando una ecografía en modo-B. La potencia del salto vertical y el porcentaje de fibras rápidas fueron medidos por el salto vertical con contramovimiento y saltos continuos durante 15 segundos. RESULTADOS: La potencia del salto vertical tipo salto vertical con contramovimiento y el espesor del vasto intermedio longitudinal y transversal presentaron una moderada correlación (0.3644 y 0.3694, V.p.< 0.05). La prueba de X² de independencia (v.p. Fisher= 0.0236) muestra asociación entre la potencia del salto vertical con contramovimiento y el espesor del vasto intermedio longitudinal y transversal. El porcentaje de fibras rápidas y la diferencia entre la ecointensidad grasa menos la ecointensidad del recto femoral sumada a la del vasto intermedio indican una moderada correlación (0.3555, V.p. 0.0142). La prueba de X² de independencia (v.p. Fisher = 0.07003) no muestra asociación entre el porcentaje de fibras rápidas y la diferencia entre la ecointensidad grasa menos la ecointensidad del recto femoral sumada a la del vasto intermedio. CONCLUSIÓN: La evaluación ecográfica del músculo cuádriceps (específicamente recto femoral y vasto intermedio) puede ser una herramienta útil para evaluar el desempeño físico anaeróbico en niños escolares sanos

OBJECTIVE: To correlate the echo-intensity, the muscular thickness of the rectus femoris (ERF) and the vast intermediate with the power of the vertical jump and the percentage of fast fibers in children of school age. METHOD: 47 children between 6 and 10 years of age were evaluated. The echo-intensity and thickness of the anterior thigh (rectus femoris and vastus intermedius) was measured using a B-mode ultrasound. The power of the vertical jump and the percentage of fast fibers were measured by the vertical jump with counter-movement and repeat jumps for 15 seconds. RESULTS: The power of the vertical jump with counter-movement and the thickness of the vast intermediate longitudinal echo-intensity and transversal showed a moderate correlation (0.3644 and 0.3694, V.p. <0.05). The X² independence test (v.p. Fisher = 0.0236) shows association between the power of the vertical jump with counter-movement and the vast intermediate longitudinal echo-intensity and transversal. The percentage of fast fibers and the difference between the echo-intensity fat minus the echo-intensity of the rectus femoris added to echo-intensity of the vast intermediate indicate a moderate correlation (0.3555, V.p. 0.0142). The X² independence test (v.p. Fisher = 0.07003) shows no association between percentage of fast fibers and the difference between the echo-intensity fat minus the echo-intensity of the rectus femoris added to echo-intensity of the vast intermediate. CONCLUSIONS: Ultrasound evaluation of the quadriceps muscle (specifically rectus femoris and vastus intermedius) can be a useful tool for evaluating anaerobic physical performance in healthy school children

Atherogenic index of plasma as a marker of cardiovascular risk factors in Mexicans aged 18 to 22 years.

The aim of this cross-sectional study was to evaluate the use and application of the atherogenic index of plasma (AIP) in the prediction of cardiovascular risk factors including mixed hyperlipidemia, hypertension, hyperuricemia, and metabolic syndrome in a population of young Mexican adults. Values were obtained for metabolic parameters, such as glucose, triglycerides, cholesterol (total, high-density, low-density, and very low density), systolic and diastolic blood pressure, and uric acid. Through univariate and multivariate analysis, parametric comparisons were applied and receiver operating characteristic curves were plotted. Logistic regression analysis was used to assess the risk of hyperuricemia, hypertension, mixed hyperlipidemia, and metabolic syndrome from a high AIP. Metabolic parameters and AIP had a significant correlation, with higher rates observed with increased AIP. As a set, metabolic parameters increased with an AIP >0.21 (λ Wilks = 0.58, F(14,344) = 7.7, P < 0.0001). The area under the curve was statistically significant for prediction of hyperuricemia (0.6), mixed hyperlipidemia (0.9), hypertension (0.8), and metabolic syndrome (0.95). In conclusion, in a sample of young Mexican adults, AIP was strongly associated with cardiovascular risk factors and could serve as a useful marker for the prediction of metabolic alterations related to cardiovascular disease.

Relación de la hiperuricemia con las alteraciones metabólicas y factores de riesgo cardiovascular en jóvenes mexicanos.

INTRODUCTION: Hyperuricemia is a risk factor for cardiovascular disease, but its impact has not been properly documented. OBJECTIVE: To assess the impact of hyperuricemia on metabolic parameters and cardiovascular risk factors (CRF) in apparently healthy Mexicans. METHOD: Cross-sectional study of 768 young adults. Association of hyperuricemia with alterations in metabolic parameters and CRF (hypertension, mixed dyslipidemia, metabolic syndrome) was sought. Log-linear and regression models were used to determine the influence of hyperuricemia. A multivariate analysis of variance was applied to observe the interaction of hyperuricemia and overweight or obesity with changes in metabolic parameters. RESULTS: Metabolic parameters were higher in patients with hyperuricemia than with normal uric acid (all < 0.05). Hyperuricemia was significantly associated with hypertension (OR=6.8, 95 % CI: 1.1-46), dyslipidemia (OR=2.5, 95% CI: 1.3-4.7) and metabolic syndrome (OR=2.3, 95% CI: 1.1-4.6). Hyperuricemia and overweight or obesity significantly predict changes in cardiovascular risk metabolic parameters (Wilks' l=0.91, F (6.175)=3.1, p=0.007). CONCLUSIONS: Hyperuricemia is significantly associated with metabolic alterations and different CRF.

INTRODUCCIÓN: La hiperuricemia es un factor de riesgo para enfermedad cardiovascular, pero su impacto no ha sido bien documentado. OBJETIVO: Evaluar el impacto de la hiperuricemia en los parámetros metabólicos y los factores de riesgo cardiovascular en mexicanos aparentemente sanos. MÉTODO: Estudio trasversal de 768 adultos jóvenes. Se buscó asociación de la hiperuricemia con alteraciones de los parámetros metabólicos y factores de riesgo cardiovascular (hipertensión, dislipidemia mixta y síndrome metabólico). Se aplicaron modelos loglineales y de regresión para determinar la influencia de la hiperuricemia. Se aplicó análisis multivariado de varianza para observar la interacción de la hiperuricemia y el sobrepeso u obesidad en los cambios de los parámetros metabólicos. RESULTADOS: Los parámetros metabólicos fueron mayores en los individuos con hiperuricemia que con ácido úrico normal (< 0.05). La hiperuricemia se asoció significativamente con hipertensión (RM = 6.8, IC 95 % = 1.1-46), dislipidemia (RM = 2.5, IC 95 % = 1.3-4.7) y síndrome metabólico (RM = 2.3, IC 95 % = 1.1-4.6). La hiperuricemia y el sobrepeso u obesidad predicen significativamente los cambios en los parámetros metabólicos de riesgo cardiovascular (l de Wilks = 0.91, F [6.175] = 3.1, p = 0.007). CONCLUSIONES: La hiperuricemia está asociada significativamente con las alteraciones metabólicas y los distintos factores de riesgo cardiovascular.

Relación de la hiperuricemia con las alteraciones metabólicas y factores de riesgo cardiovascular en jóvenes mexicanos / Relationship of hyperuricemia with metabolic alterations and cardiovascular risk factors in young Mexicans

Resumen Introducción: La hiperuricemia es un factor de riesgo para enfermedad cardiovascular, pero su impacto no ha sido bien documentado. Objetivo: Evaluar el impacto de la hiperuricemia en los parámetros metabólicos y los factores de riesgo cardiovascular en mexicanos aparentemente sanos. Método: Estudio trasversal de 768 adultos jóvenes. Se buscó asociación de la hiperuricemia con alteraciones de los parámetros metabólicos y factores de riesgo cardiovascular (hipertensión, dislipidemia mixta y síndrome metabólico). Se aplicaron modelos loglineales y de regresión para determinar la influencia de la hiperuricemia. Se aplicó análisis multivariado de varianza para observar la interacción de la hiperuricemia y el sobrepeso u obesidad en los cambios de los parámetros metabólicos. Resultados: Los parámetros metabólicos fueron mayores en los individuos con hiperuricemia que con ácido úrico normal (< 0.05). La hiperuricemia se asoció significativamente con hipertensión (RM = 6.8, IC 95 % = 1.1-46), dislipidemia (RM = 2.5, IC 95 % = 1.3-4.7) y síndrome metabólico (RM = 2.3, IC 95 % = 1.1-4.6). La hiperuricemia y el sobrepeso u obesidad predicen significativamente los cambios en los parámetros metabólicos de riesgo cardiovascular (l de Wilks = 0.91, F [6.175] = 3.1, p = 0.007). Conclusiones: La hiperuricemia está asociada significativamente con las alteraciones metabólicas y los distintos factores de riesgo cardiovascular.

Abstract Introduction: Hyperuricemia is a risk factor for cardiovascular disease, but its impact has not been properly documented. Objective: To assess the impact of hyperuricemia on metabolic parameters and cardiovascular risk factors (CRF) in apparently healthy Mexicans. Method: Cross-sectional study of 768 young adults. Association of hyperuricemia with alterations in metabolic parameters and CRF (hypertension, mixed dyslipidemia, metabolic syndrome) was sought. Log-linear and regression models were used to determine the influence of hyperuricemia. A multivariate analysis of variance was applied to observe the interaction of hyperuricemia and overweight or obesity with changes in metabolic parameters. Results: Metabolic parameters were higher in patients with hyperuricemia than with normal uric acid (all < 0.05). Hyperuricemia was significantly associated with hypertension (OR=6.8, 95 % CI: 1.1-46), dyslipidemia (OR=2.5, 95% CI: 1.3-4.7) and metabolic syndrome (OR=2.3, 95% CI: 1.1-4.6). Hyperuricemia and overweight or obesity significantly predict changes in cardiovascular risk metabolic parameters (Wilks’ l=0.91, F (6.175)=3.1, p=0.007). Conclusions: Hyperuricemia is significantly associated with metabolic alterations and different CRF.

Therapists' self-reported drift from dialectical behavior therapy techniques for eating disorders.

OBJECTIVE: Research has shown that clinicians underuse or omit techniques that constitute an essential part of evidence-based therapies. However, it is not known whether this is the case in DBT for eating disorders. The aims of this study were; 1) exploring the extent to which DBT techniques were used by self-identified DBT clinicians treating eating disorders; 2) determining whether therapists fell into distinct groups, based on their usage of DBT techniques; and 3) examining whether clinician characteristics were related to the use of such techniques. METHOD: Seventy-three clinicians offering DBT for eating disorders completed an online survey about their use of specific DBT techniques. They also completed measures of personality and intolerance of uncertainty. RESULTS: In relation to the first aim, the pattern of use of DBT techniques showed a bimodal distribution - most were used either a lot or a little. Considering the second aim, clinicians fell into two groups according to the techniques that they delivered - one characterized by a higher use of DBT techniques and the other by a higher use of techniques that were specific to the treatment of eating disorders, rather than DBT methods. Finally, more experienced clinicians were more likely to be in the 'DBT technique-focused' group. DISCUSSION: DBT clinicians are encouraged to implement both sets of techniques (DBT techniques and standard techniques for the treatment of eating disorders) in an integrated way. Training, supervision and the use of manuals are recommended to decrease therapist drift in DBT.

Validation of the Questionnaire "Stage of Change in Behavior of Scholars in Eating Habits and Physical Activity" (CEHAF) / Validación del cuestionario "Etapa de cambio del comportamiento de los escolares en hábitos alimentarios y actividad física" (CEHAF)

Abstract To validate the questionnaire "Stage of Change in Behavior of Scholars in Eating Habits and Physical Activity" (CEHAF). It is based on the Transtheoretical Model, and it intends to be a useful tool for developing strategies against childhood obesity. It measures knowledge, attitudes, and habits towards nutrition and physical activity. Observational, cross-sectional, randomized, and multi-center study in a sample of 1671 Mexican school-age children, from 8 to 12 years old, both genders. The CEHAF questionnaire is self-administered and consists of 35 questions, including 18 multiple choices, on habits and attitudes towards alimentation and physical activity. Reliability analysis through Cronbach's alpha resulted in an alpha coefficient of 0.845. The exploratory factor analysis revealed three theoretically-congruent factors. The final version of the CEHAF questionnaire was conformed of 14 items. The psychometric characteristics of the CEHAF questionnaire indicate that it is a valid and reliable tool for assessing the stage of change in school-age population.

Resumen Validar el cuestionario "Etapa de cambio del comportamiento de escolares en hábitos alimentarios y actividad física" (CEHAF), el cual está basado en el modelo transteórico, y pretende ser una herramienta útil para desarrollar estrategias para combatir la obesidad infantil. Dicha herramienta mide conocimientos, actitudes y hábitos sobre nutrición y actividad física. Estudio observacional, transversal y aleatorizado en una muestra de 1671 estudiantes mexicanos, de 8 a 12 años de edad, ambos sexos. El cuestionario CEHAF es auto-administrado y se conforma por 35 preguntas, incluyendo 18 de opción multiple, sobre hábitos de alimentación y actividad física. Resultados: El análisis de confiabilidad mediante alfa de Cronbach resultó en un coeficiente alfa de 0.845. El análisis factorial exploratorio reveló tres factores teóricamente congruentes. La versión final del cuestionario CEHAF estuvo compuesta de 14 items. Las características psicométricas del cuestionario CEHAF lo vuelven una herramienta válida y confiable para evaluar la etapa de cambio en estudiantes de escuela primaria.

Índice cintura-talla: prueba para valoración de riesgo cardiovascular y diagnóstico del síndrome metabólico / Waist-Length Index: Test for Cardiovascular Risk Assessment and Diagnosis of Metabolic Syndrome

Introducción: la presencia de síndrome metabólico y enfermedad cardiovascular está vinculada fisiopatológicamente con el sobrepeso y obesidad. Objetivo: evaluar la utilidad y precisión del Índice cintura-talla en la valoración de riesgo y diagnóstico del síndrome metabólico y otras alteraciones cardiometabólicas. Métodos: se evaluaron a adultos jóvenes aparentemente sanos para su implementación como una prueba diagnóstica o tamiz diagnóstico de rutina en los niveles primarios de atención en salud. Se realizó un estudio transversal con una muestra de 369 adultos jóvenes con edad de 18-22 años del primer año de la licenciatura de medicina en la Benemérita Universidad Autónoma de Puebla. Se determinaron parámetros bioquímicos y antropométricos para la presencia de síndrome metabólico y otras alteraciones cardiovasculares, se calculó el Índice cintura-talla y se generaron cuartiles para proponer un punto de corte con el cual se pueda valorar el riesgo y la utilidad diagnóstica. Resultados: el Índice cintura-talla mostró ser una prueba diagnóstica bastante sensible (91 por ciento, 70 por ciento y 52 por ciento) y específica (78 por ciento, 78 por ciento, 76 por ciento) en la detección de síndrome metabólico, alteraciones cardiovasculares y aterogénicas respectivamente. Los valores predictivos muestran la probabilidad del 81 por ciento de tener síndrome metabólico si el individuo cuenta con un Índice cintura-talla elevado y una probabilidad 90 por ciento de no tener síndrome metabólico si el Índice cintura-talla es normal. Conclusiones: la precisión diagnóstica del Índice cintura-talla es muy elevada, por lo que puede usarse como un tamiz diagnóstico de síndrome metabólico o de alteraciones metabólicas en adultos jóvenes aparentemente sanos(AU)

Introduction: The presence of metabolic syndrome (MS) and cadiovascular disease (CVD) is physiopathologically linked to overweight and obesity. Objective: Evaluate the usefulness and accuracy of the waist-length index (CTI) in the assessment of risk and diagnosis of the metabolic syndrome and other cardiometabolic disorders. Methods: Apparently healthy young adults were evaluated for their implementation as a diagnostic test or screening routine at the primary levels of health care. A cross-sectional study was conducted with a sample of 369 young adults aged 18-22 years of the first year of the medical degree at the Benemérita Autonomous University of Puebla (BUAP). Biochemical and anthropometric parameters were determined for the presence of metabolic syndrome and other cardiovascular alterations, the waist-height index was calculated and quartiles were generated to propose a cut-off point with which the risk and diagnostic utility could be assessed. Results: The waist-height index showed to be a very sensitive (91 percent, 70 percent and 52 percent) and specific (78 percent, 76 percent) diagnostic test in the detection of metabolic syndrome, cardiovascular and atherogenic alterations, respectively. The predictive values showed 81 percent probability of having metabolic syndrome if the subject has a high waist-height index and 90 percent chance of not having metabolic syndrome if the waist-height index is normal. Conclusions: The diagnostic accuracy of the waist-length index is very high, so it can be used as a diagnostic screen for metabolic syndrome or metabolic alterations in apparently healthy young adults(AU)

Índice cintura-talla: prueba para valoración de riesgo cardiovascular y diagnóstico del síndrome metabólico / Waist-Length Index: Test for Cardiovascular Risk Assessment and Diagnosis of Metabolic Syndrome

Introducción: la presencia de síndrome metabólico y enfermedad cardiovascular está vinculada fisiopatológicamente con el sobrepeso y obesidad. Objetivo: evaluar la utilidad y precisión del Índice cintura-talla en la valoración de riesgo y diagnóstico del síndrome metabólico y otras alteraciones cardiometabólicas. Métodos: se evaluaron a adultos jóvenes aparentemente sanos para su implementación como una prueba diagnóstica o tamiz diagnóstico de rutina en los niveles primarios de atención en salud. Se realizó un estudio transversal con una muestra de 369 adultos jóvenes con edad de 18-22 años del primer año de la licenciatura de medicina en la Benemérita Universidad Autónoma de Puebla. Se determinaron parámetros bioquímicos y antropométricos para la presencia de síndrome metabólico y otras alteraciones cardiovasculares, se calculó el Índice cintura-talla y se generaron cuartiles para proponer un punto de corte con el cual se pueda valorar el riesgo y la utilidad diagnóstica. Resultados: el Índice cintura-talla mostró ser una prueba diagnóstica bastante sensible (91 por ciento, 70 por ciento y 52 por ciento) y específica (78 por ciento, 78 por ciento, 76 por ciento) en la detección de síndrome metabólico, alteraciones cardiovasculares y aterogénicas respectivamente. Los valores predictivos muestran la probabilidad del 81 por ciento de tener síndrome metabólico si el individuo cuenta con un Índice cintura-talla elevado y una probabilidad 90 por ciento de no tener síndrome metabólico si el Índice cintura-talla es normal. Conclusiones: la precisión diagnóstica del Índice cintura-talla es muy elevada, por lo que puede usarse como un tamiz diagnóstico de síndrome metabólico o de alteraciones metabólicas en adultos jóvenes aparentemente sanos(AU)

Introduction: The presence of metabolic syndrome (MS) and cadiovascular disease (CVD) is physiopathologically linked to overweight and obesity. Objective: Evaluate the usefulness and accuracy of the waist-length index (CTI) in the assessment of risk and diagnosis of the metabolic syndrome and other cardiometabolic disorders. Methods: Apparently healthy young adults were evaluated for their implementation as a diagnostic test or screening routine at the primary levels of health care. A cross-sectional study was conducted with a sample of 369 young adults aged 18-22 years of the first year of the medical degree at the Benemérita Autonomous University of Puebla (BUAP). Biochemical and anthropometric parameters were determined for the presence of metabolic syndrome and other cardiovascular alterations, the waist-height index was calculated and quartiles were generated to propose a cut-off point with which the risk and diagnostic utility could be assessed. Results: The waist-height index showed to be a very sensitive (91 percent, 70 percent and 52 percent) and specific (78 percent, 76 percent) diagnostic test in the detection of metabolic syndrome, cardiovascular and atherogenic alterations, respectively. The predictive values showed 81 percent probability of having metabolic syndrome if the subject has a high waist-height index and 90 percent chance of not having metabolic syndrome if the waist-height index is normal. Conclusions: The diagnostic accuracy of the waist-length index is very high, so it can be used as a diagnostic screen for metabolic syndrome or metabolic alterations in apparently healthy young adults(AU)

Tailoring Copolymer Properties by Gradual Changes in the Distribution of the Chains Composition Using Semicontinuous Emulsion Polymerization.

To design the properties of a copolymer using free radical polymerization, a semicontinuous process can be applied to vary the instantaneous copolymer composition along the conversion searching for a specific composition spectrum of copolymer chains, which can be termed as weight composition distribution (WCD) of copolymer chains. Here, the styrene-n-butyl acrylate (S/BA) system was polymerized by means of a semicontinuous emulsion process, varying the composition of the comonomer feed to obtain forced composition copolymers (FCCs). Five different feeding profiles were used, searching for a scheme to obtain chains rich in S (looking for considerable modulus), and chains rich in BA (looking for large deformation) as a technique to achieve synergy in copolymer properties; the mechanostatic and dynamic characterization discloses the correspondence between WCD and the bulk properties. ¹H-nuclear magnetic resonance (¹H-NMR) analysis enabled the determination of the cumulative copolymer composition characterization, required to estimate the WCD. The static test (stress-strain) and dynamic mechanical analysis (DMA) were performed following normed procedures. This is the first report that shows very diverse mechanostatic performances of copolymers obtained using the same chemical system and global comonomer composition, forming a comprehensive failure envelope, even though the tests were carried out at the same temperature and cross head speed. The principles for synergic performance can be applied to controlled radical copolymerization, designing the composition variation in individual molecules along the conversion.

Measurement of the Jungian Psychological Types in Mexican university students / Medición de los tipos psicológicos junguianos en estudiantes universitarios mexicanos

Abstract: The aim of this study was to measure the eight Psychological Types proposed by Carl G. Jung in Mexican population. A cross-sectional, multicenter, exploratory study was carried out, for which a psychometric instrument based on Jungian typology theory was developed. The Psychological Type Indicator (ITP, for its acronym in Spanish) consisted of 8 subscales (one per psychological type). It was administered to a sample of 1194 participants and validated by the methodological and statistical procedure developed by Reyes Lagunes and García y Barragán. The participants were Mexican university students, ranging from 17 to 40 years (median = 21, IQR = 4; 63% female). The internal consistency of the instrument was determined, obtaining an alpha coefficient of 0.873. An exploratory factor analysis indicated a structure of 10 factors, which together explained 32.672% of the variance. Four of the found factors were consistent with Jungian typology (Introverted Feeling, Introverted Thinking, Extraverted Sensing and Extraverted Feeling). The rest of the factors grouped attributes of this theory, which enable a new way of assessing personality in Mexican population with reference on this model of personality.

Resumen: El objetivo de este estudio fue medir los 8 tipos psicológicos propuestos por Carl G. Jung en población mexicana. Se llevó a cabo un estudio transversal, multicéntrico y exploratorio, en el cual se desarrolló un instrumento basado en la tipología junguiana. El Indicador de Tipos Psicológicos (ITP) se conformó por 8 subescalas (una por tipo psicológico). El instrumento fue administrado a una muestra de 1,194 estudiantes universitarios mexicanos provenientes de 3 estados distintos de la República Mexicana (Guanajuato, Jalisco y la Ciudad de México), y se validó por medio de la propuesta metodológico-estadística de Reyes Lagunes y García y Barragán. Los participantes fueron hombres y mujeres (37 y 63%, respectivamente) de entre 17 y 40 años de edad (mediana = 21, RIC = 4). Se determinó la consistencia interna del instrumento, obteniéndose un coeficiente alfa de 0.873. El análisis factorial exploratorio arrojó una estructura factorial compuesta por 10 factores, que en conjunto explicó el 32.672% de la varianza. De los 10 factores encontrados, 4 fueron consistentes con la tipología junguiana (sentimiento introvertido, pensamiento introvertido, sensación extravertida y sentimiento extravertido). El resto de los factores agruparon atributos de la teoría junguiana, los cuales permiten una nueva forma de evaluar la personalidad en México de forma válida y confiable, con referencia a este modelo de personalidad.

Validación en Ciudad de La Habana, Cuba, de ENZYMEBA, inmunoensayo para la detección de Entamoeba histolytica en heces / Validation in havana City, Cuba, of the ENZYMEBA, an immunoassay for deyecting Entamoeba histolytica in faeces

Parasitólogos de diferentes instituciones médicas de Ciudad de La Habana realizaron la validación externa de ENZYMEBA, procedimiento diagnóstico de amebiosis intestinal en el Instituto de Medicina Tropical "Pedro Kourí". Para ello fueron colectadas muestras seriadas de heces de 212 individuos sobre las que se realizó la observación microscópica (prueba de referencia) y el inmunoensayo ENZYMEBA (prueba en validación). ENZYMEBA, comparada con el examen microscópico de heces, mostró satisfactorios índices de sensibilidad y especificidad. No se observaron reacciones cruzadas con muestras de heces en que estaban presentes otros parásitos. Además, si se tiene en cuenta que para el diagnóstico de amebiosis intestinal con ENZYMEBA es suficiente una sola muestra de heces por paciente, este procedimiento pudiera ser útil en estudios de eficacia terapéutica y de prevalencia

Validación en Ciudad de La Habana, Cuba, de ENZYMEBA, inmunoensayo para la detección de Entamoeba histolytica en heces / Validation in havana City, Cuba, of the ENZYMEBA, an immunoassay for deyecting Entamoeba histolytica in faeces

Parasitólogos de diferentes instituciones médicas de Ciudad de La Habana realizaron la validación externa de ENZYMEBA, procedimiento diagnóstico de amebiosis intestinal en el Instituto de Medicina Tropical "Pedro Kourí". Para ello fueron colectadas muestras seriadas de heces de 212 individuos sobre las que se realizó la observación microscópica (prueba de referencia) y el inmunoensayo ENZYMEBA (prueba en validación). ENZYMEBA, comparada con el examen microscópico de heces, mostró satisfactorios índices de sensibilidad y especificidad. No se observaron reacciones cruzadas con muestras de heces en que estaban presentes otros parásitos. Además, si se tiene en cuenta que para el diagnóstico de amebiosis intestinal con ENZYMEBA es suficiente una sola muestra de heces por paciente, este procedimiento pudiera ser útil en estudios de eficacia terapéutica y de prevalencia (AU)