Not just fibrotic: endothelial-derived TGFß maintains contractile function and lymphatic muscle phenotype during homeostasis.

Cell-cell communication within the lymphatic vasculature during homeostasis is incompletely detailed. Although many discoveries highlight the pathological roles of transforming growth factor-beta (TGFß) in chronic vascular inflammation and associated fibrosis, only a small amount is known surrounding the role of TGFß-signaling in homeostatic lymphatic function. Here, we discovered that pharmacological blockade of TGFß receptor 1 (TGFßR1) negatively impacts rat mesenteric lymphatic vessel pumping, significantly reducing vessel contractility and surrounding lymphatic muscle coverage. We have identified mesenteric lymphatic endothelial cells themselves as a source of endogenous vascular TGFß and that TGFß production is significantly increased in these cells via activation of a number of functional pattern recognition receptors they express. We show that a continuous supply of TGFß is essential to maintain the contractile phenotype of neighboring lymphatic muscle cells and support this conclusion through in vitro analysis of primary isolated lymphatic muscle cells that undergo synthetic differentiation during 2-D cell culture, a phenomenon that could be effectively rescued by supplementation with recombinant TGFß. Finally, we demonstrate that lymphatic endothelial production of TGFß is regulated, in part, by nitric oxide in a manner we propose is essential to counteract the pathological over-production of TGFß. Taken together, these data highlight the essential role of homeostatic TGFß signaling in the maintenance of lymphatic vascular function and highlight possible deleterious consequences of its inhibition.NEW & NOTEWORTHY The growth factor TGFß is commonly associated with its pathological overproduction during tissue fibrosis rather than its homeostatic functions. We expose the lymphatic endothelium as a source of endogenous TGFß, the impact of its production on the maintenance of surrounding lymphatic muscle cell phenotype, and internally regulated mechanisms of its production. Overall, these results highlight the intricate balance of TGFß-signaling as an essential component of maintaining lymphatic contractile function.

Estrategia de formación doctoral en la Universidad de Ciencias Médicas de Cienfuegos: experiencias y resultados a cinco años de su implementación

El proceso de formación y superación permanente o continuada de los profesionales de la salud, exige de las universidades de ciencias médicas cubanas, la búsqueda de alternativas creativas para la formación de sus profesionales como doctores en ciencias. Para dar respuesta a esta exigencia la Universidad de Ciencias Médicas de Cienfuegos, desde el año 2017, elaboró una estrategia de formación doctoral para compulsar la formación de los profesionales del área de la salud en todos sus niveles y así contribuir a la formación de doctores en ciencias para el sistema de salud provincial de Cienfuegos. Dicha estrategia ha sido perfeccionada con las experiencias obtenidas en el desarrollo de la misma hasta la actualidad. En el presente artículo los autores reflexionan sobre los resultados obtenidos en la estrategia de formación doctoral de la Universidad de Ciencias Médicas de Cienfuegos sobre la base de las exigencias que tiene la Comisión Nacional de Grados Científicos de la República de Cuba en los momentos actuales y las orientaciones de los centros autorizados de las instituciones de la Educación Superior y del Sistema de Salud Pública, con que se tiene convenios de colaboración científica para este fin.

The health professionals' permanent or continuous training and improvement process, requires that medical sciences cuban universities search for creative alternatives to train their professionals as science doctors. In response to this requirement, the Cienfuegos University of Medical Sciences, since 2017, developed a doctoral training strategy to validate the health professionals' training at all levels and thus contribute to the doctors in sciences training for the Cienfuegos provincial health system. This strategy has been perfected with the experiences obtained in its development up to the present. In this article the authors reflect on the results obtained in the doctoral training strategy of the Cienfuegos University of Medical Sciences based on the requirements of the Cuba's Scientific Degrees National Commission at present and the Higher Education and the Public Health System guidelines of the authorized centers, with which there are scientific collaboration agreements for this purpose.

Prenatal Exome Sequencing Analysis in Fetuses with Various Ultrasound Findings.

OBJECTIVES: To evaluate the use of Exome Sequencing (ES) for the detection of genome-wide Copy Number Variants (CNVs) and the frequency of SNVs-InDels in selected genes related to developmental disorders in a cohort of consecutive pregnancies undergoing invasive diagnostic procedures for minor or simple ultrasound findings with no indication of ES. METHODS: Women undergoing invasive diagnostic testing (chorionic villus sampling or amniocentesis) for QF-PCR and chromosomal microarray analysis (CMA) due to prenatal ultrasound findings without an indication for ES were selected over a five-month period (May-September 2021). ES was performed to compare the efficiency of genome-wide CNV detection against CMA analysis and to detect monogenic disorders. Virtual gene panels were selected to target genes related to ultrasound findings and bioinformatic analysis was performed, prioritizing variants based on the corresponding HPO terms. The broad Fetal Gene panel for developmental disorders developed by the PAGE group was also included in the analysis. RESULTS: A total of 59 out of 61 women consented to participate in this study. There were 36 isolated major fetal anomalies, 11 aneuploidy markers, 6 minor fetal anomalies, 4 multiple anomalies, and 2 other ultrasound signs. Following QF-PCR analysis, two uncultured samples were excluded from this study, and six (10%) common chromosome aneuploidies were detected. In the remaining 51 cases, no pathogenic CNVs were detected at CMA, nor were any pathogenic variants observed in gene panels only targeting the ultrasound indications. Two (3.9%) monogenic diseases, apparently unrelated to the fetal phenotype, were detected: blepharo-cheilo-odontic syndrome (spina bifida) and Duchenne muscular dystrophy (pyelocaliceal dilation). CONCLUSIONS: In our series of pregnancies with ultrasound findings, common aneuploidies were the only chromosomal abnormalities present, which were detected in 10% of cases. ES CNV analysis was concordant with CMA results in all cases. No additional findings were provided by only targeting selected genes based on ultrasound findings. Broadening the analysis to a larger number of genes involved in fetal developmental disorders revealed monogenic diseases in 3.9% of cases, which, although apparently not directly related to the indications, were clinically relevant.

Hábitos de vida saludable en estudiantes del sur de Chile / Healthy lifestyles in students from southern Chile / Hábitos de vida saudável em estudantes do sul do Chile

Resumen (analítico) Clasificar estudiantes según hábitos de vida saludable podría contribuir a optimizar programas de salud escolar, dado que existe escasa evidencia al respecto en Chile. Se determinaron grupos de estudiantes chilenos del sur, según hábitos de vida saludable. Se extrajeron datos de 1183 sujetos, desde una encuesta aplicada en 2017 en Lauta-ro. Se realizó un análisis de conglomerado jerárquico y se identificaron tres grupos. El primero presentó mayor actividad física y conducta alimentaria saludable (p < 0.05). El segundo presentó mayor tiempo de pantalla y conducta alimentaria menos saludable (p < 0.05). El tercero presentó menor tiempo de actividad física y menor conducta alimentaria (p < 0.05). Los estudiantes que practican más actividad física se alimentan mejor y quienes se mueven menos se alimentan menos. Estos hallazgos resultan útiles para el gobierno local.

Abstract (analytical) Classifying students according to healthy lifestyle could contribute to optimize school health programs, as there is little evidence in Chile regarding this topic. Groups of students from southern Chile were classified according to healthy lifestyle. Data of 1,183 subjects was extracted from a survey applied in 2017 in Lautaro. A hierarchical cluster analysis was carried out and three groups were identified. The first group presented greater physical activity and healthier eating behavior (p < 0.05). The second group presented more screen time and less healthy eating behavior (p < 0.05). The third group presented less time of physical activity and less healthy eating behavior (p<0.05). The students that practice more physical activity eat healthier and those who do less physical activity, eat less. These findings are useful for local government.

Resumo (analítico) Classificar os alunos de acordo com hábitos de vida saudável (HVS) pode ajudar a otimizar os programas de saúde escolar, pois há poucas evidências chilenas a esse respeito. Determinaram-se grupos de estudantes chilenos do sul, segundo HVS. Os dados de 1183 sujeitos foram extraídos de uma pesquisa aplicada em 2017 em Lautaro, realizando uma análise de cluster hierárquica, identificando três grupos. O primeiro grupo apresentou maior atividade física e comportamento alimentar saudável (p<0,05). O segundo grupo apresentou mais tempo de tela e comportamento alimentar menos saudável (p<0,05). O último grupo apresentou menor tempo de atividade física e menor comportamento alimentar (p<0,05). Os alunos que praticam mais atividade física comem melhor e os que se movimentam menos comem menos. Essas descobertas são úteis para o governo local.

Diagnóstico sobre el abordaje del tema prevención del cáncer cutáneo en la asignatura Dermatología para la formación del médico general / Diagnosis on the approach to the skin cancer prevention in the subject Dermatology for general practitioners training

RESUMEN Fundamento: la incidencia de cáncer de piel se ha triplicado, por lo que el conocimiento sobre factores de riesgo y prevención es necesario para el médico general en formación. Objetivo diagnosticar la forma en que se aborda el tema prevención del cáncer cutáneo en la asignatura Dermatología. Métodos: investigación pedagógica desarrollada en la Universidad de Ciencias Médicas de Cienfuegos. Se analizaron las exigencias para el tratamiento del tema prevención del cáncer cutáneo en la asignatura Dermatología. Se aplicó entrevista a muestra intencional de profesores de Dermatología y encuestas a estudiantes. Se realizó el análisis de documentos rectores, programas, etc. Resultados los estudiantes reciben el tema durante su quinto año de la carrera. Todos los profesores coinciden en que dentro de los temas de prevención impartidos en la carrera no es abordado el relacionado con el cáncer cutáneo; el 82,8 % refiere que el tema es abordado en conferencia, fundamentalmente el diagnóstico de pacientes enfermos y los aspectos sobre prevención son utilizados con menos relevancia. Todos los estudiantes coinciden en que nunca se les habla del cáncer cutáneo como una localización importante y susceptible de realizar medidas de prevención; el 85,7 % refiere que es un tema muy largo y se hace más énfasis en diagnosticar las lesiones, clasificarlas, tratarlas y no en cómo prevenirla, además en la prácticas no son observados muchos pacientes para poder identificarlas. Conclusiones: la forma en que es abordado el tema sobre prevención del cáncer cutáneo en la asignatura Dermatología no es suficiente para lo que necesita el médico general.

ABSTRACT Background: the incidence of skin cancer has tripled, so knowledge about risk factors and prevention is necessary for the general practitioner in training. Objective: to diagnose the way in which the prevention of skin cancer is approached in the Dermatology subject. Methods: pedagogical research developed at the Cienfuegos University of Medical Sciences. The requirements for the treatment of the prevention of skin cancer in the Dermatology subject were analyzed. An interview was applied to an intentional sample of Dermatology professors and student surveys. The analysis of guiding documents, programs, etc. was carried out. Results: students receive the subject during their fifth year of the degree. All the professors agree that within the prevention topics taught in the career, the one related to skin cancer is not addressed; the 82.8% refer that the subject is addressed in a conference; basically the diagnosis of sick patients and the aspects of prevention are used with less relevance. All students agree that skin cancer is never mentioned as an important location that is susceptible to preventive measures; the 85.7% refer that it is a very long topic and more emphasis is placed on diagnosing injuries, classifying them, treating them and not on how to prevent them, in addition, many patients are not observed in practice in order to identify them. Conclusions: the way in which the topic of skin cancer prevention is approached in the Dermatology subject is not enough for what the general practitioner needs.

Validación de un sistema de tareas docentes para la formación de la habilidad profesional tratar integralmente el dolor en el modo de actuación del médico general / Validation of a teaching tasks system for the professional ability formation to comprehensively treat pain in the general practitioners mode of action

RESUMEN Fundamento: la formación del Médico General demanda la preparación de la habilidad tratar integralmente el dolor mediante la combinación de alternativas terapéuticas farmacológicas y no farmacológicas, para la atención a pacientes con dolor. Objetivo: validar un sistema de tareas docentes para la formación de la habilidad tratar integralmente el dolor en el Médico General. Métodos: se utilizó el criterio de expertos, método Delphi para validar el sistema y el W de Kendall para obtener la concordancia del consenso de los expertos sobre el sistema de tareas docentes. Se realizaron entrevistas y observación a los estudiantes, para obtener las tendencias que expresan sus criterios sobre el empleo de los diferentes tipos de tareas, para formar la habilidad tratar integralmente el dolor. Resultados: el sistema de tareas docente fue validado por los expertos de muy adecuado. Se aplicó en el sexto año de la carrera de medicina, durante la práctica docente, asistencial e investigativa. Los estudiantes demostraron desempeño en las acciones y operaciones de la habilidad para tratar integralmente el dolor. Conclusiones: el sistema de tareas aplicado resultó una alternativa formativa con integración de la actividad académica, laboral e investigativa en la formación de la habilidad de tratar integralmente el dolor.

ABSTRACT Background: the training of General Practitioners requires the ability preparation to comprehensively treat pain through the combination of pharmacological and non-pharmacological therapeutic alternatives, for the care of patients with pain. Objective: to validate a system of teaching tasks for the ability formation to comprehensively treat pain in the General Practitioner. Methods: the expert criterion, the Delphi method to validate the system and the Kendall W. was used to obtain the agreement of the experts consensus on the teaching task system. Interviews and observation of the students were carried out to obtain the trends that express their criteria on the use of different types of tasks, to form the ability to treat pain comprehensively. Results: the teaching task system was validated by highly adequate experts. It was applied in the sixth year of the medical career, during the teaching, healthcare and research practice. The students demonstrated performance in ability actions and operations to comprehensively treat pain Conclusions: the applied task system was a formative alternative with integration of academic, work and research activity in the ability formation to comprehensively treat pain.

Algunas consideraciones para el cálculo del tamaño muestral en investigaciones de las Ciencias Médicas / Some considerations for the calculation of the sample size in Medical Sciences research

RESUMEN El proceso de formación y superación permanente o continuada de los profesionales, como un principio de la Educación Médica, se articula con la integración docencia, asistencia e investigación. Para responder a las exigencias de la actividad investigativa, la búsqueda y el tratamiento de la información requiere de un estudio estadístico para que aflore la cualidad desde el análisis cuantitativo; para ello, es importante considerar que en todos los estudios de esta magnitud, la población total se hace muy engorrosa, cara y lenta, por lo que se deben emplear técnicas de muestreo para obtener información significativa con el uso de menos recursos y menor tiempo. El objetivo del presente trabajo es reflexionar sobre el uso del muestreo en las ciencias médicas. Se expone la fórmula del muestreo para media y varianza conocidas, se da una técnica para encontrar el número de elementos de la muestra inicial cuando no se tienen conocimientos previos de media y varianza; se estudia el muestreo aleatorio simple de proporciones con las probabilidades de éxito y fracaso p y q respectivamente, explicándose el caso cuando se tiene p = q = 0.5 para la obtención de un tamaño de la muestra máximo.

ABSTRACT The objective of this paper is to reflect some considerations on the use of sampling in health sciences, based on the need for professionals in these sciences to familiarize themselves with scientific research in their area of knowledge, from a scientific perspective, that makes it possible to investigate the health problems that are constantly developing. The process of Permanent and Continuous Training and Improvement of professionals, as a principle of Medical Education, is articulated with that of Teaching - Assistance and research, the search and treatment of information in this area of scientific knowledge, requires of a statistical study that emerges the quality from the quantitative analysis, for this, it is important to consider that in all studies of this magnitude, the total population becomes very cumbersome, expensive and slow, so sampling techniques should be used to Obtain meaningful information with the use of less resources and less time. The sampling formula for known mean and variance is presented, a technique is given to find the number of elements of the initial sample when there is no prior knowledge of mean and variance, simple random sampling of proportions with the probabilities of success is studied and failure p and q respectively, explaining the case when you have p = q = 0.5 to obtain a maximum sample size.

Formación doctoral en la Universidad de Ciencias Médicas de Cienfuegos utilizando las vías no presenciales, en tiempos de la COVID-19 / Doctoral training at the University of Medical Sciences of Cienfuegos using distance learning methods, in the days of COVID-19

RESUMEN Fundamento: la necesidad de elevar el potencial científico de los profesionales de la salud en la provincia de Cienfuegos es un imperativo de estos tiempos. Para lograr este propósito se requiere de una Estrategia de Formación Doctoral coordinada, flexible y que pueda adecuarse a las condiciones que tiene actualmente el contexto de la salud pública en tiempos de pandemia. Objetivo: describir a la comunidad científica los resultados que se obtienen en la formación doctoral en la Universidad de Ciencias Médicas de Cienfuegos utilizando las vías no presenciales para las actividades formativas de carácter científico en tiempos de la pandemia COVID-19. Métodos: se utiliza como método de investigación la sistematización y se expresan los avances científicos de los doctorandos. Resultados: se evidenció que las vías utilizadas originan un amplio abanico de posibilidades en los procesos de enseñanza/aprendizaje como artefactos tecnológicos de producción científica con elevado potencial comunicativo e interactivo. Conclusiones: se corroboró la posibilidad de mantener la formación doctoral en tiempos de pandemia.

ABSTRACT Foundation: the need to raise health professionals´ scientific potential in the Cienfuegos province is an imperative of the current times. To achieve this purpose, a coordinated, flexible Doctoral Training Strategy is required that can be adapted to the public health context current conditions in times of pandemic. Objective: to describe for the scientific community the results obtained in doctoral training at the University of Medical Sciences of Cienfuegos using distance learning methods for scientific training activities in times of the COVID-19 pandemic. Methods: systematization is used as a research method and the scientific advances of doctoral students are expressed. Results: it was evidenced that distant learning methods used originate a wide range of possibilities in the teaching / learning processes as technological artifacts of scientific production with high communicative and interactive potential. Conclusion: the possibility of maintaining doctoral training in times of pandemic was confirmed.

La tutoría a distancia: acciones del tutor en la Estrategia de Formación Doctoral en tiempos de COVID 19 / Distance tutoring: tutor´s actions in the Doctoral Training Strategy in the time of COVID 19

RESUMEN Fundamento: durante la situación epidemiológica creada por la pandemia de COVID 19 se impuso como medida de protección el distanciamiento social por lo que se necesitó implementar la tutoría a distancia en la Estrategia de Formación Doctoral de la Universidad de Ciencias Médicas de Cienfuegos. Objetivo: determinar las acciones esenciales de los tutores realizadas mediante diferentes vías virtuales. Métodos: se utilizaron métodos del nivel teórico como el analítico sintético, el inductivo deductivo, la sistematización y el enfoque de sistema, y del nivel empírico la observación, el análisis documental y la triangulación. Resultados: se precisaron las acciones esenciales del tutor para la tutoría a distancia, las cuales se estructuraron de manera sistémica en las etapas de planificación, ejecución y control en correspondencia con las fases del proceso de investigación científica. Los resultados obtenidos hasta el momento se muestran en el progreso de la investigación por áreas del conocimiento en que se preparan para la defensa, la escritura de la memoria escrita, así como el cumplimiento de los requisitos de exámenes de mínimos y publicación de artículos científicos, todo mediante las referidas acciones por las vías virtuales. Conclusiones: las acciones esenciales precisadas para el tutor, consolidadas en la propuesta implementada, han permitido continuar el proceso de formación en la Estrategia de Formación Doctoral; se han logrado avances en los aspectos principales del proceso de formación.

ABSTRACT Foundation: during the epidemiological situation created by COVID- 19 pandemic, social distancing was imposed as a protection measure, so it was necessary to implement distance tutoring in the Doctoral Training Strategy of the Cienfuegos University of Medical Sciences. Objective: to determine tutors´ essential actions carried out online. Methods: theoretical level methods such as synthetic analytical, deductive inductive, systematization and system approach were used, and observation, documentary analysis and triangulation at the empirical level. Results: the tutor's essential actions for distance tutoring were specified, structured in a systemic way in the planning, execution and control stages in correspondence with the phases of the scientific research process. The results obtained so far are shown in the research progress by areas of knowledge in which they are preparing for dissertation, writing of the written report, as well as the fulfillment of the minimum exam requirements and publication of scientific articles, all through the aforementioned actions online. Conclusion: essential actions specified for the tutor, consolidated in the implemented proposal, have allowed continuing the training process in the Doctoral Strategy; There has been progress in the main aspects of the training process.

Propuesta de sistema de tareas docentes para el desarrollo de la habilidad tratamiento integral del dolor / Proposal of a system of teaching tasks for developing the skill of comprehensive pain treatment

RESUMEN Fundamento: las organizaciones internacionales de salud instan a los países a mejorar la asistencia sanitaria que se realiza, relacionada con la infraevaluación y el infratratamiento del dolor. Esta demanda juega un importante papel en la formación del médico general, para el fomento de la habilidad tratamiento integral del dolor. Objetivo: diseñar una propuesta de sistema de tareas docentes para enseñar el tratamiento del dolor mediante la combinación de diferentes alternativas terapéuticas. Métodos: investigación pedagógica realizada en la Universidad de Ciencias Médicas de Cienfuegos. Fueron encuestados estudiantes de sexto año de la carrera de Medicina para conocer sus criterios acerca de la enseñanza del tratamiento del dolor. Se realizó entrevista semi-estructuradas a los profesores del sexto año de la carrera de medicina y encuestas a los residentes de las diferentes especialidades médicas. Se efectuó análisis de los programas de las asignaturas, consulta a especialistas de Psicología, Medicina Física y Rehabilitación, Medicina Natural y Tradicional, Anestesiología y Reanimación y Medicina General Integral. Resultados: quedó conformada una propuesta de sistema de tareas desde la integración del contenido en tres asignaturas. Fue validada mediante criterio de expertos y evaluada como muy adecuada. Conclusiones: el sistema de tareas contribuirá a mejorar el desempeño de los modos de actuación del futuro egresado como una alternativa para la integración de la actividad académica, laboral e investigativa en la formación de la habilidad de tratar integralmente el dolor.

ABSTRACT Foundation: international health organizations urge countries to improve the health care provided, related to under-evaluation and under-treatment of pain. This demands the formation of a general practitioner, for promoting the comprehensive treatment of pain. Objective: to design a proposal of a teaching task system to teach the treatment of pain by combining different therapeutic alternatives. Methods: pedagogical research carried out at the Medical Sciences University of Cienfuegos. Sixth year students of the medical career were surveyed to know their criteria about the teaching of pain treatment. Semi-structured interviews were conducted to the professors of the sixth year medical career and surveys to the residents of different medical specialties. Program Analysis was carried out, consultation with specialists in Psychology, Physical Medicine and Rehabilitation, Natural and Traditional Medicine, Anaesthesiology and Resuscitation and Comprehensive General Medicine. Results: a task system proposal was created by integrating the content in three subjects. It was validated by expert criteria and evaluated as very adequate Conclusions: the system of tasks will contribute to improve the performance of the future graduate as an alternative for the integration of the academic, labor and research activity in training the ability to comprehensively deal with pain.

Posgrados en odontología: propuesta internacional / Postgraduate education in dental medicine: an international proposal

Introducción: Los posgrados en Odontología son parte del perfeccionamiento profesional que permiten adquirir competencias específicas del más alto nivel, aplicadas a la salud oral en la atención clínica, organización de servicios odontológicos, que reúna aspectos técnicos y especializados en la docencia e investigación. Objetivo: Exponer las tendencias del desarrollo de posgrados odontológicos a nivel internacional que se ofertan en Europa y América. Métodos: Estudio descriptivo en el área de la educación médica realizado mediante la búsqueda de posgrados odontológicos ofertados en sitios webs de instituciones de Europa y América, durante el periodo de julio a diciembre del 2017, en las categorías de especialidad, maestría profesionalizante, maestría en investigación y el nivel de PhD. El método de análisis y síntesis de la bibliografía consultada se realizó a partir de Google académico, Pubmed, SciElo, Lilacs. Resultados: Se encontraron 967 programas de posgrados de odontología en los niveles de maestrías, especialidades y doctorados, en 226 instituciones de educación superior. En Latinoamérica más de la mitad de los posgrados de odontología se enmarcan en los criterios de especialidades, a diferencia de Europa y América Anglosajona, que se inclinan en la oferta de maestrías dirigidas a la investigación y programas doctorales. En los resultados de la tendencia de Programas de Posgrados en Odontología se evidencia que ortodoncia es el más ofertado; seguido de endodoncia, pediatría odontológica y periodoncia. Conclusiones: Es necesario incrementar la oferta de posgrados en países latinoamericanos que integren la investigación, tecnología, docencia, administración y la ciencia a fin de generar profesionales capaces de ejercer internacionalmente a la par de países desarrollados(AU)

Introduction: Postgraduate courses in Dental Medicine are part of the professional development that allows to acquire specific competences of the highest level, applied to dental health in clinical care, organization of dental services, which brings together technical and specialized aspects in teaching and research. Objective: To expose the tendencies of the development of postgraduate in dental medicine offered in Europe and America. Method: Descriptive study in the area of medical education carried out through the search of postgraduate dental programs offered on websites of institutions in Europe and America, during the period from July to December 2017, in the categories specialty, professional master course, master's degree in research, and the PhD level. The method of analysis and synthesis was used to work with the consulted bibliography, mainly from Google Academic, Pubmed, SciElo, Lilacs. Results: 967 postgraduate dental programs were found at the masters, specialties and PhD levels and in 226 institutions of higher education. In Latin America, more than half of the postgraduate programs in dental can be characterized within the criteria of a specialty, unlike in Europe and Anglo-Saxon America, where the tendency is to offer master's degrees aimed at research and to offer PhD programs. Analyzing the results regarding the tendency of postgraduate programs in dental medicine, it is evident that Orthodontics is the most offered, followed by Endodontics, Dental Pediatrics and Periodontics. Conclusions: It is necessary to increase the offer of postgraduate courses in Latin American countries, integrating research, technology, teaching, management and science, in order to generate professionals capable of working worldwide at the level of developed countries(AU)

Concepción científico metodológica de la estrategia de formación doctoral de la Universidad de Ciencias Médicas de Cienfuegos / Scientific-Methodological Conception of the Strategy of Doctoral Training at the university of Medical Sciences Cienfuegos

RESUMEN Para lograr un cambio en la formación permanente de los profesionales de la salud, en cuanto a la obtención del grado de doctor, la Universidad de Ciencias Médicas de Cienfuegos, comprometida con esta exigencia, ha organizado una estrategia de formación doctoral, en convenio con los centros autorizados. Su concepción científica y metodológica se define como el sistema de ideas acerca del proceso de formación doctoral, que fundamenta las etapas y acciones de formación, caracterizadas por los principios de carácter sistémico, contextual y la sistematización e integración de las acciones declaradas en la estrategia. Como principales resultados se espera contribuir a promover el trabajo conducente a la obtención de grados científicos, incrementar el protagonismo del departamento docente y/o asistencial en el seguimiento al proceso de formación doctoral, promover redes de colaboración para la superación doctoral y posdoctoral, desarrollar la gestión de la innovación e incorporar en la estrategia a los grupos científicos estudiantiles vinculados a los proyectos y temas de doctorados que se desarrollan en la institución.

ABSTRACT Aimed at achieving a change in the health professionals continuous development, regarding the obtaining of a Doctor Degree, and committed with this demand, the University of Medical Sciences has designed a Strategy of Doctoral Training in agreement with the certified institutions. Its scientific and methodological conception is defined as the system of ideas about the process of doctoral training which sets the stages and actions characterized by the principles of systemic, contextual character and their systematization and integration . As the main results it is expected to contribute promoting the work which leads to obtaining scientific degree, increase the protagonist action of the teaching and /or assisting department in following the process of doctoral training, to promote networks of collaboration for doctoral and post-doctoral development, to develop management of on innovation and incorporating to the strategy the scientific groups of students linked to doctoral projects and topics developed at the institution.

Towards an Aspect-Oriented Design and Modelling Framework for Synthetic Biology.

Work on synthetic biology has largely used a component-based metaphor for system construction. While this paradigm has been successful for the construction of numerous systems, the incorporation of contextual design issues-either compositional, host or environmental-will be key to realising more complex applications. Here, we present a design framework that radically steps away from a purely parts-based paradigm by using aspect-oriented software engineering concepts. We believe that the notion of concerns is a powerful and biologically credible way of thinking about system synthesis. By adopting this approach, we can separate core concerns, which represent modular aims of the design, from cross-cutting concerns, which represent system-wide attributes. The explicit handling of cross-cutting concerns allows for contextual information to enter the design process in a modular way. As a proof-of-principle, we implemented the aspect-oriented approach in the Python tool, SynBioWeaver, which enables the combination, or weaving, of core and cross-cutting concerns. The power and flexibility of this framework is demonstrated through a number of examples covering the inclusion of part context, combining circuit designs in a context dependent manner, and the generation of rule, logic and reaction models from synthetic circuit designs.

A computational method for the investigation of multistable systems and its application to genetic switches.

BACKGROUND: Genetic switches exhibit multistability, form the basis of epigenetic memory, and are found in natural decision making systems, such as cell fate determination in developmental pathways. Synthetic genetic switches can be used for recording the presence of different environmental signals, for changing phenotype using synthetic inputs and as building blocks for higher-level sequential logic circuits. Understanding how multistable switches can be constructed and how they function within larger biological systems is therefore key to synthetic biology. RESULTS: Here we present a new computational tool, called StabilityFinder, that takes advantage of sequential Monte Carlo methods to identify regions of parameter space capable of producing multistable behaviour, while handling uncertainty in biochemical rate constants and initial conditions. The algorithm works by clustering trajectories in phase space, and iteratively minimizing a distance metric. Here we examine a collection of models of genetic switches, ranging from the deterministic Gardner toggle switch to stochastic models containing different positive feedback connections. We uncover the design principles behind making bistable, tristable and quadristable switches, and find that rate of gene expression is a key parameter. We demonstrate the ability of the framework to examine more complex systems and examine the design principles of a three gene switch. Our framework allows us to relax the assumptions that are often used in genetic switch models and we show that more complex abstractions are still capable of multistable behaviour. CONCLUSIONS: Our results suggest many ways in which genetic switches can be enhanced and offer designs for the construction of novel switches. Our analysis also highlights subtle changes in correlation of experimentally tunable parameters that can lead to bifurcations in deterministic and stochastic systems. Overall we demonstrate that StabilityFinder will be a valuable tool in the future design and construction of novel gene networks.

Immune response and histology of humoral rejection in kidney transplantation / Respuesta inmune e histología de rechazo humoral en el trasplante renal

The adaptive immune response forms the basis of allograft rejection. Its weapons are direct cellular cytotoxicity, identified from the beginning of organ transplantation, and/or antibodies, limited to hyperacute rejection by preformed antibodies and not as an allogenic response. This resulted in allogenic response being thought for decades to have just a cellular origin. But the experimental studies by Gorer demonstrating tissue damage in allografts due to antibodies secreted by B lymphocytes activated against polymorphic molecules were disregarded. The special coexistence of binding and unbinding between antibodies and antigens of the endothelial cell membranes has been the cause of the delay in demonstrating the humoral allogenic response. The endothelium, the target tissue of antibodies, has a high turnover, and antigen-antibody binding is non-covalent. If endothelial cells are attacked by the humoral response, immunoglobulins are rapidly removed from their surface by shedding and/or internalization, as well as degrading the components of the complement system by the action of MCP, DAF and CD59. Thus, the presence of complement proteins in the membrane of endothelial cells is transient. In fact, the acute form of antibody-mediated rejection was not demonstrated until C4d complement fragment deposition was identified, which is the only component that binds covalently to endothelial cells. This review examines the relationship between humoral immune response and the types of acute and chronic histological lesion shown on biopsy of the transplanted organ (AU)

La respuesta inmune adaptativa constituye la base del rechazo del aloinjerto. Sus armas lesivas son la citotoxicidad celular directa o los anticuerpos. La primera, identificada desde los inicios del trasplante de órganos y la segunda, limitada al rechazo hiperagudo por anticuerpos preformados y no como respuesta alogénica. Ello permitió mantener durante décadas que la respuesta alogénica tenía solo un origen celular. Pero se ignoraron los trabajos experimentales de Gorer que demostraban daño tisular en aloinjertos por anticuerpos secretados por linfocitos B activados frente a moléculas polimórficas. La especial convivencia de unión y desunión entre anticuerpos y antígenos de membrana de células endoteliales ha sido la causa que retrasó la demostración de la respuesta alogénica humoral. El endotelio, que es el tejido diana de los anticuerpos, tiene un turnover alto y la unión antígeno-anticuerpo no es covalente. Si las células endoteliales sufren el ataque de la respuesta humoral, eliminan rápidamente de su superficie las inmunoglobulinas mediante shedding o internalización y, a la vez, degradan los componentes del complemento por la acción de MCP, DAF y CD59. Así, la presencia de las proteínas del complemento en la membrana de las células endoteliales es pasajera. De hecho, la forma aguda de rechazo por anticuerpos no se demostró hasta identificar el depósito del fragmento C4d del complemento, que es el único de unión covalente a las células endoteliales. Esta revisión analiza la relación entre la respuesta inmune humoral y los tipos de lesión histológica aguda y crónica de la biopsia del órgano trasplantado (AU)