Ultrasound Muscle Evaluation for Predicting the Prognosis of Patients with Head and Neck Cancer: A Large-Scale and Multicenter Prospective Study.

Head and neck cancer (HNC) is a prevalent and aggressive form of cancer with high mortality rates and significant implications for nutritional status. Accurate assessment of malnutrition in patients with HNC is crucial for optimizing treatment outcomes and improving survival rates. This study aimed to evaluate the use of ultrasound techniques for predicting nutritional status, malnutrition, and cancer outcomes in patients with HNC. A total of 494 patients with HNC were included in this cross-sectional observational study. Various tools and body composition measurements, including muscle mass and adipose tissue ultrasound evaluations, were implemented. Using regression models, we mainly found that high levels of RF-CSA (rectus femoris cross-sectional area) were associated with a decreased risk of malnutrition (as defined with GLIM criteria (OR = 0.81, 95% CI: 0.68-0.98); as defined with PG-SGA (OR = 0.78, 95% CI: 0.62-0.98)) and sarcopenia (OR = 0.64, 95% CI: 0.49-0.82) after being adjusted for age, sex, and BMI. To predict the importance of muscle mass ultrasound variables on the risk of mortality, a nomogram, a random forest, and decision tree models were conducted. RF-CSA was the most important variable under the random forest model. The obtained C-index for the nomogram was 0.704, and the Brier score was 16.8. With an RF-CSA < 2.7 (AUC of 0.653 (0.59-0.77)) as a split, the decision tree model classified up to 68% of patients as possessing a high probability of survival. According to the cut-off value of 2.7 cm2, patients with a low RF-CSA value lower than 2.7 cm2 had worse survival rates (p < 0.001). The findings of this study highlight the importance of implementing ultrasound tools, for accurate diagnoses and monitoring of malnutrition in patients with HNC. Adipose tissue ultrasound measurements were only weakly associated with malnutrition and not with sarcopenia, indicating that muscle mass is a more important indicator of overall health and nutritional status. These results have the potential to improve survival rates and quality of life by enabling early intervention and personalized nutritional management.

COP1 dynamics integrate conflicting seasonal light and thermal cues in the control of Arabidopsis elongation.

As the summer approaches, plants experience enhanced light inputs and warm temperatures, two environmental cues with an opposite morphogenic impact. Key components of this response are PHYTOCHROME B (phyB), EARLY FLOWERING 3 (ELF3), and CONSTITUTIVE PHOTOMORPHOGENIC 1 (COP1). Here, we used single and double mutant/overexpression lines to fit a mathematical model incorporating known interactions of these regulators. The fitted model recapitulates thermal growth of all lines used and correctly predicts thermal behavior of others not used in the fit. While thermal COP1 function is accepted to be independent of diurnal timing, our model shows that it acts at temperature signaling only during daytime. Defective response of cop1-4 mutants is epistatic to phyB-9 and elf3-8, indicating that COP1 activity is essential to transduce phyB and ELF3 thermosensory function. Our thermal model provides a unique toolbox to identify best allelic combinations enhancing climate change resilience of crops adapted to different latitudes.

In vitro antibacterial activity of endodontic bioceramic materials against dual and multispecies aerobic-anaerobic biofilm models.

The aim of this in vitro study was to evaluate the antibacterial activity of calcium silicate repair cements and sealers against a dual-species planktonic aerobic model with different aging times and the ability to inhibit the formation of a mature 21-day-old multispecies anaerobic biofilm. The antibacterial activity of ProRoot MTA, MTA Angelus, Biodentine, BioRoot RCS and TotalFill BC sealer against a dual-species aerobic planktonic model, as well as measuring how materials were affected by aging, was evaluated using the Modified Direct Contact Test. Subsequently, the ability to inhibit the formation of a mature multispecies anaerobic biofilm was evaluated using scanning electron microscopy complemented with confocal laser scanning microscopy. Biodentine and BioRoot RCS had higher antibacterial action, and Biodentine was able to maintain its antibacterial action after a prolonged aging period in vitro. Calcium silicate repair cement MTA ProRoot and Biodentine had higher antibiofilm action.

Factors Associated with Oral Health-Related Quality of Life in Preschoolers of Concepción, Chile: A Cross-Sectional Study

Abstract Objective: To identify the factors associated with Oral Health-Related Quality of Life (OHRQoL) in preschool children of Concepción, Chile. Material and Methods: A cross-sectional study was conducted in a sample of enrolled preschoolers who attend public schools in Concepción, Chile. To measure OHRQoL, the chilean version of the Early Childhood Oral Health Impact Scale (ECOHIS) was used; sociodemographic variables of the children and their parents were also recorded, as well as variables regarding the last visit to the dentist. To determine differences in the ECOHIS score for categorical variables, ANOVA and t-test were used, while Pearson's r was used to correlate ECOHIS with quantitative variables (p<0.05). Results: A total of 175 children were surveyed, with a distribution of 89 boys and 86 girls aged 56-to-79 months. The total score of the ECOHIS had a mean of 4.48 ±5.96, with a score between 0-38. Statistically significant associations were with parent's educational attainment (r=−0.159), dmft (r=0.380), OHI-S debris (r=0.174) and reason for the last visit to the dentist, the highest average in the ECOHIS scores was registered in the urgency reason. Conclusion: Oral health status, dental service utilization and educational level are associated with the OHRQoL of preschoolers of Concepción (AU).

Antimicrobial Effect of Leukocyte- and Platelet-Rich Fibrin Against Aggregatibacter actinomycetemcomitans Mono-Multiserotypes Model

ABSTRACT: Leukocyte- and platelet-rich fibrin is a widely used platelet concentrate for periodontal surgery procedures. Many benefits are described regarding its use, such as antimicrobial properties. The objective of this study was to evaluate the antimicrobial effects of the different zones of this platelet concentrated against the most prevalent serotypes of Aggregatibacter actinomycetemcomitans in an in vitro mono-multiserotype model. Three patients who were treated at a School of Dentistry in the city where the researchers reside, were included. Modified direct contact method tests and results were analyzed using multivariate logistic regression analysis. In the modified direct contact method test, a decrease in bacterial count was found at time 1, but at time 2, the count increased for all serotypes and zones of L-PRF. It can be noted that the areas with more cellular content in leukocytes and platelet-rich fibrin are the areas with the most antimicrobial powe r. This platelet concentrate would have better results with serotype c. At time point 2, it is likely to act as a growth promoter of A. actinomycetemcomitans.

RESUMEN: La Fibrina rica en Leucocitos y Plaquetas es un concentrado plaquetario ampliamente utilizado en procedimientos quirúrgicos periodontales. Muchos beneficios se describen con respecto a su uso, tales como propiedades antimicrobianas. El objetivo de este estudio fue evaluar los efectos antimicrobianos de las diferentes zonas de este concentrado plaquetario frente a los serotipos más prevalentes de Aggregatibacter actinomycetemcomitans en un modelo mono-multi serotipo in vitro. Se incluyeron tres pacientes que fueron tratados en la Facultad de Odontología de la ciudad donde residen los investigadores. Se utilizó para su análisis una prueba de contacto directo modificado. En la prueba de contacto directo modificado, se encontró una disminución en el recuento bacteriano en el tiempo 1, pero en el tiempo 2, el recuento aumentó para todos los serotipos y zonas de L-PRF. Se puede observar que las áreas con mayor contenido celular en la Fibrina rica en Leucocitos y Plaquetas son las áreas con mayor poder antimicrobiano. Este concentrado de plaquetas tendría mejores resultados con el serotipo c. En el tiempo 2, es probable que actúe como un promotor del crecimiento de A. actinomycetemcomitans.

Factor analysis of the cross-cultural adaptation of the multidimensional attitudes scale towards deaf persons in Chilean dental students

There are various instruments to measure attitudes toward persons with disabilities (PwD). The Multidimensional Attitudes Scale (MAS) toward PwD is a three-dimension scale with good psychometric properties; the Spanish version has been validated with a four-factor structure. Aim: To examine the factor structure of a cross-cultural adapted version of the Spanish MAS towards deaf persons in a sample of Chilean dental students. Methods: This cross-sectional study involved five Chilean public health experts that reviewed the scale for obtaining a preliminary version of a 30-item modified MAS towards deaf persons; a pilot with 15 dental students was performed, and a final sample composed of 311 students was included. For the exploratory factor analysis (EFA), maximum likelihood estimation (ML) for determining the number of factors and parallel analysis (PA) was used, with Oblimin for the rotation method. Cronbach's alpha was used to assess reliability. The root mean square error of approximation (RMSEA), comparative fit index (CFI), incremental fit index (IFI), goodness of fit index (GFI), Tucker-Lewis fit index (TLI-NNF) and root mean square of residuals (RMSR) were used to assess model fit. Results: All items had a normal distribution with the exception of items 7 and 10. The four-factor structure without item 10 in this EFA presented an adequate Cronbach's alpha (>0.83), suggesting acceptable reliability. RMSEA, TLI-NNFI, RMSR, GFI and CFI indices suggested a good fit of the model and were consistent with the literature. Conclusion: The Spanish modified version of the MAS towards deaf persons has a four-factor structure, which in consistent with a previous version of the MAS

Formación para el manejo de publicaciones científicas y páginas web en el ámbito sociosanitario / Training for management of scientific publications and webpages in the sociosanitary context

Este trabajo presenta nociones básicas de formación sobre la búsqueda del conocimiento científico sociosanitario en internet, y reitera el uso de contenidos especializados y de rigor en revistas científicas indexadas en JCR y/o SCOPUS. Además, se ofrece una correcta formación digital en Alfabetización en Salud electrónica (e_AeS), a través del manejo de páginas correctamente contrastadas, según los 15 criterios de calidad de los sitios web y de contenidos especializados sociosanitarios(AU)

This paper presents basic notions about training for the search of socio-sanitary scientific knowledge on the Internet and reiterates the use of specialized and rigorous content in scientific journals indexed in JCR and/or SCOPUS. In addition, a correct digital training in electronic health literacy is offered, through the management of correctly contrasted pages, according to the fifteen quality criteria of the websites and specialized socio-health content(AU)

Regulation of COP1 Function by Brassinosteroid Signaling.

Small increases in temperature result in enhanced elongation of the hypocotyl and petioles and hyponastic growth, in an adaptive response directed to the cooling of the leaves and to protect the shoot meristem from the warm soil. This response, collectively termed as thermomorphogenesis, relies on the faster reversion of phyB Pfr at warmer temperatures, which leads to enhanced activity of the basic-helix-loop-helix PHYTOCHROME INTERACTING FACTOR 4 (PIF4). PIF4 acts as a molecular hub integrating light and temperature cues with endogenous hormonal signaling, and drives thermoresponsive growth by directly activating auxin synthesis and signaling genes. Growth promotion by PIF4 depends on brassinosteroid (BR) signaling, as indicated by the impaired thermoresponse of BR-defective mutants and the partial restoration of pifq thermoresponsive defects by brassinolide (BL) application. Also, phyB limits thermomorphogenic elongation through negative regulation of the E3 ubiquitin ligase COP1 that triggers nuclear degradation of multiple photomorphogenesis-promoting factors acting antagonistically to PIF4. COP1 is indeed observed to accumulate in the nucleus in darkness, or in response to warm temperatures, with constitutive photomorphogenic cop1 mutants failing to respond to temperature. Here we explored the role of BR signaling on COP1 function, by growing cop1 seedlings on BL or the inhibitor brassinazole (BRZ), under different light and temperature regimes. We show that weak cop1 alleles exhibit a hyposensitive response to BL. Furthermore, while cop1-6 mutants display as described a wild-type response to temperature in continuous darkness, this response is abolished by BRZ. Application of this inhibitor likewise suppressed temperature-induced COP1 nuclear accumulation in N. benthamiana leaves. Overall these results demonstrate that cop1-6 is not a temperature-conditional allele, but this mutation allows for a partially active protein which unveils a pivotal role of active BR signaling in the control of COP1 activity.

Chilean Health Professionals Attitudes Towards Deafness: A Cross-Sectional Study

Abstract Objective: To assess the attitudes of health professionals towards Deafness and its association with sociodemographic and Deaf contact experience. Material and Methods: A cross-sectional study was carried out in Concepcion, Chile. The sample size was estimated in 171 health professionals. The following variables were considered: sociodemographics, Deaf contact experience, and attitudes to deafness scale (ADS scale). To evaluate the association between the variables, t-test and Spearman correlation test were used (p<0.05). Results: People who had taken a LSCh course had significant more positive attitudes towards item 1 "Deaf people should learn to lipread", with a 2 points difference and in persons who do not know a Deaf person, with 1-point difference. Also, persons who have received some kind of formation in Deafness have a better attitude in item 3 "I would like to have more Deaf friends" with 1-point difference. An inverse correlation was observed within age (rho = -0.237; p=0.0014), years of academic service (rho = -0.323; p<0.0001) or PHC service (rho = -0.1085; p=0,364). Conclusion: The attitude of health professionals towards Deafness was neutral. This attitude is not modulated by sex, type of profession, type of relationship with Deaf people, type of training in hearing disability, Chilean Sign Language Courses or degree of frequency of healthcare delivery to Deaf patients. However, it is modulated by age and years of service.

Salud bucal, higiene y hábitos bucales en personas con trastorno del espectro autista / Oral health, hygiene practices and oral habits of people with autism spectrum disorder

ABSTRACT Introduction: People with autism spectrum disorder have a higher risk of dental complications due to the characteristics of the condition itself. Objective: To describe the oral health status, hygiene practices and oral habits of a group of Chilean children, adolescents and adults with autism spectrum disorder. Methods: A descriptive study was conducted of 123 subjects with autism spectrum disorder. A questionnaire was applied which dealt with socio-demographic information, dental history, oral hygiene practices and oral habits. Each participating subject underwent oral examination to determine their experience with and prevalence of caries, scores on the Simplified Oral Hygiene Index and the gingival index, and the presence of dental trauma, deep/ogival palate, anterior open bite, and anterior and posterior crossbite. Results: 48 percent of the subjects with autism spectrum disorder brushed twice a day, and 68.0 percent required assisted tooth-brushing; 94.3 percent had oral habits, of which bruxism and oral breathing were the most frequent, accounting for 57.7 percent and 52.9 percent, respectively. Prevalence of caries was 33.3 percent, the dental caries index for permanent dentition was 1.1 ± 1.8, and the dental caries index for deciduous and permanent dentition was 2.6 ± 3.3. OHI-S for the 123 subjects was 1.30 ± 0.58. Conclusions: Most subjects required assistance with tooth-brushing and brushed twice a day. Bruxism and oral breathing were the most prevalent oral habits. A low prevalence of caries, a very low dental caries index for permanent dentition and a fair Oral Hygiene Index were observed in the 123 subjects with autism spectrum disorder(AU)

RESUMEN Introducción: Las personas con trastorno del espectro autista tienen un mayor riesgo de presentar complicaciones dentales, debido a las características propias de la enfermedad. Objetivo: Describir el estado de salud bucal, hábitos de higiene y hábitos bucales de un grupo de niños, adolescentes y adultos chilenos con trastorno del espectro autista. Métodos: Se realizó un estudio descriptivo de 123 sujetos con trastorno del espectro autista. Se aplicó un cuestionario sobre información socio-demográfica, antecedentes dentales, hábitos de higiene bucal y hábitos bucales, y se realizó un examen odontológico a cada participante para determinar la experiencia y prevalencia de caries, la puntuación según el índice de higiene bucal simplificado y el índice gingival, así como la presencia de traumatismo dentario, paladar profundo/ojival, mordida abierta anterior y mordida cruzada anterior y posterior. Resultados: El 48 por ciento de los sujetos con trastorno del espectro autista se cepillaba dos veces al día y el 68,0 por ciento tenía un cepillado asistido. El 94,3 por ciento presentaba hábitos bucales, de los cuales los más frecuentes eran el bruxismo con 57,7 por ciento y la respiración bucal con 52,9 por ciento. La prevalencia de caries fue de 33,3 por ciento, el índice total de caries en dentición permanente de 1,1 ± 1,8 y el índice total de caries en dentición temporal y permanente de 2,6 ± 3,3. El índice de higiene bucal simplificado para los 123 sujetos fue de 1,30 ± 0,58. Conclusiones: La mayor parte de los sujetos tenían un cepillado asistido y lo realizaban dos veces al día. Los hábitos bucales más prevalentes fueron el bruxismo y la respiración bucal. En los 123 sujetos con trastorno del espectro autista se observó una baja prevalencia de caries, un índice total de caries en dentición permanente muy bajo y un índice de higiene bucal regular(AU)

Registro del Grupo NADYA-SENPE de Nutrición Enteral Domiciliaria en España; años 2016 y 2017 / Spanish home enteral nutrition registry of the year 2016 and 2017 from the NADYA-SENPE Group

Objetivo: exponer los resultados del registro de nutrición enteral domiciliaria (NED) de los años 2016 y 2017 del Grupo NADYA-SENPE. Material y métodos: se recopilaron los pacientes introducidos en el registro del 1 de enero al 31 de diciembre de 2016 y la mismas fechas de 2017 para proceder al análisis descriptivo y analítico de los datos. Resultados: en el año 2016 se obtuvieron 4.578 pacientes activos (prevalencia = 98,33 pacientes/millón de habitantes) y en 2017 fueron 4.777 (prevalencia = 102,57). Por sexos, hubo un 50,8% de varones en 2016 y un 50,5% en 2017. En el periodo 2016-17, la edad mediana fue de 71,5 años (IIQ 57-83); asimismo, finalizaron 1.558 episodios de NED y la causa principal fue el fallecimiento (793 pacientes, 50,89%). Los varones adultos fueron más jóvenes que las mujeres (65,3 vs. 73,3 años, p-valor < 0,001) y el diagnóstico más frecuente fue la enfermedad neurológica que cursa con afagia o disfagia severa (59%). La sonda nasogástrica (SNG) fue la vía de acceso más utilizada (48,3%) y se observa, además, que esta es la vía que se utiliza en los pacientes más ancianos (p < 0,001). Se registraron 126 pacientes pediátricos (57,1% niñas). La edad mediana de inicio de la NED fue de cuatro meses. Otras patologías fue el grupo diagnóstico más registrado (41,3%), seguido por la enfermedad neurológica que cursa con afagia o disfagia severa. Se alimentaban a través de gastrostomía en el 57,6% de los casos. Se observó que los niños más pequeños eran los que se alimentaban preferentemente por SNG (p-valor 0,001). Conclusiones: el número de pacientes del registro, así como el número de centros participantes, se va incrementando progresivamente. Las principales características de los pacientes no han variado. A pesar del aumento de posibilidades diagnósticas en la población pediátrica, llama la atención la clasificación dentro del grupo de Otras patologías

Objective: to present the results of the Spanish home enteral nutrition (HEN) registry of the NADYA-SENPE group for the year 2016 and 2017. Material and methods: from January 1st 2016 to December 31st 2017, the HEN registry was recorded and afterwards a further descriptive and analytical analysis was done. Results: in 2016, 4,578 active patients were recorded and prevalence was 98.33 patients per one million inhabitants; in 2017, 4,777 patients were recorded, with a prevalence of 102.57 per one million inhabitants; 50.8% were males in 2016 and 50.5% in 2017. During the period 2016-17, median age was 71.5 years (IIQ 57-83), 1,558 HEN episodes were finished and the main cause was death (793 patients, 50.89%). Adult males were younger than females (65.3 vs. 73.3 years, p-value < 0.001). The most frequent diagnosis was the neurological disorder that presents with aphagia or severe dysphagia (59%). Nasogastric tube was the most frequent administration route (48.3%) and it is the most widely used in elderly patients (p < 0.001). One hundred and twenty-six pediatric patients were registered (57.1% females). Median age at the beginning of HEN in children was four months. "Other disorders" was the most recorded diagnostic group (41.3%), followed by the group of neurological disorder that presents with aphagia or severe dysphagia. Regarding children, 57.6% were fed through gastrostomy and the younger ones were fed through nasogastric tube (p-value 0.001). Conclusions: the number of patients in the registry, as well as the number of participating centers, is progressively increasing. The main characteristics of the patients have not changed. Despite the increase in diagnostic possibilities in the pediatric population, the classification within the group of "Other pathologies" is quite significant

Psychoeducational intervention to improve oral assessment in people with autism spectrum disorder, BIO-BIO region, Chile

Background: To assess the effectiveness of a psychoeducational intervention program designed to facilitate the performance of a series of steps of oral examination in children, adolescents and adults with autism spectrum disorder (ASD), in the Bio-Bio region, Chile. Material and Methods: A prospective, quasi-experimental study with pre-intervention, post-intervention and maintenance tests was carried out. Behavior was measured using Frankl’s scale and the number of steps of a dental examination completed (1-10 steps) was also recorded. Only 104 of the 188 subjects with ASD that agreed to participate in the study met all the inclusion criteria. Results: 82 people with ASD completed the psychoeducational intervention. The mean number of steps achieved pre- and post-intervention was 4.1 and 9.4, resulting in a clinically and statistically significant difference. Regarding behavior, the median in the pre-test was 2 (negative behavior) and in the post-test it increased to 3 (positive behavior), this difference being relevant and statistically significant. A maintenance test one month later on 63 people with ASD found no variations in behavior and in the number of examination steps completed. Conclusions: The proposed intervention was effective as an increase of more than 5 in the number of steps of examination completed was achieved. Frankl's behavior rating also increased, from negative to positive, in a group of children, adolescents and adults with ASD

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Dental examiners consistency in applying different oral health indices in permanent dentition for a population-based study

Different indices to identify dental diseases have been developed. For population-based studies, it is imperative to use simple and reliable indices, but most importantly, clinical examiners should reach an agreement, in order to increase inter-observer reliability and obtain reliable data. The objective of this study was to describe the calibration process of the Dental Aesthetic Index, Community Periodontal Index, Simplified Oral Hygiene Index and International Caries Detection and Assessment System ICDAS II by two academics from the Public Health Department of Dentistry. All calibrations started with the individual reading of the official documents of each index and, when possible, were followed by a lecture, in-vitro or ex-vivo training and concluded with an in-vivo training. A high inter-observer reliability was obtained between the two academics in all indices.

Use of the Explicit Health Guarantee of Oral Health Care for Pregnant Women at a Family Health Center, Concepción, Chile, 2014-2015.

BACKGROUND: Oral health plays a crucial role in general health, quality of life and well-being of pregnant women and their newborns. In Chile, pregnant women have dental care guaranteed by law. However, due to the lack of previous epidemiological studies on the benefits of this guarantee, it is necessary to describe this situation and evaluate the need to change the methods of providing dental services. OBJECTIVES: The objective of this study was to describe the pattern of providing dental benefits resulting from the Explicit Health Guarantee - Integral Oral Health in Pregnant Women (GES-SOIE) program to pregnant women attending the Juan Soto Fernández Family Health Center, Concepción, Chile, in 2014-2015. MATERIAL AND METHODS: A cross-sectional study of the electronic dental records of patients admitted to GES-SOIE was conducted. The variables studied were sociodemographic data, dental chair hours, non-attendance, treatment completion, and the type of referral to secondary healthcare (SHC). RESULTS: Of 233 pregnant women, 65.2% were registered for non-attendance, 21.2% required referral to SHC and 76.4% completed their treatment. When performing logistic regression, it was found that for each non-attendance the chance of not completing the treatment increased 1.4 times. CONCLUSIONS: The level of non-attendance and opting out of the treatment in pregnant women is high, which hinders the proper functioning and effectiveness of GES-SOIE.

Exploratory factor analysis of the chilean deafness attitude scale

Negative attitudes mean a barrier for People with Disability (PwD), but attitudes towards Deaf people are structurally different from the rest of the PwD. The aim of this study is to evaluate the factorial structure and internal reliability of the Attitudes towards Deafness Scale (ADS) applied in health professionals from Concepcion, Chile. The ADS was translated to Spanish and back-translated to English, then reviewed by public health experts, and a pilot application was carried out to 15 health professional to make final modifications. The Chilean ADS version was applied to 182 health professional from primary care centers and academics working in health schools. Reliability analysis with estimation of the Cronbach's alpha coefficient, and exploratory factor analysis were made. The data presented adequate values to perform exploratory factor analysis (KMO=0.73; Bartlett's sphericity test p <0.00001). A maximum likelihood extraction method and a Quartimax rotation method with Kaiser standardization were used for a four-factor model, in which 11 items presented loads of less than 0.5, so the final model was left with 11 items. A Cronbach's alpha coefficient of 0.70 was determined in the final model, with an alpha of 0.77 for the first factor, 0.55 for the second, 0.77 for the third, and 0.61 for the fourth. The exploratory factor analysis suggested a four-dimensional structure for ADS Chilean version. The four subscales and the scale in general presented an adequate Cronbach's alpha, suggesting acceptable internal consistency

Aprendizaje cooperativo para la formación universitaria en alfabetización en salud / Cooperative learning for university education in health literacy

Introducción: La difusión de los conocimientos biosanitarios y la rapidez con la que se difunden en Internet puede generar aprendizajes erróneos por falta de una formación científica adecuada, de ahí la necesidad de realizar intervenciones formativas sobre alfabetización en salud. Sujetos y métodos: Se ha realizado un estudio descriptivo cuasiexperimental para comprobar la eficacia de una estrategia educativa en torno a la alfabetización en salud. La muestra objeto de estudio procede de un posgrado oficial destinado a la formación de futuros profesores. Los estudiantes trabajaron un contenido mediante técnicas de aprendizaje tutorizado cooperativo. El instrumento de medida ha sido la evaluación de los conocimientos científicos adquiridos y las emociones experimentadas por los estudiantes. Resultados y conclusiones: El análisis estadístico realizado permite comprobar que la metodología empleada facilita la alfabetización en salud. Se discute su proyección desde el medio universitario a la sociedad, haciendo hincapié en los paralelismos existentes entre la alfabetización en salud y el empoderamiento de los pacientes

Introduction: The dissemination of biosanitary knowledge and the speed with which they spread on the Internet, can generate erroneous learning due to lack of adequate scientific training. Hence the need to carry out training interventions on health literacy. Subjects and methods: A descriptive, quasi-experimental study was carried out to verify the effectiveness of an educational strategy around health literacy. The sample under study comes from an official postgraduate course for the training of future professors. Students worked on content using cooperative tutoring learning techniques. The instrument of measurement has been the evaluation of the acquired scientific knowledge and the emotions experienced by the students. Results and conclusions: The statistical analysis performed shows that the methodology used facilitates health literacy. It discusses its projection from the university to society, emphasizing the parallels between the health literacy and the empowerment of patients

Successful Establishment of Plasmids R1 and pMV158 in a New Host Requires the Relief of the Transcriptional Repression of Their Essential rep Genes.

Although differing in size, encoded traits, host range, and replication mechanism, both narrow-host-range theta-type conjugative enterobacterial plasmid R1 and promiscuous rolling-circle-type mobilizable streptococcal plasmid pMV158 encode a transcriptional repressor protein, namely CopB in R1 and CopG in pMV158, involved in replication control. The gene encoding CopB or CopG is cotranscribed with a downstream gene that encodes the replication initiator Rep protein of the corresponding plasmid. However, whereas CopG is an auto-repressor that inhibits transcription of the entire copG-repB operon, CopB is expressed constitutively and represses a second, downstream promoter that directs transcription of repA. As a consequence of the distinct regulatory pathways implied by CopB and CopG, these repressor proteins play a different role in control of plasmid replication during the steady state: while CopB has an auxiliary role by keeping repressed the regulated promoter whenever the plasmid copy number is above a low threshold, CopG plays a primary role by acting coordinately with RNAII. Here, we have studied the role of the regulatory circuit mediated by these transcriptional repressors during the establishment of these two plasmids in a new host cell, and found that excess Cop repressor molecules in the recipient cell result in a severe decrease in the frequency and/or the velocity of appearance of transformant colonies for the cognate plasmid but not for unrelated plasmids. Using the pMV158 replicon as a model system, together with highly sensitive real-time qPCR and inverse PCR methods, we have also analyzed the effect of CopG on the kinetics of repopulation of the plasmid in Streptococcus pneumoniae. We show that, whereas in the absence of CopG pMV158 repopulation occurs mainly during the first 45 min following plasmid transfer, the presence of the transcriptional repressor in the recipient cell severely impairs the replicon repopulation and makes the plasmid replicate at approximately the same rate as the chromosome at any time after transformation, which results in maximal plasmid loss rate in the absence of selection. Overall, these findings indicate that unrepressed activity of the Cop-regulated promoter is crucial for the successful colonization of the recipient bacterial cells by the plasmid.

[Home parenteral nutrition: a consensus document of experts from Andalucia and Extremadura]. / Documento de consenso de expertos de Andalucía y Extremadura sobre la nutrición parenteral domiciliaria.

Home parenteral nutrition (HPN) is a technique that has allowed the survival in the community of those patients with serious diseases resulting in an intestinal failure that made their nutrition impossible by other methods. It is indicated if there is a documented intestinal failure (understood by the reduction of the intestinal function to the minimum to the point that intravenous supplementation is required to maintain health and/or growth) with impossibility for oral or enteral exclusive nutrition, provided that there is the possibility of managing the patient at home and that there is no short-term survival expectancy. It requires taking into account the patient's quality of life, family environment and the capacity of the patient and/or their caregivers to be trained for HPN therapy. In low prevalence health topics, as intestinal failure, where the available scientific evidence is of poor quality, consensus documents add value in decision-making. Furthermore, HPN is a complex process and, although there is extensive experience in its application and even clinical practice guidelines, in daily practice there are uncertainties about its suitability, usefulness, rational use and associated costs. For this reason, this document of consensus has been carried out, using the GRADE method. With this document we intend to define our position with regard to the current use of HPN in our country and answer several controversial questions related to this treatment.

La nutrición parenteral en domicilio (NPD) es una técnica que ha permitido la supervivencia en la comunidad de aquellos pacientes con enfermedades graves resultantes en un fallo intestinal que hacía imposible su nutrición por otros métodos. Esta está indicada si existe un fallo intestinal documentado (entendido como la reducción de la función intestinal al mínimo hasta el punto de que se requiere suplementación intravenosa para mantener la salud y/o el crecimiento) con imposibilidad para la nutrición exclusiva por vía oral/enteral, posibilidad de manejo del enfermo en el domicilio y que no exista una expectativa corta de supervivencia, teniendo en cuenta la calidad de vida del paciente, el entorno familiar y la capacidad del paciente y/o de sus cuidadores de entrenamiento para la terapia de NPD.En los problemas de salud poco prevalentes, como es el fallo intestinal, en los cuales la evidencia científica disponible es de baja calidad, los documentos de consenso/expertos aportan valor en la toma de decisiones. Se suma a ello que la NPD es un proceso muy complejo y, a pesar de que existe una amplia experiencia en su aplicación e incluso guías de práctica clínica, en la práctica diaria se plantean incertidumbres acerca de su conveniencia, utilidad, uso racional y costes asociados. Por este motivo se ha realizado este documento de consenso, utilizando el método GRADE, con el que pretendemos definir nuestra posición con respecto al uso actual de la NPD en nuestro país y dar respuesta a una serie de preguntas que generan controversia en relación a este tratamiento.

Dolor del recién nacido expuesto a procedimientos de enfermería en la unidad de neonatología de un hospital clínico chileno / Pain in the newborn in a neonatology unit of a clinical chilean hospital

El objetivo de este estudio fue valorar la intensidad del dolor en los recién nacidos frente a procedimientos de enfermería, que les fueron realizados con ocasión de los cuidados y tratamiento. Se sustentó desde la visión humanista del cuidado de Jean Watson. Metodología: Estudio descriptivo-correlacional, de corte transversal, cuya población estuvo constituida por recién nacidos hospitalizados en la Unidad de Neonatología del Hospital Clínico Herminda Martín de Chillán, en el período de junio a septiembre del año 2015. Para Valorar el dolor se aplicó la escala de valoración del dolor de Susan Givens Bell y un cuestionario semiestructurado de variables sociodemográficas. Resultados: La muestra estuvo conformada por 52 Recién Nacidos en un porcentaje igual de hombres y mujeres. El mayor número de procedimientos realizados fueron instalación de sonda orogástrica, punción venosa y arterial, siendo esta última la causante de dolor moderado en el R.N. El nivel de dolor presentado por la muestra, fue en un 42,3% dolor intenso, el 23,1% dolor moderado y en un 34,6 % no presentó dolor. El Instrumento presentó una confiabilidad con un alfa de Crombach de 0,802. Conclusiones: Los prematuros menores de 37 semanas sintieron mayor dolor que los RN de término.El peso de nacimiento se observó que a mayor peso mayor es el dolor. El APGAR de nacimiento en el estudio se observó que hay una relación directa, pero débil, que a mayor APGAR al nacer, mayor es dolor (AU)

This study was aimed to assess the intensity of pain in newborns against nursing treatments, which were performed during care and treatment. This was sustained from the humanist view of Jean Watson. Method: A cross-sectional descriptive-correlational study, whose population consisted of newborns hospitalized at the Neonatology Unit of the Herminda Martin Clinical Hospital of Chillán, Chile, in the period between June and September, 2015. In order to assess pain, Susan Givens Bell Assessment Scale was applied, as well as a semi-structured Questionnaire of sociodemographic variables. Results: The sample consisted of 52 newborns in an equal percentage of men and women. The greatest number of procedures was the nasogastric tube insetion, venipuncture and arterial puncture, being the latter the cause of moderate pain in newborns. The level of pain presented by the sample was 42.3% intense pain, 23.1% moderate pain and in 34.6% no pain was presented. The instrument presented reliability with a Cronbach’s alpha of 0.802. Conclusions: Premature infants under 37 weeks felt greater pain than full-term newborns. Regarding Barth weight, it was observed that the greater the weight, the grater the pain. Birth APGAR in the study indicated that there is a direct but weak relation and the higher APGAR at birth, the greater the pain (AU)

Documento de consenso de expertos de Andalucía y Extremadura sobre la nutrición parenteral domiciliaria / Home parenteral nutrition: a consensus document of experts from Andalucia and Extremadura

La nutrición parenteral en domicilio (NPD) es una técnica que ha permitido la supervivencia en la comunidad de aquellos pacientes con enfermedades graves resultantes en un fallo intestinal que hacía imposible su nutrición por otros métodos. Esta está indicada si existe un fallo intestinal documentado (entendido como la reducción de la función intestinal al mínimo hasta el punto de que se requiere suplementación intravenosa para mantener la salud y/o el crecimiento) con imposibilidad para la nutrición exclusiva por vía oral/enteral, posibilidad de manejo del enfermo en el domicilio y que no exista una expectativa corta de supervivencia, teniendo en cuenta la calidad de vida del paciente, el entorno familiar y la capacidad del paciente y/o de sus cuidadores de entrenamiento para la terapia de NPD. En los problemas de salud poco prevalentes, como es el fallo intestinal, en los cuales la evidencia científica disponible es de baja calidad, los documentos de consenso/expertos aportan valor en la toma de decisiones. Se suma a ello que la NPD es un proceso muy complejo y, a pesar de que existe una amplia experiencia en su aplicación e incluso guías de práctica clínica, en la práctica diaria se plantean incertidumbres acerca de su conveniencia, utilidad, uso racional y costes asociados. Por este motivo se ha realizado este documento de consenso, utilizando el método GRADE, con el que pretendemos definir nuestra posición con respecto al uso actual de la NPD en nuestro país y dar respuesta a una serie de preguntas que generan controversia en relación a este tratamiento (AU)

Home parenteral nutrition (HPN) is a technique that has allowed the survival in the community of those patients with serious diseases resulting in an intestinal failure that made their nutrition impossible by other methods. It is indicated if there is a documented intestinal failure (understood by the reduction of the intestinal function to the minimum to the point that intravenous supplementation is required to maintain health and/or growth) with impossibility for oral or enteral exclusive nutrition, provided that there is the possibility of managing the patient at home and that there is no short-term survival expectancy. It requires taking into account the patient’s quality of life, family environment and the capacity of the patient and/or their caregivers to be trained for HPN therapy. In low prevalence health topics, as intestinal failure, where the available scientific evidence is of poor quality, consensus documents add value in decision-making. Furthermore, HPN is a complex process and, although there is extensive experience in its application and even clinical practice guidelines, in daily practice there are uncertainties about its suitability, usefulness, rational use and associated costs. For this reason, this document of consensus has been carried out, using the GRADE method. With this document we intend to define our position with regard to the current use of HPN in our country and answer several controversial questions related to this treatment (AU)