Modification of thermal and electrical characteristics of hybrid polymer nanocomposites through gamma irradiation for advanced applications.

In this article, we present a straightforward in-situ approach for producing Ag NPs incorporated in graphene oxide (GO) blended with glutaraldehyde (GA) cross-linked polyvinyl alcohol (PVA) matrix. Samples are γ-irradiated by doses of 2, 5, and 10 kGy and in comparison with the pristine films, the thermal conductivity ('k') and effusivity are measured. 'k' decreases with irradiation doses up to 5 kGy and further increase in the dosage results increase in 'k'. We performed FDTD modeling to verify the effect of polarization and periodicity on the absorptivity and emissivity spectra that are correlated to the 'k' and effusivity, empirically. Hence, we can confess that the structural properties of the prepared hybrid nanocomposite are manipulated by γ-irradiation. This attests that the PVA/GO-Ag/GA nanocomposite is radiation-sensitive and could be employed for thermal management systems. Moreover, their strong electrical insulation, as the measured dc conductivity of the γ-irradiated samples is found to be in the range of 2.66 × 10-8-4.319 × 10-7 Sm-1, which is below the percolation threshold of 1.0 × 10-6 Sm-1, demonstrates that they are excellent candidates for the use of thermal management materials. The low 'k' values allow us to use this promising material as thermal insulating substrates in microsensors and microsystems. They are also great choices for usage as wire and cable insulation in nuclear reactors due to their superior electrical insulation.

Encuesta a los estudiantes tras diez años de enseñanza semipresencial continua de ecocardiografía / Student survey after ten years of continuous blended teaching of echocardiocraphy

Objetivo: Analizar el impacto durante 10 años de nuestro programa de enseñanza semipresencial en ecocardiografía. Métodos y resultados: Se envió una encuesta retrospectiva a todos los médicos especialistas que se graduaron en el programa, desarrollado en la Universidad de Chile, con un equipo docente de Chile y España. Un total de 140 de entre 210 estudiantes, graduados en nuestro programa de 2011 a 2020, respondieron voluntariamente a la encuesta. Entre quienes respondieron, el 53,57% fueron anestesiólogos y el 26,42% intensivistas. Más del 85% de los respondedores indicó que el periodo de enseñanza online cumplió sus expectativas, y el 70,2% indicó que la experiencia práctica cumplió sus objetivos. En un análisis retrospectivo utilizando datos autorreportados, se observaron incrementos significativos en cuanto a frecuencia del uso de ecocardiografía transtorácica y transesofágica del 24,29% al 40,71% y del 13,57% al 27,86%, respectivamente, tras el programa, en comparación con el periodo anterior al mismo. Se usó la ecocardiografía principalmente en el periodo perioperatorio (56,7%) y en cuidados intensivos (32,3%), mientras que solo el 11% de los respondedores la utilizó en unidades de urgencia. Además, el 92,4% de los respondedores reveló que la información aprendida durante el programa había sido muy útil para su práctica posterior. Conclusiones: A lo largo de una década de uso, el programa de aprendizaje semipresencial de ecocardiografía fue evaluado satisfactoriamente por los especialistas que se graduaron en el programa, siendo asociado a un incremento significativo del uso de ecocardiografía en el periodo perioperatorio y en cuidados intensivos. El principal desafío es establecer un periodo más prolongado de práctica, y lograr un mayor alcance en la medicina de urgencias.(AU)

Objective:To analyse the impact of 10 years of blended echocardiography teaching. Methods and results: A questionnaire was emailed to all medical doctors who graduated from the blended learning diploma in echocardiography developed by the University of Chile and taught by a team from Chile and Spain. One hundred and forty of the 210 students who graduated from the program between 2011 and 2020 completed the questionnaire: 53.57% were anaesthesiologists, and 26.42% were intensivists. More than 85% of respondents indicated that the online teaching met their expectations, and 70.2% indicated that the hands-on practice fulfilled the stated objectives. In a retrospective analysis using self-reported data, graduates reported that their use of transthoracic and transoesophageal echocardiography has increased from 24.29% to 40.71% and from 13.57% to 27.86%, repectively, after the programme compared to before the programme. They used echocardiography mainly in the perioperative period (56.7%) and during intensive care (32.3%), while only 11% of respondents used it in emergency care units. Nearly all (92.4%) respondents reported that the skills learned was very useful in their professional practice. Conclusions: Ten years after its launch, the blended learning diploma in echocardiography was well rated by graduate specialists, and is associated with a significant increase in the use of echocardiography in the perioperative period and during intensive care. The main challenges are to establish a longer period of practice and achieve greater implantation in emergency medicine.(AU)

Co-occurrence of native and invasive macroalgae might be facilitated under global warming.

Climate change is driving compositional shifts in ecological communities directly by affecting species and indirectly through changes in species interactions. For example, competitive hierarchies can be inversed when competitive dominants are more susceptible to climate change. The brown seaweed Fucus vesiculosus is a foundation species in the Baltic Sea, experiencing novel interactions with the invasive red seaweed Gracilaria vermiculophylla, which is known for its high tolerance to environmental stress. We investigated the direct and interactive effects of warming and co-occurrence of the two algal species on their performance, by applying four climate change-relevant temperature scenarios: 1) cooling ) 2 °C below ambient - representing past conditions), 2) ambient summer temperature (18 °C), 3) IPCC RCP2.6 warming scenario (1 °C above ambient), and 4) RCP8.5 warming (3 °C above ambient) for 30 days and two compositional levels (mono and co-cultured algae) in a fully-crossed design. The RCP8.5 warming scenario increased photosynthesis, respiration, and nutrients' uptake rates of mono- and co-cultured G. vermiculophylla while growth was reduced. An increase in photosynthesis and essential nutrients' uptake and, at the same time, a growth reduction might result from increasing stress and energy demand of G. vermiculophylla under warming. In contrast, the growth of mono-cultured F. vesiculosus significantly increased in the highest warming treatment (+3 °C). The cooling treatment (-2 °C) exerted a slight negative effect only on co-cultured F. vesiculosus photosynthesis, compared to the ambient treatment. Interestingly, at ambient and warming (RCP2.6 and RCP8.5 scenarios) treatments, both F. vesiculosus and G. vermiculophylla appear to benefit from the presence of each other. Our results suggest that short exposure of F. vesiculosus to moderate or severe global warming scenarios may not directly affect or even slightly enhance its performance, while G. vermiculophylla net performance (growth) could be directly hampered by warming.

Perfil de muestras de ketamina analizadas entre el 2017-2022 / Profile of ketamine´s samples analyzed during 2017-2022

La ketamina es un anestésico disociativo que actúa como antagonista no competitivo del receptor NMDA (N-metil-D-aspartato). Actualmente se utiliza como anestésico y analgésico en medicina veterinaria y en algunas áreas de la medicina humana. La sensación disociativa que produce la ketamina comúnmente denominada “K-Hole o fuera del cuerpo”, es placentera para algunos individuos, y ha llevado a la ketamina a ganar popularidad como droga recreativa. En el presente estudio se evaluó la cantidad de muestras positivas a ketamina provenientes de distintas fiscalías de Chile entre el 2017-2022, colocando atención a muestras liquidas transparentes, donde se cuantificaron 49 muestras mediante HPLC/UV-DAD, obteniendo resultados en porcentaje de ketamina clorhidrato. Se observó si existe una relación en cuanto a la concentración y procedencia de incautación con productos veterinarios o humanos de venta legal que contienen esta sustancia. Se puede concluir que entre los años 2017 al 2022 hubo un aumento significativo en el análisis de muestras positivas a ketamina pasando de 72 muestras en el 2017 a 3202 muestras el 2022. En cuanto a las muestras liquidas transparentes positivas a ketamina, no presentaron una tendencia definida en los años evaluados. Con respecto a la concentración de ketamina clorhidrato, se aprecia que las concentraciones se encuentran en el rango de 8-12%, observándose una directa relación con la ketamina de uso veterinario que se encuentra al 10% de ketamina clorhidrato, paralelamente, la procedencia de incautación de ketamina liquida a nivel nacional, se concentra en las regiones de Arica y Parinacota y Tarapacá.(AU)

Ketamine is a dissociative anesthetic that act as non-competitive antagonist at N-methyl-D-aspartate (NMDA) receptors. Nowadays, ketamine is used in veterinary medicine and some areas on human medicine as anesthetic and analgesic. The dissociative effect produced by ketamine called “k-Hole or out of body” is pleasant to some individuals, and has led to it gaining in popularity as a recreational drug. The present study evaluated the number of positives samples for ketamine from different Chilean prosecutors between 2017 and 2022. In addition, the study paid attention in transparent liquid samples, quantifying 49 of them at random by HPLC/UV-DAD obtain the percentage of ketamine hydrochloride, and correlate this result with the concentration of veterinary and human drugs for legal sale, also, evaluate the origin of seizure of these liquid samples at the national level. Between 2017 and 2022, there was a significant increase of positive samples for ketamine, from 72 samples in 2017 to 3202 samples in 2022. Otherwise, transparent liquid samples positives for ketamine did not show a defined trend in the years evaluated. Results of the quantification of liquid samples are in the range of 8-12%; these results show a direct relation with veterinary ketamine products, which are available at 10% of ketamine hydrochloride. Additionally, the origin of seizure of liquid ketamine at the national level is concentrated in the north regions of Chile: Arica and Parinacota, and Tarapacá.(AU)

Gender Differences in Self-reported Faculty Developmental Networks.

Scholars have long recognized gender variation in social relationship dynamics. However, how gender shapes developmental networking relationships for career advancement, particularly among university faculty members, is understudied. This area of research is important since women comprise an increasing proportion of faculty and yet report receiving less mentoring and lower career satisfaction, productivity, and advancement than their male counterparts. This cross-sectional study assessed gender differences in self-reported dimensions of faculty participants' developmental networks by collecting information on relationships with developers, who are people who have taken concerted action and offered professional and personal guidance to help participants advance in their careers over the past year. The investigators used egocentric network data from an electronically administered Mentoring Network Questionnaire collected from 159 faculty involved in a mentoring intervention during the pandemic. Faculty were from multiple Southwest and Mountain West institutions. Statistical analyses were performed using the Chi-squared test, Wilcoxon rank-sum test, and unadjusted multilevel regression. Female faculty chose developers of lower gender diversity than male faculty (p=0.01). Compared to male faculty, female faculty reported receiving more psychosocial support from individual developers (p=0.03). Female faculty members' developers were more often characterized as friends and less often described as sponsors and allies than male faculty, based on relative levels of career and psychosocial support that individual developers provided (p<0.001). No gender differences were found in other network characteristics. Female faculty build developmental networks that have different factors compared to male faculty. Greater levels of psychosocial support and fewer allies and sponsors for female faculty may have long-term implications for differential career advancement for women vs. men in academic careers. Strategies to enhance networking should address gender differences and include a structured framework for assessing network gaps.

Curriculum-based Faculty Training in Networking: Knowledge and Self-efficacy Outcomes.

Although the advantages of developmental networks are well-known, most faculty do not know how to participate in such networks actively. Additionally, institutions face challenges in teaching faculty the best practices of networking. This deficiency constitutes a critical gap in the literature, which may slow career advancement for faculty, particularly from underrepresented groups. The study's purpose was to examine the effectiveness of a curriculum-based faculty training in developmental networks, utilizing the Extension for Community Health Outcomes (ECHO) platform. In this pre-post study, 33 faculty members participated in the intervention utilizing eight modules involving four competencies. Each module followed a standard format, including a short didactic, two facilitated case study discussions based on real-life scenarios, and self-reading of selected literature. Outcomes included (i) change in knowledge scores obtained from two questions per module and (ii) self-efficacy scores measured on a scale of 0-100. Paired student's t-test and mixed model regression analyses were used. A significant increase in knowledge score was documented using mixed model regression for 4 of the eight modules (mean change score 0.4-0.8, p≤0.03 for all analyses). The proportion of faculty participants reporting correct knowledge items for all modules increased from 49.8% (pre) to 64.3% (post), which was statistically significant (p<0.001). Significant increases in paired self-efficacy scores were reported for each of the eight modules (mean change score 17-37, p<0.05 for all analyses). This study highlights the importance of curriculum-based training in networking. Participants showed a significant increase in pre-post networking self-efficacy and knowledge scores. Our ECHO-based curriculum, facilitator training, and manual enable easy implementation in other institutions, ensuring scalability and adaptability. Our analysis provides the evidence basis for examining the impact of a developmental network intervention in enhancing individual career networks.

Determinantes Sociales y Conocimiento de Higiene Oral en Inmigrantes

RESUMEN: Se desconoce la relación entre determinantes sociales y nivel de conocimiento asociado a los hábitos de higiene oral que tiene la población inmigrante en la V región, Chile en el año 2021. El objetivo de este trabajo consistió en determinar la relación entre determinantes sociales en salud y nivel de conocimientos asociado a hábitos de higiene oral en inmigrantes de la V región 2021, Chile. Estudio descriptivo, transversal, No probabilístico por conveniencia con encuesta previamente validada y una muestra de 101 sujetos de 18 a 35 años. Se mide la prevalencia de los determinantes sociales. Después de verificar la normalidad de los resultados, se efectúa análisis descriptivo e inferencial mediante estadístico de Pearson y T-student. El Margen de error de la muestra es de 10 % y un nivel de confianza de 95 %. Técnica de recogida de datos en vía pública, formulario online y búsqueda activa en centros de reunión de migrantes. De los sujetos encuestados, un 29 % tiene estudios de nivel primario incompleto, un 36 % tiene un ingreso mensual menor a US$300. Respecto a los hábitos de higiene, solamente un 27 % se cepilla después de cada comida, el porcentaje restante se cepilla dos o menos veces al día. Destaca que un 71 % tiene acceso a la salud pública y un 20 % no tiene protección de salud. Se relacionaron 86 pares de variables con estadística inferencial. Los resultados demuestran asociación en 12 de ellas, de las cuales: Nivel de educación, rango de ingresos y sistema previsional se relacionan con los hábitos de higiene y nivel de conocimiento (significancia asintótica bilateral menor a 0.05). De igual manera, se observa que aquellos que están adscritos a un sistema previsional, tienen mejores hábitos y nivel de conocimiento que la población sin cobertura. Las características multifactoriales relacionadas a las causas del movimiento migratorio en Latinoamérica, promueven determinantes sociales disminuidos. Si bien, existe evidencia científica que relaciona los determinantes sociales con el estado de salud de un individuo, la literatura asociada al nivel de conocimientos y hábitos de higiene es escasa. A partir de los resultados obtenidos, se concluye que las particularidades del inmigrante en Chile son propicias para una salud oral menguada en calidad, por lo que debiese ser discutida como política sanitaria a nivel país.

ABSTRACT: The objective of this study is to determine the relationship between social determinants of health and the level of knowledge associated with oral hygiene habits among migrants in the V Region 2021, Chile. Descriptive, cross-sectional, non-probabilistic study by convenience with a previously validated survey and a sample of 101 subjects aged 18 to 35 years. The prevalence of social determinants was measured. After verifying the normality of the results, descriptive and inferential analysis was performed using Pearson and T-student statistics. The margin of error of the sample is 10 % and a confidence level of 95 %. Data collection on public roads, online form and active search in migrant meeting centers. Of the subjects surveyed, 29 % have incomplete primary education, 36 % have a monthly income of less than US$300. With respect to hygiene habits, only 27 % brushed after every meal, the remaining percentage brushed two or fewer times a day. It should be noted that 71 % have access to public health care and 20 % have no health protection. Eighty-six pairs of variables were related with inferential statistics. The results show an association in 12 of them, of which: level of education, income range and social security system are related with the following variables and pension system are related to hygiene habits and level of knowledge (bilateral asymptotic significance less than 0.05). Likewise, it is observed that those who are affiliated to a pension system have better habits and level of knowledge than those who are not, have better habits and level of knowledge than the population without coverage. The multifactorial characteristics related to the causes of migratory movement in Latin America promote diminished social determinants. Although there is scientific evidence that relates social determinants to the health status of an individual, the literature associated with the level of knowledge and hygiene habits is limited. From the results obtained, it is concluded that the particularities of the migrants in Chile are conducive to a lower quality of oral health, which should be discussed as a health policy at a national level.

Search for the optimal genotoxicity assay for routine testing of chemicals: Sensitivity and specificity of conventional and new test systems.

Many conventional in vitro tests that are currently widely used for routine screening of chemicals have a sensitivity/specificity in the range between 60 % and 80 % for the detection of carcinogens. Most procedures were developed 30-40 years ago. In the last decades several assays became available which are based on the use of metabolically competent cell lines, improvement of the cultivation conditions and development of new endpoints. Validation studies indicate that some of these models may be more reliable for the detection of genotoxicants (i.e. many of them have sensitivity and specificity values between 80 % and 95 %). Therefore, they could replace conventional tests in the future. The bone marrow micronucleus (MN) assay with rodents is at present the most widely used in vivo test. The majority of studies indicate that it detects only 5-6 out of 10 carcinogens while experiments with transgenic rodents and comet assays seem to have a higher predictive value and detect genotoxic carcinogens that are negative in MN experiments. Alternatives to rodent experiments could be MN experiments with hen eggs or their replacement by combinations of new in vitro tests. Examples for promising candidates are ToxTracker, TGx-DDI, multiplex flow cytometry, γH2AX experiments, measurement of p53 activation and MN experiments with metabolically competent human derived liver cells. However, the realization of multicentric collaborative validation studies is mandatory to identify the most reliable tests.

First detection of SARS-CoV-2 variant B.1.1.529 (Omicron) in Ecuador.

The National Institute of Research and Public Health reported the first local record of the Omicron variant detected in Ecuador. A fully vaccinated subject returned from South Africa with a negative RT-PCR. We present the cumulative frequency of the variants in Ecuador and a phylogenetic analysis of this new Omicron.

Características e impactos del aprendizaje entre pares en estudios universitarios en ciencias de la salud: una revisión sistemática / Characteristics and impacts of peer assisted learning in university studies in health science: A systematic review

Objetivo: Analizar sistemáticamente las características y los impactos de los programas e iniciativas de aprendizaje asistido por pares realizados en estudios universitarios en ciencias de la salud en los cursos de pregrado. Métodos: Siguiendo el protocolo PRISMA, se realizó una búsqueda en las bases de datos indexadas en WoS y SCOPUS, con todos los trabajos originales que reportan aprendizaje asistido por pares en estudios universitarios en ciencias de la salud. Se seleccionaron artículos originales entre enero de 2010 y enero de 2020, analizando la información sobre las características de los programas y los principales resultados e impactos de los estudios. Resultados: Se incluyeron 47 estudios en la revisión. Las características de los programas más representadas fueron la utilización de la modalidad aprendizaje entre pares próximos, el uso de clases teóricas, laboratorios clínicos y la capacitación a los tutores pares. Los principales impactos identificados son los beneficios en la confianza y en el conocimiento de los tutores, la mejor comprensión de los contenidos y la mayor comodidad en comparación con los tutores académicos en los estudiantes. Conclusión: Los programas de aprendizaje asistido por pares han demostrado beneficios cualitativos relativos al ambiente de aprendizaje, la generación de redes de apoyo y la confianza en los conocimientos adquiridos. Sin embargo, los beneficios cuantitativos, medidos como mejoría en las calificaciones, no son concluyentes. Se necesitan futuros estudios que busquen indagar sobre las metodologías utilizadas para detectar qué características impactan más positivamente sobre el proceso de aprendizaje (AU)

Objective: Systematically analyse the characteristics and impact of peer assisted learning programmes implemented in undergraduate health education. Methods: Following the PRISMA protocol, we searched the electronic indexed databases WoS and SCOPUS; original studies reporting peer assisted learning in health science careers were included in the systematic review. Among them, the studies between 2010 and January 2020 were selected, and information regarding programme structures and principal results was subsequently extracted. Results: A total of 47 studies were included in the review. The most frequent programme characteristics were the near-peer teaching modality, lecture classes, clinical laboratories and peer tutor training. The main findings identified were benefits in tutors’ confidence and knowledge, better student comprehension and a more comfortable learning environment in comparison with that established by academic tutors. Conclusion: Peer assisted learning programmes have shown qualitative benefits in the learning environment, generation of support networks and confidence in knowledge acquired. Nonetheless, quantitative benefits measured as improvements in marks are inconclusive. Future studies are needed to standardise the methodologies used to determine which characteristics are the most positive in the learning process (AU)

Disease activity in inflammatory bowel disease patients is associated with increased liver fat content and liver fibrosis during follow-up.

PURPOSE: Liver steatosis is a frequently reported condition in patients with inflammatory bowel disease (IBD). Different factors, both metabolic and IBD-associated, are believed to contribute to the pathogenesis. The aim of our study was to calculate the prevalence of liver steatosis and fibrosis in IBD patients and to evaluate which factors influence changes in steatosis and fibrosis during follow-up. METHODS: From June 2017 to February 2018, demographic and biochemical data was collected at baseline and after 6-12 months. Measured by transient elastography (FibroScan), liver steatosis was defined as Controlled Attenuation Parameter (CAP) ≥248 and fibrosis as liver stiffness value (Emed) ≥7.3 kPa. IBD disease activity was defined as C-reactive protein (CRP) ≥10 mg/l and/or fecal calprotectin (FCP) ≥150 µg/g. Univariate and multivariate regression analysis was performed; a p-value of ≤0.05 was considered significant. RESULTS: Eighty-two out of 112 patients were seen for follow-up; 56% were male. The mean age was 43 ± 16.0 years, and mean BMI was 25.1 ± 4.7 kg/m2. The prevalence of liver steatosis was 40% and of fibrosis was 20%. At baseline, 26 patients (32%) had an active episode of IBD. Using a multivariate analysis, disease activity at baseline was associated with an increase in liver steatosis (B = 37, 95% CI 4.31-69.35, p = 0.027) and liver fibrosis (B = 1.2, 95% CI 0.27-2.14, p = 0.016) during follow-up. CONCLUSIONS: This study confirms the relatively high prevalence of liver steatosis and fibrosis in IBD patients. We demonstrate that active IBD at baseline is associated with both an increase in liver steatosis and fibrosis during follow-up.

Characteristics and impacts of peer assisted learning in university studies in health science: A systematic review.

OBJECTIVE: Systematically analyse the characteristics and impact of peer assisted learning programmes implemented in undergraduate health education. METHODS: Following the PRISMA protocol, we searched the electronic indexed databases WoS and SCOPUS; original studies reporting peer assisted learning in health science careers were included in the systematic review. Among them, the studies between 2010 and January 2020 were selected, and information regarding programme structures and principal results was subsequently extracted. RESULTS: A total of 47 studies were included in the review. The most frequent programme characteristics were the near-peer teaching modality, lecture classes, clinical laboratories and peer tutor training. The main findings identified were benefits in tutors' confidence and knowledge, better student comprehension and a more comfortable learning environment in comparison with that established by academic tutors. CONCLUSION: Peer assisted learning programmes have shown qualitative benefits in the learning environment, generation of support networks and confidence in knowledge acquired. Nonetheless, quantitative benefits measured as improvements in marks are inconclusive. Future studies are needed to standardise the methodologies used to determine which characteristics are the most positive in the learning process.

Systemic ventricular assist device support in Fontan patients: A report by ACTION.

BACKGROUND: The size of the Fontan population with end-stage heart failure is growing. In this population, heart transplantation has been the only option. This study sought to investigate the efficacy of ventricular assist device (VAD) support in Fontan patients. METHODS: We conducted a retrospective study of Fontan patients in the Advanced Cardiac Therapies Improving Outcomes Network. We evaluated patient characteristics, and the clinical and physiologic outcomes after VAD implantation. RESULTS: We identified 45 Fontan patients implanted with VAD. The average age of patients was 10 years (interquartile range: 4.5-18) and 30% were female. The majority had a morphologic right ventricle (69%), moderate or greater ventricular dysfunction (83%), and moderate or greater atrioventricular valve regurgitation (65%). The majority of implants were as a bridge to transplantation (76%), and the majority of patients were Interagency Registry for Mechanically Assisted Circulatory Support Profile 2 (56%). The most commonly employed device was the Medtronic HeartWare HVAD (56%). A total of 13 patients were discharged on device support, and 67% of patients experienced adverse events, the most common of which were neurologic (25%). At 1 year after device implantation, the rate of transplantation was 69.5%, 9.2% of patients continued to be VAD supported, and 21.3% of patients had died. Hemodynamically, VAD was effective in decreasing both Fontan and ventricular end-diastolic pressures in some individuals. CONCLUSIONS: VAD is effective in supporting patients with end-stage Fontan failure awaiting heart transplantation. Future research should focus on identifying clinical and physiologic characteristics predictive of a favorable response to VAD support.

MR Elastography demonstrates reduced white matter shear stiffness in early-onset hydrocephalus.

INTRODUCTION: Hydrocephalus that develops early in life is often accompanied by developmental delays, headaches and other neurological deficits, which may be associated with changes in brain shear stiffness. However, noninvasive approaches to measuring stiffness are limited. Magnetic Resonance Elastography (MRE) of the brain is a relatively new noninvasive imaging method that provides quantitative measures of brain tissue stiffness. Herein, we aimed to use MRE to assess brain stiffness in hydrocephalus patients compared to healthy controls, and to assess its associations with ventricular size, as well as demographic, shunt-related and clinical outcome measures. METHODS: MRE was collected at two imaging sites in 39 hydrocephalus patients and 33 healthy controls, along with demographic, shunt-related, and clinical outcome measures including headache and quality of life indices. Brain stiffness was quantified for whole brain, global white matter (WM), and lobar WM stiffness. Group differences in brain stiffness between patients and controls were compared using two-sample t-tests and multivariable linear regression to adjust for age, sex, and ventricular volume. Among patients, multivariable linear or logistic regression was used to assess which factors (age, sex, ventricular volume, age at first shunt, number of shunt revisions) were associated with brain stiffness and whether brain stiffness predicts clinical outcomes (quality of life, headache and depression). RESULTS: Brain stiffness was significantly reduced in patients compared to controls, both unadjusted (p ≤ 0.002) and adjusted (p ≤ 0.03) for covariates. Among hydrocephalic patients, lower stiffness was associated with older age in temporal and parietal WM and whole brain (WB) (beta (SE): -7.6 (2.5), p = 0.004; -9.5 (2.2), p = 0.0002; -3.7 (1.8), p = 0.046), being female in global and frontal WM and WB (beta (SE): -75.6 (25.5), p = 0.01; -66.0 (32.4), p = 0.05; -73.2 (25.3), p = 0.01), larger ventricular volume in global, and occipital WM (beta (SE): -11.5 (3.4), p = 0.002; -18.9 (5.4), p = 0.0014). Lower brain stiffness also predicted worse quality of life and a higher likelihood of depression, controlling for all other factors. CONCLUSIONS: Brain stiffness is reduced in hydrocephalus patients compared to healthy controls, and is associated with clinically-relevant functional outcome measures. MRE may emerge as a clinically-relevant biomarker to assess the neuropathological effects of hydrocephalus and shunting, and may be useful in evaluating the effects of therapeutic alternatives, or as a supplement, of shunting.

Developmental Networks Among Mentors and Mentees Involved in a Mentoring Intervention.

The growing application of social network-based theories and methods (Burt et al., 2013) in scholarship on mentoring illustrates that mentoring goes beyond dyadic relationships comprising a senior mentor and a junior protégé (Higgins & Kram, 2001). However, limited data exist on the state of developmental networks of university faculty. This study examines developmental network characteristics among mentors and mentees participating in an ongoing intervention that aims to enhance career success through improved mentoring. Cross-sectional data come from 81 faculty mentors and mentees at three universities in the Southwestern United States. Using the online Modified Mentoring Network Questionnaire (MNQ), participants provided information on relationships with developers, who are people that have taken concerted action, and provided professional and/or personal guidance to help participants advance in their careers. An individual's developmental network comprises relationships with developers. We conducted exploratory analyses examining key characteristics of mentors' and mentees' developmental networks. Participants received psychosocial and career support from an average of 4.9 developers (4.8 and 5.1 for mentors and mentees respectively) from 2.3 arenas (2.2 and 2.4 arenas for mentors and mentees, respectively). While the most common arena was the respondents' current job/position (62%, 64% and 59% for all participants, mentors, and mentees respectively), developers were from graduate school (11%, 6% and 17%); prior jobs/positions (13%, 16% and 9%) and family (8%, 5% and 11%). Our preliminary findings suggest that developers are important for university faculty and that methods and insights from social network analysis can be applied to examine their support networks. As our study is part of an ongoing longitudinal intervention, these findings will inform future analyses that will examine changes in developmental network characteristics and its impact on participants' careers.

Fundamentos de mejora de la calidad de vida en citorreducción quirúrgica por carcinomatosis peritoneal / Principles on quality of life improvement in cytoreductive surgery for peritoneal carcinomatosis

Introducción. El abordaje multidisciplinar de la carcinomatosis peritoneal ha permitido un aumento relevante de la supervivencia con una morbimortalidad aceptable. Sin embargo, se dispone de muy poca información sobre el impacto del tratamiento en la calidad de vida de estos pacientes. Una valoración detallada de la calidad de vida perioperatoria debería ser un instrumento de gran valor para conocer sus expectativas y promover estrategias de mejora. Pacientes y método. Estudio retrospectivo de 79 pacientescon indicación de citorreducción quirúrgica entre 2007 y 2019 a los que se realizó un cuestionario adaptado sobre calidad de vida, según el modelo EORTC QLQ-C30 (versión 3.0), al diagnóstico y a los seis meses de finalizar el tratamiento. Se han considerado factores epidemiológicos y clinicoquirúrgicos para determinar su influencia en la valoración realizada. Resultados. La puntuaciónmedia del QLQ-C30 fue de 52.8±6.1 al diagnóstico con influencia notable de la sintomatología tumoral y 64.6±6.3 postratamiento a costa de una limitación funcional y pobre percepción de salud. Un perfil de paciente mujer menor de 65 años es más susceptible de puntuaciones más altas. El estado nutricional parece afectar a la percepción de calidad de vida (p=0.004). El grado de citorreducción (p=0.048) y la influencia de complicaciones postoperatorias mayores (p=0.041) también podrían contribuir en la opinión del paciente. Conclusiones. La escala EORTC QLQ-C30 nos aproxima a la percepción subjetiva del paciente intervenido por carcinomatosis peritoneal pero carece de una estandarización, quizás por influencia de factores socioculturales propios del área geográfica donde se desarrolla la enfermedad. (AU)

Background. Peritoneal carcinomatosis muldisciplinar approach has allowed an outstanding increase in survival with acceptable morbidity and mortality. Nonetheless, there is very little available information on the quality of life treatment impact for these patients. A perioperative quality of life detailed assessment should be a valuable instrument to know their expectations and promote improvement strategies. Patients and method. Retrospective study of 79 patients with an indication for cytoreductive surgery between 2007 and 2019 who filled out an adapted quality of life questionnaire, according to the EORTC QLQ-C30 (version 3.0), at diagnosis and six months post-treatment. Epidemiological, clinical and surgical factors have been taken into account on the assessment performed. Results. QLQ-C30 mean score was 52.8±6.1 at diagnosis with a remarkable influence of tumour symptoms and 64.6±6.3 after treatment at the expense of functional limitation and poor perception of health. Female-patient profile under 65 years of age is more susceptible to higher scores. Nutritional status seems to affect to the quality of life perception (p=0.004). Cytoreduction degree (p=0.048) in association with major postoperative complications (p=0.041) could also influence patient’s opinion. Conclusions. EORTC QLQ-C30 is bringing closer to patient subjective perception operated on peritoneal carcinomatosis, although lacking standard model, maybe due to the influence of sociocultural factors in the geographic area where the disease is happening. Association existing between survival and best possible quality of life, together with influence of these new variables, could explain their inclusion in this type of questionnaires during cancer treatment assessment and provide strategies for following actions. (AU)

Intubación con el videolaringoscopio Insighters en paciente con épulis gigante / Intubation with the video laryngoscope Insighters in a patient with giant epulis

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Criterios Ergonómicos para el Diseño de Quirófanos / Ergonomic Criteria for Operating Room Design

Resumen El personal involucrado en el área quirúrgica se ve afectado con lesiones musculoesqueléticas por esfuerzos y movimientos repetitivos acumulados. La gravedad de sus lesiones está dada en función de las posturas de trabajo, la especialidad quirúrgica y la disposición de los elementos con los que interactúa. La ergonomía ha tomado relevancia ya que ha hecho aportes muy importantes para las condiciones de trabajo en diferentes áreas. Aun cuando en la literatura se pueden encontrar diversas investigaciones de la frecuencia y los efectos de las lesiones ocupacionales en el personal del área quirúrgica, escasos estudios han propuesto pautas para el diseño ergonómico de quirófanos. El presente estudio engloba cuatro criterios ergonómicos que deben considerarse para el diseño de quirófanos.

Abstract Personnel involved in the surgical area are affected with musculoskeletal injuries due to accumulated repetitive stress and movements. The severity of the injuries is given according to the work postures, the surgical specialty and the arrangement of the elements in the operating room. Ergonomics has become relevant since it has made very important contributions to working conditions in different areas. Although in the literature investigations of the frequency and effects of occupational injuries on surgical staff can be found, few studies have proposed guidelines for the ergonomic design of operating rooms. The present study encompasses four ergonomic criteria that should be considered for the design of operating rooms.

An interdisciplinary approach to perception of water quality for human consumption in a Mapuche community of arid Patagonia, Argentina.

Vital for human consumption, water is a scarce resource, particularly in the arid environments of Patagonia. In this study we analysed local perspectives and the use of different water sources, based on two case studies in rural communities of Mapuche and Creole ancestry inhabiting extra-Andean Patagonia in Chubut, Argentina. Water quality was evaluated using an ethnolimnological, interdisciplinary approach, taking into account local perspectives and scientific contributions. In addition, we analysed appropriation strategies, management and local organoleptic characteristics. The work was based on semi-structured interviews, tours guided by informants, and physicochemical and microbiological analysis of water sources. It was found that 92% of local inhabitants mainly used superficial and subterranean sources of water for consumption, among which stood out: river, streams, springs, wells, and boreholes. Differences were observed between local and scientific perspectives in terms of water quality (chemical and microbiological). Most water sources used by inhabitants presented water of deficient quality for human consumption (61%), whereas locals considered the water to be fresh, delicious, and transparent. Nevertheless, some points of agreement were found in terms of organoleptic characteristics (e.g., odour, colour) and physicochemical parameters in certain water sources. In general, locals do not recognise the deterioration of their water supply, but the importance of organoleptic characteristics in local perception should be highlighted. These aspects speak of a need to promote opportunities for dialogue, and implement effective health measures, taking local perspectives into account.