Capi-score: a quantitative algorithm for identifying disease patterns in nailfold videocapillaroscopy.

OBJECTIVES: The European Alliance of Associations for Rheumatology (EULAR) supports the use of nailfold videocapillaroscopy (NVC) to identify disease patterns (DPs) associated with systemic sclerosis (SSc) and Raynaud's phenomenon (RP). Recently, EULAR proposed an easy-to-manage procedure, a so-called Fast Track algorithm, to differentiate SSc from non-SSc patterns in NVC specimens. However, subjectivity among capillaroscopists remains a limitation. Our aim was to perform a software-based analysis of NVC peculiarities in a cohort of samples from SSc and RP patients and, subsequently, build a Fast Track-inspired algorithm to identify DPs without the constraint of interobserver variability. METHODS: NVCs were examined by 9 capillaroscopists. Those NVCs whose DPs were consensually agreed (≥2 out of 3 interobservers) were subsequently analysed with an in-house developed software. Each variable's results were grouped according to the consensually agreed DPs in order to identify useful hallmarks to categorise them. RESULTS: Eight-hundred and fifty-one NVCs (21 957 images) whose DPs had been consensually agreed were software-analysed. Appropriate cut-offs set in capillary density and percentage of abnormal and giant capillaries, tortuosities and hemorrhages allowed DP categorization and the development of the CAPI-Score algorithm. This consisted of 4 rules: Rule 1, SSc vs non-SSc, accuracy 0.88; Rules 2 and 3, SSc-early vs SSc-active vs SSc-late, accuracy 0.82; Rule 4, non-SSc normal vs non-SSc non-specific, accuracy 0.73. Accuracy improved when the analysis was limited to NVCs whose DPs had achieved full consensus among interobservers. CONCLUSIONS: The CAPI-Score algorithm may become a useful tool to assign DPs by overcoming the limitations of subjectivity.

Clinical experience in the treatment of COVID-19 with monoclonal antibodies in solid organ transplant recipients.

Solid organ transplant (SOT) recipients are at high risk for complications from coronavirus disease 2019 (COVID-19). SOT recipients mount lower immunological responses to vaccines than general population and are at high risk for breakthrough COVID-19 infections. Passive immunotherapy in the form of anti-Spike monoclonal antibodies (MoAbs) may be an alternative for the prophylaxis and treatment of COVID-19 in these patients. SARS-CoV-2 has evolved by accumulating resistance mutations that have escaped the neutralizing action of most MoAbs. However, MoAbs directed at more conserved epitopes and that maintain effector functions could maintain efficacy in the treatment of these patients. According to published data, SOT recipients with low anti-spike antibody responses to vaccination could benefit from the use of MoAbs in pre-exposure prophylaxis, in the treatment of COVID-19 mild to moderate and severe COVID-19 with less than 15 days of symptom duration and low oxygen requirements. Combination therapy could be more effective than monotherapy for the treatment of mild-to-moderate SARS-CoV-2 infection.

Sincronismo muscular en patrones de movimiento de miembros superiores descritos por Kabat: latencia al inicio del pico de la máxima activación electromiográfica / Muscle timing in upper limb movement patterns described by Kabat: Latency at the beginning of the peak of maximum electromyographic activation

Introducción El método Kabat sostiene que el sincronismo normal se produce de distal a proximal, lo cual requiere evidencia electromiográfica. Objetivo Describir el sincronismo muscular de patrones motores de miembros superiores descritos por Kabat, en posiciones sedente y supina, a partir de la medición de la latencia al inicio del pico de la máxima activación electromiográfica (IPMA-EMG) de músculos seleccionados. Material y métodos Se realizó un estudio analítico comparativo. Se evaluó a 20 hombres y 20 mujeres entre 19 y 26 años. Cada participante realizó 3repeticiones activas sin resistencia externa de cada uno de los patrones de movimiento (flexor y extensor) de las 2diagonales. Se registró la latencia del IPMA-EMG para cada uno de los 8músculos evaluados en los 4patrones de movimiento, tanto en supino como en sedente. Estos se promediaron y se ordenaron de menor a mayor para obtener la secuencia de contracciones musculares en cada patrón de movimiento. Se compararon las secuencias obtenidas para cada patrón en sedente y supino y se valoró la existencia de correlaciones entre ellas. Resultados Se observó correlación significativa en las secuencias del IPMA-EMG entre posiciones supina y sedente, en todos los patrones de movimiento (p<0,05), excepto en el patrón extensor de la primera diagonal (p=0,139). No hubo diferencias estadísticamente significativas entre posiciones en ninguno de los patrones (p>0,05). Conclusiones Aunque con variaciones en la IPMA-EMG, se halló, en general, un sincronismo muscular de proximal a distal, más evidenciado en la posición sedente y en los patrones flexores (AU)

Introduction The Kabat method argues that normal synchronism occurs from distal to proximal, which requires electromyographic evidence. Objective To describe the muscular timing of motor patterns of the upper limbs described by Kabat, in seated and supine positions, from the measurement of the latency at the beginning of the peak of the maximum electromyographic activation (BPM-EMG-A) of selected muscles. Material and methods A comparative analytical study was carried out. Twenty men and 20 women between 19 and 26 years old were evaluated. Each participant performed 3active repetitions without external resistance of each of the movement patterns (flexor and extensor) of the 2diagonals. BPM-EMG-A latency was recorded for each of the 8muscles tested in the 4movement patterns, both supine and seated. These were averaged and ordered from lowest to highest to obtain the sequence of muscle contractions in each movement pattern. The sequences obtained for each pattern in seated and supine were compared and the existence of correlations between them was assessed. Results Significant correlation was observed in the BPM-EMG-A sequences between supine and seated positions, in all movement patterns (P<0.05), except in the extensor pattern of the first diagonal (P=0.139). There were no statistically significant differences between positions in any of the patterns (P>0.05). Conclusion Although with variations in BPM-EMG-A, muscle timing was generally found from proximal to distal, more evident in the sitting position and in flexor patterns (AU)

Gamification and cooperative learning: effects of a hybridization in physical education / Gamificación y aprendizaje cooperativo: efectos de una hibridación en educación física

El presente estudio tuvo como objetivo evaluar el impacto de una unidad didáctica de Educación Física (EF) sobre la satisfacción en las clases de EF, la satisfacción de las necesidades psicológicas básicas, la motivación, el clima social escolar y el rendimiento cognitivo. Se utilizó un diseño cuasi-experimental con grupo control para una muestra total de 120 estudiantes de Educación Secundaria (M = 13,48; DT = 1,36) a los que se les administró un cuestionario para analizar las variables de estudio. Se aplicó la unidad didáctica basada en la hibridación de la gamificación y el aprendizaje cooperativo (GF + CL) durante 8 sesiones. El programa mostró mejoras en el índice de mediadores psicológicos, la función ejecutiva de la planificación, la satisfacción de los alumnos de educación física y el clima social escolar, lo que podría ser adecuado para mejorar el rendimiento de los profesores de educación física en los centros educativos. (AU)

The present study aimed to assess the impact of a Physical Education (PE) teaching unit on PE satisfaction classes, basic psychological needs satisfaction, motivation, school social climate and cognitive performance. A quasi-experimental design with a control group was used for a total sample of 120 students of Secondary Education (M = 13,48; SD = 1,36) to whom a questionnaire was administered to analyse the study variables. The teaching unit based on the hybridization of gamification and Cooperative Learning (GF + CL) was applied for 8 sessions. The programme showed improvements in the psychological mediators index, executive function of planning, the PE students satisfaction and the school social climate, which would make it suitable for the improvement in the performance of PE teachers in educational centres. (AU)

Cell cycle, apoptosis, cell differentiation, and lipid metabolism gene expression in endometriotic tissue and exposure to parabens and benzophenones.

AIM: To describe the expression profile in endometriotic tissue of genes involved in four signaling pathways related to the development and progression of endometriosis (cell cycle, apoptosis, cell differentiation and lipid metabolism) and to explore its relationship with the women exposure to chemicals with hormonal activity released from cosmetics and personal care products (PCPs). METHODS: This cross-sectional study, encompassed within the EndEA study, comprised a subsample of 33 women with endometriosis. Expression levels of 13 genes (BMI1, CCNB1, CDK1, BAX, BCL2L1, FOXO3, SPP1, HOXA10, PDGFRA, SOX2, APOE, PLCG1 and PLCG2) in endometriotic tissue and urinary concentrations of 4 paraben (PB) and 3 benzophenone (BP) congeners were quantified. Bivariate linear and logistic regression analyses were performed to explore the associations between exposure and gene expression levels. RESULTS: A total of 8 out 13 genes (61.5 %) were expressed in >75 % of the samples. Exposure to congeners of PBs and/or BPs was associated with the overexpression of CDK1 gene (whose protein drives cells through G2 phase and mitosis), HOXA10 and PDGFRA genes (whose proteins favor pluripotent cell differentiation to endometrial cells), and APOE (whose protein regulates the transport and metabolism of cholesterol, triglycerides and phospholipids in multiple tissues) and PLCG2 genes (whose protein creates 1D-myo-inositol 1,4,5-trisphosphate and diacylglycerol, two important second messengers). CONCLUSIONS: Our findings suggest that women exposure to cosmetic and PCP-released chemicals might be associated with the promotion of cell cycle and cell differentiation as well as with lipid metabolism disruption in endometriotic tissue, three crucial signaling pathways in the development and progression of endometriosis. However, further studies should be accomplished to confirm these preliminary data.

Biological aspects of crosses between populations of Triatoma mexicana (Hemiptera: Reduviidae: Triatominae).

We examined the degree of reproductive isolation in four populations of Triatoma mexicana Herrich-Schaeffer from Mexico along with fertility and the segregation of morphological characteristics in two generations of offspring from crosses between these populations. The percentage of couples with (fertile) offspring was high among all sets of crosses between cohorts from Peñamiller, Meztitlán, and Orizabita. It was low in crosses involving a cohort from Tierra Blanca, mainly in crosses with Meztitlán. Among sets of crosses involving Tierra Blanca specimens, whole first-generation (F1) individuals were morphologically similar to the specimens from other locations. All F1 individuals of crosses involving Peñamiller looked like Peñamiller. However, in crosses between F1 and F1 progeny of parental crosses, alleles for size, overall color, length of head, ante and post ocular distance, and humeral angle apparently had Mendelian dominant/recessive relationships. The cohorts from Peñamiller and Meztitlán seemed to be dominant with respect to Orizabita and Tierra Blanca. Results indicated that cohorts from Peñamiller, Meztitlán, and Orizabita were not reproductively isolated. In contrast, Tierra Blanca was reproductively isolated from the other three populations of T. mexicana and is apparently undergoing an early divergence process of speciation for allopatry.

Ureteropelvic junction obstruction and renal calculi: Simultaneous treatment by robot-assisted laparoscopic pyeloplasty and transcutaneous retrograde flexible ureteroscopy. Technique description and early outcomes.

BACKGROUND: Ureteropelvic junction obstruction (UPJO) and renal calculi are associated in 20 to 30% of cases and treatment is mandatory. The simultaneous surgical management is a therapeutic challenge that is still a source of controversy. We describe our technique combining robot-assisted laparoscopic pyeloplasty and transcutaneous retrograde flexible ureteroscopy (fURS), assessing the feasibility of simultaneous treatment through an original technique. METHODS: This single centre series reports our initial experience with 12 patients. From January 2014 to September 2018, 12 patients underwent robot-assisted laparoscopic pyeloplasty with simultaneous fURS for UPJO and renal calculi. Mean age was 46 years (24-68). 92% had multiple renal stones and the mean cumulative stone diameter was 31,3mm. Robot-assisted pyeloplasty was performed with peroperative transcutaneous retrograde fURS through a ureteral access sheath introduced in an incision on the bassinet through a subcostal trocar. Stone extraction was performed using a basket. RESULTS: All patients underwent surgery successfully, achieving UPJ repair and complete stone extraction. Mean operating time was 92,5min (85-110). All reported Clavien-Dindo complications were grade 1. Non-contrast enhanced abdominal CT performed 1 month after surgery confirmed the absence of residual stones in all patients. Mean follow-up time was 10 months with no recurrence of UPJO. CONCLUSION: This small series confirms the feasibility with good surgical results of concomitant robot-assisted laparoscopic pyeloplasty and transcutaneous retrograde fURS stone extraction. No major complications were observed. This technique is easily reproducible but requires 2 experienced urologists to be achieved in a contained operative time.

[Pathological pelvic lymph node involvement in muscle-invasive bladder cancer patients treated with radical cystectomy: A narrative review]. / Envahissement ganglionnaire pelvien anatomopathologique après cystectomie totale pour le traitement des tumeurs de vessie infiltrant le muscle : une revue narrative de la littérature.

OBJECTIVE: To perform a narrative review of the contemporary literature on the diagnosis, prognosis and adjuvant management of muscle-invasive bladder cancer (MIBC) patients with pathological pelvic lymph node involvement (pN+) at radical cystectomy. METHOD: A narrative review of the contemporary literature available on Medline was conducted to report studies evaluating the diagnosis, prognosis and/or adjuvant treatments for MIBC patients with pN+ disease at radical cystectomy. RESULTS: Open or robotic extended pelvic lymph node dissection up to the crossing of the ureter with common iliac vessels can enhance the diagnosis of pN+ MIBC, especially using separate packages for the submission of a maximum number of lymph nodes. The main prognosis factors for pN+ patients are the number of positive and retrieved lymph nodes, lymph node density, extranodal extension as well as lymph node metastasis diameter. Adjuvant chemotherapy is likely to prolong overall survival in pN+ patients treated with radical cystectomy alone while adjuvant immunotherapy using nivolumab has been shown to decrease the risk of recurrence in all pN+ patients, especially those with ypN+ disease after neoadjuvant chemotherapy followed by radical cystectomy. However, few data are currently available on the role of adjuvant radiation therapy, which remains currently experimental for these patients. CONCLUSION: Multiple parameters have been reported to impact the diagnosis and prognosis of patients with pN+ MIBC at radical cystectomy. Adjuvant management is currently based on chemotherapy and immunotherapy with preliminary data on radiation therapy.

Neuroprotection is improved by watertightness of fetal spina bifida repair in the sheep model.

OBJECTIVES: A contributing factor to unsuccessful prenatal spina bifida aperta (SBA) repair via an open approach may be incomplete neurosurgical repair causing persistent in-utero leakage of cerebrospinal fluid (CSF) and exposure of the fetal spinal cord to amniotic fluid. We aimed to investigate the neurostructural and neurofunctional efficacy of watertight prenatal SBA repair in a validated SBA fetal lamb model. METHODS: A well-powered superiority study was conducted in the validated SBA fetal lamb model (n = 7 per group). The outcomes of lambs which underwent watertight or non-watertight multilayer repair through an open approach were compared to those of unrepaired SBA lambs (historical controls) at delivery (term = 145 days). At ∼75 days, fetal lambs underwent standardized induction of lumbar SBA. At ∼100 days, they were assigned to an either watertight or non-watertight layered repair group based on an intraoperative watertightness test using subcutaneous fluorescein injection. At 1-2 days postnatally, as primary outcome, we assessed reversal of hindbrain herniation using magnetic resonance imaging (MRI). Secondary proxies of neuroprotection were: absence of CSF leakage at the repair site; hindlimb motor function based on joint-movement score, locomotor grade and Motor Evoked Potential (MEP); four-score neuroprotection scale, encompassing live birth, complete hindbrain herniation reversal, absence of CSF leakage and joint-movement score ≥ 9/15; and brain and spinal cord histology and immunohistochemistry. As the watertightness test cannot be used clinically due to its invasiveness, we developed a potential surrogate intraoperative three-score skin-repair-quality scale based on visual assessment of the quality of the skin repair (suture inter-run distance ≤ 3 mm, absence of tear and absence of ischemia), with high quality defined by a score ≥ 2/3 and low quality by a score < 2/3, and assessed its relationship with improved outcome. RESULTS: Compared with unrepaired lambs, lambs with watertight repair achieved a high level of neuroprotection (neuroprotection score of 4/4 in 5/7 vs 0/7 lambs) as evidenced by: a significant 100% (vs 14%) reversal of hindbrain herniation on MRI; low CSF leakage (14% vs 100%); better hindlimb motor function, with higher joint-movement score, locomotor grade and MEP area under the curve and peak-to-peak amplitude; higher neuronal density in the hippocampus and corpus callosum; and higher reactive astrogliosis at the SBA lesion epicenter. Conversely, lambs with non-watertight SBA repair did not achieve the same level of neuroprotection (score of 4/4 in 1/7 lambs) compared with unrepaired lambs, with: a non-significant 86% (vs 14%) reversal of hindbrain herniation; high CSF leakage (43% vs 100%); no improvement in motor function; low brain neuron count in both the hippocampus and corpus callosum; and small spinal astroglial cell area at the epicenter. Both watertight layered repair and high (≥ 2/3) intraoperative skin-repair-quality score were associated with improved outcome, but the watertightness test and skin-repair-quality scale could not be used interchangeably due to result discrepancies. CONCLUSIONS: Watertight layered fetal SBA repair is neuroprotective since it improves brain and spinal-cord structure and function in the fetal lamb model. This translational research has important clinical implications. A neurosurgical technique that achieves watertightness should be adopted in all fetal centers to improve neuroprotection. Future clinical studies could assess whether a high skin-repair-quality score (≥ 2/3) correlates with neuroprotection. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

Influence of blood meal source on the biological parameters of Triatoma pallidipennis (Heteroptera: Reduviidae) from Mexico.

Chagas disease is one of the most important vector-borne diseases in Latin America, including Mexico. Triatoma pallidipennis (Stål) (Hemiptera: Reduviidae) is a Mexican triatomine vector commonly associated with different hosts. The influence of six blood meals (rabbits, rats, mice, dogs, cats and chickens) on six biological parameters of the biology of T. pallidipennis was evaluated. A significant difference was found in the period of egg-to-adult development between the five mammalian feeds (mean 195 days) and the chicken feed (221 days). The probability of survival was significantly lower in the chicken cohort (0.285). The total number of blood meals to moult from the first instar to the adult stage was the highest in the chicken cohort (10-15). This cohort had the significantly highest rate of females at the end cycle. The mean number of eggs laid per female and the egg eclosion rate were similar among the six food sources. Most results seemed to be influenced by the higher nutritional quality of the mammalian blood compared to the bird's blood and the increased energy expenditure required for the digestion of bird blood. These results clearly show that T. pallidipennis, unlike other triatomine species, has a high reproductive capacity when feeding on different hosts.

Predictors of in-hospital mortality in HIV-infected patients with COVID-19.

BACKGROUND: Underlying immunodeficiency is associated with severe COVID-19, but the prognosis of persons with human immunodeficiency virus (HIV) (PWH) with COVID-19 is under debate. Aim: assessment of the mortality rate and major determinants of death in HIV-infected patients hospitalized with COVID-19 in Spain before vaccine availability. Design: Retrospective nationwide public database analysis. METHODS: Nationwide, retrospective, observational analysis of all hospitalizations with COVID-19 during year 2020 in Spain. Stratification was made according to HIV status. The National Registry of Hospital Discharges was used with the ICD-10 coding list. RESULTS: A total of 117 694 adults were hospitalized with COVID-19 during 2020. Only 234 (0.2%) were HIV-positives. More than 95% were on antiretroviral therapy. Compared to HIV-negatives, PWH were younger (mean age 53.2 vs. 66.5 years old; P<0.001) and more frequently male (74.8% vs. 56.6%; P<0.001). Most co-morbidities predisposing to severe COVID-19 (diabetes, hypertension, dementia and cardiovascular disease) were more frequent in HIV-negatives. In contrast, the rate of baseline liver disease was over 6-fold higher in PWH (27.4% vs. 4.4%; P<0.001). In-hospital mortality was lower in PWH (9.4% vs. 16%; P=0.004). In multivariate analysis, older age, dementia and especially advanced liver disease (relative risk (RR): 7.6) were the major determinants of death in PWH hospitalized with COVID-19. CONCLUSION: HIV-infected patients hospitalized in Spain with COVID-19 during 2020 had better survival than HIV-negatives, most likely explained by younger age and lower rate of co-morbidities. However, advanced liver disease was a major predictor of death in PWH hospitalized with COVID-19.

The use of digital escape rooms in nursing education.

Negative attitudes and prejudices towards people with a mental disorder are common across cultures and societies. The stigma associated with mental illness leads to a lower quality of life, given the discrimination and social exclusion suffered by people with this type of disorder. In the field of health, research has shown that doctors and nurses also manifest these types of stigmatizing behaviors and attitudes. The present study aims to create and apply an educational escape room for the purpose of training nursing students in mental health, promoting positive attitudes towards people who have a mental disorder. To do so, a pre-post study was conducted with an experimental group and a control group to determine whether the escape room was effective for the modification of stigmatizing behaviors compared to transmissive lecture class, and a third measurement was made at 6 months only to the experimental group to evaluate whether the changes produced by the escape room were maintained in the long term. The results indicate that the students participating in the study obtained better scores in sensitization and these remain better over time. It is concluded that the escape room used is suitable for the training and sensitization of future nursing professionals in the field of mental health, facilitating the learning of knowledge and positive attitudes towards severe mental disorder.

Efecto del ejercicio propioceptivo sobre el equilibrio en patinadores de carrera juveniles / Effect of Proprioceptive Exercise on Balance in Youth Race Skaters

El objetivo del presente estudio fue determinar el efecto de un programa de ejercicio propioceptivo sobre el equilibrio en patinadores de carrera juveniles. Se realizó un estudio de alcance cuasiexperimental. Se aleatorizaron tres clubes de patinaje, dos al grupo control y otro al experimental. Participaron 49 jóvenes de ambos sexos entre 11 y 15 años. Al grupo experimental se le aplicó un programa de ejercicio propioceptivo, mientras el grupo control recibió un programa de entrenamiento convencional. Se realizó una evaluación estabilométrica, se midieron los límites de estabilidad, la amplitud y frecuencia de oscilaciones y el equilibrio estático. Ambos grupos mejoraron la frecuencia de balanceo en ambas direcciones, con ojos abiertos y ojos cerrados (p<0,050). Ninguno de los límites de estabilidad y amplitud de balanceo, así como el equilibrio estático evidenciaron cambios significativos (p>0,050). No se encontraron diferencias significativas en las medidas de cambio entre grupos en ninguna de las variables estudiadas (p>0,050). (AU)

The objective of the present study was to determine the effect of a proprioceptive exercise program on balance in youth running skaters. A quasi-experimental scoping study was conducted. Three skating clubs were randomized, two to the control group and one to the experimental group. 49 young people of both sexes between 11 and 15 years old participated. The proprioceptive exercise program was applied to the experimental group, while the control received a conventional training program. Stabilometric evaluation was performed, the limits of stability, the amplitude and frequency of oscillations and the static balance were measured. Both groups improved roll frequency in both directions, with eyes open and eyes closed (p <0.050). Static balance and none of the limits of stability and roll amplitude showed significant changes (p> 0.050). No significant differences were found in the measures of change between groups in any of the variables studied (p> 0.050). (AU)

The Molecular Effects of BDNF Synthesis on Skeletal Muscle: A Mini-Review.

The brain-derived neurotrophic factor (BDNF) is a member of the nerve growth factor family which is generated mainly by the brain. Its main role involve synaptic modulation, neurogenesis, neuron survival, immune regulation, myocardial contraction, and angiogenesis in the brain. Together with the encephalon, some peripheral tissues synthesize BDNF like skeletal muscle. On this tissue, this neurotrophin participates on cellular mechanisms related to muscle function maintenance and plasticity as reported on recent scientific works. Moreover, during exercise stimuli the BDNF contributes directly to strengthening neuromuscular junctions, muscle regeneration, insulin-regulated glucose uptake and ß-oxidation processes in muscle tissue. Given its vital relevance on many physiological mechanisms, the current mini-review focuses on discussing up-to-date knowledge about BDNF production in skeletal muscle and how this neurotrophin impacts skeletal muscle biology.

Evaluación de la salud sexual femenina en la consulta de Ginecología / Evaluation of female sexual health in routine gynaecological practice

Antecedentes: La disfunción sexual en la mujer es un problema multicausal y multidimensional, poco estudiado en la consulta de Ginecología. El objetivo de este trabajo fue estimar la calidad de vida sexual mediante el test de Índice de Función Sexual Femenina en las mujeres que acudieron a la consulta de Ginecología e identificar qué variables se asociaban a esta. Material y métodos: Estudio observacional descriptivo que incluye a las pacientes que acudieron a la consulta de Ginecología entre marzo y agosto 2019. Las pacientes rellenaron anónimamente el test de Índice de Función Sexual Femenina y se recogieron variables sociodemográficas y clínicas. Para establecer las características que pudieron estar asociadas con la calidad de la salud sexual se elaboró un modelo de regresión lineal múltiple. Resultados: Del total de pacientes encuestadas un 39,4% presentaban disfunción sexual con un valor medio del test de 27,2. Si excluimos pacientes que no tenían relaciones en el momento de la encuesta, este porcentaje descendió al 19,2%. La variable que más descendió el valor del Índice de Función Sexual Femenina fue la menopausia. Asimismo la edad y el tener 3 o más hijos también disminuyó el valor del test. Por el contrario, los estudios universitarios mejoraron significativamente el resultado de dicho test. Conclusiones: La disfunción sexual femenina es un problema multifactorial. Dado que afecta de forma significativa la salud global de las mujeres, se hace patente la necesidad de abordar la problemática en las consultas de Ginecología de manera real y eficaz.(AU)

Background and objective: Female sexual dysfunction is a multicausal and multidimensional pathology, often underestimated in gynaecology care. The aim of this study was to estimate the quality of sexual life using the Female Sexual Function Index test in women who attended the gynaecology practice and to identify which variables were associated with sexual dysfunction. Material and methods: Descriptive observational study that includes patients who attended routine gynaecology care between March and August 2019. The patients filled out the Female Sexual Function Index anonymously and sociodemographic and clinical variables were collected. To establish the characteristics that could be associated with the quality of sexual health, a multiple linear regression model was developed. Results: Of the total of patients surveyed, 39.4% presented sexual dysfunction with a mean value of 27.2. After excluding patients without sexual intercourse at the time of the survey, this percentage dropped to 19.2%. Menopause was the variable that most lowered the Female Sexual Function Index value. Likewise, age and having 3 or more children also decreased the test score. Nevertheless, having a university education significantly improved womeńs sexual health. Conclusions: Female sexual dysfunction is a multifactorial problem that greatly affects women's well-being. It is important to assess this problem in routine gynaecology care in order to improve female sexual and global health.(AU)

Prediction of peritoneal soiling in acute appendicitis with simple clinical and laboratory data. Prospective, multicenter, cohort study of 2,645 adult patients nationwide.

BACKGROUND AND AIMS: In order to facilitate the preoperative prediction of complicated appendicitis, we propose a complementary approach by selecting an endpoint defined by the intraoperative finding of peritoneal soiling (PS). METHODS: Over a 6-month period, 38 centers (5% of all public hospitals) attending emergency general surgery patients on a 24-h, 7-days a week basis, enrolled consecutive adult patients requiring appendectomy. Patients were stratified according to the absence or the finding of PS during the surgical procedure. RESULTS: A total of 2645 patients were included; median age (IQR) was 35 (22-51) years, 44.3% were female. The laparoscopic approach was used in 70.8% of appendectomies. In a third of patients (31.7%), there was PS with pus around the appendix, or bowel contents, free pus, or blood in the peritoneal cavity. To develop the prediction model, 1764 patients were randomly selected for the derivation cohort and the remaining 881 patients were assigned to the validation cohort. On multivariable logistic regression analysis of all patients, two clinical variables (age, and pulse) and three laboratory variables (serum urea, serum sodium, and white blood cell count) were individually associated (P < .05) with a greater probability of having PS (Hosmer-Lemeshow chi, 1.63; P = .99; C-statistic, 0.7). Based on the multivariable regression model, both static and dynamic nomograms were developed for the prediction of PS in patients with acute appendicitis. CONCLUSIONS: The entry of simple clinical and laboratory variables in the dynamic nomogram may be useful in guiding the initial management of patients with acute appendicitis in resource-limited settings.

Percepción de las competencias docentes en ciencias de la actividad física y el deporte / Perception of Teaching Competences in Sciences of Physical Activity and Sports

Se pretende analizar las mejoras significativas en la percepción de las competencias docentes en Educación Física. Se lleva a cabo una intervención basada en el Modelo de Autoeficacia docente de Bandura (1986) y el estatuto del co-sujeto Not (1987), en la asignatura de Procesos de Enseñanza-Aprendizaje curso 2018-2019 (Grado de Ciencias de la Actividad Física y del Deporte, UCLM). Se utiliza un método descriptivo, cuantitativo, correlacional y de carácter transversal, participan 104 estudiantes (74 chicos y 30 chicas). Se hallan expectativas de logro, sin distinción de sexo, en el desempeño de las competencias docentes: potencial creativo con apoyo institucional, dominio técnico didáctico y personalidad activa con capacidad didáctica metacognitiva. Se llega a la conclusión de que es posible modificar las perspectivas de actuación en la acción docente dando prioridad a la evolución personal y profesional de los futuros docentes, independientemente del sexo y del rol que ejerce la sociedad. Línea pionera de investigación en la que se necesita profundizar. (AU)

The aim is to analyze the significant improvements in the perception of the teaching competences in Physical Education. An intervention is carried out based on the Model of Teacher Self-efficacy of Bandura (1986) and the status of co-subject Not (1987), in the subject of Teaching-Learning Processes course 2018-2019 (Degree of Physics Activity and Sports Sciences, UCLM). A descriptive, quantitative, correlational and cross-sectional method is used, involving 104 students (74 boys and 30 girls). There are expectations of achievement, without distinction of sex, in the performance of teaching competences: creative potential with institutional support, didactic technical mastery and active personality with metacognitive didactic ability. So it is possible to modify the perspectives in the teaching action of future teachers, giving priority to the personal and professional evolution, regardless of sex and the role played by society. New line of research in which it is necessary to deepen. (AU)

High-efficiency grating coupler for an ultralow-loss Si3N4-based platform.

Integrated silicon nitride waveguides of 100 nm height can achieve ultralow propagation losses below 0.1 dB/cm at the 1550 nm wavelength band but lack the scattering strength to form efficient grating couplers. An enhanced grating coupler design based on an amorphous silicon layer on top of silicon nitride is proposed and demonstrated to improve the directionality of the coupler. The fabrication process is optimized for a self-alignment process between the amorphous silicon and silicon nitride layers without increasing waveguide losses. Experimental coupling losses of 5 dB and a 3 dB bandwidth of 75 nm are achieved with both regular and focusing designs.