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Abstract Histological studies have for decades documented that each of the classical meningeal membranes contains multiple fibroblast layers with distinct cellular morphology. Particularly, the sublayers of the arachnoid membranes have received attention due to their anatomical complexity. Early studies found that tracers injected into the cerebrospinal fluid (CSF) do not distribute freely but are restricted by the innermost sublayer of the arachnoid membrane. The existence of restrictions on CSF movement and the subdivision of the subarachnoid space into several distinct compartments have recently been confirmed by in vivo 2-photon studies of rodents, as well as macroscopic imaging of pigs and magnetic resonance imaging of human brain. Based on in vivo imaging and immunophenotyping characterization, we identified the structural basis for this compartmentalization of the subarachnoid space, which we term ‘Subarachnoid lymphatic-like membrane’, SLYM. The SLYM layer engages the subarachnoid vasculature as it approaches the brain parenchyma, demarcating a roof over pial perivascular spaces. Functionally, the separation of pial periarterial and perivenous spaces in the larger subarachnoid space is critical for the maintenance of unidirectional glymphatic clearance. In light of its close apposition to the pial surface and to the brain perivascular fluid exit points, the SLYM also provides a primary locus for immune surveillance of the brain. Yet, the introduction of SLYM, in terms of its anatomic distinction and hence functional specialization, has met resistance. Its critics assert that SLYM has been described in the literature by other terms, including the inner arachnoid membrane, the interlaminate membrane, the outer pial layer, the intermediate lamella, the pial membrane, the reticular layer of the arachnoid membrane or, more recently, BFB2-3. We argue that our conception of SLYM as an anatomically and functionally distinct construct is both necessary and warranted since its functional roles are wholly distinct from those of the overlying arachnoid barrier layer. Our terminology also lends clarity to a complex anatomy that has hitherto been ill-described. In that regard, we also note the lack of specificity of DPP4, which has recently been introduced as a ‘selected defining marker’ of the arachnoid barrier layer. We note that DPP4 labels fibroblasts in all meningeal membranes as well as in the trabecula arachnoides and the vascular adventitial layers, thus obviating its utility in meningeal characterization. Instead, we report a set of glymphatic-associated proteins that serve to accurately specify SLYM and distinguish it from its adjacent yet functionally distinct membranes.

The purpose of this document is to identify which actions in the Equal Opportunities Plan 2023–2026 of the Ourense Provincial Council have the potential to increase equality of opportunity between women and men in positions of similar status, with respect to an analysis of the objectives of the First Equality Plan of (2017–2021). The methodology for measuring the achievements of these strategic objectives consisted of a descriptive comparative study, where the changes in the stated objectives were analyzed, and a quantitative functional study was undertaken to determine the relationship between the typology and functionality of each position. A clear distinction was made between the goals achieved and those requiring more decisive intervention in future. In addition, it recognizes that women are very underrepresented in the most desirable positions at Ourense Provincial Council.

El interés por estudiar el liderazgo docente está relacionado con la capacidad que tiene el profesorado de promover la mejora en las escuelas. El objetivo de esta investigación es conocer las percepciones sobre las funciones y características de los líderes docente desde las perspectivas de la dirección y del profesorado y como varían estas percepciones en función de las variables sociodemográficas. La metodología utilizada es un estudio exploratorio de diseño no experimental, de carácter cuantitativo, con una muestra de 318 sujetos, de los cuales 244 (76,7%) son profesores y 74 (23,3%) son directivos. El instrumento utilizado es un cuestionario elaborado ad hoc por el grupo de investigación International Study on Teacher Leadership (ISTL). Los resultados del análisis factorial exploratorio (AFE) muestran cuatro factores relacionados con las funciones (implicación con la comunidad educativa, innovación, atención a la diversidad y promoción del cambio) y dos con las características (competencia docente y habilidades interpersonales). Los análisis descriptivos presentan una alta percepción de todos los factores, siendo mayores los valores obtenidos por parte de la dirección. El análisis diferencial realizado a través de pruebas no paramétricas nos muestra diferencias significativas según el perfil, el género, la formación, el cargo y la titularidad del centro.

El interés por estudiar el liderazgo docente está relacionado con la capacidad que tiene el profesorado de promover la mejora en las escuelas. El objetivo de esta investigación es conocer las percepciones sobre las funciones y características de los líderes docente desde las perspectivas de la dirección y del profesorado y como varían estas percepciones en función de las variables sociodemográficas. La metodología utilizada es un estudio exploratorio de diseño no experimental, de carácter cuantitativo, con una muestra de 318 sujetos, de los cuales 244 (76,7%) son profesores y 74 (23,3%) son directivos. El instrumento utilizado es un cuestionario elaborado ad hoc por el grupo de investigación International Study on Teacher Leadership (ISTL). Los resultados del análisis factorial exploratorio (AFE) muestran cuatro factores relacionados con las funciones (implicación con la comunidad educativa, innovación, atención a la diversidad y promoción del cambio) y dos con las características (competencia docente y habilidades interpersonales). Los análisis descriptivos presentan una alta percepción de todos los factores, siendo mayores los valores obtenidos por parte de la dirección. El análisis diferencial realizado a través de pruebas no paramétricas nos muestra diferencias significativas según el perfil, el género, la formación, el cargo y la titularidad del centro.

Fish of the genus Tlaloc are distributed from southern Mexico to Central America and are a distinctive example of the endemic fauna of the Mesoamerican highlands, which has been scarcely studied in Mexico. The present study provides basic life-history data for the species Tlaloc hildebrandi, T. candalarius, and T. labialis, which are native to the headwaters of the Grijalva-Usumacinta basin in southeastern Mexico. We collected 918 specimens to determine their Length-Weight Relationship (LWR), Relative Condition Factor (Kr), sex ratio, Gonadosomatic Index (GSI), fecundity, and size at first sexual maturity. Both sexes of all species had positive allometric growth, except for T. candalarius females (isometric). Mean Kr and sex ratio values differed significantly among species. Females’ GSI values differed significantly among species but were highest during the dry season in all three species. Absolute fecundity was positively correlated with standard length and weight. Sexual maturity was reached at different lengths among species. Based on these results, we suggest that all three species present an opportunistic life strategy, which is very common in fish of the order Cyprinodontiformes. These results represent a first contribution on the life-history of this group of fish and provide basic information that is fundamental to ensuring their conservation.

Abstract Glymphatic transport is vital for the physiological homeostasis of the retina and optic nerve. Pathological alterations of ocular glymphatic fluid transport and enlarged perivascular spaces have been described in glaucomatous mice. It remains to be established how diabetic retinopathy, which impairs vision in about 50% of diabetes patients, impacts ocular glymphatic fluid transport. Here, we examined ocular glymphatic transport in chronic hyperglycemic diabetic mice as well as in healthy mice experiencing a daily transient increase in blood glucose. Mice suffering from severe diabetes for two and four months, induced by streptozotocin, exhibited no alterations in ocular glymphatic fluid transport in the optic nerve compared to age-matched, non-diabetic controls. In contrast, transient increases in blood glucose induced by repeated daily glucose injections in healthy, awake, non-diabetic mice accelerated antero- and retrograde ocular glymphatic transport. Structural analysis showed enlarged perivascular spaces in the optic nerves of glucose-treated mice, which were absent in diabetic mice. Thus, transient repeated hyperglycemic events, but not constant hyperglycemia, ultimately enlarge perivascular spaces in the murine optic nerve. These findings indicate that fluid transport in the mouse eye is vulnerable to fluctuating glycemic levels rather than constant hyperglycemia, suggesting that poor glycemic control drives glymphatic malfunction and perivascular enlargement in the optic nerve.

The environmental and economic impact of an oil spill can be significant. Biotechnologies applied during a marine oil spill involve bioaugmentation with immobilised or encapsulated indigenous hydrocarbonoclastic species selected under laboratory conditions to improve degradation rates. The environmental factors that act as stressors and impact the effectiveness of hydrocarbon removal are one of the challenges associated with these applications. Understanding how native microbes react to environmental stresses is necessary for effective bioaugmentation. Herein, Micrococcus luteus and M. yunnanensis isolated from a marine oil spill mooring system showed hydrocarbonoclastic activity on Maya crude oil in a short time by means of total petroleum hydrocarbons (TPH) at 144 h: M. luteus up to 98.79 % and M. yunnanensis 97.77 % removal. The assessment of Micrococcus biofilms at different temperature (30 °C and 50 °C), pH (5, 6, 7, 8, 9), salinity (30, 50, 60, 70, 80 g/L), and crude oil concentration (1, 5, 15, 25, 35 %) showed different response to the stressors depending on the strain. According to response surface analysis, the main effect was temperature > salinity > hydrocarbon concentration. The hydrocarbonoclastic biofilm architecture was characterised using scanning electron microscopy (SEM) and atomic force microscopy (AFM). Subtle but significant differences were observed: pili in M. luteus by SEM and the topographical differences measured by AFM Power Spectral Density (PSD) analysis, roughness was higher in M. luteus than in M. yunnanensis. In all three domains of life, the Universal Stress Protein (Usp) is crucial for stress adaptation. Herein, the uspA gene expression was analysed in Micrococcus biofilm under environmental stressors. The uspA expression increased up to 2.5-fold in M. luteus biofilms at 30 °C, and 1.3-fold at 50 °C. The highest uspA expression was recorded in M. yunnanensis biofilms at 50 °C with 2.5 and 3-fold with salinities of 50, 60, and 80 g/L at hydrocarbon concentrations of 15, 25, and 35 %. M. yunnanensis biofilms showed greater resilience than M. luteus biofilms when exposed to harsh environmental stressors. M. yunnanensis biofilms were thicker than M. luteus biofilms. Both biofilm responses to environmental stressors through uspA gene expression were consistent with the behaviours observed in the response surface analyses. The uspA gene is a suitable biomarker for assessing environmental stressors of potential microorganisms for bioremediation of marine oil spills and for biosensing the ecophysiological status of native microbiota in a marine petroleum environment.

Isolation due to the COVID-19 pandemic has heightened daily tension, leading to stress and other illnesses. This research examined the impact of backyard activities on social and personal well-being, focusing on agricultural (gardens, vegetables, medicinal plants) and livestock activities (chickens, goats, sheep, cows). An exploratory study was conducted using a Likert-scale survey of 387 people, with 22 items covering economic growth, social well-being, and human development. The results showed that 50% of the respondents experienced pleasant emotions through sensory engagement with home gardens, leading to well-being, reduced anxiety and stress, better concentration, and improved family harmony. McDonald’s Omega (ω) value for item consistency was 0.964. Strong correlations were found between economic growth, social well-being, and human development with social and personal well-being, at 0.719, 0.819, and 0.812, respectively. These results are validated by an exploratory principal component factor analysis, which shows the correlation of the classes that integrate backyard activities on a principal axis. Backyard livestock activities had a lesser impact on personal and social well-being compared to agricultural activities, which were valued more for their economic and nutritional contributions. Thus, backyard activities, especially those involving home gardens, significantly enhance social and personal well-being alongside their economic and food benefits.

Resumen Se presenta en esta sección una revisión de los artículos científicos de mayor impacto publicados entre marzo y mayo de 2024 en las revistas internacionales sobre Sexología con mayor reconocimiento a nivel nacional e internacional (Journal of Sexual Medicine; International Journal of Sexual Health; Archives of Sexual Behavior; Sex roles; Sexual Health & Compulsivity, Psychology and Sexuality; Culture, Health and Sexuality; DeSexología, Psicología de la orientación sexual y la diversidad, American Journal of Sexual Education, Journal of Sex & Marital Therapy y Violence Against Woman).

Introduction Polycystic Ovarian Syndrome (PCOS) is the most prevalent endocrine disorder in adolescents. It affects brain maturation, specially in highly neuronal plasticity periods However, there is a lack of information about the impact of this exposure during brain plasticity windows. Objectives Characterize the consequences of hyperandrogenism in emotional status and social cognition (SC) on adolescents daughters of women with PCOS (dPCOS). Methods Analytical cross sectional study. dPCOS and controls between ages of 12 to 25 years old were recruited. Participants underwent a complete clinical evaluation, plasmatic hormones determinations (including total testosterone, SHBG, androstenedione and 17-OH-progesterone) and ovarian ultrasound characterization. SC was estimated by: measurements of affects (PANAS), strength and difficulties (SDQ), self-reported empathy (EQ/SQ and AQ), and gaze patterns for autonomic response measurement via Eye-Tracking. Results 33 participants were recruited, 15 cases and 18 controls. Median age was 17 and 18 years, respectively. The dPCOS presented a larger anogenital distance (cm) (9.7 vs 7.8; p=0.014), Ferryman-Gallwey score mean (13.0 vs 2.0; p=|t|=|t|=0,049). Conclusions Clinical and hormonal markers suggest that dPCOS are exposed to hyperandrogenism during the most critical neuroplasticity periods. This exposure is associated with negative affects, more social-emotional difficulties and less score on emotional recognition and prosocial behavior. Due to a high psychiatric comorbidity in PCOS patients, these findings are relevant and emphasize the importance of early mental health treatment in these patients. Disclosure of Interest None Declared

Se presenta en esta sección una revisión de los artículos científicos de mayor impacto publicados entre septiembre y noviembre del 2023 en las revistas internacionales sobre Sexología con mayor reconocimiento a nivel nacional e internacional (Journal of Sexual Medicine; International Journal of Sexual Health; Archives of Sexual Behavior; Sex roles; Sexual Health & Compulsivity, Psychology and Sexuality; Culture, Health and Sexuality; DeSexología, Psicología de la orientación sexual y la diversidad, American Journal of Sexual Education, Journal of Sex & Marital Therapy y Violence Against Woman).

No es posible pensar en el desarrollo de las sociedades sin el correspondiente desarrollo científico y tecnológico en todos los ámbitos del quehacer humano y la educación no es la excepción. El presente artículo tiene la finalidad de analizar la naturaleza de un laboratorio financiero, su relevancia para la Academia y los impactos esperados en la formación de profesionales y en el desarrollo investigativo en una universidad pública. El método aplicado para tal fin se basó en un análisis documental de fuentes especializadas y científicas, contemplando aspectos relacionados con los elementos constitutivos de un laboratorio de este tipo y los casos de éxito relacionados en otras entidades de educación superior. Ello, con el propósito de resaltar la necesidad de implementación de un Laboratorio Financiero en la Universidad Vercruzana.

Abstract Background Flow of cerebrospinal fluid (CSF) through brain perivascular spaces (PVSs) is essential for the clearance of interstitial metabolic waste products whose accumulation and aggregation is a key mechanism of pathogenesis in many diseases. The PVS geometry has important implications for CSF flow as it affects CSF and solute transport rates. Thus, the size and shape of the perivascular spaces are essential parameters for models of CSF transport in the brain and require accurate quantification. Methods We segmented two-photon images of pial (surface) PVSs and the adjacent arteries and characterized their sizes and shapes of cross sections from 14 PVS segments in 9 mice. Based on the analysis, we propose an idealized model that approximates the cross-sectional size and shape of pial PVSs, closely matching their area ratios and hydraulic resistances. Results The ratio of PVS-to-vessel area varies widely across the cross sections analyzed. The hydraulic resistance per unit length of the PVS scales with the PVS cross-sectional area, and we found a power-law fit that predicts resistance as a function of the area. Three idealized geometric models were compared to PVSs imaged in vivo, and their accuracy in reproducing hydraulic resistances and PVS-to-vessel area ratios were evaluated. The area ratio was obtained across different cross sections, and we found that the distribution peaks for the original PVS and its closest idealized fit (polynomial fit) were 1.12 and 1.21, respectively. The peak of the hydraulic resistance distribution is $$1.73\times 10^{15}$$ 1.73 × 10 15 Pa s/m $$^{5}$$ 5 and $$1.44\times 10^{15}$$ 1.44 × 10 15 Pa s/m $$^{5}$$ 5 for the segmentation and its closest idealized fit, respectively. Conclusions PVS hydraulic resistance can be reasonably predicted as a function of the PVS area. The proposed polynomial-based fit most closely captures the shape of the PVS with respect to area ratio and hydraulic resistance. Idealized PVS shapes are convenient for modeling, which can be used to better understand how anatomical variations affect clearance and drug transport.

Resumen Introducción: Las fragancias unisex pretenden borrar la frontera existente en los estereotipos de género, agradando a todos los olfatos, siendo usadas de día o de noche y compartidas por las parejas. El objetivo del trabajo fue desarrollar dos fragancias unisex para una crema humectante y un perfume. Método: Se identificaron los componentes a incluir en las dos fragancias unisex. Se realizaron los controles de calidad y estudios de estabilidad de envejecimiento natural a las fragancias, así como a la crema y el perfume. También se evaluó la influencia de la luz solar en las fragancias. La evaluación sensorial de los productos perfumados se realizó a través de métodos afectivos, incluyendo pruebas de aceptación y pruebas escalares, participando jueces no entrenados, determinando el nivel de aceptación y agrado de los cosméticos desarrollados. Resultados: Se desarrollaron dos fragancias con notas olfativas cítrica-maderable-floral, clasificándolas en la familia olfativa hespéride, subfamilia olfativa maderable. Los controles de calidad y estudios de estabilidad demostraron la calidad física y química de ambas fragancias durante 24 meses, así como de los cosméticos perfumados. Los niveles de agrado del olor y el perfume, de ambos cosméticos, fueron clasificados como “Me gusta”, mientras que los de la fijación fueron “Moderados”. Conclusiones: Las fragancias unisex cumplieron con los criterios de calidad establecidos durante 24 meses, al igual que la crema y el perfume, conservando la nota olfativa inalterada. El grado de aceptación y calidad de los cosméticos estudiados, a través de métodos afectivos, demostraron la aceptación de ambos cosméticos.

Introduction and Objectives: Hepatic Encephalopathy (HE) is a common complication in patients with Chronic Liver Disease (CLD), and the development of this decompensation is multifactorial, including ammonia levels, inflammatory status, and sepsis, among others. A poorly studied factor in our population is the serum levels of 25-hydroxyvitamin D (25-OHD), which could act as a co-factor in HE. To assess if serum 25-hydroxyvitamin D (25-OHD) deficiency acts as a cofactor in the development of HE. Materials and Patients: Observational, retrospective, analytical, case-control study; included subjects of both sexes, 18 years old and over, diagnosed with Chronic Liver Disease of different etiologies. Complete blood count, liver and kidney function, serum electrolytes, coagulation profile, and serum levels of 25-hydroxyvitamin D were recorded. They were evaluated using the West-Haven Criteria (WH). Results: Independent samples T-test was used to compare differences between 25-hydroxyvitamin D levels in patients with and without HE. The association between 25-OHD deficiency and HE was assessed using a chi-square test, with a significance level set at alpha=0.05. Out of a total of 96 patients, 36.5% had HE. The mean 25-OHD level in the HE group was 18.78 ± 8.56, compared to 22.77 ± 9.94 in the group without HE. The T-test was significant: T (1=2.072), p =0.041. Among patients with deficiency, 20/35 (57.1%) had EH, while 22/61 (36.1%) did not have HE. The chi-square test for the association between deficiency and HE was positive, with a value of (1)=4.015, p =0.045. Conclusions: A causal relationship between 25-hydroxyvitamin D (25-OHD) deficiency and the development of HE cannot be attributed, as this is multifactorial. However, 25-OHD deficiency is common in patients with Chronic liver disease, and our study demonstrates that this deficiency acts as a cofactor, as there is a significant difference between the groups. It is necessary to validate these findings in the future through multivariate analysis to confirm our results.

Introduction and Objectives: Autoimmune liver disease is classified into 3 well-defined entities: autoimmune hepatitis, primary biliary cholangitis and primary sclerosing cholangitis, there is a group of patients who show characteristics of more than one entity and is called overlap syndrome (OS), according to the Paris criteria they are classified, the prevalence of overlap in our country is low. We describe the clinical and biochemical characteristics of patients with OS treated at the liver clinic at the Hospital General de México. Materials and Patients: It is a retrospective and descriptive study, records of the autoimmune liver disease consultation were reviewed, searching for patients with OS using the Paris criteria in the period 2014-2023, descriptive statistics were performed with measures of central tendency and dispersion using SPSS 25.0. Results: 22 patients were included, all of them with liver biopsy, 95% women aged 47 ± 12.6 years, the most common phenotype was PBC/HAI (59%). The time to diagnosis from initial manifestations ranged from 1 to 6 years, the most frequent tests were ANA (81%), AMA (63%), ASMA (18%) and LKM1 (18%), Immunoglobulin G levels on average 2048 ±643.8. The most frequent comorbidities were systemic sclerosis, arterial hypertension and hypothyroidism, the predominant symptoms were fatigue and pruritus reported in 36%; 90% were cirrhotic, Child Pugh A 70%, B 25% and C 5%. The most frequent decompensation was variceal hemorrhage (22.7%), 4.7% reported portal thrombosis, and 2 patients were transplanted. Conclusions: Overlap syndromes are rare, we found the majority of patients are women with advancend stage of liver disease, the most frequent overlapping is PBC/HAI with a high proportion of positive serology tests and concordant biopsy, two patients underwent liver transplantation. It is important to always look for this rare syndrome.

Se presenta un estudio que tiene como objetivo principal identificar y analizar qué herramientas de Moodle son las más usadas por el profesorado en el contexto universitario, así como la posible relación de estos usos con los años de experiencia docente con Moodle en la enseñanza presencial, pudiendo establecer posibilidades de mejora en la variedad y frecuencia de uso de estas herramientas. Se plantea una metodología descriptiva no experimental basada en la recogida de datos a través de un formulario elaborado ad-hoc de administración on-line, con una muestra de 74 docentes universitarios. Los resultados muestran que el uso de las herramientas de Moodle es limitado y que no guarda relación con el tiempo de implementación de la plataforma en la docencia. Se concluye con la necesidad de ofrecer y formar a los profesores en las diferentes alternativas existentes y ponerlas en relación con las distintas necesidades según el estilo de docencia y el perfil del alumnado.

El aprendizaje activo de la Sustentabilidad Urbana (SU) es un área en creciente desarrollo, por lo que es importante aportar a este corpus con nuevas experiencias concretas, particularmente, aquellas que provienen desde el Sur Global. Este artículo tiene como objetivo sistematizar la implementación piloto de un manual de aprendizaje de SU en instituciones de educación superior chilena que surgieron del curso Exploraciones urbanas: Territorio sustentable dictado en la Pontificia Universidad Católica. Acá se realizó una investigación cualitativa basada en análisis de contenido que utilizó un proceso metodológico teórico – aplicado: primero, se realizó una encuesta a exestudiantes del curso pionero considerando 5 parámetros: contenidos, organización de la enseñanza, metodologías didácticas, evaluación – retroalimentación, y relación entre el estudiantado – personal docente. Luego, desde los resultados de la encuesta se generó un manual con actividades didácticas para la SU, revisado en un grupo focal de salida a ex estudiantes, docentes de dichas universidades y pares expertos/as. A continuación, este manual se implementó en el curso Exploraciones urbanas en tres universidades chilenas de forma mixta en plataforma online y algunas actividades presenciales el 2022 y, al finalizar, fue evaluado en un nuevo grupo focal realizado por las y los docentes que impartieron el curso. El primer resultado corresponde a la encuesta en donde se observó una alta satisfacción con el curso (84% manifiesta que metodología de clases resulto útil para comprender la materia). El segundo resultado es el análisis de los grupos focales que utilizaron los mismos cinco parámetros que fueron insumos en la primera revisión del manual y en su versión final. Por último, se discute la idea de que este proyecto permitió abordar desde múltiples visiones la enseñanza de la SU en distintos contextos territoriales chilenos, lo que permitió relevar intereses comunes que pueden servir para que otros centros educativos latinoamericanos utilicen este material didáctico para la educación superior que está disponible en línea para su descarga gratuita en español.

Los adenomas vellosos son un tipo de adenoma con alto potencial para transformación maligna, frecuentes en colon (recto, sigmoides y colon derecho). Generalmente asintomáticos, pueden ser hipersecretores causando diarrea y depleción de líquidos y electrolitos importante, condición denominada síndrome de McKittrick-Wheelock. Los de mayor tamaño y distales tienen mayor riesgo de desarrollar este síndrome. Presentamos el caso de un paciente de sexo masculino de 69 años, con diarrea de un año, hospitalizado por deshidratación y alteración electrolítica. Estudios de imagen y complementarios con gran tumoración en recto; resultado histopatológico adenocarcinoma invasor con lesión precursora adenoma velloso integrando la entidad clínica del síndrome de McKittrick-Wheelock.

IntroductionAdequate identification of the sexual acceptability of contraceptive methods is key for designing health promotion interventions, assessing their impacts, and increasing their effectiveness. This study aimed to develop and validate a questionnaire to explore the preferences of women depending on their epidemiological characteristics and their partner relationships—the Sexual Acceptability of Contraceptive Methods Questionnaire [in Spanish, Aceptabilidad Sexual de los Métodos Anticonceptivos (ASMA)].MethodsPsychometric validation was conducted using Exploratory Factorial Analysis (EFA) and confirmatory factor analysis (CFA). The reliability of the final version of the questionnaire was explored using Cronbach’s alpha and McDonald omega to estimate internal consistency.ResultsA three-factor model was identified. Factor 1 (explaining 28.32% of the model) corresponds to questions concerning the use and placement of the contraceptive and includes 6 items; Factor 2 (explaining 24.23%) corresponds to other factors that affect the relationship such as bleeding and side effects of the contraceptive method and includes 10 items; and Factor 3 (explaining 18.94%) corresponds to the couple relationship and includes 8 items.Conclusion and implicationsThe ASMA questionnaire provides a valid and reliable tool for assessing the sexual acceptability of various contraceptive methods. This instrument gathers data that provide information on various aspects of women’s sexuality, health, education, and beliefs, all of which can determine the preference for one contraceptive method over another. Moreover, the tool can help to identify profiles of women who have different preferences when selecting a particular method.

This work adheres to the recommendations for publication in three steps (Marin-Garcia, 2021). We propose a protocol to develop research the objective of which is to analyze the needs and challenges, as perceived by university lecturers, related to teaching, learning, or assessing competencies related to the innovative capacity of students in an array of digital remote teaching contexts. In this sense, we want to consider situations where teachers watch their students interact with each other. The interaction between students can occur face-to-face or remotely and, in the latter case, either synchronous or asynchronous. In addition, teacher observation can be done synchronously (face-to-face or remotely) or by watching a previously recorded video.

Astrocytes act as a dynamic Cl− reservoir regulating Cl− homeostasis in the CNS. Astrocytic Cl− is high and stable during sleep, it is lower during wakefulness and fluctuates in response to sensory input and motor activity. Efflux of Cl− from astrocytes supports inhibitory transmission in the CNS.

This study investigates the historical variability in annual average precipitation in the northwest region of Mexico, aiming to evaluate the cumulative impact of precipitation on soil degradation and associated risks posed by rainfall. Despite being known as “The Agricultural Heart of Mexico”, the region’s soil has experienced significant damage to its granulometric structure due to unpredictable rainfall patterns attributed to climate change. Sixteen historical series of average annual rainfall were analyzed as stationary stochastic processes for spectral analysis. The results revealed exponential decay curves in each radial spectrum, indicating a linear relationship between frequency and amplitude. These curves identified initial impulses correlated with moments of severity for structural damages caused by rainfall-induced degradation. The degradation process, exacerbated by water stress, accelerates, as evidenced by maps illustrating approximately 75% soil damage. In the context of climate change and the uncertainty surrounding soil responses to extreme meteorological events, understanding this phenomenon becomes crucial. Recognizing the dynamic nature of soil responses to environmental stressors is essential for effective soil management. Emphasizing the need to employ numerical processes tailored to new environmental considerations related to observed soil damages is crucial for sustainable soil management practices in any region.

Resumen Se presenta en esta sección una revisión de los artículos científicos de mayor impacto publicados entre septiembre y noviembre del 2023 en las revistas internacionales sobre Sexología con mayor reconocimiento a nivel nacional e internacional (Journal of Sexual Medicine; International Journal of Sexual Health; Archives of Sexual Behavior; Sex roles; Sexual Health & Compulsivity, Psychology and Sexuality; Culture, Health and Sexuality; DeSexología, Psicología de la orientación sexual y la diversidad, American Journal of Sexual Education, Journal of Sex & Marital Therapy y Violence Against Woman).

Abstract Cerebrospinal fluid (CSF) is an essential and critical component of the central nervous system (CNS). According to the concept of the “third circulation” originally proposed by Cushing, CSF is mainly produced by the choroid plexus and subsequently leaves the cerebral ventricles via the foramen of Magendie and Luschka. CSF then fills the subarachnoid space from whence it disperses to all parts of the CNS, including the forebrain and spinal cord. CSF provides buoyancy to the submerged brain, thus protecting it against mechanical injury. CSF is also transported via the glymphatic pathway to reach deep interstitial brain regions along perivascular channels; this CSF clearance pathway promotes transport of energy metabolites and signaling molecules, and the clearance of metabolic waste. In particular, CSF is now intensively studied as a carrier for the removal of proteins implicated in neurodegeneration, such as amyloid-β and tau. Despite this key function of CSF, there is little information about its production rate, the factors controlling CSF production, and the impact of diseases on CSF flux. Therefore, we consider it to be a matter of paramount importance to quantify better the rate of CSF production, thereby obtaining a better understanding of CSF dynamics. To this end, we now review the existing methods developed to measure CSF production, including invasive, noninvasive, direct, and indirect methods, and MRI-based techniques. Depending on the methodology, estimates of CSF production rates in a given species can extend over a ten-fold range. Throughout this review, we interrogate the technical details of CSF measurement methods and discuss the consequences of minor experimental modifications on estimates of production rate. Our aim is to highlight the gaps in our knowledge and inspire the development of more accurate, reproducible, and less invasive techniques for quantitation of CSF production.

A desaparição do campo socialista e da URSS teve um impacto importante na psiquiatria cubana, que foi obrigada a modificar os fundamentos filosóficos e teórico da sua prática. A partir desse momento se iniciou uma reorientação para a psiquiatria biológica inspirada no modelo norte-americano, o que veio reforçar a prática medicalizadora que já existia. Nesse sentido, a psiquiatria infantil é um exemplo de como o modelo biomédico na psiquiatria comanda as práticas de intervenção sobre a saúde mental. Neste artigo analisamos a influência do modelo biomédico na atual psiquiatria infantil cubana, tomando como ponto de partida um trabalho apresentado por uma psiquiatra infantil cubana sobre o uso da Clozapina num evento de psiquiatria realizado na Havana em 2021. Da mesma forma, analisamos a crescente tendência do uso de drogas psicotrópicas na gestão da saúde mental naquele país caribenho, tanto por psiquiatras quanto por médicos generalistas. Os principais resultados obtidos mostram como o modelo biomédico na psiquiatria responde a um ideal de normalização da infância, mas também como, desde esse paradigma os efeitos adversos dos psicofármacos e as particularidades subjetivas dos pacientes são obviados em função de um ideal de normalidade

El menisco discoide comprende una variante morfológica de los meniscos, caracterizada por cambios en la microarquitectura, vascularidad y mecanismos estabilizadores anormales, alterando la biomecánica de la rodilla, lo que lo predispone a degeneración intrasustancia y desgarros a una edad más temprana. Su incidencia es desconocida, ya que puede presentarse en pacientes asintomáticos, normalmente es un hallazgo incidental en estudios de resonancia magnética. Sin embargo algunos pacientes pueden cursar sintomáticos, refiriendo dolor e inestabilidad, presentando alteraciones más significativas como es el caso del bloqueo articular, estos síntomas pueden presentarse por periodos largos de tiempo derivando en cambios artrósicos tempranos. Debido a que su diagnóstico es principalmente incidental, es de suma importancia conocer sus características e implicaciones clínicas. Su terapéutica sigue siendo un verdadero desafío principalmente para los ortopedistas. El propósito de este trabajo es hacer una revisión de la literatura para actualizar conceptos de etiología, diagnóstico, clasificación y terapéutica a partir de lo encontrado en la literatura en los últimos 10 años.

Industrial process automation has long been the main goal in production lines that seek to decrease human involvement. However, it is broadly agreed that a collaboration between humans and technologies must still exist as human capital is required to provide certain skills and abilities that machines cannot offer yet. For instance, in the context of design and simulation, CAD, CAM, and CAE professionals must count not only on a deep knowledge of the technology employed but also on specific skills that make the human factor an integral piece of the transition. These abilities are considered fundamental to achieving sustainable development in the industrial sector. This work focuses on analyzing through four study cases where whether specular o bilateral symmetry, a.k.a. planar symmetry is present, the weaknesses found in the human factor related to CAD training of future industrial engineers. The most common mistakes found when developing the different symmetric pieces proposed are thoroughly examined in order to define their origin, which mainly lies in students’ lack of descriptive geometry (DG) understanding. This is aggravated in some cases by the lack of spatial visualization abilities. The unstoppable and fast advances in design and simulation tools and technologies require humans to update their capabilities almost in real time. However, results show that this should not threaten the need for the human mind to spatially understand the changes being made on the screen. Otherwise, humans are at risk of ending up at the service of machines and technologies instead of the opposite.

Resumen: El carcinoma hepatocelular (CHC) se presenta cada vez más frecuentemente como una de las principales complicaciones de cirrosis, su principal factor de riesgo. La última década ha presentado modificaciones en su incidencia, relacionadas con una transición epidemiológica en la etiología de la cirrosis, con disminución en la prevalencia de hepatitis C y aumento en la etiología relacionada con la enfermedad por hígado graso no alcohólico (EHNA), además del desarrollo del CHC en hígado no cirrótico por EHNA. Se han identificado marcadores genéticos asociados a la enfermedad, así como avances en vigilancia y diagnóstico. Con relación al tratamiento, el perfeccionamiento de técnicas quirúrgicas, tanto relacionadas con la resección como con el trasplante, y radiológicas en estadios curativos permite mejorar la supervivencia de los pacientes candidatos a este abordaje, y, finalmente, hay cambios radicales en el abordaje sistémico con expectativas mucho más optimistas cuando se comparan con lo disponible hace una década. Es por eso que la Asociación Mexicana de Hepatología decidió realizar el II Consenso Mexicano de Carcinoma Hepatocelular, en el cual se hizo una revisión actualizada de la evidencia disponible nacional e internacional sobre la epidemiología, factores de riesgo, vigilancia, diagnóstico y tratamiento de la enfermedad; con el objetivo de ofrecer al médico mexicano una revisión actualizada sobre los diferentes tópicos de esta enfermedad. En esta segunda parte del documento se presentan los tópicos relacionados con el tratamiento del CHC. Abstract: Hepatocellular carcinoma (HCC) is more frequently manifesting as one of the main complications of cirrhosis of the liver, its principal risk factor. There have been modifications in its incidence over the past decade, related to an epidemiologic transition in the etiology of cirrhosis, with a decrease in the prevalence of hepatitis C and an increase in nonalcoholic fatty liver disease (NAFLD) as a cause, as well as the development of HCC in the non-cirrhotic liver due to NAFLD. Genetic markers associated with the disease have been identified, and surveillance and diagnosis have improved. Regarding treatment, surgical techniques, in both resection and transplantation, have advanced and radiologic techniques, at the curative stage of the disease, have enhanced survival in those patients. And finally, there have been radical changes in the systemic approach, with much more optimistic expectations, when compared with the options available a decade ago. Therefore, the Asociación Mexicana de Hepatología decided to carry out the Second Mexican Consensus on Hepatocellular Carcinoma, which is an updated review of the available national and international evidence on the epidemiology, risk factors, surveillance, diagnosis, and treatment of the disease, to offer the Mexican physician current information on the different topics regarding hepatocellular carcinoma. In this second part of the document, the topics related to the treatment of HCC are presented.

Hepatocellular carcinoma (HCC) is more frequently manifesting as one of the main complications of cirrhosis of the liver, its principal risk factor. There have been modifications in its incidence over the past decade, related to an epidemiologic transition in the etiology of cirrhosis, with a decrease in the prevalence of hepatitis C and an increase in nonalcoholic fatty liver disease (NAFLD) as a cause, as well as the development of HCC in the non-cirrhotic liver due to NAFLD. Genetic markers associated with the disease have been identified, and surveillance and diagnosis have improved. Regarding treatment, surgical techniques, in both resection and transplantation, have advanced and radiologic techniques, at the curative stage of the disease, have enhanced survival in those patients. And finally, there have been radical changes in the systemic approach, with much more optimistic expectations, when compared with the options available a decade ago. Therefore, the Asociación Mexicana de Hepatología decided to carry out the Second Mexican Consensus on Hepatocellular Carcinoma, which is an updated review of the available national and international evidence on the epidemiology, risk factors, surveillance, diagnosis, and treatment of the disease, to offer the Mexican physician current information on the different topics regarding hepatocellular carcinoma. In this second part of the document, the topics related to the treatment of HCC are presented. Resumen: El Carcinoma Hepatocelular (CHC) se presenta cada vez más frecuentemente como una de las principales complicaciones de cirrosis, su principal factor de riesgo. La última década ha presentado modificaciones en su incidencia, relacionadas con una transición epidemiológica en la etiología de la cirrosis, con disminución en la prevalencia de hepatitis C y aumento en la etiología relacionada con la enfermedad por hígado graso no alcohólico (EHNA), además del desarrollo del CHC en hígado no cirrótico por EHNA. Se han identificado marcadores genéticos asociados a la enfermedad, así como avances en vigilancia y diagnóstico. En relación al tratamiento, el perfeccionamiento de técnicas quirúrgicas, tanto relacionadas con resección como trasplante; y radiológicas en estadios curativos permite mejorar la supervivencia de los pacientes candidatos a este abordaje; y finalmente, hay cambios radicales en el abordaje sistémico con expectativas mucho más optimistas cuando se comparan con lo disponible hace una década. Es por eso que la Asociación Mexicana de Hepatología decidió realizar el II Consenso Mexicano de Carcinoma Hepatocelular, en el cual se hizo una revisión actualizada de la evidencia disponible nacional e internacional sobre la epidemiología, factores de riesgo, vigilancia, diagnóstico y tratamiento de la enfermedad; con el objetivo de ofrecer al médico mexicano una revisión actualizada sobre los diferentes tópicos de esta enfermedad. En esta segunda parte del documento se presenta los tópicos relacionados con el tratamiento del CHC.

En el año 2017, se realizaron una serie de estudios geofísicos en la comunidad de Finca 30, provincia de Bocas del Toro, noroccidente de Panamá y cuyo objetivo se focalizó en evaluar el uso combinado de los resultados obtenidos a través de la refracción sísmica (velocidad de onda P) y el análisis multicanal de ondas superficiales (velocidad de onda S) vía el cociente de Poisson para la detección de capas freáticas someras en el sitio de estudio. En esta comunidad se estableció un perfil de 30 m de longitud en donde se utilizó un sismógrafo para estudios de onda P y S, con 16 geófonos de alta frecuencia para el primero y 12 de baja frecuencia para el segundo y adicionalmente, un prototipo de inyección de corriente alterna de 400 V con un arreglo tipo Schlumberger a fin de verificar los resultados de la prospección sísmica; el procedimiento para estudios de onda P se basaron en la norma ASTM D5777-18, para el de onda S en el documento sobre el proyecto InterPACIFIC, y para el sondeo eléctrico, la norma ASTM D6431-18. El rango de valores del cociente de Poisson obtenido (0.47-0.49), y 10.7 ohm.m a una profundidad de 1.8 m sugieren la existencia de una zona saturada la cual fue corroborada a través de una perforación desarrollada en el sitio. Gracias a estos resultados, los acuíferos superficiales podrían ser aprovechados para abastecimiento de la población y para evaluar el nivel de afectación de la capacidad portante para futuros proyectos de ingeniería civil.

Las mujeres en México incursionan masivamente en la educación superior a partir de la década de los setenta del siglo pasado; en este devenir, el acceso a los puestos de gestión, administración y poder dentro de las universidades ha sido nugatorio, aun cuando existen leyes de igualdad tanto internacionales como nacionales que norman la igualdad de condiciones entre hombres y mujeres. En este sentido el presente documento tiene como objetivo visibilizar la segregación vertical que inhibe el acceso de las mujeres al poder. La metodología utilizada fue mixta, descriptiva y transversal. Se aplicaron 1,325 cuestionarios y 60 entrevistas en seis universidades públicas del país. Los resultados señalan obstáculos relacionados con las condiciones personales y familiares a partir de los mandatos de los roles de género y, desde luego, con factores organizacionales de las instituciones universitarias. A partir de lo anterior, se concluye que las mujeres se desarrollan en ambientes de discriminación de género, que son evaluadas a partir de estereotipos de género, y ambientes patriarcales, lo cual impide su acceso al poder.

Hepatocellular carcinoma (HCC) is more frequently manifesting as one of the main complications of cirrhosis of the liver, its principal risk factor. There have been modifications in its incidence over the past decade, related to an epidemiologic transition in the etiology of cirrhosis, with a decrease in the prevalence of hepatitis C and an increase in nonalcoholic fatty liver disease (NAFLD) as a cause, as well as the development of HCC in the non-cirrhotic liver due to NAFLD. Genetic markers associated with the disease have been identified, and surveillance and diagnosis have improved. Regarding treatment, surgical techniques, in both resection and transplantation, have advanced and radiologic techniques, at the curative stage of the disease, have enhanced survival in those patients. And finally, there have been radical changes in the systemic approach, with much more optimistic expectations, when compared with the options available a decade ago.Therefore, the Asociación Mexicana de Hepatología decided to carry out the Second Mexican Consensus on Hepatocellular Carcinoma, which is an updated review of the available national and international evidence on the epidemiology, risk factors, surveillance, diagnosis, and treatment of the disease, to offer the Mexican physician current information on the different topics regarding hepatocellular carcinoma.In this first part of the document, the topics related to epidemiology and diagnosis are presented. Resumen: El carcinoma hepatocelular (CHC) se presenta cada vez más frecuentemente como una de las principales complicaciones de cirrosis, su principal factor de riesgo. La última década ha presentado modificaciones en su incidencia, relacionadas con una transición epidemiológica en la etiología de la cirrosis, con disminución en la prevalencia de hepatitis C y aumento en la etiología relacionada con la enfermedad por hígado graso no alcohólico (EHNA), además del desarrollo del CHC en hígado no cirrótico por EHNA. Se han identificado marcadores genéticos asociados a la enfermedad, así como avances en vigilancia y diagnóstico. En relación al tratamiento, el perfeccionamiento de técnicas quirúrgicas, tanto relacionadas con resección como trasplante, y radiológicas en estadios curativos permite mejorar la supervivencia de los pacientes candidatos a este abordaje; finalmente, hay cambios radicales en el abordaje sistémico con expectativas mucho más optimistas cuando se comparan con lo disponible hace una década.Es por eso que la Asociación Mexicana de Hepatología decidió realizar el II Consenso Mexicano de Carcinoma Hepatocelular, en el cual se hizo una revisión actualizada de la evidencia disponible nacional e internacional sobre la epidemiología, los factores de riesgo, la vigilancia, el diagnóstico y el tratamiento de la enfermedad, con el objetivo de ofrecer al médico mexicano una revisión actualizada sobre los diferentes tópicos de esta enfermedad.En esta primera parte del documento se presentan los tópicos relacionados con la epidemiología y el diagnóstico.

Resumen: El carcinoma hepatocelular (CHC) se presenta cada vez más frecuentemente como una de las principales complicaciones de cirrosis, su principal factor de riesgo. La última década ha presentado modificaciones en su incidencia, relacionadas con una transición epidemiológica en la etiología de la cirrosis, con disminución en la prevalencia de hepatitis C y aumento en la etiología relacionada con la enfermedad por hígado graso no alcohólico (EHNA), además del desarrollo del CHC en hígado no cirrótico por EHNA. Se han identificado marcadores genéticos asociados a la enfermedad, así como avances en vigilancia y diagnóstico. En relación al tratamiento, el perfeccionamiento de técnicas quirúrgicas, tanto relacionadas con resección como trasplante, y radiológicas en estadios curativos permite mejorar la supervivencia de los pacientes candidatos a este abordaje; finalmente, hay cambios radicales en el abordaje sistémico con expectativas mucho más optimistas cuando se comparan con lo disponible hace una década.Es por eso que la Asociación Mexicana de Hepatología decidió realizar el II Consenso Mexicano de Carcinoma Hepatocelular, en el cual se hizo una revisión actualizada de la evidencia disponible nacional e internacional sobre la epidemiología, los factores de riesgo, la vigilancia, el diagnóstico y el tratamiento de la enfermedad, con el objetivo de ofrecer al médico mexicano una revisión actualizada sobre los diferentes tópicos de esta enfermedad.En esta primera parte del documento se presentan los tópicos relacionados con la epidemiología y el diagnóstico. Abstract: Hepatocellular carcinoma (HCC) is more frequently manifesting as one of the main complications of cirrhosis of the liver, its principal risk factor. There have been modifications in its incidence over the past decade, related to an epidemiologic transition in the etiology of cirrhosis, with a decrease in the prevalence of hepatitis C and an increase in nonalcoholic fatty liver disease (NAFLD) as a cause, as well as the development of HCC in the non-cirrhotic liver due to NAFLD. Genetic markers associated with the disease have been identified, and surveillance and diagnosis have improved. Regarding treatment, surgical techniques, in both resection and transplantation, have advanced and radiologic techniques, at the curative stage of the disease, have enhanced survival in those patients. And finally, there have been radical changes in the systemic approach, with much more optimistic expectations, when compared with the options available a decade ago.Therefore, the Asociación Mexicana de Hepatología decided to carry out the Second Mexican Consensus on Hepatocellular Carcinoma, which is an updated review of the available national and international evidence on the epidemiology, risk factors, surveillance, diagnosis, and treatment of the disease, to offer the Mexican physician current information on the different topics regarding hepatocellular carcinoma.In this first part of the document, the topics related to epidemiology and diagnosis are presented.

Cada examen de imagen es una pregunta, una interrogante, muchas veces desesperada, para conocer la verdad y con base en esta, resolver un problema de salud.

La matriz germinal es un área de proliferación de células neuronales y gliales susceptible de hemorragia en los recién nacidos pretérmino, ocurriendo hasta en uno de cada cuatro recién nacidos con un peso al nacer de 1,500 g y hasta en casi la mitad de los que pesan menos de 1,000 g. La frecuencia y la gravedad de este padecimiento es inversamente proporcional a la edad gestacional y peso al nacer. Esta hemorragia puede extenderse al sistema ventricular y puede asociarse con infarto de la sustancia blanca. Papile et al. en 1978 clasificaron las hemorragias de la matriz germinal basados en sus hallazgos por tomografía, clasificación que sigue vigente hasta nuestros tiempos. El propósito de este trabajo es presentar una revisión de la literatura, así como sus hallazgos por diferentes métodos de imagen, como el ultrasonido transfontanelar y la resonancia magnética.

El tiburón sedoso Carcharhinus falciformis es una de las especies de tiburón más importantes en las capturas de la pesquería de pequeña escala de la costa mexicana del Pacífico. En el presente trabajo reportamos los principales componentes alimentarios de C. falciformis capturados por la flota pesquera de pequeña escala en Acapulco, Guerrero, México, de acuerdo con la talla (neonatos y juveniles) y el sexo (machos y hembras), así como la amplitud de su nicho y nivel trófico. Se recolectaron en total 165 estómagos de C. falciformis, de los cuales 57 presentaron contenido estomacal y 108 se encontraron vacíos. Se identificaron en total 11 componentes alimentarios: 4 crustáceos, 3 peces, 2 cefalópodos, 1 tortuga marina y 1 ave. De acuerdo con el índice de importancia relativa especifica de la presa (%IIREP), el grupo de los crustáceos representó el 77.17% de la dieta. El cangrejo Portunus xantusii fue el componente más importante de la dieta de neonatos, juveniles, machos y hembras. Las dietas entre neonatos y juveniles y entre machos y hembras no presentaron grandes diferencias (índice de Morisita-Horn: 0.86 y 0.80, respectivamente). El tiburón sedoso presentó una amplitud de nicho estrecha en todas las categorías, lo que indicó una estrategia de alimentación de tipo especialista (índice de Levin

Introduction and Objectives: Primary biliary cholangitis (PBC) is characterized by the presence of specific antimitochondrial autoantibodies (AMA), antinuclear autoantibodies (ANA), or documented by liver biopsy, treatment with ursodeoxycholic acid (UDCA) has implication in disease progression and survival without a liver transplant. This study aimed to know the clinical characteristics of patients with PBC. Materials and Methods: Observational, descriptive, longitudinal and retrospective study, case series study. It included patients aged 18 to 80 years seen in the Liver Clinic consultation with a diagnosis of PBC in the Hospital General de Mexico from 2015 to 2022. Results: Sixty patients were evaluated; 95% were women, the most frequent age of presentation was between the fifth and sixth decade of life, the prevalence of AMA was 95%, the other 5% were diagnosed by liver biopsy or specific ANA, the presence of other antibodies was 26% of which the most frequent, were ANA. Transitional elastography was performed in 68% of the patients and documented significant fibrosis in 68% and some degree of steatosis in 30%. The association with autoimmune diseases is 33%; Sjögren's syndrome and scleroderma are the most representative. Overlap with autoimmune hepatitis was documented in 25%. Osteometabolic disease was present in up to 35%. The response to treatment to AUDC, as measured by the Paris II Score, was 31%. Conclusions: The clinical characteristics are similar to those described in the literature. The low response rate to UDCA is striking, which is a factor implicated in the progression of the disease, which correlate with the high degree of documented fibrosis. Funding: The resources used in this study were from the hospital without any additional financing Declaration of interest: The authors declare no potential conflicts of interest.

Abstract Objective To study knowledge regarding genitourinary syndrome of menopause (GSM) and the treatments for it and to analyze treatment adherence during the COVID-19 confinement. Methods Multi-center observational study including women between 35 and 75 years. An extension study of treatment adherence was conducted during the coronavirus pandemic between March and April 2020. Results A sample of 2355 women were included. Vaginal dryness was the most frequently identified symptom (74.3%). Lubricants were the best-known treatments (69.6%), followed by local estrogens (25.7%); 66% of the women did not speak to their gynecologist about sexuality. Comparative analyses were conducted according to age, menopausal status, type of menopause, place of residence, type of health care received and level of education. During the coronavirus confinement period, adherence to treatments for vulvovaginal atrophy was poor in 72.5% asked (n = 204). Reduced sexual activity (p > 0.001) and coronavirus diagnosis (p = 0.003) were significantly associated with poorer treatment compliance. Conclusions There is great lack of knowledge of the treatments used for GSM. Most women do not talk to their gynecologist about sexuality. Adherence to treatments during the coronavirus confinement has been worryingly low.

Background: considering that work accidents constitute a large source of cost generation and that in Cuba there is an aging age distribution, health care for workers is a fundamental process in primary health care.Objective: to characterize occupational health care at the Juan José Apolinaire Pennine Polyclinic in Cienfuegos.Methods: descriptive, cross-sectional study carried out in 2018. The sample made up of workers from the Carlos Manuel de Céspedes Thermoelectric Plant, chosen by simple random sampling, and doctors and nurses from the polyclinic family, intentionally selected. To obtain the information, two instruments were used, one applied to health personnel, to identify knowledge about occupational health and the other to the workers of the selected company to determine perceived satisfaction with the care received.Results: in the professionals of the Juan José Apolinaire Pennini polyclinic in Cienfuegos, there is evidence of a lack of knowledge about occupational health, by not showing clarity about occupational risks, causes of work accidents, examinations to be carried out in the working population and criteria for declaring an occupational disease . In addition, the surveyed patients are moderately satisfied with the care received, mainly due to deficiencies in stability, need and comprehensiveness of care.Conclusions: the research results suggest that there is a relationship between the lack of knowledge about occupational health in polyclinic workers and the insufficient attention perceived by the surveyed patients.

Abstract A lack of personalized approaches in non-medication pain management has prevented these alternative forms of treatment from achieving the desired efficacy. One hundred and ten female patients with fibromyalgia syndrome (FMS) and 60 healthy women without chronic pain were assessed for severity of chronic or retrospective occasional pain, respectively, along with alexithymia, depression, anxiety, coping strategies, and personality traits. All analyses were conducted following a ‘resource matching’ hypothesis predicting that to be effective, a behavioral coping mechanism diverting or producing cognitive resources should correspond to particular mechanisms regulating pain severity in the patient. Moderated mediation analysis found that extraverts could effectively cope with chronic pain and avoid the use of medications for pain and mood management by lowering depressive symptoms through the use of distraction mechanism as a habitual (‘out-of-touch-with-reality’) behavior. However, introverts could effectively cope with chronic pain and avoid the use of medications by lowering catastrophizing through the use of distraction mechanism as a situational (‘in-touch-with-reality’) behavior. Thus, personalized behavior management techniques applied according to a mechanism of capturing or diverting the main individual ‘resource’ of the pain experience from its ‘feeding’ to supporting another activity may increase efficacy in the reduction of pain severity along with decreasing the need for pain relief and mood-stabilizing medications.