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Abstract Introduction Mass casualty incidents (MCI) are unforeseeable and complex events that occur worldwide, therefore enhancing the training that medical first responders (MFRs) receive is fundamental to strengthening disaster preparedness and response. In recent years, extended reality (XR) technology has been introduced as a new approach and promising teaching technique for disaster medicine education. Objective To assess the effectiveness of XR simulation as a tool to train MFRs in MCIs, and to explore the perception and experience of participants to these new forms of training. Design Systematic review. Methods This systematic review was conducted in accordance with the “Preferred reporting items for systematic reviews and meta-analyses” (PRISMA) statement. Four databases were searched (MEDLINE, EMBASE, CINAHL and LILACs) using a comprehensive search strategy to identify relevant articles, and MetaQAT was used as a study quality assessment tool. Data from included studies was not pooled for meta-analysis due to heterogeneity. Extracted data was synthesised in a narrative, semi-quantitative manner. Results A total of 18 studies were included from 8 different countries. Studies encompassed a variety of participants (e.g., nurses, paramedics, physicians), interventions (virtual, mixed and augmented reality), comparators (comparison between two groups and single groups with pre-post evaluation), and outcomes (effectiveness and MFR perception). The synthesis of data indicated that XR was an effective tool for prehospital MCI training by means of improved triage accuracy, triage time, treatment accuracy, performance correctness and/or knowledge acquired. These XR systems were well perceived by MFRs, who expressed their interest and satisfaction towards this learning experience and emphasized its usefulness and relevance. Conclusion This research supports the usefulness and significance of XR technology that allows users to enhance their skills and confidence when facing forthcoming disasters. The findings summarize recommendations and suggestions for the implementation, upgrade and/or assessment of this novel and valuable teaching method.

El presente estudio se ha ocupado de examinar los conocimientos (aciertos), concepciones erróneas (fallos) y lagunas (no sé) sobre el Trastorno por Déficit de Atención e Hiperactividad (TDAH) en base a tres áreas de contenido específicas: información general, sintomatología y tratamiento. Para ello, se ha empleado el cuestionario del KADDS (Knowledge of Attention Deficit Hyperactivity Disorder), cumplimentado por un total de 58 maestros/as españoles y boloñeses y 53 estudiantes. Los resultados del KADDS respecto a los docentes muestran un porcentaje de aciertos del 47,3%, 39,2% en fallos y 13,2% en lagunas. En estudiantes el porcentaje es del 56,6%, 26,6% y 16,8% respectivamente. Se observan diferencias entre el profesorado español e italiano. Respecto al porcentaje de aciertos, los docentes españoles puntúan menos en las tres áreas respecto a los docentes italianos: información general (54,5% vs. 78,4%), sintomatología (63,2% vs. 77%) y tratamiento (50,1% vs. 72,7%). Además, se observa que los docentes con estudios específicos en educación especial puntúan mejor en las tres áreas. Debido a la alta prevalencia del TDAH y el posible desconocimiento para su diagnóstico, manejo y tratamiento, sería recomendable una mayor formación a los docentes.

Introduction/backgroundMass-casualty incidents (MCIs) and disasters require an organised and effective response from medical first responders (MFRs). As such, novel training methods have emerged to prepare and adequately train MFRs for these challenging situations. Particular focus should be placed on extended reality (XR), which encompasses virtual, augmented and mixed reality (VR, AR, and MR, respectively), and allows participants to develop high-quality skills in realistic and immersive environments. Given the rapid evolution of high-fidelity simulation technology and its advantages, XR simulation has become a promising tool for emergency medicine. Accordingly, this systematic review aims to: 1) evaluate the effectiveness of XR training methods and 2) explore the experience of MFRs undergoing such training.MethodsA comprehensive search strategy will encompass four distinct themes: MFRs, disasters/MCIs, education and simulation, and XR. Four databases (MEDLINE, EMBASE, CINAHL and LILACs) will be searched along with an in-depth examination of the grey literature and reference lists of relevant articles. MetaQAT will be used as a study quality assessment tool and integrated into Covidence as part of the data extraction form. Given the predicted high heterogeneity between studies, it may not be possible to standardise data for quantitative comparison and meta-analysis. Thus, data will be synthesised in a narrative, semi-quantitative manner.DiscussionThis review will examine the existing literature on the effectiveness of XR simulation as a tool to train MFRs for MCIs, which could ultimately improve preparedness and response to disasters.Trial registrationProtocol registration: PROSPERO CRD42021275692.

IntroductionExcitability of the primary motor cortex measured with TMS has been associated with cognitive dysfunctions in patient populations. However, only a few studies have explored this relationship in healthy adults, and even fewer have considered the role of biological sex.MethodsNinety-seven healthy middle-aged adults (53 male) completed a TMS protocol and a neuropsychological assessment. Resting Motor Threshold (RMT) and Long-Interval Intracortical Inhibition (LICI) were assessed in the left motor cortex and related to attention, episodic memory, working memory, reasoning, and global cognition composite scores to evaluate the relationship between cortical excitability and cognitive functioning.ResultsIn the whole sample, there was a significant association between LICI and cognition; specifically, higher motor inhibition was related to better working memory performance. When the sample was broken down by biological sex, LICI was only associated with working memory, reasoning, and global cognition in men. No associations were found between RMT and cognitive functions.ConclusionGreater intracortical inhibition, measured by LICI, could be a possible marker of working memory in healthy middle-aged adults, and biological sex plays a critical role in this association.

Psychosocial hardships associated with the COVID-19 pandemic led many individuals to suffer adverse mental health consequences, however, others show no negative effects. We hypothesized that the electroencephalographic (EEG) response to transcranial magnetic stimulation (TMS) could serve as a toy-model of an individual's capacity to resist psychological stress, in this case linked to the COVID-19 pandemic. We analyzed data from 74 participants who underwent mental health monitoring and concurrent electroencephalography with transcranial magnetic stimulation of the left dorsolateral prefrontal cortex (L-DLPFC) and left inferior parietal lobule (L-IPL). Within the following 19 months, mental health was reassessed at three timepoints during lock-down confinement and different phases of de-escalation in Spain. Compared with participants who remained stable, those who experienced increased mental distress showed, months earlier, significantly larger late EEG responses locally after L-DLPFC stimulation (but not globally nor after L-IPL stimulation). This response, together with years of formal education, was significantly predictive of mental health status during the pandemic. These findings reveal that the effect of TMS perturbation offers a predictive toy model of psychosocial stress response, as exemplified by the COVID-19 pandemic.

IntroductionThe prefrontal cortex (PFC) plays a crucial role in cognition, particularly in executive functions. Cortical reactivity measured with Transcranial Magnetic Stimulation combined with Electroencephalography (TMS-EEG) is altered in pathological conditions, and it may also be a marker of cognitive status in middle-aged adults. In this study, we investigated the associations between cognitive measures and TMS evoked EEG reactivity and explored whether the effects of this relationship were related to neurofilament light chain levels (NfL), a marker of neuroaxonal damage.MethodsFifty two healthy middle-aged adults (41–65 years) from the Barcelona Brain Health Initiative cohort underwent TMS-EEG, a comprehensive neuropsychological assessment, and a blood test for NfL levels. Global and Local Mean-Field Power (GMFP/LMFP), two measures of cortical reactivity, were quantified after left prefrontal cortex (L-PFC) stimulation, and cognition was set as the outcome of the regression analysis. The left inferior parietal lobe (L-IPL) was used as a control stimulation condition.ResultsLocal reactivity was significantly associated with working memory and reasoning only after L-PFC stimulation. No associations were found between NfL and cognition. These specific associations were independent of the status of neuroaxonal damage indexed by the NfL biomarker and remained after adjusting for age, biological sex, and education.ConclusionOur results demonstrate that TMS evoked EEG reactivity at the L-PFC, but not the L-IPL, is related to the cognitive status of middle-aged individuals and independent of NfL levels, and may become a valuable biomarker of frontal lobe-associated cognitive function.

Background Evidence in older adults suggests that higher cardiorespiratory fitness and lower cardiovascular risk are associated with greater cognition. However, given that changes in the brain that lead to cognitive decline begin decades before the onset of symptoms, understanding the mechanisms by which modifiable cardiovascular factors are associated with brain health in midlife is critical and can lead to the development of strategies to promote and maintain brain health as we age. Methods and Results In 501 middle‐aged (aged 40–65 years) adult participants of the BBHI (Barcelona Brain Health Initiative), we found differential associations among cardiorespiratory fitness, cardiovascular risk, and cognition and cortical thickness. Higher cardiorespiratory fitness was significantly associated with better visuospatial abilities and frontal loading abstract problem solving (β=3.16, P=0.049) in the older middle‐aged group (aged 55–65 years). In contrast, cardiovascular risk was negatively associated with better visuospatial reasoning and problem‐solving abilities (β=−0.046, P=0.002), flexibility (β=−0.054, P

Cutaneous leishmaniosis of the New World (CLNW) is a health problem in rural areas of Venezuela. Patients with muco-cutaneous ulcers tend to present intercurrent infections of the lesions by pyogenic bacteria. After removing skin specimens from the ulcer borders for microscopic demonstration of Leishmania spp amastigotes, forty-one patients with the disease, being treated with cefadroxil per os were studied. Most of the patients came from rural Miranda state, were male adults and had one ulcer on a lower limb. Confirmatory diagnosis was made using the Montenegro test, or Leishmanin immunoserology (IFAT) and demonstration of the presence of parasites in the skin samples. All the patients were positive for the Leishmanin test, while parasites were observed in 51% of the skin smears colored by the Giemsa procedure. After a week of treatment with cefadroxil, bacterial infections were reduced and a decrease in bacterial load was also noted when visualizing the parasite from the skin smears. Patients were treated with intramuscular antimony meglumine for 10-day periods with an intervening rest period. All patients responded adequately to the meglumine antileishmania treatment; the lesions healed and accompanying tributary lymph nodes disappeared. Conclusion: Cefadroxil is a suitable antibiotic for treating intercurrent pyogenic infections in cases of tegumentary leishmaniosis. Since leishmaniosis is considered an emerging disease, a search for appropriate, alternative therapies is required.

Fundamento:La evaluación del riesgo cardiovascular es demáxima importancia para un correcto tratamiento de pacientes conriesgo. Hay varias ecuaciones de riesgo que pueden ser adaptadas auna población para evitar la sobre o infraestimación del riesgo. Seproponen a los percentiles de riesgo como un nuevo método paraadaptar los sistemas de valoración del riesgo a nuestra población.Métodos:Se ha realizado un estudio transversal de factores deriesgo cardiovascular en Palencia (ERVPA: Estudio de Riesgo Vas-cular en PAlencia). Se han registrado las variables edad, sexo, taba-quismo, tensión arterial, diabetes y colesterolemia. Se han estudiado514 sujetos entre 20 y 79 años procedentes de 9 centros de salud delárea sanitaria. Se ha calculado el riesgo cardiovascular fatal segúnlas ecuaciones del proyecto SCORE. Se han calculado y comparadolos percentiles obtenidos con cada ecuación, mediante el cálculo delos coeficientes de Spearman y kappa.Resultados:Los porcentajes de sujetos con riesgo alto varíanentre el 0% en jóvenes hasta el 92% en los varones y el 67% en lasmujeres mayores de 70 años. El coeficiente kappa entre las ecuacio-nes para países de bajo y alto riesgo es de 0.741. Dicha concordanciavaría de forma importante según el sexo y la edad. La concordanciaentre los percentiles es casi total. Conclusiones:Los percentiles de riesgo es un método de eva-luación del riesgo que permite adaptar cualquier ecuación a unapoblación particular evitando la sobre o infraestimación del riesgo ypermiten extrapolar el riesgo a cualquier edad.

A poco que se detenga uno a reflexionar sobre la influencia que tiene la formación postgraduada en Psiquiatría, sobre el ejercicio ulterior de los psiquiatras en el campo asistencial, se percibe que esa influencia es directa, más aún condicionante. La evolución de la Asistencia Psiquiátrica y del sistema docente postgraduado de la especialidad, en los últimos 10 años, no han discurrido por un camino común, como hubiera sido deseable, para obtener una buena formación básica de los jóvenes médicos que se orientan hacia la psiquiatría. La Docencia y la Asistencia han seguido derroteros diferentes, incomunicados, e incluso antagónicos.

El profesor Alberto Sois abrió el curso, hará diez años, dedicando tres cuartos de hora a arrojar sobre la mesa de la correspondiente aula de la Facultad de Medicina de la Universidad Autónoma de Madrid, un ejemplar de cada una de las revistas que había recibido el último mes sobre la materia que tenía que enseñar. El sagrado furor del bioquímico creciendo a medida que los tres cajones vomitaban bibliografía ante los ojos de sus estupefactos alumnos puede ilustrar una realidad ineludible de cualquier disciplina que roce, aunque sea de soslayo, lo científico-médico: la de una producción inabarcable de literatura que, en desigual medida, proclama la obsolescencia de los, cada vez más escasos, textos sagrados.

Hoy tenemos la oportunidad de entrevistar a un joven y eminente psicoanalista de la escuela de Jacques LACAN. El hizo prácticamente toda su formación a la sombra de un maestro cuyos efectos en el psicoanálisis actual nadie pone en duda. Nosotros le hemos invitado a que nOs dé su punto de vista sobre algunas cuestiones oscuras o polémicas. Se lo agradecemos sinceramente.

Sin resumen.

Una de las maneras de situar la práctica de la supervisión dentro del campo psicoanalítico, es la de encontrar su función y el sentido que tiene en la formación de los psicoanalistas. Aunque este planteamiento nos lleva de lleno a la cuestión del problema de la transmisión del psicoanálisis, vamos a tratar de aislarlo de la problemática más general que ello implica para poder entender los que conciernen a la supervisión específicamente

Eugenio Trías: Lo bello y lo siniestro; Joyce McDougall: Alegato por cierta anormalidad; S. B. Filskov y T. J. Boll: Handbook of clinical neuropsychology; Mercedes Várela: Psicología de la mujer embarazada.

PRESENTACION y ENSEÑANZAS DE SCHREBER, Daniel Paul Schreber -«Memorias de un Neurópata» -Ediciones Petrel. Buenos Aires -1978LA TEORIA COMO FICCION, Maud Mannoni -Editorial Crítica -1980MAS ALLA DE LA SOCIOLOGIA: EL GRUPO DE DISCUSION: TEORIA y CRITICA, Jesús Ibáñez -Ed. Siglo XXI -Madrid, 1979.LA SEXUALIDAD -Jean LaplancheEL ORDEN PSIQUIATRICO -Robert Castel -Ediciones La Piqueta. Madrid, 1980 -Colección «La Genealogía del Poder», dirigida por Julia Varela y Fernando Alvarez Uría

La falta básicaLímites de la conciencia y del materna;Neurofarmacología fundamental y clínica;Neuroleptics: Neurochemical, behavioral, and clinical perspectives.

Sin resumen.

Sin resumen.

Decir que es un honor entrevistar a una persona con las características del profesor LAIN ENTRALGO no constituye apelar a un tópico ni saldar en parte la deuda contraída por haber aceptado, sin más trámite, recibirnos. La relevancia de su obra escrita, fruto de una trayectoria por la vía del pensamiento médico humanista, es de sobra conocida: sus libros son consumaciones de un proceso de pensamiento que continúa.

Un intento de aproximación al narcisismo primario como un momento de la constitución del yo y sus posibles perturbaciones, que se manifiestan, por ejemplo, en el duelo patológico y la melancolía. Por lo demás, una reflexión sobre los escollos de la práctica psicoanalítica en sus vertientes clínica y teórica.

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Introdução: A profilaxia pré-exposição (PrEP) ganhou relevância como método de prevenção do VIH em determinados indivíduos e contextos. Após a entrada em vigor das normas para prescrição em Portugal, pretendemos aferir o conhecimento em relação à PrEP entre os estudantes de Medicina em Portugal. Material e Métodos: Foi enviado um questionário online aos estudantes de Medicina das escolas médicas portuguesas. Foi feita uma análise descritiva dos resultados e um estudo transversal analítico para identificar fatores associados a “conhecer a PrEP”, “ter tido uma aula de PrEP”, e “identificar grupos elegíveis corretamente”. Resultados: Dos 796 estudantes que responderam, 64,6% sabiam o que era a PrEP. Destes, 34,44% obteve conhecimento sobre a mesma durante a sua formação. Entre os respondentes, 4,77% identificaram correta e completamente os grupos elegíveis. Com o avançar do ano letivo, a probabilidade de conhecer a PrEP, ter tido uma aula de PrEP e identificar os grupos corretamente aumentava. No sexto ano, 43,48% tinham tido uma aula sobre PrEP e entre os que conheciam a PrEP, 28% identificaram os grupos elegíveis. Existem diferenças entre as escolas médicas após ajustamento para o ano letivo em relação aos resultados obtidos. A forma como se tomou conhecimento da PrEP não alterou de forma estatisticamente significativa a capacidade de identificar corretamente grupos elegíveis Conclusão: As diferenças entre as escolas médicas poderão ser harmonizadas. Esta temática poderá ser reforçada nos respetivos currículos.

Introduction While type 1 diabetes is frequently encountered clinically in pediatric endocrinology fellowship training, other types of diabetes may only be encountered in educational settings. Adult learners learn best through knowledge application, but to date there are no published curricula utilizing application educational strategies for all forms of diabetes. Methods We utilized a team-based learning (TBL) approach to create four modules on different types of diabetes: type 1 diabetes, type 2 diabetes, neonatal diabetes, and maturity-onset diabetes of the young. We divided our fellows (all training years, n = 11) into two teams and delivered four separate, 90-minute sessions. To emphasize the application of knowledge, we modified the format to combine the readiness assurance test (RAT) with application problem (APP) questions. The combined RAT/APP questions were answered by individuals and teams. We analyzed scores from individual and team tests and evaluated each module. Additionally, we acquired subjective data from the fellows regarding their experiences. Results Teams outperformed individuals on the tests, as expected (94% vs. 76% correct questions, respectively). All the fellows agreed that the sessions should be included permanently. Additionally, all agreed the sessions helped them apply knowledge. Subjectively, the fellows were very engaged and lively during the sessions and felt the sessions were feasible as implemented. Discussion TBL can be a valuable educational strategy to increase the application of knowledge for diabetes in pediatric endocrinology fellows. Future studies examining the use of this strategy to increase critical thinking skills and knowledge retention in the long-term would be useful.

Abstract  Given a cluster-tilted algebra B we study its first Hochschild cohomology group HH1(B) with coefficients in the B-B-bimodule B. We find several consequences when B is representation-finite, and also in the case where B is cluster-tilted of type $${\tilde{\mathbb{A}}}$$ . [ABSTRACT FROM AUTHOR]

Human activities play a key role in landscape evolution. Mining is one of the most important of these since it changes large parts of the Earth’s surface. In abandoned mines and quarries, pit lakes are quite common due to water table blocking. These lakes have remarkable ecological characteristics, but they are still poorly understood. Northwestern Spain has a long tradition in the use of slate for roofs. This exploitation, mostly open-pit, has caused a great transformation in the landscape including the generation of pit lakes. In this work, 27 pit lakes in abandoned slate quarries areas have been analysed using orthophotos of different years, UAV (unmanned aerial vehicle) images and field work. In each lake, the topographic context, geomorphological dynamics, morphometric parameters (including depth), pH, and ecological variables were measured. Other uses for these quarry pit lakes and their significance as a new geo-ecological environment are also discussed. The results show different types of pit lakes and, consequently, different potential uses in each case. Only six offer good conditions for recreational uses, whereas the rest (21) show slope instability or poor water quality.

Resumen: El SARS-CoV-2 se transmite de persona a persona por inhalación o por el contacto con gotas y aerosoles respiratorios. El período de incubación mediano es 5,1 días. Fiebre, tos seca, disnea y fatiga, son los síntomas más comunes. Casi la mitad de los casos son asintomáticos. El espectro de la enfermedad varía desde cuadros leves (81%) a críticos (5%). La edad avanzada, el sexo masculino y las comorbilidades impactan negativamente sobre la gravedad y la mortalidad de la COVID-19. El diagnóstico de la patología aguda se realiza con pruebas de reacción en cadena de la polimerasa con transcriptasa inversa (RT-PCR) o de detección antigénica. En pacientes hospitalizados, el remdesivir reduce el tiempo de recuperación. Los corticoides orales se recomiendan en casos graves o críticos que requieren oxigenoterapia o ventilación mecánica. La tromboprofilaxis se sugiere en todos los casos graves y no graves con riesgo trombótico alto. La antibioterapia se limita a pacientes de alta sospecha de sobreinfección bacteriana. Los casos leves-moderados y graves tras el alta hospitalaria deben monitorizarse clínicamente durante un período mínimo de dos semanas Abstract: SARS-CoV-2 is transmitted from person to person by inhalation or contact with respiratory droplets and aerosols. The median incubation period is 5.1 days. Fever, dry cough, dyspnea and fatigue are the most common symptoms. Almost half of the cases are asymptomatic. The spectrum of disease varies from mild (81%) to critical (5%). Older age, male gender and comorbidities negatively impact on the severity and mortality of COVID-19. The diagnosis of acute COVID-19 is made with RT-PCR or antigenic detection tests. In hospital patients, remdesivir reduces recovery time. Oral steroids are recommended for severe or critical cases requiring oxygen therapy or mechanical ventilation. Thromboprophylaxis is recommended in all severe and non-severe cases with high thrombotic risk. Antibiotherapy is limited to cases of high suspicion of bacterial superinfection. Mild-moderate and severe cases after discharge from hospital should be clinically monitored for a minimum period of two weeks

Introduction: Laser therapy and stimulation of the acupuncture points are anti-inflammatory and analgesic alternative treatments in dentistry. Objective: to describe the use of low power laser therapy in the emergency treatment of apical periodontitis after endodontic treatment during 2018. Methods: observational, descriptive, longitudinal, and prospective study of patients who attended emergency department at Guama Dentistry Clinic during 2018, Pinar del Río, presenting apical periodontitis after endodontic treatment; 86 patients participated in the study. Descriptive statistics was applied, respecting the bioethical principles. Results: female gender predominated (53,49 %), apical periodontitis after endodontic treatment was more prevalent in the age group 20-24 (30,23 %); 65,5 % of the patients presented remission and relief after the third treatment session. Only 2,33 % needed more than six treatment sessions. Conclusions: apical periodontitis after endodontic treatment is more common in women during the first half of the second decade of life. The treatment showed effectiveness from the first treatment sessions.

Landforms resulting from the interaction between paleo-glaciers and karst are studied by using the Sierra de los Grajos (Cantabrian Mountains) as a model. This area contains glacial landforms that have not interested geomorphologists due to their low altitude (Peña Castillo is about 1857 m a.s.l.), the absence of glacial cirques and the scarcity of large moraines. However, the prevalence of groundwater flow and chemical dissolution has favoured the preservation of glacial landforms. Lateral and frontal moraines show three main glacial stages and other minor glacier stabilization phases, with the paleo-ELA oscillating between 1650 and 1760 m. Moraines are combined with depressions and sinks resulting from subglacial karstic drainage. This convergence of forms and processes is an exception in the Cantabrian Mountains, where postglacial erosion has usually eroded the frontal moraines and the proglacial sediments. In the case of the Sierra de los Grajos, despite the underground drainage and preservation of many glacial deposits on karstic landforms, an outwash-plain was formed. These proglacial sediments and others from non-karstified areas filled the depressions of the preglacial terrain located at their edges. The main glaciokarstic landforms have been mapped and a sedimentological analysis of the outwash plain was made in order to reconstruct the glacial dynamics of this area. Key words: glaciokarst landforms, glacial geomorphology, karst geomorphology, geomorphological mapping, Cantabrian Mountains. Glaciokraški relief na območju Sierra de los Grajos v parku Babia in luna (Kantabrijsko gorovje, SZ Španija) Na območju Sierra de los Grajos (Kantabrijsko gorovje) smo raziskovali relief, ki je v preteklosti nastal z medsebojnim vplivanjem kraških in ledeniških procesov. Zaradi nizke nadmorske višine (Peña Castillo je le 1857 m nad morjem) ter odsotnosti velikih moren in krnic to območje geomorfologov do sedaj ni posebej zanimalo. Prav kraški procesi in z njimi povezano podzemno odtekanje so tu omogočili ohranitev ledeniških oblik. Bočne in čelne morene kažejo na tri glavne faze poledenitev in več manjših faz stabilizacije ledenikov z ravnovesno mejo (ELA) med 1650 in 1760 m.n.m. Morene so pogosto vezane na kraške globeli. Glaciokraške pojave najdemo le na tem območju Kantabrijskega gorovja, kjer je sicer poledeniška erozija odstranila čelne morene in proglacialne sedimente. Kljub podzemnemu odtoku in ohranitvi številnih ledeniških sedimentov na kraškem reliefu se je na Sierra de los Grajos oblikoval predledeniški vršaj (sander). Proglacialni sedimenti in sedimenti iz nekraških območij so zapolnili globeli v predledeniškem kraškem terenu. Kartiranje glaciokraških reliefnih in analiza sedimentov predledeniških vršajev sta nam omogočila rekonstrukcijo dinamike ledenika na obravnavanem območju. Ključne besede: glaciokraške reliefne oblike, ledeniška geomorfologija, kraška geomorfologija, geomorfološko kartiranje, Kantabrijsko gorovje, Španija.

Los procesos de enseñanza y aprendizaje en la etapa de Educación Infantil se ven especialmente favorecidos con el enfoque metodológico Aprendizaje Basado en Proyectos (ABP) y as Tecnologías del Aprendizaje y la Comunicación (TAC), entendidas como recursos educativos a utilizar en el aula. Este artículo presenta un análisis del uso que hace el profesorado de las TAC en el marco metodológico del ABP a partir de un estudio de campo realizado entre una muestra de profesores de la etapa de Educación Infantil de la Región de Murcia. En él se describen los parámetros profesionales relacionados con las buenas prácticas educativas del profesorado que utiliza esta metodología en su aula.

La hematofobia se podría definir por la presencia de miedo y una serie de conductas de evitación y/o escape ante lugares, objetos y situaciones relacionadas con la visión de sangre, agujas y heridas, existiendo un historial de desmayos en casi el 80% de los casos. Esta fobia tiene una prevalencia de 31‰ y genera un gran impacto en la vida del individuo. En el presente trabajo se han revisado las investigaciones más relevantes que han abordado tanto las distintas variables que pueden explicar el problema como los desmayos, junto con los tratamientos que han demostrado mayor eficacia en el campo. Para ello, se han agrupado los diversos estudios en tres líneas de investigación: la sensibilidad al asco, el rol de la hiperventilación y el sesgo atencional. Asimismo, también se han revisado los procedimientos de mayor eficacia probada en el campo. Los resultados obtenidos a través de la revisión apuntan que no hay diferencias significativas en cuanto a la eficacia de la tensión aplicada (TA) y la exposición (E) por sí sola, siendo estas técnicas las más eficaces para trabajar esta fobia. Respecto a las vías de investigación, en los últimos años las más significativas han sido la hiperventilación y el sesgo atencional. Finalmente, se proponen una serie de directrices encaminadas a orientar el tratamiento de estos pacientes en relación con estos resultados.

Objetivo: Analizar la tasa de detección de fetos pequeños para la edad gestacional (PEG) y crecimiento intrauterino restringido (CIR) mediante exploración ecográfica. Método: Estudio retrospectivo de casos y controles. Recién nacidos (RN) de gestaciones únicas a término (entre la semana 37-42) en el Hospital Universitario San Cecilio entre 2009 y 2010. Grupo casos: 98 RN a término con peso al nacer < 2500 g, con peso fetal estimado (PFE) por ecografía en el III trimestre. Grupo control: 100 RN durante el mismo período con peso al nacer entre 3000-4000 g, con PFE por ecografía en el III trimestre obtenido de forma aleatoria. Resultados: La tasa de detección de CIR tipo I fue de un 11,1% con una incidencia del 0,1% y la tasa de detección de pequeños para edad gestacional fue de un 56,5% con una incidencia del 2% respecto al total de RN. Conclusión: En nuestra experiencia la EPF mediante ecografía en fetos con peso bajo el p10 tiene un error de 6% respecto al peso neonatal, esto permite una adecuada identificación de fetos con PEG y CIR.Objective: To analyze the detection rate of small for gestational age (SGA) fetuses and intrauterine growth restriction (IUGR) fetuses by ultrasound exploration. Methods: Cases and controls retrospective study. Material: Newborn (NB) of singleton pregnancies at term (between 37 and 42 weeks) at the Hospital Universitario San Cecilio between 2009 and 2010 both inclusive. Cases group: 98 at term NB with a birth weight < 2500 g; and an estimated fetal weight (EFW) by ultrasound in the 3rd trimester. Controls Group: 100 NB during the same period of time with birth weight between 3000-4000g, with EFW by ultrasound in the 3rd trimester randomly extracted. Results: The detection rate of small for gestational age infants born was 56.5% with 2% of incidence and the detection rate of intrauterine growth restriction type I was 11.1% with 0.1% of incidence within the total number of newborns in the period from 2009 to 2010. Conclusion: In our experience, EPF ultrasound in fetuses with weight below the 10th percentile has an error of 6% compared to birth weight, this allows proper identification of fetuses with SGA and IUGR.

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The value of this paper lies in the fact that it provides a comparative analysis between ISO 90001:2000 standards and the Costa Rica CST sustainability standard. It aims to obtain differences and similarities between both certification systems from this comparison and to analyze how they contribute to business management and sustainability. The analysis highlights which organizational changes a company must develop in order to achieve efficiency and ensure customer satisfaction.

The use of polyproline II (PPII) helices in protein design is currently hindered by limitations in our understanding of their conformational stability and folding. Recent studies of the snow flea antifreeze protein (sfAFP), a useful model system composed of six PPII helices, suggested that a low denatured state entropy contributes to folding thermodynamics. Here, circular dichroism spectroscopy revealed minor populations of PPII like conformers at low temperature. To get atomic level information on the conformational ensemble and entropy of the reduced, denatured state of sfAFP, we have analyzed its chemical shifts and { 1 H}- 15 N relaxation parameters by NMR spectroscopy at four experimental conditions. No significant populations of stable secondary structure were detected. The stiffening of certain N-terminal residues at neutral versus acidic pH and shifted pK a values leads us to suggest that favorable charge-charge interactions could bias the conformational ensemble to favor the formation the C1-C28 disulfide bond during nascent folding, although no evidence for preferred contacts between these positions was detected by paramagnetic relaxation enhancement under denaturing conditions. Despite a high content of flexible glycine residues, the mobility of the sfAFP denatured ensemble is similar for denatured α/β proteins both on fast ps/ns as well as slower μs/ms timescales. These results are in line with a conformational entropy in the denatured ensemble resembling that of typical proteins and suggest that new structures based on PPII helical bundles should be amenable to protein design., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2022 Biophysical Society. Published by Elsevier Inc. All rights reserved.)