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Connexin 43 (CX43) is one of the major components of gap junctions, the structures responsible for the intercellular communication and transmission of the electrical impulse in the left ventricle. There is limited information on the histological changes of CX43 with age and their effect on electrophysiology, especially in humans. Here, we analyzed left ventricular biopsies from living donors starting at midlife to characterize age-related CX43 remodeling. We assessed its quantity, degree of lateralization, and spatial heterogeneity together with fibrotic deposition. We observed no significant age-related remodeling of CX43. Only spatial heterogeneity increased slightly with age, and this increase was better explained by biological age than by chronological age. Importantly, we found that CX43 features varied considerably among individuals in our population with no relevant relationship to age or fibrosis content, in contrast to animal species. We used our experimental results to feed computational models of human ventricular electrophysiology and to assess the effects of interindividual differences in specific features of CX43 and fibrosis on conduction velocity, action potential duration, and arrhythmogenicity. We found that larger amounts of fibrosis were associated with the highest arrhythmic risk, with this risk being increased when fibrosis deposition was combined with a reduction in CX43 amount and/or with an increase in CX43 spatial heterogeneity. These mechanisms underlying high arrhythmic risk in some individuals were not associated with age in our study population. In conclusion, our data rule out CX43 remodeling as an age-related arrhythmic substrate in the population beyond midlife, but highlight its potential as a proarrhythmic factor at the individual level, especially when combined with increased fibrosis.

Summary: Age-related fibrosis in the left ventricle (LV) has been mainly studied in animals by assessing collagen content. Using second-harmonic generation microscopy and image processing, we evaluated amount, aggregation and spatial distribution of LV collagen in young to old pigs, and middle-age and elder living donors. All collagen features increased when comparing adult and old pigs with young ones, but not when comparing adult with old pigs or middle-age with elder individuals. Remarkably, all collagen parameters strongly correlated with lipofuscin, a biological age marker, in humans. By building patient-specific models of human ventricular tissue electrophysiology, we confirmed that amount and organization of fibrosis modulated arrhythmia vulnerability, and that distribution should be accounted for arrhythmia risk assessment. In conclusion, we characterize the age-associated changes in LV collagen and its potential implications for ventricular arrhythmia development. Consistency between pig and human results substantiate the pig as a relevant model of age-related LV collagen dynamics.

Fundamento: La hiperreactividad cardiovascular se ha asociado a diferentes factores de riesgo, sin embargo no está claro cómo se asocia al síndrome metabólico. Objetivo: Determinar la asociación entre hiperreactividad cardiovascular y los componentes del síndrome metabólico. Método: Se realizó un estudio descriptivo correlacional con una muestra de 109 personas de ambos sexos extraídas del universo laboral de la Facultad de Ciencias Médicas de Cienfuegos. Las variables estudiadas fueron: hiperreactividad cardiovascular, hipertensión arterial, índice de masa corporal, colesterol HDL, triglicéridos, glucemia en ayuna, cintura abdominal y síndrome metabólico. Los resultados se presentan en número y porcentaje y se aplica la razón de prevalencia para determinar la asociación entre las variables. Resultados: el 27,55 % eran hiperreactivos cardiovasculares; el 30,6 % de las personas tenían hipertensión arterial; el riesgo de hiperreactividad entre los sobrepesos fue de 3,75 (1,8;7,7), y entre los que tenían triglicéridos por encima de los valores normales de 1,9 (1,1;3,2); el 22 % de los hiperreactivos cardiovasculares presentó síndrome metabólico. Conclusiones: Según los resultados de este estudio la hiperreactividad cardiovascular está asociada a los factores que forman parte del síndrome metabólico y al propio síndrome.

A review of the history of medicine was conducted in order to evaluate the evolution of “diagnosis” and it was concluded that it was firstly defined by Hippocrates almost two thousand and five hundred years ago. The evolution of the concept is analyzed according to the scientific developments of each epoch. Different methods and their stages to obtain a diagnose are exposed. Similarities of the scientific and clinical methods are analyzed, as a necessary procedure for a good medical diagnosis. Different forms of doctor patient relationship are described, as an essential step for an accurate diagnosis. Medicine is approached as a totally uncertain, probabilistic science aimed to a final diagnosis. It is also emphasized that scientific and technological development bring us adequate tools for taking better decisions in order to facilitate medical diagnosis and its confrontation, not only in a single patient but in the analysis of its effectiveness in groups and communities. Basic pieces of advice are provided on how to obtain diagnoses in daily medical practice. Finally, two patterns in medical procedures are exposed: the Galenic and the Hippocratic.

Background: Since long time ago clinic medicine established the inexorable progress or development of the human arteriosclerosis, a disease expressed through complications as coronary and cerebrovascular ischemia and obliterant arteriosclerosis of inferior limbs, among others. Objectives: To determine lipid disorders in patients of 15 to 64 years of age of a policlinic in an urban health area. Methods: A transversal cut and descriptive study that included 263 patients to whom the cold test and the cholesterol and triglyceride exams were applied. Results and Conclusions: The risk factors that were more associated with the type of hyperlipoproteinemia were alcoholic consumption, poor nutrition, sedentary habit and overweight. The 26.9% presented hyperlipoproteinemia diagnoses, the 63, 4% of them are masculine and the 50, 7% belonged to the age group of 45 to 54 years old, the one who predominated. The hyperlipoproteinemia type found with more percentage was that of IIb, followed by IIa type and IV type. The non transmissible diseases more associated were arterial hypertension, diabetes mellitus and angina.

Introduction: Hemorrhagic ictus is a significant mortality cause in hospitalized patients. The clinical variability of this disease and its frequent morphological occurrence in necropsies justify the study of clinical-pathological concordance in two institutions of secondary health care; these institutions have similar characteristics and necropsy indexes of about 80% in the last five years. Objective: To determine the clinical-pathological relation in cerebrovascular hemorrhagic disease as diagnostic quality index, patient´s age impact and the kind of provided care. Methods: Retrospective, descriptive, correlational study assessing 1556 cadavers that underwent necropsy. The age and care department in which they died were analyzed, including the following quality markers: observed concordance, kappa index, sensitivity, specificity, positive and negative predictive values, positive and negative verisimilitude ratio. Results: The most relevant result depended on concordance and diagnostic effectiveness for this stage of the disease in Sancti Spiritus (kappa = 0, 88; PPV = 86, 0 %, sensitivity = 93, 2 %, PVR =, 60.3), these numbers were higher than those of Cienfuegos province. Age proved to be a significant factor. In Sancti Spiritus ictus care unit quality markers showed the primacy of these departments. Conclusions: Age is an important variable determining the clinical diagnostic quality, mainly in elderly people. Quality markers were higher in progressive care units, when compared with clinical departments, which have an impact on the provided care.Introducción: Los ictus hemorrágicos representan una causa importante de mortalidad hospitalaria. La variabilidad clínica de esta enfermedad y su frecuente evidencia morfológica en necropsias, justifican el estudio de la concordancia clínico- patológica en dos instituciones de la atención secundaria, centros que tienen características similares e índices de necropsia cercanos al 80 % en los últimos cinco años. Objetivo: Determinar la correlación clínico-patológica en la enfermedad cerebrovascular hemorrágica como índice de calidad del diagnóstico, y la influencia en este de la edad del paciente y el tipo de cuidados recibidos. Métodos: Estudio retrospectivo, descriptivo y correlacional, en el que se evaluaron 1556 fallecidos a los que se les realizó necropsia. Se analizaron la edad y los servicios donde ocurrió el fallecimiento, así como los siguientes indicadores de calidad: concordancia observada, índice kappa, sensibilidad, especificidad, valores predictivos positivo y negativos, razones de verosimilitud positiva y negativa. Resultados: Lo más relevante dependió de la concordancia y la eficiencia diagnóstica para esta enfermedad en Sancti Spíritus (kappa = 0,88; VPP = 86, 0 %, sensibilidad = 93, 2 %, RVP =,60.3), estos fueron superiores a los de Cienfuegos y al general para esta. La edad motivó cambios de importancia, destacándose en los ancianos. En la unidad de ictus de Sancti Spíritus los indicadores de calidad evidencian la superioridad de estos servicios. Conclusiones: La edad es una variable que determina la calidad del diagnóstico clínico sobre todo en ancianos. Los indicadores de calidad fueron superiores en las unidades de cuidados progresivos con respecto a los servicios clínicos, lo cual repercute en una mejor atención del paciente.

Background: Vojta Therapy is a neurorehabilitation therapy that allows to activate reflex movement patterns. The scientific literature has shown its ability to generate muscle contractions. The activation of brain neural networks has also been proven. However, the relationship between these processes has not yet been demonstrated. For this reason, the aim of this study is to verify brain activation produced by recording with near-infrared spectroscopy and its relationship with muscle activation produced in the abdominal muscles recorded with surface electromyography. Methods: A total sample of 27 healthy subjects over 18 years of age was recruited. An experimental study on a cohort was conducted. Two experimental conditions were considered: stimuli according to the Vojta protocol, and a control non-stimuli condition. Abdominal muscle activation was measured using surface electromyography, and the activation of the motor cortex was assessed with near-infrared spectroscopy. Results: In relation to the oxygenated hemoglobin concentration (HbO), an interaction between the stimulation phase and group was observed. Specifically, the Vojta stimulation group exhibited an increase in concentration from the baseline phase to the first resting period in the right hemisphere, contralateral to the stimulation area. This rise coincided with an enhanced wavelet coherence between the HbO concentration and the electromyography (EMG) signal within a gamma frequency band (very low frequency) during the first resting period. Conclusions: The results underscore the neurophysiological effects on the brain following tactile stimulation via Vojta Therapy, highlighting increased activity in pivotal areas essential for sensory processing, motor planning, and control. This activation, particularly evident in the Vojta stimulation group, aligns with previous findings, suggesting that tactile stimuli can not only evoke the intention to move but can also initiate actual muscle contractions, emphasizing the therapy’s potential in enhancing innate locomotion and rolling movements in patients with neurological disorders.

Objetivos: ahondar en el concepto de requisitos inherentes como aquellos conocimientos, aptitudes y resultados de aprendizaje esperados dentro de un programa académico, los cuales todo el alumnado debe satisfacer. Analizar las políticas de inclusión y metodologías en el ámbito universitario en otros países que describen, de manera explícita, unos requisitos inherentes. Determinar la validez de tales requisitos como herramienta facilitadora de una educación de calidad al alumnado con discapacidad. Metodología: se realiza una revisión de alcance de artículos académicos en bases de datos y de otras fuentes de información relevantes para la materia de investigación, seleccionando finalmente 25 documentos de Reino Unido y Australia. Resultados: se presenta un marco de actuación que, de manera organizada y proactiva, describe los requisitos inherentes de un curso académico y facilita la dotación de ajustes razonables dentro de un currículo inclusivo. Conclusiones: resulta necesario acercarse hacia nuevas aproximaciones metodológicas y repensar los currículos actuales para asegurar la no discriminación del alumnado con discapacidad en las universidades españolas. El empleo de metodologías basadas en requisitos inherentes reduciría barreras y aseguraría el cumplimiento de ajustes razonables.

Abstract Objectives Mental health professionals are becoming increasingly involved in the process of employment rehabilitation of persons with psychiatric disabilities. However, few studies address the attitudes of these professionals toward the employability of those with mental illness. The aim of this research was to identify differences in the attitudes of medical and non‐medical mental health professionals, as well as to detect any association between attitude scores and the type of professional. Methods A sample of 140 employees from public and third sector mental health organizations answered a questionnaire using a scale measuring their attitudes and views on the employability of people with psychiatric disabilities. The psychometric characteristics of the scale are provided together with the variations detected in the professionals’ attitudes. Results This research shows that significant differences in the attitudes between medical and non‐medical mental health employees exist and that there is a need for the implementation of educational programs that may help to improve the attitudes of medical professionals toward the employability of people with mental illness. Conclusion This research indicates the importance of improving the professionals’ attitudes to support people attempting to return to work.

Non-invasive transcranial direct current stimulation (tDCS) over the left anterior temporal lobe (ATL) has been shown to cause a reduction in the rate of false memories with semantically related words. Such a reduction seems to be specific to false memories induced by the study of associative lists, but is not observed when the studied lists are categorical in nature. These findings are interpreted as evidence that the left ATL functions as an integration hub that is crucial for the binding of semantic information into coherent representations of concepts. In order to investigate whether the right ATL might also contribute to semantic integration in the processing of verbal associative material, a follow-up tDCS study was conducted with the stimulation at study lateralized on the right ATL. A sample of 75 undergraduate students participated in an experiment in which they studied 8 associative lists and 8 categorical lists. One third of the participants studied all their word lists under anodal stimulation, another third studied under cathodal stimulation and the other third under sham stimulation. Results showed that stimulation of the right ATL by tDCS does not modulate false recognition for either association-related critical words or category-related critical words. These results provide preliminary support to views positing asymmetric connectivity between the anterior temporal lobes and the semantic representational network, and provide evidence for understanding bilateral brain dynamics and the nature of semantically induced memory distortions.

Assistive technology (AT) is any device, software, or equipment designed for and used by individuals with disabilities to engage in everyday activities and achieve independence. However, the usefulness of those technology-based or supported treatments is a complex issue that has led to the development of various conceptual models for assistive technology outcomes research and practice as well as different assessment tools that help to explore the effect of technology on people's lives. One of those instruments is the Psychosocial Impact of Assistive Device Scale (PIADS), a 26-item questionnaire that measures the psychosocial impact of interventions, using assistive devices in three quality-of-life domains: competence, adaptability, and self-esteem. PIADS scale has been translated and adapted to several languages, and it has been successfully used to measure AT outcomes in different disability profiles to predict abandonment or even as a relevant determinant of future adoption of eHealth. Quinteiro (2010) adapted PIADS to Spanish for the first time, although no studies have yet been published to systematically study its psychometric properties. Therefore, the purpose of this study was to evaluate measurement properties of the Spanish version of PIADS scale by means of a dataset obtained from its application to a large sample (n = 417) of people with neuromuscular, neurological, or hearing disabilities that used different assistive devices. The results will provide valuable indicators about the measurement quality of the Spanish PIADS scale and will help to promote the use of reliable and valid AT outcome assessment tools for research and clinical purposes.

Las microagresiones, como expresión de discriminación dirigida hacia personas con discapacidad, son un fenómeno social que cuenta con escasa atención en nuestro entorno. El presente trabajo supone una aproximación cuantitativa hacia la experiencia de microagresiones capacitistas, atendiendo tanto a su frecuencia como a la diversidad de sus manifestaciones. Presentamos los resultados obtenidos, bajo método de encuesta (n = 681), atendiendo al grado de visibilidad de la discapacidad. Nuestros datos respaldan la implicación de dicho factor como determinante de la experiencia de microagresiones capacitistas. Las personas con discapacidades visibles presentan niveles significativamente más altos en cuanto a la frecuencia de microagresiones. Para las personas con discapacidades semi visibles o invisibles, las microagresiones más habituales están relacionadas con el cuestionamiento de las necesidades de apoyo o la minimización de la discapacidad. La interpretación desde un sesgo binario, que identifica al otro como normal o anormal, sustenta multitud de prácticas producidas por el sistema capacitista.

In two experiments with large samples of participants, we explored contextual memory effects associated with body posture, which was considered a physical and proprioceptive context and, therefore, potentially relevant to the encoding and retrieval of information. In Experiment 1 (N = 128), we studied the effect of context dependence on memory by manipulating the body posture adopted by the participants during the incidental encoding and subsequent recall of a series of action sentences not intrinsically associated with particular body postures (e.g., "to put on a pair of glasses", "to look at a postcard"). Memory performance was not affected by context manipulation, as reflected by the absence of significant differences between remembering while in the posture adopted at study or in a different posture. Experiment 2 (N = 85) was designed to analyze context congruency memory effects, and for that purpose we manipulated the participants' body posture during the recall of sentences that described actions usually performed in body postures that were congruent or incongruent with the posture of the participants (e.g., recalling the sentence "to travel by taxi" while sitting or while standing). A content-neutral posture (lying) was used for the incidental encoding phase. Memory performance was not affected by contextual congruency at the time of recall, as evidenced by the lack of significant differences between recalling in a posture congruent with the content to be recalled and recalling in an alternative posture. Bayesian analyses supported the strength of null findings in the two experiments, adding to the evidence that, when taken together, the results in this study clearly failed to show contextual memory effects of body posture on the recall of action-related verbal statements.

Current education legislation in Spain ensures the participation of all citizens in society consequently, universities have to teach about universal design. This study focuses on the implementation of this process in the undergraduate degrees of computer engineering and architecture. A total sample of 159 academic guides from both degrees werea nalysed. The main results of the study show that less than half of the universities teach universal design and there are 59 degrees in which universal design is taught, albeit with significant differences between architecture and computer engineering. Finally, the authors discuss the need to comply with university legislation on including design-related content for everyone

Research from multiple areas in neuroscience suggests a link between self-locomotion and memory. In two free recall experiments with adults, we looked for a link between (a) memory, and (b) the coherence of movement and optic flow. In both experiments, participants heard lists of words while on a treadmill and wearing a virtual reality (VR) headset. In the first experiment, the VR scene and treadmill were stationary during encoding. During retrieval, all participants walked forward, but the VR scene was stationary, moved forward, or moved backwards. In the second experiment, during encoding all participants walked forward and viewed a forward-moving VR scene. During retrieval, all participants continued to walk forward but the VR scene was stationary, forward-moving, or backward-moving. In neither experiment was there a significant difference in the amount recalled, or output order strategies, attributable to differences in movement conditions. Thus, any effects of movement on memory are more limited than theories of hippocampal function and theories in cognitive psychology anticipate.

The main objective of this paper is to describe a variety of successful cases related to the implementation of universal design as a mean to address diversity in postsecondary educational settings. First, main approaches to implementation of universal design in educational settings are presented; and second, a brief review of the main studies that support the application of universal design to learning environments is done, organizing the review around three broad categories: (a) studies on teacher training about universal design for learning; (b) studies on introduction of curricula based on universal design; and (c) studies examining student’s perceptions after universal design implementation. It is concluded that, based on the results of the studies reviewed, universal design is a valid methodology to address diversity of university students.

En el presente estudio se analizaron los efectos del olvido dirigido en pruebas directas (reconocimiento y recuerdo) e indirectas (categorización y detección de letras). Los resultados mostraron que las palabras marcadas para aprender se recordaban mejor y se reconocían más rápido y con mayor precisión que las marcadas para olvidar. Este patrón de resultados se replicó con la prueba de categorización. Sin embargo, no se encontró olvido dirigido en la prueba de detección de letras. Los resultados se discuten en función de la hipótesis basada en el repaso diferencial como mecanismo implicado en el olvido dirigido con el método de las palabras.