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This project aims to develop eligibility criteria for menopausal hormone therapy (MHT). The tool should be similar to those already established for contraception A consortium of scientific societies coordinated by the Spanish Menopause Society met to formulate recommendations for the use of MHT by women with medical conditions based on the best available evidence. The project was developed in two phases. As a first step, we conducted 14 systematic reviews and 32 metanalyses on the safety of MHT (in nine areas: age, time of menopause onset, treatment duration, women with thrombotic risk, women with a personal history of cardiovascular disease, women with metabolic syndrome, women with gastrointestinal diseases, survivors of breast cancer or of other cancers, and women who smoke) and on the most relevant pharmacological interactions with MHT. These systematic reviews and metanalyses helped inform a structured process in which a panel of experts defined the eligibility criteria according to a specific framework, which facilitated the discussion and development process. To unify the proposal, the following eligibility criteria have been defined in accordance with the WHO international nomenclature for the different alternatives for MHT (category 1, no restriction on the use of MHT; category 2, the benefits outweigh the risks; category 3, the risks generally outweigh the benefits; category 4, MHT should not be used). Quality was classified as high, moderate, low or very low, based on several factors (including risk of bias, inaccuracy, inconsistency, lack of directionality and publication bias). When no direct evidence was identified, but plausibility, clinical experience or indirect evidence were available, "Expert opinion" was categorized. For the first time, a set of eligibility criteria, based on clinical evidence and developed according to the most rigorous methodological tools, has been defined. This will provide health professionals with a powerful decision-making tool that can be used to manage menopausal symptoms.

Objetivo: Determinar las principales afectaciones en los aspectos físicos y psicoemocionales en mujeres con obesidad, para conocer las distintas maneras en las que perciben y piensan sobre este problema de salud en la actualidad. Materiales y Métodos: Estudio cuantitativo, descriptivo transversal y no probabilístico, utilizó el Cuestionario Comedor Emocional Garaulet y Test de Actitudes Corporales a 152 mujeres entre 19 a 64 años con obesidad que residan en el barrio Nueva Esperanza, durante el año 2022. Resultados: Existe una correlación moderada entre las conductas alimentarias y las actitudes hacia el cuerpo de las mujeres que participaron en la investigación con un coeficiente de correlación de 0,576 (p. valor=0,000), es decir que las mujeres con obesidad del estudio que presentan alteración en su conducta alimentaria son propensas a tener mayor rechazo o actitudes negativas hacia su propio cuerpo. Discusión: Diversos estudios corroboran que las mujeres con obesidad tienden a presentar conductas alimentarias emocionales y actitud negativa hacia su cuerpo, por lo cual se ve necesario realizar programas de prevención y disminución de la obesidad.

Background: Functional magnetic resonance imaging (fMRI) is a technique that has caught the attention of scientists since its appearance over thirty years ago. This tool allows for analyzing human brain activity through a sequence of magnetic resonance (MR) images. One important stage in the application of the fMRI technique is the statistical analysis of the sequence of post-processed images. The General Linear Model (GLM) is perhaps the most common statistical model applied for task-based fMRI analysis. However, in the majority of applications where this model is used, the spatiotemporal structures usually present in this type of data are commonly ignored. Thus, in the package introduced in this article, we have implemented a statistical method based on Matrix-Variate Dynamic Linear Models (MDLM) that allows taking into account the spatiotemporal structures in the modeling of task-based fMRI data. Results: The BayesDLMfMRI package performs statistical analysis for task-based fMRI data at both individual and group levels. The analysis to detect brain activation at the individual level is based on modeling the fMRI signal using MDLM. The analysis for the group stage is based on posterior distributions of the state parameter obtained from the modeling at the individual level. In this way, this package offers several R functions with different algorithms to perform inference on the state parameter to assess brain activation for both individual and group stages. Those functions allow for parallel computation when the analysis is performed for the entire brain as well as analysis at specific voxels when it is required. Conclusions: In summary, we present a software implementation of a well-tested statistical method for task-based fMRI analysis that would complement analysis performed with more popular packages such as FSL and SPM.

Background: Rivers and their associated vegetation are considered highly complex natural systems representing high biodiversity areas that work as biological corridors. Nevertheless, riparian vegetation of the Monarch Butterfly Biosphere Reserve (MBBR) has not been studied nor considered in the reserve’s management program. Questions: Which is the composition, structure, diversity, and state of conservation of the riparian vegetation of the MBBR? Study site and dates: The Senguio Microbasin, part of Sierra Chincua Priority Terrestrial Region, within the MBBR, in central México. 2016-2017. Methods: Using high-resolution imagery from 2014, we identified five joint categories in relation to the protection status (Core Zone, Buffer Zone, and Influence Area) and land use (conserved forest, highly disturbed forest, and farmland). We sampled three sites per category (N = 15) to analyze the composition, richness, and α- and β-diversity of the riparian communities. Results: We registered 108 species, 46 genera, and 18 families, of which 98 % are native and 2 % exotic. Richness and α-diversity were not significantly different among sites, but the composition and β-diversity showed significant differences depending on land use. The riparian vegetation is well conserved both in the Reserve´s Core and Buffer zones, and preserves high coverage, species richness, and individuals’ abundance. Conclusions: The riparian vegetation of the Senguio Microbasin hosts a biodiversity richness critical for the ecosystem’s health and evidences the relevance of considering the human use of the riparian systems to succeed in the conservation strategies.

Introducción: Los cuidados paliativos son un enfoque que mejora la calidad de vida de los pacientes y sus familias que se enfrentan a los problemas asociados a las enfermedades potencialmente mortales. Objetivo: Investigar cómo el personal de enfermería, en diversos sistemas de salud, describen su papel en la prestación de cuidados paliativos a los pacientes con enfermedades potencialmente mortales. Métodos: Una revisión sistemática cualitativa de estudios. Resultados: En base al análisis, según varios autores concuerdan que el personal de enfermería cumple un papel fundamental en los cuidados paliativos. Además de hacer lo necesario para manejar una enorme amplitud de actividades, siempre en un marco holístico de comprensión. Así mismo, de estar presente de forma atenta y dedicada, como también utilizar métodos flexibles y poco tradicionales. Conclusión: Esta revisión muestra que el personal de enfermería, en todas las instituciones sanitarias, tienen una posición única en los cuidados paliativos. El papel principal de la enfermera abarca la disponibilidad y la coordinación de los servicios sanitarios.

Dengue is endemic in many countries throughout the tropics and subtropics, and the disease causes substantial morbidity and health-care burdens in these regions. We previously compared antibody responses after one-dose, two-dose, or three-dose primary regimens with the only approved dengue vaccine CYD-TDV (Dengvaxia; Sanofi Pasteur, Lyon, France) in individuals aged 9 years and older with previous dengue exposure. In this study, we assessed the need for a CYD-TDV booster after these primary vaccination regimens.In this randomised, controlled, phase 2, non-inferiority study, healthy individuals aged 9-50 years recruited from three sites in Colombia and three sites in the Philippines (excluding those with the usual contraindications to vaccinations) were randomly assigned 1:1:1 via a permuted block method with stratification by site and by age group using an independent voice response system to receive, at 6-month intervals, three doses of CYD-TDV (three-dose group), one dose of placebo followed by two doses of CYD-TDV (two-dose group), or two doses of placebo followed by one dose of CYD-TDV (one-dose group). Participants were also randomly assigned (1:1) to receive a CYD-TDV booster at 1 year or 2 years after the last primary dose. Each CYD-TDV dose was 0·5 mL and administered subcutaneously in the deltoid region of the upper arm. The investigators and sponsor, study staff interacting with the investigators, and participants and their parents or legally acceptable representatives were masked to group assignment. Neutralising antibodies were measured by 50% plaque reduction neutralisation testing, and geometric mean titres (GMTs) were calculated. Due to a change in study protocol, only participants who were dengue seropositive at baseline in the Colombian cohort received a booster vaccination. The primary outcome was to show non-inferiority of the booster dose administered at 1 year or 2 years after the two-dose and three-dose primary regimens; non-inferiority was shown if the lower limit of the two-sided adjusted 95% CI of the between-group (day 28 post-booster dose GMT from the three-dose or two-dose group vs day 28 GMT post-dose three of the three-dose primary regimen [three-dose group]) geometric mean ratio (GMR) was higher than 0·5 for each serotype. Non-inferiority of the 1-year or 2-year booster was shown if all four serotypes achieved non-inferiority. Safety was assessed among all participants who received the booster. This trial is registered with ClinicalTrials.gov, NCT02628444, and is closed to accrual.Between May 2 and Sept 16, 2016, we recruited and enrolled 1050 individuals who received either vaccine or placebo. Of the 350, 348, and 352 individuals randomly assigned to three-dose, two-dose, and one-dose groups, respectively, 108, 115, and 115 from the Colombian cohort were dengue seropositive at baseline and received a booster; 55 and 53 in the three-dose group received a booster after 1 year and 2 years, respectively, as did 59 and 56 in the two-dose group, and 62 and 53 in the one-dose group. After the three-dose primary schedule, non-inferiority was shown for serotypes 2 (GMR 0·746; 95% CI 0·550-1·010) and 3 (1·040; 0·686-1·570) but not serotypes 1 (0·567; 0·399-0·805) and 4 (0·647; 0·434-0·963) for the 1-year booster, and again for serotypes 2 (0·871; 0·673-1·130) and 3 (1·150; 0·887-1·490) but not serotypes 1 (0·688; 0·479-0·989) and 4 (0·655; 0·471-0·911) for the 2-year booster. Similarly, after the two-dose primary schedule, non-inferiority was shown for serotypes 2 (0·809; 0·505-1·300) and 3 (1·19; 0·732-1·940) but not serotypes 1 (0·627; 0·342-1·150) and 4 (0·499; 0·331-0·754) for the 1-year booster, and for serotype 3 (0·911; 0·573-1·450) but not serotypes 1 (0·889; 0·462-1·710), 2 (0·677; 0·402-1·140), and 4 (0·702; 0·447-1·100) for the 2-year booster. Thus, non-inferiority of the 1-year or 2-year booster was not shown after the three-dose or two-dose primary vaccination regimen in dengue-seropositive participants. No safety concerns occurred with the 1-year or 2-year CYD-TDV booster.CYD-TDV booster 1 year or 2 years after the two-dose or three-dose primary vaccination regimen does not elicit a consistent, meaningful booster effect against all dengue serotypes in participants who are seropositive for dengue at baseline.Sanofi Pasteur.For the Spanish translation of the abstract see Supplementary Materials section.

Los escarabajos descortezadores son pequeños insectos que viven, se alimentan y se reproducen debajo de la corteza de los árboles. Estos insectos juegan un papel renovador en la salud de los bosques, ya que eliminan los árboles débiles y enfermos dejando únicamente a los más fuertes y sanos. Sin embargo, debido al aumento de las temperaturas y a la mayor ocurrencia de sequías, actualmente los brotes de escarabajos descortezadores ocurren con mayor frecuencia de la habitual, se extienden con mayor facilidad y tienen la capacidad de matar muchos árboles en poco tiempo. En México, los descortezadores son considerados un problema de importancia nacional, ya que constituyen el segundo agente de mayor perturbación forestal, especialmente en los bosques templados del centro del país. Tan solo en Michoacán y Estado de México, los brotes aumentaron de 38 en 2009 hasta rebasar los 1,000 en 2021. Este rápido aumento de los brotes de descortezadores implica un nuevo reto en los programas de manejo forestal, pues hay que desarrollar acciones tempranas que ayuden a frenar la expansión de estos insectos y, por tanto, el daño en los árboles.

Certain psychological and social factors modulate emotional adjustment in infertility. The aims of this study were: analyse whether there are sex and group differences (infertile vs. fertile) in emotional adjustment, and personality, dispositional optimism, coping strategies, personal and interpersonal resources; observe the modulating role of these psychosocial variables in the emotional adjustment of infertile individuals compared to fertile ones; and determine if the modulator variables associated with emotional adjustment are specific to infertile people. Method: A cross-sectional study design was used with a sample of 139 heterosexual Spanish participants (84 infertile, 55 fertile). For the data analysis we performed correlations, multiple regression analysis, MANOVAS and ANOVAS. Results: The multivariate and univariate analyses showed that the infertile group exhibited greater emotional maladjustment, more personal resources, lesser degree of confrontive coping, social support seeking, positive reappraisal, and lower marital satisfaction than the fertile group. In addition, women (infertile and fertile) sought more social support seeking and the infertile ones made more use of self-controlling strategies. Multiple regression analyses showed that for all subjects the emotional adjustment was modulated by dispositional optimism and escape/avoidance. For infertile participants, the remaining significant modulating factors were personal resources and marital satisfaction, whereas, for the fertile group, they were openness and interpersonal resources. Conclusion: Infertile women and men showed no differences in emotional maladjustment, but levels were higher than in the fertile group. We found differences between infertile and fertile subjects in terms of modulating variables of emotional adjustment. For infertile participants, the development of personal resources and increased marital satisfaction are particularly important.

El presente artículo evaluará los procesos y transformaciones que trajeron consigo los actores armados del conflicto contemporáneo en la comunidad indígena de los kankuamos, centrándose en los procesos de aculturación, violencia de la que fueron víctimas, los cambios socio-culturales, y el rol de las mujeres kankuamas durante el período establecido entre 1980-2005. Demuestra las causas iniciales por las cuales el pueblo kankuamo se vio directamente afectado por el conflicto armado, como también se reflexiona acerca de los derechos de la mujer indígena de manera necesaria y fundamental para la democratización de la sociedad y cultura.

Los modelos jerárquicos Bayesianos son utilizados en la modelación de datos en diferentes áreas en las cuales las estructuras jerárquicas se reflejan a través de efectos aleatorios. La distribución de probabilidad considerada como elección natural para el modelamiento de los efectos aleatorios es la Normal. Como distribución a priori para el parámetro de escala regularmente se utiliza Gamma-inversa (ε,ε) (IG) con valores de ε muy pequeños y esta selección ha tenido críticas, algunos autores comentan que se pueden obtener distribuciones posteriores inestables, lo cual ocasiona que la inferencia no sea robusta. Distri- buciones como half -Cauchy, Beta2 escalada (SBeta2) y Uniforme son consideradas como alternativas por diversos autores para modelar el parámetro de escala. En el presente trabajo de investigación se examinó el comportamiento de las estimaciones de los efectos aleatorios de un modelo jerárquico con un enfoque Bayesiano. Se asumió efectos aleatorios distribuidos t-Student y parámetro de escala distribuidos half - Cauchy, SBeta2 y Uniforme. Se llevó a cabo un estudio de simulación para evaluar el comportamiento del error de estimación de los efectos del modelo. Con base a los resultados obtenidos, y bajo los diferentes escenarios en consideración, fue posible examinar el encogimiento de los parámetros a posteriori del mo- delo y se pudo establecer que en presencia de valores atípicos, esta medida es menor cuando los efectos se modelan con una distribución t de Student comparados con los obtenidos cuando se le asocia a los efectos una distribución Normal bajo las misma distribuciones a priori para el parámetro de escala. 3

Pollution from oil spills can seriously affect many ecosystem processes and human health. Many articles have evaluated the impact of oil spills on human health. However, most of these articles focus on occupational exposure. The effect on people living in the areas affected by oil pollution is rarely studied. Approximately 640 million people worldwide live in areas at risk of oil pollution. Thus, studying the impact of this pollution on human health should be a priority. Here, we evaluate the presence of anemia in relation to crude oil exposure in men living in areas at risk of oil contamination in the Ecuadorian Amazon (Orellana and Napo). We evaluated the hematological and biochemical parameters of 135 participants. We divided the participants into three groups according to exposure: low, medium, and high. Our results showed a significant association between exposure risk and hemoglobin and hematocrit concentration. Groups with medium- and high- contamination exposure had levels below normal values in hemoglobin and hematocrit in more than 30% and 26% of the population, respectively. In conclusion, we found that crude oil affected human health, and the prevalence of the anemia in men was dependent of the level of contamination.

OBJETIVO: Analizar la actitud personal hacia el emprendimiento de los estudiantes de educación superior tecnológica en Hidalgo, mediante métodos cuantitativos, con la finalidad de identificar la relación con la percepción de los estudiantes respecto a la formación en emprendimiento. MATERIAL Y MÉTODO: El estudio es empírico, cuantitativo, de corte transversal, alcance descriptivo y relacional. Se aplicó la adaptación del cuestionario GUESSS (Global University Entrepreurial Spirit Student's Survey) a 338 estudiantes del área empresarial e industrial de educación superior tecnológica descentralizada en el estado de Hidalgo. RESULTADOS: La puntuación media de la actitud personal hacia el emprendimiento, se presenta en el siguiente orden: Ingeniería en Administración (4.4563), Ingeniería en Gestión Empresarial (4.3701), Ingeniería Industrial (4.1324) y Licenciatura en Administración (4.0804). El motivo principal de elección de carrera es, ser fundador de su propia empresa y al menos el 60% considera tener una sólida formación en materia de emprendimiento. CONCLUSIONES: Es fundamental el papel de las IES en la formación emprendedora, más en los Programas Educativos, donde en su perfil de egreso incluyen el emprendimiento. También, en la relación que existe entre la actitud hacia el emprendimiento y la percepción de los estudiantes, de tener una sólida formación en materia de emprendimiento.

Las hojas de moringa (Moringa oleifera Lam.) se cosechan, y almacenan previo a su comercialización. Hay dudas respecto a la calidad bromatológica después de almacenar las hojas. El objetivo de la presente investigación fue comparar las propiedades bromatológicas de las hojas de esta especie almacenadas en un periodo, para verificar si ocurren cambios bioquímicos durante el almacenamiento. Se colectaron hojas maduras de moringa en muestreos sucesivos en la huerta “Kio-Komukai” en Escuintla, Chiapas, México. Se determinó el contenido de humedad, proteína, grasa, fibra cruda y cenizas en cada muestra para cada una de las fechas de cosecha. Los resultados del análisis de la prueba t de Student, indican que no hubo diferencias en la calidad nutrimental (P > 0.05) de las hojas en las fechas de cosecha respecto al tiempo de almacenamiento. Los valores obtenidos de las cosechas de hoja en el análisis bromatológico son similares a los reportados en trabajos previos; grasa (%): 9.36 ± 1.05, fibra cruda (%): 19.94 ± 4.2, proteína: 20.35 ± 2.26, humedad (%): 7.22 ± 9.79 y cenizas (%): 10.14 ± 1.68.

Background: Early intramuscular administration of SARS-CoV-2-neutralising monoclonal antibody combination, tixagevimab–cilgavimab, to non-hospitalised adults with mild to moderate COVID-19 has potential to prevent disease progression. We aimed to evaluate the safety and efficacy of tixagevimab–cilgavimab in preventing progression to severe COVID-19 or death. Methods: TACKLE is an ongoing, phase 3, randomised, double-blind, placebo-controlled study conducted at 95 sites in the USA, Latin America, Europe, and Japan. Eligible participants were non-hospitalised adults aged 18 years or older with a laboratory-confirmed SARS-CoV-2 infection (determined by RT-PCR or an antigen test) from any respiratory tract specimen collected 3 days or less before enrolment and who had not received a COVID-19 vaccination. A WHO Clinical Progression Scale score from more than 1 to less than 4 was required for inclusion and participants had to receive the study drug 7 days or less from self-reported onset of mild to moderate COVID-19 symptoms or measured fever. Participants were randomly assigned (1:1) to receive either a single tixagevimab–cilgavimab 600 mg dose (two consecutive 3 mL intramuscular injections, one each of 300 mg tixagevimab and 300 mg cilgavimab) or placebo. Randomisation was stratified (using central blocked randomisation with randomly varying block sizes) by time from symptom onset, and high-risk versus low-risk of progression to severe COVID-19. Participants, investigators, and sponsor staff involved in the treatment or clinical evaluation and monitoring of the participants were masked to treatment-group assignments. The primary endpoints were severe COVID-19 or death from any cause through to day 29, and safety. This study is registered with ClinicalTrials.gov, NCT04723394. Findings: Between Jan 28, 2021, and July 22, 2021, 1014 participants were enrolled, of whom 910 were randomly assigned to a treatment group (456 to receive tixagevimab–cilgavimab and 454 to receive placebo). The mean age of participants was 46·1 years (SD 15·2). Severe COVID-19 or death occurred in 18 (4%) of 407 participants in the tixagevimab–cilgavimab group versus 37 (9%) of 415 participants in the placebo group (relative risk reduction 50·5% [95% CI 14·6–71·3]; p=0·0096). The absolute risk reduction was 4·5% (95% CI 1·1–8·0; p Interpretation: A single intramuscular tixagevimab–cilgavimab dose provided statistically and clinically significant protection against progression to severe COVID-19 or death versus placebo in unvaccinated individuals and safety was favourable. Treating mild to moderate COVID-19 earlier in the disease course with tixagevimab–cilgavimab might lead to more favourable outcomes.

El presente escrito tiene el objetivo de exponer los resultados obtenidos en un estudio sobre hábitos alimentarios en estudiantes universitarios de distintas licenciaturas agrupadas en tres áreas de conocimiento: económico-administrativas, ciencias de la salud, recreación y alimentación. Los factores explorados fueron las preferencias, creencias y barreras al cambio de dieta, los cuales se examinan a la luz de indicadores generales de rendimiento académico. La investigación se hizo en una escuela privada ubicada en el Valle de Toluca, México; se usó un enfoque exploratorio para una muestra de 94 alumnos; los datos se recolectaron mediante la aplicación online de un cuestionario. Los resultados demostraron que la mayoría de los jóvenes refieren tener rutinas alimentarias saludables y reportan indicadores de un rendimiento académico favorable, no obstante, al realizar un análisis individualizado, se encontró que aquellos que se autoevalúan con un aprovechamiento regular manifiestan prácticas contrarias. Este comportamiento emparejado hace pensar en la falta de desarrollo de habilidades autogestivas para el aprendizaje y la vida en general. De tal manera, se recomienda que las instituciones promuevan este tipo de competencias, además de impulsar acciones para mejorar los hábitos alimentarios.

Declines in the abundance and diversity of insects pose a substantial threat to terrestrial ecosystems worldwide. Yet, identifying the causes of these declines has proved difficult, even for well-studied species like monarch butterflies, whose eastern North American population has decreased markedly over the last three decades. Three hypotheses have been proposed to explain the changes observed in the eastern monarch population: loss of milkweed host plants from increased herbicide use, mortality during autumn migration and/or early-winter resettlement and changes in breeding-season climate. Here, we use a hierarchical modelling approach, combining data from >18,000 systematic surveys to evaluate support for each of these hypotheses over a 25-yr period. Between 2004 and 2018, breeding-season weather was nearly seven times more important than other factors in explaining variation in summer population size, which was positively associated with the size of the subsequent overwintering population. Although data limitations prevent definitive evaluation of the factors governing population size between 1994 and 2003 (the period of the steepest monarch decline coinciding with a widespread increase in herbicide use), breeding-season weather was similarly identified as an important driver of monarch population size. If observed changes in spring and summer climate continue, portions of the current breeding range may become inhospitable for monarchs. Our results highlight the increasingly important contribution of a changing climate to insect declines.