Abstract The Artificial Neural Network (ANN) techniques were utilized to predict wear rate and CoF of the Ti-5Al-2.5Sn matrix reinforced with B4C particle manufactured by the powder metallurgy. TMCs and wear test samples were characterized by the Scanning Electron Microscope (SEM). Dry sliding wear narrative of the composites was estimated on a pin-on-disc machine at various loads of 20-60N, sliding velocity of 2-6m/s and sliding distance from 1000m-3000m. The wear rate of the composite was reduced by augmentation in weight fraction of boron carbide from 3-9%. The benefits of interfacial TMCs with B4C are: increase in strength, wear-resistance, and volume fraction. ANN was planned and utilizes a Levenburg-Marquardt program algorithm to reduce the mean squared error using a back-propagation technique. The input parameters are considered to include load, sliding velocity, and sliding distance. The experimental results of an ANN model and regression model are compared. ANN replicas have been urbanized to foreshow experimental rate of wear and CoF of TMCs and examined that ANN predictions have exceptional concord with deliberated values. Accordingly, the prediction of wear rate and CoF of TMCs using ANN in earlier actual manufacture will significantly save the manufacturing time, exertion, and expenditure.

Abstract Biological activity of boron-containing compounds (BCCs) has been well-known. Growing interest and numerous applications for BCCs have been reported. Boron and boron-containing acids show low acute toxicity in mammals but data on halogenated boroxine (HB) - dipotassium-trioxohydroxytetrafluorotriborate, K2(B3O3F4OH) acute toxicity have not been reported before. This compound, characterized as a potential therapeutic for skin changes, exhibits no observable genotoxicity in doses lower that 0.1 mg/ml in vitro and 55 mg/kg in vivo. It has also been confirmed as an antitumour agent both in vitro and in vivo as well as an inhibitor of enzymes involved in antioxidant mechanisms. The aim of this study was to assess the acute toxicity of HB and to determine the maximum tolerated dose as well as a dose free of any signs of toxicity in different test organisms. Acute toxicity of HB was tested in Sprague-Dawley and Wistar rats and BALB/c mice after single parenteral application of different doses. We determined doses free of any sign of toxicity and LD50 after single dose administration. LD50 of HB ranges from 63 to 75 mg/kg in different test models, meaning that HB shows moderate toxicity.

SUMMARY: Myocardial bridges are inborn anomalies frequently found in authopsies. Although tipically clinically silent, they are occasionally associated with severe clinical manifestations, e.g. myocardial ischemia or even sudden death. The pathophysiology and risk factors for these manifestations have not yet been completely elucidated. The connective tissue underneath the bridge has been considered as one of the factors the symptoms depend on. Thus, the aim of this research was to determine the histological characteristics of the connective tissue lying underneath the myocardial bridge and to contribute to a better understanding of the protective effects this passive compartment might have in prevention of severe clinical manifestations of myocardial bridging. The study was carried out on twenty hearts with myocardial bridges. Length of the bridge was determined using a precise electronic caliper. Sections of the myocardial bridges with the underlying connective tissue were obtained and prepared for qualitative and quantitative analysis. The connective tissue underneath the bridges was composed of adipose tissue and loose connective tissue in different ratios. The tissue underneath thin bridges was predominantly composed of adipose tissue, while loose connective tissue was the dominant component under thick bridges. The myocardial bridges had an average thickness of 0,98 ± 0.44 mm and an average length of 15,25±5,65 mm. We found a strong positive correlation between the myocardial bridge thickness and length (r = 0,860, p = 0,0001). The thickness of the passive connective tissue compartment under the myocardial bridges was 0,58±0,22 mm, and there was no correlation between this parameter and the myocardial bridge thickness (r = -0,011; p = 0,963). In the clinical evaluation of patients with these anomalies it is necessary to take into account independently the myocardial bridge thickness and length on one side and the thickness of the connective tissue lying underneath it on the other.

RESUMEN: Los puentes miocárdicos son anomalías congénitas que se encuentran con frecuencia en las autopsias. Aunque típicamente éstos son clínicamente silenciosos, ocasionalmente se asocian con manifestaciones clínicas graves, como isquemia miocárdica o incluso muerte súbita. La fisiopatología y los factores de riesgo de estas manifestaciones aún no se han dilucidado por completo. El tejido conectivo debajo del puente se ha considerado como uno de los factores de los que dependen los síntomas. Por lo tanto, el objetivo de esta investigación fue determinar las características histológicas del tejido conectivo que se encuentra debajo del puente miocárdico y contribuir a una mejor comprensión de los efectos protectores que este compartimento pasivo podría tener en la prevención de manifestaciones clínicas graves de puente miocárdico. El estudio se llevó a cabo en veinte corazones con puentes miocárdicos. La longitud del puente se determinó utilizando un calibrador electrónico preciso. Se obtuvieron secciones de los puentes miocárdicos con el tejido conjuntivo subyacente y se prepararon para análisis cualitativo y cuantitativo. El tejido conectivo debajo de los puentes estaba compuesto de tejido adiposo y tejido conectivo laxo en diferentes proporciones. El tejido debajo de los puentes delgados estaba predominantemente compuesto de tejido adiposo, mientras que el tejido conectivo laxo era el componente dominante debajo de los puentes gruesos. Los puentes de miocardio tenían un espesor promedio de 0,98 ± 0,44 mm y una longitud promedio de 15,25 ± 5,65 mm. Encontramos una fuerte correlación positiva entre el grosor y la longitud del puente miocárdico (r = 0,860, p = 0,0001). El grosor del compartimiento de tejido conectivo pasivo debajo de los puentes miocárdicos era de 0,58±0,22 mm, y no hubo correlación entre este parámetro y el grosor del puente miocárdico (r = -0,011; p = 0,963). En la evaluación clínica de pacientes con estas anomalías es necesario tener en consideración de forma independiente el grosor y la longitud del puente de miocardio por un lado y el grosor del tejido conectivo que se encuentra debajo del mismo por el otro.

Abstract Introduction Indigenous populations are considered a vulnerable minority and have characteristics such as poverty, difficulties to access food, housing, and educational backwardness; these conditions make them prone to alcohol consumption problems. Dependence on alcohol consumption probably arises as a symbol of protest, challenge, and response to social anguish, which has in turn repercussions in marginal population sectors that have conditions of fragility due to exploitation and discrimination, such as indigenous people. Objective To know the effect of perceived discrimination on alcohol consumption in Mexican indigenous population. Method Research design was descriptive, correlational check-model, with a sample of 362 adults from two indigenous communities. Results A simple linear regression model was performed, which shows a significant effect in the entire model (F[248] = 78.312, p = .001), which explains 49% of the variance of alcohol consumption. A significant positive influence was also found from the perceived discrimination variable (β = .626, p < .001) on alcohol consumption. Discussion and conclusion The studied indigenous communities had characteristics that the literature highlights as risk factors for developing addictive behaviors of alcohol consumption. These results coincide with those of the National Commission for the Development of Indigenous Peoples. Indigenous population present discrimination problems that are associated with alcohol consumption problems.

Resumen Introducción Las poblaciones indígenas se consideran minoritarias y vulnerables, y se caracterizan por su pobreza, dificultad para acceder a la alimentación, la vivienda y el rezago educativo. Estas condiciones los vuelven propensos a presentar problemas de consumo de alcohol. La dependencia al consumo de alcohol surge probablemente como símbolo de protesta, reto y respuesta a la angustia social, lo cual repercute en los sectores poblacionales marginales que poseen condiciones de fragilidad por la explotación y discriminación como los pueblos indígenas. Objetivo Conocer el efecto de la discriminación percibida en el consumo de alcohol en poblaciones indígenas mexicanas. Método El diseño del estudio fue descriptivo, correlacional de comprobación de modelo, con una muestra de 362 adultos de dos comunidades indígenas. Resultados Se realizó el modelo de regresión lineal simple el cual muestra efecto significativo en la totalidad del modelo (F[248] = 78.312, p = .001), explica el 49% de la varianza del consumo de alcohol, además se encontró influencia positiva significativa de la variable discriminación percibida (β = .626, p < .001) sobre el consumo de alcohol. Discusión y conclusión Las comunidades indígenas estudiadas poseen características que la literatura destaca como factores de riesgo para desarrollar conductas adictivas de consumo de alcohol, estos resultados coinciden con lo expuesto por la Comisión Nacional para el Desarrollo de los Pueblos Indígenas. Las poblaciones indígenas presentan problemas de discriminación que se asocian con los problemas de consumo de alcohol.

Abstrato Introdução: O consumo de álcool e tabaco é um problema de saúde pública mundial que afeita adolescentes e jovens. No México, ocupa a décima posição com um consumo de álcool per capita de 7,2 litros e aproximadamente 14,9 milhões de mexicanos são atualmente fumadores. Objetivo: Analisar a relação entre a percepção de risco e o consumo de álcool e tabaco em estudantes universitários de ciências da saúde de uma universidade pública de Tabasco, México. Metodologia: Estudo descritivo correlacional, numa amostra de 601 estudantes selecionados por amostragem estratificada de probabilidade. Com critérios de seleção: ser matriculado no programa de enfermagem, medicina ou odontologia, instrumentos incompletos ou aqueles que abandonaram o estudo foram eliminados. Foram aplicados um questionário de dados pessoais e prevalência do consumo de álcool e tabaco, um questionário de percepção de risco para o consumo de drogas lícitas e um teste de auditoria, garantindo o anonimato, a confidencialidade dos dados e o direito de recusar a participação. Resultados: O consumo médio foi de 3,6 bebidas alcoólicas e 2,5 cigarros por ocasião. Houve uma relação negativa estatisticamente significativa entre a percepção de risco e o número de cigarros consumidos com p<.05 e o consumo de álcool com p<.01. Conclusões: O consumo de álcool e tabaco está presente nos estudantes universitários de ciências da saúde, pelo que devem ser estabelecidas intervenções de enfermagem sobre a percepção de risco do consumo, a fim de ter um impacto no fenómeno das dependências.

Abstract Introduction: Alcohol and tobacco consumption are a worldwide public health problem that affects adolescents and young people. Mexico is in tenth place with a per capita consumption of 7.2 liters of alcohol, and currently, approximately 14.9 million Mexican people are smokers. Objective: Evaluate the relationship between risk perception and alcohol and tobacco consumption in university students of health sciences at a public university in Tabasco, Mexico. Methodology: This is a descriptive correlational study, with a sample of 601 students selected by stratified probability sampling. Selection criteria: to be enrolled in nursing, medicine or dentistry programs; incomplete instruments and those who dropped out of the study were removed. The questionnaire of personal data and prevalence of alcohol and tobacco consumption, the questionnaire of risk perception towards licit drug consumption and the Audit test were applied, guaranteeing anonymity, data confidentiality and the right to refuse to participate. Results: The average consumption was 3.6 alcoholic beverages and 2.5 cigarettes per occasion. There was a statistically significant negative relationship between risk perception and number of cigarettes consumed (p<.05) and alcohol consumption (p<.01). Conclusions: The consumption of alcohol and tobacco is present in university students of health sciences; therefore, nursing interventions on the perception of risks of consumption should be established in order to have an impact on the phenomenon of addictions.

Resumen Introducción: El consumo de alcohol y tabaco son un problema de salud pública a nivel mundial que afecta a adolescentes y jóvenes. En México ocupa el décimo lugar con un consumo de 7.2 litros per cápita de alcohol y aproximadamente 14.9 millones de mexicanos son fumadores actualmente. Objetivo: Analizar la relación de percepción de riesgo y consumo de alcohol y tabaco en estudiantes universitarios de ciencias de la salud de una universidad pública en Tabasco, México. Metodología: Estudio descriptivo correlacional, en una muestra de 601 estudiantes seleccionados por muestreo probabilístico estratificado. Con criterios de selección: estar inscrito en el programa de enfermería, medicina u odontología, se eliminaron instrumentos incompletos o quien abandonó el estudio. Se aplicó cédula de datos personales y prevalencia de consumo de alcohol y tabaco, cuestionario de percepción de riesgo hacia el consumo de drogas lícitas y prueba Audit, garantizando anonimato, confidencialidad de datos y derecho de negarse a participar. Resultados: La media de consumo fue 3.6 en bebidas alcohólicas y 2.5 cigarrillos por ocasión. Existió relación negativa estadística significativa entre la percepción de riesgo con cantidad de cigarrillos consumidos con p<.05 y consumo de alcohol con p<.01. Conclusiones: El consumo de alcohol y tabaco se encuentra presente en los estudiantes universitarios de ciencias de la salud, por ello, se deben establecer intervenciones de enfermería sobre la percepción del riesgo del consumo para impactar en el fenómeno de las adicciones.

Breastfeeding (BF) is essential for the development of the child and the promotion of a bond between mother and child. Therefore, it is essential that medical students know how to advise on the subject, to stimulate BF, so this study aimed to identify their knowledge in relation to BF knowledge, guidance, orientation, and management. Cross-sectional study with 252 medical students from a private university, carried out in the second semester of 2021 and first semester of 2022. The students answered a questionnaire that investigated seven domains that evaluated the knowledge and experience about BF. The Stata Program, version 16.0, was used in the statistical analyses. Chi-square test was applied to verify differences between students with no prior knowledge about AM (lt;7th period) and those with prior knowledge (gt;7th period). It was observed that students with prior knowledge obtained 65% (95%CI 56.2% - 73.0%) of performance in the general knowledge item about AM, while students without knowledge had 13.2% (95%CI 8.3 % - 20.2%). The subject with the best performance in both groups, with no statistically significant difference, was on the effectiveness of BF (96.0%; 95%CI 92.8 - 97.8). The content with the worst performance was the expression of breast milk, where 10.8% (95%CI 6.5 - 17.5) of students with no prior knowledge and 16.3% (95%CI 10.7 - 23.9) with knowledge got a better score. In view of the results obtained, it was concluded that students from the 7th to 12th period have more knowledge about the subject compared to students from the initial periods, even with poor performance in the domain expression of breast milk.

O aleitamento materno (AM) é fundamental para o desenvolvimento da criança e da promoção de vínculo entre mãe e filho. Diante disso, é primordial que os estudantes de medicina oriente sobre a temática, a fim de estimular o AM, por isso, tal estudo teve por objetivo identificar o conhecimento em relação ao conhecimento, orientações e manejo do AM. Estudo transversal com 22 estudantes de medicina de uma universidade, no 2º semestre de 20 e 1º semestre de 2022. Os estudantes responderam22. O Programa Stata, versão 16.0, foi avaliado nas estimativas estatísticas. Teste quiquadrado foi aplicado para diferenças entre os estudantes sem conhecimento prévio sobre AM (lt;7º) e os com conhecimento prévio ( gt; 7º período).Observou-se que os alunos com conhecimento prévio obtiveram 65% (IC95% 56,2% - 73,0%) de desempenho no quesito conhecimento geral sobre AM, enquanto os alunos sem conheceram 13,2% (IC95% 8,3) % - 20,2%). O desempenho em diferença significativa foi sobre o melhor significado do AM (96% 92,8,8) - IC95% 92,8,8. O conteúdo com melhor desempenho foi a expressão do leite materno, onde 10,8% (IC95% 6,5 - 17,5) dos estudantes sem conhecimento prévio e 16,3% (IC95% 10,7 - 23,9) com conhecimentoram o melhor escore obtido. Resultados maternos, concluídos-se que os alunos do 7º ao 12º período possuem mais conhecimento sobre o tema com os alunos dos períodos iniciais, mesmo apresentando desempenho ruim no domínio.

RESUMEN Antecedentes Las comunidades costeras son altamente dependientes de los servicios ecosistémicos; sin embargo, los beneficios y el modo de vida de sus habitantes son afectados directa e indirectamente por el cambio climático. Por tanto, es necesario entender cómo el cambio climático se traduce en impactos medibles sobre la sociedad y los ecosistemas para implementar planes de manejo y de mitigación, pero no se cuenta con la capacidad de investigación local y regional para ello. Objetivos Investigar la capacidad de investigación de los países latinoamericanos de la costa del Pacífico, desde México hasta Chile, una región de 23,191 km de largo, que comprende 11 países con diferente grado de desarrollo socio-económico y que serán especialmente vulnerables al cambio climático. Métodos Específicamente, nos enfocamos en explorar como los efectos del cambio climático en los servicios ecosistémicos (provisión, regulación y cultural) se relacionan con la capacidad de investigación y el producto interno bruto de los países en la costa del Pacífico de Latinoamérica. Resultados Encontramos que desde 1980 el número de estudios científicos publicados relacionados con el tema se correlaciona con el PIB (r = 0.90, p< 0.05) y el esfuerzo de investigación es un orden de magnitud menor en la costa de Latinoamérica (13.8 estudios por 1,000 km) que en la vecina costa de California (103 estudios por 1,000 km). Conclusiones Nuestros resultados resaltan la necesidad de promover la investigación en la zona costera latinoamericana y de realizar más trabajos en aspectos clave de la relación entre cambio climático y servicios ecosistémicos.

ABSTRACT Background Coastal communities are highly dependent on ecosystem services, but the benefits and livelihoods people derive from natural ecosystems are directly and indirectly affected by climate change. The need for a mechanistic understanding of how components of climate change translate into measurable impacts on ecosystems and society is fundamental to the ability to manage, plan and mitigate for the most likely environmental futures, yet progress in this area in tropical and subtropical countries is frustrated by a lack of research capacity at the local and regional level. Objectives Here, we investigate the research capacity of the countries along the Pacific coast, between Mexico and Chile, a region with an extensive coastline (23,191 km) that spans 11 countries of varying socio-economic development status and anticipated to be especially vulnerable to climate change. Methods Specifically, our focus was to explore how the effects of climate change on ecosystem services (provision, regulation and cultural) may relate to research capacity and gross domestic product (GDP) in each country along the Pacific coast of the Americas. Results We find that, since 1980, the number of peer-reviewed scientific studies relevant to this topic strongly correlates with GDP (r = 0.90, p < 0.05) and that research effort is an order of magnitude lower along the Latin American Pacific coast (13.8 studies 1000 km-1) than in the neighbouring Californian coast (103 studies 1000 km-1). Conclusions Our results highlight the need to better develop the research in the Latin America Pacific, and for more work on the key links between climate change and ecosystem services.

Resumen Dada la relevancia actual de la investigación acerca de cómo se aborda la educación en y para la diversidad en la educación superior, es que este trabajo tiene por objetivo analizar la literatura científica sobre diversidad e inclusión en la educación superior publicada en la Web of Sciences y Scopus entre 2011 y 2020. Se analizaron 112 artículos en función de indicadores bibliométricos: producción temporal, por revistas y autor, fuentes de información, instrumentos y procedimientos, y análisis temático. Los hallazgos indican un aumento de productividad en el 2019, una tendencia a la colaboración, un predominio de estudios cuantitativos, y temáticas sobre creencias, actitudes y saberes, formas de diversidad y educación para la diversidad. Estos hallazgos respaldan la necesidad de avanzar hacia nuevas comprensiones de diversidad de este tópico de investigación.

Abstract Given the current relevance of research on how education in and for diversity is addressed in higher education, this paper aims to analyze the scientific literature on diversity and inclusion in higher education published in the Web of Sciences and Scopus between 2011 and 2020. A total of 112 articles were analyzed in terms of bibliometric indicators: temporal production, by journals and author, sources of information, instruments and procedures, and thematic analysis. The findings indicate an increase in productivity in 2019, a trend towards collaboration, a predominance of quantitative studies, and themes on beliefs, attitudes and knowledges, forms of diversity, and diversity education. These findings support the need to move toward new understandings about diversity on this research topic.

Resumen Introducción. El abdomen abierto es un recurso útil para el tratamiento de pacientes con patología abdominal compleja, con potencial de complicaciones. El objetivo de este estudio fue adaptar la guía de World Society of Emergency Surgery (WSES) 2018, en un hospital de nivel III de atención de la ciudad de Popayán, Colombia, y comparar los resultados obtenidos con los previos a su implementación. Métodos. Estudio cuasi-experimental en dos mediciones de pacientes con abdomen abierto y estancia en cuidado crítico, durante los meses de abril a octubre de los años 2018 y 2019, antes y después de la adaptación con el personal asistencial de la guía de práctica clínica WSES 2018. Se utilizó estadística descriptiva, prueba de Chi cuadrado y se empleó el software SPSS V.25. Resultados. Se incluyeron 99 pacientes críticos, con una edad media de 53,2 años, con indicación de abdomen abierto por etiología traumática en el 28,3 %, infecciosa no traumática en el 32,3 % y no traumática ni infecciosa en el 37,4 %. La mortalidad global fue de 25,3 %, de los cuales, un 68 % se debieron a causas ajenas a la patología abdominal. Las complicaciones postoperatorias se presentaron en 10 pacientes con infección de sitio operatorio y 9 pacientes con fístula enterocutánea. El uso del doble Viaflex se implementó en un 63,6 %, logrando un cierre de la pared abdominal en el 79,8 % de los casos (p=0,038). Conclusión. El abdomen abierto requiere de un abordaje multidisciplinar. El uso de doble Viaflex es una herramienta simple y efectiva. La implementación de la guía disminuyó el porcentaje de mortalidad, los días de abdomen abierto y la estancia en cuidados intensivos.

Abstract Introduction. The open abdomen is a useful resource for the treatment of patients with complex abdominal pathology, with the potential for complications. The aim of this study was to adapt the World Society of Emergency Surgery (WJES) 2018 guidelines, in a tertiary level hospital and compare the results obtained with those prior to its implementation. Methods. Experimental study in two measurements of patients with open abdomen and stay in critical care, during the months of April to October in 2018 and 2019, before and after the adaptation with the healthcare personnel of the WSES 2018 clinical practice guide. Descriptive statistics, Chi square test and SPSS V.25 software were used. Results. Ninety-nine critically ill patients were included, with a mean age of 53.2 years, with an indication of open abdomen due to traumatic etiology in 28.3%, infectious non-traumatic in 32.3%, and non-traumatic or infectious in 37.4 %. Overall mortality was 25.3%, of which 68% were due to causes other than abdominal pathology. Postoperative complications occurred in 10 patients with surgical site infection and 9 patients with enterocutaneous fistula. The use of the double Viaflex was implemented in 63.6%, achieving a closure of the abdominal wall in 79.8% (p=0.038) of the cases. Conclusion. The open abdomen requires a multidisciplinary approach. The use of double Viaflex is a simple and effective tool. The implementation of the guide decreased the percentage of mortality, the days of open abdomen and the stay in intensive care unit.

ABSTRACT Empathy has an important research trajectory since the last century in cognitive neurosciences. From the definition as a concept, the construction of evaluation instruments for different ages and the search for domains and aspects that address this component are still in force. This review aims to collect representative findings in the history of the conceptualization of the term and the development of measurement in empathy in populations, with special emphasis on the work carried out with the child population with self-report tools and psychophysiological measures. The review showed that there is a promising research horizon with psychophysiological techniques such as the EEG for the evaluation of the construct. The need to deepen the search for patterns in the ontogeny of empathy in childhood is discussed, as well as the design of new forms of measurement through self-report for research practice in Spanish-speaking countries that involve social dynamics and demographics of these populations.

RESUMEN La empatía ha consolidado una importante trayectoria investigativa desde el siglo pasado en las neurociencias cognitivas. Desde su definición como concepto, la construcción de instrumentos de evaluación para diferentes grupos de edad y la búsqueda de dominios y vertientes que aborden este componente no ha cesado. Esta revisión se dirige a recopilar los hallazgos representativos en la historia de la conceptualización del término y el desarrollo de la medición en empatía en las poblaciones, haciendo especial énfasis en los trabajos realizados con población infantil con herramientas de autoinforme y medidas psicofisiológicas. La revisión arrojó que existe un horizonte investigativo prometedor de la mano de técnicas psicofisiológicas como el EEG para la evaluación del constructo. Se discute la necesidad de profundizar en la búsqueda de patrones en la ontogenia de la empatía en la niñez, así como en el diseño de nuevas formas de medición a través de autoinforme para la práctica investigativa en países de habla hispana que involucre las dinámicas sociales y demográficas de estas poblaciones.

ABSTRACT Spinal cord infarction is a rare entity that can be caused by interventional procedures such as chemoembolization applied for breast tumors, despite its high level of safety. This is the case of a 51-year-old female with chest pain and hemorrhage from a friable neoplastic lesion of the bilateral breast without improvement after conservative measures. After embolization of the tumor arteries, the patient developed crural paraparesis and global lower extremity hyporeflexia. MRI showed hypersignal in the anterior spinal cord, suggesting ischemia/infarction of the spinal cord in the territory of the anterior spinal artery. Although chemoembolization is considered a safe procedure, it is necessary to recognize its inherent risks such as spinal cord infarction, in order to avoid unnecessary risks in the patient. Despite being an extremely rare complication, its incidence increases gradually and its causes need to be studied as it is potentially fatal.

RESUMEN El infarto de médula espinal es una entidad poco común que puede ser causada por procedimientos intervencionistas, como la quimioembolización aplicada a los tumores de mama, a pesar de su alto nivel de seguridad. Se presenta el caso de una mujer de 51 años con dolor torácico y hemorragia por lesión neoplásica friable de mama bilateral sin mejoría tras medidas conservadoras. Después de la embolización de las arterias tumorales, el paciente desarrolló paraparesia crural e hiporreflexia global de las extremidades inferiores. La resonancia magnética mostró hiperseñal en la médula espinal anterior, lo que sugiere isquemia / infarto de la médula espinal en el territorio de la arteria espinal anterior. Si bien la quimioembolización se considera un procedimiento seguro, es necesario reconocer sus riesgos inherentes, como el infarto de médula espinal, para evitar riesgos innecesarios en el paciente. A pesar de ser una complicación extremadamente rara, su incidencia aumenta gradualmente y es necesario estudiar sus causas, puesto que es potencialmente fatal.

BACKGROUND: The Early Learning Outcomes Measure (ELOM) assesses early learning programme outcomes in children aged 50-69 months. ELOM assesses gross motor development (GMD), fine motor coordination and visual motor integration (FMC & VMI), emergent numeracy and mathematics (ENM), cognition and executive functioning (CEF), and emergent literacy and language (ELL). Content and construct validity, reliability and cross-cultural fairness have been established. AIM: To establish the test-retest reliability and concurrent validity of the ELOM. SETTING: Low income preschool and Grade R children. METHODS: In study one, Test-retest reliability was investigated in a convenience sample of 49 English and isiXhosa speaking preschool children (Mean age = 60.77 months, SD = 3.70) tested and retested one week apart. In study two, concurrent validity was investigated in a convenience sample of 62 children (Mean age = 75.05 months, SD = .75). ELOM performance was compared with that on the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI-IV). RESULTS: Test-retest reliability was established for ELOM Total score (r = .90, p < .001). The concurrent validity of ELOM Total and the WPPSI-IV Full Scale Composite scores was established (r = .64, p < .001). FMC & VMI, CEF, and ELL domains correlated significantly with their corresponding WPPSI-IV indices: visual spatial, fluid reasoning, processing speed, working memory, and verbal comprehension. CONCLUSION: The findings of both psychometric studies contribute further to the reliability and validity of the ELOM.

ABSTRACT: Introduction: Internet addiction has been associated with self-esteem, and the meaning of life with both variables because its mediating role should be explored. Objective: To analyze the relationship between Internet addiction and self-esteem in Mexican adolescents. Methodology: A descriptive and correlational study was carried out with a sample of 238 students selected by non-probability convenience sampling. A personal data card, the Rossemberg self-esteem scale, the Internet addiction test and the meaning of life test were used. The study adhered to the provisions of the Regulations of the General Health Law on Research for Health in Human Beings in Mexico and the declaration of Helsinki. Results: Internet addiction was negatively and significantly related to the meaning of life (rs = -.359, p ≤.001) and with self-esteem (rs = -.426, p ≤ .001). The meaning of life showed a mediating effect between self-esteem and Internet addiction (B = -.188, SE = .066, 95% CI [-.320, -.056]). Sex had a moderating effect between self-esteem and Internet addiction, being significant in both sexes. Conclusion: Self-esteem and meaning of life can predict a decrease in Internet addiction. Likewise, the role of gender can present variations with respect to points of view and way of thinking and moderate the relationship between self-esteem and Internet addiction.

RESUMEN: Introducción: La adicción al Internet se ha relacionado con la autoestima, y el sentido de la vida con ambas variables, porque se debe explorar su rol mediador. Objetivo: Analizar la relación entre la adicción al Internet y la autoestima en adolescentes mexicanos. Metodología: Se efectuó un estudio descriptivo y correlacional con una muestra de 238 estudiantes seleccionados por muestreo no probabilístico por conveniencia. Se utilizaron una cédula de datos personales, la escala de autoestima de Rossemberg, el test de adicción al Internet y el test de sentido de la vida. Se apegó a lo dispuesto en el Reglamento de la Ley General de Salud en Materia de Investigación para la Salud en Seres Humanos en México y a la declaración de Helsinki. Resultados: La adicción al Internet se relacionó negativa y significativamente con el sentido de la vida (rs=-.359, p= <.001) y con la autoestima (rs=-.426, p=<.001). El sentido de la vida mostró un efecto mediador entre la autoestima y la adicción al Internet (B= -.188, SE= .066, 95% IC [-.320, -.056]). El sexo tuvo un efecto moderador entre la autoestima y la adicción al Internet siendo significativo en ambos sexos. Conclusión: La autoestima y el sentido de la vida pueden predecir una disminución de la adicción al Internet. Así mismo, el rol de género puede presentar variaciones con respecto a los puntos de vista y forma de pensar y moderan la relación entre la autoestima y la adicción al Internet.

RESUMO Objetivo. Avaliar o processo e os resultados da implantação de uma iniciativa de controle de ponto eletrônico por biometria para melhoria da qualidade em três serviços de saúde no Departamento Norte do Haiti quanto à aceitabilidade, adoção, viabilidade, fidelidade e sustentabilidade. A baixa assiduidade no trabalho do pessoal da saúde é um problema em todo o país e está estreitamente relacionada à qualidade da atenção. Foi feita uma tentativa de implantar um sistema de ponto eletrônico por biometria em três instituições de saúde, para monitorar e aumentar a assiduidade no trabalho. Métodos. Estudo exploratório, descritivo e qualitativo dos resultados da implantação da iniciativa de ponto eletrônico por biometria. Os dados foram coletados em entrevistas semiestruturadas e em um grupo de discussão usando técnica de amostragem intencional para recrutar os participantes. A análise de dados foi realizada por codificação aberta e enfoque dedutivo com o uso do software ATLAS.ti 8. Resultados. A iniciativa de ponto eletrônico por biometria foi implantada com êxito em um serviço de saúde apoiado por uma organização não governamental. Porém, apesar do planejamento, ela nunca foi implantada nos serviços da rede pública. A aceitabilidade foi muito boa na entidade sem fins lucrativos, mas foi baixa na rede pública, sobretudo em relação à presença de apoiadores e dirigentes no local. Conclusões. Recomenda-se maior envolvimento dos dirigentes dos serviços de saúde nas diferentes fases do processo de implantação para garantir a aceitabilidade, adoção, fidelidade e sustentabilidade da iniciativa. Mais pesquisas são necessárias para estruturar esta iniciativa com uso de tecnologia no sistema de saúde do Haiti.

ABSTRACT Objective. To assess the process and outcomes of the implementation of an electronic fingerprint initiative as part of quality improvement in three health facilities in the Northern Department of Haiti, in terms of its acceptability, adoption, feasibility, fidelity, and sustainability. In Haiti, poor attendance of the healthcare workforce is a nationwide problem, closely related to the quality of care. Three health institutions have tried to implement an electronic fingerprint system to monitor and improve attendance. Methods. An exploratory and qualitative descriptive study of the implementation outcomes of the fingerprint initiative. It was based on semi-structured interviews and one group discussion using purposeful sampling techniques to recruit participants, and an open coding system and deductive approach to analyze the data using ATLAS.ti 8. Results. The fingerprint initiative was successfully implemented in a non-governmental organization supported health facility but, despite some planning, it was never implemented in the public health facilities. The acceptability of the implementation was high in the not-for-profit organization and low in the public settings, mostly in relation to the presence of champions and the leadership at each health facility. Conclusions. We recommend more involvement of the leadership of health facilities in the different phases of the implementation process in order to guarantee acceptability, adoption, fidelity and sustainabiliy. More research is needed to articulate this technology-driven initiative in the Haitian health system.

RESUMEN Objetivo. Evaluar el proceso y los resultados de la puesta en práctica de una iniciativa de digitalización de huellas dactilares como parte de la mejora de la calidad en tres establecimientos de salud del departamento Norte de Haití, en cuanto a su aceptabilidad, adopción, viabilidad, fidelidad y sostenibilidad. En Haití, el absentismo de los trabajadores de atención de salud es un problema nacional, estrechamente relacionado con la calidad de la atención. Tres instituciones de salud han tratado de poner en práctica un sistema de huellas dactilares digitalizadas para monitorear y mejorar la asistencia. Métodos. Se ha llevado a cabo un estudio descriptivo cualitativo y exploratorio de los resultados de la puesta en práctica de la iniciativa de la huella dactilar. Este estudio empleó entrevistas semiestructuradas y una discusión de grupo mediante técnicas de muestreo con fines específicos para reclutar a los participantes, y un sistema de codificación abierta y enfoque deductivo para analizar los datos con ATLAS.ti 8. Resultados. La iniciativa de la huella dactilar se llevó a cabo satisfactoriamente en un establecimiento de salud no gubernamental; sin embargo, a pesar de cierta planificación, no llegó a ponerse en práctica en establecimientos públicos de salud. La aceptabilidad de la implementación fue alta en las organizaciones sin fines de lucro y baja en los entornos públicos, principalmente en lo que respecta a la presencia de líderes y dirigentes en cada establecimiento de salud. Conclusiones. Recomendamos una mayor participación de la gerencia de los establecimientos de salud en las diferentes fases del proceso de ejecución para garantizar aceptabilidad, adopción, fidelidad y sostenibilidad. Se necesita investigación adicional para integrar esta iniciativa impulsada por la tecnología en el sistema de salud haitiano.

Introduction: the superior longitudinal sinus thrombosis is a disease difficult to detect because of its different causes and because of the polymorphism of its neurological manifestations; It is also common in females related to estrogen stimuli and other hormonal factors, but unlikely in younger than 40 years. Patient: a patient younger than 40 years after having two episodes of ischemic strokes, cognitive and functional status is assessed one year after the injury using the neuropsi battery attention and memory and the mayo-portland adaptability inventory; Cognitive processes affected at a slight level of classification were attention and concentration, executive functioning; In the functional status reported by the spouse suggests involvement of clinical symptoms such as irritability, anger, aggression, headaches, fatigue and reactions to minor symptoms and inadequate interaction, these symptoms were not reported by the patient suggesting possible anosognosia in her process of adaptability conclusion: After a process of brain injury due to thrombotic involvement, the cognitive and functional sequelae remain after spontaneous recovery, suggesting the import of rehabilitation processes.

Resumen Introducción: la trombosis de seno longitudinal superior es una enfermedad de difícil detección a causa de sus diferentes causas y debido al polimorfismo de sus manifestaciones neurológicas; además es común en el sexo femenino relacionado a los estímulos estrogénicos y otros factores hormonales, pero poco probable en menor de 40 años. Paciente: paciente menor de 40 años posterior a presentar dos episodios de accidentes cerebrovasculares isquémicos, se evalúa un año después de la lesión el estado cognitivo y funcional mediante la batería Neuropsi Atención y Memoria y el Inventario de Adaptabilidad Mayo-Portland; los procesos cognitivos afectados en un nivel de clasificación leve fueron la atención y concentración, el funcionamiento ejecutivo; en el estado funcional reportado por el cónyuge sugiere afectación de síntomas clínicos como irritabilidad, ira agresividad, dolores de cabeza, cansancio y reacciones a síntomas menores e interacción inadecuada, estos síntomas no fueron reportados por la paciente sugiriendo posible anosognosia en su proceso de adaptabilidad Conclusión: Tras un proceso de lesión cerebral por afectación trombótica, las secuelas cognitivos y funcionales permanecen posterior a la recuperación espontanea, llevando a emplear procesos de rehabilitación.