Resumen Los hábitos tecnológicos de los estudiantes universitarios, actitudes y aptitudes de una sociedad cibernética cada vez consumida por la tecnología, la relación entre la cotidianidad y el ambiente académico generan varios factores como es el manejo de la multitarea. El objetivo de este estudio fue validar un instrumento de medición de la multitarea y las actitudes hacia la tecnología en estudiantes del área de salud mediante el análisis factorial. Para lograrlo se recolectaron 442 observaciones, se utilizó en el análisis de datos un enfoque con métodos estadísticos factoriales para este caso el exploratorio. Previamente el instrumento fue valorado por docentes del área, el mismo que tuvo un coeficiente de confiabilidad de 0,90. Finalmente, se estructuró el instrumento de escala de multitarea y de actitudes hacia las tecnologías constituido por 17 ítems, que se agruparon en 6 factores como la actitud positiva; actitud negativa; ansiedad/dependencia; percepciones; multitarea/redes sociales; multitarea/trabajo. los resultados arrojaron un modelo que explicó el 63% de la varianza, con una raíz cuadrada media de los residuos de 0,07. La estructura factorial identificada y validada por el método estadístico de análisis factorial exploratorio y confirmatorio, ha logrado brindar una base sólida para evaluar estas dimensiones en el contexto de universitarios ecuatorianos de ciencias de la salud en futuras investigaciones.

Abstract The technological habits, attitudes, and aptitudes of university students in a cybernetic society are increasingly consumed by technology. The relationship between everyday life and the academic environment generates several factors, such as multitasking management. This study aimed to validate an instrument for measuring multitasking and attitudes towards technology in health students through factor analysis. To achieve this, 442 observations were collected; an approach with factorial statistical methods was used in the data analysis for this exploratory case. Previously, teachers in the area evaluated the instrument with a reliability coefficient of 0,90. Finally, the multitasking and attitudes towards technologies scale instrument was structured, consisting of 17 items grouped into six factors: Positive Attitude, Negative attitude, Anxiety/Dependency, Perceptions, Multitasking/Social Networks, and Multitasking/Working. The results showed a model that explained 63% of the variance, with a root mean square of the residuals of 0,07. The factor structure identified and validated by the statistical method of exploratory and confirmatory factor analysis has provided a solid basis for evaluating these dimensions in the context of Ecuadorian health sciences university students in future research.

RESUMO Introdução O ensino técnico especializado e os métodos de treinamento em natação para crianças são a base para melhorar o efeito do treinamento de natação e reduzir a ocorrência de lesões esportivas. Nos últimos anos, a tecnologia de treinamento físico em natação na China se desenvolveu rapidamente. O treinamento físico da natação para crianças pode melhorar a qualidade esportiva integral dos jovens. Objetivo Neste artigo, foram determinados os índices de 50m de borboleta e 50m de peito. Estes dados examinam quantitativamente o efeito do programa sobre o desempenho da natação. Métodos Um total de 18 crianças e adolescentes nadadores participaram da amostra analisada neste estudo. Neste trabalho, 18 participantes foram divididos em grupos experimentais e de controle. Estes grupos têm quatro estilos de natação: borboleta, nado de peito, nado de costas e estilo livre. Resultados Após dois meses de exercícios de coordenação, o desempenho do nado borboleta e do nado sapo foi parcialmente melhorado. Houve diferenças significativas nos dados (P<0,05). Conclusão O processo de treinamento de aptidão física pode melhorar a qualidade global dos atletas. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

ABSTRACT Introduction The specialized technical teaching and swimming training methods for children are the basis for improving the effect of swimming training and reducing the occurrence of sports injuries. In recent years, swimming physical training technology in China has developed rapidly. Swimming physical training for children can improve the comprehensive sports quality of young people. Objective In this paper, the indexes of 50m butterfly and 50m breaststroke were determined. These data quantitatively examine the effect of the program on swimming performance. Methods 18 children and adolescent swimmers participated in the sample analyzed in this study. In this paper, 18 participants were divided into experimental and control groups. These groups have four swimming styles: butterfly, breaststroke, backstroke, and freestyle. Results After two months of coordination exercises, the performance of butterfly and frog swimming was partially improved. There were significant differences in the data (P<0.05). Conclusion The fitness training process can improve the overall quality of athletes. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMEN Introducción La enseñanza técnica especializada y los métodos de entrenamiento en natación para niños son la base para mejorar el efecto del entrenamiento de natación y reducir la aparición de lesiones deportivas. En los últimos años, la tecnología del entrenamiento físico de la natación en China se ha desarrollado rápidamente. El entrenamiento físico de natación para niños puede mejorar la calidad deportiva integral de los jóvenes. Objetivo En este trabajo se determinaron los índices de 50 metros mariposa y 50 metros braza. Estos datos examinan cuantitativamente el efecto del programa en el rendimiento de la natación. Métodos Un total de 18 niños y adolescentes nadadores participaron en la muestra analizada en este estudio. En este trabajo, 18 participantes fueron divididos en grupos experimentales y de control. Estos grupos tienen cuatro estilos de natación: mariposa, braza, espalda y estilo libre. Resultados Tras dos meses de ejercicios de coordinación, el rendimiento de la natación en mariposa y rana mejoró parcialmente. Hubo diferencias significativas en los datos (P<0,05). Conclusión El proceso de entrenamiento físico puede mejorar la calidad general de los deportistas. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Abstract To investigate the regulation of hydrogen peroxide (H2O2) in SA- and JA-dependent systemic defense pathways in tomato seedlings damaged by cotton bollworm. The lower two leaves of four-leaf tomato plant seedlings were treated with cotton bollworms. The upper leaves were then removed at various time points and assessed for systemic changes in H2O2 levels, enzyme activity and defense-related genes expression. Wild-type seedlings, def-5 mutant seedlings (deficient in JA accumulation) and transgenic nahG seedlings(deficient in SA content) were constructed at four-leaf stage. Wild-type plants were further treated with dimethylthiourea (DMTU) and 2,5-dihydroxycinnamic acid methyl ester (DHC). Bollworm feeding in the lower leaves induced rapid systemic accumulation of H2O2 in the upper leaves. H2O2 accumulation further increased activities for SA- and JA-dependent enzymes including proteinase inhibitors (PIs), pathogenesis-related gene 1 (PR-1), cathepsin D inhibitor (CDI), β-1,3-glucanse (BGL) and polyphenol oxidase (PPO). Furthermore, H2O2 accumulation enhanced mRNA expression of BGL-2, PR-1, PI, CDI and PPO genes. Suppression of H2O2 accumulation using H2O2 scavengers substantially diminished these effects. mRNA expression of PR-1 was not induced in transgenic nahG plants. SA- and JA-dependent signaling pathways are involved in the tomato systemic defense responses to herbivores, and that H2O2 generation is required for both systemic pathways.

Abstract Thoracolumbar tuberculosis is a common clinical disease. In this study, a 63 years old female patient had back pain after physical work. X-ray examination showed that the 8th thoracic vertebra was compressed. MR showed that the signal of the 8th thoracic vertebra was abnormal, and T2 showed an obviously high signal. Then, she was misdiagnosed as compression fracture of the thoracic spine at first diagnosis and treated with percutaneous balloon kyphoplasty (PKP) and the pain was gradually aggravated 3 months after the operation; then, lower extremity neurological symptoms began to appear. After that, she was finally diagnosed with tuberculosis of the thoracic spine and received surgery again and then the symptoms were ameliorated significantly, and the muscle strength of both lower limbs recovered. For patients with thoracolumbar compression fractures, we should fully understand the disease history of the disease and perform a detailed examination. The tuberculosis and even tumors should be considered to avoid misdiagnosis.

Abstract A direct steam injection pretreatment was added before the microwave-assisted extraction procedure for the extraction of flavonoids from seeds of Hovenia dulcis Thunb, and the antioxidant activity of flavonoid extracts was determined. Based on the experimental results, the addition of direct steam injection simultaneously increased the extraction yield of total flavonoids compared with direct microwave-assisted extraction, and antioxidant activity of flavonoid extracts obtained by adopting the steam injection pretreatment was higher than that by direct microwave extraction alone. Myricetin was isolated from the flavonoid extracts, and the structure was identified by infrared spectroscopy (IR), electrospray ionization mass spectrometry (ESI-MS), and 1H nuclear magnetic resonance (1H-NMR). Recovery yield of total flavonoids was increased by 11.63% when the direct steam injection pretreatment was added to direct microwave extraction.

Abstract Objective: To assess the effectiveness and safety of fast-track cardiac anesthesia using the short-acting opioid sufentanil in children undergoing intraoperative device closure of ventricular septal defect (VSD). Methods: This retrospective clinical study included 65 children who underwent intraoperative device closure of VSD between January 2017 and June 2017. Patients were diagnosed with isolated perimembranous VSD by transthoracic echocardiography. Then, they were divided into two groups, group F (n=30), whose patients were given sufentanil-based fast-track cardiac anesthesia, and group C (n=35), whose patients were given conventional cardiac anesthesia. Perioperative clinical data were analyzed. Results: No significant differences were found between the preoperative clinical parameters and intraoperative hemodynamic indices between the two groups. In group C, compared with group F, the postoperative duration of mechanical ventilation, the length of stay in the intensive care unit, the length of hospital stay, and the hospital costs were significantly increased. Conclusion: In this retrospective study at a single center, sufentanil-based fast-track cardiac anesthesia was shown to be a safe and effective technique for minimally-invasive intraoperative device closure of VSD in children, which was performed with reduced in-hospital costs.

Abstract Objective: To compare the results of surgical repair via median sternotomy, right submammary thoracotomy, and right vertical infra-axillary thoracotomy for atrial septal defect (ASD). Methods: This is a retrospective analysis of the relative perioperative and postoperative data of 136 patients who underwent surgical repair for ASD with the abovementioned three different treatments in our hospital from June 2014 to December 2017. Results: The results of the surgeries were all satisfactory in the three groups. No statistically significant difference was found in operative time, duration of cardiopulmonary bypass, blood transfusion amount, postoperative mechanical ventilation time, duration of intensive care unit, length of hospital stay, and hospital costs. However, the median sternotomy group had the longest incision. Meanwhile, there was no significant difference in postoperative complications. Conclusion: All three types of surgical incisions can be safely and effectively used to repair ASD. The treatments via right submammary thoracotomy and right vertical infra-axillary thoracotomy have advantages over the treatment via median sternotomy in cosmetic results and should be the recommended options.

OBJECTIVES: The prevalence of diabetes mellitus has recently increased in Taiwan, and depression is common among these patients. Moreover, a lack of health literacy may lead to depression. In this study, we explored the correlation between health literacy and depression in diabetic women. METHODS: In this cross-sectional study, 152 women with type 2 diabetes mellitus were recruited from the outpatient clinic of a regional teaching hospital in Taiwan. The data were collected through medical records and a self-reported structured questionnaire, which included items on basic attributes, self-rated health status, the Center for Epidemiologic Studies Depression Scale (CES-D), and Chinese Health Literacy Scale for Diabetes (CHLSD). The results were analyzed using descriptive statistical analyses, bivariate correlation tests, and linear regression analyses. RESULTS: One hundred thirty-five valid questionnaires were obtained. Approximately 20% of the participants had a higher tendency toward depression as per their CES-D score, and the CHLSD results showed that 13.33% had poor health literacy. There was a negative correlation between health literacy and depressive tendencies after adjusting for self-rated health status, economic satisfaction status, employment status, and education level using multivariate linear regression analyses. For each 1-point rise in the CHLSD score, the CES-D score decreased by 0.17 points (z=−2.05, p=0.042). CONCLUSIONS: A negative correlation was identified between health literacy and depression. Self-rated health status, economic satisfaction, employment status, and higher education level are factors that also affect depressive tendency among diabetic women.

Abstract Objective: To analyze and summarize the clinical safety and feasibility of minimally invasive video-assisted mitral valve replacement via a right thoracic minimal incision in patients aged over 65 years. Methods: The clinical data of 45 patients over 65 years old who had mitral valve disease were analyzed retrospectively from January 2014 to January 2017 at Union Hospital, Fujian Medical University. The patients were divided into two groups; 20 patients in group A, who underwent minimally invasive video-assisted mitral valve replacement via a right thoracic minimal incision, and 25 patients in group B, who underwent conventional mitral valve replacement. We collected and analyzed their relevant clinical data. Results: The operation was completed successfully in both groups. Compared with group B, group A was clearly superior for postoperative analgesia time, postoperative hospital length of stay, thoracic drainage liquid, blood transfusion, and length of incision. There were no differences between the two groups in postoperative severe complications and mortality. More patients in group B had pulmonary infections and poor incision healing, while more patients in group A had postoperative pneumothorax and subcutaneous emphysema. Conclusion: In patients aged over 65 years, minimally invasive video-assisted mitral valve replacement with a small incision in the right chest had the same clinical safety and efficacy as the conventional method.

Abstract The use of antithrombotic therapies and non-steroid anti-inflammatory drugs has increased worldwide and with it the risk of presenting a bleeding complication. The group of patients undergoing an invasive procedure such as a gastrointestinal endoscopy are at a higher risk of peri-procedural bleeding complications. However, in those patients receiving anti-thrombotic therapy scheduled for a gastrointestinal endoscopy the risk of bleeding must be weighted against the risk of a thrombo-embolic event while the patients are off the antithrombotic treatment. Antithrombotic drug management in the peri-endoscopic time has become more complex due to the appearance of the new direct action anticoagulants. Although several international guidelines and systematic reviews on the topic are available, its applicability and availability in Mexico are limited, considering language barriers and drug and technology availability, among others. This lead the Asociación Mexicana de Endoscopia Gastrointestinal to summon a group of gastroenterologists, endoscopists, cardiologists and hematologists to assess and review current scientific evidence with the aim to develop and propose a series of recommendations for the management of anti-thrombotic therapy before, during and after and endoscopic procedure.

Resumen El uso de terapias antitrombóticas y de antiinflamatorios no esteroideos ha aumentando progresivamente, lo cual incrementa el riesgo de hemorragia. Entre las causas y sitios de hemorragia asociada a estas terapias están aquellos que suceden alrededor de un procedimiento invasivo como la endoscopia. En los pacientes que reciben terapia antitrombótica y que serán sometidos a algún procedimiento endoscópico se debe equilibrar el riesgo de hemorragia frente al riesgo trombótico, para minimizar el tiempo en que el paciente estará sin la debida protección antiplaquetaria o anticoagulante. El manejo de la terapia antitrombótica durante una endoscopia se ha hecho más complejo debido al desarrollo de anticoagulantes de acción directa. Aunque existen guías y revisiones internacionales sobre el manejo de estos fármacos en relación con procedimientos endoscópicos, el idioma de publicación, y la disponibilidad y accesibilidad de medicamentos limitan el acceso a ellas, así como su aplicabilidad ad integrum; esto justifica su revisión y adaptación a México. La Asociación Mexicana de Endoscopia Gastrointestinal convocó a un grupo de gastroenterólogos, cardiólogos, hematólogos y endoscopistas para revisar y evaluar de manera crítica la evidencia científica para proponer estrategias de manejo de la terapia antitrombótica antes, durante y después de algún procedimiento endoscópico. El objetivo es sugerir alternativas de acuerdo con la disponibilidad de recursos humanos y tecnológicos en nuestro país basadas en la evidencia científica disponible en la actualidad.

Abstract Objectives: To compare the advantages and disadvantages of perventricular and percutaneous procedures for treating isolated ventricular septal defect (VSD). Methods: A total of 572 patients with isolated VSD were selected in our hospital between January 2015 and December 2016. The patients’ median age and weight were five years (1-26 years) and 29 kg (9-55 kg), respectively. The median diameter of VSD was 6.0 mm (5-10 mm). Patients were divided into two groups. In group A, perventricular device closure was performed in 427 patients; in group B, 145 patients underwent percutaneous device closure. Results: Four hundred twelve patients in group A and 135 patients in group B underwent successful closure. The total occlusion rate was 98.5% (immediately) and 99.5% (3-month follow-up) in group A, which were not significantly different from those in group B (97.7% and 100%, respectively). Patients in group A had longer intensive care unit (ICU) stay than those in group B, but patients in group B experienced significantly longer operative times than those in group A. The follow-up period ranged from 8 months to 1.5 year (median, 1 year). During the follow-up period, late-onset complete atrioventricular block occurred in two patients. No other serious complications were noted in the remaining patients. Conclusion: Both procedures are safe and effective treatments for isolated VSD. The percutaneous procedure has obvious advantages of shorter ICU stay and less trauma than the perventricular procedure. However, the perventricular procedure is simpler to execute, results in a shorter operative time, and avoids X-ray exposure.

Summary Objective: To investigate the neuropsychological characteristics and changes in CRP, S100B, MBP, HSP-7, and NSE in serum. Method: Sixty-six (66) patients treated in our hospital as CCCI group were chosen for our study, and 90 patients with depression were selected as the depression group. The patients in both groups were examined with CT perfusion, depression, anxiety and cognition evaluation. Their serum CRP, S100B, MBP, HSP-70 and NSE levels were detected. Neuropsychological and serum markers characteristics were compared. Results: The CBF and CBV in bilateral basal ganglia, frontal lobes, greater oval center, brain stem, and left and right regions of occipital lobes of the patients in CCCI group were significantly lower than in the depression group. The HAMD and HAMA scores of CCCI group patients were significantly lower than in the depression group; CCCI group performed better regarding attention, memory, abstract terms and delayed recall. CCCI also had significantly higher total scores than the depression group. Serum CRP, S100B, MBP, HSP-70 and NSE levels in CCCI group were significantly higher than in the depression group. The differences reach statistical significance (p<0.05). Conclusion: CCCI patients who are accompanied by minor depressive disorder have different degrees of cognitive impairment and experience a significant rise in serum CRP, S100B, MBP, HSP-70 and NSE.

Abstract: Poly(aspartic acid-citric acid) copolymer (PAC) is a new product of poly(carboxylic acid) scale inhibitor. The study aims to develop a "green" water treatment agent for calcium phosphate scale. The article compares the efficiency of three polymeric antiscalants, poly(aspartic acid-citric acid) copolymer (PAC), polymaleic acid (HPMA) and a compound inhibitor (PAC-HPMA), for calcium phosphate scale prevention under varying experimental conditions. Inhibitor concentration, calcium concentration, system pH, temperature and experimental time were varied to determine their influences on inhibitor performance by the static scale inhibition method. The copolymer (PAC) was characterized by FTIR, 1H NMR and 13C NMR. The compound inhibitor was applied in the actual circulating cooling water system. An atomic force microscope (AFM), X-ray powder diffraction (XRD) and a scale formation process analysis were used to explore the scale inhibition mechanism. The results showed that scale inhibition rates of PAC, HPMA and PAC-HPMA against Ca3(PO4)2 were, respectively, about 23%, 41.5% and 63% when the dosage was 8 mg/L in the experiment. The compound inhibitor showed the better inhibition performance than the above two kinds of monomers. Under the actual working conditions, the inhibition rate of compound inhibitor was close to 100% and completely met the actual application requirements of scale inhibitor in circulating cooling water systems. The main inhibition mechanism was the decomposition-chelation dispersion effect. The compound inhibitor can be used as an efficient "green" scale inhibitor for calcium phosphate.