ABSTRACT Background: Human immunodeficiency virus (HIV) drug resistance is a major cause of treatment failure in children and adolescents infected with the virus. Objectives: The objectives of the study are to investigate HIV drug resistance (HIVDR) in patients who attended a referral care center in Argentina over a 15-year period and to compare mutational patterns between HIV-1 pol sequences characterized as B or BF recombinants. Methods: Individual resistance-associated mutations (RAMs) (to protease and reverse transcriptase inhibitors) were identified according to IAS-USA guidelines in 374 HIV-1-infected children and adolescents. HIV-1 subtype was characterized by phylogenetic and recombination analysis using MEGA5.1 and Simplot. Poisson linear regression was used to model the dynamics of the RAMs over time. Results: The prevalence of RAMs to protease inhibitors (R2 = 0.52, p = 0.0012) and nucleoside reverse transcriptase inhibitors (R2 = 0.30, p = 0.0225) decreased over time. HIVDR to non-nucleoside reverse transcriptase inhibitors remained moderate to high, ranging between 33% and 76%. BF recombinants showed a higher frequency of thymidine analog mutation 1 RAMs profile and I54V mutation. Conclusion: In Argentina, HIVDR observed in children and adolescents has decreased over the past 15 years, regardless of the viral subtype.

RESUMEN Introducción y objetivos: La estimulación ventricular rápida reduce el gasto cardiaco, proporcionando estabilidad durante el implante percutáneo de válvula aórtica (TAVI). Nuestro objetivo fue evaluar la eficacia y la seguridad de la estimulación ventricular izquierda a través de la guía de alto soporte utilizada para el implante y una guía situada en la aurícula derecha (AD) que actúa como ánodo. Métodos: La estimulación ventricular izquierda se realiza conectando el extremo externo de una guía Safari2 preformada situada en el ventrículo izquierdo al cátodo de un marcapasos temporal, y el ánodo al cuerpo de una guía Emerald insertada en la aurícula mediante un catéter Judkins Right diagnóstico a través de un acceso venoso femoral (punción ecoguiada). El marcapasos se programa con salida máxima (20 V) y sensibilidad anulada. Resultados: Se realizó TAVI transfemoral a 62 pacientes seleccionados (mediana de edad: 79,4 ± 6,5 años) utilizando la técnica de estimulación descrita (25 SAPIEN 3 Ultra, 13 Navitor, 9 ACURATE neo2, 14 Evolut-PRO+ y 1 Myvalve), con éxito en todos los casos (hubo 1 fallo de captura atribuido a la programación del generador del marcapasos). Dos pacientes necesitaron marcapasos transitorio y definitivo posterior por bloqueo auriculoventricular completo durante el procedimiento. No se documentaron complicaciones vasculares derivadas del acceso venoso ni del posicionamiento de la guía en la AD. No aumentaron de manera significativa el tiempo del procedimiento ni la fluoroscopia. La mediana de estancia hospitalaria tras el implante fue de 2 días. Conclusiones: En nuestra serie, la estimulación ventricular izquierda utilizando como ánodo la guía situada en la AD ha demostrado ser una técnica eficaz y segura, sin aumentar significativamente el tiempo de procedimiento, y además aporta la ventaja de disponer de acceso venoso central para un posible marcapasos transitorio urgente.

ABSTRACT Introduction and objectives: Rapid ventricular pacing reduces cardiac output by providing stability during transcatheter aortic valve implantation (TAVI). Our objective is to assess the efficacy and safety profile of left ventricular pacing through the high-support guidewire used for implantation and a guidewire located in the right atrium (RA) functioning as an anode. Methods: Left ventricular pacing is performed by connecting the external end of a Safari2 pre-shaped guidewire located in the left ventricle to the cathode of a temporary pacemaker, and the anode to the body of an Emerald guidewire inserted into the RA using a diagnostic Judkins Right catheter (via ultrasound-guided femoral venous access). Pacemaker was programmed with maximum output (20 V) and null sensitivity. Results: A total of 62 selected patients (median 79.4 ± 6.5 years old) underwent transfemoral TAVI using the pacing technique described (25 patients the SAPIEN 3 Ultra; 13 the Navitor, 9 the ACURATE neo2, 14 the Evolut PRO+, and 1 patient the Myvalve). Procedure was successful in all cases (there was 1 capture failure due to pacemaker programming). Two patients required a temporary and permanent pacemaker due to high-grade atrioventricular block. No vascular complications from venous access were documented, not even from the RA guidewire. Procedural time did not increase significantly, and the median length of stay after implantation was 2 days. Conclusions: In our series, left ventricular pacing using the RA-positioned wire as the anode proved to be effective and safe without increasing procedural time significantly. This procedure also provides the advantage of being able to use the central venous access for possible emergency temporary pacemaker implantation.

ABSTRACT Background: Cyberbullying is a highly prevalent problem in our society with important implications for adolescent psychological wellbeing. The objective of the study was to examine the network structure of the Depression, Anxiety, and Stress Scale in a sample of youths, and find out the relationships between different types of cybervictimization and the presence of negative emotional states. Method: This was a descriptive cross-sectional study. The sample was made up of 2,171 high school students with a mean age of 13.84 (with 50.53% males and 49.47% females). The Cybervictimization Questionnaire (CYVIC) and the Spanish version of the Depression, Anxiety, and Stress Scale (DASS-21) were administered. Results: Positive correlations were found between all the dimensions of the DASS-21 and the types of cybervictimization. The network structure showed that the different nodes of three emotional states were positively related to each other (although some relationships were stronger than others). Furthermore, girls had significantly higher means in depression, anxiety, and stress. In analyzing the network, the strongest associations in both sexes were found to be between anxiety and written-verbal cybervictimization and exclusion. Conclusions: Negative emotional states and types of cybervictimization were related in a complex network where efforts to approach reduction of emotional symptoms associated with cybervictimization could produce lasting benefits for the emotional wellbeing of youths.

RESUMEN Antecedentes: El ciberbullying es una problemática con una alta prevalencia en nuestra sociedad y que tiene importantes implicaciones para el bienestar psicológico de los adolescentes. El objetivo del trabajo fue examinar la estructura de red de la Escala de Depresión, Ansiedad y Estrés en una muestra de jóvenes, así como comprobar las relaciones que se establecen entre diferentes tipos de cibervictimización y la presencia de estados emocionales negativos. Método: Se realizó un estudio descriptivo transversal. La muestra estuvo formada por 2,171 estudiantes de Educación Secundaria, con una media de edad de 13.84 años (donde el 50.53% fueron hombres y el 49.47% mujeres). Se aplicó el Cuestionario de Cibervictimización (CYVIC) y la versión española de Depression, Anxiety and Stress Scale (DASS-21). Resultados: Se encontraron correlaciones positivas entre todas las dimensiones del DASS-21 y los tipos de cibervictimización. Atendiendo a la estructura de redes, se halló que los diferentes nodos de los tres estados emocionales se relacionaban positivamente entre sí (aunque algunas relaciones eran más fuertes que otras). Por otro lado, en relación al sexo, las mujeres mostraron medias significativamente más elevadas en depresión, ansiedad y estrés. Al analizar la red, las asociaciones más estrechas se dieron entre la ansiedad y la cibervictimización de tipo escrita-verbal y la exclusión en ambos sexos. Conclusiones: Los estados emocionales negativos y los tipos de cibervictimización se relacionaban en una compleja red donde los esfuerzos por abordar la reducción de los síntomas emocionales asociados a la cibervictimización podrían producir beneficios duraderos en el bienestar emocional de los jóvenes.

Resumen: El objetivo de esta investigación es identificar los factores que inciden en la intención de usar aprendizaje móvil (m-learning) por parte de estudiantes de instituciones de educación superior de la ciudad de Medellín (Colombia). La metodología es cuantitativa y correlacional a partir de un análisis factorial confirmatorio. Se diseña una encuesta en escala Likert como instrumento de recolección de información, contando con una muestra de 238 estudiantes. Se aplican el modelo de aceptación tecnológica (TAM) y la teoría del comportamiento planificado (TPB). Los resultados muestran la importancia de la norma subjetiva y las actitudes para entender la intención de uso de m-learning. La norma subjetiva y las actitudes se ven afectadas por la facilidad de uso percibida y la autonomía del aprendizaje, respectivamente. En conclusión, este estudio aporta una noción holística para la implementación de programas virtuales que utilizan dispositivos móviles como herramientas de apoyo en instituciones de educación superior.

Abstract: The main objective of this research study is to identify the factors that affect student disposition to use mobile learning (m-learning) in higher education institutions from the city of Medellín (Colombia). The methodology is quantitative and correlational and is based on confirmatory factor analysis. Data are gathered through a Likert-scale survey that is applied to a sample of 238 students. The technological acceptance model (TAM) and the theory of planned behavior (TPB) are applied. The results highlight the importance of subjective norms and attitudes for understanding student disposition to use m-learning. Subjective norms and attitudes are affected by perceived ease of use and learning autonomy, respectively. In conclusion, the present study provides a holistic approach for implementing virtual programs that use mobile devices as support tools in higher education institutions.

RESUMO A produção de amendoim tem crescido anualmente no Brasil. Com as secas que ocorrem frequentemente em todas as regiões brasileiras, é necessário identificar germoplasma precoce para ser utilizado em trabalhos de melhoramento visando à adaptação ambiental. Aqui, uma mini coleção de amendoim foi estudada com o objetivo de selecionar germoplasma para uso posterior em procedimentos de melhoramento, com foco em ambiente com restrição hídrica. Doze características agronômicas foram adotadas e posteriormente utilizadas em métodos multivariados, baseados em modelos hierárquicos (UPGMA) e dispersão gráfica (variáveis canônicas), visando identificar agrupamentos de acessos precoces. Diferenças estatísticas significativas foram encontradas para a maioria das variáveis, indicando variabilidade genética nos acessos estudados. Com base nas análises multivariadas, verificou-se coerência na formação de três agrupamentos, um deles (G3: PI-268-689 e AHK-85-3) aglomerou os acessos mais promissores para produção de vagens e eficiência reprodutiva, previamente identificados na análise de variância. Portanto, ambos germoplasma são recomendados para uso em trabalhos de melhoramento voltados para o ambiente com restrição hídrica.

ABSTRACT Peanut production is growing annually in Brazil, but with frequent droughts throughout the country, it is necessary to identify an earliness germplasm for the improved environmental adaptation of peanuts. Here, a mini-core collection of peanuts was studied to select germplasms for further use in breeding, with a focus on dry environments. Twelve agronomic traits were adopted and later used in multivariate methods based on hierarchical models (UPGMA) and graphical dispersion (canonical variables), which aimed to identify earliness accession clusters. Statistically significant differences were found for most traits, indicating that there was genetic variability among accessions. Multivariate analyses subsequently revealed coherence in the formation of three clusters, one of which (G3: PI-268-689 and AHK-85-3) combined the most promising accessions for pod production and reproductive efficiency, previously identified through analysis of variance. Therefore, both germplasms are recommended here for use in future breeding studies focused on water-restricted environments.

Resumen Introducción: Aunque COVID-19 (enfermedad por coronavirus 2019) en niños es usualmente leve, en casos excepcionales requieren hospitalización y cuidados intensivos. Los resultados adversos han sido observados principalmente en los niños con comorbilidades, justificando su vacunación. El objetivo de este estudio fue evaluar el riesgo de hospitalización y muerte en niños y adolescentes mexicanos con COVID-19 y comorbilidades. Métodos: Estudio transversal en 366,542 casos de COVID-19 confirmados, menores de 18 años y reportados por la Secretaría de Salud de México, hasta el 9 de julio del 2022. Se ejecutaron modelos multivariados de regresión logística. Resultados: El promedio de edad fue de 10.98 años, 50.6% de sexo masculino, y 7.3% reportaron al menos una comorbilidad. El porcentaje de hospitalización y muerte en pacientes con COVID-19 sin comorbilidades fue 3.52% y 0.20%, respectivamente; mientras que los pacientes con comorbilidades presentaron más elevados porcentajes de hospitalización (14.0%) y muerte (1.9%). La probabilidad de hospitalización fue 5.6 veces más en los pacientes con COVID-19 y comorbilidades, comparando con aquellos sin comorbilidades. Las comorbilidades que mostraron más riesgo fueron inmunosupresión (razón de momios (RM) 22.06), enfermedad renal crónica (ERC) (RM 11.36) y enfermedades cardiovasculares (RM 5.66). La probabilidad de muerte en los pacientes con comorbilidades fue 11.01 veces más que en aquellos sin enfermedades, y fue más elevado en aquellos con ERC (RM 12.57), enfermedades cardiovasculares (RM 6.87) y diabetes (RM 5.83). Conclusiones: Los pacientes pediátricos con comorbilidades presentaron mayor riesgo de COVID-19 severo, por lo que se sugiere promover con mayor énfasis la vacunación en ellos.

Abstract Background: Although COVID-19 (coronavirus disease 2019) in children is usually mild, they need hospitalization and intensive care in exceptional cases. Adverse outcomes have been observed mainly among children with comorbidities, justifying their vaccination. This study aimed to assess the risk of hospitalization and death in Mexican children and adolescents with COVID-19 and comorbidities. Methods: A cross-sectional study was performed on 366,542 confirmed COVID-19 cases under 18 years, reported by the Mexican Ministry of Health up to July 9, 2022. Logistic regression models were performed. Results: The mean age was 10.98 years, 50.6% were male, and 7.3% reported at least one comorbidity. The percentage of hospitalization and death in COVID-19 patients with and without comorbidities was 3.52%, and 0.20%, respectively; children with comorbidities presented a higher percentage of hospitalization (14.0%) and death (1.9%). The probability of hospitalization was 5.6 times greater in pediatric patients with COVID-19 and comorbidities, and the comorbidities that showed the greatest risk were immunosuppression (odds ratio (OR) 22.06), chronic kidney disease (CKD) (11.36), and cardiovascular diseases (5.66). The probability of death in patients with comorbidities was 11.01 times higher than in those without diseases, and the highest risk was observed in those with CKD (OR 12.57), cardiovascular diseases (6.87), and diabetes (5.83). Conclusions: Pediatric patients with comorbidities presented a higher risk of severe COVID-19. It is suggested that vaccination should be promoted with greater emphasis on pediatric patients with comorbidities.

Abstract: We run logit models to explain the variability of Pinus radiata structural lumber in 71 second and third unpruned logs. The response variable was the proportion of lumber with a static modulus of elasticity greater or equal than 8000 MPa, pMSG8+, and the explanatory variables were log volume, branch index, largest branch, log internode index, wood basic density, and acoustic velocity. The average pMSG8+ volume was 44,30 % and 36,18 % in the second and third log respectively. Ten models were selected based on meeting statistical assumptions, their goodness of fit, and the statistical significance of their parameters. The best models (R2 - adj. > 0,75) included acoustic velocity (AV) as explanatory variable, which explained 56,25 % of the variability of pMSG8+. Models without AV presented goodness of fit ranging from 0,60 to 0,75 (R2 - adj.), and variables with the highest weight to explain the variability of pMSG8+ were volume, followed by wood basic density, branch index, and largest branch. It is possible to model pMSG8+ from log variables even when acoustic velocity is not available; however, this requires wood basic density models calibrated for the Pinus radiata growing zone.

Introduction. In a working group of the Administration of the regional government of Catalonia and the deans of the faculties with medical studies of the Catalan universities, a commission was created to prepare a document to promote training in professionalism and transversal competences of graduates in Medicine. Development. This commission, made up of teachers from all the faculties, prepared a document with three specific objectives: a) show the real state of said training in the curricula; b) propose specific teaching activities to improve said training, considering those good practices that are being carried out in universities; and c) suggest criteria and methods of evaluation of training in professionalism or of transversal competences and, also, evaluate specific competences that can improve the development of generic competences. Conclusions. It is hoped that the suggestions presented can serve to increase training in professional values, in the humanities and in transversal competences of future medical professionals with the ultimate goal of improving the health of the population.

Introducción. En un grupo de trabajo de la Administración de la Generalitat de Cataluña y de los decanos de las facultades con estudios de Medicina de las universidades catalanas se creó una comisión para elaborar una propuesta para fomentar la formación en profesionalismo, en humanidades y en competencias transversales de los graduados en Medicina. Desarrollo. Dicha comisión, compuesta por docentes de todas las facultades, elaboró un documento con tres objetivos específicos: a) mostrar el estado real de dicha formación en los currículos; b) proponer actividades docentes concretas para mejorar dicha formación, considerando las buenas prácticas que se están realizando en las universidades; y c) sugerir criterios y métodos de evaluación de la formación en profesionalismo o de competencias transversales y, también, evaluar competencias específicas que pueden favorecer el desarrollo de las competencias genéricas. Conclusiones. Se espera que las sugerencias presentadas puedan servir para aumentar la formación en valores profesionales, en humanidades y en competencias transversales de los futuros profesionales de la medicina, con el objetivo final de mejorar la salud de la población.

Resumen La inducción del sueño y su calidad son temas de preocupación creciente porque su deterioro afecta a un número elevado de personas y supone un riesgo en su bienestar y calidad de vida y en la salud a largo plazo. Hay diversos factores implicados en el problema, pero la nutrición es uno de ellos y, en concreto, el consumo de leche se ha relacionado frecuentemente con los hábitos de sueño, a veces como factor promotor y otras como inhibidor. Profundizar en el tema es el objeto de la presente revisión. El triptófano, al llegar al cerebro, es la base para la síntesis de serotonina y melatonina, que mejoran la inducción y la calidad del sueño. Pero hay una competencia entre el triptófano y otros aminoácidos neutros de cadena larga (ANCL) (valina, leucina, isoleucina, tirosina y fenilalanina) para cruzar la barrera hematoencefálica y llegar al cerebro. En este sentido, las proteínas de la leche, con elevado contenido en triptófano y la relación más elevada entre triptófano y ANCL, son muy útiles en la promoción del sueño. Por otra parte, la leche también aporta diversos micronutrientes que ayudan en la transformación del triptófano en serotonina y melatonina, así como componentes antioxidantes, antiinflamatorios y péptidos bioactivos, y estudios recientes indican que modula favorablemente la composición de la microbiota intestinal. Los estudios realizados ponen de relieve que aumentar el consumo de leche, hasta el aporte aconsejado y dentro de una alimentación correcta, favorece el conseguir y mantener un sueño de calidad.

Abstract Sleep induction and its quality are issues of growing concern because its deterioration affects a large number of people and poses a risk to their well-being and quality of life and long-term health. There are several factors involved in the problem, but nutrition is one of them and in particular milk consumption has often been linked to sleep habits, sometimes as a promoter and sometimes as an inhibitor. The purpose of this review is to examine the matter further. On reaching the brain, tryptophan is the basis for the synthesis of serotonin and melatonin, which improve the induction and quality of sleep. But there is competition between tryptophan and other long-chain neutral amino acids (LNAA) (valine, leucine, isoleucine, tyrosine and phenylalanine) to cross the blood-brain barrier and reach the brain. In this sense, milk proteins with a high tryptophan content and the highest ratio between tryptophan and LNAA are very useful in promoting sleep. Moreover, milk also provides various micronutrients that help in the transformation of tryptophan into serotonin and melatonin, as well as antioxidant components, anti-inflammatory and bioactive peptides, and recent studies indicate that it favorably modulates the composition of the intestinal microbiota. Studies show that increasing milk consumption, up to the recommended intake and within a correct diet, favors the achievement and maintenance of quality sleep.

Resumen Está aumentando el número de personas que siguen dietas basadas en vegetales en mayor o menor grado, pero cuanto más restrictiva es una dieta, más riesgos existen de presentar deficiencias nutricionales. La etapa infantil es una etapa de gran crecimiento físico y madurativo, por ello, las deficiencias nutricionales en esta etapa pueden acarrear consecuencias graves y, en ocasiones, permanentes. Las personas que siguen dietas restrictivas de cualquier tipo, como son las dietas basadas en vegetales, deben recibir apoyo de personal especializado para conseguir que sus dietas sean variadas y equilibradas, como es deseable en cualquier caso.

Abstract The number of people following plant-based diets to a greater or lesser degree is increasing, but the more restrictive a diet, the greater the risk of nutritional deficiencies. The childhood stage is a stage of great physical and maturational growth, therefore, nutritional deficiencies at this stage can have serious and sometimes permanent consequences. People who follow restrictive diets of any kind, such as plant-based diets, should receive support from specialized staff to ensure that their diets are varied and balanced, as is desirable in any case.

Abstract Functional diversity is an emergent approach in ecology that has been applied globally to better understand the relationships between organisms and the environment. However, assessing the functional diversity of freshwater fish is a challenge for scientists. Aiming to summarize the evolution of scientific knowledge on fish functional diversity, we performed a systematic review of the literature published from 1945 to 2021 using the Web of Science. Based on the 101 articles reviewed, we found that publications about functional diversity of fishes have increased over time, mainly in Neotropical, Indomalayan and Palearctic regions. Most studies were conducted in lotic ecosystems, especially to assess environmental impacts such as biological invasions and land use. Functional diversity has been assessed mainly by morphological traits that reflect feeding and locomotion dimensions. Functional richness was the most common index used in the studies. Our findings suggest that political neglect and lack of investments may hamper the research development in several places. The missing information about the functional traits of many species may limit the use of the functional approach. We also highlight the need for the incorporation of functional diversity in conservation programs once functional diversity is a key facet of biodiversity to maintain freshwater ecosystem functioning.

Resumo A diversidade funcional tem sido avaliada principalmente através de traços funcionais morfológicos que refletem as dimensões da alimentação e locomoção. A Riqueza Funcional foi a métrica mais comumente usada nos estudos. Esses resultados sugerem que a negligência política e a falta de investimentos podem dificultar o desenvolvimento de pesquisas em diversas regiões. A falta de informações sobre os traços funcionais de muitas espécies limita o uso da abordagem funcional. Destaca-se também a necessidade de incorporar a diversidade funcional em programas de conservação, uma vez que a diversidade funcional é uma faceta chave da biodiversidade para manter o funcionamento dos ecossistemas de água doce.

Resumen Los márgenes multifuncionales (MMF) son franjas de vegetación espontánea o sembrada que se implantan en parcelas agrícolas desempeñando múltiples funciones. Establecerlos en cultivos herbáceos de secano es una práctica innovadora y fuente de múltiples beneficios medioambientales y agronómicos. Los márgenes sirven de refugio de fauna silvestre, favorecen la presencia de polinizadores e insectos auxiliares y representan una barrera física para la escorrentía y la deriva de productos fitosanitarios. Una vez que los márgenes son segados, los restos orgánicos se degradan por la biota del suelo, provocando una recirculación de nutrientes y el incremento de materia orgánica. En este trabajo se estudió el efecto de los MMF sobre la biodiversidad de la fauna epigea y el secuestro de carbono en el suelo. Se compararon tres tipos de márgenes: dos mezclas diferentes de semillas sembradas y la flora espontánea como márgen testigo; asimismo se midió el cultivo adyacente. Los márgenes promovieron una mayor biodiversidad de artrópodos que el propio cultivo, especialmente coleópteros. El analisis de suelo mostró pérdida de carbono en el cultivo, manejado de forma tradicional, aumentando en todos los tipos de MMF, tanto sembrados como espontáneos. Esta práctica tiene un gran potencial de implantación en cualquier tipo de cultivo extensivo.

Abstract Multifunctional margins (MFM) are strips of spontaneous or sown vegetation that are implanted in agricultural plots performing multiple functions. Their establishment in rainfed arable crops is an innovative agricultural practice and a source of multiple environmental and agronomic benefits. They serve as shelter for wildlife, favour the presence of pollinators and auxiliary insects and represent a physical barrier to runoff and drift of phytosanitary products. Once the margins are mowed, the organic residues are degraded by the soil biota, causing a recirculation of nutrients and an increase in organic matter. In this work, the effects of MFM on biodiversity of epigean fauna and the carbon sequestration in soil were studied. Three types of margins were compared: two different sown mixtures and spontaneous flora as control; likewise, the adjacent crop was tested. The margins promoted greater arthropod biodiversity than the crop, especially beetles. The soil analysis showed a loss of carbon in the crop conventionally managed, increasing in all types of MFM either sown as spontaneous ones. This practice has great potential of implementation in any type of extensive crop.