Realidad virtual y biomarcadores digitales: una herramienta clínica para el diagnóstico del autismo / Virtual reality and digital biomarkers: a clinical tool for early autism diagnosis

Resumen Introducción : El Trastorno del Espectro Autista (TEA) es un trastorno del neurodesarrollo, y sus procedimien tos tradicionales de evaluación encuentran ciertas li mitaciones. El actual campo de investigación sobre TEA está explorando y respaldando métodos innovadores para evaluar el trastorno tempranamente, basándose en la detección automática de biomarcadores. Sin embargo, muchos de estos procedimientos carecen de validez ecológica en sus mediciones. En este contexto, la reali dad virtual (RV) presenta un prometedor potencial para registrar objetivamente bioseñales mientras los usuarios experimentan situaciones ecológicas. Métodos : Este estudio describe un novedoso y lúdi co procedimiento de RV para la evaluación temprana del TEA, basado en la grabación multimodal de bio señales. Durante una experiencia de RV con 12 esce nas virtuales, se midieron la mirada, las habilidades motoras, la actividad electrodermal y el rendimiento conductual en 39 niños con TEA y 42 compañeros de control. Se desarrollaron modelos de aprendizaje automático para identificar biomarcadores digitales y clasificar el autismo. Resultados : Las bioseñales reportaron un rendimien to variado en la detección del TEA, mientras que el modelo resultante de la combinación de los modelos de las bioseñales demostró la capacidad de identificar el TEA con una precisión del 83% (DE = 3%) y un AUC de 0.91 (DE = 0.04). Discusión : Esta herramienta de detección pue de respaldar el diagnóstico del TEA al reforzar los resultados de los procedimientos tradicionales de evaluación.

Abstract Introduction : Autism Spectrum Disorder (ASD) is a neurodevelopmental condition which traditional as sessment procedures encounter certain limitations. The current ASD research field is exploring and endorsing innovative methods to assess the disorder early on, based on the automatic detection of biomarkers. How ever, many of these procedures lack ecological validity in their measurements. In this context, virtual reality (VR) shows promise for objectively recording biosignals while users experience ecological situations. Methods : This study outlines a novel and playful VR procedure for the early assessment of ASD, relying on multimodal biosignal recording. During a VR experience featuring 12 virtual scenes, eye gaze, motor skills, elec trodermal activity and behavioural performance were measured in 39 children with ASD and 42 control peers. Machine learning models were developed to identify digital biomarkers and classify autism. Results : Biosignals reported varied performance in detecting ASD, while the combined model resulting from the combination of specific-biosignal models demon strated the ability to identify ASD with an accuracy of 83% (SD = 3%) and an AUC of 0.91 (SD = 0.04). Discussion : This screening tool may support ASD diagnosis by reinforcing the outcomes of traditional assessment procedures.

Wiki educativa para la Clínica Virtual de Salud de Santiago de Cuba

El programa de las tecnologías de la información y las comunicaciones se ha implementado en todas las instituciones pertenecientes al sector de la salud en Cuba, pues favorece la formación a través de los entornos de enseñanza y aprendizaje en función del desarrollo y las perspectivas académicas, mediante plataformas tecnológicas para facilitar el intercambio de información. En el presente artículo se destaca la necesidad de incrementar el uso de la wiki como herramienta educativa, que favorece el aprendizaje colaborativo como un proceso de creación de conocimiento a través de la web 2.0, donde no solo se publican contenidos sino que contribuye a desarrollar habilidades de cooperación en los procesos formativos de la salud pública.

The program of information and communications technologies has been implemented in all the institutions belonging to the health sector in Cuba, because it favors the training through the teaching and learning environments in function of development and academic perspectives, by means of technological platforms to facilitate the exchange of information. In this work the necessity to increase the wiki use as educational tool in enhanced, that favors the collaborative learning as a process of knowledge creation through the web 2.0, where contents are not only published but also contributes to develop cooperation abilities in the training processes of public health.

Percepção de enfermeiras educadoras sobre treinamento simulado utilizando realidade virtual aplicado aos alunos do curso de enfermagem

Objetivo: Verificar a percepção de enfermeiros com experiência em educação, a respeito da proposta metodológica de treinamento baseado em simulação virtual usando uma plataforma de treinamento imersivo. Métodos: Uma plataforma educacional foi desenvolvida baseada em simulação virtual e metodologias ativas para o engajamento, aprendizado e avaliação dos alunos. A mesma emprega um processo andragógico na construção do conteúdo expondo os enfermeiros a situações simuladas da sua prática diária com foco na melhoria de sua atitude. Os conteúdos são relacionados aos cuidados específicos com o acesso venoso periférico, desde a punção, manutenção, prevenção e manejo de complicações. Foi composto um comitê de especialistas com 12 enfermeiras, com experiência mínima de cinco anos na área da educação, que praticaram o treinamento simulado, e posteriormente, preencheram um formulário da percepção que foi tabulado e analisado pelos pesquisadores do projeto. Resultados: 92% das enfermeiras acreditam que o treinamento simulado aproxima os usuários dos desafios da prática diária, e que realmente pode contribuir para a consolidação do conhecimento. Com relação ao conteúdo experimentado nos roteiros, 67% das profissionais consideraram a proposta "muito importante ou imprescindível" e 33% entenderam ser "importante". Conclusões: A percepção geral das enfermeiras foi muito positiva, especialmente com relação à importância do conteúdo apresentado, à proposta metodológica de imersão em cenários próximos à realidade, que trouxeram os desafios da prática; além das questões problematizadoras que possibilitaram uma reflexão para a melhor tomada de decisão.

El metaverso en el mundo de la salud: el futuro presente. Desafíos y oportunidades / The metaverse in the world of health: The present future. Challenges and opportunities

La Organización Mundial de la Salud define la salud digital como la incorporación de tecnologías de información y comunicación para mejorar la salud. En los últimos años, se vio una fuerte aceleración en la adopción de estas herramientas digitales, lo que impactó de lleno en los modelos asistenciales tradicionales. Actualmente, estamos observando el surgimiento de un gran entorno virtual inmersivo llamado metaverso. Su aparición genera nuevas y desafiantes oportunidades en la salud. En este artículo se exploran algunos conceptos relacionados con este campo, se dan ejemplos concretos de su aplicación en pediatría, se mencionan algunas experiencias en el ámbito hospitalario para finalmente adentrarse en los desafíos y oportunidades que emergen.

The World Health Organization has defined "digital health" as the use of information and communication technologies to improve health. In recent years, there has been a strong acceleration in the adoption of these digital tools, which has had a major impact on traditional healthcare models. We are currently witnessing the emergence of a large immersive virtual environment called the "metaverse." Its emergence creates new and challenging opportunities in health care. This article explores some metaverse-related concepts, provides specific examples of its use in pediatrics, describes experiences in the hospital setting, and finally delves into the resulting challenges and opportunities.

Violação à NBCAL de produtos que competem com a amamentação na rede social Instagram / NBCAL violation of products that compete with breastfeeding on the social network Instagram

Resumo O artigo objetiva identificar infrações à NBCAL e analisar o conteúdo das mensagens postadas na rede social Instagram. Estudo de abordagem quali-quantitativa, com amostra de conveniência composta por perfis identificados por meio de termos específicos, precedidos do símbolo hashtag (#). A coleta de dados foi realizada durante dois meses por pesquisadores treinados, por meio de questionário estruturado. Calculou-se a frequência de promoção de produtos que caracterizava violação à NBCAL, segundo categoria e fabricante. As mensagens foram analisadas por meio da técnica de análise de conteúdo. Foram identificadas 64 contas pessoais de mulheres mães com infrações em 89 produtos, a maioria alimentos (n = 72), sendo os compostos lácteos (54,2%) e as fórmulas infantis para lactentes (45,8%) os mais divulgados. Duas categorias temáticas emergiram dos textos postados, uma relativa à qualidade dos produtos e a outra sobre a dificuldade com a amamentação, especialmente a baixa produção de leite. O estudo identificou violações à NBCAL na rede social Instagram, alertando para a necessidade do reconhecimento do marketing digital para incluí-lo nas regras impostas pela norma no contexto virtual, considerando a capilaridade das redes sociais na divulgação de informações para o público em questão.

Abstract The article aims to identify NBCAL violations and analyze the content of messages posted on the Instagram social network. This qualitative-quantitative study consisted of a convenience sample of profiles identified through specific terms preceded by the hashtag symbol (#). Data were collected for two months by trained researchers using a structured questionnaire. We calculated the product promotion frequency that characterized violation of the NBCAL per category and manufacturer. The messages were analyzed using the content analysis technique. We identified 64 personal accounts of mothers with violations in 89 products, mainly food (n = 72), dairy compounds (54.2%), and infant formulas (45.8%) were the most publicized. Two thematic categories emerged from the posted texts, one related to the quality of the products and the other about breastfeeding difficulty, especially low milk production. The study identified NBCAL violations on the Instagram social network, alerting the need to recognize digital marketing to include it in the rules imposed by the Norm in the virtual context, considering the capillarity of social networks in disseminating information to the public in question.

Desafíos para la enseñanza de ciencias médicas en condiciones de contingencia

La pandemia de COVID-19 contribuyó a la afectación del proceso tradicional de formación de profesionales de la salud, por lo que fueron implementados, de forma abrupta, ajustes y modificaciones que garantizaran la continuidad del proceso de enseñanza-aprendizaje. El objetivo de la revisión bibliográfica consiste en una actualización de las adecuaciones en los métodos de enseñanza en los diferentes escenarios docentes durante las diferentes etapas de contingencia. La revisión incluyó publicaciones, en su mayoría del período 2019-2021, y se emplearon principalmente las bases de datos ESBCO, CUMED y SciELO. Como resultado de la investigación, se plantea la complementación de las clases presenciales por otras modalidades a distancia, ya sea de tipo virtual o en línea: una forma de semipresencialidad, con un mayor empleo de las redes sociales y plataformas virtuales. En conclusión, la enseñanza de ciencias médicas en tiempos de contingencia constituye un reto, ya que ha sido necesario pasar de la enseñanza presencial tradicional a otras modalidades, con énfasis en las tecnologías de la información y de la comunicación, y así reorganizar la educación para garantizar la formación de profesionales de la salud.

The pandemic of COVID-19 contributed to affect the traditional training process of the health professionals, which is why adjustments and modifications were abruptly implemented to guarantee the continuity of the teaching-learning process. The objective of the bibliographical review is to update the adequacy in the teaching methods in the different teaching scenarios during the different contingency stages. The review included publications, mostly from the period 2019-2021, and database used were mainly EBSCO, CUMED and SciELO. As a result of the research, it is proposed the complementation of face-to-face classes by other remote modalities, either virtual or online: a semi-face-to-face form, with a bigger employment of the social networks and virtual platforms. In conclusion, the teaching of medical sciences in times of contingency is a challenge, since it has been necessary to move from traditional face-to-face education to other forms, with emphasis on information and communication technologies, and thus reorganize education to ensure the training of health professionals.

Mapas mentais e cartilhas no ensino remoto emergencial: uma proposta educacional inovadora frente à pandemia da Covid-19 / Mind maps and primers in emergency remote teaching: an innovative educational proposal in the face of the Covid-19 pandemicMapas mentales y primers en la enseñanza a distancia de emergencia: una propuesta educativa inovadora ante la pandemia Covid-19 / Mind maps and primers in emergency remote teaching: an innovative educational proposal in the face of the Covid-19 pandemicMapas mentales y primers en la enseñanza a distancia de emergencia: una propuesta educativa inovadora ante la pandemia Covid-19

Objetivo: Na perspectiva da formação continuada de professores universitários, o presente trabalho visa discutir os resultados obtidos através da aplicação de um tutorial virtual, com vistas à inovação da prática pedagógica docente. Método: Trata-se de um relato de experiência envolvendo a utilização de mapas mentais e cartilhas educativas em ambientes virtuais, no contexto do Ensino Remoto Emergencial (ERE), na Universidade Pública na Bahia. Resultados: Para tanto, por meio de trabalho colaborativo, foram realizadas atividades síncronas e assíncronas. Dois ambientes de aprendizagem foram utilizados, Google Classroom e Meet. Diferentes possibilidades para utilização dos mapas mentais e das cartilhas educativas foram apresentadas, considerando estudos anteriores da equipe proponente. Ademais, foram discutidas possibilidades para uso destas ferramentas didáticas durante o ERE. A atividade de capacitação docente envolveu doze professores universitários, os quais foram estimulados a inovarem as suas práticas pedagógicas, por meio da utilização das Tecnologias Digitais da Informação e Comunicação (TDICs). Conclusão: Diante da capacitação, os participantes atuaram como sujeitos reflexivos e ativos na vivência do processo de ensino-aprendizagem em ambientes virtuais. O tutorial, por meio de um processo educativo participativo, proporcionou ações de trabalho em equipe, com foco na inovação da prática pedagógica docente e na melhoria do processo de ensino-aprendizagem.

Objective:From the perspective of the continued training of university teachers, this work aims to discuss the results obtained through the application of a virtual tutorial, with a view to innovating teaching pedagogical practice. Method: This is an experience report involving the use of mind maps and educational booklets in virtual environments, in the context of Emergency Remote Teaching (ERE), at the Public University in Bahia. Results: To this end, through collaborative work, synchronous and asynchronous activities were carried out. Two learning environments were used, Google Classroom and Meet. Different possibilities for using mental maps and educational booklets were presented, considering previous studies by the proposing team. Furthermore, possibilities for using these teaching tools during the ERE were discussed. The teaching training activity involved twelve university professors, who were encouraged to innovate their pedagogical practices, through theuse of Digital Information and Communication Technologies (TDICs). Conclusion: During the training, participants acted as reflective and active subjects in experiencing the teaching-learning process in virtual environments. The tutorial, through a participatory educational process, provided teamwork actions, focusing on innovation in teaching pedagogical practice and improving the teaching-learning process.

Objetivo: Desde la perspectiva de la formación continua de docentes universitarios, este trabajo tiene como objetivo discutir los resultados obtenidos mediante la aplicación de una tutoría virtual, con miras a innovar la práctica pedagógica docente. Método: Se trata de un relato de experiencia sobre el uso de mapas mentales y folletos educativos en ambientes virtuales, en el contexto de la Enseñanza Remota de Emergencia (ERE), en la Universidad Pública de Bahía. Resultados: Para ello, a través del trabajo colaborativo, se realizaron actividades sincrónicas y asincrónicas. Se utilizaron dos entornos de aprendizaje, Google Classroom y Meet. Se presentaron diferentes posibilidades de uso de mapas mentales y folletos educativos, considerando estudios previos del equipo proponente. Además, se discutieron las posibilidades de utilizar estas herramientas didácticas durante el ERE. La actividad de formación docente involucró a doce profesores universitarios, quienes fueron incentivados a innovar en sus prácticas pedagógicas, mediante el uso de las Tecnologías de la Información y la Comunicación Digital (TDIC). Conclusión: Durante la capacitación, los participantes actuaron como sujetos reflexivos y activos al vivir el proceso de enseñanza-aprendizaje en ambientes virtuales. La tutoría, a través de un proceso educativo participativo, brindó acciones de trabajo en equipo, enfocando la innovación en la práctica pedagógica docente y la mejora del proceso deenseñanza-aprendizaje.

Application status and development trend of virtual clinical trials / 中国胸心血管外科临床杂志

@#Virtual clinical trials are clinical trials conducted through computer simulation technology, which breaks through the limitations of traditional clinical trials and has the advantages of saving time, reducing costs, and reducing the risk of human trials. With the application of new computer technologies such as population pharmacokinetics, physiologically-based pharmacokinetics, quantitative systems pharmacology, and artificial intelligence, the field of virtual clinical trials in healthcare has become an important development direction. This article will give a preliminary review of the connotation, methods and future development trends of virtual clinical trials, aiming to provide reference for the application of new technologies and methods in clinical trials.

Effect of virtual reality on upper limb function after stroke: a study of diffusion tensor imaging / 中国康复理论与实践

ObjectiveTo explore the effect of virtual reality on upper limb function in stroke patients through diffusion tensor imaging (DTI). MethodsFrom September, 2021 to March, 2023, 80 stroke patients in the Fuzhou Second General Hospital were randomly divided into control group (n = 40) and experimental group (n = 40). Both groups received routine rehabilitation, while the experimental group received virtual reality training additionally, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and Action Research Arm Test (ARAT) before treatment, after treatment and after four-week follow-up; and they were scaned with DTI to measure the fractional anisotropy (FA) and relative anisotropy (RA) of cerebral peduncle and posterior limb of inner capsule of the affected side before and after treatment. ResultsTwo cases dropped in each group. The FMA-UE and ARAT scores increased in both groups after treatment and follow-up (F > 2.790, P < 0.001), and increased more in the experimental group than in the control group (t > 2.297, P < 0.05). FA and RA in the posterior limb of inner capsule increased in both groups after treatment (t > 21.013, P < 0.001), and increased more in the experimental group (t > 2.006, P < 0.05). The d-value of FA of the posterior limb of internal capsule before and after treatment (ΔFA) was positively correlated with the d-value of FMA-UE score (r > 0.362, P < 0.05) in both groups, the ΔFA of the posterior limb of internal capsule was positively correlated with the d-value of ARAT score (r = 0.459, P < 0.01). ConclusionVirtual reality training can promote the recovery of upper limb function in stroke patients, which may associate with the conductivity of posterior limb of inner capsule.

Multisensory Conflict Impairs Cortico-Muscular Network Connectivity and Postural Stability: Insights from Partial Directed Coherence Analysis / 神经科学通报·英文版

Sensory conflict impacts postural control, yet its effect on cortico-muscular interaction remains underexplored. We aimed to investigate sensory conflict's influence on the cortico-muscular network and postural stability. We used a rotating platform and virtual reality to present subjects with congruent and incongruent sensory input, recorded EEG (electroencephalogram) and EMG (electromyogram) data, and constructed a directed connectivity network. The results suggest that, compared to sensory congruence, during sensory conflict: (1) connectivity among the sensorimotor, visual, and posterior parietal cortex generally decreases, (2) cortical control over the muscles is weakened, (3) feedback from muscles to the cortex is strengthened, and (4) the range of body sway increases and its complexity decreases. These results underline the intricate effects of sensory conflict on cortico-muscular networks. During the sensory conflict, the brain adaptively decreases the integration of conflicting information. Without this integrated information, cortical control over muscles may be lessened, whereas the muscle feedback may be enhanced in compensation.

Construction of the simulated traditional Chinese medicine pharmacy based on virtual simulation technology and its application evaluation / 中国药房

OBJECTIVE To construct the simulated traditional Chinese medicine pharmacy based on virtual simulation technology， and assist in the development of the new mode of traditional Chinese medicine dispensing education training. METHODS The field research and questionnaire surveys were conducted to identify the needs of Chinese medicine students and practitioners for the content and presentation of knowledge on the construction of simulated traditional Chinese medicine pharmacy. Taking the laws and regulations on the construction of traditional Chinese medicine pharmacy and the related teaching materials and literature on traditional Chinese medicine preparation as the knowledge source， the virtual simulation technology was applied to build a simulated traditional Chinese medicine pharmacy so as to achieve the functions of browsing the traditional Chinese medicine pharmacy， learning the knowledge of traditional Chinese medicine preparation and practical skills training. A multi-site simulated traditional Chinese medicine pharmacy evaluation scale study was conducted based on platform operational testing. RESULTS A simulated traditional Chinese medicine pharmacy was constructed， consisting of four core modules： video teaching， animation video， simulated pharmacy， and simulated experience. The overall score of evaluation scale was 93.31， with all entries scoring above 80； the ones with evaluation scales above 90 accounted for 92.31% （60/65）. CONCLUSIONS Simulated traditional Chinese medicine pharmacy based on virtual simulation technology meets the learning needs of users and enhances the teaching effect of traditional Chinese medicine dispensing technology training.

Miedo a las alturas en mareo postural perceptual persistente en ambientes arquitectónicos simulados por realidad virtual

Introducción: El mareo postural perceptual persistente (MPPP) es una de las causas más frecuentes de vértigo crónico. Si bien, los pacientes con MPPP tienen alteraciones de la percepción espacial, se desconoce si presentan alteraciones en el miedo a las alturas. Para no exponer a pacientes con MPPP a ambientes reales con altura, nos propusimos utilizar la realidad virtual para estudiar el miedo a las alturas. Objetivo: Cuantificar el miedo a las alturas en pacientes con MPPP y controles mediante ambientes simulados con realidad virtual. Material y Método: Estudio transversal, prospectivo de casos y controles pareados por edad y sexo. Se reclutaron pacientes con MPPP del Servicio de Otorrinolaringología del Hospital Clínico de la Universidad de Chile entre los años 2020 y 2021. Se midió presencia subjetiva de miedo y taquicardia. Los escenarios se desarrollaron con el programa Blender 2.8 y Oculus Link para equipo Oculus Quest. Se utilizaron cinco escenarios a diferentes alturas (pisos 1, 3, 6, 12, 19). Resultados: Se reclutaron 20 sujetos (12 mujeres, 47 años en promedio), incluyendo 10 pacientes con MPPP y 10 controles sin síntomas vestibulares. Ningún sujeto del grupo control presentó miedo en los escenarios presentados, mientras que siete pacientes del grupo MPPP tuvieron miedo subjetivo a una altura menor a 40 metros virtuales (Fischer, p < 0,05). Conclusión: Los pacientes con MPPP presentan, con mayor frecuencia, miedo subjetivo a las alturas que los controles, pero se requiere de nuevos estudios para determinar si este miedo es específico de MPPP, o es general a otras causas de vértigo crónico.

Introduction: Persistent Postural Perceptual Dizziness (PPPD) is one of the most common causes of chronic vertigo. While patients with PPPD have spatial perception alterations, it is unknown whether they present alterations in fear of heights. To avoid exposing patients with PPPD to high places, we aimed to use virtual reality to quantify fear of heights. Aim: To quantify fear of heights in patients with PPPD and controls using simulated environments with virtual reality. Material and Method: A prospective cross-sectional study of age- and sex-matched case-control pairs. PPPD patients were recruited from the Otolaryngology Service of the Clinical Hospital of the University of Chile between 2020 and 2021. Presence of subjective fear and tachycardia were measured. The scenarios were developed using Blender 2.8 and Oculus Link for the Oculus Quest. Five scenarios at different heights (floors 1, 3, 6, 12, 19) were used. Results: Twenty subjects were recruited (12 women, average age of 47 years), including 10 PPPD patients and 10 controls without vestibular symptoms. None of the control group subjects presented fear in the presented scenarios, while seven patients in the PPPD group had subjective fear at a height lower than virtual 40 meters (Fischer, p < 0.05). Conclusion: Patients with PPPD present a greater proportion of subjective fear to heights than controls, but further studies are required to determine if this fear is specific to PPPD or is general to other causes of chronic vertigo.

Percepción sobre el proceso de aprendizaje bajo el contexto de virtualidad en estudiantes de odontología / Perception of the learning process under the context of virtuality in dental students

El presente artículo tiene como objetivo conocer la percepción de los estudiantes de odontología sobre su proceso de aprendizaje bajo el contexto de la virtualidad. Para ello se realizó la búsqueda de artículos científicos, artículos de revisión y tesis publicadas desde el año 2020 hasta el 2023. Las bases de datos de donde se recopilaron los estudios fueron: Pubmed/MEDLINE, Scopus, SciELO, y Google Académico. Las opiniones de los estudiantes fueron positivas en su mayoría. Los aspectos positivos de la virtualidad se relacionaron a la flexibilidad de horarios, ahorro de tiempo y gastos extras; así mismo indicaron que resulta ser una manera didáctica de llevar las asignaturas teóricas. Por otro lado, los aspectos negativos se vincularon a las asignaturas clínicas y de laboratorio, señalaron que su proceso de aprendizaje durante la pandemia fue deficiente en estas materias. Sin embargo, algunos estudios demostraron que la virtualidad es una buena alternativa complementaria para los estudiantes de preclínica, debido a que los prepara para abordar al paciente con mayor confianza y seguridad. Se puede concluir que la virtualidad es un buen aliado en el aprendizaje de educación dental, algunos de los estudiantes alientan a que esta modalidad continúe a través del tiempo, sobre todo en cursos teóricos y preclínicos. La virtualidad puede seguir siendo parte de la educación dental en nuestro país, pero de ello también depende de las estrategias y metodologías de enseñanza que lo acompañen.

The objective of this article is to know the perception of dental students about their learning process under the context of virtuality. For this purpose, a search was carried out for scientific articles, review articles and theses published from 2020 to 2023. The databases from which the studies were compiled were: Pubmed/MEDLINE, Scopus, SciELO, and Google Scholar. The opinions of the students were mostly positive. The positive aspects of virtuality were related to the flexibility of schedules, time savings and extra expenses; They also indicated that it turns out to be a didactic way of carrying out the theoretical subjects. On the other hand, the negative aspects were linked to clinical and laboratory subjects; they indicated that their learning process during the pandemic was deficient in these subjects. However, some studies have shown that virtuality is a good complementary alternative for preclinical students, because it prepares them to approach the patient with greater confidence and security. It can be concluded that virtuality is a good ally in learning dental education; some of the students encourage this modality to continue over time, especially in theoretical and preclinical courses. Virtuality can continue to be part of dental education in our country, but it also depends on the teaching strategies and methodologies that accompany it.

Bienestar y salud ocupacional de profesores universitarios en la formación investigativa mediante el teletrabajo / Well-being and occupational health of university professors in research training through teleworking i: en

Introducción: La COVID-19 provocó cambios laborales e influyó en el comportamiento de los docentes universitarios. Objetivo: Describir el bienestar y la salud ocupacional de profesores universitarios en la formación investigativa mediante el teletrabajo. Métodos: Se realizó un análisis sistemático mediante la metodología PRISMA que incluyó todo el año 2022 y los primeros meses del 2023. Con los artículos incluidos se aplicó la herramienta de búsqueda bibliográfica en línea Litmaps. Asimismo, se empleó un cuestionario y posteriormente la escala de Likert. El instrumento se validó con el coeficiente alfa de Cronbach y se consideró la prueba t de una muestra para probar como hipótesis descriptiva si el bienestar y la salud ocupacional desde la formación investigativa en docentes universitarios mediante el teletrabajo eran satisfactorios. Resultados: En el estudio, 41,2 % de los artículos de revisión e investigación seleccionados con la metodología PRISMA correspondieron al año 2022; sin embargo, el 50,0 % de los artículos semillas fueron del 2023, donde su análisis mapa indicó que no hubo citas de correspondencias. En cuanto al resultado de la valoración con la escala de Likert y luego con la prueba de hipótesis, se obtuvo insatisfacción en los profesores respecto a la formación investigativa mediante el teletrabajo. Conclusiones: Existió insatisfacción respecto al bienestar y la salud ocupacional para la formación investigativa desde el teletrabajo porque los docentes universitarios consideraban que las condiciones laborales no fueron favorables.

Introduction: COVID-19 caused job changes and influenced the behavior of university professors. Objective: To describe well-being and occupational health in research training of university professors through teleworking. Methods: A systematic analysis was carried out using the PRISMA methodology that included the entire year 2022 and the first months of 2023. The online bibliographic search tool Litmaps was applied to the included articles. Likewise, a questionnaire was used and subsequently the Likert scale. The instrument was validated with Cronbach's alpha coefficient and the one-sample T-test was considered as a descriptive hypothesis whether well-being and occupational health from research training in university professors through teleworking were satisfactory. Results: In the study, 41.2% of the review and research articles selected with the PRISMA methodology corresponded to the year 2022; however, 50.0% of the seed articles were from 2023, where their map analysis indicated that there were no citations of correspondences. Regarding the result of the assessment with the Likert scale and then with the hypothesis test, dissatisfaction was obtained among professors concerning research training through teleworking. Conclusions: There was dissatisfaction regarding well-being and occupational health for research training through teleworking because university professors considered that working conditions were not favorable.

Desarrollo de la capacidad argumentativa de estudiantes de Odontología en el uso de un foro educativo virtual / Development of the argumentative capacity of dental students using a virtual educational forum / Desenvolvimento da capacidade argumentativa de estudantes de medicina dentária na utilização de um fórum educativo virtual

RESUMEN Se aplicó un foro de discusión virtual como recurso didáctico para el desarrollo de la capacidad argumentativa en estudiantes de Odontología del curso de Oclusión. El foro se aplicó en reemplazo de las evaluaciones semanales que tenían como finalidad evaluar si los estudiantes conocían los conceptos impartidos en cada clase magistral. Participaron 48 estudiantes y se analizaron las variables foro de discusión virtual y la capacidad argumentativa. Se obtuvo como resultado que el foro virtual utilizado como recurso didáctico influyó en la capacidad argumentativa de los estudiantes. Este hallazgo está en concordancia con diversos estudios realizados tanto en educación básica como en educación universitaria. Se concluye que el foro de discusión aplicado contribuye al desarrollo de capacidades cognitivas, específicamente las relacionadas con la argumentación.

ABSTRACT A virtual discussion forum was used as a didactic resource for developing argumentative skills in dental students in the occlusion course. The forum was applied as a replacement for the weekly evaluations intended to assess whether the students knew the concepts taught in each master class. Forty-eight students participated, and the variables of the virtual discussion forum and argumentative capacity were analyzed. The result was that the virtual forum used as a didactic resource influenced the argumentative capacity of the students. This finding agrees with several studies carried out in basic education as well as in university education. It is concluded that the discussion forum applied contributes to the development of cognitive abilities, specifically those related to argumentation.

RESUMO Um fórum de discussão virtual foi utilizado como recurso didático para o desenvolvimento de habilidades argumentativas nos alunos de odontologia do curso de oclusão. O fórum foi aplicado em substituição às avaliações semanais que tinham como objetivo avaliar se os alunos conheciam os conceitos leccionados em cada aula magna. Participaram 48 alunos e foram analisadas as variáveis fórum de discussão virtual e capacidade de argumentação. O resultado foi que o fórum virtual utilizado como recurso didático influenciou a capacidade de argumentação dos alunos. Esse achado está de acordo com diversos estudos realizados tanto na educação básica quanto no ensino universitário. Conclui-se que o fórum de discussão aplicado contribui para o desenvolvimento de habilidades cognitivas, especificamente as relacionadas à argumentação.

Anti-Hla Donor-Specific Antibodies Are Associated to Infection and Not to the Engraftment Rate in Outpatient Haploidentical Hematopoietic Cell Transplantation

ABSTRACT Background: Recipients of a related haploidentical stem cell transplant (haplo-SCT) can have preformed antibodies to HLA donor's antigens. Objective: The aim of the study was to evaluate the engraftment rate and major clinical associations of anti-HLA donor-specific antibodies (DSA) at two mean fluorescence intensity (MFI) thresholds in recipients of an outpatient haplo-SCT. Methods: Seventy haplo-HCT recipients were analyzed. A virtual crossmatch was performed using the donor HLA typing and the recipient's anti-HLA DSA test results. Data for anti-HLA-A, -B, -C, and -DR were analyzed. Recipients with DSA ≥ 500 MFI were considered positive, and those with < 500 were considered negative; the same was adopted for MFI ≥ 1000. Results: Post-transplant infection was higher in recipients with DSA ≥ 500 MFI (84.6%, p = 0.041). First-year mortality was higher in DSA-positive patients ≥ 500 MFI, p = 0.004, and DSA ≥ 1000 MFI, p = 0.022, than in DSA-negative recipients. Graft failure in the first 100 days was not associated with DSA ≥ 500 or ≥ 1000 MFI. There was no difference in acute (a-GVHD) or chronic (c-GVHD) graft versus host disease between DSA-positive and negative patients. Conclusions: There was no association of anti-HLA DSA at MFI ≥ 500 and ≥ 1000 with graft failure, however, increased infection and 1st-year mortality were documented in related haplo-HCT at the MFI cutoffs studied. (REV INVEST CLIN. 2023;75(5):249-58)

Percepción del Aprendizaje Activo Virtual de la Anatomía Humana, por Estudiantes de la Universidad Austral de Chile / Student Perceptions of Active Learning for the Practice of Virtual Human Anatomy, a Study at the Universidad Austral de Chile

Ante la pandemia del coronavirus, hubo que reinventar la forma de hacer las actividades prácticas de laboratorio de anatomía humana, la necesidad de que sean exclusivamente virtual, elevó la exigencia. La imposibilidad de trabajar con material orgánico demandó que al menos las imágenes a utilizar fueran de alta calidad. Para lo anterior, se usaron fotografías de disecciones del laboratorio de anatomía, más digitalizaciones de estructuras humanas de nuestro laboratorio en formato 3D disponibles en la plataforma web https://anatomiahumana3d.com. No obstante lo anterior, se detectó cierto grado de desidia por parte de los estudiantes y escasa participación en las actividades prácticas. Para resolver esto se implementó una modalidad de Aprendizaje Activo, específicamente de Aula Invertida, con el fin de que sea el propio estudiante quien genere su conocimiento. Una vez terminado el proceso de enseñanza aprendizaje bajo la nueva modalidad, se realizó un estudio descriptivo, a fin de detectar falencias y proponer mejoras respecto a la metodología aplicada. Los resultados arrojaron un nivel de satisfacción por sobre el 80 %, en tanto, que solo el 5 % de los estudiantes contestó como aceptable las diferentes dimensiones evaluadas, demostrando como el sistema de aula inversa fue bien recibida por los estudiantes. Sin embargo es prudente generar futuros estudios que ayuden a mejorar este tipo de metodología, como también seguir innovando en las estrategias didácticas que aporten a la comprensión de la anatomía humana.

SUMMARY: In the context of the COVID-19 pandemic it was necessary to reinvent the way of doing practical activities in the human anatomy laboratory and the need for these to be exclusively online, raised the requirement. Due to the impossibility of using organic samples, high-quality images had to be used. Therefore, photographs of dissections from our human anatomy laboratory were used, as well as digitalization of human structures from our laboratory in a three-dimensional (3D) format available on the web platform https://anatomiahumana3d.com. However, a certain degree of laziness on the part of the students and low participation in the practical activities was detected. To solve this problem, an Active Learning modality was implemented, specifically the Flipped Classroom, so that the students themselves generate their knowledge. Once the teaching-learning process was completed under the new modality, a descriptive study was carried out to detect shortcomings and propose improvements to the methodology applied. The results showed a level of satisfaction above 80 % and only 5 % of the students evaluated the different dimensions as acceptable demonstrating how the Flipped Classroom system was well received by the students. To conclude, it is prudent to generate future studies that help to improve this type of methodology, as well as to continue innovating in didactic strategies that contribute to the understanding of human anatomy.

Aprendizaje recorridos: educación virtual y acceso a la tecnología / Learning paths: virtual education and access to technology

El presente escrito es una recopilación de experiencias de tutores, que han recorrido diferentes rutas de aprendizaje desde sus saberes científicos y sus experiencias. Cabe señalar que las experiencias de los tutores se construyeron en diferentes cursos y con participantes de distintas latitudes del territorio nicaragüense, construyendo un mosaico de relatos que narran cómo se desarrolló esta experiencia de educación virtual con sus oportunidades y desafíos en cuanto al acceso a internet y los niveles de alfabetización digital. Al transitar por estas rutas de aprendizajes el lector encontrará una diversidad de escenarios y perspectivas diferentes y en ocasiones antagónicas, de la misma manera en que un paseo por la playa es un espacio de recreación o de sufrir insolación. Con esta mirada holística, el camino andado no pretende ser un viaje perfecto en la educación virtual, sino las lecciones y desafíos de un grupo multidisciplinar de profesionales que colaboró como tutores en el CVSP/OPS ­ nodo Nicaragua en el año 2022. El presente libro es parte de la serie Salud & Centroamérica a cuyos coordinadores agradecemos por esta tarea encomendada. Esta serie editorial se asoció con la "Red Internacional de Enseñanza e Investigación sobre Educación y Trabajo en Sistemas y Servicios de Salud (RED SALUD UNICA)", involucrando a la Universidad Católica Redemptoris Mater, la Organización Panamericana de Salud (OPS) y el núcleo centroamericano de la Associação Rede Unida. La serie Salud y Centroamérica tiene la función de compartir pensamientos, conceptos e iniciativas producidas en diferentes territorios. Es en este marco que presentamos el aprendizaje recorrido por este grupo de profesionales que comparten su experiencia en educación virtual en territorios diversos con particularidades al acceso a la tecnología y desde cuyas experiencias se construye el mosaico antes mencionados.

Diseño, implementación y evaluación de un programa de aprendizaje de habilidades procedimentales básicas en enfermería utilizando la plataforma C1DO1 durante la pandemia por COVID-19 / Design, implementation and evaluation of a learning program for basic procedural skills in nursing using the C1DO1 platform during the COVID-19 pandemic

Introducción: La simulación remota brindó una alternativa concreta para entrenar las habilidades procedimentales básicas durante la pandemia. El objetivo de este artículo es describir el proyecto que mantuvo el entrenamiento de las habilidades procedimentales básicas de enfermería en alumnos de pregrado UC, utilizando la aplicación C1DO1, durante el segundo semestre del 2021. Materiales y Métodos: Se diseñaron cinco etapas en la plataforma C1DO1. Cada etapa consideró un procedimiento clínico básico. Los estudiantes practicaron las técnicas en su hogar y se grabaron ejecutando el procedimiento. El video fue revisado por un docente que proporcionaba una retroalimentación personalizada y medía su aprendizaje de manera formativa. Al finalizar todas las etapas, se aplicó una encuesta para evaluar la percepción y satisfacción con el proyecto. Resultados: 183 estudiantes se inscribieron en el proyecto, de los cuales 122 participaron activamente. El porcentaje de respuesta del instrumento de evaluación fue de un 71%. La satisfacción global alcanzó una nota de 6,1. El grado de acuerdo con la simulación remota fue de un 94%. La percepción de autoeficacia alcanzó un 89%. La retroalimentación personalizada fue considerada como muy importante por el 94% de los participantes y el 98% de los estudiantes aprobó la etapa que efectúo. Discusión: Existe un alto grado de acuerdo con el entrenamiento de habilidades procedimentales mediante la simulación remota, sin embargo, los estudiantes consideran esta metodología como un complemento al aprendizaje motor, aún faltan estudios que midan transferencia.

Introduction: Remote simulation provided a concrete alternative to train basic procedural skills, given the pandemic. This article aims to describe the project that maintained the training of basic nursing procedural skills in UC undergraduate students using the C1DO1 application during the second semester of 2021. Methods: Five stages were designed on the C1DO1 platform. Each stage considered a basic clinical procedure. The students practiced the techniques at home and recorded themselves performing the procedure. The video was reviewed by a teacher who provided personalized feedback and measured their learning in a formative way. At the end of all the stages, a survey was applied to the students to evaluate their perception and satisfaction with the project. Results: The total number of students enrolled in the project was 183 of which 122 actively participated. The response rate of the evaluation instrument was 71%. Global satisfaction with the project obtained a score of 6.1. The degree of agreement with the remote simulation was 94%. The perception of self-efficacy reached 89%. The personalized feedback was considered very important by 94% of the participants and 98% of the students approved the stage they carried out. Discussion: There is a high degree of agreement with the training of procedural skills through remote simulation, however, students see this methodology as a complement to motor learning, and studies that measure transfer are still lacking.

What do retina fellows-in-training think about the vitreoretinal surgical simulator: A multicenter survey

Purpose: To profile vitreoretinal (VR) fellows?in?training from India exposed to the Eyesi surgical simulator, to identify potential barriers to voluntary use, and enumerate the most preferred tools and tasks before incorporating them into a formal skill?transfer curriculum. Methods: A questionnaire consisting of 22 questions was designed and circulated through an online portal (surveymonkey.com) to four different institutes of India having a VR surgical fellowship program and using a functional Eyesi (Haag–Streit) simulator. All fellows and trainees who were exposed to the simulator were eligible to participate, irrespective of time spent on the simulator and exposure to training steps on real patients. The responses collected were private and anonymous. Results: Of the 37 respondents, most (n = 25, 68%) considered surgical simulators to be the best training tool before operating on the human eye. A majority (n = 35, 94.5%) of participants spent <3 h per week on the simulator, which, most (n = 30, 81%) felt was not enough time. The main reasons for this underutilization were work?hour limitations (54.8%), lack of a structured training program (19.3%), or a dedicated supervisor (16.1%). Again, the majority (n = 33, 89%) of participants responded that VR surgical skills acquired during simulator training were transferrable to the operating room, which was reflected by their response (n = 31, 83.7%) that simulator?based training should be made mandatory before operating room exposure. Conclusion: This study gives an insight into the overall practice patterns and preferences in simulation training of surgical VR fellows?in?training across India. It indicates that the simulator is extremely helpful to fellows and if adopted, VR surgical simulators with organized, directed, and supervised sessions will considerably improve the surgical training experience.