Puntaje APP como predictor de mortalidad en pacientes con síndrome de dificultad respiratoria agudo grave por COVID-19 en un hospital referencial del norte del Perú

Introducción: La mortalidad por pacientes por COVID-19 grave que desarrollaban neumonía grave y síndrome de dificultad respiratoria agudo (SDRA) grave ha sido significativa a pesar del tratamiento oportuno. Es importante determinar predictores tempranos de enfermedad que nos ayuden a estratificar aquellos pacientes con mayor riesgo de fallecer. Se pretende estudiar el comportamiento del puntaje APP (APPS) como predictor de ello, basados en algunos reportes de uso y utilidad en el SDRA. no COVID-19. Objetivo: Determinar si el APPS es útil como predictor de mortalidad en SDRA. por COVID-19 grave. Pacientes y Método: Se realizó un estudio tipo cohorte retrospectivo, incluyendo pacientes de la Unidad de Cuidados Intensivos (UCI), con SDRA. por COVID-19 grave, que ingresaron a la UCI del Hospital Regional Docente de Trujillo (HRDT) en el período abril 2020- abril 2021. Se evalúo la utilidad del APPS como predictor de mortalidad em dicha población. Resultados: El APPS demostró ser un factor asociado a mortalidad en pacientes con SDRA. y COVID-19 grave (RPa 1,34; IC 95% 1,16 a 1,56; p < 0,001). Además, encontramos que, al realizar un modelo de predicción ajustado por edad, sexo, SOFA, APPS, shock, Indice de Charlson (ICh), se comportan como factores asociados a mortalidad el APPS, el sexo masculino (RPa: 1,48; IC 95% 1,09 a 2,049; p < 0,05) y el ICh (RPa: 1,11; IC 95% 1,02 a 1,21; p < 0,05). Conclusión: El APPS, el sexo masculino y el ICh son predictores de mortalidad en SDRA. por COVID-19 grave.

Background: Mortality in patients with severe COVID-19 who developed severe pneumonia and severe Acute Respiratory Distress Syndrome (ARDS) has been significant despite timely treatment. It is important to determine early predictors of disease that help us to stratify those patients with a higher risk of death. It is intended to study the behavior of the APPS score as a predictor of this, based on some reports of use and usefulness in non-COVID-19 ARDS. Aim: To determine if the APP score is useful as a predictor of mortality in ARDS due to severe COVID-19. Method: A retrospective cohort study was carried out, including patients from the Intensive Care Unit (ICU) with ARDS due to severe COVID-19 who were admitted to the ICU of the Trujillo Regional Teaching Hospital (HRDT) in the period March 2020 to March 2021. The usefulness of the APP score as a predictor of mortality in mentioned population was evaluated. Results: The APP score proved to be a factor associated with mortality in patients with ARDS and severe COVID-19 (APR 1.34; 95% CI 1.16 to 1.56; p < 0.001). We also found that when performing a prediction model adjusted for age, sex, SOFA, APP score, shock and Charlson Index (ICh) we found that the APP score, male sex (APR: 1.48; 95% CI 1.09 to 2.049; p < 0.05) and the ICh behave as factors associated with mortality (RPa: 1.11; 95% CI 1.02 to 1.21; p < 0.05). Conclusion: The APP score, male sex, and ICh are predictors of mortality in ARDS due to severe COVID-19.

Tecnología aplicada al cuidado de enfermería: wereables, apps y robótica

La tecnología y la inteligencia artificial ganan cada vez más espacio en el diagnóstico, tratamiento y seguimiento del paciente: los wearables, las apps mHealth y los dispositivos basados en la tecnología robótica son un apoyo para el personal de salud de enfermería. A través del método hermenéutico se analizaron los resultados de una revisión bibliográfica de documentos seleccionados en Pubmed, Scielo y ELSEVIER, para describir el estado del arte de las wearables, apps y dispositivos tecnológicos que pueden ser empleados en el cuidado enfermero; lo que constituyó el objetivo de la presente investigación. Se procesaron diecisiete artículos y tres informes. Los resultados se muestran en tres categorías donde se identificaron: tres wereables, ocho aplicaciones móviles y tres robots que se emplean en enfermería. Se concluye que los wereables, las aplicaciones móviles y la robótica tienen hoy día una presencia trascendente en los espacios de cuidado y atención de salud y que acercan al personal de enfermería a sus pacientes. La tecnología no suple el cuidado de enfermería, pero si constituye una herramienta de apoyo en su quehacer.

Technology and artificial intelligence are gaining more and more space in patient diagnosis, treatment and monitoring; wearables, mHealth apps and devices based on robotic technology are a support for nursing health personnel. Through the hermeneutical method, the bibliographic review was carried out with the analysis and interpretation of the selected documents in Pubmed, Scielo and ELSEVIER: seventeen articles and three reports were processed. The results are shown in three categories identified as: three wearable, eight mobile applications and three robots used in nursing. The conclusion is that wearables, mobile applications and robotics today have a significant presence in healthcare spaces nursing staff closer to their patients. Technology does not replace nursing care but it is a support tool in their work.

Smartphone-assisted online brief cognitive behavioral therapy to treat maternal depression: findings of a randomized controlled trial

Objective: To test the efficacy of smartphone-assisted online brief cognitive behavioral therapy (b-CBT) to treat maternal depression compared to online brief CBT plus an active control app. Methods: A randomized controlled trial was conducted. Assessments were performed at baseline (T0), midpoint (T1, week 4-5), post-treatment (T2, week 8), and follow-up (T3, 2-month postnatal follow-up) by blinded interviewers. The primary outcome was depression measured by the Edinburgh Postnatal Depression Scale (EPDS) at T2. We also assessed anxiety, stress, sleep quality, well-being, physical activity, treatment response, and offspring child behavior problems. Results: Eighty-one participants were randomized to the intervention (n=37) or active control (n=44) groups. Seventy-one participants completed the post-treatment assessment or reported primary outcome data. No differences were found between the intervention and active control groups regarding maternal depression or other mental health outcomes. Overall, we found large within-group effect sizes, with 80% of the total sample responding to treatment. Conclusions: Our data showed no difference between the groups, suggesting that adding apps to psychotherapy treatment may not enhance treatment effects on prenatal depression. A within-groups analysis showed that most participants with depression responded to treatment; however, future studies are needed to confirm whether this effect is related to factors other than the intervention.

Expression, purification and micelle reconstruction of the transmembrane domain of the human amyloid precursor protein for NMR studies / 生物工程学报

The multiple-step cleavage of amyloid precursor protein (APP) generates amyloid-β peptides (Aβ), highly toxic molecules causing Alzheimer's disease (AD). The nonspecific cleavage between the transmembrane region of APP (APPTM) and γ-secretase is the key step of Aβ generation. Reconstituting APPTM under physiologically-relevant conditions is crucial to investigate how it interacts with γ-secretase and for future AD drug discovery. Although producing recombinant APPTM was reported before, the large scale purification was hindered by the use of biological protease in the presence of membrane protein. Here, we expressed recombinant APPTM in Escherichia coli using the pMM-LR6 vector and recovered the fusion protein from inclusion bodies. By combining Ni-NTA chromatography, cyanogen bromide cleavage, and reverse phase high performance liquid chromatography (RP-HPLC), isotopically-labeled APPTM was obtained in high yield and high purity. The reconstitution of APPTM into dodecylphosphocholine (DPC) micelle generated mono dispersed 2D 15N-1H HSQC spectra in high quality. We successfully established an efficient and reliable method for the expression, purification and reconstruction of APPTM, which may facilitate future investigation of APPTM and its complex in more native like membrane mimetics such as bicelle and nanodiscs.

Methodological protocol for the development of a mobile application for the promotion of physical activity based on gamification: CLUMPS

A methodological description item, with the objective of presenting the theoretical foundation and the development process of CLUMPS, a smartphone application designed and developed in Brazil, which aims to promote physical activity using gamification elements in its development proposal. The manuscript describes the application's components, its proposed intervention in the users' lifestyle and the epistemological basis on which the elements were built. Thus, CLUMPS was designed as a collection instrument and aggregator tool for interventions at the behavioral level, described as a mobile application. Gamified stimuli were used, such as counting steps, counting points, incentives, goals, challenges and rank, through the cognitive social theoretical basis to promote physical activity. The gamified strategies included in the development of CLUMPS can motivate the promotion of physical activity among users.

Se realiza una descripción metodológica con la finalidad de presentar la base teórica y el proceso de desarrollo de CLUMPS, una aplicación para teléfonos inteligentes diseñada y desarrollada en Brasil, que tiene como objetivo promover la actividad física, mediante el uso de elementos de gamificación en su propuesta de desarrollo. El artículo describe los componentes de la aplicación, su propuesta de intervención en el estilo de vida de los usuarios y la base epistemológica sobre la que se construyeron los elementos. CLUMPS fue diseñado como un instrumento de recolección y herramienta agregadora de intervenciones a nivel conductual, descritas como una aplicación móvil. Se utilizaron estímulos gamificados como conteo de pasos, conteo de puntos, incentivos, metas, desafíos y rango, a través de la base teórica cognitiva social para promover la actividad física. Las estrategias gamificadas incluidas en el desarrollo de CLUMPS pueden motivar la promoción de la actividad física entre los usuarios.

The effects of short video app-guided loving-kindness meditation on college students' mindfulness, self-compassion, positive psychological capital, and suicide ideation

Abstract Objective The study investigated the effects of a short video app guided loving-kindness meditation (LKM) on college students' mindfulness, self-compassion, positive psychological capital, and suicide ideation. The purpose of the study is to investigate the intervention effect of LKM training on suicidal ideation among college students with the help of the short video application and to provide an empirical basis for the exploration of early suicide intervention strategies for college students. Methods We recruited 80 college students from a university in China. The final 74 eligible participants were divided into two groups: app use group (n = 37) and the control group (n = 37). The app group accepted an 8-week app use interference, while the control group underwent no interference. We measured four major variable factors (mindfulness, self-compassion, positive psychological capital, and suicide ideation) before and after the app use intervention. Results In the app group, self-compassion and positive psychological capital were significantly higher, and suicide ideation was significantly lower than the control group. In the control group, there were no noticeable differences in any of the four variables between the pre-test and post-test. Conclusions Our findings demonstrate that the short video app guided LKM may help to improve self-compassion, and positive psychological capital, and reduce suicide ideation. The finding of the short video app-guided LKM's effect extends our understanding of the integrative effects of positive psychology and digital media on the reduction of suicide ideation.

Development and evaluation of content of the mobile app Cinesia for patients with unilateral motor deficits after stroke / Desenvolvimento e avaliação do conteúdo do aplicativo móvel Cinesia para pacientes com déficits motores dimidiados após acidente vascular cerebral

Abstract Introduction The incidence of stroke in adults has increased in recent years, and individuals who survive often have one or more motor and cognitive deficits. In Brazil, the Unified Health System (SUS) faces difficulties in reabsorbing the entire population that needs physiotherapy after hospital discharge. In addition, the distance to rehabilitation units in Rio de Janeiro can be far, making it impossible for some patients to receive the treatment they need. Objective To create a complementary mobile application for adults with unilateral motor deficits and to evaluate its content through expert judges. Methods Applied research for the construction of a mobile app with the prototyping method by Pressman. Steps: 1) literature review; 2) development of the technological framework; 3) construction of the content; and 4) construction of a prototype. The app content was evaluated using the e-Delphi Method for peer review using a Likert-type questionnaire on the Google Forms platform. Results The application was developed and designed to run on the Android operating system. Three rounds were carried out to evaluate the app's content. The final average of the content validity index (CVI) of all content items was 0.85, reaching the minimum agreement of 0.80, suggested by authors. Conclusion The content of a mobile app for adults with unilateral post-stroke motor deficits was developed and approved, and its content was evaluated by expert judges. We believe that this app can contribute to the promotion of physical rehabilitation in people with unilateral motor deficits after hospital discharge.

Resumo Introdução A incidência do acidente vascular cerebral (AVC) em adultos tem aumentado nos últimos anos e os indivíduos sobreviventes apresentam frequentemente um ou mais déficits motores e cognitivos. O Sistema Único de Saúde enfrenta dificuldades em reabsorver toda a população que necessita de fisioterapia após a alta hospitalar. Além disso, a distância entre as unidades de reabilitação no Rio de Janeiro impossibilita que alguns pacientes realizem o tratamento necessário. Objetivo Criar um aplicativo móvel complementar para adultos com déficits motores dimidiados e avaliar seu conteúdo através de juízes-especialistas. Métodos Pesquisa aplicada para a construção de um aplicativo móvel com método de prototipação por Pressman. Etapas: 1) revisão da literatura; 2) desenvolvimento do arcabouço tecnológico; 3) construção do conteúdo; 4) construção de um protótipo. Avaliou-se o conteúdo do aplicativo pelo método e-Delphi para avaliação por pares através de um questionário do tipo Likert na plataforma Google Forms. Resultados O aplicativo foi desenvolvido e projetado para rodar no sistema operacional Android. Foram realizadas três rodadas para a avaliação do conteúdo do aplicativo. A média final do índice de validade de conteúdo (IVC) de todos os itens do conteúdo foi de 0,85, atingindo a concordância mínima de 0,80 sugerida por autores. Conclusão Foi desenvolvido e aprovado o conteúdo de um aplicativo móvel para adultos com déficits motores dimidiados pós-AVC e realizada a ava-liação de seu conteúdo através de juízes-especialistas. Espera-se que o aplicativo possa contribuir para a promoção da reabilitação física de pessoas com déficits motores dimidiados após alta hospitalar.

The risk of Alzheimer′s disease transmitted by blood transfusion based on APP/PS1 double transgenic mice / 中国输血杂志

【Objective】 To explore the risk of Alzheimer′s disease (AD) transmitted by blood transfusion. 【Methods】 There were 10 APP/PS1 mice of 3, 6 and 9 months old, half female and half male, and the cognitive and behavioral abilities of C57 mice of the same age were measured, and the blood of the oldest APP/PS1 mice with no behavioral changes were collected to detect the contents of Aβ40 and Aβ42. The polymers Aβ40 and Aβ42 were prepared and Western blotting analysis was conducted. Kunming mice aged from 6 to 7 months were randomly divided into 6 groups (10 mice/ group, half male and half female). The blood of APP/PS1 mice was injected intravenously in experimental group 1-2(100 μL/mouse) with high frequency injection (3 times/week) and low frequency injection (1 time/week), respectively. In experimental group 3-4, Aβ40 and Aβ42 polymerized mixture (100 μL/mouse) were injected in high frequency and low frequency, respectively. The control group 1-2 was injected with the same amount of normal saline, with high frequency and low frequency, respectively. The above groups were injected for 4 weeks, and the cognitive and behavioral abilities were tested and analyzed one week after injection. Finally, the contents of Aβ40 and Aβ42 in blood of Kunming mice were detected. 【Results】 Change in cognitive and behavioral ability showed in 9 months old APP/PS1 mice, but not in 3 and 6 months old APP/PS1 mice. The contents of Aβ40 and Aβ42 (pg/mL) in blood of 6-7 months old APP/PS1 mice were 418.40±2.18 and 15.68±0.20, respectively. Except for monomers, most of the polymerized mixtures of Aβ40 and Aβ42 were dimers and trimers. In both high frequency and low frequency, Kunming mice transfused with blood of APP/PS1 mice (experimental group 1-2) showed a certain degree of anxiety-like behavior and short-term memory shortening in open-field test and conditioned fear test, but without significant difference. There was no significant difference in open field test, new object recognition, Barnes maze and cognitive behavior analysis of conditioned fear between experimental group 3-4 and the control group. The levels of blood Aβ40 and Aβ42(pg/mL) of Kunming mice detected by ELISA were 10.30±0.08 and 3.360±0.005, respectively, and there was no significant difference between the two groups. 【Conclusion】 Blood transfusion of APP/PS1 mice and the mixture of Aβ40 and Aβ42 have no significant effect on the cognitive function of healthy Kunming mice in a short time, and the risk of AD transmission is relatively low.

Astragalin Inhibits Apoptosis of Cerebral Cortex Neurons in APP/PS1 Mice / 中山大学学报(医学科学版)

ObjectiveTo investigate the effect of Astragalin （AST） on apoptosis of cerebral cortex neurons in APP/PS1 transgenic mice. MethodsEighteen six-month-old male APP/PS1 transgenic mice were randomly divided into APP/PS1 group， APP/PS1+ 40 mg/kg AST group and APP/PS1+ 20 mg/kg Donepezil （DNP） group， with six mice in each group. At the same time， six male C57BL/6 mice were selected as the normal control group. After intraperitoneal injection of AST once a day and continuous administration for one month， we used Tunel staining to detect the apoptosis of neurons in the cerebral cortex of APP/PS1 mice； immunofluorescent staining to examine the expression of apoptosis-related proteins Bax， Bcl-2， Caspase9 and Cleaved-Caspase3 in the cerebral cortex neurons of APP/PS1 mice； Western blot method to evaluate the changes of the expression of Bax， Bcl-2， Caspase9 and Caspase3. ResultsTunel staining showed that 40 mg/kg AST and 20 mg/kg DNP both reduced the apoptosis of neurons in the cerebral cortex of APP/PS1 mice， AST with more significant inhibition effect. Immunofluorescent staining revealed that 40 mg/kg AST and 20 mg/kg DNP both inhibited the expression of Bax， Caspase9， and Cleaved-Caspase3， and icreased the expression of Bcl-2 in the cerebral cortex neurons of APP/PS1 mice. Western blot results further confirmed that 40 mg/kg AST and 20 mg/kg DNP both down-regulated the expression of Bax （P < 0.05， P < 0.05）， Caspase9 （P < 0.005， P < 0.05） and Caspase3 （P < 0.0001， P < 0.0001） ， and up-regulated the expresstion of Bcl-2 （P < 0.05， P < 0.05） in the cerebral cortex neurons of APP/PS1 mice. ConclusionsAST can inhibit the apoptosis of cerebral cortex neurons in APP/PS1 mice.

The exploration of online typical case module practice in the dental standardized residency training / 中华医学教育探索杂志

Based on the in-depth analysis of the defects of the existing traditional chair-side teaching and simulation examination for the oral residency training students, this paper designs an online typical case teaching module for teaching practice. After the teaching, the examination results reveal that the use of online teaching tool can improve the clinical thinking and decision-making ability, and strengthen the clinical thinking process. The questionnaire results show that most residents are satisfied with the online teaching. All in all, the online teaching mode in this study is conducive to increasing the breadth and depth of case teaching, facilitating the process and visualization of clinical thinking, and improving the clinical decision-making ability of the typical cases of the residency training students, so as to achieve the goal of training residents with great post competences.

Use of information technology to improve patient compliance: A pilot study

Background: Compliance with treatment is the key link between treatment and outcome in medical care, non-compliance leads to failure of treatment. Noncompliance with antimicrobial agents (AMAs) is the important reason for Resistance to antimicrobials. Forgetting to take medicine is one of the important causes of non-compliance. Aim and Objectives: Hence, the present study was planned to evaluate the compliance for antimicrobial treatment in patients receiving a short course of antimicrobials, with or without reminding them to take medicine using a smartphone app. Materials and Methods: Prospective interventional study was planned in a tertiary care hospital after permission from the ethics committee. The present pilot work of the study was carried out on 30 patients receiving AMAs. Patients receiving a short course of chemotherapy were enrolled and stratified based on the frequency of administration of antimicrobials. They were then allocated alternately in control (15) and study (15) groups. After explaining the prescription to all, “Pill Reminder” app was downloaded on smartphones of participants in the study group. All were contacted to enquire about compliance at the end of the treatment period. Results: Baseline characteristics of participants in both groups were comparable. URTI, UTI Tinea cruris, Tinea capitis were the disorders for which they received AMAs. The frequency of administration was once/twice/thrice a day. Duration was 3–14 days in both groups. At the end of the study, 53.3% of patients in control group and 100% of patients in intervention group were compliant to the treatment. Conclusion: The use of the reminder app significantly improved patient’s compliance with medications. Further studies are required to validate these results.

Stress Levels among Indian Doctors � An Online Survey

An Online survey was conducted by sending a ten-point questionnaire to about 200 Doctors in India, using the Survey Monkey App. A total of 146 responses were received, out of which 132 were complete. Majority of the Doctors had more than 20 years of experience in the Medical Profession and 80% of the respondents were males. Surprisingly, majority of the Doctors were happy with their income and though the prevalence of smoking and alcohol intakes was low, almost 60% had High Stress Levels. Professional Stress was almost twice that of Domestic Stress. The causes and solutions for these high levels of stress in the Indian Doctors needs to be explored further.

Can we dream of an integrated pain management app for cancer patients?

The cancer burden continues to grow globally, exerting tremendous physical, emotional, and financial strain on individuals, families, communities, and health systems. The number of health-related mobile applications (apps) is increasing rapidly. We searched for pain apps specific for cancer patients on App Store for iOS devices and Google Play for Android devices. An integrated pain management app (IPMA) is the need of the hour, which will not only provide a platform to users to assess their pain scores but also assess other associated symptoms and can provide a step-wise assessment to their symptomatology. This can offset the patient burden in the outpatient pain clinic and reduce the number of follow-up visits by addressing common concerns that can be tackled easily at home

Aplicativo web para o acompanhamento de gestantes e perpuéras: produção tecnológica / Web app for the monitoring of pregnant and puerperal women: technological production / Aplicación webpara el seguimiento de gestantes y puérperas: producción tecnológica

OBJETIVO: Descrever o processo de produção de um protótipo de aplicativo web para o acompanhamento de gestantes e puérperas. MÉTODO: Estudo de produção tecnológica, do tipo prototipagem, desenvolvido em cinco etapas: Identificação da relevância de um aplicativo para o acompanhamento online de gestantes e puérperas com a participação de duas usuárias e nove profissionais; modelagem do protótipo; validação da prototipagem; designe implementação do aplicativo em sua forma. RESULTADOS: O aplicativo tem se mostrado uma ferramenta tecnológica de fácil, rápido e seguro acesso, além de importante aliado no atendimento virtual de gestantes e puérperas, minimizando a exposição e o tempo de espera em pronto atendimentos e consultórios profissionais. CONCLUSÃO: O aplicativo web tem ampliado a adesão de usuárias às consultas pré-natais, puericultura e puerpério, possibilitando um novo espaço de atuação profissional para o Enfermeiro.

OBJECTIVE: To describe the production process of a web app prototype to monitor pregnant and puerperal women. METHOD: A technological production study, of the prototyping type, developed in five stages: Identification of the relevance of an app for the online monitoring of pregnant and puerperal women with the participation of two users and nine professionals; prototype modeling; prototyping validation; and design and implementation of the app in its online version. RESULTS: The app has proved to be a technological tool that is easy, fast and safe to access, as well as an important ally in the virtual care of pregnant and puerperal women, minimizing exposure and waiting time in emergency services and professional offices. CONCLUSION: The web app has expanded users' adherence to the prenatal, childcare and postpartum consultations, providing a new space for the nurses' professional practice.

OBJETIVO: Describir el proceso de producción de un prototipo de aplicación web para el seguimiento de gestante y puérperas. MÉTODO: Estudio de producción tecnológica sobre eldesarrollo de un prototipo, realizado en cinco etapas: Identificación de la importancia del uso de una aplicación para el seguimiento onlinede gestante y puérperas con la participación de dos usuarias y nueve profesionales; creación del modelo del prototipo; validación del desarrollo del prototipo; diseño e implementación de la aplicación online. RESULTADOS: La aplicación ha demostrado ser una herramienta tecnológica de acceso fácil, rápido y seguro, además de un importante aliado en la atención virtual de gestante y puérperas, minimizando la exposición y el tiempo de espera en los servicios de emergencia y consultorios profesionales. CONCLUSIÓN: La aplicación webha ampliado la adhesión de las usuarias a las consultas prenatales, puericultura y posparto y habilitó un nuevo espacio para la práctica profesional del enfermero

Clinicopathological characteristics and prognostic factor analysis of Siewert Ⅱ and Ⅲ adeno-carcinoma of esophagogastric junction / 中华消化外科杂志

Objective:To investigate the clinicopathological characteristics and prognostic factors of Siewert Ⅱ and Ⅲ adenocarcinoma of esophagogastric junction (AEG).Methods:The retrospetcive cohort study was conducted. The clinicopathological data of 399 patients with AEG who were admitted to Peking University People′s Hospital from January 1998 to December 2015 were collected. There were 318 males and 81 females, aged 66(range, 19-87)years. Observation indicators: (1) clinicopathological characteristics of Siewert Ⅱ and Ⅲ AEG; (2) follow-up and survival; (3) prognostic factors analysis. Patients were followed up by telephone interview and outpatient examination to detect postoperative survival up to December 2018. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Kaplan-Meier method was used to draw survival curves and calculate survival rates. Log-rank test was used for survival analysis. Univariate and multivariate analyses were done using the COX proportional hazard model. Results:(1) Clinicopathological characteristics of Siewert Ⅱ and Ⅲ AEG. Of 399 patients, 198 cases were Siewert Ⅱ AEG and 201 cases were Siewert Ⅲ AEG. There were 130 cases undergoing transthoracic radical AEG surgery, 172 cases undergoing trans-abdominal proximal gastrectomy and 97 cases undergoing transabdominal total gastrectomy. The age, tumor diameter, cases with surgical method as transthoracic radical AEG surgery, transabdo-minal proximal gastrectomy and transabdominal total gastrectomy, the number of positive lymph nodes, cases in tumor TNM stage Ⅰ, Ⅱ, Ⅲ, Ⅳ were (65±10)years, (5.1±2.4)cm, 102, 68, 28, 17(range, 12?22), 20, 57, 117, 4 for patients with Siewert Ⅱ AEG, versus (62±12)years, (6.3±3.2)cm, 28, 104, 69,18(range, 14?27), 16, 41, 134, 10 for patients with Siewert Ⅲ AEG, showing significant differ-ences betweeen them ( t=2.83, ?3.82, χ2=66.97, U=17 407.05, 17 532.00, P<0.05). (2) Follow-up and survival. All 399 patients were followed up for 34(range, 2?160)months. The 5-year overall survival rate was 29.3% for patients with Siewert Ⅱ AEG, versus 37.0% for patients with Siewert Ⅲ AEG, showing no significant difference betweeen them ( χ2=1.46, P>0.05). The median survival time and 5-year overall survival rate were 29.0 months [95% confidence interval ( CI) as 23.4?34.6 months] and 22.9% for patients undergoing transthoracic radical AEG surgery, 43.0 months(95% CI as 33.9?52.1 months) and 34.7% for patients undergoing transabdominal proximal gastrectomy, 54.0 months (95% CI as 37.6?70.4 months)and 44.3% for patients undergoing transabdominal total gastrectomy, showing a significant difference in the survival among the 3 groups ( χ2=13.81, P<0.05). Of the 198 Siewert Ⅱ AEG patients, the 5-year overall survival rate was 24.6% for the 96 patients undergoing transabdominal surgery, versus 35.4% for the 102 patients undergoing transthoracic surgery, showing no significant difference in the survival between them ( χ2=3.10, P>0.05). Of the 201 Siewert Ⅲ AEG patients, the 5-year overall survival rate was 40.0% for the 173 patients undergoing transabdominal surgery, versus 16.1% for the 28 patients undergoing transthoracic surgery, showing a significant difference between them ( χ2=11.32, P<0.05). (3) Prognostic factors analysis. Results of univariate analysis showed that surgical method, pathological N staging, patholgical M staging were related factors for prognosis of Siewert Ⅱ and Ⅲ AEG ( hazard ratio=0.68, 1.25, 2.18, 95% CI as 0.54?0.86, 1.15?1.36, 1.28?3.73, P<0.05). Results of multivariate analysis showed that transthoracic approach, pathological stage N2?N3 and pathological stage M1 were independent risk factors for prognosis of Siewert Ⅱ and Ⅲ AEG ( hazard ratio=0.64, 1.25, 2.18, 95% CI as 0.51?0.80, 1.16?1.35, 1.28?3.70, P<0.05). Conclusions:Compared with Siewert Ⅲ AEG, Siewert Ⅱ AEG has a smaller tumor diameter, less positive lymph nodes, poorer prognosis. Transthoracic approach is preffered for the Siewert Ⅱ AEG. Transthoracic approach, pathological stage N2?N3 and pathological stage M1 are independent risk factors for prognosis of Siewert Ⅱ and Ⅲ AEG.

Physical education classes in Brazil and technology: a way to a better and healthier life / Clases de educación física en Brasil y tecnología: un caminohacia una vida mejor y más saludable

ABSTRACT Many students dislike Physical Education classes in Brazil because of content repetition, unsatisfactory curricular organization, among other factors. The purpose of this study is to assess the efficiency of a proposal for Physical Education classes, which includes contents of physical activities and the use of comic books application. This is a qualitative study, which comprises both bibliographic and field researches. Twelve classes were held to a group of eight graders from a public school in the city of Piracicaba/SP/Brazil. Questionnaires were used to evaluate the proposal for Physical Education classes. We found out that the use of comic books application is an effective teaching resource, as it reveals the students' experiences, what they felt, and the mediation between their "rational" and "sensitive" knowledge about physical activities. There is evidence that our experience has provided participating students with: 1- Leisure education and health education, 2- Awakening to knowledge of the body culture of movement, 3- Access to some leisure contents, mainly those related to physical, sports and artistic ones, 4- The creation of comics by App Flaras.

RESUMEN A muchos estudiantes no les gustan las clases de Educación Física en Brasil debido a la repetición de contenidos, organización curricular insatisfactoria, entre otros factores. El propósito de este estudio es evaluar la eficiencia de una propuesta de clases de Educación Física, que incluye contenidos de actividades físicas y el uso de la aplicación de cómics. Se trata de un estudio cualitativo, que comprende tanto investigaciones bibliográficas como de campo. Se impartieron doce clases a un grupo de ocho alumnos de una escuela pública de la ciudad de Piracicaba / SP / Brasil. Se utilizaron cuestionarios para evaluar la propuesta de clases de Educación Física. Descubrimos que el uso de la aplicación de cómics es un recurso didáctico eficaz, ya que revela las experiencias de los estudiantes, lo que sentían y la mediación entre sus conocimientos "racionales" y "sensibles" sobre las actividades físicas. Existe evidencia de que nuestra experiencia ha proporcionado a los estudiantes: 1. Educación para el ocio participativa y educación para la salud, 2. Despertar al conocimiento de la cultura corporal del movimiento, 3. Acceso a algunos contenidos de ocio, principalmente los relacionados con los físicos, deportivos y artísticos, y 4. La creación de cómics por App Flaras.

Blood donor app usage behaviour and perceptions: Considerations for a blood donation app

Background: South Africa often experiences critically low blood stock levels, making it vulnerable to blood shortages for everyday use and during times of crisis. There are over 3.5 billion smartphone users worldwide and, during 2019, app downloads were estimated at 204 billion. Considering that at least 51% of South Africans own a smartphone that can access the Internet and apps, it is clear that blood donation organisations in South Africa could benefit from engaging with the public through a mobile app. Objectives: This article aimed to determine whether South African blood donors' app usage behaviour and perceptions were conducive to introduce a blood donation app, and what these behaviours and perceptions could reveal, to support South African Blood Donation Organisations in their recruitment and engagement endeavours. Method: The research problem discussed in this article sought to highlight the app usage behaviour of blood donors, and their perceptions about a proposed blood donation app. Forming part of a larger sequential mixed-methods study, the data presented in this article were gathered through a quantitative online questionnaire involving 2154 South Africans respondents. Results: The findings revealed that the majority of respondents owned a smart device and that they used apps falling within the 'Communication' category. Of the respondents, 41% believed that a blood donation app will encourage younger South Africans to donate blood more regularly, whilst 25% of respondents were of the opinion that an app will motivate all South Africans to donate blood more often. Conclusion: The value of this research lies in the insight gained into the behaviour and perceptions of South African blood donors, which can inform the conceptualisation and design of a blood donation app, thereby improving its efficacy and subsequently supporting the strategy of employing such a technology to increase blood donation.

Associated factors of fitness APP usage among college students / 中国学校卫生

Objective@#To analyze the current situation and associated factors of fitness APP usage among college students.@*Methods@#By using three stage compound sampling method, 2 171 college students were selected, and a binary Logistic regression model was established to analyze the influencing factors fitness APP usage.@*Results@#The rate of fitness APP usage among college students was 61.9%, with significant differences by grade, physical health perception, fitness awareness, fitness purpose and exercise frequency( χ 2=28.01, 37.15, 214.12, 32.23, 316.21, P <0.01). The Logistic regression analysis showed that, grade( β = -0.31 ), fitness awareness( β =0.46), fitness purpose (improving health, β =0.52, weight loss, β =0.65), APP user friendliness ( β =0.34) and specific type of sports (running, β =1.24, racket movement, β =0.80) were associated with fitness APP usage( P < 0.05 ). Gender( β =0.30), major ( β =0.01) and exercise frequency ( β =-0.29) have less effect on fitness APP usage among college students( P >0.05).@*Conclusion@#College students have a high level of acceptance and usage of fitness APP. Grade, fitness awareness and purpose, sports type and fitness APP design are prominent factors affecting fitness APP usage among college students. The personalized custom design of fitness APP could be improved for college students.

Time dependent expression profiling of PTK2B and its relationship with Aβ, Tau and LRP-1 in hippocampus and blood of APPswe/PS1dE9 double-transgenic mouse / 中国应用生理学杂志

Objective: To uncover the time-dependent expression pattern of ptk2b gene and ptk2b-encoded protein, protein tyrosine kinase 2 beta(PTK2B), in the brain tissues of transgenic animal models of Alzheimer's disease (AD) and its relationship with the levels of Aβ1-42, phosphorylation of Tau (p-Tau) and low density lipoprotein receptor-related protein-1(LRP-1) in blood and brain tissues. Methods: In this study, 5-, 10- and 15-month-old APPswe/PS1dE9 double-transgenic mice harboring the genotype of AD confirmed by the gene test were divided into the 5-, 10- and 15-month-old experiment groups, and simultaneously, age-matched C57BL/6J mice were placed into the corresponding control groups, with 8 mice in each group. All mice were subjected to the Morris Water Maze for test of cognitive and behavioral ability. Expression profiles of PTK2B, Aβ1-42, p-Tau/Tau and LRP-1 in the hippocampus or blood of mice were quantified by using the immunohistochemistry staining, Western blot or enzyme-linked immunosorbent assay (ELISA), while the mRNA expression of ptk2b in the hippocampus was quantified by using the real-time quantitative polymerase chain reaction (qRT-PCR). Results: Results of experiment groups demonstrated that as mice aged, the expression levels of PTK2B, ptk2b mRNA, Aβ1-42 and p-Tau/Tau in the hippocampus were increased, and the expression of LRP-1 was decreased gradually. While in the blood, the level of Aβ1-42 was decreased, and the cognitive and behavioral ability was decreased in an age-dependent manner (all P＜ 0.05). However, comparisons among the control groups, only the age-dependent downregulation of LRP-1 were observed in hippocampus(P＜0.05), but other indicators had no significant differences (P＞0.05). Conclusion: In the hippocampus of APP/PS1 double-transgenic mice, the expressions of PTK2B, Aβ1-42 and p-Tau/Tau are upregulated, LRP-1 is downregulated, while cognitive and behavioral ability is decreased, and such changes are presented in a time-dependent manner.

Sistema de gestión TO-BE: garantizar el derecho a la salud de pacientes con ITS en Perú / TO-BE management system: guaranteeing the right to health of patients with STIs in Peru

Se realizó una investigación de campo para conocer la gestión de los procesos de solicitud y admisión de citas médicas, considerando la estigmatización y discriminación de las personas ITS, con el fin de garantizar el derecho a la salud de estos pacientes en Perú. Se ejecutó la sistematización de la información sobre los procesos y mecanismos de exigibilidad, bajo los lineamientos y manuales de los cuatro procesos estratégicos del MINSA contemplados para el otorgamiento de citas médicas, siguiendo los lineamientos de Gob.Pe, Adicionalmente, mediante verificación de los procesos se construyeron la matriz entidad-relación de la gestión por procesos del SSP, y el flujograma del proceso de solicitud y otorgamiento de citas AS-ISS. Se consideraron aspectos tecnológicos-médicos-legales con la participación de 201 pacientes independientemente del motivo o patología a consultar, identificando incidentes en la eficiencia del proceso misional. Por último, se implementó el flujograma de procesos de reserva de citas médicas a través de la aplicación ejecutable para smartphones, tabletas y otros dispositivos móviles (APP) TO-BE la cual conlleva a 10 pasos desde el registro de usuario hasta la emisión de comprobante de otorgamiento de cita médica. Se analizaron las preferencias de los usuarios sobre las causas superables en el proceso misional, mediante una encuesta estructura a 170 usuarios de SSP(AU)

A field investigation was carried out to learn about the management of the processes of request and admission of medical appointments, considering the stigmatization and discrimination of STI people, in order to guarantee the right to health of these patients in Peru. The systematization of the information on the processes and mechanisms of enforceability was carried out, under the guidelines and manuals of the four strategic processes of the MINSA contemplated for the granting of medical appointments, following the guidelines of Gov. Pe, Additionally, through verification of the processes The entity-relationship matrix of the management by processes of the SSP, and the flowchart of the process of request and granting of appointments AS-ISS were constructed. Technological-medical-legal aspects were considered with the participation of 201 patients regardless of the reason or pathology to be consulted, identifying incidents in the efficiency of the missionary process. Finally, the flowchart of medical appointment reservation processes was implemented through the executable application for smartphones, tablets and other mobile devices (APP) TO-BE, which entails 10 steps from user registration to issuance of voucher of granting a medical appointment. Users' preferences regarding causes that can be overcome in the missionary process were analyzed through a structured survey of 170 SSP users(AU)