Uso da adaptação transcultural nos cursos de pós-graduação em Enfermagem / Use of cross-cultural adaptation in Postgraduate Nursing courses / Uso de la adaptación transcultural en las carreras de grado en Enfermería

Objetivo: analisar a produção científica brasileira, na Pós-Graduação em Enfermagem, que utilizou o método de adaptação transcultural. Método: estudo documental, com busca realizada na Biblioteca Digital de Teses e Dissertações, que resultou em 140 dissertações e 72 teses para análise, oriundas de Programas de Pós-Graduação da região Sudeste, seguida das regiões Nordeste, Sul e Centro-Oeste, sem representação da região Norte. Resultados: os instrumentos adaptados foram, em sua maioria, procedentes do idioma inglês. Prevaleceram as pesquisas na área/campo Assistencial, destacando-se a linha de pesquisa Processo de Cuidar em Saúde e Enfermagem. Identificou-se descompasso entre o que é produzido na área e o que é recomendado internacionalmente. Conclusão: verificou-se aumento na utilização da adaptação transcultural como método de pesquisa, com persistência das assimetrias acadêmicas regionais e sem consenso sobre o referencial metodológico.

Objective: to analyze the Brazilian scientific production in Postgraduate Nursing education using the cross-cultural adaptation method. Method: documentary study with searches carried out in the Digital Library of Theses and Dissertations resulting in 140 Master's theses and 72 Doctoral dissertations for analysis originated from Postgraduate Programs carried out in the Southeast region of Brazil, followed by the Northeast, South and Midwest regions ­ there was no representation of the North region. Results: the adapted instruments were, mostly, originally written in English. Research in the Care area/field prevailed, highlighting the line of research called Health and Nursing Care Process. A gap between what is produced in the area and what is recommended internationally was identified. Conclusion: an increase in the use of cross-cultural adaptation as a research method was noticed, with the persistence of regional academic asymmetries and lack of consensus on the methodological framework.

Objetivo: analizar la producción científica brasileña, en el Postgrado en Enfermería, que utilizó el método de adaptación transcultural. Método: estudio documental, la búsqueda se realizó en la Biblioteca Digital de Tesis y Disertaciones, se obtuvieron 140 tesis de maestría y 72 tesis de doctorado para análisis, provenientes de Programas de Posgrado de la región Sudeste, seguida de las regiones Nordeste, Sur y Centro-Oeste, no se encontraron documentos de la región Norte. Resultados: los instrumentos adaptados fueron, en su mayoría, del idioma inglés. Predominaron las investigaciones en el área/campo Asistencial, se destacó la línea de investigación Proceso de Atención en Salud y Enfermería. Se identificó que lo que se produce en el área no coincide con lo que se recomienda a nivel internacional. Conclusión: se comprobó que aumentó el uso de la adaptación transcultural como método de investigación, que persisten las disparidades académicas regionales y que no hay consenso sobre el marco metodológico.

Adaptación y validación del Voice Handicap Index y su versión abreviada al español rioplatense de Argentina

Objetivo: Este estudio tuvo como objetivo principal validar el Voice Handicap Index (VHI) y su versión abreviada (VHI-10) adaptados al español rioplatense de Argentina, con objetivos específicos centrados en evaluar su fiabilidad y validez. Metodología: La adaptación cultural incluyó técnicas de traducción directa, síntesis y retrotraducción, evaluación de la equivalencia semántica y aplicación a un grupo piloto. Para la validación se evaluó la fiabilidad de ambos índices adaptados mediante la consistencia interna (coeficiente alfa de Cronbach) y la estabilidad test-retest (prueba de Bland-Altman, CCI y r de Spearman). Además, se examinó la validez de criterio y de constructo. 213 sujetos participaron en la validación del índice adaptado de 30 ítems (123 disfónicos; 90 de control); 113, en la del índice abreviado (63 disfónicos; 50 de control). Resultados: Se constituyó el Índice de Desventaja Vocal (IDV) como la versión adaptada del VHI al español rioplatense de Argentina. Ambos índices demostraron excelente consistencia interna (IDV-30 α = 0,96; IDV-10 α = 0,92) y estabilidad y concordancia (IDV-30 CCI = 0,95; IDV-10 CCI = 0,96). Se halló alta correlación entre los puntajes de ambos índices y la autoevaluación de la severidad de la disfonía de los participantes (r = 0,85). Ambos índices demostraron capacidad de diferenciar entre individuos con disfonía y sujetos sanos (p< 0,001). El análisis factorial reveló tres factores para el IDV-30 y un factor para el IDV-10. Conclusiones: El IDV-30 e IDV-10 presentan grados adecuados de fiabilidad y validez. Ambos pueden ser incluidos en protocolos de valoración de la función vocal por profesionales de Argentina.

Aim: This study aimed to validate the Voice Handicap Index (VHI) and its abbreviated version (VHI-10) adapted into Rioplatense Spanish from Argentina, with specific goals centered on assessing their reliability and validity. Methods: Cultural adaptation involved direct translation, synthesis and back-translation techniques, followed by an assessment of semantic equivalence and application to a pilot group. For the validation process, the reliability of both adapted indices was assessed through measures of internal consistency (Cronbach's alpha coefficient) and test-retest stability (Bland-Altman test, ICC and Spearman's correlation coefficient). Additionally, we conducted analyses to asses criterion and construct validity. 213 subjects participated in the validation of the adapted 30-items index, (123 with dysphonia; 90 from control group); 113, in the abbreviated version (63 with dysphonia; 50 from control group). Results: The "Índice de Desventaja Vocal" (IDV) was established as the adapted version of the VHI into Rioplatense Spanish from Argentina. Both indeces exhibited excellent internal consistency (IDV-30 α = 0,96; IDV-10 α = 0,92) and satisfactory stability and agreement (IDV-30 CCI = 0,95; IDV-10 CCI = 0,96). Regarding validity, a strong correlation was observed between the scores of both indeces and the participant's self-assessment of dysphonia degree (r = 0,85). Both indices effectively differentiated between individuals with dysphonia and healthy subjects (p< 0,001). Factor analysis revealed three factors for the IDV-30 and one factor for the IDV-10. Conclusion: The IDV-30 and IDV-10 demonstrate satisfactory levels of reliability and validity. Both indices can be incorporated into the assessment protocols for evaluating the vocal function by professionals in Argentina.

Mortalidad intrahospitalaria de pacientes con COVID-19 complicados con neumonías bacterianas en asistencia respiratoria mecánica en Cuidados Intensivos de Adultos en un Hospital del Paraguay / In-hospital mortality of patients with COVID-19 complicated by bacterial pneumonia on mechanical ventilation in Adult Intensive Care in a Hospital in Paraguay

Introducción: los pacientes con COVID-19 ingresan en mayor proporción a asistencia respiratoria mecánica, aumentando: el riesgo de neumonía asociada a ventilador (NAV) las tasas de mortalidad, los días de permanencia en las unidades de terapia intensiva (UCI) y los costos sanitarios. Objetivo: determinar la Mortalidad intrahospitalaria de pacientes con COVID-19 complicados con neumonías bacterianas en asistencia respiratoria mecánica en Cuidados Intensivos de Adultos en un Hospital del Paraguay durante los años 2020 a 2021. Metodología: estudio analítico de tipo cohorte retrospectiva. Se registraron variables demográficas, comorbilidades, puntajes en scores de gravedad como el APACHE II al ingreso, la cifra más baja de oxigenación durante la internación expresado por la PaO2 / FIO2, días de ventilación, colocación en decúbito prono, traqueotomía, medidas terapéuticas farmacológicas y no farmacológicas, días de internación, así como las complicaciones y la mortalidad. Resultados: fueron incluidos 214 pacientes, 135 ingresaron a asistencia respiratoria mecánica (ARM) de los cuales 58 (42,9 %) desarrollaron NAV, con edad mediana de 52 años (40-60). Los microorganismos de NAV fueron cocos Gram negativos en 98,3 %, incluyendo Acinetobacter baumanii en 46,5 %, Klebsiella pneumoniae en 22,8 %, Pseudomona aeruginosa en 15,5 % y 5,2 % Stenotrophomona maltofilia. La mortalidad intrahospitalaria fue del 44,8 %. Los menores de 50 años tienen una sobrevida mayor que los mayores (34 días vs 22 días, con p de 0,026). Conclusión: la mortalidad intrahospitalaria fue del 44,8 %. La edad fue un factor de riesgo independiente para la mortalidad en pacientes con NAV, por lo que los profesionales de la salud deben estar atentos a la posibilidad de NAV en pacientes que requieren asistencia respiratoria mecánica, especialmente en pacientes mayores de 50 años.

Introduction: patients with COVID-19 are more likely to require mechanical ventilation, which increases the risk of ventilator-associated pneumonia (VAP), mortality rates, length of stay in intensive care units (ICUs), and healthcare costs. Objective: to determine the in-hospital mortality of patients with COVID-19 complicated by bacterial pneumonia on mechanical ventilation in Adult Intensive Care in a Hospital in Paraguay during the years 2020 to 2021. Methodology: this is a retrospective cohort analytical study. Demographic variables, comorbidities, severity scores such as APACHE II on admission, the worst oxygenation during hospitalization expressed by PaO2/FiO2, days of ventilation, prone position, tracheostomy, pharmacological and non-pharmacological therapeutic measures, days of hospitalization, as well as complications and mortality were recorded. Results: a total of 214 patients were included, 135 were admitted to mechanical ventilation (MRA), of which 58 (42.9%) developed VAP, with a median age of 52 years (40-60). VAP microorganisms were Gram-negative cocci in 98.3%, including Acinetobacter baumanii in 46.5%, Klebsiella pneumoniae in 22.8%, Pseudomona aeruginosa in 15.5%, and Stenotrophomona maltophilia in 5.2%. In-hospital mortality was 44.8%. Those under 50 years of age have a longer survival than those older (34 days vs. 22 days, with p of 0.026). Conclusion: the overall mortality rate was 44.8%. Age was an independent risk factor for mortality in patients with VAP, so healthcare professionals should be aware of the possibility of VAP in patients who require mechanical ventilation, especially in patients over 50 years of age.

Tempo de tela, qualidade da dieta de adolescentes e características do entorno escolar / Screen time, quality of the adolescent diet, and profile of the school environment

Resumo Objetivou-se investigar a associação entre o tempo de uso excessivo de diferentes telas, a qualidade da dieta em adolescentes e características do entorno escolar. Adolescentes de 30 escolas estaduais de Curitiba/PR relataram tempo de tela: televisão, videogame e portáteis. A qualidade da dieta foi avaliada pela frequência de consumo de alimentos. A renda do entorno escolar foi obtida do Censo. O ambiente construído para atividade física investigado por observação sistemática do entorno escolar. A regressão de Poisson multinível foi empregada para estimar associações com as variáveis de exposição. Entre 1.200 adolescentes, 50,9% do sexo masculino, 74,4% tiveram tempo excessivo de tela. O tempo excessivo de TV (56,5%) esteve associado à pior qualidade da alimentação. O tempo excessivo de videogame (22,0%) foi menor no sexo feminino (RP 0,25; IC95% 0,18;0,36), associado à pior qualidade da alimentação, à menor renda do entorno escolar, e à pior classificação do ambiente construído para atividade física. O tempo excessivo de telas portáteis (53,2%) apresentou tendência de aumento com a renda do entorno escolar. O uso excessivo de TV e telas portáteis foi amplamente praticado por adolescentes, com diferentes variáveis demográficas e contextuais associadas de acordo com o tipo de dispositivo utilizado.

Abstract Adolescents from 30 state schools in Curitiba, State of Paraná, reported total screen time, namely television, video games and laptops. Diet quality was assessed by the frequency of food consumption. The income of the school environment was taken from the Census. The built environment for physical activity was investigated by systematic observation of the school surroundings. Multilevel Poisson Regression was used to estimate associations with the exposure variables. Among 1,200 adolescents, 50.9% being male, and 74.4% were found to be exposed to excessive screen time. Excessive TV screen time (56.5%) was associated with poor diet quality. Excessive video game time (22.0%) was lower among females (PR 0.25; 95%CI 0.18;0.36), associated with poor diet quality, lower school environment income, and the worst classification of the built environment for physical activity. Excessive use of portable screens (53.2%) tended to increase with the income of the school environment. Excessive use of TV and laptops was widespread among adolescents, with different demographic and contextual variables associated according to the type of device used.

Insatisfação com a imagem corporal e baixa aderência ao padrão alimentar ocidental em escolares: um estudo transversal / Body image dissatisfaction and low adherence to the Western dietary standard among schoolchildren: a cross-sectional study

Resumo Este estudo objetivou identificar padrões alimentares e avaliar a associação entre percepção da imagem corporal e esses padrões em escolares. Um estudo transversal foi conduzido em 385 escolares (ambos os sexos, 10-17 anos de idade) de 4 escolas públicas de Salvador, Brasil. Dois recordatórios alimentares de 24h não consecutivos foram aplicados e o padrão alimentar foi determinado por Análise Fatorial Exploratória, após ajuste dos dados dietéticos pelo Multiple Source Method. Para avaliar percepção da imagem corporal, nós usamos uma escala brasileira de silhuetas. Avaliamos as associações entre percepção da imagem corporal e padrões alimentares usando o modelo de regressão logística politômica ajustado para covariáveis. Três padrões alimentares foram obtidos: "padrão ocidental", "padrão saudável" e "comidas típicas/junk food". Após ajuste, adolescentes que desejavam uma silhueta menor (2,48 [IC95%: 1,04-6,11], 3,49 [IC95%: 1,35-9,05] e 2,87 [IC95%: 1,13-7,26]) tinham mais chances de aderir aos quintis de menor consumo do padrão ocidental, comparados àqueles satisfeitos com sua imagem corporal. Nenhuma associação foi identificada nos outros dois padrões alimentares. Adolescentes insatisfeitos com seus corpos tendem a aderir menos a padrões alimentares não saudáveis.

Abstract This study aimed to identify dietary patterns and to evaluate the association between body image perception and these patterns among schoolchildren. A cross-sectional study was conducted on 385 schoolchildren (both sexes, 10-17 years old) from four public schools in Salvador, Brazil. Two non-consecutive 24-hour dietary recalls were applied, and the dietary pattern was determined by Exploratory Factor Analysis after adjustment of dietary data using the Multiple Source Method. To evaluate body image perception, the Brazilian body shape silhouette was used. The associations between body image perception and dietary patterns using the polytomous logistic regression model adjusted for covariables was assessed. Three dietary patterns were obtained: "Western standard," unhealthy, "healthy pattern" and "typical dishes/ junk food." After adjustment, adolescents who wished for a slimmer silhouette (2.48 [95%CI: 1.04-6.11], 3.49 [95%CI: 1.35-9.05] and 2.87 [95%CI: 1.13-7.26]) were more likely to adhere to the quintiles with the lowest consumption of the Western standard, compared to those satisfied with their body image. No associations were identified in the other two dietary patterns. Adolescents dissatisfied with their bodies tend to adhere less to unhealthy dietary patterns.

Self-rated health according to sex and associated factors in Manaus, Brazil, 2019: a population-based cross-sectional study / Autoevaluación de la salud según sexo y factores asociados en Manaus, Brasil, 2019: estudio transversal de base poblacional / Autoavaliação de saúde de acordo com sexo e fatores associados em Manaus, 2019: estudo transversal de base populacional

Abstract Objective: To assess the prevalence and factors associated with poor self-rated health according to respondents' sex in Manaus, Brazil. Methods: This was a cross-sectional population-based study with adults in Manaus in 2019. Adjusted prevalence ratios and 95% confidence intervals (95%CI) were calculated using Poisson regression following a hierarchical model. Results: Poor self-rated health occurred in 35.2% (95%CI 33.3;37.2) of the 2,321 participants and was higher in females (PR = 1.27; 95%CI 1.13;1.43). In the general population, among both sexes, poor self-rated health was higher among the oldest, those with moderate and severe food insecurity and with chronic diseases (p-value < 0.05). Among females, poor health was also higher among the evangelical and those with mild food insecurity. Among males, self-rated health was also poorer among the retired and those with education below elementary level (p-value < 0.001). Conclusion: The female sex had the poorest health rating, influenced by morbidity and access to food.

Resumen Objetivo: Analizar la prevalencia y los factores asociados a la mala autoevaluación de salud según sexo en Manaus, Brasil. Métodos: Se trata de un estudio poblacional transversal con adultos residentes en Manaus en 2019. Las razones de prevalencia ajustadas (RP) y los intervalos de confianza del 95% (IC95%) se calcularon mediante regresión jerárquica de Poisson. Resultados: Autoevaluación mala de salud ocurrió en 35,2% (IC95% 33,3;37,2) de los 2.321 participantes y fue mayor en el sexo femenino (RP = 1,27; IC95%1,13;1,43). En la población general, femenina y masculina, la mala autoevaluación de salud fue mayor entre ancianos, con inseguridad alimentaria moderada y grave y con enfermedades crónicas (p-valor < 0,05). En el sexo femenino, la mala salud fue mayor en evangélicas y con inseguridad alimentaria leve. En el sexo masculino, jubilados y con educación inferior al nivel básico también tuvieron una peor autoevaluación (p-valor < 0,001). Conclusión: Personas de sexo femenino tuvieron una peor valoración de salud, influenciada por la morbilidad y el acceso a la alimentación.

Resumo Objetivo: Analisar a prevalência e fatores associados à autoavaliação de saúde ruim segundo o sexo em Manaus. Métodos: Trata-se de estudo transversal de base populacional com adultos residentes em Manaus em 2019. Razões de prevalências (RP) ajustadas e intervalos de confiança de 95% (IC95%) foram calculadas por regressão de Poisson hierarquizada. Resultados: Saúde autoavaliada como ruim ocorreu em 35,2% (IC95% 33,3;37,2) dos 2.321 participantes e foi maior no sexo feminino (RP = 1,27; IC95% 1,13;1,43). Na população geral, em ambos os sexos, saúde autoavaliada como ruim foi maior entre os mais velhos, com insegurança alimentar moderada e grave e com presença de doenças crônicas (p-valor < 0,05). No sexo feminino, saúde ruim foi maior em evangélicas e com insegurança alimentar leve. No masculino, aposentados e com nível de ensino inferior ao fundamental também apresentaram pior autoavaliação (p-valor < 0,001). Conclusão: Pessoas do sexo feminino apresentaram pior avaliação de saúde, influenciada por morbidade e acesso a alimentação.

Knowledge about sudden infant death syndrome prevention among postpartum women in Southern Brazil, 2019: a cross-sectional survey / Conocimiento sobre la prevención del síndrome de muerte súbita del lactante en puérperas del Sur de Brasil, 2019: un estudio transversal / Conhecimento sobre prevenção da síndrome da morte súbita do lactente entre puérperas no Sul do Brasil, 2019: um estudo transversal

ABSTRACT Objective To assess knowledge on sudden infant death syndrome (SIDS) prevention among postpartum women who received prenatal care in public and private services in Rio Grande, Rio Grande do Sul, Brazil, in 2019. Methods A cross-sectional study was conducted with postpartum women who gave birth in that municipality in 2019; the outcome was the indication of incorrect sleeping position (side/supine position) to prevent SIDS; the chi-square test was used to compare proportions between those who underwent prenatal care in public and private services. Results Among all 2,195 postpartum women, 67.7% (95%CI 65.7;69.6) were unaware of the position that prevents SIDS, 71.6% were public care service users; 77.8% of them feared choking/suffocation; 1.9% were informed about SIDS during prenatal care; doctors/nurses (70.5%) and grandmothers (65.1%) were influential regarding the baby's sleeping position. Conclusion Most postpartum women were unaware of the sleeping position that prevents SIDS, especially those receiving care in the public sector; in general, this subject is not discussed in prenatal care.

RESUMEN Objetivo Evaluar el conocimiento sobre la prevención del síndrome de muerte súbita del lactante (SMSL) entre puérperas que realizaron prenatal en servicios públicos y privados en Rio Grande, Rio Grande do Sul, Brasil, en 2019. Métodos Estudio transversal, con puérperas que dieron a luz en Rio Grande, en 2019; el resultado consistió en la indicación de posición incorrecta para dormir (lado/supino) para prevenir el SMSL; utilizando chi-cuadrado, se compararon las proporciones entre mujeres que recibieron atención prenatal en servicios públicos y privados. Resultados Entre las 2.195 puérperas, 67,7% (IC95% 65,7;69,6) desconocían como se previene el SMSL, estando el 71,6%, en la red pública; 77,8% temía asfixiarse/ahogarse; el 1,9% fue informado sobre el SMSL durante el prenatal; los médicos(as)/enfermeros(as) (70,5%) y los abuelos (65,1%) influyeron en la posición para dormir del bebé. Conclusión La mayoría de las puérperas desconocían la posición que previene el SMSL, especialmente en la red pública; en general, este tema no está cubierto en la atención prenatal.

RESUMO Objetivo Avaliar o conhecimento sobre prevenção da síndrome da morte súbita do lactente (SMSL) entre puérperas com pré-natal realizado nos serviços público e privado de Rio Grande, Rio Grande do Sul, Brasil, 2019. Métodos Estudo transversal, com puérperas do município; seu desfecho constituiuse da indicação de posição incorreta para dormir (decúbito lateral ou dorsal), visando prevenir a SMSL; utilizou-se o teste qui-quadrado para comparar proporções do desfecho e de exposição entre puérperas que realizaram pré-natal nos serviços público e privado. Resultados De 2.195 puérperas, 67,7% (IC95% 65,7;69,6), majoritariamente atendidas na rede pública (71,6%), desconheciam a posição preventiva da SMSL; 77,8% temiam engasgo/afogamento; 1,9% foram informadas sobre SMSL no pré-natal; médicos(as)/enfermeiros(as) (70,5%) e avós (65,1%) mostraram-se influentes na decisão sobre como posicionar o bebê adormecido. Conclusão A maioria das puérperas, especialmente as atendidas na rede pública, desconhecia a posição que previne SMSL; geralmente, o tema não é abordado no pré-natal.

Evaluation of unilateral corneal collagen cross-linking on fellow untreated eyes of patients with keratoconus / A avaliação da reticulação unilateral do colágeno corneano em olhos não tratados de pacientes com ceratocone

ABSTRACT Purpose: This study aimed to examine the effects of unilateral corneal collagen cross-linking treatment on visual acuity and the topographic findings of the fellow untreated eye of patients who had bilateral progressive keratoconus. Methods: Patients with progressive keratoconus who underwent cross-linking treatment were screened retrospectively. A total of 188 untreated eyes of 188 patients whose eyes were treated unilaterally with either standard or accelerated cross-linking and refused cross-linking procedure for the fellow eye were included. Visual acuity and topographic findings of the fellow untreated eyes were obtained preoperatively and postoperatively at the 1st, 3rd, 6th, 12th, 24th, 30th, and 36th months. Results: The change over time of variables examined was similar in the untreated eyes of patients who received standard and accelerated cross-linking methods (p>0.05). At the 12th month, 136 (95.8%) untreated eyes were stable according to progression criteria. Only 4 (8%) eyes were progressive at the 24th month. No progression was observed in any of the 16 patients with a 36-month follow up. Conclusions: The results showed that the fellow untreated eyes of patients with bilateral progressive keratoconus did not have significant progression rates after unilateral cross-linking treatment.

RESUMO Objetivo: Examinar os efeitos do tratamento de reticulação unilateral do colágeno corneano na acuidade visual e os achados topográficos em olhos não tratados de pacientes com ceratocone progressivo bilateral. Métodos: Foram rastreados retrospectivamente pacientes com ceratocone progressivo submetidos a tratamento de reticulação. Foram incluídos no estudo 188 olhos não tratados de 188 pacientes tratado unilateralmente com reticulação padrão ou acelerada e que recusaram o procedimento de reticulação no outro olho. A acuidade visual e os achados topográficos dos olhos não tratados foram obtidos no pré- e pós-operatório no 1º, 3º, 6º, 12º, 24º, 30º e 36º mês. Resultados: As alterações ao longo do tempo foram semelhantes para as variáveis examinadas nos olhos não tratados de pacientes tratados com métodos de reticulação padrão e acelerado (p>0,05). No 12º mês, 136 olhos não tratados (95,8%) estavam estáveis, de acordo com os critérios de progressão. Apenas quatro olhos (8%) mostraram progressão no 24º mês. Nenhuma progressão foi observada nos 16 pacientes que tiveram um acompanhamento de 36 meses. Conclusões: O estudo mostrou que os olhos não tratados de pacientes com ceratocone progressivo bilateral não apresentaram taxas de progressão significativas após o tratamento unilateral com reticulação.

Keratitis in patients with corneal foreign bodies: a cross-sectional study in Cali, Colombia / Ceratite em pacientes com corpos estranhos na córnea: um estudo transversal em Cali, Colômbia

ABSTRACT Purposes: To describe the clinical characteristics and factors associated with keratitis in patients with corneal foreign bodies in Colombia. Methods: This cross-sectional study was based on a clinical records review of patients who had corneal foreign bodies and were admitted to the emergency department between June 2018 and June 2019 in Cali, Colombia. The primary outcome was the presence of keratitis diagnosed based on clinical criteria. Univariate and multivariate logistic regression models were used to identify associated factors. Results: A total of 381 corneal foreign bodies in 372 patients were analyzed (median age, 40.0; interquartile range, 29.0-53.0 years; male, 94.7% (n=352). Ninety-five patients developed keratitis (24.9%, 95% confidence interval [CI] 20.8%-29.5%). In the multivariate analysis, age 30 years (odds ratio [OR] 2.15, 95% CI 1.06-4.36), finding of aqueous flare (OR 2.81, 95% CI 1.39-5.66]), and a foreign body in the peripheral cornea (OR 2.05, 95% CI 1.19-3.50] were associated with an increased risk for keratitis. Sex, time between injury and admission, and corneal edema were not related to keratitis (p>0.05). Conclusion: In Cali, Colombia, a high proportion of keratitis was reported in patients with corneal foreign body. Age, an aqueous flare, and a foreign body in the peripheral cornea were the factors associated with keratitis.

RESUMO Objetivo: Descrever as características clínicas e os fatores associados à presença de ceratite em pacientes com corpos estranhos na córnea em uma população colombiana. Métodos: Trata-se de um estudo transversal baseado na revisão dos registros clínicos de pacientes com corpos estranhos na córnea admitidos em um departamento de emergência em Cali, Colômbia, entre junho de 2018 e junho de 2019. O desfecho primário foi a presença de ceratite diagnosticada através de critérios clínicos. Foram utilizados modelos de regressão logística univariada e multivariada para identificar os fatores associados. Resultado: Neste estudo, foi analisado um total de 381 corpos estranhos na córnea em 372 pacientes (idade média: 40,0 anos, intervalo interquartil: 29,0-53,0; sexo masculino: 94,7% [352 casos]). Noventa e cinco casos desenvolveram ceratite (24,9%, intervalo de confiança de 95% — IC 95%: 20,8%-29,5%). Na análise multivariada, para idade ≤30 anos (razão de chances — RC: 2,15, IC 95%: 1,06-4,36), o achado de flare aquoso (RC: 2,81, IC 95%: 1,39-5,66]) e a presença de corpo estranho na periferia da córnea (RC: 2,05, IC 95%: 1,19-3,50) foram associados a um risco aumentado de ceratite. Sexo, tempo entre a lesão e a internação, e edema da córnea não foram relacionados à ceratite (p>0,05). Conclusão: Há uma proporção elevada de ceratite em casos de corpos estranhos na córnea em Cali, Colômbia. Os três fatores associados à ceratite foram a idade, o achado de flare aquoso e a presença de corpo estranho na periferia da córnea.

Self-perception of need to replace dentures and oral health-related quality of life: cross-sectional study nested in a Cohort in Southern Brazil

Aim: With the significant increase in life expectancy over the last decades, it is important to understand how oral health can impact the oral health-related quality of life of older adults. This study aimed to investigate the association between need to replace dentures and oral health-related quality of life (OHRQoL) among older adults belonging to a Cohort in southern Brazil. Methods: This cross-sectional study was conducted with data from the 2019 Pelotas Elderly Cohort. The OHRQoL was assessed using the GOHAI. Need to replace dentures was self-report using a question dichotomized into yes/no. In the statistical analysis, unadjusted and adjusted models estimate from linear regression models were calculated. The significance level adopted was 5%. Results: A total of 493 older adults were included. On the GOHAI questionnaire, the mean score was 32.74 (SD±0.16). Individuals considering need of prosthesis replacement were 47.89%. Report of need to replace dentures was associated to lowest mean on the GOHAI score (ß -1.14; 95%CI - 1.80; -0.478, and on the physical (ß -0.56; 95%CI - 0.94 -0.17) and psychosocial (ß -0.48; 95%CI - 0.74; -0.22) dimensions. Conclusion: Our findings highlight the importance of also considering subjective measures of oral health in the dental care of older adults, since reporting the need for denture replacement, regardless of the reason, was associated with a worse oral health-related quality of life, including physical and psychosocial aspects

Infecções urinárias e processo do cuidado: perfil etiológico e de sensibilidade no setor de clínica médica de um hospital público da Paraíba / Urinary infections and care process: etiological profile and sensitivity in the medical clinic sector of a public hospital in Paraiba / Infecciones urinarias y proceso asistencial: perfil etiológico y de sensibilidad en el sector clínico de un hospital público de Paraíba

Introdução: Há alguns fatores preditores para ocorrência de Infecção de Trato Urinário (ITU) no processo do cuidado na Clínica Médica (CM) de um Hospital Universitário (HU) como idade e tempo de internamento sendo o controle um desafio para a saúde pública. Objetivo: Descrever os principais agentes microbiológicos de ITU hospitalar na CM nos anos de 2015-16 e avaliar a suscetibilidade aos antimicrobianos. Metodologia: Trata-se de um estudo descritivo seccional e de busca na base de dados da CCIH do HU. Resultados: Em 2015 obteve se uma prevalência de 6,5% de ITU hospitalar, o agente biológico mais comum foi Klebsiella pneumoniae. Já em 2016, a prevalência foi de 5,3%; os agentes microbiológicos foram Candida spp. e Escherichia coli. Conclusão: A ITU hospitalar demonstra ser uma condição ainda bastante prevalente no HU, tendo como principal agente em 2015 a Klebsiella pneumoniae e em 2016 a Escherichia coli, ambos com uma maior susceptibilidade aos carbapenêmicos.

Introduction: There are some predictive factors for the occurrence of Urinary Tract Infection (UTI) in the care process at the Medical Clinic (CM) of a University Hospital (HU) such as age and length of stay, being control a challenge for public health. Objective: To describe the main microbiological agents of hospital UTI in CM in the years 2015-16 and to assess susceptibility to antimicrobials. Methodology: It is a descriptive and sectional study with research through the database of hospital infection control committee (HICC). Results: In 2015, there was a 6.5% prevalence of hospital UTI, the most common biological agent was Klebsiella pneumoniae. In 2016, the prevalence was 5.3%; the microbiological agents were Candida spp. and Escherichia coli. Conclusion: Hospital UTI proves to be still a very prevalent condition in HU, having Klebsiella pneumoniae as its main agent in 2015 and Escherichia coli in 2016, both with greater susceptibility to carbapenems.

Introducción: Existen algunos factores predictores de aparición de Infección del Tracto Urinario (ITU) en el proceso asistencial en la Clínica Médica (CM) de un Hospital Universitario (HU), como la edad y el tiempo de estancia, y su control es un reto para la salud pública. Objetivo: Describir los principales agentes microbiológicos de ITU de adquisición hospitalaria en la CM en 2015-16 y evaluar la susceptibilidad antimicrobiana. Metodología: Se trata de un estudio descriptivo, transversal, basado en una búsqueda en la base de datos CCIH del HU. Resultados: En 2015, la prevalencia de ITU adquirida en el hospital fue del 6,5%, y el agente biológico más frecuente fue Klebsiella pneumoniae. En 2016, la prevalencia fue del 5,3%; los agentes microbiológicos fueron Candida spp. y Escherichia coli. Conclusión: La ITU hospitalaria sigue siendo una patología muy prevalente en la UH, siendo Klebsiella pneumoniae el principal agente en 2015 y Escherichia coli en 2016, ambos con mayor susceptibilidad a carbapenems.

Exploration of cross-cultivar group characteristics of a new cultivar of Prunus mume 'Zhizhang Guhong Chongcui' / 生物工程学报

'Zhizhang Guhong Chongcui' is a new cultivar of Prunus mume with cross-cultivar group characteristics. It has typical characteristics of cinnabar purple cultivar group and green calyx cultivar group. It has green calyx, white flower, and light purple xylem, but the mechanism remains unclear. In order to clarify the causes of its cross-cultivar group traits, the color phenotype, anthocyanin content and the expression levels of genes related to anthocyanin synthesis pathway of 'Zhizhang Guhong Chongcui', 'Yuxi Zhusha' and 'Yuxi Bian Lü'e' were determined. It was found that the red degree of petals, sepals and fresh xylem in branches was positively correlated with the total anthocyanin content. MYBɑ1, MYB1, and bHLH3 were the key transcription factor genes that affected the redness of the three cultivars of flowers and xylem. The transcription factors further promoted the high expression of structural genes F3'H, DFR, ANS and UFGT, thereby promoting the production of red traits. Combined with phenotype, anthocyanin content and qRT-PCR results, it was speculated that the white color of petals of 'Zhizhang Guhong Chongcui' were derived from the high expression of FLS, F3'5'H, LAR and ANR genes in other branches of cyanidin synthesis pathway, and the low expression of GST gene. The green color of sepals might be originated from the relatively low expression of F3'H, DFR and ANS genes. The red color of xylem might be derived from the high expression of ANS and UFGT genes. This study made a preliminary explanation for the characteristics of the cross-cultivar group of 'Zhizhang Guhong Chongcui', and provided a reference for molecular breeding of flower color and xylem color of Prunus mume.

Association of Estimated Glucose Disposal Rate With the Stenosis Severity of Coronary Artery Disease： A Cross-sectional Study / 中山大学学报(医学科学版)

ObjectiveTo investigate the association between estimated glucose disposal rate （eGDR） and the severity of coronary heart disease. MethodsWe conducted a hospital-based cross-sectional study that included 1258 patients （mean age： 62（53-68） years） who underwent coronary angiography for suspected coronary artery disease （53.9% were male）. Insulin resistance level （IR） was calculated according to eGDR formula： eGDR = 21.158 - （0.09 × WC） - （3.407 × hypertension） - （0.551 × HbA1c） ［hypertension （yes = 1 / no = 0）， HbA1c = HbA1c （%）］. Subjects were grouped according to the eGDR quantile. CAD severity was determined by the number of narrowed vessels： no-obstructive CAD group （all coronary stenosis were<50%， n=704）， Single-vessel CAD group （only one involved major coronary artery stenosis≥50%， n=205）， Multi-vessel CAD group （two or more involved major coronary arteries stenosis≥50%， n=349）； Multivariate logistic regression model was used to analyze the association between eGDR and CAD severity. The linear relationship between eGDR and CAD in the whole range of eGDR was analyzed using restricted cubic spline. Subgroup analyses were used to assess the association between eGDR and CAD severity in different diabetic states. Receiver operating characteristic （ROC） curve analysis were used to evaluate the value of eGDR in improving CAD recognition. ResultsA decrease in the eGDR index was significantly associated with an increased risk of CAD severity （OR： 2.79； 95%CI： 1.72~4.55； P<0.001）. In multivariate logistic regression models， individuals with the lowest quantile of eGDR （T1） were 2.79 times more likely to develop multi-vessel CAD than those with the highest quantile of eGDR （T3） （OR： 2.79； 95%CI： 1.72~4.55； P<0.001）. Multivariate restricted cubic spline analysis showed that eGDR was negatively associated with CAD and multi-vessel CAD （P-nonlinear>0.05）. In non-diabetic patients， compared with the reference group （T3）， the T1 group had a significantly increased risk of CAD （OR： 1.42； 95% CI： 1.00~2.01； P<0.05） and multi-vessel CAD （OR： 1.86； 95%CI： 1.21~2.86； P<0.05）. No statistical association was found between eGDR and CAD in diabetic patients. In ROC curve analysis， when eGDR was added to traditional model for CAD， significant improvements were observed in the model's recognition of CAD and multi-vessel CAD. ConclusionOur study shows eGDR levels are inversely associated with CAD and CAD severity. eGDR， as a non-insulin measure to assess IR， could be a valuable indicator of CAD severity for population.

Meta-analysis of Distribution Frequency of Traditional Chinese Medicine Syndrome in Primary Osteoporosis / 中国实验方剂学杂志

ObjectiveTo systematically evaluate the distribution of traditional Chinese medicine（TCM） syndromes of primary osteoporosis（POP） in China by using evidence-based medicine methods， and to understand the distribution law of the syndromes. MethodChina National Knowledge Infrastructure（CNKI）， VIP Chinese Science and Technology Journal Database（VIP）， WanFang Data Knowledge Service Platform（WanFang） and China Biology Medicine（CBM） were searched to obtain representative literature， and each database was searched from the 1994 World Health Organization defined diagnostic criteria for osteoporosis until May 1， 2023. Two researchers independently screened literature according to the criteria， extracted data， and cross-checked them. Meta analysis was conducted using R4.1.3， and subgroup analysis was performed. ResultA total of 56 Chinese papers were included， involving 14 415 patients. After standardized classification of syndromes， 11 articles were excluded， and Meta analysis results of the ultimately included 45 Chinese articles showed that the distribution frequencies of liver-kidney Yin deficiency syndrome， spleen-kidney Yang deficiency syndrome and kidney deficiency and blood stasis syndrome in 12 723 patients were 27%［95% confidence interval（CI） 0.24-0.31］， 32%（95% CI 0.29-0.36）， 36%（95% CI 0.30-0.42）. Subgroup analysis showed that there was a statistically significant difference in the distribution of the three TCM syndromes in the north and south（P<0.05）. In addition， the incidence of TCM syndrome fractures in different types of POP was 15%（95% CI 0.09-0.24） for liver-kidney Yin deficiency syndrome， 20%（95% CI 0.12-0.30） for spleen-kidney Yang deficiency syndrome， and 31%（95% CI 0.25-0.39） for kidney deficiency and blood stasis syndrome. ConclusionThe distribution of syndromes in POP patients is mainly kidney deficiency， accompanied by liver and spleen dysfunction. Liver-kidney Yin deficiency syndrome， spleen-kidney Yang deficiency syndrome and kidney deficiency and blood stasis syndrome are all the main syndromes of POP and osteoporotic fractures， and kidney deficiency and blood stasis syndrome is most closely related to the development of osteoporotic fractures. The reference standards for syndrome determination among the included studies are inconsistent， and in the future， it is necessary to focus on their determination standards to obtain consensus research results， at the same time， conduct large-scale syndrome research to obtain representative research results， providing a basis for clinical practice and research.

Clinical effect of cross positioning method for correcting low and moderate astigmatism during small incision lenticule extraction / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the clinical outcomes of using the cross-positioning method for correcting low and moderate astigmatism during small incision lenticule extraction(SMILE)surgery with Alpins vector analysis.METHODS: A total of 50 patients(81 eyes)with low and moderate astigmatism with the rule ≤1.50 D who underwent SMILE surgery at the laser myopia treatment center of Xi'an No.1 Hospital from May 2022 to November 2022 were included in the prospective randomized controlled study, and they were divided into two groups according to the random table, with 25 case(41 eyes)in cross-positioning group and 25 cases(40 eyes)in control group. In the cross-positioning group, the patients' head position was adjusted based on the cross intersection lines before the standard SMILE procedure, aligning the lateral canthi with the horizontal line and the midpoint of the eyebrows and the nose bridge with the vertical line. Postoperative visual acuity and refractive results at 3 mo were observed in both groups, and astigmatic changes were analyzed and evaluated using the Alpins vector analysis method.RESULTS: During the follow-up period, 6 cases(11 eyes)in the cross-positioning group were lost to follow-up, while in the control group, 8 cases(14 eyes)were lost to follow-up, with 19 cases(30 eyes)and 17 cases(26 eyes)finally included in the cross-positioning group and the control group, respectively. At 3 mo postoperatively, the uncorrected visual acuity(UCVA)of both groups' operated eyes was ≥1.0, and no serious complications occurred, with no significant differences in UCVA, best corrected visual acuity(BCVA), spherical power, and spherical equivalent between the cross-positioning group and the control group(all P&#x0026;#x003E;0.05). The cylindrical power in the cross-positioning group was 0.00(0.00, 0.00)D, which was lower than -0.13(-0.50, 0.00)D in the control group(P=0.01). The vector analysis results showed that the difference vector(DV)in the cross-positioning group was lower than that in the control group [0.00(0.00, 0.00)vs 0.13(0.00, 0.50), P=0.01], and the index of success(IOS)was better than that of the control group [0.00(0.00, 0.00)vs 0.18(0.00, 0.77), P&#x0026;#x003C;0.01]. At 3 mo postoperatively, 26(87%)and 15(58%)eyes in the cross-positioning group and control groups achieved an angle of error(AE)within ±5°, respectively.CONCLUSION: The cross positioning method was used to calibrate the patients' head position during SMILE surgery, which reduced the axial position error and improved the accuracy of SMILE in correcting low and moderate astigmatism.

Corrective effect of femtosecond laser assisted laser in situ keratomileusis Xtra on patients with moderate to high myopia after 2a postoperatively / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate corrective effect and stability of corneal morphology in patients with moderate to high myopia after 2a treatment of femtosecond laser assisted laser in situ keratomileusis(FS-LASIK)Xtra.METHODS:Retrospective case-control study. A total of 30 cases(58 eyes)Patients with moderate to high myopia combined with astigmatism who planned to undergo refractive surgery in our hospital from August 2019 to August 2020 were included, and different types of surgery were performed respectively based on the relevant index of keratoconus screening in the preoperative corneal topography. They were divided into FS-LASIK group and Xtra group, with 15 cases(29 eyes)in each group. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), spherical equivalent(SE)and the corneal curvature of the anterior and posterior surfaces of different diameters(3, 5 and 7 mm)measured by Sirius three-dimensional corneal topography were observed preoperatively and 3 mo, 1 and 2 a postoperatively.RESULTS: The UCVA of the two groups of patients at different time points after surgery was significantly increased compared with preoperatively(both P&#x0026;#x003C;0.01), and there was no difference in UCVA and SE between the two groups(P&#x0026;#x003E;0.05). After 2 a postoperatively, residual astigmatism was -0.25-0 D in 25 eyes(86%)of the FS-LASIK Xtra group and 24 eyes(83%)of the FS-LASIK group. The actual corrected SE and expected corrected SE of both groups were positively correlated(both P&#x0026;#x003C;0.05). There were differences in corneal curvature on the surface of different diameter areas(3, 5, and 7 mm)between the two groups at 3 mo, 1, and 2 a postoperatively compared with preoperatively. After 1 and 2 a postoperatively, the corneal posterior surface curvature of the FS-LASIK Xtra group with corneal diameter of 3 and 5 mm was higher than that of the FS-LASIK group(P&#x0026;#x003C;0.05).CONCLUSIONS:FS-LASIK Xtra has good safety, efficacy and predictability in correcting patients with moderate to high myopia.

Capacity building in schistosomiasis control institutions in China: a cross-sectional study / 中国血吸虫病防治杂志

Objective To understand the current status of capacity building in schistosomiasis control institutes in schistosomiasis-endemic provinces (municipality, autonomous region) of China. Methods The responsibilities and construction requirements of various schistosomiasis control institutions were surveyed by expert discussions, and field interviews and visits during the period between May and June, 2023, and the questionnaire for capacity maintenance and consolidation in schistosomiasis control institutions was designed. An online questionnaire survey was conducted in county-, municipal-, and provincial-level institutions that undertook schistosomiasis control and surveillance activities through the Wenjuanxing program. The distribution of schistosomiasis control institutions, the status of institutions, departments and staff undertaking schistosomiasis control activities and the translation of scientific researches on schistosomiasis control in China were analyzed. The laboratories accredited by China National Accreditation Service for Conformity Assessment (CNAS) were considered to be capable for testing associated with schistosomiasis control, and the testing capability of schistosomiasis control institutions was analyzed. Results A total of 486 valid questionnaires were recovered from 486 schistosomiasis control institutions in 12 endemic provinces (municipality, autonomous region) of China, including 12 provincial-level institutions (2.5%), 77 municipal-level institutions (15.8%) and 397 county-level institutions (81.7%). Of all schistosomiasis control institutions, 376 (77.4%) were centers for disease control and prevention or public health centers, 102 (21.0%) were institutions for schistosomiasis, endemic disease and parasitic disease control, and 8 (1.6%) were hospitals, healthcare centers or others. There were 37 713 active employees in the 486 schistosomiasis control institutions, including 5 675 employees related to schistosomiasis control, and the proportions of employees associated with schistosomiasis control among all active employees were 5.9% (231/3 897), 5.5% (566/10 134), and 20.6% (4 878/23 682) in provincial-, municipal-, and county-level institutions, respectively. There were 3 826 full-time employees working in schistosomiasis control activities, with 30.5% (1 166/3 826), 34.6% (1 324) and 34.9% (1 336/3 826) at ages of 40 years and below, 41 to 50 years and over 50 years, and there were 1 571 (41.0%) full-time schistosomiasis control employees with duration of schistosomiasis control activities for over 25 years, and 1 358 (35.5%) employees with junior professional titles and 1 290 with intermediate professional titles (35.5%), while 712 (18.6%) full-time employees working in schistosomiasis control activities had no professional titles. The three core schistosomiasis control activities included snail control (26.3%, 374/1 420), epidemics surveillance and management (25.4%, 361/1 420) and health education (18.8%, 267/1 420) in schistosomiasis control institutions. The Kato-Katz method, miracidium hatching test with nylon gauzes, and indirect haemagglutination assay (IHA) were the most commonly used techniques for detection of schistosomiasis, and there were less than 50% laboratories that had capabilities or experimental conditions for performing enzyme-linked immunosorbent assay (ELISA), dipstick dye immunoassay (DDIA), dot immunogold filtration assay (DIG-FA), loop-mediated isothermal amplification (LAMP) and polymerase chain reaction (PCR) assays. During the period from 2018 to 2022, schistosomiasis control institutions had undertaken a total of 211 research projects for schistosomiasis control, with a total funding of 18.596 million RMB, published 619 articles, participated in formulation of 13 schistosomiasis control-related criteria, and applied for 113 schistosomiasis control-related patents, including 101 that were granted, and commercialized 4 scientific research outcomes. Conclusions The proportion of independent specialized schistosomiasis control institutions is low in schistosomiasis control institutions in China, which suffers from problems of unsatisfactory laboratory testing capabilities, aging of staff and a high proportion of low-level professional titles. More investment into and intensified schistosomiasis control activities and improved capability building and talent cultivation in schistosomiasis control institutions are recommended to provide a powerful support for high-quality elimination of schistosomiasis in China.

The Practice of Cross-Cultural Medical Services in the United States and Its Enlightenment to China / 中国医学伦理学

This paper collected and sorted out the cross-cultural medical practice in the top 20 US hospitals in 2019-2020 through web surveys, and summarized the concepts, featured projects and models of cross-cultural medical services in American hospitals. Generally, hospitals in the US advocate the service concept of "patient-centered", provide full-process services before, during and after the treatment, involving appointments, accommodation, transportation, language translation, medical process management, etc., and attach great importance to the role of culture factors in medical treatment and cross-cultural medical education and training for employees. On this basis, it is proposed that Chinese medical institutions should focus on the following aspects in the development of foreign-related medical services: conform to international medical service concepts and standards, improve the cross-cultural medical competence of medical staff and other groups, explore cross-cultural medical service models with localized characteristics, and build the international image of the hospital with the construction of international environment.

Research on Cross-cultural Competence of Medical Staff and Its Cultivation Path / 中国医学伦理学

With the acceleration of globalization, the number of foreigners in China is rising year by year, and their demand for medical treatment is also increasing. It is imperative to strengthen the supply of international professional medical services in China and improve the cross-cultural competence of medical staff. As the origin of cross-cultural medical competence research, the United States has accumulated rich theoretical and practical experience. By defining the concept and connotation of cross-cultural competence in the medical context and explaining its constituent elements, based on the experience of the United States and combined with the actual situation of China, this paper put forward that the cultivation path of cross-cultural competence of medical staff should be explored from the aspects of enhancing cross-cultural awareness of medical staff, strengthening cross-cultural medical competence training, and utilizing a variety of measures and tools.

Influencing Factors of Cross-cultural Communication between Medical Professionals and Patients and Ways to Improve Competence / 中国医学伦理学

In order to build a global community of health for all, it is necessary to deeply understand the influencing factors of cross-cultural communication between medical professionals and patients. Factors such as different health beliefs, cultural values and communication mediators influence cross-cultural communication between medical professionals and patients, and then affect the medical satisfaction and treatment compliance. Medical education should adopt the learning concept of constructivism, advocate maintaining a humble cultural attitude, incorporate more patient perspectives and adopt cross-cultural teaching mode to improve the cross-cultural communication competence of medical students and medical staff, so as to establish a relationship based on communication and understanding.