Design and implementation of registration system based on Elasticsearch / 中国医学装备

Objective:To design and implement a registration system based on Elasticsearch,so as to solve the problems of the conventional registration system included single method of appointment and registration,and one-sidedness information of search registration platform,and to meet the growing needs of patients for diversified and intelligent medical registration and treatment.Methods:The browser/server(B/S)architecture was used to implement the design of registration system.The front-end used the neuron organic object description language(NOODL)language to render the interface,and implemented interaction between function methods and interface data through Typescript.The Elasticsearch search engine implemented high efficient search functions.The back-end processed the requirements of data through the(edge-based cloud object storage)ECOS system,and stored business data in the MySQL database.The system included a three-layer architecture with application layer,service layer and storage layer,which can realize a series of functions such as login and registration,search for appointments,link appointments,scan code for appointments,and setting appointment information by doctors.Results:The registration system based on Elasticsearch can realize multiple methods of appointment registration such as online search appointment,exclusive link appointment of hospital,appointment by scanning code,etc.,which was suitable to multiple platforms such as Web and mobile device.It has been applied in many overseas medical institutions.As of June 2023,the system possessed 219 doctors,and had serviced for 19,903 patients,and had completed 62,737 appointments,which saved a lot of time for patients to seek medical treatment,and improved operation efficiency of hospital.Conclusion:The registration system based on Elasticsearch can meet the diversified and intelligent needs of patients for medical treatment,which can provide comprehensive,accurate and intelligent services of appointment and treatment for patients,and can effectively improve the efficiency of appointment and treatment.

Expert consensus on the resolution level of the methods for HLA genotyping / 中国输血杂志

Human leukocyte antigen (HLA) genotyping has been widely used in establishing the database of the donors for hematopoietic stem cell, HLA matching selection between the donor and recipient, establishing the database of platelet donors with known HLA genotype, diagnosis of HLA association with diseases, genetics study and other scientific research. With the increasing number of HLA alleles and the development of HLA genotyping technology, there are some controversy in the definition of resolution for HLA genotyping, the description of the results for HLA genotyping between donor and recipient and the determination of HLA matching level. In order to improve the normalization of the definition and interpretation of HLA genotyping resolution, this expert consensus is formulated by many experts from the fields of HLA genotyping in the laboratory and clinical transplantation according to the relevant domestic and foreign literature and clinical practice. The definition of the resolution of HLA genotyping, the methods of HLA genotyping, the description of the results between donor and recipient and HLA matching determination are summarized, which will further standardize HLA genotyping technology and ensure the accuracy of the results for HLA genotyping.

Efectividad del procedimiento para la formación del proyecto de vida profesional en estudiantes de Medicina

Fundamento: el proyecto de vida profesional constituye una formación psicológica compleja que debe ser desarrollada y evaluada durante las acciones que se realizan en los procesos sustantivos universitarios: formación, investigación y extensión universitaria. Objetivo: evaluar la efectividad del procedimiento para la formación del proyecto de vida profesional en estudiantes de Medicina. Métodos: se realizó una investigación cualitativa de tipo prexperimental en la Universidad de Ciencias Médicas de Holguín, Facultad de Ciencias Médicas "Mariana Grajales Coello", desde enero 2021 hasta diciembre 2022. Se utilizaron como métodos teóricos el análisis-síntesis, la inducción-deducción y la modelación. Los métodos empíricos aplicados fueron la observación y el instrumento Exploración del proyecto de vida profesional; así como el prexperimento para evaluar su efectividad. Resultados: se aportó un procedimiento para la formación del proyecto de vida profesional en estudiantes de la carrera Medicina a implementarse durante los procesos sustantivos universitarios. El prexperimento mostró su efectividad para alcanzar el objetivo. Conclusiones: el procedimiento presentado incrementa la calidad de la formación inicial de estudiantes de la carrera Medicina. A través de su evaluación se constató que perfecciona el proceso pedagógico y favorece el proyecto de vida profesional.

Background: the professional life project constitutes a complex psychological training that must be developed and evaluated during the actions carried out through core university processes: training, research and university extension. Objective: to evaluate the effectiveness of the procedure for the formation of the professional life project in medical students. Methods: a pre-experimental quantitative research was carried out at "Mariana Grajales Coello" University of Medical Sciences from Holguín, Faculty of Medical Sciences, from January 2021 to December 2022. Analysis-synthesis, induction-deduction were used as theoretical methods. The empirical methods applied were observation, the Exploration of the professional life project instrument; as well as the pre-test, post test and modeling to evaluate its effectiveness. Results: a procedure was provided for the formation of the professional life project in Medicine students to be implemented trough core university processes. The pre-test and post test showed its effectiveness in achieving the objective. Conclusions: the procedure presented increases the quality of the initial training of medical students. Through its evaluation, it was found that it improves the pedagogical process and favors the professional life project.

Sociodemographic and training profile of nursing professionals in the state of São Paulo in relation to Integrative and Complementary Health Practices / Perfil sociodemográfico y de formación de los profesionales de enfermería del estado de São Paulo en relación a las Prácticas Integrativas y Complementarias de Salud / Perfil sociodemográfico e de formação dos profissionais de Enfermagem do estado de São Paulo em relação às Práticas Integrativas e Complementares em Saúde

Objective: to analyze the sociodemographic and training profile of nursing professionals in the state of São Paulo in relation to Integrative and Complementary Practices in Health. Method: cross-sectional study, developed with 3,794 nursing professionals in the state of São Paulo, from 645 municipalities. To collect data, an online questionnaire was used containing sociodemographic and professional training variables. A hierarchical multiple Poisson regression model was constructed, considering training in practices as the dependent variable, with a significance level of 5%. Results: of the 3,794 (100%) participants, 479 (12.62%) had training in Integrative and Complementary Health Practices. The most frequent practices were auriculotherapy, Traditional Chinese Medicine/acupuncture and Reiki. The predominant training modalities were free, face-to-face and theoretical-practical courses. The variables age, no formal religion, higher education and specialization level, working hours and knowledge and previous experience on integrative practices were significant. Conclusion: the results indicate the need to encourage and expand the training of Integrative and Complementary Health Practices for nursing professionals, in order to strengthen their performance in health services.

Objetivo: analizar el perfil sociodemográfico y de formación de los profesionales de enfermería del estado de São Paulo en relación a las Prácticas Integrativas y Complementarias en Salud. Método: estudio transversal, desarrollado con 3.794 profesionales de enfermería del estado de São Paulo, provenientes de 645 municipios. Para la recolección de datos se utilizó un cuestionario online que contenía variables sociodemográficas y de formación profesional. Se construyó un modelo de regresión de Poisson múltiple jerárquico, considerando la formación en prácticas como variable dependiente, con nivel de significancia del 5%. Resultados: de los 3.794 (100%) participantes, 479 (12,62%) tenían formación en Prácticas Integrativas y Complementarias en Salud. Las prácticas más frecuentes fueron la auriculoterapia, la Medicina Tradicional China/acupuntura y el reiki. Las modalidades de formación predominantes fueron cursos libres, presenciales y teórico-prácticos. Las variables edad, sin religión formal, nivel superior de formación y especialización, carga horaria de trabajo, y conocimiento y experiencia previa sobre prácticas integrativas presentaron significancia. Conclusión: los resultados indican la necesidad de incentivar y expandir la formación en Prácticas Integrativas y Complementarias en Salud a los profesionales de enfermería, con el fin de fortalecer su actuación en los servicios de salud.

Objetivo: analisar o perfil sociodemográfico e de formação dos profissionais de Enfermagem do estado de São Paulo em relação às Práticas Integrativas e Complementares em Saúde. Método: estudo transversal, desenvolvido com 3.794 profissionais de Enfermagem do estado de São Paulo, provenientes de 645 municípios. Para a coleta de dados, utilizou-se um questionário online contendo as variáveis sociodemográficas e de formação profissional. Foi construído um modelo de regressão de Poisson múltiplo hierárquico, considerando a formação em práticas como variável dependente, com nível de significância de 5%. Resultados: dos 3.794 (100%) participantes, 479 (12,62%) tinham formação em Práticas Integrativas e Complementares em Saúde. As práticas mais frequentes foram a auriculoterapia, a Medicina Tradicional Chinesa/acupuntura e o Reiki . As modalidades de formação predominantes foram cursos livres, presenciais e teórico-práticos. As variáveis idade, sem religião formal, nível superior de formação e especialização, carga horária de trabalho e conhecimento e experiência prévia sobre práticas integrativas apresentaram significância. Conclusão: os resultados indicam a necessidade de incentivar e expandir a formação em Práticas Integrativas e Complementares em Saúde dos profissionais de Enfermagem, a fim de fortalecer sua atuação nos serviços de saúde.

Effect of acupuncture sensation on body sway during one legged stance / 全日本鍼灸学会雑誌

[Objectives]The purpose of this study is to clarify the effect of acupuncture sensation on the body sway during a one-legged stance.[Methods] The study participants were 16 healthy adults (mean age 21.8±1.6 years). The study design was a crossover method, wherein the same individuals participated in the acupuncture stimulation condition and the control condition at intervals of more than one week. Evaluation was performed before and after each intervention by holding a one-legged stance for 40 seconds on a force plate. A total of six items of body sway were measured, including: circumferential area, rectangular area, effective value area, total trajectory length, unit trajectory length, and unit area trajectory length. In addition, Visual analog scale (VAS) was used to evaluate the ease with which the lower leg was subjected to force during measurement. In the acupuncture stimulation condition, single acupuncture was performed on the lower limb muscle group of the measuring leg, and the VAS of the acupuncture sensation was evaluated at the time of stimulation and at the end of measurement. Stainless steel disposable acupuncture needles (length: 50 mm, diameter: 0.20 mm.) were used for stimulation. The stimulation sites were the ST32, ST37, BL37, BL57, and GB37 of the test leg, and acupuncture needles were inserted to the desired depth and removed when sensation was felt. The control condition was the supine position for five minutes. Comparisons were made between the pre- and post-acupuncture stimulation conditions and the pre- and post-control conditions(body sway, lower leg VAS, acupuncture sensation VAS). [Results] There was no significant difference between the two conditions in terms of body sway. However, the VAS of lower limb effort was significantly lower, from 78.0±14.9 mm to 63.1±17.0 mm before and after the intervention (p<0.05). On the other hand, in the control condition, there was no significant difference from 79.5±12.3 mm to 75.2±12.7 mm before and after rest. The VAS of acupuncture sensation was 50.4±14.3 mm during stimulation and 9.8±9.0 mm at the end of measurement, which was significantly lower (p<0.05). [Conclusion] Acupuncture sensation did not affect the body sway before and after acupuncture stimulation. However, the subjective sensation of weakness appeared, suggesting that acupuncture stimulation may cause a transient sensation of weakness.

New species of Claudiotendipes Andersen, Mendes & Pinho and Tapajos Trivinho-Strixino, Silva & Oliveira from Brazil (Diptera, Chironomidae, Chironominae)

ABSTRACT Two recently revealed genera, Claudiotendipes, consisting of three distinct species, and the monotypic Tapajos, have new species described. We describe and figure Claudiotendipes gilbertoi sp. n., based on male adult specimens collected in the southern Atlantic Forest of Rio Grande do Sul State. Additionally, we describe and figure Tapajos froehlichi sp. n., from male adults collected in the Amazon Forest from Amazonas and Rondônia States. In order to place the newly described T. froehlichi sp. n., minor emendations have been made to the diagnosis and description of Tapajos.

Challenges and potentialities of business entrepreneurship in nursing: analogies to brazilian entrepreneurial activity / Desafíos y potencialidades del emprendimiento empresarial en enfermería: analogías con la actividad empresarial brasileña / Desafios e potencialidades do empreendedorismo de negócios na enfermagem: analogias à atividade empreendedora brasileira

ABSTRACT Objective: to reflect on the potentialities and challenges of entrepreneurial activity in the early-stage stage of nurses, considering the analogies between the profile of Brazilian nursing and business entrepreneurs in the country. Method: this is a theoretical reflection articulated around the concept of phases of entrepreneurial activity. From this starting point, common variables from the Nursing Profile survey and the Global Entrepreneurship Monitor Brazil Report were selected, such as sex, age group, education level, family income and occupation. Taking into account a parallel between variables, reflection on the challenges and potential of entrepreneurial nurses in the nascent and new entrepreneurial activity phases was ordered. Results: it is possible that nascent and new entrepreneurial nurses are predominantly women, specialized with the possibility of income compatible with traditional jobs. Specialization, professional experience and professional legislation are strengths, while sex is a challenge. Conclusion: there are both potentialities and challenges. For nascent and new entrepreneurs to emerge, entrepreneurial education, promotion of gender equality, work and income policies are particularly relevant.

RESUMEN Objetivo: reflexionar sobre las potencialidades y desafíos de la actividad empresarial en la etapa inicial de los enfermeros frente a las analogías entre el perfil de la enfermería brasileña y los empresarios del país. Método: reflexión teórica articulada en torno al concepto de fases de la actividad emprendedora. A partir de ese punto de partida, fueron seleccionadas variables comunes de la Encuesta Perfil de Enfermería y del Informe Global Entrepreneurship Monitor Brasil, entre las que se encuentran género, grupo etario, nivel educativo, renta familiar y ocupación. Teniendo en cuenta un paralelismo entre las variables, se ordenó la reflexión sobre los desafíos y potencialidades de los enfermeros emprendedores en las fases de actividad emprendedora naciente y nueva. Resultados: es posible que las enfermeras nacientes y nuevas emprendedoras sean predominantemente mujeres, especializadas, con posibilidad de ingresos compatibles con los trabajos tradicionales. La especialización, la experiencia profesional y la legislación profesional son potencialidades, mientras que el género es un desafío. Conclusión: hay potencialidades y desafíos. Para el surgimiento de emprendedores emergentes y nuevos, la educación emprendedora, la promoción de la igualdad de género, las políticas de trabajo e ingresos son particularmente relevantes.

RESUMO Objetivo: refletir sobre potencialidades e desafios da atividade empreendedora em estágio inicial de enfermeiros face à analogias entre o perfil da enfermagem brasileira e de empreendedores de negócios no país. Método: reflexão teórica articulada em torno do conceito de fases de atividade empreendedora. Deste ponto de partida foram selecionadas variáveis comuns da pesquisa Perfil da Enfermagem e do Relatório do Global Entrepreneurship Monitor Brasil, sendo sexo, faixa etária, nível de escolaridade, renda familiar e ocupação. Levando em conta um paralelo entre as variáveis, ordenou-se a reflexão sobre os desafios e potencialidade de enfermeiros empreendedores nas fases de atividade empreendedora nascente e nova. Resultados: é possível que enfermeiros empreendedores nascentes e novos sejam predominantemente mulheres, especializadas, com possibilidade de renda compatível com postos tradicionais de trabalho. A especialização, a experiência profissional e a legislação profissional são potencialidades; enquanto que o sexo, um desafio. Conclusão: há tanto potencialidades quanto desafios. Para que empreendedores nascentes e novos surjam são relevantes, sobretudo, a educação empreendedora, promoção da igualdade de gênero, políticas de trabalho e renda.

Modelo de evaluación de la competencia investigativa del licenciado en Imagenología / Model for evaluating the researching competence of the graduate in Imaging

Fundamento: la evaluación del desempeño profesional y la competencia constituye el eje fundamental del modelo cubano para el análisis y evaluación de la calidad en la educación y práctica médicas. Objetivo: diseñar un modelo de evaluación de la competencia investigativa del licenciado en Imagenología. Métodos: se realizó una investigación de desarrollo en los centros de atención secundaria del municipio Holguín desde 2021 a 2022. Se emplearon métodos teóricos: histórico-lógico, análisis-síntesis, sistémico-estructural-funcional y modelación; y empíricos: análisis documental y cuestionario a licenciados en Imagenología. Para la valoración del modelo se empleó el criterio de 10 especialistas con reconocido prestigio en los centros de atención. Los indicadores fueron la pertinencia, utilidad, factibilidad. Resultados: se constataron insuficiencias en la competencia investigativa evidenciadas en el desempeño profesional. Se elaboró un modelo de evaluación compuesto por dos subsistemas: teórico funcional y contextualización; de sus relaciones deviene una nueva cualidad que se enuncia en la mejora del desempeño profesional investigativo para la solución de problemas tecnológicos y biomédicos. Conclusiones: los dos subsistemas que componen el modelo de evaluación de la competencia investigativa tienen una relación de coordinación. Los especialistas lo valoraron como pertinente, útil y factible de ser aplicado.

Background: the evaluation of professional performance and competence constitutes the fundamental axis of the Cuban model for the analysis and evaluation of quality in medical education and practice. Objective: to design a model for evaluating the research competence of the graduate in Imaging. Methods: a development investigation was carried out in the secondary care centers of the Holguín municipality from 2021 to 2022. Theoretical methods were used: historical-logical, analysis-synthesis, systemic-structural-functional and modeling; and empirical: documentary analysis and questionnaire to graduates in Imaging. To evaluate the model, the criteria of 10 specialists with recognized prestige in care centers were used. The indicators were relevance, usefulness, feasibility. Results: insufficiencies in the researching competence were found, evidenced in professional performance. An evaluation model composed of two subsystems was developed: functional theory and contextualization; from their relationships becomes a new quality that is expressed in the improvement of professional researching performance for the solution of technological and biomedical problems. Conclusions: the two subsystems that make up the research competence evaluation model have a coordination relationship. The specialists valued it as pertinent, useful and feasible to be applied.

Evaluación del impacto de la especialidad Oftalmología en el desarrollo docente de sus egresados / Assessment of the impact of the Ophthalmology specialty on the teaching development of its graduates

Fundamento: la evaluación del impacto en el contexto de la educación superior es el proceso mediante el cual se valoran los cambios que ocurren en el egresado por influencia del programa, un tiempo después de aplicadas las acciones formativas. Objetivo: evaluar el impacto de la especialidad Oftalmología en el desarrollo docente de sus egresados en la Facultad de Ciencias Médicas "Mariana Grajales Coello" de Holguín. Métodos: se realizó un estudio de evaluación con enfoque mixto y de corte transversal en el campo del posgrado académico, en el período enero 2021-junio 2022. Se aplicaron métodos teóricos y empírico: cuestionario para obtener información sobre la percepción de los egresados respecto al impacto de la especialidad en su preparación docente. El procesamiento incluyó análisis de frecuencias relativas, índice de posición, la correlación elemento escala y el índice de Cronbach para la confiabilidad. Resultados: las subdimensiones aportes al dominio de las categorías de la didáctica, preparación en el trabajo metodológico, preparación en la organización y dirección del trabajo docente calificaron de Alto el impacto de la especialidad en la preparación docente de los egresados. Además, hubo 47 % de participación en la ejecución de actividades docentes de pregrado y posgrado después de haber cursado la especialidad. Conclusiones: la percepción de los egresados evidenció el alto impacto de la especialidad Oftalmología en su preparación docente, componente esencial en la educación médica para la calidad del proceso docente educativo.

Background: impact evaluation in the context of higher education is the process through which the changes that occur in the graduate due to the influence of the program are assessed, sometime after the training actions have been applied. Objective: to assess the impact of the Ophthalmology specialty on the teaching development of its graduates at "Mariana Grajales Coello" Faculty of Medical Sciences in Holguín. Methods: an evaluation study was carried out with a mixed and cross-sectional approach in the field of academic postgraduate studies, from January 2021 toJune 2022. Theoretical and empirical methods were applied: questionnaire to obtain information on the perception of graduates regarding the impact of the specialty on their teaching preparation. The processing included analysis of relative frequencies, position index, scale element correlation and Cronbach's index for reliability. Results: the sub dimensions contributions to the mastery of the categories of didactics, preparation in methodological work, preparation in the organization and direction of teaching work rated the impact of the specialty on the teaching preparation of graduates as High. In addition, there was 47% participation in the execution of undergraduate and graduate teaching activities after having completed the specialty. Conclusions: the perception of the graduates evidenced the high impact of the Ophthalmology specialty on their teaching preparation, an essential component in medical education for the quality of the educational teaching process.

Perfil dos fonoaudiólogos com formação em motricidade orofacial no Brasil / Profile of speech therapists trained in orofacial myology in Brazil

RESUMO Objetivo Caracterizar o perfil do fonoaudiólogo brasileiro com formação especializada em motricidade orofacial (MO). Métodos Estudo descritivo e exploratório, transversal, de abordagem quantitativa, realizado entre setembro 2022 e fevereiro 2023, com parceria do Conselho Federal de Fonoaudiologia. Participaram 87 fonoaudiólogos com formação em MO. Resultados Evidenciou-se predominância feminina, faixa etária entre 41 e 50 anos e tempo de formação especializada em MO entre 16 e 20 anos; maioria com título de especialista e da Região Sudeste do Brasil, atuando em consultórios/ambulatórios e/ou clínicas, com ações interdisciplinares com Medicina e Odontologia, abrangendo adultos e crianças, principalmente na rede privada. Prevaleceram os domínios da MO quanto à reabilitação de estruturas moles e hábito oral e maior uso de tecnologias: leve - acolhimento e assistência; leve-dura - avaliação e terapia e dura - fotobiomodulação. Conclusão Os fonoaudiólogos brasileiros com formação especializada em MO, participantes do estudo, são, em sua maioria, mulheres com mais de 41 anos de idade, que detêm titulação de especialista, com práticas nos vários domínios e níveis de tecnologia da área, principalmente em diagnóstico e reabilitação dos distúrbios miofuncionais orofaciais.

ABSTRACT Purpose To characterize the profile of Brazilian speech therapists with specialized training in orofacial myology (OM). Methods Descriptive and exploratory, cross-sectional study, with a quantitative approach, carried out between September 2022 and February 2023, in partnership with CFFa. Eighty-seven speech therapists with specialized training in OM participated. Results showed female predominance, age between 41 and 50 years, and time of specialized training in OM between 16-20 years; most with specialist titles in the Southeast of Brazil. Most work in offices/outpatient clinics and/or clinics with interdisciplinary actions with Medicine and Dentistry; seeing adults and children, mainly in a private sector. As to OM domains there was a predominance of rehabilitation of soft structures and oral habits, and most use technologies: light - reception and assistance, light-hard - evaluation and therapy, and hard - photobiomodulation (40.2%). Conclusion The Brazilian speech therapists with specialized training in OM participating in the study are mostly women over 41 years old, who hold the title of specialists, and carry out practices in various domains and levels of technology in the area, with a predominance of diagnosis and rehabilitation of oromyofunctional disorders.

Perfil dos secretários municipais de Saúde do Brasil: um panorama de três décadas / Perfil de los secretarios de salud municipales en Brasil: un panorama de tres décadas / Profile of municipal managers of healthcare in Brazil: an overview of three decades

Resumo Os secretários municipais de saúde são atores estratégicos na construção e governança do SUS. Neste estudo, foi realizada uma análise comparativa do perfil dos secretários municipais ao longo de três décadas (1996, 2006 e 2017), com base em dados de três inquéritos transversais realizados em âmbito nacional, por meio de questionários estruturados direcionados para todos os secretários do país. A análise evidenciou aumento da participação feminina, maior diversidade étnica e racial e maior qualificação profissional dos gestores, além da renovação do perfil geracional, mas ainda com predomínio de homens brancos e importantes diferenças regionais. Foi observado avanço da democratização desses espaços de gestão, mas permanece o desafio de tornar a máquina pública mais representativa do conjunto da sociedade brasileira.

Resumen: Les secretarios municipales de salud son actores estratégicos en la construcción del SUS (Sistema Único de Salud) y participan activamente en la gobernanza del sistema. El análisis comparativo del perfil de los secretarios municipales a lo largo de tres décadas (1996, 2006 y 2017) se realizó utilizando la base de datos de tres encuestas transversales realizadas a nivel nacional con cuestionarios estructurados dirigidos a todos los secretarios municipales de salud del país. El aumento de la participación femenina, la mayor diversidad en términos étnicos y raciales, mayor cualificación profesional de los gestores, además de la renovación del perfil generacional, reitera el avance de la democratización de estos espacios de gestión. A pesar de la renovación del perfil durante la construcción del SUS, queda el desafío de hacer que la máquina pública sea más representativa de la sociedad brasileña en su conjunto.

Abstract Municipal health secretaries are strategic actors in the construction of the Brazilian national health system - SUS, actively participating in the system's governance. The comparative analysis of the profile of municipal secretaries over three decades (1996, 2006, and 2017) was carried out using the database of three cross-sectional surveys carried out at the national level with structured questionnaires aimed at all municipal health secretaries in the country. The increase in female participation, greater diversity in ethnic and racial terms, greater professional qualification of managers, and the renewal of the generational profile, reiterates the advance of the democratization of these management spaces. Despite the renewal of the profile during SUS's construction, the challenge remains to make the public machine more representative of Brazilian society as a whole.

Myoid gonadal stromal tumor, a case report with review of the literature

The diagnosis of myoid gonadal stromal tumor (MSGT) can represent a difficult challenge, both for the extreme rarity of this neoplasm and for the clinical?radiological characteristics similar to other neoplasms of the testicle. The case management we present suggests how a complete differential diagnosis can be obtained by integrating ultrasonographic and pathological data.

Sedentarismo laboral en distintos contextos ocupacionales en México: prevalencia y factores asociados / Sedentary work in different occupational contexts in Mexico: prevalence and associated factors

Resumen: Objetivo: Analizar la prevalencia de sedentarismo laboral en diferentes contextos ocupacionales y estimar los factores asociados de acuerdo con el sector de actividad económica. Material y métodos: Análisis secundario de datos de la Encuesta Nacional de Ocupación y Empleo (ENOE); se identificó la ocupación y se clasificó en cuatro categorías. La variable dependiente fue el sedentarismo laboral; las variables independientes fueron sexo, edad, escolaridad, ingreso, zona de residencia urbana del trabajador, formalidad laboral y región socioeconómica. Los factores asociados se estimaron mediante regresión logística múltiple por sector de actividad económica. Resultados: La mayor prevalencia del sedentarismo laboral se encontró en el sector de servicios (43%, IC95%: 42.3-43.6). Los factores asociados fueron nivel de estudios superior, mayores ingresos, ser mujer y trabajar en el sector formal. Conclusiones: La prevalencia de sedentarismo laboral es alta en sectores productivos estratégicos, por lo que es necesario considerar los factores de riesgo identificados en este trabajo para establecer estrategias de mitigación.

Abstract: Objective: To analyze the prevalence of sedentary work in different occupational contexts and to estimate the associated factors to economic activity sector. Materials and methods: Secondary analysis of the Occupation and Employment National Survey (ENOE, in Spanish) was conducted. Occupation was classified into four categories. Sedentary work was the dependent variable; the independent variables were sex, age, education, income, inhabitant of urban area, work formality and socioeconomic region. The associated factors were estimated using multiple logistic regression by economic activity sector. Results: The highest prevalence of sedentary work was found in services sector (43%, 95%CI= 42.3-43.6). The associated factors were college degree, higher income, being a woman and working in the formal sector. Conclusions: Sedentary work has a high prevalence in strategic productive sectors. It is necessary to consider the risk factors identified here to establish mitigation strategies.

La educación médica posgraduada en el enfrentamiento a la COVID-19 en Villa Clara, Cuba / Postgraduate medical education in the confrontation against COVID-19 in Villa Clara, Cuba

RESUMEN Fundamento: capacitar a los trabajadores del sistema de salud y otros sectores en temas relacionados con la COVID-19 resulta necesario para enfrentar con éxito la pandemia. Objetivo: describir el comportamiento del proceso de capacitación sobre el nuevo coronavirus en la provincia Villa Clara durante el año 2020. Métodos: se realizó un estudio descriptivo transversal en la Universidad de Ciencias Médicas de Villa Clara entre febrero-octubre 2020 para lo cual se revisó la documentación existente en la Dirección de Posgrado y en la Secretaria General. La información obtenida se analizó a través de la estadística descriptiva. Resultados: se realizaron diversas actividades de superación posgraduada dirigidas al personal de la salud; en una primera etapa se logró capacitar al 98,59 %, en otros momentos resultaron preparados 293 055 personas de varios organismos y organizaciones. Se efectuaron talleres relacionados con los protocolos de actuación, medidas de bioseguridad y otras acciones. Para garantizar la atención efectiva en el cumplimiento de misiones en el territorio nacional e internacional, se graduaron 54 médicos y 287 licenciados en Enfermería en un diplomado sobre Bioseguridad, más 54 técnicos en Enfermería en un entrenamiento sobre riesgo biológico. Conclusiones: la actualización del personal del sistema de salud y de otros sectores ha garantizado un adecuado enfrentamiento a la pandemia, lo cual ha permitido que en el período estudiado, esta provincia se mencione entre las que han logrado un mayor control de la enfermedad en Cuba.

ABSTRACT Background: training workers in the health system and other sectors on issues related to COVID-19 is necessary to successfully face the pandemic. Objective: to describe the behavior of the training process on the new corona virus in Villa Clara province during 2020. Methods: a cross-sectional descriptive study was carried out at Villa Clara University of Medical Sciences from February to October 2020, so the existing documentation in the Postgraduate Department and the General Secretariat was reviewed. The information obtained was analyzed through descriptive statistics. Results: various postgraduate improvement activities were carried out aimed at health personnel; In the first stage, 98.59% were trained, at other times 293,055 people from various agencies and organizations were trained. Workshops related to action protocols, biosafety measures and other actions were held. To guarantee effective care in the fulfillment of missions in the national and international territory, 54 doctors and 287 graduates in Nursing graduated from a diploma course on Biosafety, plus 54 Licensed Practical Nurses graduated from a training course on biological risk. Conclusions: the updating of the health system personnel and of other sectors has guaranteed an adequate confrontation with the pandemic, which has allowed that in the period studied, this province is considered among those that have achieved greater control of the disease in Cuba.

Morphological description of extrinsic muscles of the thoracic limb in a specimen of pudu (Pudu puda) / Descripción morfológica de la musculatura extrínseca del miembro torácico de un espécimen de pudú (Pudu puda)

SUMMARY: The pudu (Pudu puda) is classified as an artiodactyl of the Cervidae family. It is a native species found in Argentina and Chile. It is estimated that its population has been substantially reduced due to several causes, such as loss of forests, predation, hunting, and vehicle accident. Therefore, this species is protected due to its vulnerable conservation status. The extrinsic muscles of the thoracic limb have great importance in the biomechanical functionality of the suspension of the limb, neck, and head, as well as participating in the movement of the thoracic wall and thoracic limb. The objective of the present study is to describe the extrinsic musculature of the thoracic limb of a specimen of pudu, comparing the results with those described for domestic ruminants in the classical anatomical bibliography. Basic procedures: All extrinsic muscles were analyzed, describing shape, distribution, origin, and insertion. The results indicate that the pudu specimen has anatomical characteristics similar to domestic ruminants; however, some differences should be considered. Main findings: The brachiocephalicus muscle has an evident clavicular intersection that separates it into cleidobrachialis, cervicalis, and mastoideus pars. The pectoralis superficialis muscle has two distinct and independent pars, and the pectoralis profundus muscle has a partial fusion with the latissimus dorsi and cutaneous trunci muscles. The subclavius muscle is small and has an elongated shape and goes deep into the cephalic vein, just at the point it is a tributary of the external jugular vein. The results of this study present specific anatomical features of Pudu puda providing novel reference information and expanding scientific knowledge of this scarcely studied wild species.

RESUMEN: El pudu (Pudu puda) se clasifica como un artiodáctilo de la familia Cervidae. Es una especie nativa que se encuentra en Argentina y Chile y se estima que su población se ha reducido sustancialmente debido a varias causas, tal como la pérdida de bosques, depredación, caza y accidentes de vehículo. Debido a lo anterior esta especie está protegida por su estado de conservación vulnerable. Los músculos extrínsecos del miembro torácico tienen gran importancia en la funcionalidad biomecánica de la suspensión del miembro, el cuello y la cabeza, además de participar en el movimiento de la pared torácica y el miembro torácico. El objetivo del presente estudio es describir la musculatura extrínseca del miembro torácico de un ejemplar de pudu, comparando los resultados con los descritos para rumiantes domésticos en la bibliografía anatómica clásica. Se analizaron todos los músculos extrínsecos, describiendo la forma, distribución, origen e inserción. Los resultados indican que el espécimen de pudu tiene características anatómicas similares a las de los rumiantes domésticos; sin embargo, deben tenerse en cuenta algunas diferencias. Hallazgos principales: El músculo braquiocefálico tiene una interección clavicular evidente que lo separa en pars cleidobraquial, cervical y mastoideo. El músculo pectoral superficial tiene dos porciones distintas e independientes, y el músculo pectoral profundo tiene una fusión parcial con los músculos latissimus dorsi y cutáneo del tronco. El músculo subclavio es pequeño y tiene una forma alargada y se ubica profundamente a la vena cefálica, justo en el punto en el que es un afluente de la vena yugular externa. Los resultados de este estudio presentan características anatómicas específicas de Pudu puda proporcionando información de referencia novedosa y ampliando el conocimiento científico de esta especie silvestre escasamente estudiada.

Diversity of white spot patterns in the eagle ray Aetobatus laticeps (Myliobatiformes: Aetobatidae) in the north Pacific coast of Costa Rica / Diversidad de patrones de manchas blancas de Aetobatus laticeps (Myliobatiformes: Aetobatidae) en la costa del Pacífico Norte de Costa Rica

Introduction: The Pacific white-spotted eagle ray Aetobatus laticeps, has recently separated from the Atlantic A. narinari based on both morphological and genetic evidence. This species is characterized by a dark body with numerous white spots all over its dorsal side. Considering the type, shape, number, and distribution of these natural markings as potential identifiers at the individual level, we studied the variation in the spot patterns. Objective: Describe and compare the white spot pattern (type and distribution) of individuals and evaluate their potential use as identifiers at the individual level. Methods: We analyzed 54 videos (105 subsequent extracted photos) and 19 photographic records that were taken at different sites along the Pacific coast of northern Costa Rica. Results: Seventeen distinctive types of white spots were identified across the entire dorsal side of the rays. Significant differences between each major body section (pectoral fins, back, head, and pelvic fins) were found in the type and frequency of white spots. The type 'single spot' was commonly distributed across the entire dorsal side, and the spot pattern on the pelvic fins was informative to identify 72 individuals. Conclusions: The analysis of the type, shape, and distribution of white spots in A. laticeps determined several combinations of white spot patterns that be used for further taxonomic description and provide potential identification of the individual for future population studies along with its distribution.

Introducción: La raya águila de manchas blancas del Pacífico, Aetobatus laticeps, se ha separado recientemente de A. narinari del Atlántico basándose en pruebas tanto morfológicas como genéticas. Esta especie se caracteriza por un cuerpo oscuro con numerosas manchas blancas en toda su parte dorsal. Considerando el tipo, la forma, el número y la distribución de estas marcas naturales como identificadores potenciales a nivel individual, estudiamos la variación en los patrones de manchas. Objetivo: Describir y comparar el patrón de manchas blancas (tipo y distribución) de individuos y evaluar su uso potencial como identificadores a nivel individual en especímenes recapturados. Métodos: Analizamos 54 videos (con 105 fotografías extraídas posteriormente) y 19 registros fotográficos que fueron tomados en diferentes sitios a lo largo de la costa pacífica del norte de Costa Rica. Resultados: Se identificaron diecisiete tipos distintivos de manchas blancas en todo el lado dorsal de los radios. Se encontraron diferencias significativas entre cada sección principal del cuerpo (aletas pectorales, espalda, cabeza y aletas pélvicas) en el tipo y frecuencia de manchas blancas. El tipo 'punto único' se distribuyó comúnmente en todo el lado dorsal, y el patrón de puntos en las aletas pélvicas fue informativo para identificar 72 individuos. Conclusiones: El análisis del tipo, la forma y la distribución de las manchas blancas en A. laticeps determinó varias combinaciones de patrones de manchas blancas que se utilizarán para una descripción taxonómica adicional y brindan una identificación potencial del individuo para futuros estudios de población a lo largo de su distribución.

Intelligent Screening of Pieces of Chinese Medicine Based on BMFnet-WGAN / 中国实验方剂学杂志

Objective:To explore the feasibility of machine vision and deep learning methods in intelligent screening of pieces of Chinese medicine， so as to meet the needs of modern screening of pieces of Chinese medicine and overcome the problems of strong subjectivity and low efficiency in traditional screening based on manual experience. Method:An image set containing 11 125 images for 60 kinds of pieces of Chinese medicine was constructed， and the network architectures for high- and low-frequency feature learning were designed. Specifically， the parallel convolutional network was employed to obtain the low frequency feature and the deep multi-scale convolutional neural network to uncover the high-frequency feature. The semantic network was used to realize the feature learning mode with generalization ability. In this study， Wasserstein distance was introduced into the generative adversarial networks （GANs） to complete the screening of pieces of Chinese medicine， and the conditional parameters were added to the generation and discrimination networks to make the network training more reliable and improve the accuracy of identification. Result:The experiment results showed that when the ratio of training samples to test samples was greater than 6∶4， the identification accuracy of pieces of Chinese medicine was relatively stable. The identification accuracy of images captured in different states and environments by bi-view multi-feature network Wasserstein generative adversarial network （BMFnet-WGAN） reached up to 85.9% on average and the stability was high， demonstrating that BMFnet-WGAN was superior to VGG-Net and AlexNet. Conclusion:The BMFnet-WGAN method enables the revealing of rich and typical characteristics of decoction pieces and the introduced WGAN model and Wasserstein distance make the network training more reliable. The resulting accuracy， robustness， and batch effects in the intelligent screening of pieces of Chinese medicine were good， which has provided the technical support for the sorting and quantitative quality screening of pieces of Chinese medicine.

Perfil sociodemográfico e laboral dos profissionais de enfermagem que assistem crianças e adolescentes com câncer / Perfil socio demográfico y laboral de profesionales de enfermería que ayudan a niños y adolescentes con cáncer / Socio-demographic and labor profile of nursing professionals who assist children and adolescents with cancer

Objetivos: Descrever e analisar o perfil sociodemográfico e laboral dos profissionais de enfermagem que prestam assistência a crianças e adolescentes com câncer. Método: Estudo transversal, analítico, exploratório, realizado em hospital universitário entre outubro de 2016 e março de 2017. O instrumento de coleta de dados utilizado foi um questionário sociodemográfico e laboral, desenvolvido para esse estudo. Resultados: A maioria dos participantes foram mulheres, com idade entre 20 e 59 anos, casadas, com filhos, com pelo menos graduação concluída e mais de 10 anos de atuação. Frequentemente estavam alocadas em função de nível médio, com número de pacientes por plantão amplamente superior ao preconizado pela legislação, além de carga horária semanal extensa e até triplas jornadas. Muitos deles já vivenciaram doenças graves seja com eles próprios ou familiares. Considerações Finais: Tornou-se evidente que a assistência de enfermagem em oncopediatria é cercada por inúmeras singularidades e que o perfil dos profissionais de enfermagem influencia em questões que envolvem desde as condições de trabalho da enfermagem, suas práticas e se somam as condições frágeis inerentes ao estado de saúde das crianças e adolescentes com câncer e seus familiares(AU)

Objectives: To describe and analyze the sociodemographic and labor profile of nursing professionals who provide care to children and adolescents with cancer. Method: Crosssectional, analytical, exploratory study, carried out in a university hospital between October 2016 and March 2017. The data collection instrument used was a sociodemographic and labor questionnaire, developed for this study. Results: Most participants were women, aged between 20 and 59 years, married, with children, with at least graduation and more than 10 years of experience. They were often allocated as a function of medium level, with the number of patients per shift much higher than that recommended by law, in addition to an extensive weekly workload and even triple shifts. Many of them have already experienced serious illnesses either with themselves or with family members. Final Considerations: It became evident that nursing care in pediatric oncopediatrics is surrounded by numerous singularities and that the profile of nursing professionals influence issues that involve from the working conditions of nursing, their practices and add to the fragile conditions inherent to the health state of children and adolescents with cancer and their families(AU)

Objetivos: describir y analizar el perfil sociodemográfico y laboral de los profesionales de enfermería que atienden a niños y adolescentes con cáncer. Método: estudio transversal, analítico, exploratorio realizado en un hospital universitario entre octubre de 2016 y marzo de 2017. El instrumento de recolección de datos utilizado fue un cuestionario sociodemográfico y laboral, desarrollado para este estudio. Resultados: la mayoría de los participantes fueron mujeres, con edades entre 20 y 59 años, casadas, con hijos, con al menos graduación y más de 10 años de experiencia. A menudo se asignaban en función del nivel medio, con un número de pacientes por turno muy superior al recomendado por la ley, además de una extensa carga de trabajo semanal e incluso turnos triples. Muchos de ellos ya han experimentado enfermedades graves consigo mismos o con miembros de su familia. Consideraciones finales: Se hizo evidente que el cuidado de enfermería en oncopediatría pediátrica está rodeado de numerosas singularidades y que el perfil de los profesionales de enfermería incide en cuestiones que involucran desde las condiciones laborales de la enfermería, sus prácticas y se suman a las frágiles condiciones inherentes al estado de salud de niños y adolescentes cáncer y sus familias(AU)

Down the rabbit hole: a quick guide for histopathology description / Descendo a toca do coelho: um guia rápido para descrição histopatológica

Histopathology is an old science that is still currently utilized for disease diagnosis and research. The routinely processed histologic slides stained with hematoxylin and eosin are still used worldwide in most if not every histopathology laboratory. The technique is inexpensive, quick to perform, and allows the diagnosis of a fantastic variety of tissue changes and diseases. Skills in description and interpretation in histopathology are a craft that can be learned by repeatedly and systematically observing simple rules. In this article, we offer a few advices to help trainees in veterinary pathology at the start of their careers. Those advices are drawn from our experience in the diagnostic pathology routine and from the veterinary pathology literature. To enhance the understanding of these important steps in the histopathologic description of tissues, we decided to illustrate most concepts expressed here. We hope that our effort can add a bit to the development of future pathologists. Just like Alice, let us follow the White Rabbit into his burrow for this challenging experience!(AU)

A histopatologia é uma ciência antiga, mas ainda usada para diagnosticar e investigar a patogênese de doenças. As lâminas histológicas processadas rotineiramente e coradas por hematoxilina e eosina ainda são utilizadas em virtualmente todos os laboratórios de histopatologia do mundo. A técnica não é cara, é de execução rápida e permite o diagnóstico de uma fantástica variedade de doenças. As habilidades em descrever e interpretar os achados histopatológicos é um ofício que pode ser aprendido pela observação repetida e sistemática de regras simples. Para ajudar os estudantes de patologia no início de suas carreiras, abordamos aqui algumas dessas regras, extraídas tanto de nossa experiência quanto da literatura relacionada à patologia veterinária. Para aumentar a compreensão dos tópicos, decidimos ilustrar praticamente todos os conceitos expressados neste manuscrito. Esperamos que nosso esforço possa contribuir um pouco para o desenvolvimento de aspirantes a patologistas. Assim como Alice no País das Maravilhas, vamos seguir o coelho branco até a sua toca para essa aventura desafiadora.(AU)

Down the rabbit hole: a quick guide for histopathology description

ABSTRACT: Histopathology is an old science that is still currently utilized for disease diagnosis and research. The routinely processed histologic slides stained with hematoxylin and eosin are still used worldwide in most if not every histopathology laboratory. The technique is inexpensive, quick to perform, and allows the diagnosis of a fantastic variety of tissue changes and diseases. Skills in description and interpretation in histopathology are a craft that can be learned by repeatedly and systematically observing simple rules. In this article, we offer a few advices to help trainees in veterinary pathology at the start of their careers. Those advices are drawn from our experience in the diagnostic pathology routine and from the veterinary pathology literature. To enhance the understanding of these important steps in the histopathologic description of tissues, we decided to illustrate most concepts expressed here. We hope that our effort can add a bit to the development of future pathologists. Just like Alice, let us follow the White Rabbit into his burrow for this challenging experience!

RESUMO: A histopatologia é uma ciência antiga, mas ainda usada para diagnosticar e investigar a patogênese de doenças. As lâminas histológicas processadas rotineiramente e coradas por hematoxilina e eosina ainda são utilizadas em virtualmente todos os laboratórios de histopatologia do mundo. A técnica não é cara, é de execução rápida e permite o diagnóstico de uma fantástica variedade de doenças. As habilidades em descrever e interpretar os achados histopatológicos é um ofício que pode ser aprendido pela observação repetida e sistemática de regras simples. Para ajudar os estudantes de patologia no início de suas carreiras, abordamos aqui algumas dessas regras, extraídas tanto de nossa experiência quanto da literatura relacionada à patologia veterinária. Para aumentar a compreensão dos tópicos, decidimos ilustrar praticamente todos os conceitos expressados neste manuscrito. Esperamos que nosso esforço possa contribuir um pouco para o desenvolvimento de aspirantes a patologistas. Assim como Alice no País das Maravilhas, vamos seguir o coelho branco até a sua toca para essa aventura desafiadora.