Assessing Self-Concept in Children (Aged 5-7) with Functional Dyslalia.

Language not only plays a powerful role in human life, as it is also a crucial factor in our minds. It shapes our personality, memory and even the way in which we see the world, as well as playing a fundamental role in the building of self-concept and self-esteem. Having a good self-concept, that is, knowing one's own qualities and strengths, will, in turn, promote good self-esteem. The aim of this research was to analyze self-concept in 50 children (aged 5-7) with functional dyslalia in the city of Granada (Spain). A quantitative approach was taken, with a non-experimental design; it was descriptive, cross-sectional and correlational. The Perception of Child Self-concept Scale (PCS), a Spanish scale, was used. In general, the children who were interviewed showed a medium level of self-concept. It is noteworthy that differences were found in the average scores on the scale according to the sex of the children, with girls showing a higher level of self-concept than boys. Participants scored higher on Factor 1, family attachment, followed by Factor 3, feelings, with the values of both these factors decreasing with age. On the other hand, lower average scores were found for Factor 2, environment, and Factor 4, autonomy. It was found that self-concept was higher in young children (five-year-old children) as well as in those who studied in rural areas. Finally, guidelines for improvement were provided. Self-concept is a fundamental aspect of personality, but it is not innate; it develops and evolves.

ICT training for educators of Granada for working with people with autism.

Background: Innovative methodologies based on Information and Communication Technology (ICT) are a tested and motivating option for working with people with autism. Their use, however, should not be indiscriminatory and arbitrary, but didactic and appropriate. Objective: We aimed to discover the training in ICT they had, its frequency of use, and the types of digital resources that they used. Methods: We administered the questionnaire, "Demands and Potentials of ICT and Apps for Assisting People with Autism" to 310 educators in the city of Granada (Spain). The participants belonged to schools and associations that worked with people with autism. Adopting a quantitative-type study, we carried out descriptive analyses (frequencies, mean, mode, and standard deviation). Having confirmed that the data did not follow a normal distribution (Kolmogorov-Smirnov test for samples of >50 participants), we carried out non-parametric inferential and intrafactorial correlation analyses. We also calculated the effect size. Results: The educators revealed that they had ICT training for working with people with autism, but not enough. This suggests that there is still a need to improve the digital competence of these professionals. Strong, direct and significant correlations were found between ICT training and the frequency with which they were used. There were also statistically significant differences according to sex, gender, age, type of institution, and type of educator. The educators who worked as Therapeutic Pedagogy teachers and those who worked in Special Education schools were shown to be more competent than the rest in educational technology applied to people with autism. Conclusions: The results, which were not wholly positive since ICT training should be better and have achieved higher scores, revealed that there is a foundation in ICT education but it needs to be heightened and improved with greater knowledge and more practical experience.

Opinions, training and requirements regarding ICT of educators in Florence and Granada for students with functional diversity.

Information and communication technology (ICT) is a means of learning for people with functional diversity (FD), in the context of both formal and non-formal education. These digital options favor their inclusion, participation and motivation, so having competent professionals in the field of educational technology is crucial for the full development of this population. Within this framework, the opinion, training and requirements regarding ICT of 809 educators in Florence (Italy) and Granada (Spain) were analyzed, following a quantitative study, with a non-experimental, descriptive, cross-sectional and comparative design. Descriptive statistics (mean, standard deviation and mode) and frequencies were used. After checking the normality of the data (Kolmogórov-Smirnov test), inferential analyses were performed, applying Student's t- test and one-factor ANOVA, calculating the effect size (Cohen's d and eta squared). Statistically significant differences were found according to city of origin, gender, and years of experience with students with FD. The results point to the need for different educators to have sufficient technological training, as despite being aware of the functionalities of ICT and having a favorable opinion of them, resources and knowledge about their use fall short of what is desirable.

ICT Training Perception of Professionals in Functional Diversity in Granada.

Training in Information and Communication Technologies (ICTs) has become very valuable in the current educational panorama, given the proliferation of digital resources available in the formal and non-formal education context. Fortunately, the field of attention to diversity has also benefited from it. For this reason, it is essential that the professionals who attend to people with functional diversity have a good attitude towards them, as well as training in accordance with their requirements. The aim of this study was to analyse how professionals in Granada (Spain) perceived their ICT training. A total of 404 specialists who worked in the field of attention to diversity were interviewed. In general, participants showed a favourable opinion towards ICT but they expressed a medium-low perception of their digital training. Nevertheless, these results are encouraging, as younger teachers showed a more favourable opinion and training towards ICT. In the long term, this will be a generation that is more educated and aware of the benefits, applicability and usefulness of these resources for working with people with functional diversity.

Real-World Outcomes of Belantamab Mafodotin for Relapsed/Refractory Multiple Myeloma (RRMM): Preliminary Results of a Spanish Expanded Access Program (EAP).

INTRODUCTION: Belantamab mafodotin (BM) is a new anti-BCMA antibody-drug conjugate, recently approved for triple-class relapsed and refractory multiple myeloma (RRMM). We assessed real-world outcomes with BM in patients under the Spanish Expanded Access Program (EAP). METHODS: We conducted an observational, retrospective, multicenter study including RRMM patients who received ≥ 1 dose of BM (Nov 2019 to Jun 2021). The primary endpoint was overall response rate (ORR). Secondary endpoints were progression-free survival (PFS), overall survival (OS), and incidence of treatment-emergent adverse events (TEAEs). RESULTS: Thirty-three patients were included with a median of 70 years of age (range, 46-79 years). Median time from diagnosis was 71 months (range, 10-858 months). Median prior lines was 5 (range, 3-8 lines); 90% of patients were triple-/quad-/penta-refractory; 48% showed high-risk cytogenetics. Median BM doses was 3 (range 1-16 doses), with a median follow-up of 11 months (6-15 months). ORR was 42.2% (≥ VGPR, 18.2%). Median PFS was 3 months (95% CI 0.92-5.08) in the overall population, and 11 months (HR 0.26; 95% CI 0.10-0.68) for patients who achieved ≥ PR. PFS was not significantly different according to age, cytogenetic risk, and prior therapy lines. OS was 424 days (95% CI 107-740). Non-hematological TEAEs (57.6% of patients; 30.3% ≥ G3) included keratopathy (51.5%; 21.2% ≥ G3) and patient-reported vision-related symptoms (45.5%). Keratopathy was resolved in 70.6% of patients. G3 hematological TEAEs was 18.2%, thrombocytopenia (21.2%). Dose reductions due to TEAEs: 30.3%; delays: 36.4%. Treatment discontinuation causes: progression (54.5%), toxicity (non-ocular; 6%/ocular; 6% /ocular + non-ocular toxicity; 3%), death (6%), and patient's decision (3%). CONCLUSIONS: BM showed relevant anti-myeloma activity in RRMM with a manageable safety profile. These results corroborate those observed in the BM pivotal trial.

Functionality of Apps for People with Autism: Comparison between Educators from Florence and Granada.

BACKGROUND: Studies on the potential of smartphone apps for people with autism are currently increasing in number, given the large digital supply available and the benefits they offer. We analyzed the opinion of educators from Florence (Italy) and Granada (Spain) regarding the benefits and applicability of apps, frequency of their use, and the type of apps used for people with autism. METHODS: The study involved 1261 professionals, of whom 286 worked with apps, using a non-experimental quantitative design, descriptive and frequency statistics, parametric inferential analyses (Student's t and one-factor ANOVA), and calculation of the effect size (Cohen's d and eta squared) and intrafactorial correlations. RESULTS: Statistically significant differences were observed in respect of city, sex, age, years of experience, place of work, and type of teacher. The teachers from Granada found more benefits and applicability in apps, and revealed a slightly higher usage than those from Florence. CONCLUSIONS: It is an arduous but worthy task for professionals from schools and associations that work with people with autism to acquire the necessary knowledge to apply methodologies based on information and communication technology (ICT), as this will help achieve the integrated development of people with different capabilities.

Recovery of polyclonal immunoglobulins during treatment in patients ineligible for autologous stem-cell transplantation is a prognostic marker of longer progression-free survival and overall survival.

Immunoparesis is the suppression of normal polyclonal immunoglobulins and is present in most patients with newly diagnosed multiple myeloma (MM). The association of immunoparesis at diagnosis, and particularly its recovery along with treatment, with survival in patients ineligible for autologous stem-cell transplantation (ASCT) has not been well established. This retrospective study evaluated the impact of immunoparesis in 431 patients diagnosed with MM, ineligible for ASCT, with a median overall survival of 36 months [95% confidence interval (CI): 31-40]. Immunoparesis was present in 81.2% of patients at diagnosis and was associated with a trend to a worse overall response rate (ORR: 84.8% vs. 74.9%; OR 1.88 (95% CI: 0.97-3.63), shorter progression-free survival (PFS) [22.0 vs. 18.2 months; hazard ratio (HR) 0.775; 95%CI: 0.590-1.018; p = 0.066], and overall survival (OS) (45.9 vs. 34.2 months; HR 0.746; 95% CI: 0.551-1.010; p = 0.057). Twenty-four per cent of patients who had immunoparesis at diagnosis recovered polyclonal immunoglobulins in the follow-up period. Interestingly, these patients had a better ORR (96.3% vs. 68.2%; OR 12.29 (95% CI: 3.77-40.06), PFS (HR 0.703; 95CI%: 0.526-0.941; p = 0.018) and OS (HR 0.678; 95 CI%: 0.503-0.913; p = 0.011) than patients who did not recover it. In summary, restoring a healthy immune system along with first-line treatment in patients with MM, not receiving ASCT, is associated with better outcomes.

Role and effects of zinc supplementation in HIV-infected patients with immunovirological discordance: A randomized, double blind, case control study.

INTRODUCTION: It has been estimated that between 15% and 18% of patients who start antiretroviral therapy (ART) do not achieve a successful immune recovery despite complete virological suppression. In the literature this phenomenom is known as poor immune recovery or immunovirological discordance (IVD). Zinc has an immunomodulatory role associated with T lymphocytes and its supplementation could enhance immune recovery. OBJECTIVE: To determine if zinc supplementation on IVD patients prevents immune failure after 12 months of supplementation. Secondary objectives were to determine serum zinc levels in HIV patients with and without IVD and the frequency of hypozincemia in discordant patients. METHOD: We reviewed the historical record of patients under care at Arriarán Foundation. Following inclusion criteria were defined: 1) age ≥ 18 years, 2) standard ART (three effective drugs) for at least 18 months, 3) virologically suppressed for 12 months, 3) persistence of CD4 count ≤200 cells/mm3 and/or increase ≤ 80 cells/mm3 after one year of viral undetectability. A control group was assigned paired 1:1 by sex, age (± 2 years) that did achieved an increase of CD4> 350 cells/ mm3. In both groups plasma zinc levels were determined. In a later phase, patients with IVD were randomized to receive zinc (15 mg daily) versus placebo. Patients were followed for 12 months with CD4 count, viral load and zinc levels determinations every 4-6 months. RESULTS: A total of 80 patients, 40 patients with IVD criteria and 40 controls were included. 92.5% were men, and age average was 47.5 years. The median baseline CD4 was 189 cells/mm3 (71-258) in the cases vs. 552.5 cells/ mm3 (317-400) in the control group with a median increase at the end of the study of 39 cell/mm3 and 19 cell/mm3 respectively. There was no difference in baseline plasma zinc levels between both groups (81.7 + 18.1 in cases versus 86.2 + 11.0 in controls). In the 40 patients with IVD, the median absolute increase in CD4 after annual zinc supplementation was 31.5 cells/mm3 in the treated group versus 50 cells/mm3 in the placebo group, this difference being statistically not significant (p = 0.382). CONCLUSIONS: Patients with IVD have plasma zinc levels similar to those who achieve adequate immune recovery. Zinc supplementation in IVD patients showed a statistically non-significant difference in in CD4 levels between cases and controls. The results warrant a comparative study with a larger number of patients.

In vitro antileishmanial activity and iron superoxide dismutase inhibition of arylamine Mannich base derivatives.

Leishmaniasis is one of the world's most neglected diseases, and it has a worldwide prevalence of 12 million. There are no effective human vaccines for its prevention, and treatment is hampered by outdated drugs. Therefore, research aiming at the development of new therapeutic tools to fight leishmaniasis remains a crucial goal today. With this purpose in mind, we present 20 arylaminoketone derivatives with a very interesting in vitro and in vivo efficacy against Trypanosoma cruzi that have now been studied against promastigote and amastigote forms of Leishmania infantum, Leishmania donovani and Leishmania braziliensis strains. Six out of the 20 Mannich base-type derivatives showed Selectivity Index between 39 and 2337 times higher in the amastigote form than the reference drug glucantime. These six derivatives affected the parasite infectivity rates; the result was lower parasite infectivity rates than glucantime tested at an IC25 dose. In addition, these derivatives were substantially more active against the three Leishmania species tested than glucantime. The mechanism of action of these compounds has been studied, showing a greater alteration in glucose catabolism and leading to greater levels of iron superoxide dismutase inhibition. These molecules could be potential candidates for leishmaniasis chemotherapy.

Group-Level Progressive Alterations in Brain Connectivity Patterns Revealed by Diffusion-Tensor Brain Networks across Severity Stages in Alzheimer's Disease.

Alzheimer's disease (AD) is a chronically progressive neurodegenerative disease highly correlated to aging. Whether AD originates by targeting a localized brain area and propagates to the rest of the brain across disease-severity progression is a question with an unknown answer. Here, we aim to provide an answer to this question at the group-level by looking at differences in diffusion-tensor brain networks. In particular, making use of data from Alzheimer's Disease Neuroimaging Initiative (ADNI), four different groups were defined (all of them matched by age, sex and education level): G1 (N1 = 36, healthy control subjects, Control), G2 (N2 = 36, early mild cognitive impairment, EMCI), G3 (N3 = 36, late mild cognitive impairment, LMCI) and G4 (N4 = 36, AD). Diffusion-tensor brain networks were compared across three disease stages: stage I (Control vs. EMCI), stage II (Control vs. LMCI) and stage III (Control vs. AD). The group comparison was performed using the multivariate distance matrix regression analysis, a technique that was born in genomics and was recently proposed to handle brain functional networks, but here applied to diffusion-tensor data. The results were threefold: First, no significant differences were found in stage I. Second, significant differences were found in stage II in the connectivity pattern of a subnetwork strongly associated to memory function (including part of the hippocampus, amygdala, entorhinal cortex, fusiform gyrus, inferior and middle temporal gyrus, parahippocampal gyrus and temporal pole). Third, a widespread disconnection across the entire AD brain was found in stage III, affecting more strongly the same memory subnetwork appearing in stage II, plus the other new subnetworks, including the default mode network, medial visual network, frontoparietal regions and striatum. Our results are consistent with a scenario where progressive alterations of connectivity arise as the disease severity increases and provide the brain areas possibly involved in such a degenerative process. Further studies applying the same strategy to longitudinal data are needed to fully confirm this scenario.

In Vitro and in Vivo Anti-Trypanosoma cruzi Activity of New Arylamine Mannich Base-Type Derivatives.

Chagas disease is a neglected tropical disease with 6-7 million people infected worldwide, and there is no effective treatment. Therefore, there is an urgent need to continue researching in order to discover novel therapeutic alternatives. We present a series of arylaminoketone derivatives as means of identifying new drugs to treat Chagas disease in the acute phase with greater activity, less toxicity, and a larger spectrum of action than that corresponding to the reference drug benznidazole. Indexes of high selectivity found in vitro formed the basis for later in vivo assays in BALB/c mice. Murine model results show that compounds 3, 4, 7, and 10 induced a remarkable decrease in parasitemia levels in acute phase and the parasitemia reactivation following immunosuppression, and curative rates were higher than with benznidazole. These high antiparasitic activities encourage us to propose these compounds as promising molecules for developing an easy to synthesize anti-Chagas agent.

Mapping the HLA diversity of the Iberian Peninsula.

The polymorphism of HLA genes can be used to reconstruct human peopling history. However, this huge diversity impairs successful matching in stem cell transplantation, a situation which has led to the recruitment of millions of donors worldwide. In parallel to the increase of recruitment, registries are progressively relying on information from population genetics to optimize their donor pools in terms of HLA variability. In this study, the HLA data of 65,000 Spanish bone marrow donors were analyzed together with 60,000 Portuguese individuals to provide a comprehensive HLA genetic map of the Iberian Peninsula. The frequencies of many alleles were shown to vary continuously across the Peninsula, either increasing or decreasing from the Mediterranean coast to the Atlantic domain or from the Strait of Gibraltar to the Pyrenees and Bay of Biscay. Similar patterns were observed for several haplotypes. In addition, within some regions neighboring provinces share a close genetic similarity. These results outline the genetic landscape of the Iberian Peninsula, and confirm that the analysis of the HLA polymorphism may reveal relevant signatures of past demographic events even when data from donor registries are used. This conclusion stimulates future developments of the Spanish registry, presented here for the first time.

Características familiares relacionadas con el estado nutricional en escolares de la ciudad de Cartagena / Family characteristics associated with the nutritional status of schools children in the city of Cartagena

Objetivo Determinar las características familiares asociadas al estado nutricional de los niños escolarizados de la ciudad de Cartagena. Método Estudio transversal, población 104 384 niños de 6 a 10 años de la ciudad de Cartagena. Nivel de confianza 95 %, prevalencia 5,8 %, error 2 %. La muestra fue de 544 escolares. Se seleccionaron los colegios por afijación proporcional en cada una de las tres localidades de la cuidad, para un total de 21 colegios, posteriormente se seleccionaron, aleatoriamente los salones y de estos los niños hasta completar la muestra. Los instrumentos utilizados fueron la ficha y el APGAR familiar, para valorar las características familiares así como su funcionalidad y para el estado nutricional se tomaron las medidas antropométricas y se evaluaron en el programa WHO Anthro Plus. La información se procesó en el paquete estadístico Epiinfo 7. Resultados El 53,9 % de los escolares presentó un adecuado estado nutricional mientras que el 46,1 % estaban malnutridos. Las características familiares asociadas a la malnutrición infantil por exceso fueron el número de integrantes OR 0.65 (IC: 0,4-0,9) y los ingresos familiares OR 0,53 (IC: 0,3-0,7). Por su parte a la malnutrición por déficit se asoció el ingreso familiar OR 2,08 (IC: 1,1-3,9). Conclusión Las variables que mostraron asociación con el estado nutricional fueron: ingresos económicos menores/iguales al salario mínimo y número de integrantes de la familia.(AU)

Objective To determine the family characteristics associated with the nutritional status of school children in the city of Cartagena. Method A cross-sectional study involving a population of 104 384 children aged 6 to 10 in the city of Cartagena. Confidence levels were 95 % and prevalence levels were 5.8 % with 2 % error. The sample was 544 students. The schools were selected by proportional affixation in each of the three locations in the city, for a total of 21 schools. Later, the number of classrooms and the list of the students were requested. Children from these classrooms were randomly selected to complete the sample in each school. The tab and the family APGAR were the instruments used to assess the family characteristics as well as their family functionality. For nutritional status, anthropometric measurements were taken and evaluated in the WHO Anthro Plus program. The information was processed in the statistical package Epi info 7. Results 53.9 % of students had adequate nutritional status and 46.1% malnutrition. The family characteristics associated with the child malnutrition by excess are: the number of family members OR 0.65 (CI: 0.4 -0.9) and family income OR 0.53 (CI: 0.3 -0.7). Meanwhile, the malnutrition by deficit was associated only with family income OR 2.08 (CI: 1.1 -3.9). Conclusion The variables that showed association with nutritional status were: income equal to or less than the minimum wage and number of family members.(AU)

Percepción de la iniciativa Instituciones Amigas de la Mujer y la Infancia (IAMI) en Cartagena, 2012 / Perception of the Mother- and Baby-Friendly Hospital Initiative (MBFHI) in Cartagena, Colombia, 2012 / Percepção da iniciativa Instituições Amigas da Mulher e a Infância (IHAC) em Cartagena, 2012

Objetivo: Establecer el grado de percepción de la implementación de los pasos de la iniciativa Instituciones Amigas de la Mujer y la Infancia (IAMI) en establecimientos de salud de la ciudad de Cartagena en 2012. Materiales y métodos: Estudio descriptivo, cuya población estuvo constituida por 21 instituciones públicas y privadas, la muestra fue de 8 instituciones seleccionadas aleatoriamente. Participó todo el personal capacitado en iniciativa de hospitales amigos de los niños que labora en las instituciones. La información fue analizada a partir de 2 instrumentos: "Evaluación del Grado de implementación de la estrategia Iniciativa de hospitales amigos de los niños" y "Formulario de autoapreciación y aplicación en instituciones hospitalarias y ambulatorios". Resultados: El grado de implementación de la iniciativa varía dependiendo de las características de la atención de la institución valorada. En el ámbito hospitalario, se encontró que disponer de una política de apoyo a la infancia, capacitación del personal -en este aspecto-, así como garantizar la calidad del parto, el inicio precoz de lactancia materna (LM) y su práctica, entre otros, (pasos 1, 2, 4 y 6) tuvieron un grado de implementación medio. Mientras que la conformación de grupos de apoyo (paso 10) presentó un grado bajo. En el nivel ambulatorio fueron los pasos 1, 4, 5 y 10 sobre los que se obtuvo un grado medio, los demás pasos mantuvieron un grado alto. Ninguna institución ofrece chupos o biberones. Conclusión: La iniciativa Instituciones Amigas de la Mujer y la Infancia en las instituciones de salud se encuentra en un grado de implementación alto y medio en los niveles de atención ambulatoria y alto, medio y bajo en el nivel hospitalario.

Objective: To establish the perception level of the implementation of the BFHI initiative stEPS in health institutions in Cartagena in 2012. Material and methods: Descriptive study in a population constituted by 21 public and private institutions, as well as all trained personnel in the initiative of baby friendly hospitals ,who work in these institutions, with a sample of 8 institutions. Information was collected by means of two instruments: "Assessment of the implementation levels of the initiative baby friendly hospitals' strategy" and "Application form of self-perception and application in hospitals and in ambulatory level". Results: The implementation level varies depending on the characteristics of each assessed institution. At hospital level the stEPS number 1, 2, 4 y 6 showed a middle implementation level, while the step number 10 indicated a low level. While at ambulatory level the stEPS number 1, 4, 5 and 10 presented a middle level, the others stEPS showed a high level. No institution offers pacifiers or baby bottles. Conclusion: Implementation of the BFHI initiative in health institutions is in a high and middle level in ambulatory institutions, while in hospitals it is in high, middle and low levels.

Objetivo: estabelecer o grau de percepção da implementação dos passos da iniciativa Instituições Amigas da Mulher e a Infância (IHAC) em estabelecimentos de saúde da cidade de Cartagena em 2012. Materiais e métodos: estudo descritivo, cuja população esteve constituída por 21 instituições públicas e privadas, a amostra foi de 8 instituições selecionadas aleatoriamente. Nelas participou tudo o pessoal capacitado em iniciativa de hospitais amigos das crianças que trabalha nas instituições. A informação foi analisada a partir de 2 instrumentos: "Avaliação do Grau de implementação da estratégia iniciativa de hospitais amigos das crianças" e "Formulário de auto-apreciação e aplicação em instituições hospitaleiras e ambulatórios". Resultados: o grau de implementação da iniciativa varia, dependendo das características da atenção da instituição valorada. No âmbito hospitaleiro, encontrou-se que dispor de uma política de apoio à infância, capacitação do pessoal -neste aspecto-, assim como garantir a qualidade d parto, o início precoce do aleitamento materno (AM) e sua prática, entre outros, (passos 1, 2, 4 e 6) tiveram um grau de implementação médio. Enquanto que a conformação de grupos de apoio (passo 10) apresentou um grau baixo. No nível ambulatório foram os passos 1, 4, 5 e 10 sobre os que se obteve um grau médio, os demais passos mantiveram um grau alto. Nenhuma instituição oferece chupetas ou biberões. Conclusão: a iniciativa Instituições Amigas da Mulher e a Infância nas instituições de saúde encontra-se em um grau de implementação alto e médio nos níveis de atenção ambulatória e alto, médio e baixo no nível hospitaleiro.

Lagged and instantaneous dynamical influences related to brain structural connectivity.

Contemporary neuroimaging methods can shed light on the basis of human neural and cognitive specializations, with important implications for neuroscience and medicine. Indeed, different MRI acquisitions provide different brain networks at the macroscale; whilst diffusion-weighted MRI (dMRI) provides a structural connectivity (SC) coincident with the bundles of parallel fibers between brain areas, functional MRI (fMRI) accounts for the variations in the blood-oxygenation-level-dependent T2(*) signal, providing functional connectivity (FC). Understanding the precise relation between FC and SC, that is, between brain dynamics and structure, is still a challenge for neuroscience. To investigate this problem, we acquired data at rest and built the corresponding SC (with matrix elements corresponding to the fiber number between brain areas) to be compared with FC connectivity matrices obtained by three different methods: directed dependencies by an exploratory version of structural equation modeling (eSEM), linear correlations (C) and partial correlations (PC). We also considered the possibility of using lagged correlations in time series; in particular, we compared a lagged version of eSEM and Granger causality (GC). Our results were two-fold: firstly, eSEM performance in correlating with SC was comparable to those obtained from C and PC, but eSEM (not C, nor PC) provides information about directionality of the functional interactions. Second, interactions on a time scale much smaller than the sampling time, captured by instantaneous connectivity methods, are much more related to SC than slow directed influences captured by the lagged analysis. Indeed the performance in correlating with SC was much worse for GC and for the lagged version of eSEM. We expect these results to supply further insights to the interplay between SC and functional patterns, an important issue in the study of brain physiology and function.

[Family characteristics associated with the nutritional status of schools children in the city of Cartagena]. / Características familiares relacionadas con el estado nutricional en escolares de la ciudad de Cartagena.

Objective To determine the family characteristics associated with the nutritional status of school children in the city of Cartagena. Method A cross-sectional study involving a population of 104 384 children aged 6 to 10 in the city of Cartagena. Confidence levels were 95 % and prevalence levels were 5.8 % with 2 % error. The sample was 544 students. The schools were selected by proportional affixation in each of the three locations in the city, for a total of 21 schools. Later, the number of classrooms and the list of the students were requested. Children from these classrooms were randomly selected to complete the sample in each school. The tab and the family APGAR were the instruments used to assess the family characteristics as well as their family functionality. For nutritional status, anthropometric measurements were taken and evaluated in the WHO Anthro Plus program. The information was processed in the statistical package Epi info 7. Results 53.9 % of students had adequate nutritional status and 46.1 % malnutrition. The family characteristics associated with the child malnutrition by excess are: the number of family members OR 0.65 (CI: 0.4 -0.9) and family income OR 0.53 (CI: 0.3 -0.7). Meanwhile, the malnutrition by deficit was associated only with family income OR 2.08 (CI: 1.1 -3.9). Conclusion The variables that showed association with nutritional status were: income equal to or less than the minimum wage and number of family members.

Conocimientos sobre VIH/SIDA en adolescentes de una universidad en Cartagena – Colombia, 2011 / Conhecimentos sobre Vih/Aids em Adolescentes de uma Universidade em Cartagena – Colômbia, 2011 / Undergraduate Teenage Students’ Knowledge About Hiv/Aids in a University in the City of Cartagena Colombia, 2011

Objetivo: Determinar el nivel de conocimientos sobre VIH/SIDA en adolescentes de pregrado en modalidad presencial de una universidad en Cartagena de Indias 2011-II. Materiales y Métodos: Estudio descriptivo. Población 8706 estudiantes. Muestra 919 estudiantes. La información fue recolectada a través de “escala ECOVIH”, se califica de 0 a 10 puntos, a mayor puntaje mayor conocimiento, y una encuesta que valoró las características sociodemográficas. Error 3% y nivel de confianza 95%. Resultados: La edad promedio fue 18,4 años, las edades oscilaron entre 15 y 19 años; el 50,7% son mujeres y el 49,3% hombres. El 70% de los encuestados tienen “conocimientos regulares”, “conocimientos deficientes” el 19,8% y solo el 11,4% “buen nivel de conocimientos”. Las mujeres tienen mejores conocimientos que los hombres logrando un promedio de 5,8 y 4,8 respectivamente. Las áreas que obtuvieron mejores puntajes fueron: área de la salud con 6,8, ciencias económicas y exactas 5,2 y humanidades y educación 5,3. Conclusión: Los adolescentes presentan un nivel regular de conocimientos sobre VIH/SIDA, demostrando pocos conocimientos respecto a la transmisión oral, y conocimientos casi nulos acerca de los efectos de la infección. Las mujeres tienen mejores conocimientos respecto a los hombres, ubicándolas en un nivel regular y los hombres en nivel deficiente. El área de la salud presenta mejor nivel de conocimientos respecto a las demás; sin embargo, todas las áreas de estudio se clasificaron en el nivel regular. Los estudiantes de los programas de química, matemáticos y economía presentan conocimientos deficientes.

Objective: To determine the level of knowledge about HIV / AIDS in adolescents of undergraduate programs in on campus education at a university in Cartagena de Indias, Colombia during the second academic period of 2011. Materials and Methods: A descriptive study with a population of 8,706 students. Sample constituted by 919 students. The information was collected by means of “ECOVIH scale” which is scored from 0 to 10 points, the higher the score, the more knowledge, and a survey that evaluated sociodemographic characteristics. Error was 3% and level of confidence was 95%. Results: Mean age was 18.4 years; the ages ranged from 15 to 19 years, 50.7% were women and 49.3% were men. 70% of respondents have “regular knowledge”, 19.8% have “deficient knowledge” and only 11.4% “good knowledge”. Women have better knowledge than men achieving an average of 5.8 and 4.8 respectively. The areas that achieved higher scores were: health with 6.8, economic and exact sciences 5.2 and humanities and education 5.3. Conclusion: Adolescents present regular level of knowledge about HIV / AIDS, showing little knowledge regarding oral transmission, and almost no knowledge about the effects of the infection. Women have better knowledge compared to men, placing them in a regular knowledge level and men are placed in a deficient level. The area of Health shows a better level of knowledge in comparison with the other areas, but all areas of study were classified into the regular knowledge level. Students from Chemistry, Mathematics and Economics programs show deficient knowledge.

Objetivo: Determinar o nível de conhecimentos sobre VIH/AIDS em adolescentes de pré-grau em modalidade presencial de uma universidade em Cartagena de Índias 2011-II. Materiais e Métodos: Estudo descritivo. Povoação 8706 estudantes. Amostra 919 estudantes. A informação foi coletada a través de “escala ECOVIH”, qualifica se de 0 a 10 pontos, a maior pontuação maior conhecimento, e uma enquete que valorou as características sociodemográficas. Erro 3% e nível de confiança 95%. Resultados: A idade média foi 18,4 anos, as idades oscilaram entre 15 e 19 anos; o 50,7% são mulheres e o 49,3% homens. O 70% dos inquiridos tem “conhecimentos regulares”, “conhecimentos deficientes” o 19,8% e só o 11,4% “bom nível de conhecimentos”. As mulheres têm melhores conhecimentos que os homens logrando uma média de 5,8 e 4,8 respectivamente. As áreas que obtiveram melhores pontuações foram: área da saúde com 6,8, ciências econômicas e exatas 5,2 e humanidades e educação 5,3. Conclusão: Os adolescentes apresentam um nível regular de conhecimentos sobre VIH/AIDS, demonstrando poucos conhecimentos respeito à transmissão oral, e conhecimentos quase nulos acerca dos efeitos da infecção. As mulheres têm melhores conhecimentos respeito aos homens, posicionando-as em num nível regular e os homens em nível deficiente. A área da saúde apresenta melhor nível de conhecimento respeito às demais; contudo todas as áreas de estudo se classificaram no nível regular. Os estudantes dos programas de química, matemáticos e economia apresentam conhecimentos deficientes.

Mannose-binding lectin gene variants and infections in patients receiving autologous stem cell transplantation.

BACKGROUND: Serious infections are common in patients undergoing autologous stem cell transplantation (ASCT) mainly because of the effects of immunosuppression. The innate immune system plays an important role in the defense against different infections. Mannose binding lectin (MBL) is a central molecule of the innate immune system. There are several promoter polymorphisms and structural variants of the MBL2 gene that encodes for this protein. These variants produce low levels of MBL and have been associated with an increased risk for infections. METHODS: Prospective cohort study. The incidence, severity of infections and mortality in 72 consecutive patients with hematologic diseases who underwent ASCT between February 2006 and June 2008 in a tertiary referral center were analyzed according to their MBL2 genotype. INNO-LiPA MBL2 was used for MBL2 gene amplification and genotyping. Relative risks (RR) (IC95%) as measure of association were calculated. Multivariate analysis was performed using logistic regression. RESULTS: A statistically significant higher number of fungal infections was found in patients with MBL2 variants causing low MBL levels (21.1%versus1.9%, p=0.016). In this MBL2 variant group infection was more frequently the cause of mortality than in the MBL2 wild-type group (p=0.05). Although not statistically significant, there was a higher incidence of major infections in the MBL2 variant group as well as a higher number of infections caused by gram-positive bacteria. CONCLUSIONS: Low-producer MBL2 genotypes were associated with an increased number of fungal infections in ASCT patients, which would suggest that MBL has a protective role against such infections. ASCT patients with MBL2 variant genotypes are more likely to die as a result of an infection.

Validez y confiabilidad de la versión en español de la escala de evaluación de la funcionalidad familiar (ASF-E-20) / Validity and reliability of the spanish version of the rating scale of family functionality (ASF-E-20)

Objetivo: Determinar la consistencia interna del instrumento Escala de Evaluación de Efectividad del Funcionamiento Familiar, ASF-E, en familias con hijos preescolares, de estratos bajos de Cartagena, Colombia. Método: Se diseñó un estudio de validación en el que participaron 276 familias. Los informantes familiares, estuvieron conformados por las personas que se encargaban del cuidado de los niños en el hogar que en su mayoría fueron mujeres adultas, madres de niños en edad preescolar y de estrato socioeconómico 1 y 2 de Cartagena. Se calcularon correlaciones corregidas (r) de Pearson entre la puntuación de cada ítem y la puntuación global en la versión de veinte ítems, se estimó el coeficiente de alfa de Cronbach para las subescalas y la escala global y se realizó un análisis factorial exploratorio. Resultados: La consistencia interna para la ASF-E-20 fue 0,671; para la subescala coherencia 0,582 y para la subescala mantenimiento 0,645. Una versión de 10 ítems, (ASFE- 10) mostró consistencia interna de 0,765 y mostró dos factores principales que explicaron el 44,3% de la varianza. Conclusiones: Se encontró baja consistencia interna en las dimensiones y metas de la escala. Se propone una escala con 10 ítems que valore la estabilidad familiar, previa validación en otras poblaciones.

Objective: To determine the internal consistency of the Effectiveness Assessment Scale of Family Functioning, ASF-E, in families with preschool children from low strata residence in Cartagena, Colombia Method: We performed a validation study involving 276 families. Informants were shaped by caregivers in charge of children in their houses who mostly were adult women, mothers of children under school age and socioeconomic status 1 and 2 of Cartagena. Corrected correlations were calculated (r) of Pearson between each item score and overall score on the version of twenty items, Cronbach alpha was computed for each subscales and total scale; and an exploratory factor analysis was performed. Results: The internal consistency for the ASF-E-20 was 0.671; consistency subscale, 0.582; and maintenance subscale, 0.645. A 10-item version (ASF-E -10) showed internal consistency of 0.765, and two salient factors that accounted for 44.3% of the variance. Conclusions: ASF-E-20 presents low internal consistency (total scale and subscales). We propose a 10-item version which needs assessment of validity and stability in other populations.

Objetivo: Conhecer a consistência interna do instrumento Escala de Avaliação da Eficácia do Funcionamento Familiar, ASF-E, em famílias com crianças pré-escolares, dos estratos sociais mais baixos de Cartagena, Colômbia. Método: Foi realizado um estudo de validação envolvendo 276 famílias, os informantes familiares foram os cuidadores das crianças em suas casas, que na sua maioria eram mulheres adultas, mães de crianças com idade escolar e nível socioeconômico 1 e 2 de Cartagena. Foram calculadas correlações corrigidas (r) de Pearson entre a pontuação de cada item e pontuação geral da versão de vinte itens. Estimou-se o coeficiente alfa de Cronbach para as subescalas e escala global e foi realizada uma análise fatorial exploratória. Resultados: A consistência interna para a ASF-E-20 foi 0,671; para a subescala coerência, 0,582 e para a subescala manutenção, 0,645. A versão de 10 itens (ASF-E-10) mostrou consistência interna de 0,765 e mostrou dois fatores principais responsáveis por 44,3% da variância. Resultados: A consistência interna para a ASF-E-20 foi 0,671; para a subescala coerência, 0,582 e para a subescala manutenção, 0,645. A versão de 10 itens (ASF-E-10) mostrou consistência interna de 0,765 e mostrou dois fatores principais responsáveis por 44,3% da variância.