Transient Performance Analysis of Centrifugal Left Ventricular Assist Devices Coupled With Windkessel Model: Large Eddy Simulations Study on Continuous and Pulsatile Flow Operation.

Computational fluid dynamics (CFD) simulations are widely used to develop and analyze blood-contacting medical devices such as left ventricular assist devices (LVADs). This work presents an analysis of the transient behavior of two centrifugal LVADs with different designs: HeartWare VAD and HeartMate3. A scale-resolving methodology is followed through Large Eddy Simulations, which allows for the visualization of turbulent structures. The three-dimensional (3D) LVAD models are coupled to a zero-dimensional (0D) 2-element Windkessel model, which accounts for the vascular resistance and compliance of the arterial system downstream of the device. Furthermore, both continuous- and pulsatile-flow operation modes are analyzed. For the pulsatile conditions, the artificial pulse of HeartMate3 is imposed, leading to a larger variation of performance variables in HeartWare VAD than in HeartMate3. Moreover, CFD results of pulsatile-flow simulations are compared to those obtained by accessing the quasi-steady maps of the pumps. The quasi-steady approach is a predictive tool used to provide a preliminary approximation of the pulsatile evolution of flow rate, pressure head, and power, by only imposing a speed pulse and vascular parameters. This preliminary quasi-steady solution can be useful for deciding the characteristics of the pulsatile speed law before running a transient CFD simulation, as the former entails a significant reduction in computational cost in comparison to the latter.

Self-assessed health associated with lifestyles in young adults:National survey - Young Lives - Perú / Salud autoevaluada asociado a estilos de vida en adultos jóvenes: Encuesta nacional - Young Lives – Perú

Introducción: La salud es un estado de bienestar físico, mental y social. La autopercepción en salud es un indicador relacionado a la morbilidad y mortalidad, esta percepción estaría influenciada en cada una de las personas por diversos factores, tales como culturales, psicológicos, sociales y otros. Día a día los jóvenes están expuestos a modificar sus estilos de vida de manera positiva o negativa. El objetivo principal del presente estudio fue determinar la relación entre los estilos de vida y la autoevaluación en salud en adultos entre 18 y 23 años de Perú.Materiales y métodos: Se realizó un estudio analítico transversal en una base de datos secundaria-“Young Lives” Ronda 5 - Perú. 595 adultos jóvenes entre 18 y 23 años formaron parte de nuestra muestra. Para estilos de vida se utilizaron los indicadores: actividad física, horas de sueño, consumo de alcohol, consumo de tabaco, estos fueron asociados a la variable salud autoevaluada.Resultados: Se observó que el 24.37% de la muestra autoevaluó su salud como buena, siendo esta evaluación más frecuente en los varones (OR=2.00, IC: 1.35-2.94). Los factores relacionados con una buena autoevaluación en salud fueron la actividad física (OR=1.50 IC:1.02 - 2.23), dormir de 7 a 8 horas (OR=1.69 IC: 1.01-2.81) y fumar a veces (OR=2.02 IC:1.002-4.11).Conclusiones: Se encontró asociación entre la autoevaluación en salud buena y el realizar actividad física, dormir entre 7 a 8 horas y fumar raramente.(AU)

Introduction: Self-perception of health serves as an im-portant marker for both morbidity and mortality, and it is sub-ject to various influences, including cultural, psychological,and social factors. In their daily lives, young individuals areconstantly exposed to opportunities for altering their lifestyleseither positively or negatively. Therefore, the primary aim ofthis study is to examine the association between lifestyles andself-assessment of health among Peruvian adults aged 18 to23 years.Methods: A cross-sectional analytical study was conductedutilizing a secondary database, specifically the “Young Lives”Round 5 dataset for Peru. Our sample consisted of 595 youngadults aged between 18 and 23 years. To assess theirlifestyles, we utilized indicators such as physical activity, hoursof sleep, alcohol consumption, and tobacco consumption.These lifestyle factors were then associated with the variableof “self-assessed health”. Additionally, we analyzed other vari-ables, including the sociodemographic characteristics of theevaluated population.Results: We found that 24.37% of the sample rated theirhealth as good. Several factors were identified as being asso-ciated with a positive self-assessment of health. These factorsincluded being male (odds ratio [OR] = 2.00, 95% confidenceinterval [CI]: 1.35-2.94), engaging in regular physical activity(OR = 1.50, 95% CI: 1.02-2.23), sleeping for 7 to 8 hours (OR = 1.69, 95% CI: 1.01-2.81), and occasionally smoking(OR = 2.02, 95% CI: 1.002-4.11).Conclusions: Engaging in physical activity, getting 7 to8 hours of sleep, and occasional smoking have been foundto be associated with a positive self-assessment of health.(AU)

Factors associated with sexually transmitted diseases amongst female prison inmates in Peru.

OBTECTIVES: The number of women in prison is rapidly increasing every year and it is important to establish what factors are related to the probability of presenting STDs in this population to enable health control policies to be established. MATERIAL AND METHOD: An analysis was carried out on the open database of the national prison population survey conducted in 2016 in all Peruvian prisons. The study was based on the census and all female and male adults in prison were surveyed using a validated questionnaire. RESULTS: The sample consisted of 4,574 inmates in 67 institutions, covering 98.8% of the inmate population. It was found that presenting tuberculosis (PR: 2.64; CI 95%, 1.32-5.26), HIV/AIDS (PR 6.54, CI 95% 1.52-28.18), hepatitis (PR: 4.01; CI 95%, 1.23-13.11) and drug use (PR: 2.44; CI 95%, 1.32-4.52), are statistically related (P ≤0.05) are factors associated with the presence of STDs in the multivariate model with a P ≤0.05. DISCUSSION: The inclusion of associated factors (tuberculosis, HIV/AIDS, hepatitis and drug use) should be part of the strategy to control and treat STD in women's prisons in Peru.

Factores asociados a las infecciones de transmisión sexual en mujeres privadas de la libertad en el Perú / Factors associated with sexually transmitted diseases amongst female prison inmates in Peru

Objetivos: El número de mujeres en condición de prisión se incrementa rápidamente todos los años, por lo que es importante establecer cuáles son los factores que se relacionan con la probabilidad de presentar infecciones de trasmisión sexual (ITS) en esta población para establecer políticas de control sanitario. Material y método: Se realizó un análisis de la base de datos abierta de la encuesta nacional de población penitenciaria del año 2016 realizada en todas las prisiones del Perú. El estudio fue censal y se entrevistaron a todas las mujeres y hombres adultos en situación de cárcel mediante un cuestionario validado. Resultados: La muestra abarcó a 4.574 internas de 67 establecimientos penitenciarios, cubriendo el 98,8% de la población penitenciaria. Se encontró que haber presentado tuberculosis (razón de prevalencia ajustada [RPa]: 1,32; intervalo de confianza [IC] del 95%, 1,32-5,26), presentar virus de la inmunodeficiencia humana (VIH)/sida o síndrome de inmunodeficiencia adquirida (RPa: 1,52; IC del 95%, 1,52-28,18), hepatitis (RPa: 4,01; IC del 95%, 1,23-13,11) y consumo de drogas (Rpa: 2,44; IC del 95%, 1,32-4,52) son factores asociados a la presencia de ITS en el modelo multivariado con un valor p ≤0,05. Discusión: Incluir los factores asociados identificados (tuberculosis, VIH/sida, hepatitis y consumo de drogas) debe ser parte de la estrategia de control y tratamiento de las ITS en las prisiones femeninas del Perú. (AU)

Objectives: The number of women in prison is rapidly increasing every year and it is important to establish what factors are related to the probability of presenting STDs in this population to enable health control policies to be established. Material and method: An analysis was carried out on the open database of the national prison population survey conducted in 2016 in all Peruvian prisons. The study was based on the census and all female and male adults in prison were surveyed using a validated questionnaire. Results: The sample consisted of 4,574 inmates in 67 institutions, covering 98.8% of the inmate population. It was found that presenting tuberculosis (PR: 2.64; CI 95%, 1.32-5.26), HIV/AIDS (PR 6.54, CI 95% 1.52-28.18), hepatitis (PR: 4.01; CI 95%, 1.23-13.11) and drug use (PR: 2.44; CI 95%, 1.32-4.52), are statistically related (P ≤0.05) are factors associated with the presence of STDs in the multivariate model with a P ≤0.05.Discussion: The inclusion of associated factors (tuberculosis, HIV/AIDS, hepatitis and drug use) should be part of the strategy to control and treat STD in women’s prisons in Peru. (AU)

Formation of multiple BGK-like structures in the time-asymptotic state of collisionless Vlasov-Poisson plasmas.

The time-asymptotic state of a finite-amplitude perturbation in a collisionless and Maxwellian plasma is typically represented as a steady state of two nonlinearly superposed, counterpropagating Bernstein-Greene-Kruskal (BGK) modes. Using high-resolution Vlasov-Poisson simulations, we show that the plasma evolves self-consistently into a time-asymptotic state of multiple vortexlike structures that gradually fill the phase space and reduce filamentation. This occurs without the need for external forcing or the presence of an energetic plasma population. This finding suggests that the time-asymptotic regime of the plasma is rather akin to a nonlinear superposition of multiple BGK-like modes associated with nearly constant phase-speed waves. The electric field and the space-averaged particle distribution function exhibit a power-law broad spectrum, which is consistent with an energy cascade towards smaller scales in both position and velocity spaces.

Exploring the prevalence of abortion and its characteristics in Perú.

OBJECTIVES: Our paper presents the analysis of a nationwide survey that explored induced abortion among women using a ballot-box technique. Our objective was to determine the prevalence of abortion and the main characteristics of the procedure. STUDY DESIGN: We conducted surveys in households with 2400 women aged 18-49 from urban areas nationwide, between October 15 and 29, 2018. Data collection was overseen by the Instituto de Opinión Pública de la Universidad Católica del Perú. We performed a probabilistic, multistage, and socioeconomic level-stratified sampling. Our study used the "ballot-box technique" to ensure anonymity and reduce the risk of social desirability. RESULTS: We visited 15,433 houses nationwide. Among those households where surveys could not be conducted, it was due to abandoned or inaccessible property, unwilling to participate, absent members, out of quota, or inconclusive survey. On average, 19.0% of Peruvian women at all socioeconomic levels reported having had at least one abortion in their lifetime. Induced abortion is reported at all socioeconomic levels and reported age of the abortion is concentrated between 19 and 29 years old. In 57.7% of cases, women sought healthcare personnel for their last induced abortion. Among them, procedure abortion (45.3%) stands out over medical abortions (34.0%). Thirty-three percent of women who reported having had at least one induced abortion in their lifetime were admitted to a hospital after their last abortion. CONCLUSIONS: The illegality of abortion has not prevented its occurrence in Peru. Our results suggest that, in Peru, legal restrictions on induced abortion create an unfavorable context for women's health, exposing them to services whose safety is not guaranteed. Efforts should be made to increase awareness and education about contraception and family planning methods to prevent unwanted pregnancies and reduce the need for abortion. IMPLICATIONS: These findings should be considered in public policy discussions regarding abortion, since they might have a great impact for better decision making. They demonstrate that legal restrictions have not prevented the occurrence of abortion but has only created unsafe conditions around it.

Endocrine disruptors in plastics alter ß-cell physiology and increase the risk of diabetes mellitus.

Plastic pollution breaks a planetary boundary threatening wildlife and humans through its physical and chemical effects. Of the latter, the release of endocrine disrupting chemicals (EDCs) has consequences on the prevalence of human diseases related to the endocrine system. Bisphenols (BPs) and phthalates are two groups of EDCs commonly found in plastics that migrate into the environment and make low-dose human exposure ubiquitous. Here we review epidemiological, animal, and cellular studies linking exposure to BPs and phthalates to altered glucose regulation, with emphasis on the role of pancreatic ß-cells. Epidemiological studies indicate that exposure to BPs and phthalates is associated with diabetes mellitus. Studies in animal models indicate that treatment with doses within the range of human exposure decreases insulin sensitivity and glucose tolerance, induces dyslipidemia, and modifies functional ß-cell mass and serum levels of insulin, leptin, and adiponectin. These studies reveal that disruption of ß-cell physiology by EDCs plays a key role in impairing glucose homeostasis by altering the mechanisms used by ß-cells to adapt to metabolic stress such as chronic nutrient excess. Studies at the cellular level demonstrate that BPs and phthalates modify the same biochemical pathways involved in adaptation to chronic excess fuel. These include changes in insulin biosynthesis and secretion, electrical activity, expression of key genes, and mitochondrial function. The data summarized here indicate that BPs and phthalates are important risk factors for diabetes mellitus and support a global effort to decrease plastic pollution and human exposure to EDCs.

Hemocompatibility and hemodynamic comparison of two centrifugal LVADs: HVAD and HeartMate3.

Mechanical circulatory support using ventricular assist devices is a common technique for treating patients suffering from advanced heart failure. The latest generation of devices is characterized by centrifugal turbopumps which employ magnetic levitation bearings to ensure a gap clearance between moving and static parts. Despite the increasing use of these devices as a destination therapy, several long-term complications still exist regarding their hemocompatibility. The blood damage associated with different pump designs has been investigated profoundly in the literature, while the hemodynamic performance has been hardly considered. This work presents a novel comparison between the two main devices of the latest generation-HVAD and HM3-from both perspectives, hemodynamic performance and blood damage. Computational fluid dynamics simulations are performed to model the considered LVADs, and computational results are compared to experimental measurements of pressure head to validate the model. Enhanced performance and hemocompatibility are detected for HM3 owing to its design incorporating more conventional blades and larger gap clearances.

Long-Read Metagenome-Assembled Genomes Improve Identification of Novel Complete Biosynthetic Gene Clusters in a Complex Microbial Activated Sludge Ecosystem.

Microorganisms produce a wide variety of secondary/specialized metabolites (SMs), the majority of which are yet to be discovered. These natural products play multiple roles in microbiomes and are important for microbial competition, communication, and success in the environment. SMs have been our major source of antibiotics and are used in a range of biotechnological applications. In silico mining for biosynthetic gene clusters (BGCs) encoding the production of SMs is commonly used to assess the genetic potential of organisms. However, as BGCs span tens to over 200 kb, identifying complete BGCs requires genome data that has minimal assembly gaps within the BGCs, a prerequisite that was previously only met by individually sequenced genomes. Here, we assess the performance of the currently available genome mining platform antiSMASH on 1,080 high-quality metagenome-assembled bacterial genomes (HQ MAGs) previously produced from wastewater treatment plants (WWTPs) using a combination of long-read (Oxford Nanopore) and short-read (Illumina) sequencing technologies. More than 4,200 different BGCs were identified, with 88% of these being complete. Sequence similarity clustering of the BGCs implies that the majority of this biosynthetic potential likely encodes novel compounds, and few BGCs are shared between genera. We identify BGCs in abundant and functionally relevant genera in WWTPs, suggesting a role of secondary metabolism in this ecosystem. We find that the assembly of HQ MAGs using long-read sequencing is vital to explore the genetic potential for SM production among the uncultured members of microbial communities. IMPORTANCE Cataloguing secondary metabolite (SM) potential using genome mining of metagenomic data has become the method of choice in bioprospecting for novel compounds. However, accurate biosynthetic gene cluster (BGC) detection requires unfragmented genomic assemblies, which have been technically difficult to obtain from metagenomes until very recently with new long-read technologies. Here, we determined the biosynthetic potential of activated sludge (AS), the microbial community used in resource recovery and wastewater treatment, by mining high-quality metagenome-assembled genomes generated from long-read data. We found over 4,000 BGCs, including BGCs in abundant process-critical bacteria, with no similarity to the BGCs of characterized products. We show how long-read MAGs are required to confidently assemble complete BGCs, and we determined that the AS BGCs from different studies have very little overlap, suggesting that AS is a rich source of biosynthetic potential and new bioactive compounds.

CFD analysis of the HVAD's hemodynamic performance and blood damage with insight into gap clearance.

Mechanical circulatory support using ventricular assist devices has become commonplace in the treatment of patients suffering from advanced stages of heart failure. While blood damage generated by these devices has been evaluated in depth, their hemodynamic performance has been investigated much less. This work presents the analysis of the complete operating map of a left ventricular assist device, in terms of pressure head, power and efficiency. Further investigation into its hemocompatibility is included as well. To achieve these objectives, computational fluid dynamics simulations of a centrifugal blood pump with a wide-blade impeller were performed. Several conditions were considered by varying the rotational speed and volumetric flow rate. Regarding the device's hemocompatibility, blood damage was evaluated by means of the hemolysis index. By relating the hemocompatibility of the device to its hemodynamic performance, the results have demonstrated that the highest hemolysis occurs at low flow rates, corresponding to operating conditions of low efficiency. Both performance and hemocompatibility are affected by the gap clearance. An innovative investigation into the influence of this design parameter has yielded decreased efficiencies and increased hemolysis as the gap clearance is reduced. As a further novelty, pump operating maps were non-dimensionalized to highlight the influence of Reynolds number, which allows their application to any working condition. The pump's operating range places it in the transitional regime between laminar and turbulent, leading to enhanced efficiency for the highest Reynolds number.

Desarrollo de la Escala de Actitudes Disfuncionales Traumáticas (EADT) para víctimas de terrorismo / Development of the traumatic dysfunctional attitude scale (EADT) for victims of terrorism

Introduction and objectives. Post-traumatic stress disorder (PTSD) is the most common psychological disorder in victims of terrorism. Cognitive models of PTSD postulate that dysfunctional attitudes play a fundamental role in its etiology, maintenance, and treatment. The objective of this study was to develop a self-report instrument to assess traumatic dysfunctional attitudes typical of victims of terrorism: the Traumatic Dysfunctional Attitude Scale (EADT by its original Spanish acronym). Materials and method. The EADT items were extracted from 480 recorded hours of trauma-focused cognitive-behavioral therapy administered to 59 victims of terrorism with PTSD and after an analysis of items’ content and intelligibility by a group of psychologists. A preliminary 84-item version was administered to a sample of 253 victims of terrorism along with measures of PTSD, depression, and depressive dysfunctional attitudes. Results. A series of factorial and reliability analyses on the preliminary version allowed one to arrive at a definitive version composed of 34 items and three correlated factors: dangerous world, negative view of society and the human being, and chronicity of distress. The psychometric analyses of the definitive version revealed good evidence concerning the internal structure of the test, score internal consistency, the differentiation of known groups, and the relationships with conceptually related constructs. Conclusions. The EADT is a simple instrument whose scores have good psychometric properties and can be useful to assess, both in research and applied contexts, the dysfunctional attitudes that victims of terrorism may present.

Introducción y objetivos. El trastorno de estrés postraumático (TEPT) es el trastorno psicológico más frecuente en las víctimas del terrorismo. Los modelos cognitivos del TEPT postulan que las actitudes disfuncionales desempeñan un papel fundamental en su etiología, mantenimiento y tratamiento. El objetivo de este estudio fue desarrollar un instrumento de autoinforme para evaluar las actitudes disfuncionales traumáticas específicas de las víctimas del terrorismo: la Escala de Actitudes Disfuncionales Traumáticas (EADT). Materiales y método. Los ítems de la EADT fueron extraídos de 480 horas grabadas de terapia cognitivo-conductual centrada en el trauma aplicada a 59 víctimas del terrorismo con TEPT y tras un análisis del contenido e inteligibilidad de los ítems por un grupo de psicólogos. Una versión preliminar de 84 ítems se aplicó a una muestra de 253 víctimas del terrorismo junto con medidas de TEPT, depresión y actitudes disfuncionales depresivas. Resultados. Una serie de análisis factoriales y de fiabilidad sobre la versión preliminar permitió llegar a una versión definitiva compuesta por 34 ítems y tres factores correlacionados: mundo peligroso, visión negativa de la sociedad y del ser humano, y cronificación del malestar. Los análisis psicométricos de la versión definitiva revelaron buenos datos empíricos para la estructura interna de la EADT, la consistencia interna de sus puntuaciones, la diferenciación de grupos contrastados y las relaciones con constructos conceptualmente relacionados. Conclusiones. La EADT es un instrumento sencillo cuyas medidas presentan buenas propiedades psicométricas y pueden ser útiles para evaluar, tanto en contextos de investigación como aplicados, las actitudes disfuncionales que pueden presentar las víctimas del terrorismo.

La Lista de Verificación del Trastorno de Estrés Postraumático (PCL) en víctimas del terrorismo: análisis comparativo de las propiedades psicométricas de su aplicación telefónica frente a presencial / The PTSD Checklist (PCL) in victims of terrorism: Comparative analysis of the psychometric properties of its administration by telephone vs. in person

Introducción y objetivos: En muchas situaciones tales como las de confinamiento provocadas por la pandemia de la COVID-19, es imposible aplicar los instrumentos psicológicos presencialmente, como originalmente se concibieron. Sin embargo, el modo de aplicación puede afectar a las propiedades psicométricas de las medidas de un instrumento. La Lista de Verificación del Trastorno de Estrés Postraumático (del inglés PTSD Checklist; en adelante PCL) es uno de los instrumentos más utilizados para evaluar presencialmente la sintomatología del trastorno de estrés postraumático (TEPT). Este es el primer estudio que analiza y compara la estructura factorial, consistencia interna y validez diagnóstica, nomológica y de grupos contrastados de las medidas de la PCL aplicada presencial y telefónicamente. Material y métodos: Se administró la PCL en ambos formatos a una muestra de 634 personas víctimas del terrorismo junto con una entrevista diagnóstica estructurada y medidas de depresión y ansiedad. Resultados: Las puntuaciones de ambas formas de aplicación de la PCL presentan una misma estructura unifactorial, índices excelentes de consistencia interna (alfa > .90) e índices muy buenos de validez diagnóstica para identificar el TEPT (AUC > .90); ambas discriminan significativamente y con tamaños del efecto grandes (d = 0.88–2.84) entre víctimas con TEPT, con trastornos depresivos o de ansiedad y sin trastornos, y ambas presentan correlaciones significativas y grandes con medidas de otros constructos con los que el TEPT guarda una estrecha relación: depresión y ansiedad. Conclusiones: Los resultados sugieren que la PCL se puede aplicar telefónicamente con las mismas garantías psicométricas que presencialmente.(AU)

Introduction and objectives: In many situations, such as confinement situations caused by the COVID-19 pandemic, it is not possible to administer psychological instruments in person, as originally contemplated in their development. However, the mode of administration can affect the psychometric properties of instrument scores. The PTSD Checklist (PCL) is one of the most widely used instruments for assessing the symptoms of posttraumatic stress disorder (PTSD) in person. This study is the first research that has analyzed and compared the factorial structure, the internal consistency, the validity of contrasted groups, the diagnostic validity, and the nomological validity of scores on the PCL administered in person and by telephone. Material and methods: The PCL was administered in both application modes to a sample of 634 victims of terrorism along with a structured diagnostic interview and measures of depression and anxiety. Results: Scores on both administration modes of the PCL have the same unifactorial structure, excellent indexes of internal consistency (alpha > .90) and very good indexes of diagnostic validity to identify the PTSD (AUC > .90), discriminate significantly and with large effect sizes (d = 0.88–2.84) between victims with PTSD, with depressive or anxiety disorders and without disorders, and present significant and large correlations with measures of other constructs with which PTSD is closely related, namely depression and anxiety. Conclusions: The results suggest that the PCL can be administered over the telephone with the same psychometric guarantees as in person.(AU)

SARS-CoV-2 in wastewater from Mexico City used for irrigation in the Mezquital Valley: quantification and modeling of geographic dispersion.

Quantification of SARS-CoV-2 in urban wastewaters has emerged as a cheap, efficient strategy to follow trends of active COVID-19 cases in populations. Moreover, mathematical models have been developed that allow the prediction of active cases following the temporal patterns of viral loads in wastewaters. In Mexico, no systematic efforts have been reported in the use of these strategies. In this work, we quantified SARS-CoV-2 in rivers and irrigation canals in the Mezquital Valley, Hidalgo, an agricultural region where wastewater from Mexico City is distributed and used for irrigation. Using quantitative RT-PCR, we detected the virus in six out of eight water samples from rivers and five out of eight water samples from irrigation canals. Notably, samples showed a general consistent trend of having the highest viral loads in the sites closer to Mexico City, indicating that this is the main source that contributes to detection. Using the data for SARS-CoV-2 concentration in the river samples, we generated a simplified transport model that describes the spatial patterns of dispersion of virus in the river. We suggest that this model can be extrapolated to other wastewater systems where knowledge of spatial patterns of viral dispersion, at a geographic scale, is required. Our work highlights the need for improved practices and policies related to the use of wastewater for irrigation in Mexico and other countries.

Growing Up With Terrorism: The Age at Which a Terrorist Attack Was Suffered and Emotional Disorders in Adulthood.

Abundant scientific literature shows that exposure to traumatic situations during childhood or adolescence has long-term psychopathological consequences, for example, in the form of a higher prevalence of emotional disorders in adulthood. However, an evolutionary perspective suggests that there may be differential vulnerabilities depending on the age at which the trauma was suffered. As there are no studies on the psychopathological impact in adulthood of attacks suffered during childhood or adolescence, the objective of this study was to analyze the influence of the age at which a terrorist attack was suffered in the presence of emotional disorders many years after the attack. A sample of 566 direct and indirect victims of terrorist attacks in Spain was recruited, of whom 50 people were between the age of 3 and 9 when they suffered the attack, 46 were between 10 and 17 years old, and 470 were adults. All of them underwent a structured diagnostic interview (SCID-I-VC) an average of 21 years after the attacks. No significant differences were found between the three age groups at which the attack occurred in terms of the current prevalence of post-traumatic stress disorder, major depressive disorder, or anxiety disorders. The results of several multiple binary logistic regression analyses also indicated that, after controlling for the effect of sex, current age, the type of victims, and the time since the attack, the age at which the attack was suffered was not related to the current prevalence of those emotional disorders. The results are discussed concerning the differences between various types of trauma and in the context of the theories that propose that traumatic experiences are processed differently at different ages and can lead to differences in the likelihood of developing different emotional disorders.

Desarrollo de una versión breve de la PTSD Checklist (PCL) basada en la definición de trastorno de estrés postraumático de la CIE-11 / Development of a short version of the PTSD (PCL) based on the ICD-11 definitions of posttraumatic stress disorder

Introducción y objetivos. El objetivo principal del presente estudio fue desarrollar, a partir de la Lista de Verificación del Trastorno de Estrés Postraumático (PCL), una medida de autoinforme de la sintomatología de estrés postraumático basada en los criterios sintomáticos de la CIE-11 para el trastorno de estrés postraumático (TEPT). Material y métodos. Se seleccionaron siete ítems de la PCL para formar la PCL-CIE-11 y se analizaron sus propiedades psicométricas en una muestra de 634 víctimas del terrorismo a las que se aplicó la versión específica de la PCL (PCL-S) junto con una entrevista diagnóstica estructurada y medidas de depresión y ansiedad. Resultados. La PCL-CIE-11 muestra una estructura unifactorial con buenos índices de ajuste que se replica en dos submuestras de víctimas creadas aleatoriamente a partir de la muestra global, y presenta índices excelentes o muy buenos de consistencia interna (α > .85) y de validez diagnóstica para identificar el TEPT (AUC > .90 y kappa ≥ .75). La escala también discrimina significativamente y con tamaños del efecto grandes (d = 0.88 – 2.32) entre víctimas con TEPT, víctimas con trastornos depresivos o de ansiedad y víctimas sin trastornos, presenta correlaciones significativas y grandes con medidas de depresión y ansiedad, dos constructos con los que el TEPT guarda una estrecha relación, y muestra una correlación muy elevada, de .95, con la PCL-S completa. Conclusiones. La PCL-CIE-11 es una versión breve de la PCL-S que presenta buenas propiedades psicométricas y puede ser útil para evaluar la presencia y gravedad de la sintomatología del TEPT tanto desde la perspectiva del DSM como de la CIE-11.(AU)

Introduction and objectives. The main objective of the present study was to develop, from the PTSD Checklist (PCL), a self-report measure of posttraumatic stress symptoms based on the ICD-11 symptomatic criteria for posttraumatic stress disorder (PTSD). Material and methods. Seven PCL items were selected to develop the PCL-ICD-11, and its psychometric properties were analyzed in a sample of 634 victims of terrorism who completed the specific version of the PCL (PCL-S) along with a structured diagnostic interview and measures of depression and anxiety. Results. The results indicate that the PCL-ICD-11 shows a unifactorial structure with good fit indices that is replicated in two subsamples of victims created randomly from the global sample. The PCL-ICD-11 shows excellent indices of internal consistency (α > .85) and very good indices of diagnostic validity to identify PTSD (AUC > .90 and kappa ≥ .75), discriminates significantly and with large effect sizes (d = 0.88 – 2.32) between victims with PTSD, victims with depressive or anxiety disorders and victims without disorders, presents significant and large correlations with measures of depression and anxiety, two constructs with which PTSD it is closely related, and shows a very high correlation of .95 with the complete PCL-S. Conclusions. The PCL-ICD-11 is a short version of the PCL-S that has good psychometric properties and can be useful to assess the presence and severity of PTSD symptoms from both the DSM and ICD-11 perspectives.(AU)

The challenges facing indigenous communities in Latin America as they confront the COVID-19 pandemic.

The coronavirus disease 2019 (COVID-2019) pandemic struck Latin America in late February and is now beginning to spread across the rural indigenous communities in the region, home to 42 million people. Eighty percent of this highly marginalized population is concentrated in Bolivia, Guatemala, Mexico and Peru. Health care services for these ethnic groups face distinct challenges in view of their high levels of marginalization and cultural differences from the majority. Drawing on 30 years of work on the responses of health systems in the indigenous communities of Latin America, our group of researchers believes that countries in the region must be prepared to combat the epidemic in indigenous settings marked by deprivation and social disparity. We discuss four main challenges that need to be addressed by governments to guarantee the health and lives of those at the bottom of the social structure: the indigenous peoples in the region. More than an analysis, our work provides a practical guide for designing and implementing a response to COVID-19 in indigenous communities.

Sound Absorption Properties of Perforated Recycled Polyurethane Foams Reinforced with Woven Fabric.

The acoustic properties of recycled polyurethane foams are well known. Such foams are used as a part of acoustic solutions in different fields such as building or transport. This paper aims to seek improvements in the sound absorption of these recycled foams when they are combined with fabrics. For this aim, foams have been drilled with cylindrical perforations, and also combined with different fabrics. The effect on the sound absorption is evaluated based on the following key parameters: perforation rate (5% and 20%), aperture size (4 mm and 6 mm), and a complete perforation depth. Experimental measurements were performed by using an impedance tube for the characterization of its acoustic behavior. Sound absorption of perforated samples is also studied-numerically by finite element simulations, where the viscothermal losses were considered; and analytically by using models for the perforated foam and the fabric. Two textile fabrics were used in combination with perforated polyurethane samples. Results evidence a modification of the sound absorption at mid frequencies employing fabrics that have a membrane-type acoustic response.

Importancia de la laparoscopia diagnóstica en la detección de implantes tumorales. Reporte de un caso / Importance of diagnostic laparoscopy in the detection of tumor implants. A case report

Resumen ANTECEDENTES: Los tumores malignos de células germinales de ovario constituyen un grupo heterogéneo de neoplasias de rápida evolución a la malignización, que suelen aparecer durante las dos primeras décadas de la vida. La prevalencia en México es de 3.4% de los tumores ováricos. El 10% de las pacientes afectadas padece dolor abdominal agudo por distención capsular, necrosis, hemorragia, rotura o torsión. CASO CLÍNICO: Paciente de 17 años, acudió al servicio de Urgencias por dolor pélvico de inicio súbito. En la laparotomía se encontró una torsión ovárica secundaria a una tumoración anexial derecha; por eso se le efectuó la salpingooferectomía. Se detectó elevada concentración de alfa-fetoproteína (10,702 ng/mL); el servicio de Oncología pediátrica indicó quimioterapia durante dos años; sin embargo, después de suspender el tratamiento persistió elevada su concentración. El ultrasonido y PET-SCAN no evidenciaron enfermedad activa. En la laparoscopia diagnóstica se observaron múltiples implantes tumorales. El reporte histopatológico fue de tumoración de senos endodérmicos. La paciente se envió, nuevamente, a Oncología pediátrica para continuar con quimioterapia y radioterapia. En la actualidad permanece estable, con descenso de la concentración de alfa-fetoproteína (última determinación: 1200 ng/mL). CONCLUSIÓN: La importancia de la laparoscopia toma relevancia en este tipo de casos, cuando existe discordancia entre los estudios bioquímicos y de imagen (ultrasonido y PET-SCAN); además, orienta hacia un diagnóstico más certero, mediante la visualización y obtención de biopsias directas, con la finalidad de establecer el tratamiento específico.

Abstract BACKGROUND: Malignant germ cell tumors of the ovary constitute a heterogeneous group of highly malignant and rapidly progressive neoplasms that usually appear during the first two decades of life. Its frequency in Mexico is 3.4% on ovarian tumors. Approximately 10% of affected patients report acute abdominal pain due to capsular distension, necrosis, hemorrhage, rupture or torsion. CLINICAL CASE: A 17 years-old patient, who went to the Emergency Department for pelvic pain of sudden onset. It was decided to perform a laparotomy and ovarian torsion was found secondary to a right adnexal tumor, so salpingo-ophorectomy was performed. High alpha-fetoprotein concentration (10.702 ng/mL) was detected; the Pediatric Oncology Service indicated chemotherapy for two years; however, after stopping the treatment, its concentration persisted. The ultrasound and PET-SCAN did not show active disease, so it was sent to the gynecological endoscopy service, where they performed diagnostic laparoscopy, observing multiple tumor implants. The histopathological results was endodermal sinus tumor. The patient was sent, again, to Pediatric Oncology to continue with chemotherapy and radiotherapy. It is currently stable, with a decrease in values of alpha-fetoprotein (last determination: 1200 ng/mL). CONCLUSION: The importance of diagnostic laparoscopy is especially relevant in this type of cases when there is disagreement between biochemical and imaging studies (ultrasound and PET-SCAN), which through laparoscopy guides us towards a more accurate diagnosis through visualization and direct biopsy taking sample and give a directed management.

Tratamiento Psicológico por Videoconferencia de una Víctima de Terrorismo con Trastorno por Estrés Postraumático y Otros Trastornos Emocionales Comórbidos 30 Años después del Atentado / Videoconference-delivered psychological treatment for a victim of terrorism with posttraumatic stress disorder and other comorbid emotional disorders 30 years after the terrorist attack

En este trabajo se muestra la efectividad o utilidad clínica de la terapia cognitivo-conductual centrada en el trauma (TCCCT) cuando se aplica por videoconferencia a un paciente de 52 años víctima directa de un atentado terrorista sufrido hace 30 años, que presentaba trastorno por estrés postraumático (TEPT), trastorno depresivo mayor, fobia social y trastorno obsesivo-compulsivo. Tras 36 sesiones de tratamiento, se produjo una reducción clínicamente significativa de la sintomatología postraumática, ansiosa y depresiva, la cual se mantuvo estable a largo plazo. La TCC-CT aplicada por videoconferencia parece ser efectiva cuando se utiliza con víctimas del terrorismo que sufren TEPT y otros trastornos comórbidos a muy largo plazo, aunque la comorbilidad y la cronicidad parecen requerir un aumento en el número de sesiones

This paper shows the effectiveness or clinical utility of trauma-focused cognitive-behavioral treatment (TF-CBT) that was delivered by videoconference in a 52 year old patient who was victim of a terrorist attack 30 years ago and suffered from posttraumatic stress disorder (PTSD) comorbid with major depressive disorder (MDD), social phobia, and obsessive-compulsive disorder (OCD). After 36 sessions, a clinically significant decrease in posttraumatic, depressive and anxious symptomatology was obtained and remained stable in the long term. TF-CBT delivered by videoconference seems to be effective when is used with victims of terrorism suffering from PTSD and comorbid emotional disorders in the very long term, although comorbidity and chronicity seem to an increase in the number of treatment sessions