Cervidae antlers exploited to manufacture prehistoric tools and hunting implements as a reliable source of ancient DNA.

Antler is one of the primary animal raw materials exploited for technical purposes by the hunter-gatherer groups of the Eurasian Upper Palaeolithic (UP) all over the ecological range of deers, and beyond. It was exhaustively employed to produce one of the most critical tools for the survival of the UP societies: hunting weapons. However, antler implements can be made from diverse deer taxa, with different ecological requirements and ethological behaviours. Identifying the antler's origin at a taxonomic level is thus essential in improving our knowledge of humans' functional, practical and symbolic choices, as well as the human-animal interface during Prehistoric times. Nevertheless, palaeogenetics analyses have focused mainly on bone and teeth, with genetic studies of antler generally focused on modern deer conservation. Here we present the results of the first whole mitochondrial genome ancient DNA (aDNA) analysis by means of in-solution hybridisation capture of antlers from pre-Holocene archaeological contexts. We analysed a set of 50 Palaeolithic and Neolithic (c. 34-8ka) antler and osseous objects from South-Western Europe, Central Europe, South-Western Asia and the Caucasus. We successfully obtained aDNA, allowing us to identify the exploited taxa and demonstrate the archaeological relevance of those finds. Moreover, as most of the antlers were sampled using a minimally-invasive method, further analyses (morphometric, technical, genetic, radiometric and more) remain possible on these objects.

Increased Incidence of TdT-negative Pre-B Acute Lymphoblastic Leukemia Associated With Poor Prognostic Features Among Mexican Children in Central Mexico.

Mexican and Hispanic children in Mexico and the United States, respectively, have the highest incidence and worst outcomes of pre-B acute lymphoblastic leukemia (ALL) compared with other racial/ethnic groups. Terminal deoxynucleotidyl transferase (TdT) is an intranuclear DNA polymerase normally present on immature lymphocytes (TdT-positive) and distinguishes ALL from mature lymphoid malignancies. We performed a multisite retrospective study to determine the incidence of TdT-negative precursor B-cell acute lymphoblastic leukemia (pre-B ALL) among Mexican, Caucasian, and US-born Hispanic children to correlate TdT expression with patient characteristics and known prognostic factors. Fisher exact test was performed for categorical variables and the Wilcoxon rank-sum test was used for continuous variables. TdT-negative pre-B ALL was most frequently identified in patients with National Cancer Institute high-risk disease ( P =0.014). TdT-negative expression was also most frequently associated with hypodiploid pre-B ALL ( P =0.001) and KMT2A gene rearrangement ( P =0.0012). Mexican children had the highest incidence of TdT-negative ALL compared with Caucasians and US Hispanics ( P <0.001), with an increased incidence of poor prognostic features as well. This study demonstrates significant differences in TdT-negative expression, genomic alterations, and leukemic ploidy based on race and ethnicity.

Imipramine Administration in Brucella abortus 2308-Infected Mice Restores Hippocampal Serotonin Levels, Muscle Strength, and Mood, and Decreases Spleen CFU Count.

Brucellosis infection causes non-specific symptoms such as fever, chills, sweating, headaches, myalgia, arthralgia, anorexia, fatigue, and mood disorders. In mouse models, it has been associated with increased levels of IL-6, TNF-α, and IFN-γ, a decrease in serotonin and dopamine levels within the hippocampus, induced loss of muscle strength and equilibrium, and increased anxiety and hopelessness. Imipramine (ImiP), a tricyclic antidepressant, is used to alleviate neuropathic pain. This study evaluated the effects of ImiP on Balb/c mice infected with Brucella abortus 2308 (Ba) at 14- and 28-days post-infection. Serum levels of six cytokines (IFN-γ, IL-6, TNF-α, IL-12, MCP-1. and IL-10) were assessed by FACS, while the number of bacteria in the spleen was measured via CFU. Serotonin levels in the hippocampus were analyzed via HPLC, and behavioral tests were conducted to assess strength, equilibrium, and mood. Our results showed that mice infected with Brucella abortus 2308 and treated with ImiP for six days (Im6Ba14) had significantly different outcomes compared to infected mice (Ba14) at day 14 post-infection. The mood was enhanced in the forced swimming test (FST) (p < 0.01), tail suspension test (TST) (p < 0.0001), and open-field test (p < 0.0001). Additionally, there was an increase in serotonin levels in the hippocampus (p < 0.001). Furthermore, there was an improvement in equilibrium (p < 0.0001) and muscle strength (p < 0.01). Lastly, there was a decrease in IL-6 levels (p < 0.05) and CFU count in the spleen (p < 0.0001). At 28 days, infected mice that received ImiP for 20 days (Im20Ba28) showed preservation of positive effects compared to infected mice (Ba28). These effects include the following: (1) improved FST (p < 0.0001) and TST (p < 0.0001); (2) better equilibrium (p < 0.0001) and muscle strength (p < 0.0001); (3) decreased IL-6 levels (p < 0.05); and (4) reduced CFU count in the spleen (p < 0.0001). These findings suggest the potential for ImiP to be used as an adjuvant treatment for the symptoms of brucellosis, which requires future studies.

Identification of a cytotoxic factor from a non-pigmented entomopathogenic Serratia marcescens isolate toxic towards human carcinoma cell lines.

It has been reported that cell-free culture broths and some proteins from pigmented and non-pigmented Serratia spp. are cytotoxic towards cancerous and non-cancerous human cell lines. Looking for new molecules toxic against human cancerous cells but harmless towards normal human cells, the aim of this work was (a) to determine whether cell-free broths from the entomopathogenic non-pigmented S. marcescens 81 (Sm81), S. marcescens 89 (Sm89) and S. entomophila (SeMor4.1) presented cytotoxic activity towards human carcinoma cell lines; (b) to identify and purify the associated cytotoxic factor(s) and (c) to evaluate whether the cytotoxic factor(s) was cytotoxic towards non-cancerous human cells. This research was focussed on the observed morphology changes and the proportion of remaining viable cells after incubation in the presence of cell-free culture broths from the Serratia spp isolates to evaluate cytotoxic activity. The results showed that broths from both S. marcescens isolates presented cytotoxic activity and induced cytopathic-like effects on the human neuroblastoma CHP-212 and the breast cancer MDA-MB-231 cells. Slight cytotoxicity was observed in the SeMor4.1 broth. A serralysin-like protein of 50 kDa was identified in Sm81 broth as responsible for cytotoxic activity after purification by ammonium sulphate precipitation and ion-exchange chromatography followed by tandem-mass spectrometry (LC-MS/MS). The serralysin-like protein was toxic against CHP-212 (neuroblastoma), SiHa (human cervical carcinoma) and D-54 (human glioblastoma) cell lines in a dose-dependent manner and showed no cytotoxic activity in primary cultures of normal non-cancerous human keratinocytes and fibroblasts. Therefore, this protein should be evaluated for a potential use as an anticancer agent.

The Guadalajara Declaration on sepsis: emergency physicians' constructive comments on the Surviving Sepsis Campaign's 2021 updated guidelines. / Declaración de Guadalajara: una visión constructiva desde el servicio de urgencias a partir de la Surviving Sepsis Campaign 2021.

TEXT: The Surviving Sepsis Campaign (SSC) published a 2021 update of its 2016 recommendations. The update was awaited with great anticipation the world over, especially by emergency physicians. Under the framework of the CIMU 2022 (33rd World Emergency Medicine Conference) in Guadalajara, Mexico in March, emergency physiciansreviewed and analyzed the 2021 SSC guidelines from our specialty's point of view. In this article, the expert reviewers present their consensus on certain key points of most interest in emergency settings at this time. The main aims of the review are to present constructive comments on 10 key points and/or recommendations in the SSC 2021 update and to offer emergency physicians' experience- and evidence-based proposals. Secondarily, the review's recommendations are a starting point for guidelines to detect severe sepsis in emergency department patients and prevent progression, which is ultimate goal of what has become known as the Guadalajara Declaration on sepsis.

TEXTO: En noviembre del año 2021, la Surviving Sepsis Campaign (SSC) publicó una actualización de sus recomendaciones y directrices de 2016. Estas fueron recibidas con una enorme expectativa en todo el mundo, especialmente entre los médicos de urgencias y emergencias (MUE). Recientemente, en el marco del CIMU 2022 (33 Congreso Mundial de Medicina de Urgencias celebrado en marzo de 2022 en Guadalajara ­ México) se ha revisado y analizado, desde la perspectiva del MUE, la Guía SSC de 2021. Los expertos que realizaron esa tarea y también consensuaron algunos de los puntos clave que más interesan y preocupan a los MUE en la actualidad han elaborado este documento. Su objetivo principal es analizar de forma constructiva diez de los puntos clave y recomendaciones de la SSC 2021 para complementarlas con argumentos y propuestas desde la experiencia, evidencia y perspectiva del urgenciólogo. Además, de forma secundaria, pretende ser el punto de partida de la elaboración de las guías para detectar, prevenir la progresión y atender a los pacientes con infección grave y sepsis en urgencias, que supone la meta final de lo que desde la MUE ya se conoce como "la Declaración de Guadalajara".

Declaración de Guadalajara: una visión constructiva desde el servicio de urgencias a partir de la Surviving Sepsis Campaign 2021 / The Guadalajara Declaration on sepsis: emergency physicians’ constructive comments on the Surviving Sepsis Campaign’s 2021 updated guidelines

En noviembre del año 2021, la Surviving Sepsis Campaign (SSC) publicó una actualización de sus recomendaciones y directrices de 2016. Estas fueron recibidas con una enorme expectativa en todo el mundo, especialmente entre los médicos de urgencias y emergencias (MUE). Recientemente, en el marco del CIMU 2022 (33 Congreso Mundial de Medicina de Urgencias celebrado en marzo de 2022 en Guadalajara – México) se ha revisado y analizado, desde la perspectiva del MUE, la Guía SSC de 2021. Los expertos que realizaron esa tarea y también consensuaron algunos de los puntos clave que más interesan y preocupan a los MUE en la actualidad han elaborado este documento. Su objetivo principal es analizar de forma constructiva diez de los puntos clave y recomendaciones de la SSC 2021 para complementarlas con argumentos y propuestas desde la experiencia, evidencia y perspectiva del urgenciólogo. Además, de forma secundaria, pretende ser el punto de partida de la elaboración de las guías para detectar, prevenir la progresión y atender a los pacientes con infección grave y sepsis en urgencias, que supone la meta final de lo que desde la MUE ya se conoce como “la Declaración de Guadalajara”. (AU)

The Surviving Sepsis Campaign (SSC) published a 2021 update of its 2016 recommendations. The update was awaited with great anticipation the world over, especially by emergency physicians. Under the framework of the CIMU 2022 (33rd World Emergency Medicine Conference) in Guadalajara, Mexico in March, emergency physicians reviewed and analyzed the 2021 SSC guidelines from our specialty’s point of view. In this article, the expert reviewers present their consensus on certain key points of most interest in emergency settings at this time. The main aims of the review are to present constructive comments on 10 key points and/or recommendations in the SSC 2021 update and to offer emergency physicians’ experience- and evidence-based proposals. Secondarily, the review’s recommendations are a starting point for guidelines to detect severe sepsis in emergency department patients and prevent progression, which is ultimate goal of what has become known as the Guadalajara Declaration on sepsis. (AU)

Fast Chromatographic Determination of Free Amino Acids in Bee Pollen.

The consumption of bee pollen has increased in the last few years due to its nutritional and health-promoting properties, which are directly related to its bioactive constituents, such as amino acids. Currently, there is great interest in understanding the role of these in bee products as it provides relevant information, e.g., regarding nutritional value or geographical and botanical origins. In the present study, two fast chromatographic methods were adapted based on commercial EZ:faast™ kits for gas chromatography-mass spectrometry and liquid chromatography−mass spectrometry for determining free amino acids in bee pollen. Both methods involved the extraction of amino acids with water, followed by a solid phase extraction to eliminate interfering compounds, and a derivatization of the amino acids prior to their chromatographic separation. The best results in terms of run time (<7 min), matrix effect, and limits of quantification (3−75 mg/kg) were obtained when gas chromatography−mass spectrometry was employed. This latter methodology was applied to analyze several bee pollen samples obtained from local markets and experimental apiaries. The findings obtained from a statistical examination based on principal component analysis showed that bee pollen samples from commercial or experimental apiaries were different in their amino acid composition.

Differentiation of bee pollen samples according to the betaines and other quaternary ammonium related compounds content by using a canonical discriminant analysis.

In the last years, an increase has been observed in the adulteration of bee pollen. Consequently, different tools are required to authenticate the origin of this product, such as a study of the profile and composition of a specific family of compounds. The present study investigates the potential of betaines and related compounds as markers of the apiary of origin and harvest period of 71 bee pollen samples. These were collected from four apiaries (Pistacho, Tío Natalio, Monte and Fuentelahiguera), located in the same geographical area (Guadalajara, Spain) and sampled during three consecutive harvest periods in the same year (April-May, June, July-August). They were analyzed by means of a previously developed methodology, which involved solvent extraction, hydrophilic interaction liquid chromatography coupled to mass spectrometry, and a statistical analysis of the data (canonical discriminant analysis). Variable amounts of betaines and related compounds were found in the samples, with four of these being identified in all of them (betonicine, betaine, trigonelline and choline); betonicine was the predominant compound in a concentration range of 264 to 52384 mg/kg. It was possible to statistically assign over 50 % of the samples to the corresponding apiary of origin, the best results being obtained for the Tío Natalio apiary (75 %); this classification was even better in the case of the harvest period, as more than 75 % of the samples were correctly assigned, and in two periods (April-May and June) a 90 % rate was obtained.

Prevalence and associated factors of mental health outcomes among healthcare workers in Northern Colombia: A cross-sectional and multi-centre study.

Background: Mental health outcomes in Healthcare Workers (HCWs) has been few evaluated during COVID-19 pandemic in low-and middle-income countries. Our aim was carry-out a study to identify the prevalence of stress, anxiety, depressive symptoms in HCWs and associated factors to severe illness in a northern region in Colombia. Method: A cross-sectional, hospital-based survey was conducted to assess mental health outcomes in 1,149 HCWs in Colombia. The study used Perceived Stress Scale (PSS-10), 7-item Generalized Anxiety Disorder (GAD-7), and 9-item Patient Health Questionnaire (PHQ-9) to evaluate stress, anxiety, and depression symptoms, respectively. Results: 682 HCWs completed the questionnaire. The 58,21% (397/682) were nurses, 31,23% were physicians (213/682), and 10,56% (72/682) were other health professionals. The proportion of HCWs with stress, anxiety, and depressive symptoms were 59,97%, 44,87%, and 23,02%, respectively. HCWs in emergency room and Intensive Care Units (ICU) have 2-3-fold increase risk to have severe symptoms of stress. Staff in ICU have 64% more likely to have severe anxiety symptoms, and 97% more likely to have severe depression symptoms. Limitations: Including HCWs only in the northern region in Colombia; a non-probabilistic sample, and a cross-sectional design to identify causality. Conclusion: A higher proportion on mental health outcomes has been reported in HCWs in Colombia. There are work areas related with severe mental symptoms such as ICU and emergency room. Hospitals and patient-care institutions in Latin-America needs consider the mental and physical health of HCWs during outbreaks and identify health staff at-risk to implementing support strategies to mitigate adverse mental outcomes.

Glucosinolates as Markers of the Origin and Harvesting Period for Discrimination of Bee Pollen by UPLC-MS/MS.

Bee pollen is currently one of the most commonly consumed food supplements, as it is considered to be a good source of bioactive substances and energy. It contains various health-promoting compounds, such as proteins, amino acids, lipids, as well as glucosinolates. In the present study, the glucosinolate content was determined, by means of ultra-performance liquid chromatography coupled to a quadrupole time-of-flight mass detector, in 72 bee pollen samples from four different apiaries in Guadalajara (Spain), harvested in three different periods. In addition, 11 commercial multifloral samples from different Spanish regions were also analyzed. The aim was to verify the suitability of these compounds as biomarkers of their geographical origin, and to test their potential for distinguishing the harvesting period. By means of a canonical discriminant analysis, it was possible to differentiate the apiary of origin of most of the samples, and these could also be clearly differentiated from the commercial ones, simply as a result of the glucosinolate content. In addition, it was also demonstrated for the first time that bee pollen samples were capable of being differentiated according to the time of harvesting and their glucosinolate content.

Data envelopment analysis efficiency in the public sector using provider and customer opinion: An application to the Spanish health system.

Measuring the relative efficiency of a finite fixed set of service-producing units (hospitals, state services, libraries, banks,...) is an important purpose of Data Envelopment Analysis (DEA). We illustrate an innovative way to measure this efficiency using stochastic indexes of the quality from these services. The indexes obtained from the opinion-satisfaction of the customers are estimators, from the statistical view point, of the quality of the service received (outputs); while, the quality of the offered service is estimated with opinion-satisfaction indexes of service providers (inputs). The estimation of these indicators is only possible by asking a customer and provider sample, in each service, through surveys. The technical efficiency score, obtained using the classic DEA models and estimated quality indicators, is an estimator of the unknown population efficiency that would be obtained if in each one of the services, interviews from all their customers and all their providers were available. With the object of achieving the best precision in the estimate, we propose results to determine the sample size of customers and providers needed so that with their answers can achieve a fixed accuracy in the estimation of the population efficiency of these service-producing units through the use of a novel one bootstrap confidence interval. Using this bootstrap methodology and quality opinion indexes obtained from two surveys, one of doctors and another of patients, we analyze the efficiency in the health care system of Spain.

School Climate and Teachers’ Motivational Variables: Effects on Teacher Satisfaction and Classroom Motivational Climate Perceived by Middle School Students. A Cross-cultural Study / Clima escolar y variables motivacionales del profesorado: efectos sobre la satisfacción de los docentes y el clima motivacional del aula percibido por los estudiantes de secundaria. Un estudio transcultural

This paper seeks two objectives. First, to study the potential effect of teachers’ perception of school climate and teachers’ motivational variables related to students on teachers’ satisfaction with school, and classroom motivational climate (CMC). Second, to validate a battery of questionnaires for assessing different teachers’ motivational variables related to students: motivational knowledge, teachers’ focus on students’ grades and emotional needs, and expectancies. In total, 441 teachers and 5,380 students from Spain and Costa Rica participated in the study. Confirmatory factor analyses showed the adequacy of each questionnaire structure. Besides, results on correlation and regression analyses showed, first, that school climate perception, together with teachers’ expectancies are the main factors potentially influencing teachers’ satisfaction with school. Second, that CMC does not depend on teachers’ satisfaction, but only on two components of school climate – teacher’s mutual support and students’ attitudes –, and on self-efficacy expectancies. In both regression analyses – satisfaction and CMC –, cross-cultural differences were found.

Este trabajo persigue dos objetivos. En primer lugar, estudiar el efecto potencial de la percepción del clima escolar por parte de los profesores y de las variables motivacionales de estos relacionadas con los estudiantes en la satisfacción de los profesores con la escuela y el clima motivacional del aula (CMC). En segundo lugar, validar una batería de cuestionarios para evaluar las diferentes variables motivacionales de los docentes relacionadas con los estudiantes: conocimiento motivacional, enfoque de los docentes en las calificaciones y necesidades emocionales de los estudiantes y expectativas. En total, 441 profesores y 5,380 estudiantes de España y Costa Rica participaron en el estudio. Los análisis factoriales confirmatorios mostraron la adecuación de la estructura de cada cuestionario. Además, los resultados de los análisis de correlación y regresión mostraron, en primer lugar, que la percepción del clima escolar, junto con las expectativas de los profesores, son los principales factores que pueden influir en la satisfacción de los profesores con la escuela. En segundo lugar, que el CMC no depende de la satisfacción de los profesores, sino solo de dos componentes del clima escolar, el apoyo mutuo de los profesores y las actitudes de los estudiantes, y de las expectativas de autoeficacia. En ambos análisis de regresión, satisfacción y CMC, se encontraron diferencias transculturales.

Assessment of Goal Orientations from the “Person-Situation Interaction” Perspective / Evaluación de las orientaciones a metas desde la perspectiva de la “interacción persona-situación”

The objective of this study is twofold: to analyze the role of different task situations in the activation of goals and goal orientations and, to make it possible to achieve such an objective to support theoretically, develop, and previously validate the Situated Goals Questionnaire for secondary and high school students (SGQ-SHS). A total of 1,010 Secondary and High School Students from Madrid (Spain) participated in the study. Data analysis using confirmatory techniques, as well as ANOVA and regression techniques, showed the effect of the type of task on the degree to which students declare to pursue different goals – as suggested by the person-situation interaction model –, the relationship between goals, expectancies, and self-regulation styles, as well as the validity of the measures developed for predicting achievement (self-estimated mean grade).

El objetivo de este estudio es doble: estudiar el papel de las situaciones definidas por las diferentes tareas en la activación de metas y de orientaciones a metas por objetivos y, para hacer posible la consecución de dicho objetivo, apoyar teóricamente, desarrollar y validar previamente el Cuestionario de Metas Situadas para Estudiantes de Secundaria y Bachillerato (MESI-SB). Un total de 1,010 estudiantes de Secundaria de Madrid (España) participaron en el estudio. Los datos analizados mediante técnicas confirmatorias, así como técnicas de ANOVA y regresión, pusieron de manifiesto que el efecto del tipo de tarea influye en el grado en que los estudiantes declaran perseguir diferentes objetivos –como sugiere el modelo de interacción persona-situación–, la relación entre los objetivos, las expectativas y los estilos de autorregulación, así como la validez de las medidas desarrolladas para predecir el logro (calificación media autoestimada).

Post-traumatic stress disorder, anxiety, and depression symptoms in healthcare workers during COVID-19 pandemic in Colombia.

Background: Mental health outcomes in healthcare workers (HCWs) in low- and middle-income countries (LMICs) have been poorly explored during COVID-19 pandemic. Our aim was to carry out a cross-sectional study of the prevalence of mental health symptoms in HCWs in Colombia. Methods: A cross-sectional web-survey study was performed during the COVID-19 pandemic mid-2021 including HCWs in two hospitals in Colombia. The PCL-5, GAD-7, and PHQ-9 scales were used to assess the prevalence of symptoms and severity of PTSD, anxiety, and depression in Colombia. Results: From 257 surveyed respondents, 44.36% were nurses, 36.58% physicians and 19.07% other health professionals. The prevalence of PTSD, anxiety, and depressive symptoms were 18.68%, 43.19%, and 26.85%, amongst HCWs. The regression model evidence a strong risk of PTSD, anxiety, and depressive symptoms in HCWs in Colombia during the second wave of COVID-19 in the middle of 2021. Conclusions: The prevalence for several mental health symptoms in HCWs in Colombia were higher compared with the general population. HCWs are at-risk population to develop chronic symptoms and mental disorders during and after outbreaks. These results will be helpful to tailor strategies to support the physical and mental health of the HCWs in LMICs.

The Existence of the StartReact Effect Implies Reticulospinal, Not Corticospinal, Inputs Dominate Drive to Motoneurons during Voluntary Movement.

Reaction time is accelerated if a loud (startling) sound accompanies the cue-the "StartReact" effect. Animal studies revealed a reticulospinal substrate for the startle reflex; StartReact may similarly involve the reticulospinal tract, but this is currently uncertain. Here we trained two female macaque monkeys to perform elbow flexion/extension movements following a visual cue. The cue was sometimes accompanied by a loud sound, generating a StartReact effect in electromyogram response latency, as seen in humans. Extracellular recordings were made from antidromically identified corticospinal neurons in primary motor cortex (M1), from the reticular formation (RF), and from the spinal cord (SC; C5-C8 segments). After loud sound, task-related activity was suppressed in M1 (latency, 70-200 ms after cue), but was initially enhanced (70-80 ms) and then suppressed (140-210 ms) in RF. SC activity was unchanged. In a computational model, we simulated a motoneuron pool receiving input from different proportions of the average M1 and RF activity recorded experimentally. Motoneuron firing generated simulated electromyogram, allowing reaction time measurements. Only if ≥60% of motoneuron drive came from RF (≤40% from M1) did loud sound shorten reaction time. The extent of shortening increased as more drive came from RF. If RF provided <60% of drive, loud sound lengthened the reaction time-the opposite of experimental findings. The majority of the drive for voluntary movements is thus likely to originate from the brainstem, not the cortex; changes in the magnitude of the StartReact effect can measure a shift in the relative importance of descending systems.SIGNIFICANCE STATEMENT Our results reveal that a loud sound has opposite effects on neural spiking in corticospinal cells from primary motor cortex, and in the reticular formation. We show that this fortuitously allows changes in reaction time produced by a loud sound to be used to assess the relative importance of reticulospinal versus corticospinal control of movement, validating previous noninvasive measurements in humans. Our findings suggest that the majority of the descending drive to motoneurons producing voluntary movement in primates comes from the reticulospinal tract, not the corticospinal tract.

Los desafíos de la educación médica en México / The challenges of medical education in Mexico

La educación médica genera impacto en la salud de las poblaciones; formar médicos profesionalizados con capacidad para adaptarse a entornos cambiantes permite comprender con mayor detalle la epidemiología de una comunidad o país y mejorar la salud pública. Dar al estudiante de medicina las herramientas necesarias para proporcionar una atención de calidad puede mejorar la salud de cientos de pacientes. La educación médica está llena de desafíos y se encuentra en una búsqueda continua de excelencia. El modelo educa-tivo actual busca centrarse en las competencias requeridas por los sistemas de salud y educación de México, pero COVID-19 rompió paradigmas y revolucionó la manera en la que se enseña medicina, centrándose en el aprendizaje autorregulado. El mundo está en constante cambio y la educación médica debe evolucionar con el mundo. La tecnología es la herramienta que revoluciona la enseñanza y permite introducir la globalización a las escuelas, aprendiendo así sobre otras culturas y su manera de practicar la medicina. La salud mental de los estudiantes es determinante para evitar la deserción y formar médicos sanos. El integrar condiciones de bienestar a nivel nacional e institucional tendrá un impacto positivo en la vida de los estudiantes, y los ayudará a desempeñarse mejor en el futuro. El reto de la educación médica actualmente es inspirar la formación de médicos capaces de insertarse en un mercado laboral competitivo, sin descuidar la atención al paciente, con habilidades directivas y organizacionales, evitando la sobre-especialización como limitante del desarrollo profesional.

Medical education creates an impact on the health of the population. To train professional doctors capable of adapting to changing environments allows a more detailed understanding of the epidemiology in a community or country; and improves public health. When medical students have the tools needed to provide quality care, it can improve the health of hundreds of patients. Medical edu-cation is full of challenges and is in a continuous search of excellence. The current educational model focuses on the skills required by Mexico ́s health and educational systems, but COVID-19 broke paradigms and revolutionised the way we teach medicine, focusing on self-regulated learning. The world is in constant change, and medical education has to evolve with the world. Technology is a tool that revolutionises teaching and allows us to introduce globalisation to schools while learning about other cultures and how they practice medicine. Focusing on the mental health of students is a determining factor in training healthy doctors and avoiding desertion. Incor-porating well-being conditions at hospitals and schools can have a positive impact on the lives of the students, helping them have a better performance. The challenge of medical education today is to inspire the training of doctors capable of inserting themselves in a competitive labour market without neglecting patient care and with managerial and organisational skills, avoiding over-specialization as a limitation of professional development

Behavioral and Neurochemical Shifts at the Hippocampus and Frontal Cortex Are Associated to Peripheral Inflammation in Balb/c Mice Infected with Brucella abortus 2308.

Brucellosis is a zoonosis affecting 50,000,000 people annually. Most patients progress to a chronic phase of the disease in which neuropsychiatric symptoms upsurge. The biological processes underlying the progression of these symptoms are yet unclear. Peripheral inflammation mounted against Brucella may condition neurochemical shifts and hence unchained neuropsychiatric disorders. Our work aimed at establishing whether neurological, behavioral, and neurochemical disarrays are circumstantially linked to peripheral inflammation uprise secondary to Brucella abortus 2308 infections. We then evaluated, in control and Brucella-infected mice, skeletal muscle strength, movement coordination, and balance and motivation, as well as dopamine, epinephrine, norepinephrine, and serotonin availability in the cerebellum, frontal cortex, and hippocampus. Serum levels of proinflammatory cytokines and corticosterone in vehicle-injected and -infected mice were also estimated. All estimates were gathered at the infection acute and chronic phases. Our results showed that infected mice displayed motor disabilities, muscular weakness, and reduced motivation correlated with neurochemical and peripheral immunological disturbances that tended to decrease after 21 days of infection. The present observations support that disturbed peripheral inflammation and the related neurochemical disruption might lead to mood disorders in infected mice. Future experiments must be aimed at establishing causal links and to explore whether similar concepts might explain neurological and mood disorders in humans affected by brucellosis.