Biopsychosocial factors are associated with impaired sexual function in Mexican patients with rheumatoid arthritis.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic disease with worldwide representation that impacts every domain of a patient´s life, extending to sexual and reproductive domains. The study characterized sexual health (SH) and reproductive health (RH) in Mexican RA outpatients and identified factors associated with impaired sexual function (ISF). METHODS: From September 1, 2020-January 31, 2022, consecutive RA participants had semi-structured interviews focusing on their SH and RH biographies, and self-administered questionnaires were applied to assess patient-reported outcomes, including fatigue with the Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-F). ISF was defined based on published cut-offs of the International Index of Erectile Function (IIEF) in males and the Female Sexual Function Index (FSFI) in females (≥1 sexual intercourse in the last four weeks was required for index scoring). Multivariable logistic regression analysis was used to identify the factors associated with ISF. RESULTS: There were 268 participants, and 246 (91.8%) were females. Participants had 13 years of disease duration. Among females, 151 (61.4%) had FSFI applied, and the satisfaction domain was impaired in 111 (73.5%). Among males (N = 22), 17 (77.3%) had IIEF applied, and erectile dysfunction was present in 5 (29.4%). Almost half of the participants denied using a family planning method, were in their 50s, and receiving teratogenic drugs; 89.7% of the participants had children. ISF was detected in 94 (62.3%) females and 3 (17.6%) males. Male sex (aOR: 0.07, 95%CI: 0.01-0.36, p = 0.001), FACIT-F score (aOR: 0.96, 95%CI: 0.92-1.00, p = 0.03), and cohabitation with the couple (aOR: 0.32, 95%CI: 0.11-0.96, p = 0.04) were associated with ISF. CONCLUSIONS: We observed a disproportionate burden of ISF among women with RA compared to male participants. Male sex, lesser fatigue, and cohabitation with the couple were protective against ISF. Regardless of the prevalent use of teratogenic medications, contraceptive use was suboptimal among the participants.

Chromosome-scale Salvia hispanica L. (Chia) genome assembly reveals rampant Salvia interspecies introgression.

Salvia hispanica L. (Chia), a member of the Lamiaceae, is an economically important crop in Mesoamerica, with health benefits associated with its seed fatty acid composition. Chia varieties are distinguished based on seed color including mixed white and black (Chia pinta) and black (Chia negra). To facilitate research on Chia and expand on comparative analyses within the Lamiaceae, we generated a chromosome-scale assembly of a Chia pinta accession and performed comparative genome analyses with a previously published Chia negra genome assembly. The Chia pinta and Chia negra genome sequences were highly similar as shown by a limited number of single nucleotide polymorphisms and extensive shared orthologous gene membership. However, there is an enrichment of terpene synthases in the Chia pinta genome relative to the Chia negra genome. We sequenced and analyzed the genomes of 20 Chia accessions with differing seed color and geographic origin revealing population structure within S. hispanica and interspecific introgressions of Salvia species. As the genus Salvia is polyphyletic, its evolutionary history remains unclear. Using large-scale synteny analysis within the Lamiaceae and orthologous group membership, we resolved the phylogeny of Salvia species. This study and its collective resources further our understanding of genomic diversity in this food crop and the extent of interspecies hybridizations in Salvia.

[Incidence of intrahospitalary major cardiac events with the use of mechanic thromboaspiration versus only use of IIB/IIIA glucoprotein inhibitors on patients with acute ST elevation myocardial infarction]. / Incidencia de eventos cardiovasculares mayores intrahospitalarios en pacientes sometidos a tromboaspiración mecánica más IIb/IIIa contra solo inhibidores de la glucoproteína IIb/IIIa en infarto agudo al miocardio con elevación del segmento ST.

Objective: To identify the incidence of in-hospital major adverse cardiac events (MACE) with the use of mechanic thromboaspiration plus IIb/IIIa glycoprotein inhibitors versus only use of IIb/IIIa glycoprotein inhibitors on patients with acute ST elevation myocardial infarction. Method: Retrospective, observational, cohort analytic study, on patients with acute ST elevation myocardial infarction that had angiography thrombus TIMI 5 grade, treated between October 2021 and December 2022. Results: A total of 237 patients were included. In 113 patients thromboaspiration were used, 124 patients didn't used. 81.6% were men. In-hospital MACE occurred on 31.9% of patients with thromboaspiration use vs. 30.6% on patients with no use (RR: 1.05; IC95%: 0.61-1.93; p = 0.840). Incidence of malignant arrhythmias were of 8% with thromboaspiration use vs. 1.6% on patients with no use (RR: 5.27; IC95%: 1.11-24.97; p = 0.020). Conclusions: The use of thromboaspiration on concomitant treatment with IIb/IIIa glycoprotein inhibitors was similar with only IIb/IIIa glycoprotein inhibitors in reducing incidence of in-hospital MACE on patients with ST elevation acute myocardial infarction and high thrombus burden. The study has several limitations, so results should be taken with caution.

Objetivo: Identificar la incidencia de eventos cardiovasculares adversos mayores (ECAM) intrahospitalarios con el uso de tromboaspiración mecánica más inhibidores de la glucoproteína IIb/IIIa contra solo inhibidores de la glucoproteína IIb/IIIa en pacientes con infarto agudo al miocardio con elevación del segmento ST (IAMCEST). Método: Estudio retrospectivo, observacional, analítico, de cohorte, en pacientes con IAMCEST con trombo angiográfico de grado TIMI 5, tratados entre octubre de 2021 y diciembre de 2022. Resultados: Cumplieron los criterios de inclusión 237 pacientes. En 113 se usó tromboaspirador más inhibidores IIb/IIIa y en 124 solo inhibidores IIb/IIIa. El 81.6% fueron hombres. La incidencia de ECAM intrahospitalarios fue del 31.9% en los pacientes con tromboaspiración y del 30.6% en los pacientes con solo inhibidores IIb/IIIa (RR: 1.05; IC95%: 0.61-1.93; p = 0.840). La incidencia de arritmias graves fue del 8% en los pacientes con tromboaspiración y del 1.6% en los pacientes con solo inhibidores IIb/IIIa (RR: 5.27; IC95%: 1.11-24.97; p = 0.020). Conclusiones: La frecuencia de ECAM asociados al uso de tromboaspiración mecánica como coadyuvante a los inhibidores de la glucoproteína IIb/IIIa en pacientes con IAMCEST y trombo angiográfico de grado TIMI 5 no es diferente de la de aquellos pacientes en las que solo se utilizan inhibidores de la glucoproteína IIb/IIa. El estudio tiene varias limitaciones, por lo que los resultados deben tomarse con cautela.

Sexual and reproductive health while living with rheumatoid arthritis: The impact of the disease stage on patient perspectives.

BACKGROUND: Rheumatoid arthritis (RA) is one of the most prevalent rheumatic diseases that harms all aspects of patients' lives, including sexual and reproductive health (SRH), often neglected in patients' care. The study aimed to explore the sexual and reproductive experiences of Mexican outpatients with RA from a narrative perspective. PATIENTS AND METHODS: From July 2020 to October 2021, 30 adult patients with RA from the Department of Immunology and Rheumatology outpatient clinic of a national referral center for rheumatic diseases had in-depth interviews audiotaped, transcribed, and analyzed using a thematic analysis approach. Results are presented in a descriptive and interpretative manner and integrated into a theoretical model for the topic understanding. RESULTS: Five intertwined major themes emerged: I) RA onset: Absence of SRH contents, II) Healthcare for RA: Emerging SRH contents, III) RA's impact: Proliferation of SRH contents, IV) Coping with the process of living with RA: SRH-related strategies, and V) The impact of the COVID-19 pandemic on patients' experiences: Increased SRH burden. SRH contents emerged through these major themes (but at RA onset), mostly when inquired and mainly when narrating the RA impact and coping. Patients identified that RA affected their couple dynamics, sexual function, and reproductive project. The SRH care was considered relevant but limited and focused on reproductive contents. It worsened during the COVID-19 pandemic. We proposed a theoretical model where patients' SRH experiences are embedded across their RA biography and integrated with the RA impact and the copy with the disease process. These intertwined experiences were also evident during the COVID-19 pandemic, which challenged participants' biopsychosocial resources. CONCLUSIONS: The sexual and reproductive experiences narrated by the RA outpatients concerning their disease-related biography showed that even when the SRH appeared as not prioritized at the disease onset, it was widely expressed during the process of living and coping with the disease and was additionally affected by the COVID-19 pandemic.

Indirect Measurement of Variables in a Heterogeneous Reaction for Biodiesel Production.

This research focuses on the development of a state observer for performing indirect measurements of the main variables involved in the soybean oil transesterification reaction with a guishe biochar-based heterogeneous catalyst; the studied reaction takes place in a batch reactor. The mathematical model required for the observer design includes the triglycerides' conversion rate, and the reaction temperature. Since these variables are represented by nonlinear differential equations, the model is linearized around an operation point; after that, the pole placement and linear quadratic regulator (LQR) methods are considered for calculating the observer gain vector L(x). Then, the estimation of the conversion rate and the reaction temperature provided by the observer are used to indirectly measure other variables such as esters, alcohol, and byproducts. The observer performance is evaluated with three error indexes considering initial condition variations up to 30%. With both methods, a fast convergence (less than 3 h in the worst case) of the observer is remarked.

Determinants of Vitamin D Status in Healthy Young Adults from Mexico City.

BACKGROUND AND AIMS: Vitamin D deficiency is a global health problem. The determinants of this deficiency have not been evaluated in developing countries such as Mexico. Thus, this study aimed to determine vitamin D intake and sun exposure and its relationship with plasma concentrations of 25-hydroxyvitamin D -25(OH)D- in young adults from Mexico City. METHODS: One hundred fifty five urban adult subjects were enrolled during 2017 and 2018. Sociodemographic, anthropometric, and clinical data, vitamin D intake, and sun exposure habits were collected. Plasma concentrations of 25(OH)D were also determined. RESULTS: The proportion of vitamin D deficiency was significantly higher in women than in men (65.7 vs. 43.4%, p = 0.012). The overall median dietary vitamin D intake was 112 IU/d (less than 20% of the recommended daily intake; RDI). 25-hydroxyvitamin D correlated directly with vitamin D intake, sun exposure score, waist-to-hip ratio, and age; an inverse significant association was found with body fat percentage. A multiple regression analysis was performed; simultaneous and significant (p <0.01) effects of sun exposure score, dietary vitamin D, the season of the year (spring-summer vs. fall-winter), and age were observed on 25(OH)D levels. CONCLUSION: High rates of vitamin D deficiency and insufficiency were observed in young adults from Mexico City. According to the RDI of this vitamin, its consumption, assessed by a 24 h multi-step nutritional questionnaire, was significantly low. A linear multiple regression model identified several predictors of plasma 25(OH)D concentrations. This multiple regression model was statistically validated.

Aflatoxin exposure in adults in southern and eastern Mexico in 2018: A descriptive study.

OBJECTIVE: To estimate the frequency of detection and levels of aflatoxin B1-lysine adduct (AFB1-lys), an important hepatocellular carcinoma (HCC) risk factor, in eastern and southern Mexico. MATERIALS AND METHODS: We determined serum AFB1-lys using mass spectrometry in a representative sample of 952 adults (weighted n = 7,493,354) from five states (Campeche, Chiapas, Tamaulipas, Veracruz and Yucatán) in 2018. We calculated overall and subgroup-specific frequency of detection and 95% confidence intervals (95%CI) and median AFB1-lys levels and quartiles. RESULTS: The overall frequency of detection of AFB1-lys was 91.9% (95%CI 88.6, 94.3). The median AFB1-lys level was 0.172 pg/µL (Q1-Q3, 0.060-0.582). Levels differed geographically (median pg/µL, 0.361 for Veracruz and 0.061 for Yucatan) and were higher among men and older individuals. Levels were almost three times higher in rural relative to urban areas (0.317 vs. 0.123 pg/µL). We observed higher AFB1-lys exposure in lower socioeconomic status (SES) level populations. CONCLUSION: AFB1-lys frequency of detection was very high and exposure levels were highest in Veracruz, men, rural areas, and among persons of lower SES. Understanding modifiable HCC risk factors in populations with unique epidemiological patterns could inform preventative interventions.

A continuous process in mixers-settlers for the removal/recovery of chromium in effluents from the tanning industry.

One of the main environmental issues caused by the tanning industry is given by the high concentration of chromium contained on its effluents. The removal of this pollutant has become a technological challenge. To solve this issue, this work proposes a continuous process based on mixers-settlers for the removal of the chromium present in effluents from the tanning industry. The process involves the use of liquid-liquid extraction systems. The study includes the development of isotherms for the removal and stripping, which are further represented through a mathematical model to determine the number of theoretical extraction stages and other operational variables. The results show that a better extraction is achieved in a system with two theoretical stages using Cyanex 272 as extractant, reaching more than 94% of removal of chromium with an extractant concentration of 0.32 mol/L. For stripping, sulfuric acid is used, obtaining a maximum recovery of 94%.

Effect of Micro-Nanobubbles on Arsenic Removal by Trichoderma atroviride for Bioscorodite Generation.

The global environmental issue of arsenic (As) contamination in drinking water is a significant problem that requires attention. Therefore, the aim of this research was to address the application of a sustainable methodology for arsenic removal through mycoremediation aerated with micro-nanobubbles (MNBs), leading to bioscorodite (FeAsO4·2H2O) generation. To achieve this, the fungus Trichoderma atroviride was cultivated in a medium amended with 1 g/L of As(III) and 8.5 g/L of Fe(II) salts at 28 °C for 5 days in a tubular reactor equipped with an air MNBs diffuser (TR-MNBs). A control was performed using shaking flasks (SF) at 120 rpm. A reaction was conducted at 92 °C for 32 h for bioscorodite synthesis, followed by further characterization of crystals through Fourier-Transform Infrared Spectroscopy (FTIR), Scanning Electron Microscopy (SEM), and X-ray diffraction (XRD) analyses. At the end of the fungal growth in the TR-MNBs, the pH decreased to 2.7-3.0, and the oxidation-reduction potential (ORP) reached a value of 306 mV at 5 days. Arsenic decreased by 70%, attributed to possible adsorption through rapid complexation of oxidized As(V) with the exchangeable ferrihydrite ((Fe(III))4-5(OH,O)12), sites, and the fungal biomass. This mineral might be produced under oxidizing and acidic conditions, with a high iron concentration (As:Fe molar ratio = 0.14). The crystals produced in the reaction using the TR-MNBs culture broth and characterized by SEM, XRD, and FTIR revealed the morphology, pattern, and As-O-Fe vibration bands typical of bioscorodite and römerite (Fe(II)(Fe(III))2(SO4)4·14H2O). Arsenic reduction in SF was 30%, with slight characteristics of bioscorodite. Consequently, further research should include integrating the TR-MNBs system into a pilot plant for arsenic removal from contaminated water.

Candida albicans the main opportunistic pathogenic fungus in humans / Candida albicans el principal hongo patógeno oportunista en humanos

Abstract Candida albicans is a commensal of the mammalian microbiome and the primarypathogenic fungus of humans. It becomes a severe health problem in immunocompromisedpatients and can cause a wide variety of mucosal and systemic infections. The interactionbetween C. albicans and host cells is characterized by the expression of virulence factors suchas adhesins and invasins, the secretion of hydrolytic enzymes, a transition from yeast to fil-amentous hyphae form, and the ability to form biofilms; these features collectively result in cell adhesion, invasion, and damage. This review describes complex commensal interactions of C. albicans with host cells and the cellular events that it triggers in a pathogenic environment. We also review the host immune response induced by C. albicans antigens and the mechanisms developed by this fungus to avoid the action of antifungal agents.

Resumen Candida albicans es un comensal del microbioma de mamíferos y el principal hongopatógeno de humanos. En pacientes inmunocomprometidos se convierte en un grave problemade salud por causar una amplia variedad de infecciones en mucosas y sistémicas. La interacciónentre C. albicans y las células del huésped lleva a la expresión de factores de virulencia, comoadhesinas e invasinas, a la secreción de enzimas hidrolíticas y a la transición de levadura a hifa filamentosa, capaz de para formar biopelículas, lo que genera adherencia, invasión y dano celular. En esta revisión describimos la compleja interacción comensal de C. albicans con la célula huésped y los eventos celulares que ejecuta en un ambiente patogénico. También se revisa la respuesta inmunitaria del huésped inducida por antígenos de C. albicans y los mecanismos desarrollados por este hongo para evitar la acción de agentes antifúngicos.

Deep Learning Model for COVID-19 Sentiment Analysis on Twitter.

The COVID-19 pandemic impacted the mood of the people, and this was evident on social networks. These common user publications are a source of information to measure the population's opinion on social phenomena. In particular, the Twitter network represents a resource of great value due to the amount of information, the geographical distribution of the publications and the openness to dispose of them. This work presents a study on the feelings of the population in Mexico during one of the waves that produced the most contagion and deaths in this country. A mixed, semi-supervised approach was used, with a lexical-based data labeling technique to later bring these data to a pre-trained model of Transformers completely in Spanish. Two Spanish-language models were trained by adding to the Transformers neural network the adjustment for the sentiment analysis task specifically on COVID-19. In addition, ten other multilanguage Transformer models including the Spanish language were trained with the same data set and parameters to compare their performance. In addition, other classifiers with the same data set were used for training and testing, such as Support Vector Machines, Naive Bayes, Logistic Regression, and Decision Trees. These performances were compared with the exclusive model in Spanish based on Transformers, which had higher precision. Finally, this model was used, developed exclusively based on the Spanish language, with new data, to measure the sentiment about COVID-19 of the Twitter community in Mexico.

Investigation of TiO2 Deposit on SiO2 Films: Synthesis, Characterization, and Efficiency for the Photocatalytic Discoloration of Methylene Blue in Aqueous Solution.

TiO2-SiO2 thin films were created on Corning glass substrates using a simple method. Nine layers of SiO2 were deposited; later, several layers of TiO2 were deposited, and their influence was studied. Raman spectroscopy, high resolution transmission electron spectroscopy (HRTEM), an X-ray diffractometer (XRD), ultraviolet-visible spectroscopy (UV-Vis), a scanning electron microscope (SEM), and atomic force microscopy (AFM) were used to describe the sample's shape, size, composition, and optical characteristics. Photocatalysis was realized through an experiment involving the deterioration of methylene blue (MB) solution exposed to UV-Vis radiation. With the increase of TiO2 layers, the photocatalytic activity (PA) of the thin films showed an increasing trend, and the maximum degradation efficiency of MB by TiO2-SiO2 was 98%, which was significantly higher than that obtained by SiO2 thin films. It was found that an anatase structure was formed at a calcination temperature of 550 °C; phases of brookite or rutile were not observed. Each nanoparticle's size was 13-18 nm. Due to photo-excitation occurring in both the SiO2 and the TiO2, deep UV light (λ = 232 nm) had to be used as a light source to increase photocatalytic activity.

High Adsorption of Hazardous Cr(VI) from Water Using a Biofilter Composed of Native Pseudomonas koreensis on Alginate Beads.

Most conventional methods to remove heavy metals from water are efficient for high concentrations, but they are expensive, produce secondary pollution, and cannot remove low concentrations. This paper proposes a biological system to remove Cr(VI) from aqueous solutions; the biofilter is composed of a native Pseudomonas koreensis immobilized in calcium alginate beads. Lab experiments were conducted in batch reactors, considering different operating conditions: Cr(VI) concentration, temperature, pH, and time. At 30 °C and a pH of 6.6, the immobilized bacteria achieved their optimal adsorption capacity. In the chromium adsorption system, saturation was reached at 30 h with a qmax = 625 mg g-1. By adjusting the experimental data to the Langmuir and Freundlich models, it is suggested that P. koreensis forms a biofilm with a homogeneous surface where Cr(VI) is adsorbed and that the bacteria also incorporates the metal in its metabolism, leading to a multilayer adsorption. On the other hand, using Fourier transform infrared spectroscopy, it was inferred that the functional groups involved in the adsorption process were O-H and C=O, which are a part of the P. koreensis cell wall.

Candida albicans the main opportunistic pathogenic fungus in humans.

Candida albicans is a commensal of the mammalian microbiome and the primary pathogenic fungus of humans. It becomes a severe health problem in immunocompromised patients and can cause a wide variety of mucosal and systemic infections. The interaction between C. albicans and host cells is characterized by the expression of virulence factors such as adhesins and invasins, the secretion of hydrolytic enzymes, a transition from yeast to filamentous hyphae form, and the ability to form biofilms; these features collectively result in cell adhesion, invasion, and damage. This review describes complex commensal interactions of C. albicans with host cells and the cellular events that it triggers in a pathogenic environment. We also review the host immune response induced by C. albicans antigens and the mechanisms developed by this fungus to avoid the action of antifungal agents.

Impact of a hybrid medical care model in the rheumatoid arthritis patient-reported outcomes: A non-inferiority crossover randomized study.

OBJECTIVE: Patients and physicians can naturally adopt hybrid healthcare models that combine face-to-face consultations with telemedicine. The study's objective was to compare the impact of two healthcare interventions, hybrid care modality and face-to-face consultation, on the patient-reported outcomes of rheumatoid arthritis patients, during the COVID-19 pandemic. METHODS: Consecutive outpatients reincorporated to a clinic previously in lockdown were invited to a non-inferiority, randomized study (October 2020--May 2022). Patients were randomized to 6 months of face-to-face consultation or hybrid care modality (intervention period-1) and then the converse modality (intervention period-2). The primary outcome was disease activity/severity behavior (Routine Assessment of Patient Index Data 3). Additional patient-reported outcomes were disability (Health Assessment Questionnaire Disability Index), quality-of-life (World Health Organization quality of life questionnaire-brief version), adherence and satisfaction with medical care, and treatment recommendation. Sample size calculation established 55 patients/healthcare interventions. RESULTS: There were 138 patients invited to participate, 130 agreed and 121 completed their study participation. Sixty-one and 60 patients respectively, received face-to-face consultation and hybrid care modality over intervention period-1. Patients were primarily middle-aged females (90.1%), with (median, IQR) 12 (9-16) years of education, long-standing disease, working (62.8%), receiving disease-modifying anti-rheumatic drugs (96.7%), and corticosteroids (61.2%). Patients had low disease activity (median Routine Assessment of Patient Index Data 3: 2.7) and Health Assessment Questionnaire Disability Index score that translated into the absence of disability, while quality of life was compromised. Baseline characteristics were similar between patients assigned to each healthcare intervention. Differences in Routine Assessment of Patient Index Data 3 behavior were below the non-inferiority margin. Results considered the order in which patients received the intervention and baselines scores, and extended to the patient-reported outcomes left. CONCLUSIONS: Hybrid care modality was non-inferior to in-person consultations in achieving patient-reported outcomes during the COVID-19 pandemic in rheumatoid arthritis patients.

Expression, purification, and refolding of the recombinant extracellular domain ß1-subunit of the dog Na+/K+-ATPase of the epithelial cells.

The ß1-subunit of the Na+/K+-ATPase is a cell membrane protein, beyond its classic functions, it is also a cell adhesion molecule. ß1-subunits on the lateral membrane of dog kidney epithelial cells trans-interact with ß1-subunits from another neighboring cells. The ß-ß interaction is essential for the formation and stabilization of intercellular junctions. Previous studies on site-directed mutagenesis and in silico revealed that the interaction interface involves residues 198-207 and 221-229. However, it is necessary to report the interaction interface at the structural level experimentally. Here, we describe the successful cloning, overexpression in E. coli, and purification of the extracellular domain of the ß1-subunit from inclusion bodies. Experimental characterization by size exclusion chromatography and DLS indicated similar hydrodynamic properties of the protein refolded. Structural analysis by circular dichroism and Raman spectroscopy revealed the secondary structures in the folded protein of type ß-sheet, α-helix, random coil, and turn. We also performed ß1-ß1 interaction assays with the recombinant protein, showing dimers' formation (6xHisß1-ß1). Given our results, the recombinant extracellular domain of the ß1-subunit is highly similar to the native protein, therefore the current work in our laboratory aims to characterize at the atomic level the interaction interface between EDß1.

La interculturalidad vacía: derecho a la salud intercultural de los pueblos indígenas y personas migrantes en Chile / Empty interculturality: the right to intercultural health of indigenous peoples and migrants in Chile / A interculturalidade vazia: direito à saúde intercultural dos povos indígenas e pessoas migrantes no Chile

Resumen: Este trabajo analiza el desarrollo de la perspectiva intercultural en la protección y garantía del derecho a la salud en pueblos indígenas y población migrante en Chile desde el punto de vista jurídico. Revisa las prácticas y experiencias prevalentes en el ámbito de la salud pública en Chile, para establecer la forma y alcance de la interculturalidad en la protección del derecho a la salud y la manera en que tributa a la interculturalidad. La perspectiva intercultural en el acceso a la justicia en Chile es débil, formal, se trata de iniciativas incipientes en el caso de los pueblos indígenas, mientras en el caso de las personas migrantes apenas abordan barreras idiomáticas.

Abstract: This work analyzes the development of the intercultural perspective in the protection and guarantee of the right to health in indigenous peoples and migrant population in Chile from the legal point of view. It reviews the prevalent practices and experiences in the field of public health in Chile, to establish the shape and scope of interculturality in the protection of the right to health, and the way in which it contributes to interculturality. The intercultural perspective on access to justice in Chile is weak, formal, these are incipient initiatives in the case of indigenous peoples while in the case of migrants, they hardly address language barriers.

Resumo: Este trabalho analisa o desenvolvimento da perspectiva intercultural na proteção e garantia do direito à saúde nos povos indígenas e população migrante no Chile do ponto de vista jurídico. Revisa as práticas e experiências prevalentes no âmbito da saúde pública no Chile, para estabelecer a forma e alcance da interculturalidade na proteção do direito à saúde e à forma com que contribui à interculturalidade. A perspectiva intercultural no acesso à justiça no Chile é débil, formal, tratando-se de iniciativas incipientes no caso dos povos indígenas, enquanto que no caso das pessoas migrantes apenas abordam barreiras idiomáticas.

How Do Mexican Patients With Rheumatoid Arthritis Define Sexual and Reproductive Health? A Content Analysis Study.

BACKGROUND: A patient-centered approach is essential for promoting sexual health (SH) and reproductive health (RH) in rheumatoid arthritis patients. The study aimed to describe and interpret Mexican rheumatoid arthritis outpatients' testimonies of their SH and RH definitions. METHODS: Qualitative and quantitative content analysis was conducted on free-text comments from 219 and 223 descriptions of patients' SH and RH definitions, respectively. A comprehensive system of major themes, categories, and subcategories was structured for each definition. The representational foundations of these categories and the context of their production were analyzed. Integration of quantitative and qualitative content analysis was used to comprehend patients' definitions of SH and RH. Internal review board approved the study. RESULTS: Ten major themes emerged for each definition, and their assigned frequencies differed between SH and RH definitions, and between groups of patients integrated according to age, education level, and sex. Both definitions had similar contents, expressed in the shared major themes and categories, and in managing at the same time SH- and RH-related contents within each definition. The "overall prevention-patient oriented care" major theme defined a common core for both definitions' contents. Meanwhile, a diversity of meanings was also evident particularly at the subcategory level. CONCLUSIONS: In our population, SH content was distinguished by related diseases and their consequences, individual actions directed to prevention, and couple mentions. Meanwhile, RH was distinguished by a primarily biological perspective of the reproductive function, which was required at a particular life stage to concrete a family project.

Vitamin D Receptor Gene Polymorphisms, ß-cell Function, and Vitamin D Status in Non-obese Mexican Adults.

BACKGROUND: FokI (rs2228570 T>C) and BsmI (rs1544410 A>G) polymorphisms of the vitamin D receptor (VDR) have been associated to abnormal glucose metabolism and could be inversely associated with ß-cell function (BCF) and vitamin D status. There is a lack of information about this topic in the Mexican population. AIM OF THE STUDY: To evaluate the relationship between VDR gene polymorphisms FokI and BsmI with BCF and vitamin D status in a population of non-obese Mexican adults. METHODS: A sample of 192 participants were enrolled during 2016-2018. Blood samples were collected to determine fasting concentrations of glucose, insulin, and vitamin D. Genomic DNA was isolated from leucocytes and the polymorphic variants of FokI and BsmI were analyzed. The Homeostasis Model Assessment Calculator was used to estimate the BCF (HOMA2-B). RESULTS: FokI polymorphism showed a frequency of 20.1% for homozygous TT carriers and 7.8% for the BsmI GG. The recessive model of FokI (TT genotype) showed a lower mean value of BCF compared to the combination of CC + CT (99.2 vs. 109.6%, p = 0.045). Likewise, significantly lower mean values of HOMA2-B and insulin were observed for BsmI (GG genotype, p = 0.016 and p = 0.039, respectively). After covariates adjustment, only FokI polymorphism remained as an independent predictor of BCF. CONCLUSIONS: the TT and GG variants of the FokI and BsmI polymorphisms are related to a decrease in FCB. In the case of FokI, this decrement was independent of insulin sensitivity, vitamin D levels, percentage of body fat, gender, and age.

Comparison of Teleconsultations and In-Person Consultations from Outpatients with Rheumatoid Arthritis, During the COVID-19 Pandemic: An Internal Audit of Medical Notes.

Introduction: The objectives of this study were to compare the quality-of-care and compliance with medical record regulations between in-person consultations (QIP and CIP) and telephone consultations (QTP and CTP), from rheumatoid arthritis (RA) outpatients, during the COVID-19 pandemic, and to explore the impact of the consultation modality on the treatment. Methods: Data from 324 medical notes corresponding to rheumatic consultations between July and December 2020 were abstracted. Notes were selected considering a stratified (in-person and telephone consultations) random sampling strategy. QIP, CIP, QTP, and CTP were scored based on prespecified criteria as percentages, where higher numbers translated into better standards. Logistic regression analysis investigated the association between the consultation modality and the treatment recommendation (dependent variable). Results: There were 208 (64.2%) medical notes related to in-person consultations and 114 (35.2%) to telephone consultations. Overall, medical notes corresponded to middle-aged women with long-standing disease. QIP was superior to QTP (median, interquartile range): 60% (60-75%) versus 50% (25-60%), p ≤ 0.001, and differences were related to disease activity and prognosis documentation (81.3% vs. 34.5% and 55.8% vs. 33.6%, respectively, p ≤ 0.001) and the prolonged prescription of glucocorticoids with a documented management plan (58.5% vs. 30.4%, p = 0.045). Meanwhile, CIP and CTP were similar. Telephone consultation was a significant risk factor for no changes in the treatment recommendation (odds ratio: 2.113, 95% confidence interval: 1.284-3.479, p = 0.003), and results were consistent in the 142 medical notes with documented absence of disease activity. Conclusions: In the clinical context of RA, the quality-of-care provided by telephone consultations is below the standard of care and impacts the treatment.