Resiliencia en estudiantes universitarios de ciencias de la salud chilenos en el contexto de la telesimulación / Resilience in Chilean university health science students in the context of telesimulation

Introducción: El presente trabajo tuvo como propósito conocer el nivel de resiliencia en contexto pandémico en una muestra de estudiantes de pregrado de ciencias de la salud y cómo ésta se comporta en escenarios de telesimulación. Sujetos y métodos: El estudio tuvo un enfoque cuantitativo, con diseño observacional y temporalidad transversal. Se incluyó a 192 estudiantes pertenecientes a cinco carreras de las ciencias de la salud, cuyas edades oscilaron entre los 20 y los 49 años. Para medir la variable de interés se utilizó el cuestionario de resiliencia adaptado a 44 ítems con respuestas en escalamiento de tipo Likert. Resultados: Los resultados muestran niveles altos de resiliencia en carreras con programas de estudio que incluyen la telesimulación y las diferencias entre cada una de estas carreras. Conclusiones: Se sugiere la ampliación de la línea de investigación en otros contextos situacionales e intervención de metodologías de enseñanza-aprendizaje, con el fin de potenciar los procesos de adaptación de los estudiantes de salud y evaluar competencias esperadas del perfil de egreso, directamente relacionadas con su desempeño en su quehacer profesional.(AU)

Introduction: The purpose of this work was to know the level of resilience in a pandemic context in a sample of undergraduate students of health sciences, and how it behaves in tele-simulation scenarios. The study had a quantitative approach, with observational design, cross-sectional temporality and prospective.Subjects and methods: We included 192 students belonging to 5 careers in health sciences, whose ages ranged between 20 and 49 years. To measure the variable of interest, the resilience questionnaire adapted to 44 items with Likert-type scaling responses was used. Results: The results show high levels of resilience in careers with study programs that include tele-simulation and the differences between each of these careers. Conclusions: It is suggested to expand the line of research in other situational contexts and intervention of teachinglearning methodologies, to enhance the adaptation processes of health students and evaluate expected competencies of the graduation profile, directly related to their performance in their professional work.(AU)

Association of Toxoplasmosis and COVID-19 in a MexicanPopulation.

SARS-CoV-2 is the causal agent of COVID-19; the first report of SARS-CoV-2 infection was in December 2019 in Wuhan, China. This virus has since caused the largest pandemic in history, and the number of deaths and infections has been significant. Nevertheless, the development of vaccines has helped to reduce both deaths and infections. Comorbidities such as diabetes, hypertension, heart and lung diseases, and obesity have been identified as additional risk factors for infection and the progression of COVID-19. Additionally, latent toxoplasmosis has been reported to be a risk factor for acquiring COVID-19 in some studies, but other studies have suggested a negative association between these two infections. Furthermore, in patients after vaccination or with COVID-19 and coinfection, an increase in the lethality and mortality of toxoplasmosis has been observed. Therefore, the objective of the current study is to determine the association of toxoplasmosis with COVID-19 in patients diagnosed with COVID-19. Serum samples from 384 patients previously diagnosed with COVID-19 using IgG antibodies against the S1/S2 antigens of SARS-CoV-2 were collected. Subsequently, anti-Toxoplasma IgG and IgM antibodies were analyzed with ELISA. Statistical analysis was performed using SPSS Version 20.0 frequencies, percentages, 2 × 2 tables, and the Pearson correlation coefficient. IgG and IgM anti-Toxoplasma antibodies were positive in 105/384 (27.34%) and (26/191) 13.6% of patients, respectively. The positivity for both infections was higher in patients aged >40 years old. Subjects who were overweight or obese were mainly positive for both IgG antibodies against S1/S2 SARS-CoV-2 and Toxoplasma antibodies. In conclusion, the coinfection rate was 21.7%. The prevalence of S1/S2 SARS-CoV-2 was 308/384 (80.2%), and the percentage of Toxoplasma antibodies was 27.34%.

Biomolecular Condensation of the Human Papillomavirus E2 Master Regulator with p53: Implications in Viral Replication.

p53 exerts its tumour suppressor activity by modulating hundreds of genes and it can also repress viral replication. Such is the case of human papillomavirus (HPV) through targeting the E2 master regulator, but the biochemical mechanism is not known. We show that the C-terminal DNA binding domain of HPV16 E2 protein (E2C) triggers heterotypic condensation with p53 at a precise 2/1 E2C/p53 stoichiometry at the onset for demixing, yielding large regular spherical droplets that increase in size with E2C concentration. Interestingly, transfection experiments show that E2 co-localizes with p53 in the nucleus with a grainy pattern, and recruits p53 to chromatin-associated foci, a function independent of the DNA binding capacity of p53 as judged by a DNA binding impaired mutant. Depending on the length, DNA can either completely dissolve or reshape heterotypic droplets into irregular condensates containing p53, E2C, and DNA, and reminiscent of that observed linked to chromatin. We propose that p53 is a scaffold for condensation in line with its structural and functional features, in particular as a promiscuous hub that binds multiple cellular proteins. E2 appears as both client and modulator, likely based on its homodimeric DNA binding nature. Our results, in line with the known role of condensation in eukaryotic gene enhancement and silencing, point at biomolecular condensation of E2 with p53 as a means to modulate HPV gene function, strictly dependent on host cell replication and transcription machinery.

Are there differences between a real C0-C1 mobilization and a sham technique in function and pressure pain threshold in patients with chronic neck pain and upper cervical restriction? A randomised controlled clinical trial.

BACKGROUND: Chronic neck pain is one of the main reasons for visiting a healthcare professional. In recent years, it has been shown that upper cervical restriction may be a factor involved in neck pain. OBJECTIVE: To compare the immediate effects of a real cervical mobilization technique versus a sham cervical mobilization technique in patients with chronic neck pain and upper cervical restriction. METHODS: This was a randomised, controlled, double-blind clinical trial. Twenty-eight patients with chronic neck pain were recruited and divided into two groups (14 = real cervical mobilization; 14 = sham mobilization). Both groups received a single 5-minute treatment session. Upper cervical range motion, flexion-rotation test, deep cervical activation and pressure pain threshold were measured. RESULTS: In the between-groups comparison, statistically significant differences were found in favour of the real cervical mobilization group in upper cervical extension (p= 0.003), more restricted side of flexion-rotation test (p< 0.001) and less restricted side of flexion-rotation test (p= 0.007) and in the pressure pain threshold of the right trapezius (p= 0.040) and right splenius (p= 0.049). No differences in deep muscle activation were obtained. CONCLUSION: The real cervical mobilization group generates improvements in upper cervical spine movement and pressure pain threshold of right trapezius and right splenius compared to the sham group in patients with chronic neck pain and upper cervical restriction.

Autoeficacia para el desempeño de actividad física en personas mayores / Self-efficacy for the performance of physical activity in the elderly

La autoeficacia, concebida como la creencia en poder realizar una tarea a pesar de las dificultades, es uno de los más consistentes predictores de iniciación y mantenimiento de la actividad física en las personas de todas las edades, pero más aún, en edad avanzada. Por lo tanto, esta revisión describe primero la autoeficacia y su distinción de construcciones similares e incorpora la autoeficacia dentro de la teoría sociocognitiva donde se describió por primera vez. Luego, se describen los principales abordajes de diferentes disciplinas para promover la autoeficacia, y, en consecuencia, la actividad física; poniendo foco en la evidencia disponible en el área de ciencias de la salud sobre cómo impulsar las fuentes de esta importante autoconfianza en las personas mayores.(AU)

Self-efficacy, conceived as the belief in being able to perform a task despite the difficulties, is one of the most consistent predictors of initiation and maintenance of physical activity in people of all ages, but even more, in the elderly. Therefore, this review first describes self-efficacy and its distinction from similar constructions and incorporates self-efficacy into the socio-cognitive theory where it was first described. Then, the main approaches of different disciplines to promote self-efficacy are described, and consequently, physical activity; focusing on the evidence available in the area of health sciences of how to boost the sources of this important self-confidence in the elderly.(AU)

A autoeficácia, concebida como a crença em ser capaz de realizar uma tarefa apesar das dificuldades, é um dos preditores mais consistentes de iniciação e manutenção da atividade física em pessoas de todas as idades, mas ainda mais nos idosos. Portanto, esta revisão descreve primeiro a autoeficácia e sua distinção de construções semelhantes e incorpora a autoeficácia na teoria sócio-cognitiva em que foi descrita pela primeira vez. Em seguida, são descritas as principais abordagens de diferentes disciplinas para promover a autoeficácia e, conseqüentemente, a atividade física; enfocando as evidências disponíveis na área das ciências da saúde sobre como aumentar as fontes dessa importante autoconfiança nas pessoas idosas.(AU)

Ten-Week Sucralose Consumption Induces Gut Dysbiosis and Altered Glucose and Insulin Levels in Healthy Young Adults.

Sucralose consumption alters microbiome and carbohydrate metabolism in mouse models. However, there are no conclusive studies in humans. Our goals were to examine the effect of sucralose consumption on the intestinal abundance of bacterial species belonging to Actinobacteria, Bacteroidetes, and Firmicutes and explore potential associations between microbiome profiles and glucose and insulin blood levels in healthy young adults. In this open-label clinical trial, volunteers randomly drank water, as a control (n = 20), or 48 mg sucralose (n = 20), every day for ten weeks. At the beginning and the end of the study, participants were subjected to an oral glucose tolerance test (OGTT) to measure serum glucose and insulin every 15 min for 3 h and provided fecal samples to assess gut microbiota using a quantitative polymerase chain reaction. Sucralose intake altered the abundance of Firmicutes without affecting Actinobacteria or Bacteroidetes. Two-way ANOVA revealed that volunteers drinking sucralose for ten weeks showed a 3-fold increase in Blautia coccoides and a 0.66-fold decrease in Lactobacillus acidophilus compared to the controls. Sucralose consumption increased serum insulin and the area under the glucose curve compared to water. Long-term sucralose ingestion induces gut dysbiosis associated with altered insulin and glucose levels during an OGTT.

Alkaloid Profiling and Cholinesterase Inhibitory Potential of Crinum × amabile Donn. (Amaryllidaceae) Collected in Ecuador.

Natural products are one of the main sources for developing new drugs. The alkaloids obtained from the plant family Amaryllidaceae have interesting structures and biological activities, such as acetylcholinesterase inhibition potential, which is one of the mechanisms used for the palliative treatment of Alzheimer's disease symptoms. Herein we report the alkaloidal profile of bulbs and leaves extracts of Crinum × amabile collected in Ecuador and their in vitro inhibitory activity on acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) enzymes. Using Gas Chromatography coupled to Mass Spectrometry (GC-MS), we identified 12 Amaryllidaceae alkaloids out of 19 compounds detected in this species. The extracts from bulbs and leaves showed great inhibitory activity against AChE and BuChE, highlighting the potential of Amaryllidaceae family in the search of bioactive molecules.

The chromatin insulator CTCF regulates HPV18 transcript splicing and differentiation-dependent late gene expression.

The ubiquitous host protein, CCCTC-binding factor (CTCF), is an essential regulator of cellular transcription and functions to maintain epigenetic boundaries, stabilise chromatin loops and regulate splicing of alternative exons. We have previously demonstrated that CTCF binds to the E2 open reading frame (ORF) of human papillomavirus (HPV) 18 and functions to repress viral oncogene expression in undifferentiated keratinocytes by co-ordinating an epigenetically repressed chromatin loop within HPV episomes. Keratinocyte differentiation disrupts CTCF-dependent chromatin looping of HPV18 episomes promoting induction of enhanced viral oncogene expression. To further characterise CTCF function in HPV transcription control we utilised direct, long-read Nanopore RNA-sequencing which provides information on the structure and abundance of full-length transcripts. Nanopore analysis of primary human keratinocytes containing HPV18 episomes before and after synchronous differentiation allowed quantification of viral transcript species, including the identification of low abundance novel transcripts. Comparison of transcripts produced in wild type HPV18 genome-containing cells to those identified in CTCF-binding deficient genome-containing cells identifies CTCF as a key regulator of differentiation-dependent late promoter activation, required for efficient E1^E4 and L1 protein expression. Furthermore, our data show that CTCF binding at the E2 ORF promotes usage of the downstream weak splice donor (SD) sites SD3165 and SD3284, to the dominant E4 splice acceptor site at nucleotide 3434. These findings demonstrate that in the HPV life cycle both early and late virus transcription programmes are facilitated by recruitment of CTCF to the E2 ORF.

Modelo de retroalimentación mediante evaluación de 360º para la docencia de pregrado en ciencias de la salud / 360-degree feedback model for undergraduate teaching in health sciences

Introducción: La educación es un proceso dinámico que precisa evaluación constante. Los docentes necesitan un modelo de evaluación amplio que les permita observar la mayor cantidad de variables posibles, para, de esta forma, aportar a la mejora continua del proceso formativo. Objetivo: Elaborar una propuesta de evaluación y retroalimentación de 360º para la docencia de educación superior en ciencias de la salud, tomando como base los componentes: evaluación por autoridades académicas, evaluación por parte de los estudiantes, autoevaluación y evaluación por pares académicos. Materiales y métodos: Se aplicó la evaluación en 360º a ocho docentes de la carrera de Fonoaudiología de la Universidad San Sebastián (Chile). El instrumento se concentró en la evaluación de competencias transversales catalogadas en cuatro dimensiones: disciplinar, pedagógica, actitudinal y gestión. Se aplicaron cuatro encuestas: evaluación por jefatura, por docente par, por estudiantes y autoevaluación. Resultados: La propuesta presentó alta validez de contenido, indicadores con una buena capacidad de discriminación y fiabilidad de los ítems en las distintas escalas. Conclusión: Se recomienda su uso en situaciones similares donde el objetivo sea obtener una mirada integral de la calidad del servicio docente entregado.(AU)

Introduction: Education is a dynamic process that requires constant evaluation. Teachers need a broad evaluation model that allows them to observe as many variables as possible, thus contributing to the continuous improvement of the training process. Objective: Develop a 360-degree feedback model for higher education teaching in health sciences, based on the following components: evaluation by academic authorities, evaluation by students, self-evaluation and evaluation by academic peers. Materials and methods: The 360-degree feedback was applied to 8 teachers of the Speech Therapy career at the San Sebastián University (Chile). The instrument focused on the evaluation of transversal competences cataloged in four dimensions: Disciplinary, Pedagogical, Attitudinal and Management. Four surveys were applied: evaluation by headquarters, by peer teacher, by students and self-evaluation. Results: The model presented high content validity, indicators with a good capacity for discrimination and reliability of the items in the different scales. Conclusion: The model is recommended in similar situations where the objective is to obtain a comprehensive view of the quality of the teaching service provided.(AU)

Alkaloids of Phaedranassa dubia (Kunth) J.F. Macbr. and Phaedranassa brevifolia Meerow (Amaryllidaceae) from Ecuador and its cholinesterase-inhibitory activity.

Alzheimer's disease is considered the most common cause of dementia and, in an increasingly aging population worldwide, the quest for treatment is a priority. Amaryllidaceae alkaloids are of main interest because of their cholinesterase inhibition potential, which is the main palliative treatment available for this disease. We evaluated the alkaloidal profile and the in vitro inhibitory activity on acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) of bulb alkaloid extract of Phaedranassa dubia and Phaedranassa brevifolia collected in Ecuador. Using gas chromatography coupled to mass spectrometry (GC-MS), we identified typical Amaryllidaceae alkaloids in these species, highlighting the presence of lycorine-type alkaloids in P. dubia and haemanthamine/crinine-type in P. brevifolia. The species P. dubia and P. brevifolia showed inhibitory activities against AChE (IC50 values of 25.48 ± 0.39 and 3.45 ± 0.29 µg.mL-1, respectively) and BuChE (IC50 values of 114.96 ± 4.94 and 58.89 ± 0.55 µg.mL-1, respectively). Computational experiments allowed us to understand the interactions of the alkaloids identified in these samples toward the active sites of AChE and BuChE. In silico, some alkaloids detected in these Amaryllidaceae species presented higher estimated binding free energy toward BuChE than galanthamine. This is the first study about the alkaloid profile and biological potential of P. brevifolia species.

Emociones académicas frente al proceso de evaluación de aprendizajes en estudiantes de kinesiología / Academic emotions on the learning evaluation process in kinesiology students

INTRODUCCIÓN: La línea de trabajo sobre las emociones en el aprendizaje y su relación con el logro académico considera las emociones como motivadoras o residuales del aprendizaje intelectual-cognitivo y busca determinar el papel o la función de las emociones como formadoras del aprendizaje. OBJETIVO: Evaluar las diferencias de la emoción del logro académico frente a distintos momentos evaluativos en estudiantes de kinesiología. SUJETOS Y MÉTODOS: El estudio tuvo un enfoque cuantitativo, con diseño observacional, temporalidad transversal y alcance correlacional. Se incluyó a 238 estudiantes regulares de primer a quinto año pertenecientes a la carrera de kinesiología de una universidad privada de la provincia de Concepción. A todos ellos se les aplicó el cuestionario de emociones de prueba. RESULTADOS: Se hallaron puntuaciones más altas para las emociones positivas y más bajas para las emociones negativas. Los estudiantes muestran un promedio estadísticamente significativo más elevado en la emoción de disfrute y esperanza antes de la evaluación. Emociones como el orgullo, la vergüenza y el enojo muestran variabilidad en el eje temporal que rodea al hito evaluativo y muestran una disminución significativa posterior a la rendición de una evaluación. No se encontraron diferencias de las emociones entre hombres o mujeres, grupos etarios o el curso de los estudiantes. CONCLUSIÓN: Es imperativo que los educadores en kinesiología consideren el aprendizaje emocional que emana junto con el proceso de enseñanza-aprendizaje y se transformen en facilitadores del entorno educativo, para que sus estudiantes puedan identificar de forma precisa sus emociones, las definan y puedan regularlas en los distintos momentos evaluativos

INTRODUCTION: The line of work on emotions in learning and its relationship with academic achievement considers emotions as motivating or residual of intellectual-cognitive learning and seeks to determine the role or function of emotions as formators of learning. AIM: To evaluate the differences in the student's emotion of academic achievement versus different evaluative moments in kinesiology. SUBJECTS AND METHODS: The study had a quantitative approach, with observational design, transverse temporality and correlational scope. 238 regular first to fifth year students belonging to the kinesiology degree at a private university in the Province of Concepción were included. The Test Emotions Questionnaire was applied to all of them. RESULTS: Higher scores were found for positive emotions and lower scores for negative emotions. Students show a statistically significant higher average in the emotion of enjoyment and hope before the assessment. Emotions such as pride, shame, and anger show variability in the time axis surrounding the assessment milestone, showing a significant decrease after the assessment was completed. No differences in emotions were found between men or women, age groups or the students' course. CONCLUSION: It is imperative that kinesiology educators consider the emotional learning that emanates along with the teaching-learning process and become facilitators of the educational environment, so that their students can accurately identify their emotions, define them and regulate them in the different evaluative moments

Aprendizaje basado en equipos en una asignatura profesionalizante de una escuela de kinesiología / Team based learning in a professionalizing course of a kinesiology school

INTRODUCCIÓN: A medida que los estudiantes progresan, pueden ir convergiendo su capacitación y sus proyectos profesionales. El aprendizaje basado en equipos (ABE) ha demostrado ser una herramienta valiosa en la educación superior, que favorece procesos reflexivos de forma individual y mediante trabajo colaborativo. OBJETIVO: Describir la implementación de la metodología de ABE en una asignatura profesionalizante de kinesiología. SUJETOS Y MÉTODOS: Estudio de enfoque cuantitativo y alcance descriptivo. La asignatura pertenece al sexto semestre de un total de 10 semestres en la carrera de kinesiología. El curso cuenta con tres tipos de evaluación: prueba escrita teórica, evaluación de proyecto en salud y evaluación de actividades de taller; en esta última se integró la metodología ABE. Participaron 65 estudiantes distribuidos en 12 equipos. RESULTADOS: El rendimiento grupal y el de la evaluación final fueron más altos que el rendimiento individual en el contexto de una asignatura profesionalizante. CONCLUSIÓN: La implementación de la metodología ABE puede generar mejora del rendimiento académico en actividades de trabajo en equipo dentro del contexto de una asignatura profesionalizante de ciencias de la salud; ello resulta muy relevante porque es en estos niveles donde se presenta la máxima necesidad de aprendizaje reflexivo en los estudiantes con motivo de resolver un problema o necesidad en situaciones de salud

INTRODUCTION: As students progress, they can take convergence between training and their professional projects. Team based learning (TBL) has proven to be a valuable tool in higher education, which favors reflective processes individually and through collaborative work. AIM: To describe the implementation of TBL's methodology in a professionalizing course of Kinesiology. SUBJECTS AND METHODS: Study of quantitative approach and descriptive scope. The subject belongs to the sixth semester of a total of 10 semesters in the Kinesiology degree. The course has three types of evaluation: theoretical written test, project evaluation in health and evaluation of workshop activities, in the latter the TBL's methodology was integrated. 65 students distributed in 12 teams participated. RESULTS: The group performance and that of the final evaluation were higher than the individual performance in the context of a professionalizing subject. CONCLUSION: The implementation of the TBL's methodology can generate improvement of academic performance in teamwork activities within the context of a professionalizing course in health sciences, being highly relevant because it is at these levels that there is the greatest need for reflective learning in students in order to solve a problem or need in health situations

Chemical Profiling and Cholinesterase Inhibitory Activity of Five Phaedranassa Herb. (Amaryllidaceae) Species from Ecuador.

It is estimated that 50 million people in the world live with dementia, 60-70% of whom suffer from Alzheimer's disease (AD). Different factors are involved in the development of AD, including a reduction in the cholinergic neurotransmission level. The Amaryllidaceae plant family contains an exclusive, large, and still understudied alkaloid group characterized by a singular skeleton arrangement and a broad spectrum of biological activities. The chemistry and biodiversity of Ecuadorian representatives of the Phaedranassa genus (Amaryllidaceae) have not been widely studied. In this work, five Ecuadorian Phaedranassa species were examined in vitro for their activity towards the enzymes acetyl- (AChE) and butyrylcholinesterase (BuChE), and the alkaloid profile of bulb extracts was analyzed by GC-MS. The species Phaedranassa cuencana and Phaedranassa dubia showed the most AChE and BuChE inhibitory activity, respectively. To obtain insight into the potential role of the identified alkaloids in these inhibitory effects, docking experiments were carried out, and cantabricine showed in silico inhibitory activity against both cholinesterase structures. Our results show that Amaryllidaceae species from Ecuador are a potential source of new drugs for the palliative treatment of AD.

A Single 48 mg Sucralose Sip Unbalances Monocyte Subpopulations and Stimulates Insulin Secretion in Healthy Young Adults.

Sucralose is a noncaloric artificial sweetener that is widely consumed worldwide and has been associated with alteration in glucose and insulin homeostasis. Unbalance in monocyte subpopulations expressing CD11c and CD206 hallmarks metabolic dysfunction but has not yet been studied in response to sucralose. Our goal was to examine the effect of a single sucralose sip on serum insulin and blood glucose and the percentages of classical, intermediate, and nonclassical monocytes in healthy young adults subjected to an oral glucose tolerance test (OGTT). This study was a randomized, placebo-controlled clinical trial. Volunteers randomly received 60 mL water as placebo (n = 20) or 48 mg sucralose dissolved in 60 mL water (n = 25), fifteen minutes prior to an OGTT. Blood samples were individually drawn every 15 minutes for 180 minutes for quantifying glucose and insulin concentrations. Monocyte subsets expressing CD11c and CD206 were measured at -15 and 180 minutes by flow cytometry. As compared to controls, volunteers receiving sucralose exhibited significant increases in serum insulin at 30, 45, and 180 minutes, whereas blood glucose values showed no significant differences. Sucralose consumption caused a significant 7% increase in classical monocytes and 63% decrease in nonclassical monocytes with respect to placebo controls. Pearson's correlation models revealed a strong association of insulin with sucralose-induced monocyte subpopulation unbalance whereas glucose values did not show significant correlations. Sucralose ingestion decreased CD11c expression in all monocyte subsets and reduced CD206 expression in nonclassical monocytes suggesting that sucralose does not only unbalance monocyte subpopulations but also alter their expression pattern of cell surface molecules. This work demonstrates for the first time that a 48 mg sucralose sip increases serum insulin and unbalances monocyte subpopulations expressing CD11c and CD206 in noninsulin-resistant healthy young adults subjected to an OGTT. The apparently innocuous consumption of sucralose should be reexamined in light of these results.

Perception of clinical educational environment by student of physiotherapy based on the Educational Environment Measurement Questionnaire of the Postgraduate Hospital in Chile.

PURPOSE: It aimed at describing the perception of the clinical educational environment by physiotherapy students based on the Educational Environment Measurement Questionnaire of the Postgraduate Hospital in Chile. METHODS: The clinical education environment was evaluated according to the PHEEM by 192 students originally enrolled in the fifth year of the physiotherapy career at three different headquarters of the academic institution: Santiago, Viña del Mar and Concepcion Campus (Metropolitan, Valparaiso and Bio Bio region, respectively), from March to October 2018. The Cronbach's alpha was applied to measure the reliability of the instrument and the Student t and ANOVA tests were used to compare the differences of PHEEM scores by headquarters, environmental areas, and experience of internship. RESULTS: A total overall average score of 125.88 was obtained, which meant an excellent educational environment. The overall score was 127.6±22.7 for Headquarters1, 125.6±21.6 for Headquarters2 and 122.5±26.9 for Headquarters3. According to the type of establishment, the scores were of 127.1±22.1 for private and 123.5±26.3 for public institutes. According to the type of area, the score was cataloged as an excellent educational environment in all cases, except in the respiratory care area (lowest score: 117.5±29.1). Finally, the score was 126.9±20.5 for the first internship, 121.7±29.3 for the second and 129.4±19.6 for the third. CONCLUSION: There is relative homogeneity of the clinical educational environment for different headquarters, types of establishment or type of area; but there are significant differences in the number of the internship. The promotion of a good clinical educational environment can have an important impact on the development and performance of the future professional, being the detection of negative aspects an opportunity to improve the hidden curriculum.

Relationship between sleep quality and postural balance in community-dwelling older persons: studio transversal. / Relación entre calidad de sueño y balance postural en personas mayores de la comunidad: estudio transversal.

OBJETIVE: To determine the relationship between sleep quality and postural balance in older adults living in the community. METHODS: An analytical cross-sectional study was used. We recruited 53 subjects who fulfilled the inclusion criteria. The Pittsburgh Sleep Quality Index (PSQI) was administered, and a static balance test was performed through a computerized posturography to evaluate the postural balance. RESULTS: Fifty-three subjects 60 to 80 years old (M = 70.13; standard deviation = 6.06) were evaluated; 69.8% were women and 30.2% were men. The correlation test found a statistically significant and positive relationship, but moderate (p = 0.002; r = 0.417) between total displacement and sleep quality in the Romberg open eyes test. The same happened with the total displacement in the Romberg close eyes test (p = 0.002, r = 0.445). Displacements were always greater in the anteroposterior plane, where a statistically significant and positive correlation with sleep quality was also found in all posturological tests. The correlation was moderate in all cases. CONCLUSION: There is a relationship between the quality of sleep measured and postural balance. However, this relationship is low to moderate, and the size of the effect must be considered before accepting the hypothesis.

OBJETIVO: Determinar la relación entre la calidad del sueño y el equilibrio postural en las personas mayores que viven en la comunidad. MÉTODOS: Se aplicó un estudio analítico y transversal. Se reclutaron 53 sujetos que cumplían los criterios de selección. Se aplicó el índice de calidad del sueño de Pittsburgh (PSQI) y se realizó una prueba de equilibrio estático a través de una posturografía computarizada para evaluar el equilibrio postural. RESULTADOS: Cincuenta y tres sujetos entre 60 y 80 años (M = 70,13; desviación estándar: 6,06) fueron evaluados; 69,8% correspondían a mujeres y 30,2% a hombres. La prueba de correlación encontró una relación estadísticamente significativa y positiva, pero moderada (p = 0,002; r = 0,417) entre el desplazamiento total y la calidad del sueño en la prueba de Romberg ojos abiertos. Lo mismo ocurrió con el desplazamiento total en la prueba Romberg ojos cerrados (p = 0,002, r = 0,445). Los desplazamientos siempre fueron mayores en el plano anteroposterior, donde también se encontró una correlación estadísticamente significativa y positiva con la calidad del sueño en todas las pruebas posturológicas. La correlación fue moderada en todos los casos. CONCLUSIÓN: Existe una relación entre la calidad del sueño medida. Sin embargo, esta relación tiene un nivel bajo a moderado. Además, el tamaño del efecto es un factor que debe considerarse antes de aceptar la hipótesis. Los estudios futuros deben abordar la dependencia de cada una de las variables.

Reliability of two gait speed tests of different timed phases and equal non-timed phases in community-dwelling older persons.

BACKGROUND: Gait speed is a fast, low cost and accurate measurement for evaluating older persons’ functional ability, both health and with comorbidities. Previous studies have evaluated gait speed measured over courses of varying distances, but the non-timed phases are not measured uniformly. It is unknown if this affects the results of the test. OBJECTIVE: This study aims to evaluate the reliability of the running speed test of two different timed phases compared to the same nontimed phases. METHODS: We conducted a descriptive reliability study, with an observational and cross-sectional analytical design. One hundred thirty-six older persons were included. Two gait speed tests were taken, one of 4 and 10 meters, and 2 meters for the acceleration/deceleration phase for both tests. The average of two attempts was obtained as a final measure of each test. The intraclass correlation coefficient was used to express the results (ICC) with a fixed effects model and the Bland and Altman method (confidence interval of 95%), complemented with the standard error of the mean and minimal detectable change with 95% confidence values (MDC95). RESULTS: The results indicate an excellent level of agreement between the attempts of the tests of 4- and 10-m (ICC = 0.959 and 0.976, respectively), as well as between the average of the two tests (ICC = 0.867). The agreement was slightly better between the two attempts in the 10-meter test. The number of attempts does not affect the results of gait speed. Further analysis is required to conclude the same regarding the distance of the test (4 and 10 meters). The difference in the results of the Bland Altman analysis for the average of the 4 and 10-meter tests was 1.5945 m/s (95% confidence interval: 0.9759 to 2.2130 m/s), which is too wide and higher than the MDC95 value. CONCLUSIONS: The ICC value was excellent in all cases, and the number of attempts does not affect the results of gait speed. However, further analysis is required to conclude the same regarding the distance of the test. There is an insufficient agreement between the two tests to allow them to be used interchangeably in populations with the characteristics of this study. .

ANTECEDENTES: La velocidad de la marcha es una medida rápida, económica y precisa para evaluar la capacidad funcional de las personas mayores, tanto saludables como con diferentes comorbilidades. Estudios previos han evaluado la velocidad de la marcha medida a lo largo de cursos de diferentes distancias, pero las fases no cronometradas no se miden de manera uniforme y se desconoce si esto afecta los resultados de la prueba. OBJETIVO: El objetivo de este estudio fue evaluar la confiabilidad de la prueba de velocidad de marcha de diferentes fases cronometradas e iguales fases no cronometradas. MÉTODOS: Estudio de confiabilidad descriptivo, con diseño observacional analítico y de corte transversal. Se incluyeron 136 personas mayores. Se realizaron pruebas de 4 y 10 metros, con 2 metros para la fase de aceleración/desaceleración de ambas. El promedio de dos intentos se obtuvo como la medida final de cada prueba. Los resultados se obtuvieron mediante el coeficiente de correlación intraclase (CCI) con un modelo de efectos fijos y el método Bland y Altman (con un intervalo de confianza del 95%). Se complementaron con los valores de error estándar de la media y del cambio mínimo detectable (CMD95). RESULTADOS: Los resultados indican un excelente nivel de acuerdo entre los intentos de las pruebas de 4 y 10 metros (CCI = 0,959 y 0,976, respectivamente), así como entre el promedio de las dos pruebas (CCI = 0,867). Destaca un nivel de acuerdo ligeramente mejor entre los dos intentos de la prueba de 10 metros. Por lo tanto, el número de intentos no es capaz de afectar los resultados de la velocidad de la marcha; sin embargo, se requieren análisis adicionales para concluir lo mismo con respecto a la distancia de la prueba. La diferencia del análisis Bland Altman para el promedio de las pruebas de 4 y 10 metros fue 1,5945 m/s (intervalo de confianza 95%: 0,9759 a 2,2130 m/s), siendo demasiado grande y más alto que el valor CMD95. CONCLUSIONES: El CCI fue excelente en todos los casos, pero se requiere un análisis adicional para concluir lo mismo con respecto a la distancia de la prueba. Existe un acuerdo insuficiente entre las dos pruebas para permitir que se utilicen indistintamente en poblaciones con las características de este estudio. .

Disruption of CTCF-YY1-dependent looping of the human papillomavirus genome activates differentiation-induced viral oncogene transcription.

The complex life cycle of oncogenic human papillomavirus (HPV) initiates in undifferentiated basal epithelial keratinocytes where expression of the E6 and E7 oncogenes is restricted. Upon epithelial differentiation, E6/E7 transcription is increased through unknown mechanisms to drive cellular proliferation required to support virus replication. We report that the chromatin-organising CCCTC-binding factor (CTCF) promotes the formation of a chromatin loop in the HPV genome that epigenetically represses viral enhancer activity controlling E6/E7 expression. CTCF-dependent looping is dependent on the expression of the CTCF-associated Yin Yang 1 (YY1) transcription factor and polycomb repressor complex (PRC) recruitment, resulting in trimethylation of histone H3 at lysine 27. We show that viral oncogene up-regulation during cellular differentiation results from YY1 down-regulation, disruption of viral genome looping, and a loss of epigenetic repression of viral enhancer activity. Our data therefore reveal a key role for CTCF-YY1-dependent looping in the HPV life cycle and identify a regulatory mechanism that could be disrupted in HPV carcinogenesis.

Association of Human Papillomavirus 16 E2 with Rad50-Interacting Protein 1 Enhances Viral DNA Replication.

Rad50-interacting protein 1 (Rint1) associates with the DNA damage response protein Rad50 during the transition from the S phase to the G2/M phase and functions in radiation-induced G2 checkpoint control. It has also been demonstrated that Rint1 is essential in vesicle trafficking from the Golgi apparatus to the endoplasmic reticulum (ER) through an interaction with Zeste-White 10 (ZW10). We have isolated a novel interaction between Rint1 and the human papillomavirus 16 (HPV16) transcription and replication factor E2. E2 binds to Rint1 within its ZW10 interaction domain, and we show that in the absence of E2, Rint1 is localized to the ER and associates with ZW10. E2 expression results in a disruption of the Rint1-ZW10 interaction and an accumulation of nuclear Rint1, coincident with a significant reduction in vesicle movement from the ER to the Golgi apparatus. Interestingly, nuclear Rint1 and members of the Mre11/Rad50/Nbs1 (MRN) complex were found in distinct E2 nuclear foci, which peaked during mid-S phase, indicating that the recruitment of Rint1 to E2 foci within the nucleus may also result in the recruitment of this DNA damage-sensing protein complex. We show that exogenous Rint1 expression enhances E2-dependent virus replication. Conversely, the overexpression of a truncated Rint1 protein that retains the E2 binding domain but not the Rad50 binding domain acts as a dominant negative inhibitor of E2-dependent HPV replication. Put together, these experiments demonstrate that the interaction between Rint1 and E2 has an important function in HPV replication.IMPORTANCE HPV infections are an important driver of many epithelial cancers, including those within the anogenital and oropharyngeal tracts. The HPV life cycle is tightly regulated and intimately linked to the differentiation of the epithelial cells that it infects. HPV replication factories formed in the nucleus are locations where viral DNA is copied to support virus persistence and amplification of infection. The recruitment of specific cellular protein complexes to these factories aids efficient and controlled viral replication. We have identified a novel HPV-host interaction that functions in the cellular response to DNA damage and cell cycle control. We show that the HPV E2 protein targets Rad50-interacting protein 1 (Rint1) to facilitate virus genome replication. These findings add to our understanding of how HPV replicates and the host cell pathways that are targeted by HPV to support virus replication. Understanding these pathways will allow further research into novel inhibitors of HPV genome replication.

The Cellular DNA Helicase ChlR1 Regulates Chromatin and Nuclear Matrix Attachment of the Human Papillomavirus 16 E2 Protein and High-Copy-Number Viral Genome Establishment.

In papillomavirus infections, the viral genome is established as a double-stranded DNA episome. To segregate the episomes into daughter cells during mitosis, they are tethered to cellular chromatin by the viral E2 protein. We previously demonstrated that the E2 proteins of diverse papillomavirus types, including bovine papillomavirus (BPV) and human papillomavirus 16 (HPV16), associate with the cellular DNA helicase ChlR1. This virus-host interaction is important for the tethering of BPV E2 to mitotic chromatin and the stable maintenance of BPV episomes. The role of the association between E2 and ChlR1 in the HPV16 life cycle is unresolved. Here we show that an HPV16 E2 Y131A mutant (E2Y131A) had significantly reduced binding to ChlR1 but retained transcriptional activation and viral origin-dependent replication functions. Subcellular fractionation of keratinocytes expressing E2Y131A showed a marked change in the localization of the protein. Compared to that of wild-type E2 (E2WT), the chromatin-bound pool of E2Y131A was decreased, concomitant with an increase in nuclear matrix-associated protein. Cell cycle synchronization indicated that the shift in subcellular localization of E2Y131A occurred in mid-S phase. A similar alteration between the subcellular pools of the E2WT protein occurred upon ChlR1 silencing. Notably, in an HPV16 life cycle model in primary human keratinocytes, mutant E2Y131A genomes were established as episomes, but at a markedly lower copy number than that of wild-type HPV16 genomes, and they were not maintained upon cell passage. Our studies indicate that ChlR1 is an important regulator of the chromatin association of E2 and of the establishment and maintenance of HPV16 episomes. IMPORTANCE: Infections with high-risk human papillomaviruses (HPVs) are a major cause of anogenital and oropharyngeal cancers. During infection, the circular DNA genome of HPV persists within the nucleus, independently of the host cell chromatin. Persistence of infection is a risk factor for cancer development and is partly achieved by the attachment of viral DNA to cellular chromatin during cell division. The HPV E2 protein plays a critical role in this tethering by binding simultaneously to the viral genome and to chromatin during mitosis. We previously showed that the cellular DNA helicase ChlR1 is required for loading of the bovine papillomavirus E2 protein onto chromatin during DNA synthesis. Here we identify a mutation in HPV16 E2 that abrogates interaction with ChlR1, and we show that ChlR1 regulates the chromatin association of HPV16 E2 and that this virus-host interaction is essential for viral episome maintenance.