Data for functional MRI connectivity in transgender people with gender incongruence and cisgender individuals

We provide T2 *-weighted and T1-weighted images acquired on a 3T MRI scanner obtained from 17 transwomen and 29 transmen with gender incongruence; and 22 ciswomen and 19 cismen that identified themselves to the sex assigned at birth. Data from three different techniques that describe global and regional connectivity differences within functional resting-state networks in transwomen and trans men with early-in-life onset gender incongruence are provided: (1) we obtained spatial maps from data-driven independent component analysis using the melodic tool from FSL software; (2) we provide the functional networks interactions of two functional atlases' seeds from a seed to-seed approach; (3) and global graph-theoretical metrics such as the smallworld organization, and the segregation and integration properties of the networks. Interpretations of the present dataset can be found in the original article, doi:10.1016/j.neuroimage.2020.116613 [1] . The original and pro cessed nifti images are available in Mendeley datasets. In addition, correlation matrices for the seed-to-seed and graph theory analyses as well as the graph-theoretical measures were made available in Matlab files. Finally, we present supplementary information for the original article. (C) 2020 The Author(s). Published by Elsevier Inc

L.E.O.: EXPLORACIONES AL DESEO LECTOESCRITURAL

Este trabajo tiene como objetivo analizar la influencia de didácticas aplicadas para potenciar el deseo de saber alrededor de las habilidades: Lectura, Escritura y Oralidad (L.E.O.) en los estudiantes de los diversos programas académicos de la Institución Universitaria Politécnico Grancolombiano, durante los primeros semestres. Se concibe, desde el aprendizaje experiencial, aprendizaje basado en la resolución de problemas (ABRP). A partir, de un diseño de investigación cualitativo y se orientó desde la técnica taller de investigación y co-creación, desde un paradigma hermenéutico interpretativo; se realizaron (24) Talleres de creación, durante (4) semestres académicos (2021-2022). Los hallazgos resaltan el desarrollo de espacios dialógicos para la problematización de aspectos asociados a los procesos de enseñanza-aprendizaje en los estudiantes frente a las habilidades L.E.O. y la emergencia de generar espacios formativos permanentes y abiertos que permitan asegurar la continuidad, la autoevaluación de la estrategia y nuevos saberes profesionales relacionados con la lectura, escritura y oralidad, por medio del Semillero/Taller L.E.O

Brain network interactions in transgender individuals with gender incongruence

Functional brain organization in transgender persons remains unclear. Our aims were to investigate global and regional connectivity differences within functional networks in transwomen and transmen with early-in-life onset gender incongruence; and to test the consistency of two available hypotheses that attempted to explain gender variants: (i) a neurodevelopmental cortical hypothesis that suggests the existence of different brain phenotypes based on structural MRI data and genes polymorphisms of sex hormone receptors; (ii) a functional-based hypothesis in relation to regions involved in the own body perception. T2*-weighted images in a 3-T MRI were obtained from 29 transmen and 17 transwomen as well as 22 cisgender women and 19 cisgender men. Restingstate independent component analysis, seed-to-seed functional network and graph theory analyses were performed. Transmen, transwomen, and cisgender women had decreased connectivity compared with cisgender men in superior parietal regions, as part of the salience (SN) and the executive control (ECN) networks. Transmen also had weaker connectivity compared with cisgender men between intra-SN regions and weaker inter-network connectivity between regions of the SN, the default mode network (DMN), the ECN and the sensorimotor network. Transwomen had lower small-worldness, modularity and clustering coefficient than cisgender men. There were no differences among transmen, transwomen, and ciswomen. Together these results underline the importance of the SN interacting with DMN, ECN, and sensorimotor networks in transmen, involving regions of the entire brain with a frontal predominance. Reduced global connectivity graph-theoretical measures were a characteristic of transwomen. It is proposed that the interaction between networks is a keystone in building a gendered self. Finally, our findings suggest that both proposed hypotheses are complementary in explaining brain differences between gender variants

Data for functional MRI connectivity in transgender people with gender incongruence and cisgender individuals

We provide T2*-weighted and T1-weighted images acquired on a 3T MRI scanner obtained from 17 transwomen and 29 transmen with gender incongruence; and 22 ciswomen and 19 cismen that identified themselves to the sex assigned at birth. Data from three different techniques that describe global and regional connectivity differences within functional resting-state networks in transwomen and transmen with early-in-life onset gender incongruence are provided: (1) we obtained spatial maps from data-driven independent component analysis using the melodic tool from FSL software; (2) we provide the functional networks interactions of two functional atlases' seeds from a seed-to-seed approach; (3) and global graph-theoretical metrics such as the smallworld organization, and the segregation and integration properties of the networks. Interpretations of the present dataset can be found in the original article, doi:10.1016/j.neuroimage.2020.116613[1]. The original and processed nifti images are available in Mendeley datasets. In addition, correlation matrices for the seed-to-seed and graph-theory analyses as well as the graph-theoretical measures were made available in Matlab files. Finally, we present supplementary information for the original article

Determining Factors in the Access to Mental Health Services by the Adult Colombian Population

Introducción Tradicionalmente el acceso a servicios de salud mental de las personas con trastornos mentales ha sido limitado, y ello se asocia a variables conductuales, sociales y estructurales. Objetivo Analizar los factores que determinan el acceso a servicios de salud mental de la población adulta (18 a 44 años) en Colombia, a partir de los resultados obtenidos en la Encuesta Nacional de Salud Mental 2015. Material y métodos Análisis de variables de acceso a consulta en atención a salud mental para adultos. Se clasificaron las razones de consulta en barreras de acceso por oferta o demanda comportamental. Para el análisis de los factores asociados a acceso a los servicios de salud mental en la población adulta colombiana, se tuvo en cuenta el uso de los servicios de salud en los últimos 12 meses por problemas emocionales, nerviosos o de salud mental y las características demográficas, actividad laboral, afiliación a régimen de seguridad social y variables de estados de salud. Las asociaciones entres estas variables se estimaron mediante modelos bivariables de regresión logística multinomial. Resultados Se encontraron asociaciones entre residir en áreas rurales, estar casado y padecer una enfermedad crónica con la decisión de consultar al médico o no. Conclusiones Se deben realizar más estudios que permitan evaluar la situación del acceso a servicios de atención en salud mental, y que permitan encontrar los posibles factores relacionados que limiten al mismo.Q489-95Introduction Access to mental health services by people with mental disorders has traditionally been limited, and is associated with attitudinal, social, and structural variables. Objective To analyse the factors that determine access to mental health services by the adult population (18-44 years old) in Colombia, from the results obtained in the 2015 National Mental Health Survey. Material and methods Analysis of variables of access to attention in mental health care for adults. The reasons for not consulting were classified as barriers of behavioural supply and demand. To analyse the factors associated with access to mental health services in the Colombian adult population, the use of health services in the last 12 months for emotional, nervous or mental health problems was taken into account, as well as associated variables such as demographic characteristics, occupational activity, affiliation to social security, and health status variables. The relationships between these variables were estimated using bivariate multinomial logistic regression models. Results Rural residence, being married, and having a chronic disease were associated with the decision to consult or not to consult the doctor. Conclusions Further studies should be conducted to evaluate the situation as regards mental health care access, as well as to determine the potential factors associated with these limitations

La Imagen y la Narrativa como Herramientas para el Abordaje Psicosocial en Escenarios de Violencia – Municipios de Medellín y Titiribí

En el desarrollo de las actividades del diplomado en “Acompañamiento Psicosocial en Escenarios de Violencia” adscrito al programa de psicología de la Universidad Nacional Abierta y a Distancia UNAD, se logra ahondar, interiorizar e integrar las herramientas teóricas, conceptuales y metodológicas, vistas a lo largo del proceso de formación profesional; y que hacen parte de la praxis psicológica dentro de los proceso de diagnóstico, acompañamiento y evaluación psicosocial a los cuales están expuestas las personas, los grupos, las instituciones y/o comunidades vulneradas por los diferentes conflictos socio políticos y económicos que afectan al país. Es por esta razón que desde la técnica de Análisis del Relato dentro de un escenario de eventos psicosociales traumáticos de crisis y/o violencia, se analizan diferentes relatos y experiencias que han generado en el sujeto y las comunidades un alto impacto subjetivo e intersubjetivo que afecta todas las dimensiones del ser humano; es decir, la salud física, emocional, mental y espiritual e inclusive el desarrollo cognitivo e interacción social de la población colombiana. En el presente informe, se podrá encontrar el estudio de casos como son el Relato de Vida de Alfredo Campos y el Caso de las comunidades de Cacarica; análisis que permitió la integración y aplicación de los referentes teóricos, conceptuales y las herramientas metodológicas como la formulación de preguntas orientadas hacia un acercamiento psicosocial ético y proactivo que posibilite la valoración de los eventos traumáticos y la generación de estrategias de acompañamiento psicosocial que vinculen la construcción y reconstrucción de estilos de afrontamiento desde la subjetividad del individuo y la intersubjetividad emergentes del grupo o la comunidad como fuentes de memoria y acción transformadora desde una visión ética, activa y propositiva que favorezca la superación de las condiciones de victimización. Así mismo, el lector encontrara; el informe analítico y reflexivo de la experiencia de Foto Voz realizado por cada integrante del grupo colaborativo, las conclusiones del ejercicio realizado y el link de la galería de fotos que hicieron parte del ejercicio.In the development of activities of the certification in “Psychosocial Accompanying in Violence Scenarios” subscribed to Psychology program in Universidad Nacional Abierta y a Distancia UNAD, theorical conceptual and methodological tools learned through the professional training were delved into, embraced and integrated. Those make a part of the psychological praxis in the process of diagnosis, accompanying and psychosocial evaluation which people, groups, institutions and/or communities are exposed to, while they are forced by different socio political and economic conflicts affecting the country. For this reason, different testimonies and experiences are done from an narrative analysis technique in scenario of by-violence psychosocial traumatic events, which have generated a subjective and inter-subjective impact on all dimensions of human being, that is, physical, emotional mental and spiritual health of Colombian. In the report, study cases will be found as Alfredo Campos’ Life Story and the case of Cacarica communities; this analysis allowed the integration and application of theorical and conceptual references and methodological tools such as questions oriented to a psychosocial-ethical approach making possible evaluation of traumatic events and generation of psychosocial accompanying strategies to link deconstruction, construction and reconstruction of coping since subjectivity and intersubjectivity from a group as source of memory and transforming action through an ethical, active and active vision, in order to allow the overcoming of victimization conditions. Likewise, it is included: an analytical and reflexive report of Photovoice experience, that was made by each participant of collaborative group, conclusions and a web link to photo gallery

Linfadenitis tuberculosa en niños: Revisión sistemática de reportes de caso

Objective: To conduct a systematic review of tuberculous lymphadenitis cases in children published until April 2022. Material and methods: Case reports of tuberculous lymphadenitis by M. tuberculosis in children were searched in Scopus, PubMed, Science Direct, Web of Science, LILACs, Ovid MEDLINE, EBSCO, and BMC Case Reports databases. Results: Forty-one reports were selected and a total of 46 patients were included. The majority were males (52,2%) of 8,5 (5-12) years old. The time of disease was 2 (1-5) months. The most frequent clinical manifestations were palpable lymphadenopathy (60,9%), fever (52,2%) and cough (26,1%). Weight loss (17,4%), scrofula (15,2%), respiratory distress (13%), hyporexia (13%), localized pain (13%), skin rash (13%), night sweats (4.3%), abdominal pain (4.3%) and jaundice (2,2%) were also founded. Cervical nodes were most frequently involved (71,4%). Only 17,4% were associated with lung involvement. PPD was positive in 77.1%, bacilloscopy in 17.2%, histopathology in 94,1% and culture in 58,8%. Conclusions: Tuberculous lymphadenitis in children was more frequent in boys, between 5 and 12 years, immunized by BCG and without known contact with tuberculosis. The principal symptoms were palpable lymphadenopathy, fever and cough. However, atypical symptoms were respiratory difficulty, localized pain, skin rash, abdominal pain, and jaundice. Cervical nodes were the most affected. The test with greatest sensitivity was the histopathological study which detected 94,1% of cases.Objetivo:  Realizar una revisión sistemática de casos de linfadenitis tuberculosa en niños publicados en la literatura hasta abril de 2022. Material y Métodos: Se buscó reportes de casos de linfadenitis tuberculosa por M. tuberculosis en niños, en las bases de datos de Scopus, PubMed, Science Direct, Web of Science, LILACs, Ovid MEDLINE, EBSCO y BMJ Case Reports. Resultados: Se seleccionó 41 reportes, que informaron 46 pacientes. La mayoría fueron varones (52,2%), de 8,5 (5-12) años, con tiempo de enfermedad de 2 (1-5) meses. Las manifestaciones clínicas más frecuentes fueron linfadenopatía palpable (60,9%), fiebre (52,2%) y tos (26,1%). También se encontró pérdida de peso (17,4%), escrófula (15,2%), dificultad respiratoria (13%), hiporexia (13%), dolor localizado (13%), exantema cutáneo (13%), sudoración nocturna (4,3%), dolor abdominal (4,3%) e ictericia (2,2%). Los ganglios cervicales fueron los más comprometidos (71,4%). Solo 17,4% tuvo compromiso pulmonar asociado. El PPD fue positivo en 77,1%, la baciloscopia en 17,2%, la histopatología en 94,1% y el cultivo en 58,8%. Conclusiones: La linfadenitis tuberculosa en niños fue más frecuente en varones, entre 5 y 12 años, inmunizados por BCG y sin contacto conocido de tuberculosis. Los síntomas más frecuentes fueron linfadenopatía palpable, fiebre y tos. Además, se presentaron cuadros atípicos con dificultad respiratoria, dolor localizado, exantema cutáneo, dolor abdominal e ictericia. Los ganglios cervicales fueron los más afectados. El estudio histopatológico fue la prueba con mayor sensibilidad diagnóstica detectando el 94,1% de casos

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality