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While extensive research exists on general pornography consumption, there is limited focus on the consumption of non-preferred sexual content and its potential associated discomfort. In 2019, a total of 1,133 Spanish men aged between 18 and 40 years (M = 24.78; SD = 5.91) completed a questionnaire regarding their consumption of male–female, female–female, and male–male pornography, the attentional focus, as well as the discomfort they experienced when aroused by such materials. The results were analyzed based on five groups of sexual attraction, ranging from “exclusively heterosexual” to “exclusively gay.” Regardless of sexual attraction, men reported consuming and experiencing arousal by all three types of pornography. Exclusively heterosexual men primarily consumed and were aroused by male–female and female–female pornography, while exclusively gay men preferred male–female and male–male pornography. Men with nonexclusive sexual attraction, especially bisexual men, exhibited high levels of consumption and arousal across all types of pornography evaluated. When watching male–female pornography, exclusively heterosexual men reported focusing more on women, exclusively gay men on men, and men with nonexclusive attractions on interactions among individuals. Male–male pornography material caused the most discomfort. These findings illustrate the variety of experiences of consumption and arousal by pornography, even from featuring non-preferred sexual activities. The study also highlights the associated discomfort, particularly with male–male pornography. Further exploration is needed to understand the phenomenon behind this discomfort, such as internalized desires, and to promote a more flexible understanding of sexual identities to support inclusive and healthy sexual health practices.
The macro-social and environmental conditions in which people live, such as the level of a country’s development or inequality, are associated with brain-related disorders. However, the relationship between these systemic environmental factors and the brain remains unclear. We aimed to determine the association between the level of development and inequality of a country and the brain structure of healthy adults.
Methods
We conducted a cross-sectional study pooling brain imaging (T1-based) data from 145 magnetic resonance imaging (MRI) studies in 7,962 healthy adults (4,110 women) in 29 different countries. We used a meta-regression approach to relate the brain structure to the country’s level of development and inequality.
Results
Higher human development was consistently associated with larger hippocampi and more expanded global cortical surface area, particularly in frontal areas. Increased inequality was most consistently associated with smaller hippocampal volume and thinner cortical thickness across the brain.
Conclusions
Our results suggest that the macro-economic conditions of a country are reflected in its inhabitants’ brains and may explain the different incidence of brain disorders across the world. The observed variability of brain structure in health across countries should be considered when developing tools in the field of personalized or precision medicine that are intended to be used across the world.
Limb salvage surgery (LSS) with megaprosthesis is a common treatment for distal femur tumors, but its impact on gait remains poorly understood. Traditional gait analysis methods are costly and require specialized equipment. This study aims to compare spatiotemporal gait parameters between patients with distal femur megaprosthesis and healthy controls using an inertial measurement unit (IMU). We conducted a case–control study with 79 participants: 31 patients with distal femur megaprosthesis and 48 healthy controls. Gait data were collected using an IMU placed at L5-S1, capturing metrics such as gait quality index (GQI), pelvic kinematics, propulsion index, and gait speed. Statistical analysis included Student’s t-test, Mann–Whitney U test, and one-way ANOVA to compare gait parameters across groups. Patients with megaprosthesis exhibited significantly lower gait speed, propulsion index and anteroposterior acceleration symmetry index compared to controls (p < .05). GQI was reduced in the healthy legs of the cases (92.3%) compared to control legs (96.6%). Adaptations included prolonged stance phases in healthy legs and decreased single support phases in prosthetic legs. Despite these changes, gait patterns remained within functional ranges. IMU-based gait analysis reveals significant but functional alterations in gait mechanics among patients with distal femoral megaprosthesis. These findings underscore the need for tailored rehabilitation strategies to address compensatory mechanisms, optimize mobility, and enhance long-term outcomes. The use of IMU technology offers a cost-effective and portable alternative for clinical gait assessments.
From the thought of mid-twentieth-century Mexican philosopher Jorge Portilla (1919–1964), I develop a three-prong existentialist response to the problem of evil. One prong is granting that a version of the problem of evil is successful: no theodicy is credible while beholding innocent suffering. A second prong involves an affective engagement with evil that facilitates a loving human flourishing grounded in solidarity with sufferers, compassion, loving self-sacrifice, and taking responsibility for one’s own culpability. The final prong is the capacity of this affective engagement with evil to permit a belief in God as an existential commitment to a suffering God as a transcendental ideal of self-sacrificing love that guides one’s perpetual project of self-creation.
Guinea pigs (Cavia porcellus) have been consumed and revered in South American countries since precolonial times and continue to serve as both an important protein source and an economic driver for underserved and remote communities in the region. However, currently, there is limited peer-reviewed research on the welfare status of these animals in meat production systems. This scoping review seeks to provide an overview of guinea pig meat production in the region, highlighting potential welfare challenges and exploring opportunities to advance animal welfare practices within these systems.
This Element explores the organization of power in ancient Egypt and Mesopotamia and the interaction of diverse social actors between 2100 and 1750 BC. On the one hand, the forms of integration of towns and villages in larger political entities and the role played by local authorities, with a focus on local agency, the influence of mobile populations, the exercise of power in small localities, and the contrast between power reality and royal ideological claims, be they legal, divinely sanctioned, or other. On the other hand, the modalities of penetration of the royal authority in the local sphere, the alliances that linked court dignitaries and local potentates, and the co-option of local leaders. Finally, the influence of such networks of power on the historical evolution of the monarchies and the adaptability of the latter in coping with the challenges they faced to assert and reproduce their authority.
Antidepressants are essential in managing depression, including treatment-resistant cases. Public perceptions of these medications, shaped by social media platforms like X (formerly Twitter), can influence treatment adherence and outcomes. This study explores public attitudes toward antidepressants through sentiment and topic modeling analysis of tweets in English and Spanish from 2007 to 2022.
Methods
Tweets mentioning antidepressants approved for depression were collected. The analysis focused on selective serotonin reuptake inhibitors (SSRIs) and glutamatergic drugs. Sentiment analysis and topic modeling were conducted to identify trends, concerns, and emotions in discussions across both languages.
Results
A total of 1,448,674 tweets were analyzed (1,013,128 in English and 435,546 in Spanish). SSRIs were the most mentioned antidepressants (27.9% in English, 58.91% in Spanish). Pricing and availability were key concerns in English tweets, while Spanish tweets highlighted availability, efficacy, and sexual side effects. Glutamatergic drugs, especially esketamine, gained attention (15.61% in English, 25.23% in Spanish), evoking emotions such as fear, sadness, and anger. Temporal analysis showed significant increases in discussions, with peaks in 2012 and 2021 for SSRIs in Spanish, and exponential growth from 2018 to 2021 for glutamatergic drugs. Emotional tones varied across languages, reflecting cultural differences.
Conclusions
Social media platforms like X provide valuable insights into public perceptions of antidepressants, highlighting cultural variations in attitudes. Understanding these perceptions can help clinicians address concerns and misconceptions, fostering informed treatment decisions. The limitations of social media data call for careful interpretation, emphasizing the need for continued research to improve pharmacovigilance and public health strategies.
This study aims to empirically test whether family has a unique significance for the self that cannot be captured by the social self alone. Specifically, it examines whether family self-concept, compared to social self-concept, is more closely related to family-specific indicators (i.e., parent–child communication and family functioning) as well as to indicators of emotional maladjustment like mental health deterioration (i.e., psychological distress and depressive symptoms). The sample comprised 4,953 Mexican adolescents, including 2,551 men (51.5%) and 2,402 women, aged 14–17 years (M = 15.60, SD = 0.92). Confirmatory factor analysis was applied to evaluate the proposed big five-dimensional self-concept model. Cohen’s d confidence intervals, derived from the shared variance of Pearson’s r correlations, were analyzed to relate self-concept dimensions to parent–child communication, family functioning, and mental health deterioration. Results from factorial confirmatory analysis showed that the five-dimensional oblique model (i.e., academic, social, emotional, physical, and family, as different from social) provided a better fit than competing unidimensional and orthogonal models. Correlation analyses showed that family self-concept was significantly associated with both parent–child communication and family functioning, as well as with psychological distress (d = −1.10, confidence interval [CI] −1.21 to −1.02) and depressive symptoms (d = −1.24, CI −1.31 to −1.22). These findings add evidence that family is not accurately represented within the social self-concept. Furthermore, perceiving oneself as unloved and undervalued at home (i.e., low family self-concept) is strongly associated not only with dysfunctional family processes but also with mental health deterioration.
Members of Sinistroporomonorchis Wee, Cutmore, Pérez-del-Olmo & Cribb, 2020 represent a small group of trematodes belonging to the Monorchiidae Odhner, 1911 with 5 species described from mugilid hosts. Specimens consistent with the generic concept of Sinistroporomonorchis were obtained from Floridichthys polyommus (Cyprinodontidae); most of them were juveniles from 4 localities within the Yucatán Peninsula. After a detailed morphological examination including scanning electron microscopy images and a principal component analysis, the specimens collected represented a new species, Sinistroporomonorchis bolini n. sp. The new species can be differentiated by the presence of an overall large pharynx including the proportion of pharynx width to oral sucker width, a uterus arranged in 2 main lateral fields, and by presenting robust caeca. In addition, sequences of the 28S of large subunit of nuclear ribosomal RNA and cox1 of the mitochondrial DNA were obtained. Phylogenetic trees inferred from each dataset, placed all the specimens in a monophyletic clade, confirming that the isolates belonged to the same species. The new species is the sixth described for the genus Sinistroporomonorchis, the fifth described from the Yucatán Peninsula and the first described from a non-mugilid host.
The Nasrid emirate of southern Iberia emanated power through architecture; this project aims to better understand how this was made possible, via an interdisciplinary exploration of the Alhambra monument and other Al-Andalus constructions. Initial results of archaeological campaigns, structure chronologies and communication plans undertaken in 2021 and 2022 are presented.
Innovative public procurement (IPP) is a driver of innovation across sectors. IPP involves the strategic acquisition of cutting-edge technologies and solutions by public entities in collaboration with the private sector. This approach aims to leverage the potential of “omics” technologies, such as genomics and proteomics, within the public sector to advance healthcare solutions.
Methods
The IPP process comprises key phases such as needs identification, solicitation preparation, execution, evaluation and awarding, and impact and assessment. The methodology applied was based on the Rapid Assessment Tool for Omics Technologies developed by the Andalusian Agency for Health Technology Assessment, accompanied by clinical validity reports from the impact and evaluation phase of the Technical Office for IPP of Andalusia. The aim was to assess the clinical validation results of two omics technologies, that is, two diagnostic tests. A systematic review was performed to identify existing evidence. We also addressed the challenges associated with implementing the Rapid Assessment Tool in the IPP process.
Results
Systematic reviews identifying evidence on the clinical validity and utility of omics technologies provided a foundation for the subsequent evaluation of two technologies in development, once the clinical trials had finished. An analysis of scientific evidence, together with the compilation of information provided by industry, was conducted through a questionnaire and clinical data derived from the company’s studies. The analysis of clinical and diagnostic validity was not conclusive. We delivered the final assessment report to support decision-making in the public health system of Andalusia.
Conclusions
Both assessed technologies presented a high degree of innovation, but different challenges and issues were identified during the application of the Rapid Assessment Tool for Omics Technologies. Further improvement in IPP procedures for innovative technologies in Andalusia, including integration of our methodological approach at the start the IPP process, could facilitate the acquisition of cutting-edge technologies in collaboration with public entities.
Personalized precision medicine (PPM) is an innovative approach to disease diagnosis, prognosis, and treatment of individual or group characteristics using diverse data sources. While omics technologies are integral to PPM, they pose challenges. Therefore, developing an appropriate methodology to assess these technologies is crucial for patient safety, resource efficiency, and clinical decision-making within the Spanish National Health System.
Methods
This health technology assessment (HTA) methodology procedure was developed by combining three different approaches: a systematic review (SR); a survey targeting experts in omics technology, ranging from basic science researchers to clinicians, and patient associations; and, finally, a consensus method (RAND Appropriateness Method [RAM]).
Results
Through data extraction and evidence synthesis of the 38 studies included in SR, 30 existing frameworks for evaluating omics technologies were identified, as well as the elements needed to assess these technologies, leading to the first version of the framework. Two surveys were performed to integrate the perspectives of omics technology experts and patients. Subsequently, this framework version was further developed by a RAM consensus panel of experts from HTA agencies to ensure a rigorous evaluation of gathered data. The final framework was categorized into 94 elements divided into sections, categories, domains, and subdomains.
Conclusions
A methodological guide, including the assessment framework, was developed for the Spanish HTA network. The framework is divided into several sections addressing evidence-gathering, provision models, organizational elements, economic evaluation, and ethical and social implications. Compared to other available frameworks, our proposal included aspects such as bioinformatics, technological maturity level, and the patient perspective with the personal utility domain.
The relevance of education and outreach (E&O) activities about the Antarctic Treaty has been recognized at the Antarctic Treaty Consultative Meetings (ATCM) and at the Committee for Environmental Protection (CEP). This study examines the key topics and the target audiences detailed in papers submitted to the ATCM on E&O. Since the Antarctic Treaty entered into force in 1961, a total of 216 ATCM papers on E&O have been produced. The number of papers has increased substantially since the mid-1990s. ‘Science’ (76.9%) and ‘Wildlife/Biodiversity/Environment’ (75.5%) were the most addressed topics in these papers, while the ‘Public’ (81.0%) and those attending ‘Schools’ (69.0%) are the main target audiences. ‘Science’ in ATCM papers increased ~120-fold from 1961–1997 to 2015–2023, while ATCM papers discussing engagement with the ‘Public’ increased ~40-fold during the same period. ‘Climate change’ was first mentioned in 2006, and the number of papers per year increased fourfold by 2015–2023. This study shows the increasing interest in E&O through time, addressing key topics to relevant audiences related to the Antarctic region. From an educational perspective, attention should be paid to emerging topics (e.g. equity, diversity and inclusion), and the engagement of early-career professionals and educators should be made a priority.
Ecuador is a key area in South America when it comes to understanding the economic, social and archaeological aspects of pre-Hispanic cultures in the northwestern region of the Andes. Among the most complex societies to have inhabited this territory is the so-called Manteño culture (AD ∼800–1530), which spanned across most of Ecuador’s central Pacific coast. Ongoing research at the site of Ligüiqui (Manta, Manabí) has enabled us to obtain a more complete overview of the chronological sequence of the Manteño period as well as contributing further data on the advanced stage of social development reached during the period; characterized by the hierarchical arrangement of sites, the use of extensive settlement models, and semi-circular stone fish traps (corrales). In order to understand the role played by this coastal site in the complex Manteño culture, a detailed radiocarbon study was performed in the sequence of the Ligüiqui site. In addition, using a detailed review of available Manteño settlement radiocarbon data (13 sites and 64 dates), we established a chronostratigraphic framework for the culture. Our data indicate that Ligüiqui probably acted as a supply centre for marine-origin products from the twelfth century onwards with activity peaking during the Late Manteño period. A multisite comparison using Bayesian modeling indicates an early onset of the Manteño culture in Ligüiqui around AD 700, and a general demise in most of the sites AD ∼1500 or slightly before. This culture finally collapsed before AD ∼1600 during the early Spanish colonial period. Only one site, La Libertad, shows potential evidence of having remained a Manteño settlement after that date.
Antimicrobial resistance (AMR) is positioning as one of the most relevant threats to global public health and threatens the effective treatment of an ever-growing number of bacterial infections in various healthcare settings, particularly in acute care and surgical units, as well as in the community. Among multidrug-resistant (MDR) gram-negative bacteria (MDRGNB), Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumannii require special attention, since they account for most of the mortality associated with bacterial infections and are often MDR. It is clear that there is an important global variation in antibiotic resistance profiles among MDRGNB species. Extended-spectrum β-lactamase-producing Enterobacterales, carbapenem-resistant Enterobacterales, DTR-P. aeruginosa, and MDR-A. baumannii are the focus of this review. Here, we summarize a series of relevant studies on risk factors associated with colonization and infection with these MDRGNB. Likewise, we offer a comparative overview of those studies providing scoring systems to predict the risk of infection with these MDR pathogens, and their pros and cons. Despite the variable accuracy of published risk factors for predicting colonization or infection with MDRGNB, these scores are valuable tools that may help anticipate colonization and infection among those colonized. More importantly, they may help reduce unnecessary use of broad-spectrum antimicrobials and guiding the selection of an optimal treatment.
El objetivo principal de este trabajo es presentar importantes novedades sobre el marco histórico y productivo de la explotación minera de la sierra de Corduba en época romana, así como de la gestión de sus recursos. Desde hace años y a partir de la documentación epigráfica disponible, se ha venido apuntando una posible presencia en este territorio de la societas Sisaponensis y de la explotación de plomo y plata por su parte, a pesar de la afamada vinculación con el beneficio del cinabrio que recoge un conocido pasaje de Plinio. Nuestras investigaciones en el norte de Córdoba y los análisis arqueométricos realizados sobre tres lingotes de plomo recuperados en el paraje de Los Escoriales de Doña Rama, situado en la Sierra de Gata (Belmez-Córdoba), suponen una superación de la frontera del conocimiento sobre los aspectos reseñados, ya que permiten contrastar estas dos hipótesis tradicionales y proponer nuevas cuestiones sobre la explotación de estos parajes y la actividad de esta societas. Estos lingotes fueron encontrados en una instalación minero-metalúrgica romana, algo que es excepcional, y conservan una inscripción, S S, que los vincula sin duda con la societas Sisaponensis.
Community-based psychosocial support (CB-PSS) interventions utilizing task sharing and varied (in-person, remote) modalities are essential strategies to meet mental health needs, including during the COVID-19 pandemic. However, knowledge gaps remain regarding feasibility and effectiveness.
Methods
This study assesses feasibility, acceptability and preliminary effectiveness of a CB-PSS intervention for conflict-affected adults in Colombia through parallel randomized controlled trials, one delivered in-person (n = 165) and the other remotely (n = 103), implemented during the COVID-19 pandemic and national protests. Interventions were facilitated by nonspecialist community members and consisted of eight problem-solving and expressive group sessions.
Findings
Attendance was moderate and fidelity was high in both modalities. Participants in both modalities reported high levels of satisfaction, with in-person participants reporting increased comfort expressing emotions and more positive experiences with research protocols. Symptoms of depression, anxiety and posttraumatic stress disorder improved among in-person participants, but there were no significant changes for remote participants in comparison to waitlist controls.
Implications
This CB-PSS intervention appears feasible and acceptable in both in-person and remote modalities and associated with reduction in some forms of distress when conducted in-person but not when conducted remotely. Methodological limitations and potential explanations and areas for future research are discussed, drawing from related studies.
OBJECTIVES/GOALS: To teach the historical development of CTR, make a compelling scientific presentation, and use bibliographic databases and library resources. In addition, students learn how to write the research question, design the career development plan, know the protection of human subjects in research, and understand the mentor-mentee relationship. METHODS/STUDY POPULATION: The course includes a variety of educational strategies and activities that allow the student to increase their knowledge and initiate their interest in the field of CTR. Both academic semesters (August to December and January to May) are offered remotely in two-hour synchronous sessions on Fridays from 3:00 p.m. to 5:00 p.m. through videoconferences, in addition to asynchronous activities. Invited expert lecturers and faculty reinforce the course content in each of the topics they address. In addition, course coodinators assign guided tasks where the students perform the work. Then, they present or send their work to the course coordinators for evaluation. RESULTS/ANTICIPATED RESULTS: The course began in January 2020 and has six offerings, including one in the current academic semester (August to December 2023). Its first offering was in the semester from January to May, and due to the interest generated in students in August 2022, it is now avalilable in both semesters. From its beginning to the present, the course has included students from the University of Puerto Rico (UPR) Bayamón, Cayey, Humacao, Mayagüez, and Rio Piedras campuses, impacting all geographic areas of Puerto Rico. The course has also represented an opportunity for graduate faculty to teach CTR to undergraduate students. Until 2023, 56 students have enrolled. DISCUSSION/SIGNIFICANCE: Upon completing six-course offerings, the evaluation carried out by the students demonstrates satisfaction with the learning obtained. The knowledge and skills achieved have led them to participate in CTR with the mentoring of collaborating course professors and starting a new professional development opportunity for undergraduate students.
Few studies have examined the psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC) in a large adolescent community sample, finding a significant disparity. This study explores the psychometric properties of the CD-RISC among Spanish adolescents by means of exploratory factor analysis (EFA), Rasch analysis, and measurement invariance (MI) across sex, as well as internal consistency and criterion validity. The sample was comprised of 463 adolescents (231 girls), aged 12 to 18 years, who completed the CD-RISC and other measures on emotional status and quality of life. The EFA suggested that the CD-RISC structure presented a unidimensional model. Consequently, shorter unidimensional CD-RISC models observed in the literature were explored. Thus, the Campbell-Sills and Stein CD–RISC–10 showed the soundest psychometric properties, providing an adequate item fit and supporting MI and non-differential item functioning across sex. Item difficulty levels were biased toward low levels of resilience. Some items showed malfunctioning in lower response categories. With regard to reliability, categorical omega was. 82. Strong associations with health-related quality of life, major depressive disorder symptoms, and emotional symptoms were observed. A weak association was found between resilience and the male sex. Campbell-Sills and Stein’s CD–RISC–10 model emerges as the best to assess resilience among Spanish adolescents, as already reported in adults. Thus, independently of the developmental stage, the core of resilience may reside in the aspects of hardiness and persistence.