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Introduction: The increase in school violence following the COVID-19 pandemic underscores the need for schools to adopt a multilevel whole-school approach. This study examines a national program designed by the Chilean Ministry of Education, in collaboration with universities, as part of the Ministry's Educational Reactivation Plan, aimed at improving school climate management across Chile. Methods: The "Learning to Live Together Program" (LLT) was implemented across all 16 regions of Chile, focusing on establishing school climate networks, providing direct intensive university technical assistance, and enhancing professional development and training. The feasibility, acceptability, and appropriability of the LLT program were assessed through a survey distributed to 1,561 staff members from 783 schools. Participants responded to a comprehensive set of instruments measuring acceptability, appropriability, feasibility, attitudes toward implementation, fidelity, and initial perceived results. Results: The results indicate high initial adoption rates and significant improvements in the assessed dimensions. The enhancement of school climate practices and strengthening school collaboration networks were of considerable relevance. Discussion: These findings support the efficacy of the multilevel whole-school approach as a viable strategy for Latin American countries, providing critical data for educational and governmental decision-making. Furthermore, this study provides evidence that these outcomes may be applicable to the implementation of similar policies in different contexts and countries.

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The increasing participation of photovoltaic sources in power grids presents the challenge of enhancing power quality, which is affected by the intrinsic characteristics of these sources, such as variability and lack of inertia. This power quality degradation mainly generates variations in both voltage magnitude and frequency, which are more pronounced in microgrids. In fact, the magnitude problem is particularly present in the distribution systems, where photovoltaic sources are spread along the grid. Due to the power converter's lack of inertia, frequency problems can be seen throughout the network. Grid-forming control strategies in photovoltaic systems have been proposed to address these problems, although most proposed solutions involve either a direct voltage source or energy storage systems, thereby increasing costs. In this paper, a photovoltaic injection system is designed with a virtual synchronous machine control strategy to provide voltage and frequency support to the grid. The maximum power point tracking algorithm is adapted to provide the direct voltage reference and inject active power according to the droop frequency control. The control strategy is validated through simulations and key experimental setup tests. The results demonstrate that it is possible to inject photovoltaic power and provide voltage and frequency support.

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Background: Fungal meningitis can be associated with epidural anesthesia procedures. Fusariosis is a rare infection typically affecting immunocompromised patients and rarely causes meningitis. During 2022-2023, public health officials responded to a large outbreak of Fusarium solani meningitis associated with epidural anesthesia in Durango, Mexico. Methods: The public health response and epidemiological and clinical features of patients affected by this outbreak were described. Coordinated actions were addressed to identify the etiological agent, determine its drug susceptibility, develop diagnostic tests, and implement clinical and epidemiological protocols. Retrospective analyses of clinical variables and outcomes were performed to determine association with better patient survival. Results: A total of 1801 persons exposed to epidural anesthesia were identified, of whom 80 developed meningitis. Fusarium solani was found in 3 brain biopsies and showed susceptibility to voriconazole and amphotericin B. After F solani polymerase chain reaction (PCR) implementation, 57 patients with meningitis were PCR-screened, and 31 (38.8%) had a positive result. Most patients were female (95%), and cesarean section was the most common surgical procedure (76.3%). The case fatality rate was 51.3% (41 patients) and the median hospitalization duration was 39.5 days (interquartile range, 18-86 days). Seventy-one patients (88.8%) received voriconazole/amphotericin B and 64 subjects (80%) additionally received steroids. Cox regression analysis showed an increased lethality risk in patients who received antifungal treatment after 5 days (hazard ratio, 2.1 [95% confidence interval, 1.01-4.48], P < .05). Conclusions: The F solani meningitis outbreak in Durango was an unprecedented medical challenge. Timely treatment and effective healthcare management were associated with better survival outcomes.

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Pharmacovigilance (PV) activities aim to identify potential risks of medicines and vaccines after they have been authorised in the market by collecting and analysing information on suspected adverse events from different stakeholders. These can be captured and transmitted electronically in the form of Individual Case Safety Reports (ICSRs). Hence, up-to-date ICSRs management systems, like VigiFlow and signal detection and management systems as VigiLyze, have an important role in the PV system of a country. In 2019, after various attempts to establish a PV database that could fulfil the needs of the country, Mexico's National Regulatory Authority, COFEPRIS (Federal Commission for the Prevention against Sanitary Risks) decided to implement these tools. This has been a successful project that is still ongoing, it has involved national and international organisations, and has required the participation and integration of different components of the national PV system. The implementation of these tools has allowed COFEPRIS to increase its reporting trends and quality of reporting, while contributing to make more efficient interactions and processes with PV stakeholders, even during the COVID-19 pandemic. It has also allowed them to strengthen their commitment to the WHO-Programme for International Drug Monitoring, while highlighting opportunities for improvement in the national PV scenario and in the PV tools themselves. The aim of this article is to describe the implementation process, give an overview of current results regarding ICSR data and processes, and highlight the achievements, challenges, and opportunities for improvement after the three years since the beginning of the project.

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Introduction: During the COVID-19 pandemic, adolescents had to deal with a range of mental health problems that has increased social media addiction levels with adverse effects on life satisfaction. Previous studies have explored coping mechanisms to deal with this addiction problem, but did not consider the need to simultaneously cope with different dimensions. Therefore, our study aimed to examine the moderating effect of various coping mechanisms on the relationship between social media addiction and adolescent life satisfaction. Methods: Self-report questionnaires were applied to 1290 secondary school students (age mean = 16.03, SD = 1.27, range: 14 to 19; and 57% female). An exploratory and a confirmatory factor analysis were performed to determine the factor structure of the Brief-Cope 28 scale. Then, a descriptive and correlational analysis of the variables and a multiple linear regression analysis was performed. Results: We found that the social media addiction risk was negatively associated with life satisfaction, adaptive strategies were positively correlated to life satisfaction, and maladaptive strategies were negatively correlated to it. Also, a moderation model was evaluated in which four stress management strategies, namely acceptance and perspective-taking, seeking socio-emotional support, active coping, and maladaptive strategies all conditioned the relationship between social media addiction risk and life satisfaction after controlling for demographic variables and the specific strategies of using comedy, religion and substance use. Results indicate additive and multiplicative effects of management strategies for stressful situations in the studied relationship. Seeking socio-emotional support and active coping were positively related to life satisfaction and maladaptive strategies were negatively associated with it. Multiplicative effects indicate that the relationship between the social media addiction risk and life satisfaction depends only on the acceptance and perspective taking that adolescents report. When adolescents reported having low or average levels of acceptance and perspective taking, there was a negative correlation with general life satisfaction, a connection that grew markedly stronger. In contrast, no connection between social media addiction and life satisfaction was detected for adolescents who report higher levels of acceptance and perspective-taking. Discussion: Abuse of social media and the use of maladaptive stress coping strategies were risk factors that decreased life satisfaction among adolescents during the COVID-19 pandemic period.

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Introduction: School social climate is central to understanding learning experiences in education environments. Previous studies describe various conceptual and operational definitions around the construct; however, there are no records of reviews focused on Latin America. Aim: This study sought to analyze the available evidence and the quality of school social climate measures in Latin America through a systematic review of the literature based on the PRISMA methodology and the COSMIN checklist to assess the psychometric properties of the instruments. Methodology: The Web of Science, Scopus, Psycinfo, and SciELO databases were consulted. A total of 582 records was identified, of which 27 fulfilled the inclusion criteria and methodological quality to be included in the systematization. Results: The results show that the country with the greatest scientific production on the topic is Chile, the measures are centered mainly on the students' perspective and the most used instrument is the CECSCE. In addition, a common aspect to all the records is that they were not sufficient to capture the complexity of school social climate. Conclusion: Multidimensional and multi-informant measures are needed to adequately assess the construct.

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Purpose: To analyze the association of perceived stress on the life satisfaction of Chilean adolescents during the recent pandemic, and to evaluate the moderating role that school community support provides. Methods: A total of 1337 adolescents in Chile (56.6% females), aged 14 through 19 (M = 15.99; SD = 1.3) participated. Descriptive statistics, a multiple linear regression model, and moderation analysis were all employed. Results: Females were associated with lower levels of Life Satisfaction (B = -0.19, p = .042), which was not the case for the Age variable (p = .160). The level of Perceived Stress was shown to have a negative association on Life Satisfaction (B = -1.93, p < .001). The moderation analysis revealed an interaction factor between Perceived Stress and School Community Support as predictors of Life Satisfaction (B = 0.37, t = 4.91, p < .001), showing that higher levels of School Community Support moderated the negative effect of Perceived Stress on Life Satisfaction. Conclusions: Perceived stress during the pandemic had a negative association on life satisfaction. School community support was a protective factor for this negative effect, even in the case of online classes due to school closures. Strengthening the connection between adolescents and their school communities along with providing additional tools and resources in support of such a connection are both essential.

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OBJECTIVE: Variants in STAT4 are associated with systemic lupus erythematosus (SLE) and other autoimmune diseases. We undertook this study to investigate how disease-associated variants affect STAT4 expression, in particular in CD4+ T cells where STAT4 plays an essential role. METHODS: We compared Th1 differentiation between naive CD4+ T cells from healthy donors homozygous for the risk (R/R) or nonrisk (NR/NR) alleles. We analyzed epigenetic marks in STAT4 and evaluated the relevance of its third intron, assessed the consequences of Stat4 overexpression in vivo in mice, and analyzed the effects of the STAT4 genotype in patients with lupus nephritis. RESULTS: Naive CD4+ T cells from NR/NR healthy donors down-regulated STAT4 in response to interleukin-12 (IL-12). In contrast, cells from R/R healthy donors maintained high levels. R/R cells exhibited a higher abundance of transcriptionally active STAT4 and increased interferon-γ production. Accordingly, R/R healthy donors exhibited a stronger induction of local active enhancer marks. Genetic editing confirmed the presence of a negative regulatory region in the STAT4 third intron, where most of the SLE-associated STAT4 single-nucleotide polymorphisms (SNPs) are located. In vivo forced expression demonstrated that increases in Stat4 levels in T cells enhanced glomerulonephritis in mice. Accordingly, the R/R genotype was associated with suboptimal response to treatment and with worse clinical outcomes in patients with proliferative lupus nephritis. CONCLUSION: The SLE-associated STAT4 haplotype correlates with an abnormal IL-12-mediated STAT4 transcriptional regulation. Carriers of the risk variant exhibit exaggerated CD4+ proinflammatory capacities that, in the context of SLE, contribute to more severe disease. R/R patients may benefit from blockade of the IL-12/STAT4 pathway.

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Introduction: The United States is home to 10.5 million undocumented immigrants, of which 5 out of 10 are Mexican or Central American. Their immigration status is an obstacle to secure employment that provides labor benefits such as sick leave and health insurance. Living through the global pandemic in the U.S. had a negative impact on this vulnerable population's mental and physical health. They avoided seeking primary or hospital care fearful that they were undocumented and uninsured. The services provided by the Ventanillas de Salud (VDS) "Health Windows" mitigated this pandemic's negative impact and have become an important source to support and increase access to health services among the immigrant community. Methods: De-identified data from a database system called the Continuous Information System and Health Reports of Mexicans in the United States (SICRESAL-MX) to perform this secondary analysis. The descriptive analysis describes socio-demographic, epidemiological, and situational characteristics of COVID-19. Results: Between January 2020 and July 2021, the VDS and UMS provided 11.5 million individual services to just over 4.3 million people. The main health conditions are overweight and obesity, high blood pressure and elevated cholesterol and glucose levels. Between March 2020 to July 2021 a total of 2,481,834 specific services related to COVID-19 were offered. Discussion: The Mexican migrant community in the United States is in a vulnerable situation, largely due to its immigration status which limits their access to health and human services, including primary health care services. Many of them have suffered from chronic diseases since before the pandemic, generating difficulties in monitoring the ailments and exacerbating their conditions.

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BACKGROUNDBackground: Childhood maltreatment extends beyond this stage of development, impacting adolescence and adulthood, and even adolescent dating violence. Adolescence is an essential transitional stage, so dating violence puts development at risk. In Chile, studies on adolescent dating violence are just emerging and still show a gap. Aim: To examine the relationship between abuse during childhood with victimization and perpetration experiences for adolescent dating violence. MATERIAL AND METHODS: The sample consisted of 242 adolescents between 14 and 19 years of age (59% females) who completed the Conflict in Adolescent Dating Relationship Inventory (CADRI) and the Childhood Trauma Questionnaire-Short Form (CQT-SF), both in their Spanish version. Multiple regression analysis was used to evaluate the degree of association between sexual, emotional, and physical abuse during childhood with adolescent dating violence. Results: Sexual and emotional abuse were predictors of dating victimization. In addition, sexual and physical abuse were found to be predictors of perpetration. CONCLUSIONS: Our study supports the evidence on differentiated outcomes between adolescent dating victimization and perpetration. Moreover, it highlights the role of childhood sexual abuse as a predictor of both.

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