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13 pages, 5 figures, 3 tables, additional files http://dx.doi.org/10.1186/s12864-017-4345-7 ; [Background]: Understanding the consequences of thermal and chemical variations in aquatic habitats is of importance in a scenario of global change. In ecology, the sex ratio is a major population demographic parameter. So far, research that measured environmental perturbations on fish sex ratios has usually involved a few model species with a strong genetic basis of sex determination, and focused on the study of juvenile or adult gonads. However, the underlying mechanisms at the time of gender commitment are poorly understood. In an effort to elucidate the mechanisms driving sex differentiation, here we used the European sea bass, a fish species where genetics and environment (temperature) contribute equally to sex determination. [Results]: Here, we analyzed the transcriptome of developing gonads experiencing either testis or ovarian differentiation as a result of thermal and/or exogenous estrogen influences. These external insults elicited different responses. Thus, while elevated temperature masculinized genetic females, estrogen exposure was able to override thermal effects and resulted in an all-female population. A total of 383 genes were differentially expressed, with an overall downregulation in the expression of genes involved in both in testicular and ovarian differentiation when fish were exposed to Estradiol-17ß through a shutdown of the first steps of steroidogenesis. However, once the female phenotype was imposed, gonads could continue their normal development, even taking into account that some of the resulting females were fish that otherwise would have developed as males. [Conclusions]: The data on the underlying mechanisms operating at the molecular level presented here contribute to a better understanding of the sex ratio response of fish species subjected to a combination of two of the most common environmental perturbations and can have implications in future conservational policies. ; N.D. was supported first by a scholarship from the Government of Spain (BES-2007-14,273) and then by a contract from the Epigen-Aqua (AGL2010–15939) project granted to F.P. Research was supported by the Spanish Ministry of Economy and Competitiveness grants Consolider Aquagenomics (CDS2007-002) and Epifarm (AGL2013-41047-R) to F.P. ; We acknowledge support by the CSIC Open Access Publication Initiative through its Unit of Information Resources for Research (URICI).

[Background] Sex in fish is plastic and in several species can be influenced by environmental factors. In sensitive species, elevated temperatures have a masculinizing effect. Previous studies on the effects of temperature on gene expression have been restricted to a few cognate genes, mostly related to testis or ovarian development, and analyzed in gonads once they had completed the process of sex differentiation. However, studies on the effect of temperature at the whole gonadal transcriptomic level are scarce in fish and, in addition, temperature effects at the time of sex differentiation at the transcriptomic level are also unknown. Here, we used the European sea bass, a gonochoristic teleost with a polygenic sex determination system influenced by temperature, and exposed larvae to elevated temperature during the period of early gonad formation. Transcriptomic analysis of the gonads was carried out about three months after the end of temperature exposure, shortly after the beginning of the process of sex differentiation. ; [Results] Elevated temperature doubled the number of males with respect to untreated controls. Transcriptomic analysis of early differentiating female gonads showed how heat caused: 1) an up-regulation of genes related to cholesterol transport (star), the stress response (nr3c1) and testis differentiation (amh, dmrt, etc.), 2) a decrease in the expression of genes related to ovarian differentiation such as cyp19a1a, and 3) an increase in the expression of several genes related to epigenetic regulatory mechanisms (hdac11, dicer1, ehmt2, jarid2a, pcgf2, suz12, mettl22). ; [Conclusions] Taken together, the results of this study contribute to the understanding of how the early environment sets permanent changes that result in long-lasting consequences, in this case in the sexual phenotype. Results also show the usefulness of comparing the effects of heat on the behavior of cognate genes related to sex differentiation as well as that of genes involved in establishing and maintaining cell identity through epigenetic mechanisms. ; ND was supported first by a scholarship from the Government of Spain (BES-2007-14273) and then by a contract from the Epigen-Aqua Project (AGL2010-15939).

12 pages, 4 figures, 1 table, supplementary material https://dx.doi.org/10.1038/s41598-017-10861-6 ; In natural fish populations, temperature increases can result in shifts in important phenotypic traits. DNA methylation is an epigenetic mechanism mediating phenotypic changes. However, whether temperature increases of the magnitude predicted by the latest global warming models can affect DNA methylation is unknown. Here, we exposed European sea bass to moderate temperature increases in different periods within the first two months of age. We show that increases of even 2 °C in larvae significantly changed global DNA methylation and the expression of ecologically-relevant genes related to DNA methylation, stress response, muscle and organ formation, while 4 °C had no effect on juveniles. Furthermore, DNA methylation changes were more marked in larvae previously acclimated to a different temperature. The expression of most genes was also affected by temperature in the larvae but not in juveniles. In conclusion, this work constitutes the first study of DNA methylation in fish showing that temperature increases of the magnitude predicted by the latest global warming models result in stage-dependent alterations in global DNA methylation and gene expression levels. This study, therefore, provides insights on the possible consequences of climate change in fish mediated by genome-wide epigenetic modifications ; DA and ND were supported by Ph.D. scholarships from the Spanish Government (BES-2011-044860 and BES-2007-14273, respectively). Research was supported by the Ministry of Economy and Competitiveness "Epifarm" (AGL2013-41047-R) to FP ; Peer Reviewed

13 pages, 6 figures, 2 tables, supporting information http://dx.doi.org/10.1371/journal.pone.0111304 ; Background: Food supply is a major factor influencing growth rates in animals. This has important implications for both natural and farmed fish populations, since food restriction may difficult reproduction. However, a study on the effects of food supply on the development of juvenile gonads has never been transcriptionally described in fish. Methods and Findings: This study investigated the consequences of growth on gonadal transcriptome of European sea bass in: 1) 4-month-old sexually undifferentiated fish, comparing the gonads of fish with the highest vs. the lowest growth, to explore a possible link between transcriptome and future sex, and 2) testis from 11-month-old juveniles where growth had been manipulated through changes in food supply. The four groups used were: i) sustained fast growth, ii) sustained slow growth, iii) accelerated growth, iv) decelerated growth. The transcriptome of undifferentiated gonads was not drastically affected by initial natural differences in growth. Further, changes in the expression of genes associated with protein turnover were seen, favoring catabolism in slow-growing fish and anabolism in fast-growing fish. Moreover, while fast-growing fish took energy from glucose, as deduced from the pathways affected and the analysis of protein-protein interactions examined, in slow-growing fish lipid metabolism and gluconeogenesis was favored. Interestingly, the highest transcriptomic differences were found when forcing initially fast-growing fish to decelerate their growth, while accelerating growth of initially slow-growing fish resulted in full transcriptomic convergence with sustained fast-growing fish. Conclusions: Food availability during sex differentiation shapes the juvenile testis transcriptome, as evidenced by adaptations to different energy balances. Remarkably, this occurs in absence of major histological changes in the testis. Thus, fish are able to recover transcriptionally their testes if they are provided with enough food supply during sex differentiation; however, an initial fast growth does not represent any advantage in terms of transcriptional fitness if later food becomes scarce. © 2014 Díaz et al. ; Research was supported by the Spanish Ministry of Science projects ''Epigen-Aqua'' (AGL2010-15939) and ''Aquagenomics'' (CDS2007-0002) to FP. ND was supported by a scholarship from the Government of Spain (BES-2007-14273) and then by a contract by the Epigen-Aqua project. LR was supported by an Aquagenomics postdoctoral contract and Epigen-Aqua project ; Peer Reviewed

9 pages, 6 figures, 1 table, supplementary information http://jeb.biologists.org/content/220/6/1056?panels_ajax_tab_tab=jnl_template_cob_tab_supp&panels_ajax_tab_trigger=supplemental ; The zebrafish (Danio rerio) has become a well-established experimental model in many research fields but the loss of the primary sex-determining region during the process of domestication renders laboratory strains of zebrafish susceptible to the effects of environmental factors on sex ratios. Further, an essential husbandry aspect – the optimal rearing density to avoid stress-induced masculinization – is not known. We carried out two experiments: the first focusing on the effects of density on survival, growth and sex ratio by rearing zebrafish at different initial densities (9, 19, 37 and 74 fish per litre) for 3 months (6–90 days post-fertilization, dpf), and the second focusing on the effects of cortisol during the sex differentiation period (15–45 dpf) for zebrafish reared at low density. The results showed an increase in the number of males in groups subjected to the two highest initial rearing densities; we also observed a reduction of survival and growth in a density-dependent manner. Furthermore, zebrafish treated with cortisol during the sex differentiation period showed a complete masculinization of the population; treatment with the cortisol synthesis inhibitor metyrapone negated the effects of exogenous cortisol. Our results indicate that the process of sex differentiation in domesticated zebrafish can be perturbed by elevated stocking density and that this effect is likely to be mediated by an increase in cortisol through the stress response. However, the underlying mechanism needs further study ; This study was supported by Ministerio de Economía y Competitividad grants from Spanish government ('EpiFarm': AGL2013-41047-R) to F.P. L.R. was supported by an Epifarm contract; A.V. and N.D. were supported by Ministerio de Economía y Competitividad PhD scholarships (BES-2014-069051 and BES-2007-14273, respectively) ; Peer Reviewed

This article is part of the Research Topic Genomics in aquaculture to better understand species biology and accelerate genetic progress.-- 13 pages, 3 figures ; Controlling the sex ratio is essential in finfish farming. A balanced sex ratio is usually good for broodstock management, since it enables to develop appropriate breeding schemes. However, in some species the production of monosex populations is desirable because the existence of sexual dimorphism, primarily in growth or first time of sexual maturation, but also in color or shape, can render one sex more valuable. The knowledge of the genetic architecture of sex determination (SD) is convenient for controlling sex ratio and for the implementation of breeding programs. Unlike mammals and birds, which show highly conserved master genes that control a conserved genetic network responsible for gonad differentiation (GD), a huge diversity of SD mechanisms has been reported in fish. Despite theory predictions, more than one gene is in many cases involved in fish SD and genetic differences have been observed in the GD network. Environmental factors also play a relevant role and epigenetic mechanisms are becoming increasingly recognized for the establishment and maintenance of the GD pathways. Although major genetic factors are frequently involved in fish SD, these observations strongly suggest that SD in this group resembles a complex trait. Accordingly, the application of quantitative genetics combined with genomic tools is desirable to address its study and in fact, when applied, it has frequently demonstrated a multigene trait interacting with environmental factors in model and cultured fish species. This scenario has notable implications for aquaculture and, depending upon the species, from chromosome manipulation or environmental control techniques up to classical selection or marker assisted selection programs, are being applied. In this review, we selected four relevant species or fish groups to illustrate this diversity and hence the technologies that can be used by the industry for the control of sex ratio: turbot and European sea bass, two reference species of the European aquaculture, and salmonids and tilapia, representing the fish for which there are well established breeding programs ; This research work was supported by the Spanish Government (Consolider Ingenio Aquagenomics: CSD2007-00002 project) and Spanish Ministerio de Ciencia e Innovación (AGL2009-13273 and AGL2010-15939) projects to Paulino Martínez and Francesc Piferrer ; Peer Reviewed

La evaluación actual de la gestión por procesos es crucial para garantizar la competitividad y la eficiente organización de las instituciones en el contexto global. Este estudio se propone resaltar la evidencia disponible sobre la implementación de la gestión por procesos en entidades de la administración pública. La revisión bibliográfica, abarcando artículos publicados entre 2019 y 2022 en bases de datos como Scielo, Scopus, Google Scholar y Web of Science, destaca la relevancia de la gestión de procesos en la administración local pública, centrándose en la satisfacción de las demandas ciudadanas. En última instancia, se concluye que el modelo de gestión por procesos busca impulsar la mejora continua en la organización, característica esencial de una entidad eficaz que gestiona actividades y resultados como procesos orientados a objetivos.

Background: The COVID-19 pandemic has led to important changes in the approach to patients worldwide. Different agencies have proposed and implemented telemedicine-based care services in order to ensure access to health care for all people. Aim: The aim of this study was to determine the satisfaction of patients using the Telepsychiatry service offered by the Department of Psychiatry of the Hospital de Clínicas (National University of Asunción, Paraguay). Methods: A cross sectional and descriptive study has been conducted. Participants were recruited through a phone-based survey. Satisfaction with Telepsychiatry has been measured with an adapted version of a satisfaction survey in Teleneurology. As a complement, psychiatrists from the Hospital de Clínicas were also interviewed about their rate of satisfaction with Telepsychiatry. Results: A total of 530 patients were included, 51.3% of whom were women. The consultation satisfaction scale ranged between 2.15 and 4.30 with a mean score of 3.02 ± 0.32. Cronbach's alpha for the scale was .897, indicating a good internal consistency. Patients' satisfaction was higher for the perception of Telepsychiatry and lower for the doctor-patient relationship. Of the physicians, 87.5% were satisfied with the Telepsychiatry service. Conclusion: The satisfaction overall score indicates patients' general satisfaction with the quality of care in Telepsychiatry, mainly regarding the perception of health care. and lower satisfaction with the doctor-patient relationship. Nine out of 10 psychiatrists felt satisfied with the Telepsychiatry service and considered that the degree of patient's satisfaction was acceptable during the Telepsychiatry consultation.

15 pages, 6 figures, supplementary material https://doi.org/10.1007/s10126-019-09886-x ; The European sea bass is one of the most important cultured fish in Europe and has a marked sexual growth dimorphism in favor of females. It is a gonochoristic species with polygenic sex determination, where a combination between still undifferentiated genetic factors and environmental temperature determines sex ratios. The molecular mechanisms responsible for gonadal sex differentiation are still unknown. Here, we sampled fish during the gonadal developmental period (110 to 350 days post fertilization, dpf), and performed a comprehensive transcriptomic study by using a species-specific microarray. This analysis uncovered sex-specific gonadal transcriptomic profiles at each stage of development, identifying larger number of differentially expressed genes in ovaries when compared to testis. The expression patterns of 54 reproduction-related genes were analyzed. We found that hsd17β10 is a reliable marker of early ovarian differentiation. Further, three genes, pdgfb, snx1, and nfy, not previously related to fish sex differentiation, were tightly associated with testis development in the sea bass. Regarding signaling pathways, lysine degradation, bladder cancer, and NOD-like receptor signaling were enriched for ovarian development while eight pathways including basal transcription factors and steroid biosynthesis were enriched for testis development. Analysis of the transcription factor abundance showed an earlier increase in females than in males. Our results show that, although many players in the sex differentiation pathways are conserved among species, there are peculiarities in gene expression worth exploring. The genes identified in this study illustrate the diversity of players involved in fish sex differentiation and can become potential biomarkers for the management of sex ratios in the European sea bass and perhaps other cultured species ; This work was supported by Spanish Government Consolider-Ingenio 2010 grant "Aquagenomics" (ref. CDS2007-0002) to SMK, FM, SZ and FP. BC was supported by an Aquagenomics contract; LR was supported by Aquagenomics postdoctoral contract; ND was supported by Aquagenomics predoctoral contract. NSB was supported by AGL2016-78710-R ; Peer Reviewed

Background: Positive mental health includes not only the absence of mental disorders but also the presence of subjective well-being, good coping strategies for life stress, and strategies for adapting to community life. It is well known that the COVID-19 pandemic has challenged mental health in general population worldwide. However, research has not measured protective factors for mental health in the general population after the declared end of pandemic by the World Health Organization. Methods: This observational, cross-sectional study surveyed 591 Paraguayan participants aged ⩾18 years, who were recruited through an online survey. Demographic characteristics, socioeconomic status were collected as well as mental health and validated tools for hope, resilience, subjective happiness were administered. Results: Of the participants, 81.6% were women, 54% were married or in a relationship and 90.7% reported an university education. The main source of stress was economic issues (30.3%). A total of 22.7% had been previously diagnosed with a mental disorder, 22.2% had consulted a mental health professional and 10.8% had consumed prescription drugs. 42.6% reported flourishing, 36.2% reported moderate and 21.2% reported languishing mental health. Conclusions: This large survey has shown that most of participants reported a flourishing mental health with high ratings at hope, resilience, and subjective happiness scales. Also, the main sources of stress were economic issues, not consequently related to the pandemic. This may add evidences to the international debate on the long term effects of the global pandemic and probably suggests that recovery processes have been collectively adopted in Paraguay.

Background: The number of suicides has been increasing worldwide, year after year, becoming the fourth leading cause of death among young people between 15 and 29 years of age. Aim: In this study, we explored the frequency and characteristics of suicides among the adult general population in Paraguay between 2004 and 2022, considering that suicide attempts and suicidal risk/ideation are frequent and relevant issues in the consultation activity, even if epidemiological evidence on the national rates of suicide is scarce. Methods: In this observational, descriptive, and exploratory study, official records of all deaths by suicide were reviewed and information analyzed. In addition, an attempt was made to predict the number of suicides in the next 5 years according to a mathematical modeling. Results: In the 18-year period, 5,527 suicides of adults were recorded. Patients' mean age was 36.8 ± 17 years old. A 76.77% of them were males, 77.44% were from an urban area and 25.98% from the Greater Asunción and Central Department of Paraguay. The most frequently used method of suicide was intentional self-inflicted injury by hanging, strangulation, or suffocation (all 67.6%). The expected number of national suicides in the following years from 2023 to 2027 will range between 462 and 530. Limitations include the lack of information regarding diagnoses and personal history in the suicide reports as well as the possibility of underreporting of national suicide cases. Conclusion: Our results represent the first large national epidemiological report of suicides in Paraguay and may be of interest for mental health professionals and health authorities in order to reduce the suicide mortality rate within the country.

Background: Although technologies (including information, e-learning, and communication) have been daily employed by University students in the last years, the COVID-19 pandemic has led to a considerable increase in their use. Technostress is a modern term referring to levels of stress caused by the prolonged exposure to technology. Aim: The aim of this study is to assess the technostress and related anxiety and depression among Paraguayan University students, describing their sociodemographic characteristics and relevant associations. Methods: A cross-sectional and descriptive study has been conducted. Participants were recruited through an Internet-based survey. Technostress, anxiety, and depression have been assessed with the Technostress Questionnaire (TechQ), the Generalized Anxiety Disorder-7 (GAD-7) questionnaire, and the Patient Health Questionnaire-2 (PHQ-2), respectively. Results: A total of 378 participants were included, 74.1% of whom were women. According to the TechQ scores, 47.4% of the participants reported a low/moderate level of technostress whereas 5.2% showed severe scores. About 58.5% of participants reported a GAD-7 score ⩾10, meeting diagnostic criteria for generalized anxiety. About 60.3% scored ⩾3 at the PHQ-2 reporting significant levels of depression. Technostress has been significantly associated with levels of anxiety ( p < .001) as well as depression ( p < .001). Conclusion: Our results suggest further research regarding the implications of technostress on the well-being of University students. Specific measures aimed to improve students' coping with the challenges of technology and technostress should be promoted.

Since the explosion of the indignados movement beginning in 2011, there has been a renewed interest in the concept of the "public sphere" in a Spanish context: how it relates to society and to political power, and how it has evolved over the centuries. The Configuration of the Spanish Public Sphere brings together contributions from leading scholars in Hispanic studies, across a wide range of disciplines, to investigate various aspects of these processes, offering a long-term, panoramic view that touches on one of the most urgent issues for contemporary European societies