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Background: During the first wave of the pandemic, a constant concern of healthcare workers, who are more vulnerable to contagion, is their personal safety. This is directly related to the availability of adequate PPE, which led to a perception of dissatisfaction and inequality with government responses. We aim t o determines whether perception of adequate PPE availability is associated with depressive, anxiety, and stress symptoms in different types of healthcare workers. Methods: Analytical cross-sectional study surveyed clinical and non-clinical healthcare workers in two third-level hospitals in Lima, Peru. An online self-survey assessed the perception of adequate PPE availability, using a Likert scale question, which was then dichotomized for the analysis. In addition, we assessed the depressive, anxiety, and stress symptoms using validated questionnaires. Results: 563 participants were included. In general, there is no association between perception of PPE availability and three mental health outcomes. However, in the subgroup analysis, physicians with better perception of PPE availability had less moderate-severe outcomes in mental health; in contrast, nurses had higher moderate-severe outcomes. The type of profession in healthcare workers may modify the effect of this association. Conclusion: The association between perception of PPE availability and mental health outcomes is complex in healthcare workers from two third-level hospitals. This association can vary according to the type of work.

The TP53 tumor suppressor is mutated in ~75% of pancreatic cancers. The mutant TP53 protein in pancreatic ductal adenocarcinomas (PDAC) promotes tumor growth and metastasis. Attempts have been made to develop molecules that restore at least some of the properties of wild-type (WT) TP53. APR-246 is one such molecule, and it is referred to as a mutant TP53 reactivator. To understand the potential of APR-246 to sensitize PDAC cells to chemotherapy, we introduced a vector encoding WT-TP53 into two PDAC cell lines, one lacking the expression of TP53 (PANC-28) and one with a gain-of-function (GOF) mutant TP53 (MIA-PaCa-2). APR-246 increased drug sensitivity in the cells containing either a WT or mutant TP53 protein with GOF activity, but not in cells that lacked TP53. The introduction of WT-T53 into PANC-28 cells increased their sensitivity to the TP53 reactivator, chemotherapeutic drugs, and signal transduction inhibitors. The addition of WT-TP53 to PDAC cells with GOF TP53 also increased their sensitivity to the drugs and therapeutics, indicating that APR-246 could function in cells with WT-TP53 and GOF TP53. These results highlight the importance of knowledge of the type of TP53 mutation that is present in cancer patients before the administration of drugs which function through the reactivation of TP53.

Abstract Microarray experiments are capable of determining the relative expression of tens of thousands of genes simultaneously, thus resulting in very large databases. The analysis of these databases and the extraction of biologically relevant knowledge from them are challenging tasks. The identification of potential cancer biomarker genes is one of the most important aims for microarray analysis and, as such, has been widely targeted in the literature. However, identifying a set of these genes consistently across different experiments, researches, microarray platforms, or cancer types is still an elusive endeavor. Besides the inherent difficulty of the large and nonconstant variability in these experiments and the incommensurability between different microarray technologies, there is the issue of the users having to adjust a series of parameters that significantly affect the outcome of the analyses and that do not have a biological or medical meaning. In this study, the identification of potential cancer biomarkers from microarray data is casted as a multiple criteria optimization (MCO) problem. The efficient solutions to this problem, found here through data envelopment analysis (DEA), are associated to genes that are proposed as potential cancer biomarkers. The method does not require any parameter adjustment by the user, and thus fosters repeatability. The approach also allows the analysis of different microarray experiments, microarray platforms, and cancer types simultaneously. The results include the analysis of three publicly available microarray databases related to cervix cancer. This study points to the feasibility of modeling the selection of potential cancer biomarkers from microarray data as an MCO problem and solve it using DEA. Using MCO entails a new optic to the identification of potential cancer biomarkers as it does not require the definition of a threshold value to establish significance for a particular gene and the selection of a normalization procedure to compare different experiments is no longer necessary.

Abstract The Coma Recovery Scale-revised (CRS-r) is the gold standard for the behavioral assessment of patients with Disorders of Consciousness (DoCs). However, the misdiagnosis rate is around 40%. For this reason, recent guidelines suggested enhancing the assessment with neurophysiological measures: among these, surface electromyography (sEMG) represents a convenient bedside solution. This work presents the use of the STRIVEfc system, a wearable device that allows CRS-r administration while recording four sEMG signals. STRIVEfc was employed in 40 sessions on 33 DoCs patients and the sEMG was analyzed to look for voluntary and consistent over threshold (OT) muscular activities. Their duration, amplitude, and number were retained and compared between patients in Unresponsive Wakefulness Syndrome (UWS) and Minimally Conscious State (MCS), revealing more numerous and significantly longer OTs in the latter group. Lastly, the EMG information was exploited to enrich the behavioral assessment by building the instrumented CRS-r score (ICRS-r). In 9/16 UWS sessions, the ICRS-r score suggested a higher-level functioning, not translated into a behavioral response, compatible with MCS diagnosis. Overall, the use of STRIVEfc allows to reveal hidden muscular patterns not detectable by the clinician, thus improving the characterization of DoCs patient’s functional capabilities and supporting the diagnostic process.

Abstract Background and aim Migraine is a common disabling conditions which, globally, affects 15.2% of the population. It is the second cause of health loss in terms of years lived with disability, the first among women. Despite being so common, it is poorly recognised and too often undertreated. Specialty centres and neurologists with specific expertise on headache disorders have the knowledge to provide specific care: however, those who do not regularly treat patients with migraine will benefit from a synopsis on the most relevant and updated information about this condition. This paper presents a comprehensive view on the hallmarks of migraine, from genetics and diagnostic markers, up to treatments and societal impact, and reports the elements that identify migraine specific features. Main results The most relevant hallmark of migraine is that it has common and individual features together. Besides the known clinical manifestations, migraine presentation is heterogeneous with regard to frequency of attacks, presence of aura, response to therapy, associated comorbidities or other symptoms, which likely reflect migraine heterogeneous genetic and molecular basis. The amount of therapies for acute and for prophylactic treatment is really wide, and one of the difficulties is with finding the best treatment for the single patient. In addition to this, patients carry out different daily life activities, and might show lifestyle habits which are not entirely adequate to manage migraine day by day. Education will be more and more important as a strategy of brain health promotion, because this will enable reducing the amount of subjects needing specialty care, thus leaving it to those who require it in reason of refractory condition or presence of comorbidities. Conclusions Recognizing the hallmarks of migraine and the features of single patients enables prescribing specific pharmacological and non-pharmacological treatments. Medical research on headaches today particularly suffers from the syndrome of single-disease approach, but it is important to have a cross-sectional and joint vision with other close specialties, in order to treat our patients with a comprehensive approach that a heterogeneous condition like migraine requires.

IntroductionCD38 is an ectoenzyme receptor found on hematopoietic cells and its expression is used in the flow cytometric analysis of sub-populations of circulating B cells among peripheral blood mononuclear cells (PBMC) to aid in diagnosing patients with different antibody production defects (AbD). Monoclonal antibodies derived from the sea lamprey Variable Lymphocyte Receptor B (VLRB) are emerging as an alternative to conventional mammalian antibodies. We hypothesized that VLRB MM3 (V-CD38) which specifically recognizes CD38 in a manner correlating with its enzymatic activity could identify terminally differentiated B cells in human PBMC. Here we investigate the ability of V-CD38 as a tool to diagnose patients with diverse immune abnormalities including AbD.MethodsThe expression of CD38 on CD3-CD19+CD27+ plasmablasts and CD3-CD19+IgMhiCD27- transitional B cells in PBMC was analyzed by flow cytometry using V-CD38 and compared with a commercial conventional antibody to CD38 (C-CD38).ResultsA highly significant correlation (p

Drought significantly impacts freshwater ecosystems, disrupting all biological levels. In particular, freshwater macroinvertebrates undergo significant changes in taxonomic and functional diversity bioassessments. The effects often synergize with other stressors, such as pollution that drought can exacerbate. Several techniques have been well-developed (traditional) or have the potential (innovative) to address this issue. This review provides a comprehensive description of the impact of drought as a primary stressor on macroinvertebrate diversity. An overview of the research and projections are presented. Three conceptual pillars drive this study: taxonomic-functional responses, simultaneous pressure dynamics, and innovative techniques. Few studies have been conducted on lentic water bodies, arid and semi-arid systems, and on multiple continents. Common research keywords across continents are observed less frequently in experimental than in field studies. Most analyzed studies examine community structure, which is more common in field-based than experimental studies. Agricultural land use effect, urbanization, and invasive species are the stressors most associated with drought. Integrating traditional with advanced/innovative techniques that have hardly been applied makes it challenging to understand ecological responses comprehensively. If innovative techniques are employed to consider the dynamics of multiple stressors and to consistently estimate taxonomic and functional diversity, promising avenues for future research could be uncovered.

Abstract Objective With potential therapies for many forms of Charcot‐Marie‐Tooth disease (CMT), responsive outcome measures are urgently needed for clinical trials. Quantitative lower limb MRI demonstrated progressive calf intramuscular fat accumulation in the commonest form, CMT1A with large responsiveness. In this study, we evaluated the responsiveness and validity in the three other common forms, due to variants in GJB1 (CMTX1), MPZ (CMT1B) and MFN2 (CMT2A). Methods 22 CMTX1, 21 CMT1B and 21 CMT2A patients and matched controls were assessed at a 1‐year interval. Intramuscular fat fraction (FF) was evaluated using three‐point Dixon MRI at thigh and calf level along with clinical measures including CMT examination score, clinical strength assessment, CMT‐HI and plasma neurofilament light chain. Results All patient groups had elevated muscle fat fraction at thigh and calf levels, with highest thigh FF and atrophy in CMT2A. There was moderate correlation between calf muscle FF and clinical measures (CMTESv2 rho = 0.405; p = 0.001, ankle MRC strength rho = −0.481; p

Abstract The World Health Organization (WHO) Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders was developed by WHO to address the worldwide challenges and gaps in provision of care and services for people with epilepsy and other neurological disorders and to ensure a comprehensive, coordinated response across sectors to the burden of neurologic diseases and to promote brain health across life-course. Headache disorders constitute the second most burdensome of all neurological diseases after stroke, but the first if young and midlife adults are taken into account. Despite the availability of a range of treatments, disability associated with headache disorders, and with migraine, remains very high. In addition, there are inequalities between high-income and low and middle income countries in access to medical care. In line with several brain health initiatives following the WHOiGAP resolution, herein we tailor the main pillars of the action plan to headache disorders: (1) raising policy prioritization and strengthen governance; (2) providing effective, timely and responsive diagnosis, treatment and care; (3) implementing strategies for promotion and prevention; (4) fostering research and innovation and strengthen information systems. Specific targets for future policy actions are proposed. The Global Action Plan triggered a revolution in neurology, not only by increasing public awareness of brain disorders and brain health but also by boosting the number of neurologists in training, raising research funding and making neurology a public health priority for policy makers. Reducing the burden of headache disorders will not only improve the quality of life and wellbeing of people with headache but also reduce the burden of neurological disorders increasing global brain health and, thus, global population health.

La nueva tendencia del desarrollo de las tecnologías de la información y la comunicación significa un salto en cuanto a la mejora de la calidad, más aún en situación adversas como las derivadas por la pandemia de la COVID-19. El análisis de los riesgos y el aprovechamiento de las oportunidades constituyen las premisas para el presente trabajo el cual se trazó como objetivo el análisis del contexto actual y la propuesta de soluciones de mejora para la entrega de los resultados de los servicios al cliente considerando la digitalización de la información. Para ello se realizó una revisión documental puntualizando en las solicitudes de los clientes, las salidas de los informes, la evaluación de la satisfacción del cliente, los resultados de las propias revisiones por la dirección y los análisis de riesgos realizados en el sistema. Los resultados indicaron la mejora continua del sistema y la fidelización del cliente durante todo el período de estudio. No obstante, dadas las condiciones actuales por las que atraviesa el mundo y en particular Cuba, especialmente para períodos de situaciones adversas, se identificaron brechas que pueden ser enmendadas insertando la gestión de las firmas digitales en los informes de resultado, apoyado en las técnicas criptográficas, de acuerdo con lo dispuesto en la Resolución 23/2022 del Ministerio de Interior.

Abstract The 2030 Agenda for Sustainable Development sets out, through 17 Sustainable Development Goals (SDGs), a path for the prosperity of people and the planet. SDG 3 in particular aims to ensure healthy lives and promote well-being for all at all ages and includes several targets to enhance health. This review presents a “headache-tailored” perspective on how to achieve SDG 3 by focusing on six specific actions: targeting chronic headaches; reducing the overuse of acute pain-relieving medications; promoting the education of healthcare professionals; granting access to medication in low- and middle-income countries (LMIC); implementing training and educational opportunities for healthcare professionals in low and middle income countries; building a global alliance against headache disorders. Addressing the burden of headache disorders directly impacts on populations’ health, as well as on the possibility to improve the productivity of people aged below 50, women in particular. Our analysis pointed out several elements, and included: moving forward from frequency-based parameters to define headache severity; recognizing and managing comorbid diseases and risk factors; implementing a disease management multi-modal management model that incorporates pharmacological and non-pharmacological treatments; early recognizing and managing the overuse of acute pain-relieving medications; promoting undergraduate, postgraduate, and continuing medical education of healthcare professionals with specific training on headache; and promoting a culture that favors the recognition of headaches as diseases with a neurobiological basis, where this is not yet recognized. Making headache care more sustainable is an achievable objective, which will require multi-stakeholder collaborations across all sectors of society, both health-related and not health-related. Robust investments will be needed; however, considering the high prevalence of headache disorders and the associated disability, these investments will surely improve multiple health outcomes and lift development and well-being globally.

Abstract Background Metastatic disease in tumors originating from the gastrointestinal tract can exhibit varying degrees of tumor burden at presentation. Some patients follow a less aggressive disease course, characterized by a limited number of metastatic sites, referred to as “oligo-metastatic disease” (OMD). The precise biological characteristics that define the oligometastatic behavior remain uncertain. In this study, we present a protocol designed to prospectively identify OMD, with the aim of proposing novel therapeutic approaches and monitoring strategies. Methods The PREDICTION study is a monocentric, prospective, observational investigation. Enrolled patients will receive standard treatment, while translational activities will involve analysis of the tumor microenvironment and genomic profiling using immunohistochemistry and next-generation sequencing, respectively. The first primary objective (descriptive) is to determine the prevalence of biological characteristics in OMD derived from gastrointestinal tract neoplasms, including high genetic concordance between primary tumors and metastases, a significant infiltration of T lymphocytes, and the absence of clonal evolution favoring specific driver genes (KRAS and PIK3CA). The second co-primary objective (analytic) is to identify a prognostic score for true OMD, with a primary focus on metastatic colorectal cancer. The score will comprise genetic concordance (> 80%), high T-lymphocyte infiltration, and the absence of clonal evolution favoring driver genes. It is hypothesized that patients with true OMD (score 3+) will have a lower rate of progression/recurrence within one year (20%) compared to those with false OMD (80%). The endpoint of the co-primary objective is the rate of recurrence/progression at one year. Considering a reasonable probability (60%) of the three factors occurring simultaneously in true OMD (score 3+), using a significance level of α = 0.05 and a test power of 90%, the study requires a minimum enrollment of 32 patients. Discussion Few studies have explored the precise genetic and biological features of OMD thus far. In clinical settings, the diagnosis of OMD is typically made retrospectively, as some patients who undergo intensive treatment for oligometastases develop polymetastatic diseases within a year, while others do not experience disease progression (true OMD). In the coming years, the identification of true OMD will allow us to employ more personalized and comprehensive strategies in cancer treatment. Trial registration ClinicalTrials.gov ID NCT05806151.

The present study provides a detailed macroscopic examination (with some microscopic insights) of the genital apparatus of seven adult and intact male sugar gliders, as well as one castrated individual. The scrotum is pendulous and attached to the ventral abdominal wall, situated in the caudal part of the abdomen and cranial to the cloacal opening. The testes are oval shaped with their long axes oriented vertically. The epididymides are attached along the caudomedial border of their respective testes. The head and tail of the epididymides are in close proximity to the poles of the testes but are not directly attached. The deferent ducts are positioned laterally to their ipsilateral ureter as they run near the dorsal surface of the urinary bladder. The ampulla of the deferent duct is absent. The penis is located post-scrotally, lacks insertion into the bony pelvis, and has a bifid distal end. The crura of the penis originate within the ischiocavernosus muscles, and there are two bulbs of the penis. When flaccid, the entire penis is concealed in the perineal region and externalizes through an orifice situated in the ventral part of the cloaca, traversing its floor towards the cloacal opening. The urethral external orifice is positioned at the point where the bifurcation of the free part of the penis begins. The prostate gland resides in the pelvic cavity and consists of two parts: a macroscopically visible body surrounding the urethra and a microscopically identifiable portion embedded within the walls of the duct. Sugar gliders possess two pairs of bulbous bulbourethral glands, located dorsally and laterally to the rectum, but lack vesicular glands.

Fish by-products can be converted into high-value-added products like fish protein hydrolysates (FPHs), which have high nutritional value and are rich in bioactive peptides with health benefits. This study aims to characterise FPHs derived from salmon heads (HPSs) and Cape hake trimmings (HPHs) using Alcalase for enzymatic hydrolysis and Subcritical Water Hydrolysis (SWH) as an alternative method. All hydrolysates demonstrated high protein content (70.4–88.7%), with the degree of hydrolysis (DH) ranging from 10.7 to 36.4%. The peptide profile of FPHs indicated the breakdown of proteins into small peptides. HPSs showed higher levels of glycine and proline, while HPHs had higher concentrations of glutamic acid, leucine, threonine, and phenylalanine. Similar elemental profiles were observed in both HPHs and HPSs, and the levels of Cd, Pb, and Hg were well below the legislated limits. Hydrolysates do not have a negative effect on cell metabolism and contribute to cell growth. HPSs and HPHs exhibited high 2,2′–azino-bis(3 ethylbenzthiazoline-6)-sulfonic acid (ABTS) radical scavenging activity, Cu2+ and Fe2+ chelating activities, and angiotensin-converting enzyme (ACE) inhibitory activity, with HPHs generally displaying higher activities. The α-amylase inhibition of both FPHs was relatively low. These results indicate that HPHs are a promising natural source of nutritional compounds and bioactive peptides, making them potential candidates for use as an ingredient in new food products or nutraceuticals. SWH at 250 °C is a viable alternative to enzymatic methods for producing FPHs from salmon heads with high antioxidant and chelating properties.

A growing interest in the recovery and enhancement of crops, particularly local varieties such as ‘Caaveiro’ wheat, has been observed. This study aims to investigate the impact of cultivation systems (organic versus conventional) on the nutritional quality of ‘Caaveiro’ flour and breads protected by the PGI “Pan Galego,” employing two fermentation methods (sourdough versus sourdough and biological yeast). Organic flour exhibited significantly higher levels of moisture, fat, sucrose, phosphorus (P), sodium (Na), and copper (Cu) while also exhibiting a lower total starch and zinc (Zn) content. Organic bread, produced using both fermentation methods, demonstrated significantly higher protein, carbohydrate, total, resistant, and rapidly digestible starch, ash, Na, P, iron (Fe), and Cu content. Additionally, they contained less moisture compared to conventional bread. Despite variations in nutritional characteristics based on the cultivation system, the organic approach proved effective at producing high-quality products with a positive environmental impact, which is highly appreciated by consumers.

Objetivo: Los trabajadores de la salud se enfrentaron a niveles sin precedentes de carga emocional relacionada con la pandemia de la COVID-19. Este estudio pretende conocer la autopercepción del estado de sobrecarga emocional de los profesionales del Servicio Navarro de Salud-Osasunbidea (SNS-O) en dos momentos durante la pandemia y sus factores asociados. Método: Estudio transversal mediante el uso de un cuestionario que incluye la Escala de Autoevaluación de Sobrecarga Emocional, enviado por correo electrónico a todos los profesionales sanitarios del SNS-O en dos momentos de la pandemia, en octubre de 2020 y octubre de 2021. Los resultados de la escala global y de las subescalas ‘“miedos-ansiedad”’ y ‘“respuesta afectiva”’ se compararon entre los dos momentos de medición según puesto de trabajo, ámbito, área y servicio, mediante modelos ANCOVA?. Resultados: Participaron en la encuesta de 2020 1.485 (11,3%) sanitarios y 950 (7,3%) en la encuesta de 2021 de. La diferencia media para el score global entre 2020 y 2021 fue -1.87 (95% IC: -2.38, -1.35), indicando una reducción de la sobrecarga emocional con la evolución de la pandemia, con algunas diferencias entre categorías profesionales. Conclusiones: El año 2020 tuvo gran impacto en la sobrecarga emocional que disminuyó al año siguiente. Uno de los mayores temores del personal sanitario durante su exposición laboral a enfermedades infecciosas epidémicas sigue siendo el miedo a contraer la enfermedad y transmitirla a sus familiares y entorno social. Conforme aumenta la proximidad con el paciente y su entorno, incrementa la probabilidad de afectación psicoemocional.

Dentro del proceso inversionista del Centro Nacional de Investigaciones Científicas se proyecta la planta de producción industrial del ingrediente activo Palmex, indicado para el tratamiento de la hiperplasia prostática benigna. Esta planta permitirá sustituir importaciones y un significativo aporte al cuadro de medicamentos del país. Para dar cumplimiento a los requerimientos ambientales de la inversión, el presente trabajo se trazó como objetivo caracterizar las aguas residuales de las producciones de este ingrediente, con vistas a proponer un esquema tecnológico de tratamiento para la planta industrial. Estos residuos presentan características oleosas, con variación en su composición y flujo. Los resultados indicaron altas concentraciones de materia orgánica (14 950 mg DQO L- 1), grasas y aceites (263 mg L-1), conductividad eléctrica (8 251 μS cm- 1) y sólidos totales (6 268 mg L-1). Se evaluaron diferentes condiciones, tanto a nivel de laboratorio como de banco. A partir de los resultados de la eficiencia de reducción de los indicadores ambientales obtenidos y de la estimación del balance de la carga contaminante se propuso el esquema de tratamiento, el cual consta de los órganos siguientes: tamiz-sedimentador, tanque homogeneizador-1, trampa de grasas-sedimentador primario, tanque de compensación, tanque homogeneizador-2, sistema de ozonización y tanque séptico-filtro biológico. Esta secuencia garantizó que los efluentes tratados cumplieran con la norma de vertimiento NC 27:2012, al sistema de alcantarillado. Los resultados constituyen la base de la Tarea Técnica de la planta de tratamiento de aguas residuales de la planta de producción a escala industrial presentada, como requerimiento de la inversión,

Abstract Aim When studying brain networks in patients with Disorders of Consciousness (DoC), it is important to evaluate the structural integrity of networks in addition to their functional activity. Here, we investigated whether structural MRI, together with clinical variables, can be useful for diagnostic purposes and whether a quantitative analysis is feasible in a group of chronic DoC patients. Methods We studied 109 chronic patients with DoC and emerged from DoC with structural MRI: 65 in vegetative state/unresponsive wakefulness state (VS/UWS), 34 in minimally conscious state (MCS), and 10 with severe disability. MRI data were analyzed through qualitative and quantitative approaches. Results The qualitative MRI analysis outperformed the quantitative one, which resulted to be hardly feasible in chronic DoC patients. The results of the qualitative approach showed that the structural integrity of HighOrder networks, altogether, had better diagnostic accuracy than LowOrder networks, particularly when the model included clinical variables (AUC = 0.83). Diagnostic differences between VS/UWS and MCS were stronger in anoxic etiology than vascular and traumatic etiology. MRI data of all LowOrder and HighOrder networks correlated with the clinical score. The integrity of the left hemisphere was associated with a better clinical status. Conclusions Structural integrity of brain networks is sensitive to clinical severity. When patients are chronic, the qualitative analysis of MRI data is indicated.

La tercera edición de la norma ISO/IEC 17025 tuvo cambios significativos con respecto a su versión antecesora como son, el enfoque y estructura basados en el proceso, el pensamiento y acción basados en el riesgo y el nuevo requisito de imparcialidad y confidencialidad, entre otros, no menos importantes. El problema fue cómo afrontar la transición hacia esta tercera versión de la norma y cumplir con todos sus requisitos. El Grupo de Gestión de los Servicios Científico-Técnicos DECA (GG SCT-DECA), del CNIC tiene como misión proporcionar Servicios Científico-técnicos (SCT) especializados para la caracterización de aguas, aguas residuales y residuos sólidos, el diseño y la tarea técnica de soluciones tecnológicas de tratamiento, así como servicios en protección de materiales. Todos ellos están cubiertos por un sistema de gestión de acuerdo con la NC- ISO / IEC 17025 y acreditado por el Órgano Nacional de Acreditación de la República de Cuba (ONARC). El trabajo tuvo como objetivo la estrategia a seguir en el Grupo para dar cumplimiento a los nuevos requisitos de la ISO/IEC 17025. El proceder de, tipo descriptivo y cualitativo, tuvo en cuenta los principales cambios, tomando como guía una correlación entre la segunda y tercera edición de la norma, lo cual permitió, conjuntamente con una revisión documental, definir que faltaba por hacer o mejorar. Se definieron las acciones necesarias para dar conformidad a los nuevos requisitos de la tercera edición y se elaboró un plan, estableciendo los plazos de cumplimiento y los responsables para ejecutarlos. Entre otras acciones, se elaboro

Monk Parakeets are considered one of the most invasive bird species given its unique capacity among psittacines to build their own communal nests. Originally introduced as pets in houses from where they escaped or were released, they are currently considered invasive in more than 20 countries worldwide. This is the case in Chile, where Monk Parakeets were introduced during the 1970s. Between 2016 and 2019 we searched Monk Parakeets’ nests structures in the Santiago metropolis region. We identified 1458 Monk Parakeets’ communal nests on 546 trees belonging to 34 tree species. Ninety-one percent of the occupied trees were also introduced. Paraná pine and cedar of Lebanon were the tree species with highest abundance of nests, averaging more than four nests/tree/species, with 23 and 18 maximum number of nests, respectively. Tasmanian blue gum and black locust were selected by parakeets more often than expected, based on availability. From all trees, 24.6% denoted health problems and 47.3% were pruned. The average nest height was 14.2 m and nests were observed mainly in secondary branches (59.3%). The occupancy rate was 89.7% and was associated to nest height and type of branch. During two reproductive seasons we quantified eggs and nestlings in chambers averaging 4.5 and 4.2, respectively. We provide a rough population size estimate and the characteristics of Monk Parakeets nest and tree selectivity, aiming to characterize several decades of a neglected urban invasion to warrant strategies for improved management measures.

Abstract Migraine is a complex condition in which genetic predisposition interacts with other biological and environmental factors determining its course. A hyperresponsive brain cortex, peripheral and central alterations in pain processing, and comorbidities play a role from an individual biological standpoint. Besides, dysfunctional psychological mechanisms, social and lifestyle factors may intervene and impact on the clinical phenotype of the disease, promote its transformation from episodic into chronic migraine and may increase migraine-related disability. Thus, given the multifactorial origin of the condition, the application of a biopsychosocial approach in the management of migraine could favor therapeutic success. While in chronic pain conditions the biopsychosocial approach is already a mainstay of treatment, in migraine the biomedical approach is still dominant. It is instead advisable to carefully consider the individual with migraine as a whole, in order to plan a tailored treatment. In this review, we first reported an analytical and critical discussion of the biological, psychological, and social factors involved in migraine. Then, we addressed the management implications of the application of a biopsychosocial model discussing how the integration between non-pharmacological management and conventional biomedical treatment may provide advantages to migraine care.

A significant number of people, following acute SARS-CoV-2 infection, report persistent symptoms or new symptoms that are sustained over time, often affecting different body systems. This condition, commonly referred to as Long-COVID, requires a complex clinical management. In Italy new health facilities specifically dedicated to the diagnosis and care of Long-COVID were implemented. However, the activity of these clinical centers is highly heterogeneous, with wide variation in the type of services provided, specialistic expertise and, ultimately, in the clinical care provided. Recommendations for a uniform management of Long-COVID were therefore needed. Professionals from different disciplines (including general practitioners, specialists in respiratory diseases, infectious diseases, internal medicine, geriatrics, cardiology, neurology, pediatrics, and odontostomatology) were invited to participate, together with a patient representative, in a multidisciplinary Panel appointed to draft Good Practices on clinical management of Long-COVID. The Panel, after extensive literature review, issued recommendations on 3 thematic areas: access to Long-COVID services, clinical evaluation, and organization of the services. The Panel highlighted the importance of providing integrated multidisciplinary care in the management of patients after SARS-CoV-2 infection, and agreed that a multidisciplinary service, one-stop clinic approach could avoid multiple referrals and reduce the number of appointments. In areas where multidisciplinary services are not available, services may be provided through integrated and coordinated primary, community, rehabilitation and mental health services. Management should be adapted according to the patient’s needs and should promptly address possible life-threatening complications. The present recommendations could provide guidance and support in standardizing the care provided to Long-COVID patients.

En el presente trabajo se presentan los principales resultados obtenidos del análisis del comportamiento de las aguas residuales en la Empresa Centro Nacional de Investigaciones Científicas. Para ello se colectó y analizó la información de los resultados analíticos emitidos por el Laboratorio acreditado “Grupo de Gestión de los Servicios Científico Técnicos – DECA”, por la NC-ISO/IEC 17025:2017, referente a la caracterización de las aguas residuales que se vierten en el centro, contemplando un período de 15 años de trabajo sostenido. La investigación consideró dos etapas, una inicial en condiciones estables de las actividades de la institución y una segunda, en el cual se introducen nuevas descargas generadas de la diversificación de los procesos productivos y su impacto al medio ambiente. Además, tuvo en cuenta el marco legal amparado en las normas cubanas de vertimiento de aguas residuales vigentes. El estudio permitió caracterizar los residuos líquidos, no solo desde el punto de vista físico – químico, sino también de su biodegradabilidad, la carga orgánica dispuesta al sistema de alcantarillado y su aporte al sistema de tratamiento de la comunidad. De esta forma se identifica y sienta la línea base a partir de la cual se mantendrá la evaluación del comportamiento de los vertimientos originados por la incorporación de nuevas líneas de producción o servicios, debido a la reorganización de la empresa hacia una comercialización sostenible, con el control del cumplimiento de las regulaciones ambientales.

Abstract The Global Campaign against Headache, as a collaborative activity with the World Health Organization (WHO), was formally launched in Copenhagen in March 2004. In the month it turns 18, we review its activities and achievements, from initial determination of its strategic objectives, through partnerships and project management, knowledge acquisition and awareness generation, to evidence-based proposals for change justified by cost-effectiveness analysis.

The quest for biocompatible drug-delivery devices that could be able to open new administration routes is at the frontier of biomedical research. In this contribution, porous polysaccharide-based microsponges based on crosslinked alginate polymers were developed and characterized by optical spectroscopy and nanoscopic microscopy techniques. We show that macropores with a size distribution ranging from 50 to 120 nm enabled efficient loading and delivery of a therapeutic peptide (CIGB814), presently under a phase 3 clinical trial for the treatment of rheumatoid arthritis. Alginate microsponges showed 80% loading capacity and sustained peptide release over a few hours through a diffusional mechanism favored by partial erosion of the polymer scaffold. The edible and biocompatible nature of alginate polymers open promising perspectives for developing a new generation of polysaccharide-based carriers for the controlled delivery of peptide drugs, exploiting alternative routes with respect to intravenous administration.

La norma ISO/IEC 17025 es la referencia internacional, desarrollada con el objetivo de establecer requisitos para acreditar el Sistema de Gestión de la Calidad y la Competencia Técnica de los Laboratorios de ensayo y/o calibración. La tercera edición del 2017, presenta una transformación importante, adaptándose a la estructura de alto nivel de las normas para sistemas de gestión de ISO, con una mayor orientación del proceso, la implementación del pensamiento y la acción basados en el riesgo, sustituyendo las acciones preventivas por el análisis de riesgo en varios de sus requisitos. Los servicios analíticos del Laboratorio Grupo de Gestión de los Servicios Científico-Técnicos DECA, del Centro Nacional de Investigaciones Científicas, están cubiertos por un Sistema de Gestión de acuerdo con la NC-ISO / IEC 17025: 2017, que garantiza la validez de los resultados de ensayo y la satisfacción sostenible de las expectativas del cliente y está acreditado por el Órgano Nacional de Acreditación de la República de Cuba. Este trabajo tuvo como objetivo implementar una metodología para abordar la gestión de los riesgos y las oportunidades asociados con las actividades del Laboratorio, satisfaciendo requisitos de la norma. Se realizó una tormenta de ideas, se identificaron los factores internos y externos que pueden limitar el logro de los objetivos del Laboratorio, se confeccionó una matriz de debilidades, amenazas, fortalezas y oportunidades, se identificaron las partes interesadas y sus expectativas. La metodología implementada permitió identificar los riesgos y las oportunidades en el contexto de las operaciones del Laboratorio, analizar la probabilidad de

The biological properties of therapeutic peptides, such as their pharmacokinetics and pharmacodynamics, are correlated with their structure and aggregation properties. Herein, we studied the aggregation properties of a therapeutic peptide (CIGB-814), currently in phase 2 clinical trial, for the treatment of rheumatoid arthritis over a wide range of concentrations (µM–mM). We applied spectroscopic techniques (fluorescence, circular dichroism, resonance, and dynamic light scattering), atomic force microscopy, and molecular dynamics simulations to determine the aggregation mechanism of CIGB-814. We found that the hierarchical aggregation of CIGB-814 at micromolar concentrations was initiated by the formation of peptide oligomers. Subsequently, the peptide oligomers trigger the nucleation and growth of peptide nanostructures (cac = 123 µM), ultimately leading to the fibrillization of CIGB-814 (cac’ = 508 µM). These results pave the way for a deeper understanding of the CIGB-814 therapeutic activity and may give important insights on its pharmacokinetics.

IntroductionBeing able to write is a key competency in educational models; therefore, it is important to have a scale to assess writing self-efficacy.ObjectiveThe study evaluated the internal structure, providing evidence of reliability, validity, and factorial invariance of the self-efficacy for writing scale (SEWS) across sex and age in Peruvian schoolchildren.MethodsAn instrumental study was carried out on 1,107 Peruvian adolescents (early, middle, and late) of school age. A confirmatory factor analysis was carried out and the factorial invariance for sex and age was evaluated.ResultsA good fit was obtained for the total sample (χ2 = 1229.08, df = 101, CFI = 0.997, TLI = 0.997, RMSEA = 0.057 [90% CI: 0.0540.059], and SRMR = 0.029) and presented good α, ω, and H reliability (>0.89). Correlations between another measure of writing self-efficacy (p = 0.76; p < .01), study satisfaction (p = 0.31; p < .01), and burnout (p = −0.12; p < .01) scales supported convergent and concurrent validity. Multigroup factor analysis supported strict invariance for sex and age, for which the SEWS provides evidence of validity and reliability.DiscussionThis adaptation of the SEWS is a valid, reliable, and invariant measure that can be considered for assessing self-efficacy for writing in Peruvian high school students.

BackgroundThere is limited research examining the impact of risk and protective factors on late-life depression using large population-based datasets, particularly those examining differences among older migrants and non-migrants in Europe countries. Thus, the first aim was to analyze differences between migrants and non-migrants regarding socioeconomic status, depression, multimorbidity, healthy aging, and lifestyle behaviors. The second aim was to examine the impact of healthy aging on late-life depression in older migrants compared to their counterparts without a history of international migration in extensive and harmonized data from different population-based cohort studies.Materials and methodsWe analyzed cross-sectional, predominantly nationally representative, community-based data from European participants in the Aging Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) cohort. The descriptive analyses included sociodemographic variables, somatic comorbidities, multimorbidity, healthy aging, and lifestyle behaviors according to migration status. The effects of these variables on late-life depression were examined in a multivariate logistic regression model, including migration status and years since migration as predictors.ResultsData of 122,571 individuals aged ≥ 50 years were analyzed, of which 11,799 (9.60%) were migrants. The descriptive analyses indicated that compared to non-migrants, migrants showed a higher prevalence of diabetes (25.6%), hypertension (38.0%), coronary artery disease (49.4%), stroke (4.9%), and depression (31.1%). Healthy aging was also better in non-migrants (51.7; SD = 9.7) than in migrants (39.6; SD = 18.2). The results of the logistic regression showed that migration status [OR = 1.231 (CIs: 0.914–1.547)] and increased number of years since migration in the host country [OR = 0.003 (CIs: 0.001–0.005)] were associated with greater levels of depressive symptoms. Concerning health variables, multimorbidity was associated with higher levels of depressive symptoms [OR = 0.244 (CIs: 0.211–0.278)], whereas better healthy aging was associated with fewer depressive symptoms [OR = -0.100 (CIs: -0.102 to -0.098)]. The interaction between migration and healthy aging status was also significant [OR. = -0.019 (CIs: -0.025 to -0.014)].ConclusionMigrants reported higher risks for worse health outcomes compared to non-migrants. Significantly, worse healthy aging was associated with a greater risk of depressive symptoms in migrants than in non-migrants. Shedding light on migration and aging processes is essential for promoting a cross-cultural understanding of late-life depression in Europe.

We dissected carcasses of eight mature females, both parous and non-parous specimens, to study the macroscopic anatomy of the female reproductive system in the sugar glider. The genital system includes double organs, namely the right and left ones, which are completely separated. It includes two ovaries, two oviducts, two uteri and a vaginal complex. The uteri are fusiform-shaped and lack horns. The vaginal complex includes two lateral vaginae and a median vagina, also called the ‘birth canal’. The cranial end of both lateral vaginae partially fuses, forming an expansion named the vaginal sinus, which is divided into two parts by a longitudinal septum, one for each vagina, where the ipsilateral uterine cervix opens. The caudal end of the lateral vaginae opens into a medial and impar duct: the urogenital sinus that serves as a common passage for the reproductive and urinary systems. In non-pregnant females, only the lateral vaginae are present. In pregnant and recently parous females, a short median vagina extends from the caudal wall of the vaginal sinus to the cranial end of the urogenital sinus. In the ventral wall of this sinus, next to its caudal opening, there is a forked clitoris.

Abstract Background There have been several calls for estimations of costs and consequences of headache interventions to inform European public-health policies. In a previous paper, in the absence of universally accepted methodology, we developed headache-type-specific analytical models to be applied to implementation of structured headache services in Europe as the health-care solution to headache. Here we apply this methodology and present the findings. Methods Data sources were published evidence and expert opinions, including those from an earlier economic evaluation framework using the WHO-CHOICE model. We used three headache-type-specific analytical models, for migraine, tension-type-headache (TTH) and medication-overuse-headache (MOH). We considered three European Region case studies, from Luxembourg, Russia and Spain to include a range of health-care systems, comparing current (suboptimal) care versus target care (structured services implemented, with provider-training and consumer-education). We made annual and 5-year cost estimates from health-care provider and societal perspectives (2020 figures, euros). We expressed effectiveness as healthy life years (HLYs) gained, and cost-effectiveness as incremental cost-effectiveness-ratios (ICERs; cost to be invested/HLY gained). We applied WHO thresholds for cost-effectiveness. Results The models demonstrated increased effectiveness, and cost-effectiveness (migraine) or cost saving (TTH, MOH) from the provider perspective over one and 5 years and consistently across the health-care systems and settings. From the societal perspective, we found structured headache services would be economically successful, not only delivering increased effectiveness but also cost saving across headache types and over time. The predicted magnitude of cost saving correlated positively with country wage levels. Lost productivity had a major impact on these estimates, but sensitivity analyses showed the intervention remained cost-effective across all models when we assumed that remedying disability would recover only 20% of lost productivity. Conclusions This is the first study to propose a health-care solution for headache, in the form of structured headache services, and evaluate it economically in multiple settings. Despite numerous challenges, we demonstrated that economic evaluation of headache services, in terms of outcomes and costs, is feasible as well as necessary. Furthermore, it is strongly supportive of the proposed intervention, while its framework is general enough to be easily adapted and implemented across Europe.

Abstract Background Health economic evaluations support health-care decision-making by providing information on the costs and consequences of health interventions. No universally accepted methodology exists for modelling effectiveness and cost-effectiveness of interventions designed to close treatment gaps for headache disorders in countries of Europe (or elsewhere). Our aim here, within the European Brain Council’s Value-of-Treatment project, was to develop headache-type-specific analytical models to be applied to implementation of structured headache services in Europe as the health-care solution to headache. Methods We developed three headache-type-specific decision-analytical models using the WHO-CHOICE framework and adapted these for three European Region country settings (Luxembourg, Russia and Spain), diverse in geographical location, population size, income level and health-care systems and for which we had population-based data. Each model compared current (suboptimal) care vs target care (delivered in accordance with the structured headache services model). Epidemiological and economic data were drawn from studies conducted by the Global Campaign against Headache; data on efficacy of treatments were taken from published randomized controlled trials; assumptions on uptake of treatments, and those made for Healthy Life Year (HLY) calculations and target-care benefits, were agreed with experts. We made annual and 5-year cost estimates from health-care provider (main analyses) and societal (secondary analyses) perspectives (2020 figures, euros). Results The analytical models were successfully developed and applied to each country setting. Headache-related costs (including use of health-care resources and lost productivity) and health outcomes (HLYs) were mapped across populations. The same calculations were repeated for each alternative (current vs target care). Analyses of the differences in costs and health outcomes between alternatives and the incremental cost-effectiveness ratios are presented elsewhere. Conclusions This study presents the first headache-type-specific analytical models to evaluate effectiveness and cost-effectiveness of implementing structured headache services in countries in the European Region. The models are robust, and can assist policy makers in allocating health budgets between interventions to maximize the health of populations.

Abstract In countries where headache services exist at all, their focus is usually on specialist (tertiary) care. This is clinically and economically inappropriate: most headache disorders can effectively and more efficiently (and at lower cost) be treated in educationally supported primary care. At the same time, compartmentalizing divisions between primary, secondary and tertiary care in many health-care systems create multiple inefficiencies, confronting patients attempting to navigate these levels (the “patient journey”) with perplexing obstacles. High demand for headache care, estimated here in a needs-assessment exercise, is the biggest of the challenges to reform. It is also the principal reason why reform is necessary. The structured headache services model presented here by experts from all world regions on behalf of the Global Campaign against Headache is the suggested health-care solution to headache. It develops and refines previous proposals, responding to the challenge of high demand by basing headache services in primary care, with two supporting arguments. First, only primary care can deliver headache services equitably to the large numbers of people needing it. Second, with educational supports, they can do so effectively to most of these people. The model calls for vertical integration between care levels (primary, secondary and tertiary), and protection of the more advanced levels for the minority of patients who need them. At the same time, it is amenable to horizontal integration with other care services. It is adaptable according to the broader national or regional health services in which headache services should be embedded. It is, according to evidence and argument presented, an efficient and cost-effective model, but these are claims to be tested in formal economic analyses.

Background and purpose: A doubling of arthroscopic meniscal procedures was observed in Denmark from 2000 to 2011, but arthroscopic meniscal procedures for degenerative meniscal tears are no longer recommended. We performed an updated investigation of Danish meniscal procedure trends in the private and public healthcare sectors in Denmark from 2006 to 2018, including trends for other arthroscopic knee procedures. Patients and methods: We extracted data on the 5 most commonly registered arthroscopic knee procedures (diagnostic arthroscopy, meniscal surgery, anterior cruciate ligament reconstruction, synovectomy, and cartilage resection) from the Danish National Patient Register from January 1, 2006 to December 31, 2018, linked with the Danish Population Statistic Register, to obtain data on age and sex. Results: 414,253 arthroscopic knee procedures were registered during 315,290 surgeries on 244,113 individual patients in the study period. For meniscal procedures, the highest incidence was observed in 2010 (319 per 105 persons/year, 95% CI 314–323) and the lowest in 2018 (173 per 105 persons/year, CI 169–176), corresponding to relative decrease of 46% from 2010 to 2018. Remaining arthroscopic procedures also showed declining trends, with lowest incidence for all procedures in 2018. Interpretation: A large decrease in the incidence for arthroscopic meniscal procedures was observed from 2010 to 2018, possibly in response to mounting evidence of limited benefit of this procedure for degenerative knee disease. All other investigated arthroscopic knee procedures also declined in the same period.

Objective: Describe the needs and nursing diagnosis of expectant mothers with depression. Materials and method: Descriptive, retrospective, cross-sectional study. The convenience non-probabilistic sampling was made with 55 expectant mothers, hospitalized between Janu-ary 2013 and December 2018. The information was collected through the application of two questionnaires: the first was built considering the objectives and the operationalization of the variables related to the demographic, obstetrics, and psychiatric information; the second one with the care needs, taken from the M. Gordon’s assessment guideline and symptomatology rom DSM-5. Absolute and relative frequencies were extracted from the qualitative variables, median and IQR for age. Results: The most frequent nursing diagnoses were the following: deterioration of mood regulation 67.3%; suicide risk 56.4%; hopelessness 52.7%; acute pain 50.9%; insomnia 50.9%. The most frequent care needs were: mood swings 67.3%; suicidal behavior 56.4%; negative perspective of one-self and the future 52.7%; pain 50.9%. Conclu-sions: According to alteration patterns, care needs and the diagnoses, the mental component was the most affected health component for these women; it was found that the patients have a high tendency of drug consumption, unwillingness to take the psychiatric treatment and more attitudes related to: suicidal behavior, hopelessness, a negative perspective of the fu-ture, and pain, showing that depression is highly present in expectant mothers

La tipificación sanguínea es un método de identificación de antígenos en la superficie de los eritrocitos. Los tipos de grupos sanguíneos sangre pueden ser evaluados utilizando pruebas rápidas para la tipificación sanguínea en perros; en el presente trabajo se evaluaron un total de 103 perros (Canis lupus familiaris). Los animales en estudio se agruparon de acuerdo a la raza y sexo. Se tipificó a cada uno de los perros con la prueba comercial Kabb Dog Blood®, se utilizó este kit ya que hay otro estudio acerca de su especificidad y sensibilidad que avala su uso. Después de identificar los tipos sanguíneos, se escogieron a 3 donantes, uno de cada grupo DEA 1.1, DEA 1.2 positivo y DEA 1- negativo para realizar la prueba cruzada con los 100 perros restantes y determinar la compatibilidad in vitro. Los resultados obtenidos con los 103 perros fueron 93,2 % con DEA 1.1 positivos; 4,9 % fueron DEA 1.2 y el 1,9 % fueron 1- negativo. Se confirmó que el tipo de sangre DEA 1- es el donante universal dado que en el presente estudio no hubo ningún tipo de aglutinación al cruzarla con los otros tipos de sangre DEA 1.1 y DEA 1.2. Del total de las pruebas cruzadas realizadas, el 5,3 % fueron incompatibles y el 94,7 % compatibles. Se destaca la eficacia, rapidez y lo sencillo que fue realizar la prueba, aproximadamente de dos minutos (min), frente al método de pruebas cruzadas que lleva 30 min aproximadamente, con lo que se ahorraría tiempo en casos de emergencia en donde corre peligro la vida del paciente.

BackgroundThe increase in life expectancy is leading to a worldwide increase in chronic diseases and disability, with significant concern about their management and long-term care. Investigating the aging process using a bio-psychosocial perspective is essential to understanding how to reduce disability and improve the quality of life of aging people. This study aims to explore the role of social networks and built environment as predictors of disability and quality of life in the Italian population aged over 50 years.Materials and MethodsThe research protocol is composed of several tools: World Health Organization Disability Assessment Scale 2.0 (WHODAS 2.0), World Health Organization Quality of Life Assessment in Aging (WHOQOL-AGE), Social Network Index (SNI), the Courage Built Environment Self-Reported Questionnaire (CBE-SR), and collection of sociodemographic information and information on health system coverage.ResultsA total of 431 people were administered the protocol, and among them, 209 were males and 222 were females, with a mean age of 70 years. The majority of the sample reported earning a middle or high school diploma, and 60.6% of the sample declared to have a good health status. The results showed that people with a good social support network have higher levels of functioning and quality of life. However, the built environment did not significantly predict either disability or quality of life.ConclusionsThese results could provide elements for dialogue with institutions and policymakers. This is fundamental to develop active policies aimed at the implementation of services and systems to promote healthy aging process.

Un laboratorio debe producir datos analíticos de precisión y confiabilidad suficientes en un plazo aceptable y a un costo admisible. Para los laboratorios acreditados por la norma 17025 este objetivo cobra una importancia mayor, siendo la participación en Ensayos de Aptitud (EA), como control de la calidad externo, la forma superior de demostrar su competencia técnica. El DECA (anteriormente Departamento de Estudios sobre Contaminación Ambiental, hoy en día, Unidad de Gestión de los Servicios Científico-Técnicos DECA (UG SCT-DECA)) perteneciente al Centro Nacional de Investigaciones Científicas de Cuba, con larga tradición de trabajo en el campo del medioambiente (entre ellos la caracterización de aguas, aguas residuales y residuos sólidos), logró su primera acreditación por el Órgano Nacional de Acreditación de la República de Cuba (ONARC) en 2001 y ha mantenido una participación regular en EA. El objetivo del presente trabajo es demostrar la competencia técnica de la Unidad de Gestión de los Servicios Científico-Técnicos DECA (UG SCT-DECA) en los servicios analíticos que brinda, mediante los resultados que ha obtenido en la participación continuada en Ensayos de Aptitud. Teniendo en cuenta los EA (nacionales e internacionales) en el período 2008-2019, se emplearon diferentes indicadores para medir el desempeño en los mismos, así como herramientas gráficas que permitieran visualizar el comportamiento en el tiempo. Se pudo evidenciar la competencia técnica mantenida por el DECA en los servicios analíticos que brinda, fortaleciendo con ello la calidad y confiabilidad de los resultados que entrega a sus clientes, lo que ha permitido la fidelización de una

Abstract Autosomal dominant mutations in LITAF are responsible for the rare demyelinating peripheral neuropathy, Charcot–Marie–Tooth disease type 1C (CMT1C). The LITAF protein is expressed in many human cell types and we have investigated the consequences of two different LITAF mutations in primary fibroblasts from CMT1C patients using confocal and electron microscopy. We observed the appearance of vacuolation/enlargement of late endocytic compartments (late endosomes and lysosomes). This vacuolation was also observed after knocking out LITAF from either control human fibroblasts or from the CMT1C patient-derived cells, consistent with it being the result of loss-of-function mutations in the CMT1C fibroblasts. The vacuolation was similar to that previously observed in fibroblasts from CMT4J patients, which have autosomal recessive mutations in FIG4. The FIG4 protein is a component of a phosphoinositide kinase complex that synthesises phosphatidylinositol 3,5-bisphosphate on the limiting membrane of late endosomes. Phosphatidylinositol 3,5-bisphosphate activates the release of lysosomal Ca2+ through the cation channel TRPML1, which is required to maintain the homeostasis of endosomes and lysosomes in mammalian cells. We observed that a small molecule activator of TRPML1, ML-SA1, was able to rescue the vacuolation phenotype of LITAF knockout, FIG4 knockout and CMT1C patient fibroblasts. Our data describe the first cellular phenotype common to two different subtypes of demyelinating CMT and are consistent with LITAF and FIG4 functioning on a common endolysosomal pathway that is required to maintain the homeostasis of late endosomes and lysosomes. Although our experiments were on human fibroblasts, they have implications for our understanding of the molecular pathogenesis and approaches to therapy in two subtypes of demyelinating Charcot–Marie–Tooth disease.

Objectives An increased burden of chronic diseases in the working age population is observed across high income countries. Persons with chronic diseases (PwCDs) are less likely to maintain or return to work due to several constraints they experience. The purpose of the study was to assess the preferences and needs of PwCDs regarding 6 areas of flexibility at the workplace. It was assessed whether there were any personal characteristics associated with higher or lower expectations and needs. Material and Methods This was a part of a large multicenter international project, i.e., the PArticipation To Healthy Workplaces And inclusive Strategies in the Work Sector (PATHWAYS) project, aimed to contribute to the development of innovative approaches to promote professional integration and reintegration of PwCDs into the work sector. In Poland, 59 respondents diagnosed with different chronic diseases were identified through advocacy groups. An on-line survey was conducted to collect information on their needs and expectations. A cluster analysis was performed to reveal some expectation types which differentiated individuals across 6 analyzed domains, along with a multivariable logistic regression to identify some characteristics associated with a special expectation type. Results Workplace facilitator items were generally scored as needed (“rather conductive” and “very conductive” groups identified). The factors positively associated with higher needs in this domain were education, and a hindering type of the disease. Unrestricted working hours were very conductive or indifferent, and were positively associated with education. Legal solutions were more conductive for older people. Medical support, access to training, and supervisors’ knowledge were needed in general, with no associations with the personal characteristics identified. Conclusions Persons with chronic diseases report several facilitators which are needed for them to maintain or return to work, but they are not satisfied with the existing economy in Poland. These needs should be taken into consideration in the effective policy development. Int J Occup Med Environ Health. 2020;33(4):427–44

Abstract Background Pain is a common symptom, often associated with neurological and musculoskeletal conditions, and experienced especially by females and by older people, and with increasing trends in general populations. Different risk factors for pain have been identified, but generally from studies with limited samples and a limited number of candidate predictors. The aim of this study is to evaluate the predictors of pain from a large set of variables and respondents. Methods We used part of the harmonized dataset of ATHLOS project, selecting studies and waves with a longitudinal course, and in which pain was absent at baseline and with no missing at follow-up. Predictors were selected based on missing distribution and univariable association with pain, and were selected from the following domains: Socio-demographic and economic characteristics, Lifestyle and health behaviours, Health status and functional limitations, Diseases, Physical measures, Cognition, personality and other psychological measures, and Social environment. Hierarchical logistic regression models were then applied to identify significant predictors. Results A total of 13,545 subjects were included of whom 5348 (39.5%) developed pain between baseline and the average 5.2 years’ follow-up. Baseline risk factors for pain were female gender (OR 1.34), engaging in vigorous exercise (OR 2.51), being obese (OR 1.36) and suffering from the loss of a close person (OR 1.88) whereas follow-up risk factors were low energy levels/fatigue (1.93), difficulties with walking (1.69), self-rated health referred as poor (OR 2.20) or average to moderate (OR 1.57) and presence of sleep problems (1.80). Conclusions Our results showed that 39.5% of respondents developed pain over a five-year follow-up period, that there are proximal and distal risk factors for pain, and that part of them are directly modifiable. Actions aimed at improving sleep, reducing weight among obese people and treating fatigue would positively impact on pain onset, and avoiding vigorous exercise should be advised to people aged 60 or over, in particular if female or obese.

Abstract Background Pain is a common symptom, often associated with neurological and musculoskeletal conditions, and experienced especially by females and by older people. The aims of this study are to evaluate the temporal variations of pain rates among general populations for the period 1991–2015 and to project 10-year pain rates. Methods We used the harmonized dataset of ATHLOS project, which included 660,028 valid observations in the period 1990–2015 and we applied Bayesian age–period–cohort modeling to perform projections up to 2025. The harmonized Pain variable covers the content “self-reported pain experienced at the time of the interview”, with a dichotomous (yes or no) modality. Results Pain rates were higher among females, older subjects, in recent periods, and among observations referred to cohorts of subjects born between the 20s and the 60s. The 10-year projections indicate a noteworthy increase in pain rates in both genders and particularly among subjects aged 66 or over, for whom a 10–20% increase in pain rate is foreseen; among females only, a 10–15% increase in pain rates is foreseen for those aged 36–50. Conclusions Projected increase in pain rates will require specific interventions by health and welfare systems, as pain is responsible for limited quality of subjective well-being, reduced employment rates and hampered work performance. Worksite and lifestyle interventions will therefore be needed to limit the impact of projected higher pain rates.

Objectives The main objective of this study is to examine the relationship between health and an early exit from paid employment in the Finnish, Polish, and Spanish populations. The authors have addressed the following 3 issues: who chooses not to work according to gender patterns, whether the health status is a determinant of being non-employed, and what diseases are associated with being non-employed. Material and Methods The studied material consists of data from the Collaborative Research on Ageing in Europe (COURAGE in Europe) project. The analysis was based on a sample of 5868 individuals, including 1214 from Finland, 2152 from Poland and 2532 from Spain. In the paper, these data were complemented with the results of the PArticipation To Healthy Workplaces And inclusive Strategies in the Work Sector (PATHWAYS) project. Results The results of the study revealed that self-rated health was a strong predictor of being non-employed for different reasons. Chronic diseases, such as arthritis, angina, diabetes, chronic obstructive pulmonary disease, depression and hypertension, were typically associated with an increased risk of being non-employed due to health problems and early retirement. Women more frequently reported arthritis and depression, while a higher proportion of men suffered from angina and diabetes. Conclusions The results obtained by the authors highlight the importance of evaluating gender patterns in work cessation and, at the same time, the importance of gender-focused actions in terms of preventing withdrawal from the labor market. In principle, all chronic diseases have some impact on participation in the labor market. It is worth noting, however, that each of them affects workforce participation in a different manner, depending on the specific disease, country and gender. For this reason, tailored support to every individual’s needs is highly recommended. Int J Occup Med Environ Health. 2020;33(3):365–84

Abstract Background One of the main goals of the plant breeding in the twenty-first century is the development of crop cultivars that can maintain current yields in unfavorable environments. Landraces that have been grown under varying local conditions include genetic diversity that will be essential to achieve this objective. The Center of Plant Genetic Resources of the Spanish Institute for Agriculture Research maintains a broad collection of wheat landraces. These accessions, which are locally adapted to diverse eco-climatic conditions, represent highly valuable materials for breeding. However, their efficient use requires an exhaustive genetic characterization. The overall aim of this study was to assess the diversity and population structure of a selected set of 380 Spanish landraces and 52 reference varieties of bread and durum wheat by high-throughput genotyping. Results The DArTseq GBS approach generated 10 K SNPs and 40 K high-quality DArT markers, which were located against the currently available bread and durum wheat reference genomes. The markers with known locations were distributed across all chromosomes with relatively well-balanced genome-wide coverage. The genetic analysis showed that the Spanish wheat landraces were clustered in different groups, thus representing genetic pools providing a range of allelic variation. The subspecies had a major impact on the population structure of the durum wheat landraces, with three distinct clusters that corresponded to subsp. durum, turgidum and dicoccon being identified. The population structure of bread wheat landraces was mainly biased by geographic origin. Conclusions The results showed broader genetic diversity in the landraces compared to a reference set that included commercial varieties, and higher divergence between the landraces and the reference set in durum wheat than in bread wheat. The analyses revealed genomic regions whose patterns of variation were markedly different in the landraces and reference varieties, indicating loci that have been under selection during crop improvement, which could help to target breeding efforts. The results obtained from this work will provide a basis for future genome-wide association studies.

Introducción: En la cirugía de carótida, el conocimiento anatómico resulta fundamental para disminuir el tiempo quirúrgico y las complicaciones. El objetivo del presente trabajo es estudiar la disposición de la vena facial respecto a la bifurcación carotídea y sus características anatómicas. Materiales y Métodos: 20 hemicuellos de cadáveres adultos fijados en solución de formaldehído. Se registró: longitud del “eje carotideo” (distancia en cm siguiendo el eje longitudinal de la carótida común e interna desde la clavícula hasta el borde superior del vientre posterior del digástrico) (L1); distancia de la bifurcación carotídea en el eje carotídeo (L2); distancia de la vena facial en el eje carotídeo (L3); distancia de la vena facial a la bifurcación carotídea (L4); cantidad de afluentes que recibía la vena facial y sitio de desembocadura. Resultados: L1 promedio 14 cm (rango 9.6-15); L2 promedio 10.1 cm (rango 7.5-12.5); L3 promedio 8.6 cm (rango 5-12.6). L4 promedio 1.3 cm (0.2-3.1). Discusión: en la mayoría de casos estudiados la vena facial se encontró por debajo a la bifurcación carotidea, no obstante, la distancia entre ambos fue en promedio 1,3cm, por lo cual podemos afirmar que se encuentran en proximidad la una con la otra. Conclusión: la proximidad entre la vena facial y la bifurcación carotídea encontrada en el presente estudio permite concluir que la vena facial es potencialmente útil como reparo anatómico para localizar la bifurcación carotidea en cirugía de carótida. Así también por su proximidad, la vena facial puede verse lesionada y dar así a complicaciones durante dicho procedimiento.

Summary: Background: Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for public health planning and resource prioritisation. This study aimed to improve on previous forecasts of dementia prevalence by producing country-level estimates and incorporating information on selected risk factors. Methods: We forecasted the prevalence of dementia attributable to the three dementia risk factors included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 (high body-mass index, high fasting plasma glucose, and smoking) from 2019 to 2050, using relative risks and forecasted risk factor prevalence to predict GBD risk-attributable prevalence in 2050 globally and by world region and country. Using linear regression models with education included as an additional predictor, we then forecasted the prevalence of dementia not attributable to GBD risks. To assess the relative contribution of future trends in GBD risk factors, education, population growth, and population ageing, we did a decomposition analysis. Findings: We estimated that the number of people with dementia would increase from 57·4 (95% uncertainty interval 50·4–65·1) million cases globally in 2019 to 152·8 (130·8–175·9) million cases in 2050. Despite large increases in the projected number of people living with dementia, age-standardised both-sex prevalence remained stable between 2019 and 2050 (global percentage change of 0·1% [–7·5 to 10·8]). We estimated that there were more women with dementia than men with dementia globally in 2019 (female-to-male ratio of 1·69 [1·64–1·73]), and we expect this pattern to continue to 2050 (female-to-male ratio of 1·67 [1·52–1·85]). There was geographical heterogeneity in the projected increases across countries and regions, with the smallest percentage changes in the number of projected dementia cases in high-income Asia Pacific (53% [41–67]) and western Europe (74% [58–90]), and the largest in north Africa and the Middle East (367% [329–403]) and eastern sub-Saharan Africa (357% [323–395]). Projected increases in cases could largely be attributed to population growth and population ageing, although their relative importance varied by world region, with population growth contributing most to the increases in sub-Saharan Africa and population ageing contributing most to the increases in east Asia. Interpretation: Growth in the number of individuals living with dementia underscores the need for public health planning efforts and policy to address the needs of this group. Country-level estimates can be used to inform national planning efforts and decisions. Multifaceted approaches, including scaling up interventions to address modifiable risk factors and investing in research on biological mechanisms, will be key in addressing the expected increases in the number of individuals affected by dementia. Funding: Bill & Melinda Gates Foundation and Gates Ventures.

This Special Issue was the result of reviewing Leonardo da Vinci's anatomical drawings of the bear foot and the horse trunk (among others) [...]