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ABSTRACT Background Older adults with cancer are at an increased risk of treatment related toxicities and early death. Routinely collected clinico‐demographic characteristics inadequately explain this increased risk limiting accurate prognostication. Prior studies have suggested that altered body composition and frailty are independently associated with worse survival among older adults with cancer; however, their combined influence remains unclear. Methods We used data from a single‐institution prospective cohort study of older adults (≥ 60 years) who underwent geriatric assessment (GA) at the time of initial consultation with a medical oncologist from September 2017 to December 2020 and available baseline abdominal computed tomography within 60 days of GA. Using multi‐slice CT images from T12 to L5 level, we assessed volumetric measures of skeletal muscle (SMV), visceral adipose tissue (VATV), subcutaneous adipose tissue (SATV) and averaged skeletal muscle density (SMD), computing sex‐specific z for each measure. Frailty was measured using a 44‐item frailty index using the deficit accumulation approach. Primary outcome of interest was overall survival (OS) defined as time from GA to death or last follow up. We used multivariable Cox regression model to study the independent association between the above four body composition measurements and OS adjusted for baseline confounders and frailty. Results We included 459 patients with a mean age of 69.7 ± 7.5 years, 60% males and 77% non‐Hispanic Whites. Most had colorectal (27%) or pancreatic cancer (20%) and 48% had stage IV disease. Over a median follow up of 39.4 months, 209 patients (46%) died. In multivariable Cox regression models adjusted for age, sex, race, cancer type, cancer stage and frailty, skeletal muscle volume (HR 0.74; 95% CI 0.58–0.96; p = 0.02, per 1 SD increment) was independently associated with OS. The addition of body composition variables to baseline clinico‐demographic variables and frailty led to a slightly improved model discrimination. Conclusions SMV is independently associated with OS among older adults with newly diagnosed gastrointestinal cancers. Capturing body composition measurements in oncology practice may provide additional prognostic information for older adults with cancer above and beyond what is captured in routine clinical assessment including frailty.

Background Traumatic brain injury (TBI) is associated with an increased risk of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). We aimed to identify predictors and develop models for the prediction of depression and PTSD symptoms at 6 months post-TBI.Methods We analysed data from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury study. We used linear regression to model the relationship between predictors and depression (Patient Health Questionnaire-9) and PTSD symptoms (PTSD Checklist for Diagnostic and Statistical Manual for Mental Health Disorders Fifth Edition). Predictors were selected based on Akaike’s Information Criterion. Additionally, we fitted logistic models for the endpoints ‘probable MDD’ and ‘probable PTSD’. We also examined the incremental prognostic value of 2–3 weeks of symptoms.Results We included 2163 adults (76% Glasgow Coma Scale=13–15). Depending on the scoring criteria, 7–18% screened positive for probable MDD and about 10% for probable PTSD. For both outcomes, the selected models included psychiatric history, employment status, sex, injury cause, alcohol intoxication and total injury severity; and for depression symptoms also preinjury health and education. The performance of the models was modest (proportion of explained variance=R2 8% and 7% for depression and PTSD, respectively). Symptoms assessed at 2–3 weeks had a large incremental prognostic value (delta R2=0.25, 95% CI 0.24 to 0.26 for depression symptoms; delta R2=0.30, 95% CI 0.29 to 0.31 for PTSD).Conclusion Preinjury characteristics, such as psychiatric history and unemployment, and injury characteristics, such as violent injury cause, can increase the risk of mental health problems after TBI. The identification of patients at risk should be guided by early screening of mental health.

Emotional education helps to develop emotional intelligence skills and to bolster teachers' overall well-being., Aims: to gauge the effectiveness of the programme designed to enhance the emotional intelligence, life satisfaction, life orientation, and work well-being of teaching staff. A quasi-experimental design was employed with an experimental group and a control group, using pre-test and post-test to measure changes., Method: 425 teachers of basic general education from Ecuador took part. The experimental group participated in an intervention programme in emotional intelligence during one term, while the control group were not subject to any intervention. An array of instruments were used to measure the variables of interest before and after intervention., Results: significant improvements emerged in emotional intelligence factors in the experimental group compared to the control group. Significant increases were seen in life satisfaction, optimism, feeling energy, enthusiasm, and immersion, and there was reduced pessimism. Women improved more in emotional perception, while men evidenced greater improvement in understanding and emotional regulation. A positive correlation was found between the study variables., Conclusions: these findings highlight the importance of implementing emotional education programmes in teacher training in order to promote a healthier and more effective educational environment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.)

The aim of this research is to analyse the performance of the extended producer responsibility model for the management of end-of-life tires (ELTs) in Ecuador that has been implemented since 2013. For this research, we conducted case studies of, and subsequently, a comparative analysis between, the ELT management system in Ecuador with respect to the ELT management models in Colombia and Brazil. Our findings show that although the programme implementation represented a significant advance in Ecuador's waste management system there are important challenges that should be considered in future adaptations of the programme. Among the measures that can be adopted to improve the ELT management system are the consolidation and stimulation of the market for products made from ELT waste; promotion of other productive sectors linked to the creation of new products and sectors that generate complementary products; enhancement of the generation, socialization and access to knowledge of the waste by-products for micro-, small- and medium-sized enterprises; increase the tire consumer fee, known as 'Ecovalor' and improvement of the quality and availability of information and indicators regarding ELT management. In this sense, the experiences of Colombia and Brazil show important lessons for the Ecuadorian case., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Near-infrared spectroscopy (NIRS) was evaluated to trace the high hydrostatic pressure (HHP) processing and preservation temperature (4 °C vs. 20 °C) over the course of a long term in vacuum-packaged Iberian dry-cured tenderloin ( Iliopsoas et psoas minor ). Spectra were obtained from a total of 298 samples, without opening the package, using a handheld MicroNIR TM 1700 OnSite-W microspectrophotometer (908.1 nm-1676.2 nm) (VIAVI Solutions Inc., United States). The discriminant models were developed by means of partial least squares-discriminant analysis (PLS-DA). The models obtained were capable of correctly classifying more than 60% of the samples according to their HHP processing, while almost 100% of the samples were correctly classified according to the temperature at which the samples were preserved. Thus, NIRS could help to support the traceability of treatments that represent a high added value to the product, such as HHP in premium Iberian dry-cured products.

Metabolic syndrome (MetS) is associated with osteogenic transdifferentiation of vascular smooth muscle cells (VSMCs) and accumulation of arterial calcifications (ACs). Metformin (MET) inhibits this transdifferentiation in vitro. Here, we evaluate the in vivo efficacy of oral MET to reduce AC in a model of MetS. Twenty young male Wistar rats were divided into two groups: one received water and the other received water plus 20% fructose to induce MetS. After 14 days, and for another 4 weeks, MET (100 mg/kg per day) was added to half of each group's drinking source, thus C (water), F (fructose), M (MET) and FM (fructose + MET). Serum and adipose tissue were collected. Aortas were dissected for histomorphometric and immunohistochemical analysis, ex vivo calcification studies and isolation of VSMCs to measure their alkaline phosphatase activity (ALP), collagen production, extracellular mineralization, gene expression of RUNX2 and receptor for advanced glycation end-products (AGEs) (RAGE), and elastic fiber production. F group showed parameters compatible with MetS. Aortic tunica media from F showed decreased elastic-to-muscular layer ratio, increased collagen content and increased levels of the AGEs structure carboxymethyl-lysine. Aortic arches from F presented a tendency for higher ex vivo calcification. VSMCs from F showed increased ALP, collagen secretion, mineralization and expression of RUNX2 and RAGE, and decreased elastic fiber production. All these effects were reverted by MET cotreatment (FM group). In vitro, AGEs-modified bovine serum albumin upregulated RAGE expression of control VSMCs, and this was prevented by MET in an AMP kinase-dependent manner. Thus, experimental MetS induces RAGE upregulation and osteogenic transdifferentiation of aortic VSMCs curbed by oral treatment with MET.

Background: Chronic non-cancer pain (CNCP) is one of the leading causes of disability. The use of strong opioids (SOs) in the management of CNCP is increasing, although evidence supporting their use remains limited. Primary care (PC) plays a key role in this context. Objectives: Our objectives were to determine the prevalence and profile of patients using SOs for CNCP in PC consultations in Valladolid in 2022, and to describe the consumption of SO prescribed for CNCP from 2020 to 2023. Methods: We conducted a descriptive and retrospective study using data extracted from the Pharmaceutical Consumption Information System of Castilla y León. Patients in Valladolid with SO use for more than three months due to CNCP were analyzed. Sociodemographic and clinical characteristics of these patients in 2022 were described. The number of defined daily doses (nº DDDs) and costs from 2020 to 2023 were analyzed. Results: A total of 3642 patients were included (0.7% of the population of Valladolid), 71.8% of whom were women. Of the patients, 62.4% were aged 70 or older, 39.8% lived in rural areas, and 9.9% resided in nursing homes. The most frequently prescribed SOs in nº DDDs were fentanyl and tapentadol. The highest consumption in nº DDDs was in patients who lived in nursing homes, were over 70 years old and were resident in rural areas. The number of DDDs from 2020 to 2023 for SOs in DCNO increased by 41%. Conclusions: In total, 0.7% of the population of Valladolid consumes SOs for CNCP, mostly women and people over 70 years old. The consumption of strong opioids in DDDs grew by 41% from 2020 to 2023.