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IntroductionClostridioides difficile infection (CDI) is the main cause of nosocomial diarrhoea in developed countries. Recurrent CDI (R-CDI), which affects 20%-30% of patients and significantly increases hospital stay and associated costs, is a key challenge. The main objective of this study was to explore the role of the microbiome and calprotectin levels as predictive biomarkers of R-CDI.MethodsWe prospectively (2019-2021) included patients with a primary episode of CDI. Clinical data and faecal samples were collected. The microbiome was analysed by sequencing the hypervariable V4 region of the 16S rRNA gene on an Illumina Miseq platform.ResultsWe enrolled 200 patients with primary CDI, of whom 54 developed R-CDI and 146 did not. We analysed 200 primary samples and found that Fusobacterium increased in abundance, while Collinsella, Senegalimassilia, Prevotella and Ruminococcus decreased in patients with recurrent versus non-recurrent disease. Elevated calprotectin levels correlated significantly with R-CDI (p=0.01). We built a risk index for R-CDI, including as prognostic factors age, sex, immunosuppression, toxin B amplification cycle, creatinine levels and faecal calprotectin levels (overall accuracy of 79%).DiscussionCalprotectin levels and abundance of microbial genera such as Fusobacterium and Prevotella in primary episodes could be useful as early markers of R-CDI. We propose a readily available model for prediction of R-CDI that can be applied at the initial CDI episode. The use of this tool could help to better tailor treatments according to the risk of R-CDI.

IntroductionClostridioides difficile infection (CDI) is the main cause of nosocomial diarrhea in developed countries. A key challenge in CDI is the lack of objective methods to ensure more accurate diagnosis, especially when differentiating between true infection and colonization/diarrhea of other causes. The main objective of this study was to explore the role of the microbiome as a predictive biomarker of CDI.MethodsBetween 2018 and 2021, we prospectively included patients with CDI, recurrent CDI (R-CDI), non-CDI diarrhea (NO-CDI), colonization by C. difficile, and healthy individuals. Clinical data and fecal samples were collected. The microbiome was analyzed by sequencing the hypervariable V4 region of the 16S rRNA gene on an Illumina Miseq platform. The mothur bioinformatic pipeline was followed for pre-processing of raw data, and mothur and R were used for data analysis.ResultsDuring the study period, 753 samples from 657 patients were analyzed. Of these, 247 were from patients with CDI, 43 were from patients colonized with C. difficile, 63 were from healthy individuals, 324 were from NOCDI, and 76 were from R-CDI. We found significant differences across the groups in alpha and beta diversity and in taxonomic abundance. We identified various genera as the most significant biomarkers for CDI (Bacteroides, Proteus, Paraprevotella, Robinsoniella), R-CDI (Veillonella, Fusobacterium, Lactobacillus, Clostridium sensu stricto I), and colonization by C. difficile (Parabacteroides, Faecalicoccus, Flavonifractor, Clostridium XVIII).DiscussionWe observed differences in microbiome patterns between healthy individuals, colonized patients, CDI, R-CDI, and NOCDI diarrhea. We identified possible microbiome biomarkers that could prove useful in the diagnosis of true CDI infections. Further studies are warranted.

IntroductionSince the COVID-19 outbreak, specific mRNA-based anti-SARS-CoV-2 vaccines have been developed and distributed worldwide. Because this is the first time that mRNA vaccines have been used, there are several questions regarding their capacity to confer immunity and the durability of the specific anti-SARS-CoV-2 response. Therefore, the objective of this study was to recruit a large cohort of healthcare workers from the Gregorio Marañón Hospital vaccinated with the mRNA-1273 or BNT126b2 vaccines and to follow-up on IgG anti-RBD levels at 8 months post-vaccination.MethodsWe recruited 4,970 volunteers and measured IgG anti-RBD antibodies on days 30 and 240 post-vaccination.ResultsWe observed that both vaccines induced high levels of antibodies on day 30, while a drastic wane was observed on day 240, where mRNA-1273 vaccinated induced higher levels than BNT162b2. Stratifying by vaccine type, age, gender, and comorbidities, we identified that older mRNA-1273-vaccinated volunteers had higher antibody levels than the younger volunteers, contrary to what was observed in the BNT162b2-vaccinated volunteers.DiscussionIn conclusion, we observed that mRNA-1273 has a higher capacity to induce a humoral response than BNT162b2 and that age is a factor in the specific response.

Information on Clostridioides difficile infection (CDI) in patients with COVID-19 is scarce and points to an overall decrease of episodes during the pandemic. This situation results paradoxical, as COVID-19 patients had long periods of hospital stay and high use of antibiotics. We conducted a retrospective study from January 1st 2019 to December 31st 2020 comparing the incidence of hospital-acquired episodes of CDI (HA-CDI) among patients with and without COVID-19 admitted to our institution. During the study period, there were 47,048 patient admissions in 2019, 35,662 admissions of patients without COVID-19 in 2020 and 6,763 of COVID-19 patients. There were 68 episodes of HA-CDI in COVID-19 patients (14.75/10,000 days), 159 in 2020-non-COVID-19 patients (5.54/10,000 days) and 238 in 2019 (6.80/10,000 days). Comparison of HA-CDI in COVID-19 and non-COVID-19 patients indicates it occurs more frequently, in terms of CDI disease severity, COVID-19 does not seem to have a negative impact.

In a population, chemical communication determines the response of animals to changing environmental conditions, what leads to an enhanced resistance against stressors. In response to starvation, the nematode Caenorhabditis elegans arrest post-embryonic development at the first larval stage (L1) right after hatching. As arrested L1 larvae, C. elegans become more resistant to diverse stresses, allowing them to survive for several weeks expecting to encounter more favorable conditions. L1 arrested at high densities display an enhanced resistance to starvation, dependent on soluble compounds released beyond hatching and the first day of arrest. Here, we show that this chemical communication also influences recovery after prolonged periods in L1 arrest. Animals at high density recovered faster than animals at low density. We found that the density effect on survival depends on the final effector of the insulin signaling pathway, the transcription factor DAF-16. Moreover, DAF-16 activation was higher at high density, consistent with a lower expression of the insulin-like peptide DAF-28 in the neurons. The improved recovery of animals after arrest at high density depended on soluble compounds present in the media of arrested L1s. In an effort to find the nature of these compounds, we investigated the disaccharide trehalose as putative signaling molecule, since its production is enhanced during L1 arrest and it is able to activate DAF-16. We detected the presence of trehalose in the medium of arrested L1 larvae at a low concentration. The addition of this concentration of trehalose to animals arrested at low density was enough to rescue DAF-28 production and DAF-16 activation to the levels of animals arrested at high density. However, despite activating DAF-16, trehalose was not capable of reversing survival and recovery phenotypes, suggesting the participation of additional signaling molecules. With all, here we describe a molecular mechanism underlying social communication that allows C. elegans to maintain arrested L1 larvae ready to quickly recover as soon as they encounter nutrient sources.

The aim of the present study is to analyze individual differences in academic self-efficacy within a population of Unaccompanied Foreign Minors (UFM) from the European cities of Ceuta and Melilla (Spain). Variables describing educational level and length of stay were considered in a sample of 377 individuals being cared for in different youth centers. Of these, 63.4% belonged to the group who had stayed at the center for less than 9 months and 36.6% reported a length of stay of more than 9 months. The age of participants ranged between 8 and 17 years old (M = 14.87 years). Once the quality parameters of the instrument (academic self-efficacy) were elaborated, reliability and validity was confirmed through Confirmatory Factor Analysis (CFA) using Structural Equation Modeling (SEM) methodology. Data collection was then initiated. The results overall indicate that 87.6% of those who completed the questionnaire reported a higher level of self-efficacy with regards to working with any classmate, whilst at the same time seeing themselves as capable of achieving good marks. ANOVA results indicated significant differences with respect to educational level and length of stay. In this regard, students who had received professional training and had been at the Center for more than 9 months, were the ones who developed greater academic self-efficacy for spending more time working when tasks were judged to be difficult. The results obtained demonstrate that any intervention will be positive as long as it promotes different institutions to develop strategies that cater to a length of stay of more than 9 months and target education, academic self-efficacy, socialization and strengthening the future workforce. Such interventions can be directed through new European, Spanish or local level policies. It is clear that institutions still have a lot of work left to do.

The aim of the present study was to adapt the educational motivation scale into an abbreviated version (EMS-SF), in addition to analyzing its psychometric properties for use with vocational training (VT) and baccalaureate students using structural equations. A cross-sectional and ex post facto study was conducted with a sample of 1,159 students from the autonomous community of Andalusia (Spain). IBM SPSS® and IBM AMOS® software programs were used for data analysis. With regard to the main outcomes, the scale reflected good fit indices in its short form, presenting a more parsimonious and easily understood questionnaire. The questionnaire was reduced from a total of 28–19 items. In the same way, the number of dimensions was reduced from seven to four, facilitating scale understanding and interpretation according to self-determination theory. As a main finding, it was observed that the most relevant items for baccalaureate students pertained to the pleasure derived from discovering things and to overcoming challenges, whereas in VT students, items pertaining to the satisfaction generated from exerting effort, achieving one’s best and being well paid were more relevant. In conclusion, findings urge the need to strengthen intrinsic motivation in VT students with the aim of avoiding demotivation and poor academic performance.

BackgroundThe practice of Physical Activity (PA) is a key factor for the improvement of physical and mental health, making the study of the motivational processes that take part in the development of active lifestyles of interest.MethodsThis cross-sectional study was conducted on 775 university students of Physical Education (PE) from Spain. This research aims to develop an explanatory model for the relationships between motivational climate and resilience according to the level of PA, using structural equations analysis. The main instrument used were the Perceived Motivational Climate in Sport (PMCSQ-2) and the Connor-Davidson Resilience Scale (CD-RISC).ResultsA negative relationship was observed between task-oriented climate (TC) and ego-oriented climate, which acquired greater correlation strength in the respondents who did less PA. Likewise, a positive relationship was obtained between TC and resilience, which was higher in participants who did more than 3 h of weekly PA. Finally, it was observed that resilience was highly correlated with personal competence, tenacity and control capacity in the most active respondents.ConclusionThe importance of promoting task-oriented motivational climates in PA is highlighted, since this could develop a better resilience capacity in university students and will favor the tolerance to adversity and the positive acceptance of changes.