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Seasonal influenza is an acute respiratory infection caused by the influenza virus which constitutes a significant public health issue associated with high morbidity and mortality. The aim of this study was to investigate changes in attitudes, perceptions, and practices regarding influenza vaccination in the Spanish adult population during the COVID-19 pandemic, as well as their vaccination intentions, with special attention paid to those over 65 years old and in high-risk groups. To this end, a cross-sectional study was conducted through 2219 telephone interviews, and the results were compared with results obtained a year earlier. Regarding the reasons for deciding to get vaccinated in the 2022/23 season, a significant increase was observed in vaccine confidence (36.7% vs. 42.8%), social responsibility (32.5% vs. 43.8%), and in awareness of the importance of vaccination due to COVID-19 (21.7% vs. 25.4%). Advanced age (OR 2.8, 95% CI 2.0–3.9), belonging to high-risk groups (OR 2.7, 95% CI 2.0–3.7), and prior vaccination (OR 25.3, 95% CI 19.5–32.7) emerged as significant predictors for the intent to receive the influenza vaccine in the 2022/23 season. Continuously observing shifts in perceptions and behaviors related to influenza immunization is crucial to pinpoint factors that may influence the willingness to receive the vaccine and, in this way, design public health strategies that achieve a greater acceptance of it. [ABSTRACT FROM AUTHOR]

Copyright of Policy Studies Journal is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Research on EU-related politicization has advanced in the empirical measurement of controversy within and between political arenas, but continues to debate the impacts of political contestation on policy-making on a theoretical level. While postfunctionalism predicts a 'constraining dissensus', empirical accounts present mixed evidence, suggesting the ability of executives to avoid or circumvent such political constraints. The article harnesses discursive institutionalism (DI) to revise postfunctionalist theory, arguing that the resulting theoretical model – labelled discursive postfunctionalism – better specifies the triggers, transmission, and eventual effects of politicization. A key element is to highlight the role of 'interfaces': those institutional venues, political agents, and acts of discursive framing that either establish a linkage between or shield supranational decision-making from public controversy at the domestic level. The article presents a sequential model of discursive postfunctionalism and illustrates its analytical potential with reference to three empirical examples: the Eurozone crisis, the EU-Canada trade agreement, and Brexit. [ABSTRACT FROM AUTHOR]

Background: Mid-Regional pro-Adrenomedullin (MR-proADM) is an inflammatory biomarker that improves the prognostic assessment of patients with sepsis, septic shock and organ failure. Previous studies of MR-proADM have primarily focussed on bacterial infections. A limited number of small and monocentric studies have examined MR-proADM as a prognostic factor in patients infected with SARS-CoV-2, however there is need for multicenter validation. An evaluation of its utility in predicting need for hospitalisation in viral infections was also performed. Methods: An observational retrospective analysis of 1861 patients, with SARS-CoV-2 confirmed by RT-qPCR, from 10 hospitals across Europe was performed. Biomarkers, taken upon presentation to Emergency Departments (ED), clinical scores, patient demographics and outcomes were collected. Multiclass random forest classifier models were generated as well as calculation of area under the curve analysis. The primary endpoint was hospital admission with and without death. Results: Patients suitable for safe discharge from Emergency Departments could be identified through an MR-proADM value of ≤ 1.02 nmol/L in combination with a CRP (C-Reactive Protein) of ≤ 20.2 mg/L and age ≤ 64, or in combination with a SOFA (Sequential Organ Failure Assessment) score < 2 if MR-proADM was ≤ 0.83 nmol/L regardless of age. Those at an increased risk of mortality could be identified upon presentation to secondary care with an MR-proADM value of > 0.85 nmol/L, in combination with a SOFA score ≥ 2 and LDH > 720 U/L, or in combination with a CRP > 29.26 mg/L and age ≤ 64, when MR-proADM was > 1.02 nmol/L. Conclusions: This international study suggests that for patients presenting to the ED with confirmed SARS-CoV-2 infection, MR-proADM in combination with age and CRP or with the patient's SOFA score could identify patients at low risk where outpatient treatment may be safe. [ABSTRACT FROM AUTHOR]

Mandatory meat inspection requirements have long been a source of frustration for advocates of ethical meat. Seen as overly restrictive and ill-adapted to the realities on the ground, some argue that farm-to-consumer sales should be subject to less stringent inspection requirements than conventional meat supply chains. Recently, a series of legislative reforms authorizing on-farm slaughter suggests that policy makers are listening. But do on-farm slaughter exemptions really facilitate ethical meat sales? To answer this question, this paper explores meat inspection systems in Quebec, Ontario, and Vermont. Drawing on data obtained from semi-structured interviews with producers, processors, and policy advisors, it argues that inspection requirements may not be the barriers they are presumed to be. Instead, producers and processors face other more significant financial and structural challenges. These need to be addressed if ethical meat is to be a viable alternative to the dominant model of animal agriculture. [ABSTRACT FROM AUTHOR]

Onychomycosis accounts for 50% of nail disorders, making it one of the most prevalent fungal diseases and a therapeutic challenge. Photodynamic therapy (PDT) could constitute a therapeutic alternative, owing to its good adherence, the low probability of resistance, the lack of interaction with antimicrobials, and its favorable adverse effect profile. This retrospective observational study included all patients with a microbiological diagnosis of onychomycosis treated with PDT at Miguel Servet University Hospital, Zaragoza (Spain), between January 2013 and June 2021. The protocol consisted of pre-treatment with 40% urea for 7 days, followed by 16% methyl-aminolevulinate (MAL) for 3 h and subsequent irradiation with a red-light LED lamp (37 J/cm2), every 1 or 2 weeks. Combined treatment with oral and/or topical antifungals was recorded. Of the 20 patients included (mean age, 59 ± 17 years), 55% were men. The most frequently detected microorganism was Trichophyton rubrum (55%). The most commonly affected location was the feet (90%): 50% of these cases were associated with tinea pedis. The median (standard deviation) number of PDT sessions was 6 (2.8). PDT was combined with systemic terbinafine (250 mg/day) in 10 cases (in 8 cases, this was administered for only 1 month), and with topical terbinafine in 3 cases. A complete clinical response was achieved in 80% (16) of cases and microbiological cure in 60% (12). PDT is a therapeutic alternative for onychomycosis, and can be administered either in monotherapy or combined with antifungals, allowing for a reduction in the duration and possible adverse effects of antifungal treatment and achieving higher cure rates than those obtained with either treatment alone. [ABSTRACT FROM AUTHOR]

Objective: Severe COVID-19 is characterized by a dysregulated immune response in which neutrophils play a critical role. Calprotectin reflects neutrophil activation and is involved in the self-amplifying thrombo-inflammatory storm in severe COVID-19. We aimed to evaluate the role of calprotectin in early prediction of severity in COVID-19 patients. Methods: This was a multicenter prospective observational study enrolling consecutive adult COVID-19 patients. On arrival to emergency department, blood samples were collected for laboratory tests, including serum calprotectin. The primary outcome was severe respiratory failure requiring invasive mechanical ventilation and the secondary outcome was need for Intensive Care Unit (ICU) admission. Results: Study population included 395 patients, 57 (14.4%) required invasive mechanical ventilation and 100 (25.3%) were admitted to ICU. Median serum calprotectin levels were significantly higher in intubated (3.73 mg/L vs. 2.63 mg/L; p < 0.001) and ICU patients (3.48 mg/L vs. 2.60 mg/L; p = 0.001). Calprotectin showed a significant accuracy to predict the need for invasive mechanical ventilation (ROC AUC 0.723) and ICU admission (ROC AUC 0.650). In multivariate analysis, serum calprotectin was an independent predictor of invasive mechanical ventilation (OR 1.161) and ICU admission (OR 1.068). Conclusion: Serum calprotectin can be used as an early predictor of severity in COVID-19 patients. [ABSTRACT FROM AUTHOR]

Background: Early identification of patients at high risk of progression to severe COVID- 19 constituted an unsolved challenge. Although growing evidence demonstrates a direct association between endotheliitis and severe COVID- 19, the role of endothelial damage biomarkers has been scarcely studied. We investigated the relationship between circulating mid- regional proadrenomedullin (MR- proADM) levels, a biomarker of endothelial dysfunction, and prognosis of SARS- CoV- 2- infected patients. Methods: Prospective observational study enrolling adult patients with confirmed COVID- 19. On admission to emergency department, a blood sample was drawn for laboratory test analysis. Primary and secondary endpoints were 28- day all- cause mortality and severe COVID- 19 progression. Area under the curve (AUC) and multivariate regression analysis were employed to assess the association of the biomarker with the established endpoints. Results: A total of 99 patients were enrolled. During hospitalization, 25 (25.3%) cases progressed to severe disease and the 28- day mortality rate was of 14.1%. MR- proADM showed the highest AUC to predict 28- day mortality (0.905; [CI] 95%: 0.829- 0.955; P < .001) and progression to severe disease (0.829; [CI] 95%: 0.740- 0.897; P < .001), respectively. MR- proADM plasma levels above optimal cut- off (1.01 nmol/L) showed the strongest independent association with 28- day mortality risk (hazard ratio [HR]: 10.470, 95% CI: 2.066- 53.049; P < .005) and with progression to severe disease (HR: 6.803, 95% CI: 1.458- 31.750; P = .015). Conclusion: Mid- regional proadrenomedullin was the biomarker with highest performance for prognosis of death and progression to severe disease in COVID- 19 patients and represents a promising predictor for both outcomes, which might constitute a potential tool in the assessment of prognosis in early stages of this disease. [ABSTRACT FROM AUTHOR]

Mid-regional proadrenomedullin (MR-proADM), a novel biomarker, has recently gained interest particularly with regards to its potential in assisting clinicians' decision making in patients with suspicion of infection in the emergency department (ED). A group of international experts, with research and experience in MR-proADM applications, produced this review based on their own experience and the currently available literature. The review provides evidence related to MR-proADM as a triaging tool in avoiding unnecessary admissions to hospital and/or inadequate discharge, and identifying patients most at risk of deterioration. It also covers the use of MR-proADM in the context of COVID-19. Moreover, the authors provide a proposal on how to incorporate MR-proADM into patients' clinical pathways in an ED setting. The data we have so far on the application of MR-proADM in the ED is promising. Incorporating it into clinical scoring systems may aid the clinician's decision making and recognizing the 'ill looking well' and the 'well looking ill' sooner. However there are still many gaps in our knowledge especially during the ongoing COVID-19 waves. There is also a need for cost-effectiveness analysis studies especially in the era of increasing cost pressures on health systems globally. [ABSTRACT FROM AUTHOR]

Background: To study the urinalysis request, pre-analytical sample conditions, and analytical procedures. Methods: Laboratories were asked to provide the number of primary care urinalyses requested, and to fill out a questionnaire regarding pre-analytical conditions and analytical procedures. Results: 110 laboratories participated in the study. 232.5 urinalyses/1,000 inhabitants were reported. 75.4% used the first morning urine. The sample reached the laboratory in less than 2 hours in 18.8%, between 2 - 4 hours in 78.3%, and between 4 - 6 hours in the remaining 2.9%. 92.5% combined the use of test strip and particle analysis, and only 7.5% used the strip exclusively. All participants except one performed automated particle analysis depending on strip results; in 16.2% the procedure was only manual. Conclusions: Urinalysis was highly requested. There was a lack of compliance with guidelines regarding time between micturition and analysis that usually involved the combination of strip followed by particle analysis. [ABSTRACT FROM AUTHOR]

Copyright of Matronas Profesion is the property of Ediciones Mayo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article aims to present some of the initial work of developing a social science grounded game theory-as a clear alternative to classical game theory. Two distinct independent initiatives in Sociology are presented: One, a systems approach, social systems game theory (SGT), and the other, Erving Goffman's interactionist approach (IGT). These approaches are presented and contrasted with classical theory. They focus on the social rules, norms, roles, role relationships, and institutional arrangements, which structure and regulate human behavior. While strategic judgment and instrumental rationality play an important part in the sociological approaches, they are not a universal or dominant modality of social action determination. Rule following is considered, generally speaking, more characteristic and more general. Sociological approaches, such as those outlined in this article provide a language and conceptual tools to more adequately and effectively than the classical theory describe, model, and analyze the diversity and complexity of human interaction conditions and processes: (1) complex cognitive rule based models of the interaction situation with which actors understand and analyze their situations; (2) value complex(es) with which actors operate, often with multiple values and norms applying in interaction situations; (3) action repertoires (rule complexes) with simple and complex action alternatives-plans, programs, established (sometimes highly elaborated) algorithms, and rituals; (4) a rule complex of action determination modalities for actors to generate and/or select actions in game situations; three action modalities are considered here; each modality consists of one or more procedures or algorithms for action determination: (I) following or implementing a rule or rule complex, norm, role, ritual, or social relation; (II) selecting or choosing among given or institutionalized alternatives according to a rule or principle; and (III) constructing or adopting one or more alternatives according to a value, guideline, or set of criteria. Such determinations are often carried out collectively. The paper identifies and illustrates in a concluding table several of the key differences between classical theory and the sociological approaches on a number of dimensions relating to human agency; social structure, norms, institutions, and cultural forms; patterns of game interaction and outcomes, the conditions of cooperation and conflict, game restructuring and transformation, and empirical relevance. Sociologically based game theory, such as the contributions outlined in this article suggest a language and conceptual tools to more adequately and effectively than the classical theory describe, model, and analyze the diversity, complexity, and dynamics of human interaction conditions and processes and, therefore, promises greater empirical relevance and scientific power. An Appendix provides an elaboration of SGT, concluding that one of SGT's major contributions is the rule based conceptualization of games as socially embedded with agents in social roles and role relationships and subject to cognitive-normative and agential regulation. SGT rules and rule complexes are based on contemporary developments relating to granular computing and Artificial Intelligence in general. [ABSTRACT FROM AUTHOR]

Background To study the inter-practice regional variation in the request of urinary albumin by general practitioners and compare to guideline recommendations. Methods A cross-sectional study enrolled laboratories from different Spanish autonomous communities. Laboratories were invited to report the number of urinary albumin requested by general practitioners during 2012 and 2014. Urinary albumin requested per 1000 inhabitants and the index of variability (90th centile/10th centile) was calculated, and compared between autonomous communities and time periods. To investigate potential inappropriate requesting in the management of diabetes and arterial hypertension, the actual number of requests was compared to the theoretical, based on prevalence and guideline recommendations. Results Urinary albumin requested per 1000 inhabitants was similar for years 2012 and 2014 (78.2 (60.1) to 85.4 (55.4); P = 0.235), as was the variability index (4.6 for both). There were significant differences between autonomous communities, with the indicator ranging from 46.0 (33.1) to 125.8 (64.3) ( P < 0.05). The theoretical cut-off ratios of urinary albumin per 1000 inhabitants to manage patients with diabetes and arterial hypertension were, respectively, 78 and 159; no laboratory reached both values. Conclusions Requesting of urinary albumin showed a significant regional variability in primary care in Spain, and was insufficient to correctly monitor patients with diabetes and arterial hypertension. [ABSTRACT FROM AUTHOR]

This article addresses a remarkable conceptual change in China: the replacement of the perception of charities as organizations associated with anti-governmental activity by one that views charities as organized expressions of civic duty. This shift occurred within a period of just 20 years. Following theories of public policy paradigm change, this study analyses the specific societal, institutional and rhetorical changes that were required for the rehabilitation of charity in China; the articulation of a blueprint for the new paradigm; and the implementation of the model in practice, focusing on attempts to foster a charitable spirit and culture. This study is based on official documents and articles in the People’s Daily (人民日报). Furthermore, the analysis is complemented by interviews with staff members of charity associations carried out in Tianjin in 2007 and 2008. The findings contribute to the broader discussion of the features of China’s civil society by elaborating on the boundaries of acceptable civic action. The study shows how the party-state has permitted the emergence of a space for the expression of a voluntary charitable spirit while still expecting that charitable spirit to be expressed within the confines of state-defined morally correct acts. [ABSTRACT FROM AUTHOR]

Copyright of Revista Jurídica de Castilla y León is the property of Junta de Castilla y Leon, Direccion de Servicios Juridicos and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives The aim was to study the inter-practice variability in anemia laboratory tests requested by general practitioners in Spain, to evaluate for a potential requesting inappropriateness. Methods Laboratories from diverse Spanish regions filled out the number of cell blood count, ferritin, folate, iron, transferrin, and vitamin B12 requested by general practitioners during 2012. The number of test requests per 1000 inhabitants and ratios of related tests requests were calculated. The results obtained in hospitals from different areas (urban, rural, or urban–rural), type of management (public or private), and geographic regions were compared. Results There was a high variability in the number of test requests and ratios of related tests. Cell blood count was over requested in rural areas and in hospitals with private management. Andalucía was the community with the lowest number of iron requests and the lowest folate/vitamin B12 indicator value. Conclusions Iron and transferrin seemed over requested in some areas; as were folate and ferritin when compared to vitamin B12 and cell blood count, respectively. The differences observed between areas indicate that other factors besides clinical reasons could be behind that variability and emphasize the need to accomplish interventions to improve the appropriate use of anemia laboratory tests. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Political Science / Revue Canadienne de Science Politique is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zer: Journal of Communication Studies / Revista de Estudios de Comunicacion / Komunikazio Ikasketen Aldizkaria is the property of Universidad del Pais Vasco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A phosphatase inhibition assay for detection of okadaic acid (OA) toxins in shellfish, OkaTest, was single laboratory validated according to international recognized guidelines (AOAC, EURACHEM). Special emphasis was placed on the ruggedness of the method and stability of the components. All reagents were stable for more than 6 months and the method was highly robust under normal laboratory conditions. The limit of detection and quantification were 44 and 56 μg/kg, respectively; both below the European legal limit of 160 μg/kg. The repeatability was evaluated with 2 naturally contaminated samples. The relative standard deviation (RSD) calculated was 1.4% at a level of 276 μg/kg and 3.9% at 124 μg/kg. Intermediate precision was estimated by testing 10 different samples (mussel and scallop) on three different days and ranged between 2.4 and 9.5%. The IC50 values of the phosphatase used in this assay were determined for OA (1.2 nM), DTX-1 (1.6 nM) and DTX-2 (1.2 nM). The accuracy of the method was estimated by recovery testing for OA (mussel, 78-101%; king scallop, 98-114%), DTX-1 (king scallop, 79-102%) and DTX-2 (king scallop, 93%). Finally, the method was qualitatively compared to the mouse bioassay and LC-MS/MS. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus disease 2019 (COVID-19) is a systemic disease characterized by a disproportionate inflammatory response in the acute phase. This study sought to identify clinical sequelae and their potential mechanism. Methods: We conducted a prospective single-center study (NCT04689490) of previously hospitalized COVID-19 patients with and without dyspnea during mid-term follow-up. An outpatient group was also evaluated. They underwent serial testing with a cardiopulmonary exercise test (CPET), transthoracic echocardiogram, pulmonary lung test, six-minute walking test, serum biomarker analysis, and quality of life questionaries. Results: Patients with dyspnea (n = 41, 58.6%), compared with asymptomatic patients (n = 29, 41.4%), had a higher proportion of females (73.2 vs. 51.7%; p = 0.065) with comparable age and prevalence of cardiovascular risk factors. There were no significant differences in the transthoracic echocardiogram and pulmonary function test. Patients who complained of persistent dyspnea had a significant decline in predicted peak VO2 consumption (77.8 (64–92.5) vs. 99 (88–105); p < 0.00; p < 0.001), total distance in the six-minute walking test (535 (467–600) vs. 611 (550–650) meters; p = 0.001), and quality of life (KCCQ-23 60.1 ± 18.6 vs. 82.8 ± 11.3; p < 0.001). Additionally, abnormalities in CPET were suggestive of an impaired ventilatory efficiency (VE/VCO2 slope 32 (28.1–37.4) vs. 29.4 (26.9–31.4); p = 0.022) and high PETCO2 (34.5 (32–39) vs. 38 (36–40); p = 0.025). Interpretation: In this study, >50% of COVID-19 survivors present a symptomatic functional impairment irrespective of age or prior hospitalization. Our findings suggest a potential ventilation/perfusion mismatch or hyperventilation syndrome. [ABSTRACT FROM AUTHOR]

Background: The long time from exposure to potentially harmful chemicals until breast cancer occurrence poses challenges for designing etiologic studies and for implementing successful prevention programs. Growing evidence from animal and human studies indicates that distinct time periods of heightened susceptibility to endocrine disruptors exist throughout the life course. The influence of environmental chemicals on breast cancer risk may be greater during several windows of susceptibility (WOS) in a woman's life, including prenatal development, puberty, pregnancy, and the menopausal transition. These time windows are considered as specific periods of susceptibility for breast cancer because significant structural and functional changes occur in the mammary gland, as well as alterations in the mammary micro-environment and hormone signaling that may influence risk. Breast cancer research focused on these breast cancer WOS will accelerate understanding of disease etiology and prevention.Main Text: Despite the plausible heightened mechanistic influences of environmental chemicals on breast cancer risk during time periods of change in the mammary gland's structure and function, most human studies of environmental chemicals are not focused on specific WOS. This article reviews studies conducted over the past few decades that have specifically addressed the effect of environmental chemicals and metals on breast cancer risk during at least one of these WOS. In addition to summarizing the broader evidence-base specific to WOS, we include discussion of the NIH-funded Breast Cancer and the Environment Research Program (BCERP) which included population-based and basic science research focused on specific WOS to evaluate associations between breast cancer risk and particular classes of endocrine-disrupting chemicals-including polycyclic aromatic hydrocarbons, perfluorinated compounds, polybrominated diphenyl ethers, and phenols-and metals. We outline ways in which ongoing transdisciplinary BCERP projects incorporate animal research and human epidemiologic studies in close partnership with community organizations and communication scientists to identify research priorities and effectively translate evidence-based findings to the public and policy makers.Conclusions: An integrative model of breast cancer research is needed to determine the impact and mechanisms of action of endocrine disruptors at different WOS. By focusing on environmental chemical exposure during specific WOS, scientists and their community partners may identify when prevention efforts are likely to be most effective. [ABSTRACT FROM AUTHOR]

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has not been fixed in the paper. [ABSTRACT FROM AUTHOR]