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IntroductionHistorically, Multiple Endocrine Neoplasia type 1 (MEN1)-related pituitary adenomas (PAs) were considered more aggressive and treatment-resistant than sporadic PAs. However, recent studies suggest similarities in their behavior. This study aimed to evaluate the long-term outcomes of MEN1 PAs and identify predictive factors.MethodsNationwide multicenter retrospective cohort study of MEN1-related PAs with a minimum 1-year follow-up, collecting patient demographics, germline MEN1 pathogenic variants (PV), PA size, secretory profile, radiological characteristics, treatments, and outcomes.ResultsWe analyzed 84 PAs, 69%in females and 31% in males (P

The objective was to evaluate the incidence of nephrotoxicity related to vancomycin and other anti-MRSA antibiotics (linezolid and daptomycin). Patients receiving any of these drugs between July 2014 and December 2020 at a tertiary hospital were included. Renal failure was evaluated using the acute renal injury (AKIN) system. Univariate analysis was conducted on the 5806 patients who were included. Among them, 1023 patients (17.62%) developed renal failure. The renal damage incidence was 14.74% (496/3365) for vancomycin, 19.13% (367/1918) for linezolid, and 30.59% (160/523) for daptomycin. Patients with lower basal glomerular filtration had a higher risk of AKIN. In the vancomycin group, the risk factors were high creatinine and urea serum basal values, duration of treatment (DOT), body mass index (BMI), ICU stay, age, and low CKDEPI and albumin levels. In the linezolid group, AKIN was linked to high creatinine and urea levels, BMI, age, and ICU stay and to low CKDEPI levels; for daptomycin, AKIN was associated with low CKDEPI and albumin levels and a long DOT. Patients with AKIN showed higher mortality rates. Vancomycin-associated nephrotoxicity remains a great concern. However, linezolid and daptomycin could also cause nephrotoxicity. Bearing in mind risk factors that may prompt nephrotoxicity in hospitalized patients taking anti-staphylococcal antibiotics will result in better pharmacotherapeutic management.

Objectives Neck recurrence of papillary thyroid cancer (PTC) is frequently detected after initial surgery. The management of these lesions may include rescue surgery (RS) or minimally invasive techniques in selected patients, but comparative studies evaluating the effectiveness and safety of these techniques are lacking. In this paper, we compared ultrasound-guided ethanol ablation (EA) in selected patients to RS in a matched cohort. Methods We retrospectively compared 41 patients and 41 matched PTC patients without known distant metastases, who underwent ultrasound-guided EA or RS (matched reference group), who had 63 and 75 thyroid bed and/or lymph node confirmed PTC recurrences during a median follow-up of 72.8 and 89.6 months, respectively. The primary outcome was time until structural recurrence, compared using Kaplan-Meier survival curves. The secondary outcomes included time until biochemical recurrence, plasma thyroglobulin (Tg) levels, American Thyroid Association (ATA) response-to-therapy categories by the last available observation, and treatment-derived complications in each group. Results No significant differences were found between the EA and RS groups for time until structural recurrence (log-rank test, P=0.94). The time until biochemical recurrence was also similar (P=0.51); and the plasma Tg concentration reduction and proportions of patients in the ATA reclassification categories were also similar. A significantly higher proportion of patients in the RS group presented treatment-derived complications (29.27% vs. 9.75%, P

Resumen: Objetivo: Analizar las variables predictoras del uso de métodos anticonceptivos en jóvenes. Diseño: Revisión sistemática. Fuentes de datos: Se consultaron las bases de datos PubMed, CINAHL, Scopus, Cuiden Plus, LILACS e IME. Selección de estudios: Se realizó una evaluación de la calidad de los estudios que fue revisada por dos investigadores en paralelo. Como resultado, se seleccionaron un total de cinco investigaciones primarias. Extracción de datos: Se extrajo información sobre la población seleccionada en el estudio, método anticonceptivo estudiado y las variables predictoras identificadas. Resultados: Se identificaron siete variables predictoras que explican específicamente el uso del preservativo masculino, píldora anticonceptiva o píldora anticonceptiva de emergencia. Las variables más relevantes fueron el nivel de conocimiento y las actitudes hacia el empleo de los métodos anticonceptivos, de manera que un mayor conocimiento y unas actitudes positivas incrementan la probabilidad de uso de métodos anticonceptivos. Otro resultado destacado fue la presencia de un sesgo formativo con un mayor conocimiento de las mujeres sobre las opciones anticonceptivas hormonales y actitudes más positivas. Conclusión: Los futuros programas formativos deben orientarse hacia la evaluación de cambios en el comportamiento, mediante el desarrollo de actitudes positivas hacia el uso de los métodos anticonceptivos a través de la adquisición de un conocimiento de calidad sobre las opciones contraceptivas. Abstract: Objective: To analyse predictor variables of contraceptive method use in young people. Design: Systematic review. Data sources: PubMed, CINAHL, Scopus, Cuiden Plus, LILACS and IME databases were consulted. Study selection: An assessment of the quality of studies was carried out by two researchers in parallel. As a result, a total of 5 primary research studies were selected. Data extraction: Information was extracted on the selected study population, contraceptive method studied and predictor variables identified. Results: Seven predictor variables were identified that specifically explain the use of the male condom, contraceptive pill or emergency contraceptive pill. The most relevant variables were the level of knowledge and attitudes towards contraceptive use, therefore high knowledge and positive attitudes increase the likelihood of contraceptive use. Another notable finding was the presence of a formative bias with women having higher knowledge of hormonal contraceptive options and more positive attitudes. Conclusion: Future training programs should be oriented towards assessing behavioral changes through the development of positive attitudes towards contraceptive use by gaining knowledge of contraceptive options.

Background Previous research in nursing has found favorable results from the use of teaching methodologies alternative to lectures. One of the complementary methodologies used for university teaching is gamification, or the inclusion of game elements, creating a dynamic learning environment that allows the acquisition of knowledge and the development of other skills necessary for nursing students. The purpose of this study was to evaluate the effect of a gamification session on student satisfaction and knowledge scores in nursing students in simulated laboratory practice. Methods A pre-post quasi-experimental study was conducted with 122 students from the nursing degree program who participated in the research. The evaluation consisted of four sessions of three hours each. In two sessions, participants were trained through a vertical methodology, by means of theoretical training provided by teaching staff, and two hours of clinical simulation, where the students were able to practice the techniques on professional simulators. At the other two sessions, participants received an explanation of the theoretical aspects of the session, one hour of clinical simulation, and one hour of gamification, in which they had to pass tests based on the performance of practical activities on the subject of the session. At the end of the gamification session, all the participants received a certificate as winners of the “nursing game”. Results There was an improvement in the satisfaction and the knowledge level in the gamification sessions. Both were statistically significant (P < 0.001). There was an improvement in the items related to the development of critical thinking and the mobilizing concepts from theory to practice in the gamification sessions. Conclusion The intervention was effective in improving the satisfaction of the sessions received and in knowledge development.

PurposeTo evaluate the rate of recurrence among patients with pheochromocytomas and sympathetic paragangliomas (PGLs; together PPGLs) and to identify predictors of recurrence (local recurrence and/or metastatic disease).MethodsThis retrospective multicenter study included information of 303 patients with PPGLs in follow-up in 19 Spanish tertiary hospitals. Recurrent disease was defined by the development of local recurrence and/or metastatic disease after initial complete surgical resection.ResultsA total of 303 patients with PPGLs that underwent 311 resections were included (288 pheochromocytomas and 15 sympathetic PGLs). After a median follow-up of 4.8 years (range 1-19), 24 patients (7.9%) had recurrent disease (3 local recurrence, 17 metastatic disease and 4 local recurrence followed by metastatic disease). The median time from the diagnosis of the PPGL to the recurrence was of 11.2 months (range 0.5-174) and recurrent disease cases distributed uniformly during the follow-up period. The presence of a pathogenic variant in SDHB gene (hazard ratio [HR] 13.3, 95% CI 4.20-41.92), higher urinary normetanephrine levels (HR 1.02 per each increase in standard deviation, 95% CI 1.01-1.03) and a larger tumor size (HR 1.01 per each increase in mm, 95% CI 1.00-1.02) were independently associated with disease recurrence.ConclusionThe recurrence of PPGLs occurred more frequently in patients with SDHB mutations, with larger tumors and with higher urinary normetanephrine levels. Since PPGL recurrence may occur at any time after the initial PPGL diagnosis is performed, we recommend performing a strict follow-up in all patients with PPGLs, especially in those patients with a higher risk of recurrent disease.

Objective: Global thyroid cancer (TC) incidence is growing worldwide, but great heterogenicity exists among published studies, and thus, population-specific epidemiological studies are needed to adequate health resources and evaluate the impact of overdiagnosis. Methods: We conducted a Public Health System database retrospective review of TC incident cases from 2000 to 2020 in the Balearic Islands region and evaluated age-standardized incidence rate (ASIR), age at diagnosis, gender distribution, tumor size and histological subtype, mortality rate (MR), and cause of death. Estimated annual percent changes (EAPCs) were also evaluated and data from the 2000–2009 period were compared to the 2010–2020 period when neck ultrasound (US) was routinely performed by clinicians at Endocrinology Departments. Results: A total of 1387 incident cases of TC were detected. Overall, ASIR (×105) was 5.01 with a 7.82% increment in EAPC. A significant increase in the 2010–2020 period was seen for ASIR (6.99 vs 2.82, P < 0.001) and age at diagnosis (52.11 vs 47.32, P < 0.001) compared to the 2000–2009 period. A reduction in tumor size (2.00 vs 2.78 cm, P < 0.001) and a 6.31% increase in micropapillary TC (P < 0.05) were also seen. Disease-specific MR remained stable at 0.21 (×105). The mean age at diagnosis for all mortality groups was older than survivors (P < 0.001). Conclusion: The incidence of TC has grown in the 2000–2020 period in the Balearic Islands, but MR has not changed. Beyond other factors, a significant contribution of overdiagnosis to this increased incidence is likely due to changes in the routine management of thyroid nodular disease and increased availability of neck US.

Abstract Background Living safely sexuality and without risk to one’s health is an international priority. The youth age group has specific characteristics that make it a particularly vulnerable group for adverse consequences such as unwanted pregnancies or sexually transmitted infections. Health professionals are an important group to address this issue; however, to achieve a good result, sufficient knowledge is required to solve all the issues. This study aimed to assess the level of knowledge of young university students studying a nursing or a medical degree. Methods A descriptive cross-sectional study of young medical and nursing students was conducted. The selection of participants was made by convenience. The Sexuality and Contraceptive Knowledge Instrument scale was used to measure knowledge level. A bivariate analysis was conducted using the Mann–Whitney U test or the Kruskal–Wallis H test, depending on the number of categories of the independent variable. Finally, a multivariate analysis was conducted using a multiple linear regression model, establishing the level of knowledge as the dependent variable and all variables that obtained statistical significance in the bivariate analysis as predictors. Data collection was carried out from October 2020 to March 2021. Results The sample comprised 657 health university students. Participants had a good level of knowledge, with 77.9% answering 50% of the questions correctly. Before training, 34.15% of the participants did not pass 50% of the questions asked. This percentage decreased to 12.87% after receiving sexuality training during their university degrees. The main training gaps were found for the items on hormonal contraceptive methods. The bivariate analysis showed that female participants had significantly higher knowledge scores, as did those who had used a hormonal contraceptive method during the most recent intercourse or were aware of family planning centers. These variables maintained their significant effect at the multivariate level, obtaining two models with good explanatory power for participants of both university degrees. Conclusion The general level of knowledge of the healthcare students was high and sufficient after receiving training during the university degree (87.13% of the participants obtain more than 50% of items correct). The main training gap was found for items on hormonal contraceptive methods, which should be emphasized in future training programs.

The molecular mechanisms underlying metastasis in pheochromocytoma/paraganglioma (mPPGL) remain to be explored. Here, the authors perform genomic and immunogenomic profiling of mPPGL tumors and suggest potential biomarkers for risk of metastasis and immunotherapy response.

Abstract Background Mainstreaming sustainable healthcare into the curricula of health professions is a key action to raise awareness and change attitudes. Therefore, the present study aimed to assess the contribution of scenario-based learning and augmented reality to the environmental awareness and attitudes toward climate change and sustainability among undergraduate nursing students. Methods This study was designed as a time-series analysis. Undergraduate nursing students in their 3 years were introduced to sustainability and climate change in the context of healthcare through scenario-based learning sessions. Questionnaires were used to collect data on participants’ attitudes towards sustainability and climate change, the usefulness of the educational sessions and the extent to which students changed their clinical practice. A data summary, related sample Friedman and Wilcoxon signed-rank tests were used to test for differences in survey scores. Results Attitudes and environmental awareness toward climate change and sustainability increased significantly as students received the learning sessions over the 3 years. After their first clinical training period, students already showed a high awareness of unsustainable practices in their working environment; however, they still struggled to apply sustainability and address unsustainable practices in healthcare settings. Most students felt that the scenarios helped them to make links between climate change, resources, and health. Conclusions The scenario-based learning and augmented reality increase environmental awareness and attitudes toward climate change and sustainability among nursing students. Students are very aware of unsustainable practices in their work environment, but more work needs to be done on the application of sustainability principles to nursing practice.

Este estudio describe un nuevo tipo de censura en traducción, la “censura por homenaje”. Se trata de una censura procedente de un plano interno, ya que la produce el propio traductor, pero condicionada por factores externos previos, debido a que rinde homenaje a una traducción influenciada por un sistema censor. Esta censura, además, se suele manifestar en el uso de la creación discursiva, es decir, de equivalentes ficticios, o la modulación para suavizar aquellos elementos polémicos que contradicen la versión del sistema censor. A partir de una revisión de las estrategias de traducción a las que se recurre en la subtitulación de la canción “The Last Supper” de la película Jesus Christ Superstar, ofrecida en la plataforma Filmin, y las empleadas en la que parece ser la versión utilizada como referente para esta nueva traducción, la obra de teatro musical Jesucristo Superstar, de 1975, se sostiene la hipótesis de que esta nueva traducción tuvo como modelo la versión de 1975, censurada por el régimen franquista, debido a la gran influencia de la versión de 1975 sobre el público español. Para realizar este análisis, se ha utilizado la metodología aplicada en un estudio anterior, basada en el análisis contrastivo de estrategias a partir de las descritas por Molina (2001). Se discuten, además, aquellos pasajes en los que la traducción se aleja más del significado original, con el fin de observar la influencia de la censura en esta nueva versión.

Abstract Predicting which acromegaly patients could benefit from somatostatin receptor ligands (SRL) is a must for personalized medicine. Although many biomarkers linked to SRL response have been identified, there is no consensus criterion on how to assign this pharmacologic treatment according to biomarker levels. Our aim is to provide better predictive tools for an accurate acromegaly patient stratification regarding the ability to respond to SRL. We took advantage of a multicenter study of 71 acromegaly patients and we used advanced mathematical modelling to predict SRL response combining molecular and clinical information. Different models of patient stratification were obtained, with a much higher accuracy when the studied cohort is fragmented according to relevant clinical characteristics. Considering all the models, a patient stratification based on the extrasellar growth of the tumor, sex, age and the expression of E-cadherin, GHRL, IN1-GHRL, DRD2, SSTR5 and PEBP1 is proposed, with accuracies that stand between 71 to 95%. In conclusion, the use of data mining could be very useful for implementation of personalized medicine in acromegaly through an interdisciplinary work between computer science, mathematics, biology and medicine. This new methodology opens a door to more precise and personalized medicine for acromegaly patients.

Over the last several years, the models for organic waste management have changed to implement circular economy in the productive cycle. In this context, new scenarios have emerged, where the management of different organic waste streams by composting is conducted with decentralized models that manage organic wastes in a more local way. However, in these new models, the standardization of the process control and of the end-product characteristics is necessary to guarantee the quality and agronomic value of the compost obtained, avoiding potential risks for human health and the environment. Thus, the aim of this work was to study two different scenarios of community composting of the organic fraction of municipal solid waste separately collected in order to guarantee the effectiveness and reproducibility of the composting processes and the quality of the composts obtained. For this, the development of the process and the characteristics of the composts at agronomic, hygienic–sanitary and environmental levels were assessed in real conditions and during three cycles of the process. The results obtained show high similarity among the different composting cycles, indicating an important degree of reproducibility among the processes. In addition, the composts obtained showed a good sanitary quality, absence of phytotoxicity and low contents of potentially toxic elements, which guarantee their use in agriculture without posing any risk to human health and to the environment.

Abstract The purpose of our study was to develop a predictive model to rule out pheochromocytoma among adrenal tumours, based on unenhanced computed tomography (CT) and/or magnetic resonance imaging (MRI) features. We performed a retrospective multicentre study of 1131 patients presenting with adrenal lesions including 163 subjects with histological confirmation of pheochromocytoma (PHEO), and 968 patients showing no clinical suspicion of pheochromocytoma in whom plasma and/or urinary metanephrines and/or catecholamines were within reference ranges (non-PHEO). We found that tumour size was significantly larger in PHEO than non-PHEO lesions (44.3 ± 33.2 versus 20.6 ± 9.2 mm respectively; P

Resumen: Los «Objetivos para el desarrollo sostenible 2030» marcan la necesidad de una educación para el desarrollo sostenible que logre mantener la salud planetaria. Así, las instituciones de educación superior que forman a profesionales sanitarios deberían considerar la integración de competencias para promover la salud planetaria. Las competencias para lograr la salud planetaria incluyen los desplazamientos debidos al cambio climático, las poblaciones vulnerables como niños, ancianos o los más pobres, la seguridad del agua y alimentaria, la carga de enfermedades infecciosas, las catástrofes como inundaciones o temperaturas extremas, los contaminantes aéreos, o los efectos en la salud mental. De esta forma, la educación para el desarrollo sostenible pretende dotar y capacitar al alumnado con los conocimientos, las habilidades y las actitudes para que pueda ser eficaz en la resolución de los retos de la salud planetaria, como son la interdependencia de los ecosistemas y la salud humana, incluyendo los efectos del cambio ambiental en la salud, así como el impacto del sector sanitario y su dependencia del medio ambiente. Algunas universidades europeas ya han empezado a sostenibilizar la formación de profesionales sanitarios, siendo ejemplos de los pasos necesarios a seguir. Abstract: The “2030 Sustainable Development Goals” outline the need for education for sustainable development to sustain planetary health. Thus, higher education institutions that train health professionals should consider embedding competencies to promote planetary health. Competencies for achieving planetary health include displacement due to climate change, vulnerable populations such as children, the elderly or the poorest, water and food security, the burden of infectious diseases, catastrophes such as floods or extreme temperatures, air pollutants, or mental health effects. Therefore, education for sustainable development aims to provide students with the knowledge, skills and attitudes to be effective in addressing global health challenges, such as the interdependence of ecosystems and human health, including the effects of environmental change on health, as well as the impact of the health sector and its dependence on the environment. Some European universities have already started to make the training of health professionals more sustainable and are examples of the steps that need to be taken.

Background Latent autoimmune diabetes in adults (LADA) is a type of diabetes mellitus showing overlapping characteristics between type 1 Diabetes Mellitus and type 2 Diabetes Mellitus (T2DM), and autoimmunity against insulin-producing pancreatic cells. For its diagnosis, at least one type of anti-pancreatic islet antibody (GADAb is the most common) is required. Many authors recommend performing this measure in all newly diagnosed patients with DM, but it is not possible in Primary Health Care (PHC) due to its high cost. Currently, a relevant proportion of patients diagnosed as T2DM could be LADA. Confusing LADA with T2DM has clinical and safety implications, given its different therapeutic approach. The main objective of the study is to develop and validate a clinical score for identifying adult patients with DM at high risk of LADA in PHC. Methods This is an observational, descriptive, cross-sectional study carried out in Primary Care Health Centers with a centralized laboratory. All people over 30 years of age diagnosed with diabetes within a minimum of 6 months and a maximum of 4 years before the start of the study will be recruited. Individuals will be recruited by consecutive sampling. The study variables will be obtained through clinical interviews, physical examinations, and electronic medical records. The following variables will be recorded: those related to Diabetes Mellitus, sociodemographic, anthropometric, lifestyle habits, laboratory parameters, presence of comorbidities, additional treatments, personal or family autoimmune disorders, self-perceived health status, Fourlanos criteria, and LADA diagnosis (as main variable) according to current criteria. Discussion The study will provide an effective method for identifying patients at increased risk of LADA and, therefore, candidates for antibody testing. However, a slight participation bias is to be expected. Differences between participants and non-participants will be studied to quantify this potential bias.

Objetivo: Evaluar las diferencias en los componentes biométricos oculares, como longitud axial, profundidad de la cámara anterior, espesor del cristalino, curvatura corneal y espesor corneal entre hombres y mujeres. Método: Estudio observacional analítico de corte transversal, en 106 estudiantes universitarios en edades entre 18 y 36 años. Todos los sujetos fueron sometidos a refracción bajo cicloplejia y valorados mediante autorrefractometría. El error refractivo fue medido después de la aplicación de ciclopentolato al 1%. Para la identificación de los componentes biométricos se realizó una valoración con el equipo Aladdin (Topcon Corporation, Equipos Oftalmológicos Colombia). Resultados: De los 106 participantes, el 71.7% (76) correspondían al sexo femenino, en edades entre 18 y 36 años. En las mujeres, el promedio de la longitud axial fue de 23.3 ± 0.88 mm y en los hombres 23.9 ± 0.99 mm. La profundidad de la cámara anterior fue de 3.5 ± 0.26 mm en las mujeres y de 3.6 ± 0.22 mm en los hombres. El espesor del cristalino en las mujeres fue de 3.47 ± 0.22 mm y en los hombres de 3.53 ± 0.20 mm. El espesor corneal en las mujeres fue de 538.65 ± 0.36 µm y en los hombres de 542.43 ± 32.73 µm. El promedio de la queratometría en las mujeres fue de 43.54 ± 1.35 D y en hombres de 42.76 ± 1.79 D. Hubo diferencias estadísticamente significativas entre la curvatura corneal (−0.78 D; hombres p = 0.01 y mujeres p = 0.003) y la longitud axial (0.63 mm; hombres p = 0.02 y mujeres p = 0.04). Conclusiones: Existen diferencias en la curvatura corneal de hasta 0.75 D, siendo más curva en las mujeres, y un mayor tamaño del globo ocular en los hombres, características anatómicas que intervienen en la prevalencia de errores de refracción.

ContextSome reports suggest that acromegaly in elderly patients has a more benign clinical behavior and could have a better response to first-generation long-acting somatostatin receptor ligands (SRL). However, there is no specific therapeutic protocol for this special subgroup of patients.ObjectiveThis study aimed at identifying predictors of response to SRL in elderly patients.DesignMulticentric retrospective nationwide study of patients diagnosed with acromegaly at or over the age of 65 years.ResultsOne-hundred and eighteen patients (34 men, 84 women, mean age at diagnosis 71.7 ± 5.4 years old) were included. Basal insulin-like growth factor type 1 (IGF-1) above the upper limit of normal (ULN) and growth hormone (GH) levels (mean ± SD) were 2.7 ± 1.4 and 11.0 ± 11.9 ng/ml, respectively. The mean maximal tumor diameter was 12.3 ± 6.4 mm, and up to 68.6% were macroadenoma. Seventy-two out of 118 patients (61.0%) underwent surgery as primary treatment. One-third of patients required first-line medical treatment due to a rejection of surgical treatment or non-suitability because of high surgical risk. After first-line surgery, 45/72 (63.9%) were in disease remission, and 16/34 (46.7%) of those treated with SRL had controlled disease. Patients with basal GH at diagnosis ≤6 ng/ml had lower IGF-1 levels and had smaller tumors, and more patients in this group reached control with SRL (72.7% vs. 33.3%; p < 0.04) [OR: 21.3, IC: 95% (2.4–91.1)], while male patients had a worse response [OR: 0.09, IC 95% (0.01–0.75)]. The predictive model curve obtained for SRL response showed an AUC of 0.82 CI (0.71–0.94).ConclusionsThe most frequent phenotype in newly diagnosed acromegaly in the elderly includes small adenomas and moderately high IGF-1 levels. GH at diagnosis ≤6 ng/ml and female gender, but not age per se, were associated with a greater chance of response to SRL.

Objetivo. Identificar diferencias en el valor dióptrico del error refractivo de universitarios y analizar la sensibilidad, especificidad y los valores predictivos de los valores de autorefracción no ciclopléjica para miopía e hipermetropía. Materiales y métodos. Estudio observacional de corte transversal con 208 participantes incluidos. El error refractivo fue medido con autorefractómetro antes y después del uso de ciclopentolato tópico al 1 %. Para determinar la validez de la autorefracción no ciclopléjica se analizaron la prueba de sensibilidad, especificidad y valores predictivos para miopía e hipermetropía. Resultados. Las estimaciones de prevalencia de miopía sin cicloplejia y con cicloplejia fueron antes del 74,88 % [IC 95 % -0,95-4,79] y después del 29,71 % [IC 95% -1,60-2,31] y para hipermetropía antes del 2,46 % [IC 95 % 1,16-2,70] y después del 25,14 % [IC 95 % 0,83-1,32]. La magnitud de miopía antes y después de cicloplejia fue de -2,87 D y -1,96 D y para hipermetropía +1,93 D y +1,08 D, respectivamente. La diferencia entre el examen sin y con cicloplejia para miopía fue de -0,91 D, y para hipermetropía +0,85 D. La validez de la autorefracción no ciclopléjica, identificó correctamente a 96,6 % de sujetos miopes y erróneamente a 39,43 %. En hipermetropía la prueba no ciclopléjica identificó de forma correcta a los hipermétropes (90,90 %) y no hubo ninguna clasificación errónea en este diagnóstico. Conclusiones. La valoración sin cicloplejia refleja diferencias en la magnitud de las ametropías bajas y medias hasta en una dioptría, en comparación con el examen de cicloplejia. La validez de la prueba de autorefracción sin cicloplejia demostró una identificación errónea de sujetos miopes, resultando un incremento en la prevalencia de miopía en población menor a 40 años. Por lo tanto, es conveniente identificar a los sujetos miopes por medio de valoración ciclopléjica.

Las técnicas de estudio son herramientas educativas que permiten el desarrollo de las máximas capacidades de los estudiantes en su proceso de formación educativa. Investigaciones previas han mostrado la ausencia de técnicas educativas adecuadas en estudiantes universitarios. El objetivo del estudio fue diseñar estrategias para aumentar el conocimiento y la motivación sobre técnicas de estudio que contribuyan a mejorar el rendimiento académico en los estudiantes universitarios de enfermería de primer ingreso. El estudio siguió un enfoque mixto, cualitativo-cuantitativo, utilizando la investigación-acción participativa. La muestra fue constituida por diez profesores y sesenta y tres estudiantes. Se aplicó una entrevista cualitativa realizada ad hoc y el Cuestionario de Hábitos y Técnicas de Estudio. Se usaron pruebas de diferencias de medias para relacionar las diferentes dimensiones de los hábitos y las técnicas de estudio y el rendimiento académico. Los resultados mostraron que los hábitos (actitud general ante el estudio, lugar de estudio, estado físico y plan de trabajo) y las técnicas de estudio (técnicas de estudio, exámenes-ejercicios y trabajos) presentaron correlaciones estadísticamente significativas con el rendimiento académico (hábitos, 0.672, p < 0.001; técnicas de estudio, 0.385, p = 0.002).Como conclusión se pone de relieve la necesidad de formación en adecuadas técnicas de estudios desde el comienzo de la carrera universitaria, ya que adecuadas técnicas de estudio aumentan el rendimiento académico.

Resumen: Los tumores secretores de catecolaminas derivan de la médula adrenal o de los ganglios del sistema nervioso autónomo, y se conocen, respectivamente, como feocromocitomas y paragangliomas. A pesar de que las manifestaciones clínicas son similares, su diferenciación es importante por la posibilidad de formar parte de un síndrome endocrino hereditario y el diferente pronóstico. Abstract: Catecholamine-secreting tumors derive from the adrenal medulla or autonomic nervous system ganglia and are known as pheochromocytomas and paragangliomas, respectively. Although the clinical manifestations are similar, their differentiation is important due to the possibility of being part of a hereditary endocrine syndrome and the different prognosis.

Introducción: Las células caliciformes secretan mucinas, citocinas y antígenos específicos para la respuesta immunitaria de la superficie ocular. Las alteraciones en la densidad de células caliciformes y de su secreción provocan inestabilidad de la película lagrimal y, por ello, ojo seco. Objetivo: Se estudiaron las conexiones entre las publicaciones, las citaciones y las revistas sobre célula caliciforme y ojo seco, con el objetivo de analizar el tamaño de sus grupos y núcleo, y cuantificar el volumen de literatura existente para dirigir futuras investigaciones sobre el tema. Método: La búsqueda de “goblet cell and dry eye” se realizó en Web of Science y luego se analizó con CitNetExplorer® para obtener las publicaciones más citadas e identificar los grupos y núcleo de publicaciones. Resultados: 555 publicaciones y 3066 citaciones fueron generadas por WoS. Los años 2016 y 2017 son los que tienen mayor número de publicaciones. La más citada fue The definition and classification of dry eye disease: report of the definition and classification subcommittee of the International Dry Eye Worshop, de Lemp et al., publicada en 2007. Empleando la función Cluster resultaron tres grupos con diferentes áreas de investigación en este campo: ojo seco, mucinas y tratamientos. Conclusiones: El estudio de la célula caliciforme y del ojo seco es relevante para los investigadores, mostrándose además conexiones entre ellos. Aumentar el conocimiento de la célula caliciforme producirá mejoras en los tratamientos del ojo seco.

IMPORTANCE:. A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 is hypothesized to play a role in the pathogenesis of invasive infection, but studies in sepsis are lacking. OBJECTIVES:. To study A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 protein level in pediatric sepsis and to study the association with outcome. DESIGN:. Data from two prospective cohort studies. SETTING AND PARTICIPANTS:. Cohort 1 is from a single-center study involving children admitted to PICU with meningococcal sepsis (samples obtained at three time points). Cohort 2 includes patients from a multicenter study involving children admitted to the hospital with invasive bacterial infections of differing etiologies (samples obtained within 48 hr after hospital admission). MAIN OUTCOMES AND MEASURES:. Primary outcome measure was mortality. Secondary outcome measures were PICU-free days at day 28 and hospital length of stay. RESULTS:. In cohort 1 (n = 59), nonsurvivors more frequently had A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 levels above the detection limit than survivors at admission to PICU (8/11 [73%] and 6/23 [26%], respectively; p = 0.02) and at t = 24 hours (2/3 [67%] and 3/37 [8%], respectively; p = 0.04). In cohort 2 (n = 240), A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 levels in patients within 48 hours after hospital admission were more frequently above the detection limit than in healthy controls (110/240 [46%] and 14/64 [22%], respectively; p = 0.001). Nonsurvivors more often had detectable A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 levels than survivors (16/21 [76%] and 94/219 [43%], respectively; p = 0.003), which was mostly attributable to patients with Neisseria meningitidis. CONCLUSIONS AND RELEVANCE:. In children with bacterial infection, detection of A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 within 48 hours after hospital admission is associated with death, particularly in meningococcal sepsis. Future studies should confirm the prognostic value of A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 and should study pathophysiologic mechanisms.

Barley straw was subjected to hydrothermal pretreatment (steam explosion) processing to evaluate its potential as a raw material to produce xylooligosaccharides (XOS) suitable for use as a prebiotic. The steam explosion pretreatment generated a liquid fraction containing solubilised hemicellulose. This fraction was purified using gel permeation chromatography to obtain a fraction rich in XOS DP2-DP6. The sample was characterised through analytical techniques such as HPAEC-PAD, FTIR and MALDI-TOF-MS. The prebiotic activity was evaluated using in vitro fermentation in human faecal cultures through the quantification of short-chain fatty acid (SCFA) and lactate production, the evolution of the pH and the consumption of carbon sources. The total SCFA production at the end of fermentation (30 h) was 90.1 mM. Positive significant differences between the amount of XOS from barley straw and fructooligosaccharides after incubation were observed.

Introduction: Birth by elective caesarean section in late preterm and early term newborn increases the risk of respiratory distress. Administration of antenatal corticosteroids in these cases could reduce the respiratory distress and its severity. Objectives: To determine the influence of antenatal corticosteroids use in elective caesarean sections in the respiratory distress of the newborn from 35+0 to 38+6 weeks of gestational age. Patients and methods: Retrospective analytical study of caesarean sections from 35+0 to 38+6 gestational age was conducted in a tertiary hospital from January 2013 to April 2017. Data were collected from medical records of pregnant women and newborns after an implementation of new protocol of betamethasone administration to these elective caesarean sections. Analysis was performed on 2 newborn subgroups: preterm newborn (PTN) 35–36 gestational age and term (TN) 37–38 weeks. Results: A total of 208 elective caesarean sections were performed in the study period. Corticosteroids were administered in 97 (46.6%) of cases. The percentage of respiratory distress was higher in the group of preterm newborn compared to term newborn (29% vs. 8.8%, P

Resumen: Introducción: El nacimiento por cesárea programada de los recién nacidos pretérmino tardíos y a término precoces aumenta el riesgo de distrés respiratorio. La administración de corticoides antenatales en estos casos podría disminuir el distrés respiratorio y su gravedad. Objetivos: Determinar la repercusión del uso de corticoides antenatales en las cesáreas programadas en el distrés respiratorio del recién nacido de 35 a 38+6 semanas de edad gestacional (SEG). Pacientes y métodos: Estudio analítico retrospectivo en un hospital de tercer nivel, de las cesáreas de 35+0 a 38+6 SEG desde enero de 2013 hasta abril de 2017. Recogida de datos de las historias clínicas de las gestantes y recién nacidos tras la instauración de un nuevo protocolo de administración de una dosis de betametasona a las gestantes con cesáreas programadas de esta edad gestacional. Análisis en 2 subgrupos: recién nacidos pretérmino (RNPT) 35-36 SEG y a término (RNT) 37-38 SEG. Resultados: En este periodo se realizaron 208 cesáreas programadas. Se administraron corticoides en 97 casos (46,6%). El porcentaje de distrés fue mayor en el grupo de cesáreas programadas de RNPT comparado con los RNT (29 vs. 8,8%; p

Primary hyperparathyroidism is the most frequent manifestation of multiple endocrine neoplasia type 1 (MEN1) syndrome. Bone and renal complications are common. Surgery is the treatment of choice, but the best timing for surgery is controversial and predictors of persistence and recurrence are not well known. Our study describes the clinical characteristics and the surgical outcomes, after surgery and in the long term, of the patients with MEN1 and primary hyperparathyroidism included in the Spanish Registry of Multiple Endocrine Neoplasia, Pheochromocytomas and Paragangliomas (REGMEN). Eighty-nine patients (49 men and 40 women, 34.2 ± 13 years old) were included. Sixty-four out of the 89 underwent surgery: a total parathyroidectomy was done in 13 patients, a subtotal parathyroidectomy in 34 and a less than subtotal parathyroidectomy in 15. Remission rates were higher after a total or a subtotal parathyroidectomy than after a less than subtotal (3/4 and 20/22 vs 7/12, P < 0.05), without significant differences in permanent hypoparathyroidism (1/5, 9/23 and 0/11, N.S.). After a median follow-up of 111 months, 20 of the 41 operated patients with long-term follow-up had persistent or recurrent hyperparathyroidism. We did not find differences in disease-free survival rates between different techniques, patients with or without permanent hypopar athyroidism and patients with different mutated exons, but a second surgery was more freq uent after a less than subtotal parathyroidectomy.

Abstract Background As a consequence of biological, psychological and social changes during puberty, youth is a period characterized by impulsiveness and risk-taking. Members of this population often feel invulnerable and have a strong motivation to explore their identity. A good level of knowledge is necessary to allow young people to experience their sexuality in a healthy way, without associated risks. In our environment there is currently no valid Spanish-language tool to measure the level of knowledge about sexuality and contraception. This study sought to develop and test the psychometric properties of a new sexuality and contraception knowledge instrument. Methods This is a cross-sectional study to validate the sexuality and contraception knowledge instrument. The validation process followed four phases: (1) development of the instrument, (2) content validation by an expert panel, (3) pilot test and (4) psychometric analysis of the instrument using item response theory according to the Rasch model. The validation process took place from September 2017 to February 2018. Results The sample included 387 students enrolled at the Nursing and Law degrees from the University of Jaen. The final instrument was made up of 15 items. All of the items presented good adaptation values with respect to the model. The scale showed good fit and reliability: 0.99 for items and 0.74 for people. The temporal stability of the scale was calculated using test–retest, obtaining a value of 0.81 (CI 0.692–0.888). The construct validity showed the one-dimensionality of the construct, while the discriminant validity obtained good results, so the scale appears to be able to differentiate between participants with low or high levels of knowledge. Conclusion The results suggest the Sexuality and Contraception Knowledge Instrument is psychometrically valid and reliable for measuring the knowledge level concerning sexuality and contraceptive methods in young university students.

Resumen: Objetivo: Evaluar la efectividad de las intervenciones educativas dirigidas a prevenir el embarazo en la adolescencia. Diseño: Revisión sistemática. Fuentes de datos: Se consultaron las bases de datos PubMed, CINAHL, Scopus, Cuiden Plus, LILACS e IME para buscar estudios sobre intervenciones educativas para la prevención del embarazo en la adolescencia. Selección de estudios: Se seleccionaron un total de 24 investigaciones primarias, donde se evaluaba el efecto de un programa educativo para la prevención del embarazo en la adolescencia. La calidad de los estudios seleccionados se evaluó usando la escala CASPe. Resultados: Los programas educativos que midieron una modificación de la tasa de embarazo en la adolescencia muestran resultados poco concluyentes, ya que 2 investigaciones obtienen una reducción y otros 2 no hallan cambios significativos. Sin embargo, los programas educativos se muestran efectivos para aumentar el nivel de conocimiento sobre sexualidad y métodos anticonceptivos, y para modificar las actitudes sobre el riesgo de embarazo en la adolescencia o las actitudes hacia el uso de los métodos anticonceptivos. No se encuentran diferencias estadísticamente significativas entre los estudios que muestran un resultado positivo y los estudios con resultado negativo (p > 0,05) para ninguno de los resultados analizados en la revisión. Conclusión: No existe una modalidad de intervención que sea la más efectiva para la prevención de un embarazo en la adolescencia. Se necesita un mayor número de investigaciones con un abordaje longitudinal que valoren no solo resultados intermedios, sino una modificación en la tasa de embarazo. Abstract: Objective: To assess the effectiveness of the interventions to prevent a pregnancy in adolescence. Design: Systematic review. Data sources: The following databases were consulted: PubMed, CINAHL, Scopus, Cuiden Plus, LILACS, and IME, in order to identify interventions aimed at preventing a pregnancy in adolescence. Study selection: A total of 24 primary investigations, in which an educational program to prevent a pregnancy in the adolescence was evaluated, were selected. The quality of the selected studies was assessed according to the CASPe scale. Results: Educational programs for the modification of the teenage pregnancy rate show inconclusive results, as there are 2 studies that find a reduction, and 2 that find that there are no significant changes. For secondary outcomes, it was found that educational programs are effective for increasing the knowledge level about sexuality and contraceptive methods and changing attitudes about the risk of a teenage pregnancy or the use of contraceptive methods. There are no statistically significant differences between the studies with a positive and negative outcome (P > .05) for any of the results analysed in this review. Conclusion: There is no a single intervention modality that is the most effective for prevention of a teenage pregnancy. More research is needed with a longitudinal approach that assess not only intermediate results, but also a modification in the pregnancy rate. Palabras clave: Embarazo en la adolescencia, Prevención primaria, Educación sanitaria, Revisión sistemática, Keywords: Pregnancy in adolescence, Primary prevention, Health education, Systematic review

Copoly(o-hydroxyamide)s (HPA) and copoly(o-hydroxyamide-amide)s (PAA) have been synthesized to be used as continuous phases in mixed matrix membranes (MMMs). These polymeric matrices were blended with different loads (15 and 30 wt.%) of a relatively highly microporous porous polymer network (PPN). SEM images of the manufactured MMMs exhibited good compatibility between the two phases for all the membranes studied, and their mechanical properties have been shown to be good enough even after thermal treatment. The WAX results show that the addition of PPN as a filler up to 30% does not substantially change the intersegmental distance and the polymer packing. It seems that, for all the membranes studied, the free volume that determines gas transport is in the high end of the possible range. This means that gas flow occurs mainly between the microvoids in the polymer matrix around the filler. In general, both HPA- and PAA-based MMMs exhibited a notable improvement in gas permeability, due to the presence of PPN, for all gases tested, with an almost constant selectivity. In summary, although the thermal stability of the PAA is limited by the thermal stability of the polyamide side chain, their mechanical properties were better. The permeability was higher for the PAA membranes before their thermal rearrangement, and these values increased after the addition of moderate amounts of PPN.

Mixed matrix membranes (MMMs), derived from three aromatic polyimides (PIs), and an affordable porous organic polymer (POP) having basic bipyridine moieties were prepared. Matrimid and two fluorinated polyimides, which were derived from 4,4′-(hexafluoroisopropylidene)diphthalic anhydride and 2,2′-bis(4-aminophenyl)hexafluoropropane (6F6F) or 2,4,6-trimethyl-m-phenylenediamine (6FTMPD), were employed as polymer matrixes. The used POP was a highly microporous material (surface area of 805 m2 g−1) with excellent thermal and chemical stability. The MMMs showed good compatibility between the PIs and POP, high thermal stabilities and glass transition temperatures superior to those of the neat PI membranes, and good mechanical properties. The addition of POP to the matrix led to an increase in the gas diffusivity and, thus, in permeability, which was associated with an increase in the fractional free volume of MMMs. The increase in permeability was higher for the less permeable matrix. For example, at 30 wt.% of POP, the permeability to CO2 and CH4 of the MMMs increased by 4- and 7-fold for Matrimid and 3- and 4-fold for 6FTMPD. The highest CH4 permeability led to a decrease in CO2/CH4 selectivity. The CO2/N2 separation performance was interesting, as the selectivity remained practically constant. Finally, the POP showed no molecular sieving effect towards the C2H4/C2H6 and C3H6/C3H8 gas pairs, but the permeability increased by about 4-fold and the selectivity was close to that of the matrix. In addition, because the POP can form metal ion bipyridine complexes, modified POP-based MMMs could be employed for olefin/paraffin separations.

The use of drones for triage in mass-casualty incidents has recently emerged as a promising technology. However, there is no triage system specifically adapted to a remote usage. Our study aimed to develop a remote triage procedure using drones. The research was performed in three stages: literature review, the development of a remote triage algorithm using drones and evaluation of the algorithm by experts. Qualitative synthesis and the calculation of content validity ratios were done to achieve the Aerial Remote Triage System. This algorithm assesses (in this order): major bleeding, walking, consciousness and signs of life; and then classify the injured people into several priority categories: priority 1 (red), priority 2 (yellow), priority 3 (green) and priority * (violet). It includes the possibility to indicate save-living interventions to injured people and bystanders, like the compression of bleeding injuries or the adoption of the recovery position. The Aerial Remote Triage System may be a useful way to perform triage by drone in complex emergencies when it is difficult to access to the scene due to physical, chemical or biological risks.

Objetivo: Identificar las conexiones entre los investigadores más citados y el impacto de autores, revistas y contenidos en el campo de ojo seco tras cirugía refractiva, para focalizar la futura investigación en ello. Método: Se realizó una búsqueda de “ojo seco y cirugía refractiva” en Web of Science, y se limitó el campo para artículo, palabras clave y resumen, vinculados con “OR”. El archivo resultante se analizó con el software CitNetExplorer® y se obtuvieron las publicaciones más citadas. Se realizó otro subanálisis sobre citaciones entre autores para identificar grupos y publicaciones principales. Resultados: Se hallaron 220 publicaciones entre 1997 y 2019 que generaron 675 citaciones en la red. Los 20 artículos más citados, encabezados por Hovanesain, et al., fueron publicados por Journal of Cataract and Refractive Surgery y Journal of Refractive Surgery. Mediante las funciones “cluster” y “core” se obtuvieron dos grupos y 106 artículos con al menos cuatro citas en la red, respectivamente. Conclusiones: Las técnicas actuales de cirugía refractiva son procedimientos avanzados y su complicación más frecuente es la aparición de ojo seco, que provoca insatisfacción y disminución de la calidad de vida de los pacientes. El ojo seco y la cirugía refractiva son un área destacada para los investigadores, con una cantidad significativa de publicaciones y conexiones entre ellos. Ampliar el conocimiento en este ámbito servirá para la mejora de aplicaciones clínicas con el fin de disminuir la aparición de ojo seco.

Objective To describe the epidemiological characteristics and trends of work-related eye injuries (WREIs) in Spain over a 10-year period by sex, age and occupational sector.Design and settings A descriptive, retrospective and longitudinal study based on data from workers insured by a labour insurance company in Spain from 2008 to 2018 was presented. The study considered the ratio of the number of WREI per 100 000 population and the relative risk of suffering an ocular injury. WREIs were characterised by sex, age and occupational sector of injured workers.Primary and secondary outcome measures Ratio of the number of WREI.Participants In Spain, all workers are insured by a labour insurance company that provides cover in the event of work-related accidents. In this study, we have included all workers insured by one of these insurance companies, IBERMUTUA, with workers in all areas of Spain.Results The study included 50 265 WREI in the company over the 10-year period. Most of the injuries occurred in males (44 445; 88.4%), in 35–44 age group (15 992; 31.8%) and in industry workers (18 899; 42.6%). The average incidence was 429.75 per 100 000 workers insured and 4273.36 per 100 000 IBERMUTUA accidents (related and not related to eyes). Males, 16–24 age group and industry occupational sector group, have the highest incidence for WREI. The incidence of WREI decrease over the study period in all variables. Males have 6.56 (95% CI 6.38 to 6.75) times more risk of suffering WREI than females. 16–24 age group have 1.77 (95% CI 1.71 to 1.83) times more risk than in the group of workers older than 55. Finally, industry workers have 7.73 (95% CI 7.55 to 7.92) times more risk than services workers.Conclusions The risks of suffering WREI is higher for males, younger and less experienced workers, and for those who works in a manual task.

Resumen: Objetivo: Este estudio evalúa la influencia del crecimiento de la población en la utilización del Servicio de Urgencias Pediátricas de un hospital universitario de Cantabria (España) entre enero de 2001 y diciembre de 2013. Material y métodos: Se realizó un estudio retrospectivo de todas las urgencias ocurridas durante 13 años. Se emplean modelos de regresión lineal simple y polinómica para analizar la relación entre la población y la frecuentación en 2 grupos de edad (0-2 y 3-14 años). Resultados: De 2001 a 2013, las urgencias aumentaron un 14,1% y la población pediátrica un 26,3%. Las tasas de presentación por persona fueron mayores en los menores de 3 años, 1,48 (IC 95% 1,40 a 1,56) frente a 0,46 (IC 95% 0,44 a 0,48) (p

Objective: The aim of the present study is to describe the trend in volume and age-specific rates in visits to the paediatric emergency department of a university teaching hospital in Cantabria (Spain) from January 2001 to December 2013, and evaluate the influence of population growth on emergency department use. Material and methods: A retrospective study was conducted to analyze all emergency department visits over a 13 year period. Simple and polynomial linear regressions were used to assess the relationship between population size and emergency department attendance rates across 2 age groups (0–2 and 3–14 years). Results: From 2001 to 2013, attendance in the emergency department increased by 14.1%, whereas the paediatric population rose by 26.3%. Rates of presentation per head of population were greatest among those aged

In this work, the dissipation of the antibiotics doxycycline (DC) (from the group of tetracyclines), enrofloxacin (ENR) (a fluoroquinolone), and sulfamethoxypyridazine (SMP) (a sulfonamide) is investigated both under simulated sunlight and in the dark, at three different pH (4.0, 5.5, and 7.2), and in the presence of different salts and humic acids. The results indicate that all three antibiotics are very sensitive to photodegradation, and this sensitivity increased with rising pH values, from 4.0 to 7.2. The rise in pH also caused an increase in the degradation kinetic constants and a decrease in the half-lives of antibiotics. In general, the half-lives ranged from a few minutes to 6 h, depending on the pH conditions and the specific antibiotic, and followed the sequence DC > SMP > ENR, although at pH 5.5 the sequence changed to SMP > DC > ENR. After 24 h of simulated sunlight, mineralization was always lower than 10%, although the antibiotic was not quantifiable after the same time of exposure to light (24 h), which indicates that intermediate compounds were generated. The effect of the presence of salts on the dissipation of the three antibiotics was negligible for NaCl and NaNO3, while NaHCO3 did favor the dissipation of DC and ENR. The presence of humic acids showed no effect on the dissipation of SMP, and it only slightly increased the dissipation of DC and ENR. These results may be useful in the assessment of the persistence/degradation of the antibiotics studied when they reach different environmental compartments and may suffer exposure to light under different physicochemical conditions.

The valorization of municipal solid waste (MSW) can serve as an organic amendment in agriculture while reducing solid waste accumulation in the environment. This research aimed to evaluate the valorization of a bio-stabilized MSW amendment for the production of faba bean (Vicia faba L.) crop. For this purpose, biomass production and growth, as well as, seed yield and seed components, seed nutrient accumulation, plant pigments, soil properties, and microorganisms were evaluated in comparison with faba bean mineral fertilization in a greenhouse experiment. The results demonstrated that the bio-stabilized MSW amendment achieved similar biomass production, plant growth, seed yield, nitrogen and protein content, and pigment content as the mineral fertilization treatment. On the other hand, the organic fertilization did not exhibit significant effects on the yield components number of pods per plant, and number of seeds per pod, and nutrient accumulation in seeds with respect to mineral and control treatments in both soils. Sandy and clay soil properties were improved in the organic treatments in comparison with the control soils by increasing soil organic carbon, nitrogen, and other soil nutrients, and providing a suitable pH for faba bean growth. Additionally, biological activity was favored by applying this source of organic fertilizer, enriching the nematode community. Reusing bio-stabilized MSW for agronomical purposes can add value to this waste product, serving as an effective alternative to mineral fertilizers in faba bean cultivation.

La prevalencia de miopía varía en las diferentes poblaciones del mundo y la incidencia aumenta de una forma acelerada, motivo por el cual los defectos refractivos se convierten en un problema de salud pública, con un impacto económico y social. La progresión de la miopía puede desencadenar cambios patológicos en el globo ocular que afectan estructuras como el cristalino, la retina, la coroides y la mácula. Estos cambios degenerativos constituyen la causa más frecuente de pérdida de visión y se relacionan con un incremento en los valores refractivos, que ascienden desde la infancia hasta la adultez. El desarrollo y progresión se relacionan con un componente genético y hereditario, sin embargo, hay una compleja interacción con factores externos, los cuales podrían explicar el incremento de casos en algunas poblaciones, en donde se perciben aumentos de urbanización y la necesidad por alcanzar altos niveles de educación. Además, otros factores ambientales como destinar mayor tiempo a actividades al aire libre puede ser un hábito favorable para evitar la aparición de la enfermedad.

Antecedentes: La neuromonitorización intraoperatoria intermitente del nervio laríngeo recurrente es el complemento ideal en las cirugías tiroideas, ya que disminuye las lesiones. Objetivo: Analizar la prevalencia de lesiones del nervio laríngeo recurrente con y sin el uso de neuromonitorización en cirugía de tiroides. Método: Estudio observacional, descriptivo y retrospectivo, en el que se incluyeron 571 pacientes entre los años 2012 y 2018. De ellos, en 180 se utilizó neuromonitorización y en 391 no. Resultados: De los 180 pacientes que se sometieron a tiroidectomía total con neuromonitorización hubo 8 (4.4%) parálisis transitorias y 2 (1.1%) parálisis definitivas. Sin el uso de neuromonitorización hubo 12 (3%) parálisis transitorias y 7 (1.85%) definitivas. Conclusiones: Creemos que la neuromonitorización debe usarse sistemáticamente con la técnica habitual. Obtenemos resultados significativos con respecto a la reducción de las lesiones del nervio laríngeo recurrente con el uso de neuromonitorización intraoperatoria.

Increasing awareness of resource sustainability and waste management has led to the search for solutions while promoting circular economy principles. Among all kinds of lignocellulosic biomass available, one with growing interest is municipal forestry and greening waste (MFGW). MFGW makes up an important part of waste streams of municipal solid waste and is a potential feedstock for biological conversion in a lignocellulosic biorefinery. This work studied the fermentable sugars production from MFGW after steam explosion (SE) pretreatment combined with other pretreatments such as dilute acid, organosolv, and metal salts. A range of pretreatment conditions was evaluated according to different parameters: sugars recovery, degradation product generation, and enzymatic hydrolysis yield. At selected pretreatment conditions (diluted acid plus SE, 195 °C, 10 min, and 60 mg H2SO4/g MFGW), 77% of potential sugars content in MFGW was obtained. The effect of solids loading and enzyme dose on glucose release and glucose yield on enzymatic hydrolysis were also determined. Up to 70% of the main sugars in the MFGW were recovered for the coupled pretreatment and enzymatic hydrolysis (45 FPU/g glucan enzyme loading and 20% dry matter solid consistency), resulting in 80 g/L glucose that could be further utilized for ethanol production.

Álvarez de Morales, C. (2018): “Turismo accesible y evaluación de usuarios con diversidad funcional visual. Los proyectos OPERA y PRA2”. Revista Española de Discapacidad, 6 (I): 305-316.

OBJECTIVE:To evaluate the potential signaling effect of the Mexican tax on sugar-sweetened beverages (SSBs) by analyzing the association between awareness of and opinions about its effectiveness with current consumption of taxed SSBs and with a self-reported change in consumption of SSBs since the implementation of the tax. We also examined the association between psychosocial and environmental determinants of SSB consumption with current consumption of taxed SSBs and with a reported change in consumption of SSBs. METHODS:Cross-sectional analyses of survey and food-frequency questionnaire data from the Mexican National Health and Nutrition Survey 2016. Participants were Mexican adults (20-59 years, N = 6,650). Logistic regression was used to evaluate the probability of a person reporting a decrease in SSB consumption, given their awareness of the tax, opinion about its effectiveness, psychosocial (SSB health-related beliefs, self-efficacy, and liking of SSBs) and environmental (availability of potable water) determinants. Multiple linear regression analysis was utilized to examine the association between the aforementioned factors and current consumption of taxed SSBs. RESULTS:Compared with adults not aware, adults who were aware of the SSB tax were more likely (OR = 1.30) to report a decrease in SSB consumption (p = .012). In urban areas, adults aware of the tax drank a significantly lower amount of taxed SSBs (-15.7%; p = .023) than those not aware. Self-efficacy and liking of SSBs were significantly associated with a reported decrease in consumption and with current consumption (p < .001), while health beliefs and availability of potable water were not significantly associated with either reported change in SSB consumption or current consumption of taxed SSBs. CONCLUSIONS:Implementation of an SSB tax accompanied by highly visible campaigns may further influence the impact of taxes on SSBs consumption. Future public health and nutrition education campaigns designed to increase knowledge and enhance motivation should be complemented by programs to assist individuals develop self-efficacy and self-regulation skills.

La presente experiencia es el resultado de una nueva metodología aplicada en las clases de la asignatura de Traducción accesible impartida desde el 2014 en el Máster Universitario en Traducción Profesional de la Universidad de Granada. El objetivo principal fue aplicar la modalidad de traducción accesible a espacios turísticos innovando la docencia de la traducción. La metodología utilizada se basa en la aplicación de las teorías socio-constructivistas a las clases de traducción accesible; en concreto, enseñaremos la forma de elaborar la audiodescripción de dos entornos arquitectónicos de la ciudad de Granada: (a) la fachada de la catedral de Granada y (b) de la Iglesia del Sagrario. La audiodescripción de estos espacios constituía un contexto ideal (macrotexto) para que el alumnado trascendiera el aula, experimentara la epistemología del proceso traductor y fuera capaz de crear sus textos meta. Para completar este proceso, el alumnado realizó un estudio de recepción a una persona ciega que evaluó los materiales accesibles creados en clase. Para llevar a cabo esta evaluación se utilizaron una encuesta y entrevista. Ambas ayudaron a medir variables de perfil, así como los contenidos de las audiodescripciones. La utilidad de estas herramientas empleadas se puso de manifiesto en la satisfacción que expresó la persona ciega con aquella audiodescripción que cubría sus expectativas.

This paper is based on the study of different elements at the University of Granada’s Faculty of Translation and Interpreting and seeks to elaborate a prototype for a multilingual and accessible audio guide (audio description, SDHH and Spanish sign language interpretation). We defend a new methodology, one that focuses on teaching the translation process from previous museum-based learning experiences in the translation classroom using QR codes. Our main goal is to innovate translation-related teaching based on the new approaches acquired through learning workshop perspectives. In this sense, we will offer an ideal framework in developing the new concept of translation learning. This concept involves systemising a new means of learning and organising the realities of translation itself, encompassing objectives, competences, methodology and evaluation.

Purpose: In light of the world's accelerating march towards a sustainable future, the education for sustainable healthcare must be sufficiently acknowledged in health professions curricula. Early integration of these competences into nursing degree programme emphasizes its importance and applicability. This paper aims to investigate the effectiveness of an educational sustainability intervention in higher education to change nursing students' attitudes towards sustainability and climate change, and environmental awareness. Design/methodology/approach: A quasi-experimental study was performed with repeated measures between September 2019 and May 2023. Undergraduate students were introduced to sustainability and climate change in the context of healthcare using scenario-based learning and augmented reality over the courses in nursing degree. Participants' attitudes and awareness were collected by online questionnaires. Findings: The educational intervention showed effectiveness in significantly improving attitudes towards climate change and sustainability, and the environmental awareness for changing their clinical practice (p < 0.01). However, students struggled to apply sustainability and address unsustainable practices in healthcare settings. Originality/value: This study shows an effective model of curricular sustainability that can be implemented in other universities and health disciplines. The findings highlighting the importance of sustainability education in nursing and its potential to drive positive change in healthcare practice and society at large. Embedding key topics aligned with sustainable development goals in the curriculum prepares nursing or health workforce to address planetary health and implement sustainable practices that provide climate-smart care.