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Background: Wound healing competence is implied in the nursing profession, but there is no standardized content regulation for wound care in university curricula. The primary objective of this study was to identify the barriers to the acquisition of knowledge about skin integrity impairment. Methods: A quasi-experimental pre-test and post-test study with an ad hoc questionnaire involved 304 students (control: 165; intervention: 139) from June to July 2023. A 10-h educational intervention focused on skin integrity assessment and treatment was conducted. Results: The control group, scoring 17 ± 0.22 out of a maximum of 61, achieved a significantly lower final test score (p < 0.001) compared to the wound care educational intervention group, with the pre-test group scoring 30 ± 0.76 and the post-test group scoring 43 ± 0.61. The educational intervention in wound care program improved nursing students’ knowledge of prevention, assessment/diagnosis, treatment, lower limb wounds, and wound bed preparation by replacing the number of "Don’t know" answers in the post-test group with correct answers. Conclusions: The barriers identified to the acquisition of knowledge about skin integrity impairment in nursing studies are the following: the transversality of teaching, the teaching and evaluation system, and the variability in the training of professionals and teachers in charge of their education. The educational intervention can be used to consolidate knowledge and to enhance students’ self-confidence in caring for patients with wounds.

Abstract The immune effector mechanisms involved in protecting against severe COVID-19 infection in elderly nursing home residents following vaccination or natural infection are not well understood. Here, we measured SARS-CoV-2 Spike (S)-directed functional antibody responses, including neutralizing antibodies (NtAb) and antibody Fc-mediated NK cell activity (degranulation and IFNγ production), against the Wuhan-Hu-1, BA.4/5 (for NtAb), and Omicron XBB.1.5 variants in elderly nursing home residents (n = 39; median age, 91 years) before and following a third (pre- and post-3D) and a fourth (pre- and post-4D) mRNA COVID-19 vaccine dose. Both 3D and 4D boosted NtAb levels against both (sub)variants. Likewise, 3D and 4D increased the ability of sera to trigger both LAMP1- and IFNγ-producing NK cells, in particular against XBB.1.5. In contrast to NtAb titres, the frequencies of LAMP1- and IFNγ-producing NK cells activated by antibodies binding to Wuhan-Hu-1 and Omicron XBB.1.5 S were comparable at all testing times. Stronger functional antibody responses were observed in vaccine-experienced participants compared to vaccine-naïve at some testing times. These findings can contribute to identifying a reliable correlate of protection in elderly nursing home residents against severe COVID-19 and inform future vaccine strategies in this population group.

Introducción: estudios previos informaron un aumento de los debuts de diabetes mellitus tipo 1 (DM1) en niños residentes de las regiones gravemente afectadas por la pandemia de COVID-19. Objetivos: determinar las tasas y la severidad de los debuts por DM1 en poblaciones pediátricas de varios centros argentinos durante la pandemia de COVID-19 durante el confinamiento de 2020, y compararlos con la prepandemia (2018-2019) y la pospandemia (2021-2022). Materiales y métodos: revisión retrospectiva de historias clínicas donde se determinaron las tasas de debuts de DM1 en niños de 6 meses a 16 años durante el confinamiento (2020), la prepandemia (2018 y 2019) y la pospandemia (2021-2022) en 28 centros argentinos. Para determinar la tasa de debuts de DM1, se dividió el número de debuts de DM1 por año por la población proyectada. Resultados: se incluyeron 1997 casos (48,5% mujeres), el 50,1% tenía obra social. Los valores medios ± un desvío estándar fueron: edad 8,7±3,7 años, glucosa 468±184 mg/dL, HbA1c 11,3% ±2,5, pH 7,21±0,2 y bicarbonato 13,4±7,7. No hubo diferencias significativas en la edad, índice de masa corporal (IMC), glucosa y HbA1c entre 2018 y 2022. Sin embargo, el pH (7,19 versus 7,23) y el bicarbonato (12,5 versus 14,7 mEq/L) fueron significativamente más bajos en 2020 versus 2018. La tasa de debuts de DM1 por 100.000 habitantes fue mayor en 2020 (3,5) versus la prepandemia: 2,9 en 2018 y 3,2 en 2019. No obstante, durante 2021 y 2022 las tasas de DM1 fueron incluso superiores a la de 2020, con 4,4 y 4,0, respectivamente. Conclusiones: se ha registrado un aumento de debuts de DM1 en diferentes centros médicos de Argentina desde la pandemia. Los niveles de bicarbonato y pH de los debuts de DM1 fueron significativamente más bajos durante el confinamiento por la pandemia (2020) comparados con la prepandemia (2018).

Abstract To determine the readmissions trends and the comorbidities of patients with heart failure that most influence hospital readmission rates. Heart failure (HF) is one of the most prevalent health problems as it causes loss of quality of life and increased health-care costs. Its prevalence increases with age and is a major cause of re-hospitalisation within 30 days after discharge. INCA study had observational and ambispective design, including 4,959 patients from 2000 to 2019, with main diagnosis of HF in Extremadura (Spain). The variables examined were collected from discharge reports. To develop the readmission index, capable of discriminating the population with higher probability of re-hospitalisation, a Competing-risk model was generated. Readmission rate have increased over the period under investigation. The main predictors of readmission were: age, diabetes mellitus, presence of neoplasia, HF without previous hospitalisation, atrial fibrillation, anaemia, previous myocardial infarction, obstructive pulmonary disease (COPD) and chronic kidney disease (CKD). These variables were assigned values with balanced weights, our INCA index showed that the population with values greater than 2 for men and women were more likely to be re-admitted. Previous HF without hospital admission, CKD, and COPD appear to have the greatest effect on readmission. Our index allowed us to identify patients with different risks of readmission.

La0.6Sr0.4CoO3 (LSC) coatings with a thickness of 50–100 µm were deposited on Fe-25Cr ferritic stainless steel (DIN 50049) via screen printing. The required suspension had been prepared using fine LSC powders synthesised using EDTA gel processes. In its bulk form, the LSC consisted entirely of the rhombohedral phase with space group R-3c, and it exhibited high electrical conductivity (~144 S·cm−1). LSC-coated steel was oxidised in air at 1073 K, i.e., under conditions corresponding to SOFC cathode operation, for times of up to 144 h. The in situ electrical resistance of the steel/La0.6Sr0.4CoO3 layered system during oxidation was measured. The products formed on the samples after the oxidation reaction resulting from exposure to the corrosive medium were investigated using XRD, SEM-EDS, and TEM-SAD. The microstructural, nanostructural, phase, and chemical analysis of films was performed with a focus on the film/substrate interface. It was determined that the LSC coating interacts with the oxidised steel in the applied conditions, and a multi-layer interfacial zone is formed. Detailed TEM-SAD observations indicated the formation of a main layer consisting of SrCrO4, which was the reaction product of (La,Sr)CoO3, and the Cr2O3 scale formed on the metal surface. The formation of the SrCrO4 phase resulted in improved electrical conductivity of the investigated metal/ceramics layered composite material, as demonstrated by the low area-specific resistance values of 5 mΩ·cm2, thus making it potentially useful as a SOFC interconnect material operating at the tested temperature. In addition, the evaporation rate of chromium measured for the uncoated steel and the steel/La0.6Sr0.4CoO3 layered system likewise indicates that the coating is capable of acting as an effective barrier against the formation of volatile compounds of chromium.

IntroductionSilver-releasing dressings are used in the treatment of infected wounds. Despite their widespread use, neither the amount of silver released nor the potential in vivo toxicity is known. The aim of this study was to evaluate the cytotoxic effects and the amount of silver released from commercially available dressings with infected wounds.MethodsThe review was conducted according to the PRISMA statement. The Web of Science, PubMed, Embase, Scopus, and CINAHL databases were searched for studies from 2002 through December 2022. The criteria were as follows: population (human patients with infected wounds); intervention (commercial dressings with clinical silver authorized for use in humans); and outcomes (concentrations of silver ions released into tissues and plasma). Any study based on silver-free dressings, experimental dressings, or dressings not for clinical use in humans should be excluded. According to the type of study, systematic reviews, experimental, quasi-experimental, and observational studies in English, Spanish, or Portuguese were considered. The quality of the selected studies was assessed using the JBI critical appraisal tools. Studies that assessed at least 65% of the included items were included. Data were extracted independently by two reviewers.Results740 articles were found and five were finally selected (all of them quasi-experimental). Heterogeneity was found in terms of study design, application of silver dressings, and methods of assessment, which limited the comparability between studies.ConclusionIn vivo comparative studies of clinical dressings for control of infection lack a standardized methodology that allows observation of all the variables of silver performance at local and systemic levels, as well as evaluation of its cytotoxicity. It cannot be concluded whether the assessed concentrations of released silver in commercial dressings for the topical treatment of infected wounds are cytotoxic to skin cells.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022351041, PROSPERO [CRD42022351041].

IntroductionIt is now clear that coronavirus disease 19 (COVID-19) severity is associated with a dysregulated immune response, but the relative contributions of different immune cells is still not fully understood. SARS CoV-2 infection triggers marked changes in NK cell populations, but there are contradictory reports as to whether these effector lymphocytes play a protective or pathogenic role in immunity to SARS-CoV-2.MethodsTo address this question we have analysed differences in the phenotype and function of NK cells in SARS-CoV-2 infected individuals who developed either very mild, or life-threatening COVID-19 disease.ResultsAlthough NK cells from patients with severe disease appeared more activated and the frequency of adaptive NK cells was increased, they were less potent mediators of ADCC than NK cells from patients with mild disease. Further analysis of peripheral blood NK cells in these patients revealed that a population of NK cells that had lost expression of the activating receptor NKG2D were a feature of patients with severe disease and this correlated with elevated levels of cell free NKG2D ligands, especially ULBP2 and ULBP3 in the plasma of critically ill patients. In vitro, culture in NKG2DL containing patient sera reduced the ADCC function of healthy donor NK cells and this could be blocked by NKG2DL-specific antibodies.DiscussionThese observations of reduced NK function in severe disease are consistent with the hypothesis that defects in immune surveillance by NK cells permit higher levels of viral replication, rather than that aberrant NK cell function contributes to immune system dysregulation and immunopathogenicity.

Crimean-Congo haemorrhagic fever (CCHF) virus (CCHFV) is a tick-borne zoonotic pathogen that can cause a lethal haemorrhagic disease in humans. Although the virus appears to be endemically established in the Iberian Peninsula, CCHF is an emerging disease in Spain. Clinical signs of CCHFV infection are mainly manifested in humans, but the virus replicates in several animal species. Understanding the determinants of CCHFV exposure risk from animal models is essential to predicting high-risk exposure hotspots for public health action. With this objective in mind, we designed a cross-sectional study of Eurasian wild boar (Sus scrofa) in Spain and Portugal. The study analysed 5,291 sera collected between 2006 and 2022 from 90 wild boar populations with a specific double-antigen ELISA to estimate CCHFV serum prevalence and identify the main determinants of exposure probability. To do so, we statistically modelled exposure risk with host- and environment-related predictors and spatially projected it at a 10 × 10 km square resolution at the scale of the Iberian Peninsula to map foci of infection risk. Fifty-seven (63.3 %) of the 90 populations had at least one seropositive animal, with seroprevalence ranging from 0.0 to 88.2 %. Anti-CCHFV antibodies were found in 1,026 of 5,291 wild boar (19.4 %; 95 % confidence interval: 18.3–20.5 %), with highest exposure rates in southwestern Iberia. The most relevant predictors of virus exposure risk were wild boar abundance, local rainfall regime, shrub cover, winter air temperature and soil temperature variation. The spatial projection of the best-fit model identified high-risk foci as occurring in most of western and southwestern Iberia and identified recently confirmed risk foci in eastern Spain. The results of the study demonstrate that serological surveys of CCHFV vector hosts are a powerful, robust and highly informative tool for public health authorities to take action to prevent human cases of CCHF in enzootic and emergency settings.

In this study, we focused on the occurrence of respiratory disorders in rabbit farms, as well as several risk factors. We based the assessment on 11 217 visits to 1288 commercial farms in Spain and Portugal from 1996 to 2020. There was a sub-set of 307 visits due to respiratory system issues on 172 farms; the main causes were high prevalence of rhinitis in does and high mortality risk in weaned rabbits. During the 25-yr observational study, we physically examined 29 000 males and 200 000 lactating does to monitor their sanitary status on 894 farms. The mean annual prevalence of clinical rhinitis (CR) and 95% binomial confidence interval (CI) in does was 19.9% (95% CI [19.7-20.1%]). We observed an improvement as prevalence of annual CR fell from 29.6% in 1996 to 15.2% in 2020. The main risk factor for rhinitis was the rabbit line, followed by gender (males become sick more than females) and age of females. The median age of farmed does was 5 parities (minimum to maximum: 1-39). The enabling risk factors were year, season (more often affected in summer) and service timing (lowest prevalence when does were served ≥32 d postpartum). In a sub-set of 208 farms, we determined the prevalence of apparent atrophic rhinitis, which was 0.04% in females and 0.11% in males. Concerning bacteriological studies with 444 samples from 153 farms, Pasteurella multocida and Staphylococcus aureus were the main agents isolated from cases of pneumonia, rhinitis and other issues. We may infer that much work is required to determine in greater detail the factors linked to the farm environment and apply this knowledge in practice.

Abstract Background Promoter hypermethylation of tumour suppressor genes is frequently observed during the malignant transformation of colorectal cancer (CRC). However, whether this epigenetic mechanism is functional in cancer or is a mere consequence of the carcinogenic process remains to be elucidated. Results In this work, we performed an integrative multi-omic approach to identify gene candidates with strong correlations between DNA methylation and gene expression in human CRC samples and a set of 8 colon cancer cell lines. As a proof of concept, we combined recent CRISPR-Cas9 epigenome editing tools (dCas9-TET1, dCas9-TET-IM) with a customized arrayed gRNA library to modulate the DNA methylation status of 56 promoters previously linked with strong epigenetic repression in CRC, and we monitored the potential functional consequences of this DNA methylation loss by means of a high-content cell proliferation screen. Overall, the epigenetic modulation of most of these DNA methylated regions had a mild impact on the reactivation of gene expression and on the viability of cancer cells. Interestingly, we found that epigenetic reactivation of RSPO2 in the tumour context was associated with a significant impairment in cell proliferation in p53−/− cancer cell lines, and further validation with human samples demonstrated that the epigenetic silencing of RSPO2 is a mid-late event in the adenoma to carcinoma sequence. Conclusions These results highlight the potential role of DNA methylation as a driver mechanism of CRC and paves the way for the identification of novel therapeutic windows based on the epigenetic reactivation of certain tumour suppressor genes.

Reports on neoplasms in bears are scarce, especially concerning ovarian tumors. A large primary ovarian neoplasm with multiple metastasis was found during the necropsy of a 14-year-old free-ranging Eurasian brown bear (Ursus arctos) from Northwestern Spain. Histopathology and immunohistochemistry allowed for the diagnosis of a sex cord stromal tumor. This is a complex group of neoplasms which differ in the predominant cell morphology and immunohistochemical features. The microscopic examination revealed two types of cells, one with eosinophilic cytoplasm, intermingled with larger vacuolated cells rich in lipids. The evaluation of the immunoreactivity to different markers, frequently used in the characterization of gonadal tumors (INHA, inhibin-alpha; PLAP, placental alkaline phosphatase; Ki-67; α-SMA, actin alpha-smooth muscle) and inflammation patterns (IBA1, ionized calcium-binding adapter molecule for macrophages; CD3 for T lymphocytes; CD20 for B lymphocytes), displayed significant INHA positive immunostaining of neoplastic cells, as well as inflammatory cell infiltration, mainly composed of macrophages and B lymphocytes. These findings were consistent with a malignant ovarian steroid cell tumor, not otherwise specified. The present study characterizes an unusual type of neoplasm, and also represents the first report of an ovarian sex cord stromal tumor in Ursidae.

N-alkyl-substituted polyacrylamides exhibit a thermal coil-to-globule transition in aqueous solution driven by an increase in hydrophobic interactions with rising temperature. With the aim of understanding the role of N-alkyl substituents in the thermal transition, this study focuses on the molecular interactions underlying the phase transition of poly(N,N-diethylacrylamide-co-N-ethylacrylamide) random copolymers. Poly(N,N-diethylacrylamide) (PDEAm), poly(N-ethylacrylamide) (PNEAm), and their random copolymers were synthesized by free radical polymerization and their chemical structure characterized spectroscopically. It was found that the values of the cloud-point temperature increased with PNEAm content, and particle aggregation processes took place, increasing the negative charge density on their surface. The cloud-point temperature of each copolymer decreased with respect to the theoretical values calculated assuming an absence of interactions. It is attributed to the formation of intra- and interchain hydrogen bonding in aqueous solutions. These interactions favor the formation of more hydrophobic macromolecular segments, thereby promoting the cooperative nature of the transition. These results definitively reveal the dominant mechanism occurring during the phase transition in the aqueous solutions of these copolymers.

Objective The main objective of the study was to evaluate the influence of arterial hypertension, diabetes, dyslipidaemia, smoking, alcoholism and COPD (chronic obstructive pulmonary disease) on the viability of the extracted tissue as well as the donor.Design Observational case–control study.Setting Regional hospital in Northern Spain.Participants 1517 corneas were registered.Interventions Patients’ medical history was reviewed after corneal donation and evaluation. Previous medical information (age, sex and cardiovascular risk factors (CVRFs)) and data related to the donor (type of donor), the corneal tissue and its evaluation, and the viability of the implant were collected.Results A total of 1517 corneas were registered and 81.5% of the donors presented at least one CVRF. In relation to the viability of the donor, it was observed that having suffered from COPD reduced the viability of the donor (no COPD: 93.8% vs COPD: 88%; OR=0.49; 95% CI: 0.28 to 0.84) while alcohol consumption increased it (drinker or ex-drinker: 95.8% vs non-drinker: 92.5%; OR=1.84; 95% CI: 1.01 to 3.33). Regarding tissue viability, decreased viability was observed in the presence of COPD (no COPD: 72.5% vs COPD: 64; OR=0.67; 95% CI: 0.47 to 0.96) and diabetes mellitus (no diabetes: 72.9% vs diabetes: 67.2%; OR=0.76; 95% CI: 0.58 to 0.99). As regards the viability of the implant, a total of 1039 corneas (68.9%) were suitable, observing decreased viability when suffering from COPD (no COPD: 69.8% vs COPD: 60.7%; OR=0.67; 95% CI: 0.47 to 0.94) and increased when having an active smoking habit (no habit: 65.3% vs habit: 74.1%; OR=1.52; 95% CI: 1.21 to 1.91).Conclusions Through this study, it can be concluded that in the absence of absolute exclusion criteria for donors, the assessment of how CVRF, alcoholism and COPD may affect the donor provides details about the quality of the tissue to be obtained.

The selection of the most suitable material is one of the key decisions to be made during the design stage of a manufacturing process. Traditional approaches, such as Ashby maps based on material properties, are widely used in industry. However, in the production of multi-material components, the criteria for the selection can include antagonistic approaches. The aim of this work is to implement a methodology based on the results of process simulations for several materials and to classify them by applying an advanced data analytics method based on machine learning (ML)—in this case, the support vector regression (SVR) or multi-criteria decision-making (MCDM) methodology. Specifically, the multi-criteria optimization and compromise solution (VIKOR) was combined with entropy weighting methods. To achieve this, a finite element model (FEM) was built to evaluate the extrusion force and the die wear during the multi-material co-extrusion process of bimetallic Ti6Al4V-AZ31B billets. After applying SVR and VIKOR in combination with the entropy weighting methodology, a comparison was established based on material selection and the complexity of the methodology used. The results show that the material chosen in both methodologies is very similar, but the MCDM method is easier to implement because there is no need for evaluating the error of the prediction model, and the time required for data preprocessing is less than the time needed when applying SVR. This new methodology is proven to be effective as an alternative to traditional approaches and is aligned with the new trends in industry based on simulation and data analytics.

This paper investigates the effect of GaAsBi strain reduction layers (SRLs) on InAs QDs with different Bi fluxes to achieve nanostructures with improved temperature stability. The SRLs are grown at a lower temperature (370 °C) than the usual capping temperature for InAs QDs (510 °C). The study finds that GaAs capping at low temperatures reduces QD decomposition and leads to larger pyramidal dots but also increases the threading dislocation (TD) density. When adding Bi to the capping layer, a significant reduction in TD density is observed, but unexpected structural changes also occur. Increasing the Bi flux does not increase the Bi content but rather the layer thickness. The maximum Bi content for all layers is 2.4%. A higher Bi flux causes earlier Bi incorporation, along with the formation of an additional InGaAs layer above the GaAsBi layer due to In segregation from QD erosion. Additionally, the implementation of GaAsBi SRLs results in smaller dots due to enhanced QD decomposition, which is contrary to the expected function of an SRL. No droplets were detected on the surface of any sample, but we did observe regions of horizontal nanowires within the epilayers for the Bi-rich samples, indicating nanoparticle formation.

The use of the common mode current for stator winding insulation condition assessment has been extensively studied. Two main approaches have been followed. The first models the electric behavior of ground-wall insulation as an equivalent RC circuit; these methods have been successfully applied to high-voltage high-power machines. The second uses the high frequency of the common mode current which results from the voltage pulses applied by the inverter. This approach has mainly been studied for the case of low-voltage, inverter-fed machines, and has not yet reached the level of maturity of the first. One fact noticed after a literature review is that in most cases, the faults being detected were induced by connecting external elements between winding and stator magnetic core. This paper presents a case study on the use of the high-frequency common mode current to monitor the stator insulation condition. Insulation degradation occurred progressively with the machine operating normally; no exogenous elements were added. Signal processing able to detect the degradation at early stages will be discussed.

Roller mills are commonly used in the production of mining derivatives, since one of their purposes is to reduce raw materials to very small sizes and to combine them. This research evaluates the mechanical condition of a mill containing four rollers, focusing on the largest cylindrical roller bearings as the main component that causes equipment failure. The objective of this work is to make a prognosis of when the overall vibrations would reach the maximum level allowed (2.5 IPS pk), thus enabling planned replacements, and achieving the maximum possible useful life in operation, without incurring unscheduled corrective maintenance and unexpected plant shutdown. Wireless sensors were used to capture vibration data and the ARIMA (Auto-Regressive Integrated Moving Average) and Holt–Winters methods were applied to forecast vibration behavior in the short term. Finally, the results demonstrate that the Holt–Winters model outperforms the ARIMA model in precision, allowing a 3-month prognosis without exceeding the established vibration limit.

BackgroundA large number of workers attend work despite being ill. Attending work during sickness can have a number of consequences for the worker (e.g., worsening of physical and mental condition), for co-workers, and for the company, and for service users.ObjectivesThe aim of this study was to assess the factors influencing presenteeism and mental health of workers during the COVID-19 pandemic.MethodsA systematic review following the PRISMA format was conducted in the PubMed, Scopus, Web of Science (WoS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, and ScienceDirect electronic databases in January 2023, using the following key words: Presenteeism, Mental Health, and COVID-19. The eligibility criteria applied were original articles published in English, Spanish, French, German, and Portuguese, workers during the COVID-19 pandemic (data collection date: January 01, 2020 – January 01, 2023), and articles assessing at least one measure of presenteeism and mental health status. Methodological quality was assessed using the critical appraisal tools of the Joanna Briggs Institute. The followed protocol is listed in the International Prospective Register of Systematic Reviews (PROSPERO) with code CRD42023391409.ResultsA total of 25 studies were included in this review recruiting a total of 164,274 participants. A number of factors influencing mental health and sickness presenteeism were identified: (1) mental health-related factors (burnout [in 4 studies], stress [in 9 studies], depression [in 1 study], fear of COVID-19 [in 1 study], no well-being [in 2 studies], etc.); (2) individual factors (health status [in 1 study], being young [in 1 study], workers who experienced interrupted medical care [in 2 studies], having a chronic disease [in 1 study], etc.); (3) factors related to the situation caused by COVID-19 (confinement, symptoms, loss of contract, risk of bankruptcy, etc. [in 1 study each one]); and (4) factors derived from working conditions (organisational support [in 1 study], patient care [in 1 study], work functioning or task performance impairment [in 4 studies], work fatigue [in 2 studies], safety climate [in 1 study], workload [in 1 study], etc.).ConclusionIdentifying the key determinants of presenteeism and understanding the phenomena and origins of sickness presenteeism will help to create a safe working environment and optimal organisational systems to protect vulnerable workers in a pandemic context.Systematic review registrationThe unique identifier is CRD42023391409.

La problemática ambiental cubana y en particular la guantanamera, está condicionada por una difícil situación económica, y caracterizada, por la escasa conciencia de los actores sociales y la insuficiente aplicación de una política que en la práctica integre la dimensión ambiental a los procesos de desarrollo. Por ello se requiere de un manejo racional basado en la armonía entre la conservación de las conquistas sociales alcanzadas y la protección sostenible de nuestros recursos naturales. Las Cátedras Honoríficas de la Universidad de Guantánamo tienen entre sus premisas esa labor. Dentro de sus objetivos incentivan la realización de actividades dirigidas a la preservación del Medio Ambiente y a la gestión de una cultura ambiental como aporte a la formación cívica de la comunidad intra y extra universitaria, y al programa de la Tarea Vida.

En este artículo abordamos el análisis de la autoría de una comedia de finales del siglo XVI, Las burlas y enredos de Benito, que se ha atribuido con muchas dudas a dramaturgos como Lope de Vega o Góngora, entre otros. A partir del estudio detallado de una copia manuscrita muy temprana, de las indicaciones e información que nos proporcionan una serie de bases de datos y herramientas digitales (CATCOM, MANOS, ETSO), y de diversos análisis métricos, lingüísticos y ortológicos, proponemos un nuevo nombre como probable autor de esta comedia, el sevillano Cepeda. Esta nueva atribución nos permite iluminar nuevos aspectos de Las burlas y enredos de Benito y valorar su relevancia en el panorama teatral de finales del siglo XVI.

Background: Caesarean section is necessary to save the lives of mothers and newborns at times, but it is important to perform it only when it is essential due to all the risks involved. This study aimed to examine the rate of caesarean sections performed at a tertiary hospital using the Robson classification to detect methods for the detection of and/or reduction in these caesarean section rates. Methods: A descriptive, cross-sectional study of a retrospective database was carried out. Results: A total of 10,317 births were assessed. The Robson classification was used to assess these interventions and verify whether the indication for performed caesarean sections was appropriate. In total, 2036 births by caesarean section were performed in the whole sample. The annual caesarean section rate varied between 18.67% and 21.18%. Conclusions: Caesarean sections increased by about 20% in 2021 compared to 2020 even though the trend over the years of study was decreasing. Vaginal delivery after caesarean section is a reasonable and safe option. Caesarean section rates could be improved, mostly in Robson’s Group 2. The Robson classification facilitated progress in the implementation of measures aimed at improving care and adjusting caesarean section rates.

Natural cyclodextrins (CDs) can be formed by 6, 7, or 8 glucose molecules (α-, β-, and γ-, respectively) linked in a ring, creating a cone shape. Its interior has an affinity for hydrophobic molecules, while the exterior is hydrophilic and can interact with water molecules. This feature has been used to develop active packaging applied to food, interacting with the product or its environment to improve one or more aspects of its quality or safety. It also provides monitoring information when food is optimal for consumption, as intelligent packaging is essential for the consumer and the merchant. Therefore, this review will focus on discerning which packaging is most appropriate for each situation, solubility and toxicological considerations, characterization techniques, effect on the guest properties, and other aspects related to forming the inclusion complex with bioactive molecules applied to packaging.

Bismuth titanate (BTO) nanoparticles were obtained by pulsed laser ablation in liquid media (PLAL). Distilled water, ethanol, isopropanol, and acetone were used as media for laser ablation experiments, in which the colloidal solutions were obtained. Laser ablation was carried out using the second harmonic and fundamental wavelength of a pulsed Nd:YAG laser (532 nm and 1064 nm, respectively) with laser fluences of 25 and 12 mJ/cm2, respectively. Transmission electron microscopy was utilized for morphological characterization. BTO nanoparticles obtained have spherical shapes with orthorhombic structure and the average size distribution depended on the liquid media nature. In alcohols, BTO NPs were spherical with a carbon layer around them. X-ray diffraction, UV-Vis absorption spectra, and X-ray photoelectron spectroscopy were used to confirm the structural, optical, and elemental properties of the ablated products. The presented results show that PLAL is a viable technique for the synthesis of high-quality BTO nanoparticles with enhanced optical properties for possible applications in photocatalysis.

Background: Data with ordinal categories occur in many diverse areas, but methodologies for modeling ordinal data lag severely behind equivalent methodologies for continuous data. There are advantages to using a model specifically developed for ordinal data, such as making fewer assumptions and having greater power for inference. Methods: The ordered stereotype model (OSM) is an ordinal regression model that is more flexible than the popular proportional odds ordinal model. The primary benefit of the OSM is that it uses numeric encoding of the ordinal response categories without assuming the categories are equally-spaced. Results: This article summarizes two recent advances in the OSM: (1) three novel tests to assess goodness-of-fit; (2) a new Generalized Estimating Equations approach to estimate the model for longitudinal studies. These methods use the new spacing of the ordinal categories indicated by the estimated score parameters of the OSM. Conclusions: The recent advances presented can be applied to several fields. We illustrate their use with the well-known arthritis clinical trial dataset. These advances fill a gap in methodologies available for ordinal responses and may be useful for practitioners in many applied fields.

Abstract Although mitochondria are widely studied organelles, the recent interest in the role of mitochondrial small noncoding RNAs (sncRNAs), miRNAs, and more recently, piRNAs, is providing new functional perspectives in germ cell development and differentiation. piRNAs (PIWI-interacting RNAs) are single-stranded sncRNAs of mostly about 20–35 nucleotides, generated from the processing of pre-piRNAs. We leverage next-generation sequencing data obtained from mouse primordial germ cells and somatic cells purified from early-differentiating embryonic ovaries and testis from 11.5 to 13.5 days postcoitum. Using bioinformatic tools, we elucidate (i) the origins of piRNAs as transcribed from mitochondrial DNA fragments inserted in the nucleus or from the mitochondrial genome; (ii) their levels of expression; and (iii) their potential roles, as well as their association with genomic regions encoding other sncRNAs (such as tRNAs and rRNAs) and the mitochondrial regulatory region (D-loop). Finally, our results suggest how nucleo-mitochondrial communication, both anterograde and retrograde signaling, may be mediated by mitochondria-associated piRNAs.

Stroke is one of the most common causes of disability and exerts a high burden of direct and indirect costs. Stroke may cause spasticity, which limits patients’ abilities and affects their activities of daily living, decreasing their quality of life. Conventional treatments are based on physical therapy, anti-spasticity medication, and botulinum toxin type A (BTX-A). However, recently, non-pharmacological approaches have been used, such as dry needling (DN) of myofascial trigger points. BTX-A and DN are two treatments that aim to decrease spasticity in patients with stroke, but their mode of action, application, and costs differ. Thus, there is a need to determine the comparative economics of post-stroke spasticity treatments. For this purpose, a search for all types of cost-effectiveness studies (randomized controlled trials, matched controls, and cohorts) and models of epidemiological data was performed. Studies were selected if they included economic outcomes in stroke patients treated with BTX-A or DN. As a result, 7 studies of BTX-A and 2 of DN were selected. Similarities were found in the outcomes used to assess the effectiveness of both treatments in most studies, with modifications of the Ashworth Scale [Modified Ashworth Scale (MAS)/Modified Modified Ashworth Scale (MMAS)] and quality-adjusted life year (QALY) being the main indicators of effectiveness. However, both the duration of the studies and the evaluation of costs were highly heterogeneous, making comparison difficult. In conclusion, both BTX-A and DN are cost-effective to treat spasticity in patients with stroke, but there is a need for comparative studies to make direct comparisons of cost-effectiveness with the most frequently used outcomes such as the MMAS and QALYs.

Abstract Automated segmentation of human cardiac magnetic resonance datasets has been steadily improving during recent years. Similar applications would be highly useful to improve and speed up the studies of cardiac function in rodents in the preclinical context. However, the transfer of such segmentation methods to the preclinical research is compounded by the limited number of datasets and lower image resolution. In this paper we present a successful application of deep architectures 3D cardiac segmentation for rats in preclinical contexts which to our knowledge has not yet been reported. We developed segmentation models that expand on the standard U-Net architecture and evaluated models separately trained for systole and diastole phases (2MSA) and a single model trained for all phases (1MSA). Furthermore, we calibrated model outputs using a Gaussian process (GP)-based prior to improve phase selection. The resulting models approach human performance in terms of left ventricular segmentation quality and ejection fraction (EF) estimation in both 1MSA and 2MSA settings (Sørensen-Dice score 0.91 ± 0.072 and 0.93 ± 0.032, respectively). 2MSA achieved a mean absolute difference between estimated and reference EF of 3.5 ± 2.5%, while 1MSA resulted in 4.1 ± 3.0%. Applying GPs to 1MSA enabled automating systole and diastole phase selection. Both segmentation approaches (1MSA and 2MSA) were statistically equivalent. Combined with a proposed cardiac phase selection strategy, our work presents an important first step towards a fully automated segmentation pipeline in the context of rat cardiac analysis.

El siguiente texto presenta el análisis comparativo de las estructuras ligeras del ingeniero uruguayo Eladio Dieste y el Arquitecto español Félix Candela. A través de 4 obras relevantes, como son el restaurante Los Manantiales, la Iglesia Ntra Sra de Guadalupe, La iglesia de San Juan de Ávila y el pabellón del colegio Don Bosco, se comparan aspectos clave en el desarrollo de la arquitectura de ambos y su funcionamiento. A través de las luces, como objetivo principal de las arquitecturas singulares, los soportes y el proceso de ejecución, se pretende extraer las ventajas e inconvenientes de las técnicas constructivas singulares de estos dos genios de la ingeniería del siglo XX, la cerámica estructural y las cáscaras de hormigón. Como principales resultados podemos obtener que el uso de soportes estructurales (pilares) hace que se puedan conseguir alturas mayores que con el uso de las cáscaras de hormigón. En cuanto a los procesos de ejecución, no hay una clara ventaja de uno con respecto a otro, ya que cada uno tiene sus particularidades a la hora de llevarlos a cabo. Las luces conseguidas con las cáscaras de hormigón llegan a ser de casi el doble que, con la cerámica armada, lo cual lo hace adecuado para aquellas edificaciones singulares con necesidad de espacialidad diáfana. Abstract The following text presents a comparative analysis of the light structures of the Uruguayan engineer Eladio Dieste and the Spanish architect Félix Candela. Through 4 relevant works, such as the restaurant Los Manantiales, the Church of Our Lady of Guadalupe, the church of San Juan de Ávila and the pavilion of the Don Bosco school, key aspects in the development of the architecture of both and their functioning are compared. By means of the spans, as the main objective of the singular architectures, the supports and the execution process, the aim is to extract the advantages and disadvantages of the singular construction techniques of these two geniuses of 20th century engineering, structural ceramics and concrete shells. The main results are that the use of structural supports (pillars) makes it possible to achieve greater heights than with the use of concrete shells. As for the execution processes, there is no clear advantage of one over the other, as each one has its own particularities when it comes to carrying them out. The spans achieved with concrete shells are almost twice as large as with reinforced ceramics, which makes it suitable for unique buildings with a need for diaphanous spatiality.

En los últimos años el empleo de la metodología del eye tracking ha sido objeto de estudio de diferentes investigaciones en torno a esta técnica como posible medida objetiva para la detección temprana de indicadores de Trastorno del Espectro Autista (TEA). En el presente estudio se ha elaborado un total de 15 vídeos estímulo divididos en cuatro bloques con el objeto de diseñar una prueba objetiva de sencilla y rápida aplicación, mediante un dispositivo eye tracker, que permita realizar una detección objetiva y muy temprana de indicadores de riesgo de desarrollar TEA; para ello se cuenta con una muestra formada por 148 sujetos, 74 sujetos con indicadores clínicos de TEA y 74 sujetos con desarrollo típico. Los resultados confirman que es posible configurar un software que, tras analizar los registros de mirada de un bebé obtenidos con un dispositivo eye tracker, nos proporcione automáticamente su probabilidad de presentar un “patrón de mirada de máxima atención al objeto (riego de TEA) o un patrón de mirada de recogida de información social (no TEA)”. Con las tareas aquí presentadas, tras analizar la sensibilidad de cada vídeo y cada variable, se han obtenido resultados estadísticamente significativos en cada uno de los vídeos estímulo, por lo que se concluye que la metodología del eye tracking con el empleo de los estímulos aquí diseñados puede operar como método de detección objetivo y eficaz de indicadores de alarma de TEA.

Introducción: la lactancia materna es el acto fisiológico por medio del cual la madre alimenta y aporta los nutrientes necesarios al recién nacido (RN), los lineamientos tanto de la OMS (Organización Mundial de la Salud) y el Ministerio de Salud y Protección Social de Colombia, proponen lactancia materna exclusiva hasta los 6 primeros meses de vida, complementándola hasta los dos años con el fin de lograr los aportes nutricionales necesarios para el desarrollo sano del RN. Materiales y métodos: estudio descriptivo de corte transversal y prospectivo. Se incluyeron las madres de los RN prematuros y de bajo peso al nacer, incluidos en el seguimiento del Programa Madre Canguro de nuestro hospital, quienes interrumpieron la lactancia materna exclusiva hacia los 3 meses de edad corregida. Resultados: se identificaron 124 pacientes, la principal causa de abandono fue la percepción de la baja producción de leche materna en 43,5% de las madres encuestadas; la edad gestacional de los recién nacidos fue de 32 a 36 semanas en el 61.3% de los pacientes. Discusión: la deserción de la lactancia materna exclusiva en los primeros meses de vida es importante para el desarrollo integral y los factores para mantenerla son variables de una población a otra; hay que analizar las principales causas y así implementar medidas que la fomenten y eviten la deserción de esta práctica fundamental.

Despite the traditional use of average values for determining physical demands, the intermittent and fluctuating nature of team sports may lead to underestimation of the most demanding scenarios. All the most demanding scenario-related investigations to date only report one maximal scenario per game, the greatest. However, the latest research on this subject has shown additional scenarios of equal or similar magnitude that most researchers have not considered. This repetition concept started a new way of describing competition and training loads; then the study aims were: first, to quantify and assess differences between playing positions in terms of the most demanding scenarios in official matches; and second, to quantify and assess the differences between playing positions in the repetition of different intensity scenarios relative to the most demanding individual scenario. We monitored nine professional rink hockey players (7 exterior and 2 interior players) in 18 competitive matches using an electronic performance tracking system. The interior players are closest to the opponent’s goal, while the exterior players are farthest from it. Peak physical demands variables included total distance (m), distance covered at >18 km·h-1 (m), the number of accelerations (≥2 m∙s-2, count) and decelerations (≤-2 m∙s-2, count) in 30 s. An average from the top three individual most demanding scenarios was used to define a reference value to quantify the distribution scenario repetition during matches. The results showed that peak demands in rink hockey are position-dependent, with more distance covered by exterior players and more accelerations performed by interior players. In addition, rink hockey matches include multiple scenario exposures that are close to the peak physical demands of a match. Using the results of this study, coaches can prepare tailored training plans for each position, focusing on distances covered or accelerations for exterior players.

ObjectiveTo assess the clinical outcome (death and/or Intensive Care Unit (ICU) admission) based on the time from hospital admission to the administration of anakinra and the possible usefulness of a "simplified" SCOPE score to stratify the risk of worse prognosis in our cohort of patients with moderate/severe SARS-CoV-2 pneumonia, both vaccinated and unvaccinated, that received anakinra and corticosteroids. In addition, the clinical, analytical, and imaging characteristics of patients at admission are described.MethodsRetrospective cohort study of 312 patients admitted to Hospital Clínico San Cecilio in Granada for moderate/severe pneumonia caused by SARS-CoV-2 that received anakinra and corticosteroids between March 2020 and January 2022. Clinical and analytical data were collected as well as the patient outcome at 30 and 60 days after admission. Three treatment groups were established according to the time from hospital admission to administration of anakinra: early (1st-2nd day), intermediate (3rd-5th day), and late (after the 5th day).ResultsThe median age was 67.4 years (IQR 22-97 years) and 204 (65.4%) were male. The most common comorbidity was hypertension (58%). The median time from the start of symptoms to anakinra administration was 6 days (IQR 5-10) and the SaFi (SaO2/FiO2) was 228 (IQR 71-471). The cure rate was higher in the early-onset anakinra group versus the late-onset group (73% vs 56.6%). The latter had a higher percentage of deaths (27.4%) and a greater number of patients remained hospitalized for a month (16%). On admission, the patients had elevated C-reactive protein (CRP), ferritin, and D-dimer values and decreased total lymphocytes. Analytical improvement was observed at both 72 hours and one month after treatment. 42 (13.5%) required ICU admission, and 23 (7.3%) orotracheal intubation. At 60 days, 221 (70.8%) were discharged, 87 (27.8%) had died and 4 (1.4%) remained hospitalized. The mean dose of anakinra was 1000 mg (100-2600 mg) with differences found between the dose administered and the clinical outcome. There were no differences in the primary outcome based on vaccination. A simplified SCOPE score at the start of anakinra administration was lower in patients with better clinical evolution.ConclusionsEarly treatment with anakinra and corticosteroids was associated with a better outcome regardless of vaccination status. A simplified SCOPE was found to be a good prognostic tool.

Resumen: Introducción: las revistas científicas son el principal canal a través del cual se comparten los avances clínicos, se intercambian opiniones y se proponen teorías. El objetivo de este manuscrito fue determinar la situación de las revistas de enfermería. Esto es presencia, visibilidad y prestigio. Materiales y métodos: en mayo de 2022 se llevó a cabo una selección de revistas de enfermería a partir de la base de datos ULRICH. Los criterios de selección fueron revistas revisadas por pares, activas en el momento de la consulta. Del listado final se analizó: visibilidad (idioma de publicación y presencia en bases de datos internacionales), accesibilidad (suscripción, gratuidad y libre acceso) y prestigio (editorial y factor de impacto). Resultados: 374 revistas cumplieron los criterios. El 70% estaban indexadas en, al menos, una base de datos. El 55,3% permiten el acceso al texto completo. Un 46% están incorporadas a Journal Citation Reports. Conclusión: el número de revistas es adecuado, aunque las publicaciones deben ajustarse cada vez más a los mínimos establecidos por bases de datos y políticas editoriales internacionales de libre acceso. Abstract: Background: Nursing journals are the main channel where researchers share their clinical development, opinions and theories. The aim of this study was to determine the situation of nursing journals. There are presence, visibility and prestige. Materials and methods: In May 2022 selection of nursing journals was carried out using the Ulrich database. The inclusion criteria were active peer-reviewed journals at the time of consultation. From the final list, the following were analyzed: visibility (language and presence in international databases), accessibility (subscription, free and open access,) and prestige (publisher and impact factor). Results: 374 journals met the criteria. 70% were indexed in at least one database. 55.3% allow access to full text. 46% are incorporated to Journal Citation Reports. Conclusion: The number of journals is adequate, although the publications must increasingly comply with the minimums established by databases and international open access editorial policies.

Abstract Background The Mediterranean Diet (MD) is recognized as heart-healthy, but the economic cost associated with this type of diet has scarcely been studied. The objective of the present study is to explore the cost and adherence of a low-income region population to the MD and its relationship with income. Methods A population-based study was carried out on 2,833 subjects between 25 and 79 years of age, 54% women, selected at random from the municipalities of Vegas Altas, La Siberia and La Serena in the province of Badajoz, Extremadura (Spain). Average monthly cost of each product included in the MD was computed and related to adherence to the MD using the Panagiotakos Index and average disposable income. Results The monthly median cost was 203.6€ (IQR: 154.04-265.37). Food-related expenditure was higher for men (p

The contribution of wildlife species to pathogen maintenance in multi-host communities has seldom been quantified. To assess the relative contribution of the main wildlife hosts of animal tuberculosis (TB) to its maintenance, we estimated the basic reproduction number (R0) of Mycobacterium tuberculosis complex in wild boar and red deer at 29 sites in the Iberian Peninsula. Host abundance and true TB prevalence were estimated for each species at each site by sampling from distributions incorporating the uncertainty in the proportion of the population harvested each year, sensitivity, and specificity of the diagnostic methods, while excretion of mycobacteria was estimated using site-occupancy models. The distributions of these parameters were then used to estimate, at each site, the R0,wild boar (range 0.1 – 55.9, average 8.7, standard deviation 11.8), and the R0,red deer (0.1 – 18.9, 2.2, 3.9). Animal TB is maintained in epidemiological scenarios ranging from any single species acting as a maintenance host (the wild boar in 18 sites and the red deer in 5), to facultative multi-host disease (6 sites). The prevalence of TB in the red deer is likely an important driver of the epidemiology in multi-host communities. The wild boar was the main maintenance host of TB in most of the study sites and could have an epidemiological role linking the wildlife multi-host community and livestock.

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

Abstract In pulmonary arterial hypertension (PAH) patients it is essential to perform a prognostic assessment to optimize the treatment. The aim of this study is to evaluate the risk stratification concordance assessed with different exercise test variables in a cohort of PAH patients. A retrospective analysis was performed using patient data registered in the PAH unit. Only those patients in whom the mean time elapsed between the 6‐min walking test (6MWT) and the cardiopulmonary exercise test (CPET) was a maximum of 6 months were selected. A total of 140 records from 40 patients were finally analyzed. When it came to assessing the concordance between the two exercise tests in the guidelines (CPET and 6MWT), up to 84.3% of the records did not coincide in terms of the risk stratification. Exclusively considering the CPET parameters, most of the records (75%) failed to include all three variables in the same risk category. When analyzing the VO2 alone, up to 40.7% of the tests yielded different risk classifications depending on whether the parameter was expressed. In conclusion, there is a low concordance between the two proposed exercise tests. These results should be a call for reflection on whether the cut‐off points set for the exercise tests proposed for the current risk stratification are adequate to achieve a correct risk stratification or whether they require an appropriate revision.

An objective behavioral test for motivational traits has been developed taking as a reference the structure of the Motivational Trait Questionnaire, which is a validated self-report questionnaire to measure motivational traits in the population. The objective test consists of a computer game, which makes it possible to evaluate a person’s motivational traits and to display them on the same scale as the Motivational Trait Questionnaire. To evaluate the validity of the results obtained in the measurement of motivational traits using the objective behavioral test, a study was carried out with 31 participants whose motivational traits were evaluated using the two methods, and the results obtained were compared to find out whether the two forms of assessment can be considered equivalent. Statistical tests support the high degree of similarity of the results, concluding that the objective behavioral test can be a useful instrument to assess motivational traits as an alternative to the self-report questionnaire. Despite the increasing popularity of game-based assessment of personality traits, this is the first time a game has been designed for the assessment of motivational traits. Being able to obtain a model of the user’s motivational traits without having to rely on a questionnaire opens the possibility to build software applications that adapt to the user’s motivational profile, providing them with the kind of motivational support that best fits their needs.

Introducción. La artritis reumatoide es una enfermedad autoinmunitaria, crónica y deformante asociada con discapacidad. Quienes la padecen reciben inmunosupresores y tienen un gran riesgo de desarrollar tuberculosis. La prueba de intradermorreacción a la tuberculina se utiliza como tamización en quienes van a recibir terapia biológica. Objetivo. Evaluar la frecuencia de positividad en la prueba de intradermorreacción a la tuberculina en una cohorte de pacientes con artritis reumatoide. Materiales y métodos. Se hizo un estudio descriptivo de corte transversal de una cohorte de pacientes con artritis reumatoide a quienes se les practicó la prueba de tuberculina antes de iniciar la terapia biológica o en el momento del cambio de tratamiento. Los pacientes presentaban enfermedad moderada o grave y eran candidatos para iniciar o cambiar de terapia biológica. Se definió el valor de ≥6 mm como punto de corte para la positividad de la prueba y se hizo un análisis descriptivo de cada una de las variables. Resultados. Se incluyeron 261 pacientes con artritis reumatoide, 92 % de ellos eran mujeres, la edad promedio fue de 55 años (desviación estándar, DE=13,92) y el tiempo desde el diagnóstico era de 12,3 años (DE=8,54). La frecuencia de positividad de la prueba fue de 15,71 % (n=41). Nueve de los 41 pacientes positivos habían recibido la prueba previamente (entre 1 y 6 años antes), todos con resultado negativo; 18 (43,9 %) de ellos venían recibiendo tratamiento con glucocorticoides y todos los 41 (100 %) recibían metotrexate. Conclusiones. La frecuencia de positividad de la prueba de tuberculina en pacientes colombianos con artritis reumatoide fue de aproximadamente 16 %. Se recomienda optimizar las estrategias para detectar esta condición y darle un tratamiento oportuno y, así, disminuir el riesgo de reactivación de la tuberculosis.

Recensión del libro «Deliberación y participación ciudadana. Derechos e instrumentos en el ordenamiento constitucional, Enriqueta Expósito Gómez, publicado en 2021 por Marcial Pons.

Summary: Background: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p

Resumen: Objetivo: Estudiar la evolución del perfil clínico de una población dada de alta con diagnóstico principal de insuficiencia cardíaca (IC) en las dos primeras décadas del siglo y las variables predictoras de mortalidad y reingreso en el primer año de alta. Diseño: Estudio observacional, retrospectivo, longitudinal. Emplazamiento: Área de salud Don Benito-Villanueva de la Serena, Badajoz, España. Participantes: Todos los pacientes dados de alta con diagnóstico principal de IC entre 2000 y 2019 en un complejo hospitalario general. Mediciones principales: Se recogieron variables sociodemográficas y clínicas, y se realizó un seguimiento de un año; la variable resultado fue un compuesto de mortalidad y/o reingreso. Resultados: Se incluyeron 4.107 altas, edad media 77,1 (DE 10,5) años, 53,1% de mujeres. El número de ingresos, la edad, los antecedentes de neoplasias, los ictus, la insuficiencia renal y la anemia fueron en aumento, así como los reingresos (p de tendencias

Introduction: The purpose of this study was to compare the most demanding scenarios (MDS) of match-play across five different team sports of the same club (basketball, futsal, handball, rink hockey and soccer) during five different time epochs (30, 60, 120, 180 and 300 s). Material and methods: Sixty-five professional male players were monitored across 14 to 17 official matches via a local positioning system. Peak physical demands included total distance, distance, and actions >18 km·h−1 and distance and number of accelerations and decelerations >2 m·s−2. One-way analysis of variance and Tukey post-hoc tests were used to test statistical significance (p 18 km·h−1 during all the time epochs examined, basketball presented the highest peak values in number of accelerations and decelerations >2 m·s−2 during 30-s and 60-s time epochs. Conclusion: In conclusion, the MDS during competition are significantly different across team sports, which can be useful in determining the upper limit threshold for sport-specific training optimisation and return to play purposes.

Smoking causes significant morbidity and mortality worldwide, mainly in developed countries. In addition, it is the cause of numerous diseases in the body, despite the fact that the prevalence of tobacco use is decreasing. Nursing students, as future professionals, should be aware of action plans for cessation and information designed for smokers. To determine the level of knowledge among nursing students about smoking-related diseases and analyze the prevalence of student who smoke at the University of Leon, Spain, a descriptive cross-sectional study was carried out in which students were given an anonymous questionnaire, which was previously validated, during the 2021–2022 academic year. In a sample of 477 (79.5%) nursing students, a smoking prevalence of 17.6% was obtained. In addition, students’ knowledge about the diseases directly caused by tobacco consumption and others associated with exposure to environmental smoke was assessed, and in both cases (8.03 points of 9 for consumption and 5.24 of 6 to exposure), scores were obtained that allow us to state that students do not know for sure the types of diseases that are related to tobacco use and passive smoking. In spite of this, it is necessary to continue to reduce the prevalence of smoking through different programs implemented in schools and universities, as it is also necessary to improve teaching plans when explaining smoking-related diseases, so that students, in the future, will be able to advise patients correctly.

The Cantabrian capercaillie (Tetrao urogallus cantabricus) is one of the most severely threatened subspecies of capercaillie. Its current population range is restricted to a small area of the Cantabrian Mountains (northwestern Spain), with only around 200 individuals remaining. As part of the national strategy for the conservation of the subspecies, the Cantabrian capercaillie Captive Breeding Center of Sobrescobio opened in 2009. Here, we use the information provided by the necropsies performed in this facility on 29 individuals (11 males, 13 females and 5 undetermined; 16 chicks and 13 adults) in order to describe the main mortality causes of captive-bred Cantabrian capercaillies. After necropsy, tissue samples were taken for evaluation using standard methods in histology and microbiology. The majority of the captive animals (18/29, 62.07%) died due to infectious diseases, mainly due to Escherichia coli, Clostridium perfringens, or Aspergillus fumigatus infection. The remaining 11 animals died due to stress-related processes (i.e., rupture of the heart apex and cardiomyopathy or neurogenic shock) (8/29, 27.59%), duodenal obstruction and coelomitis (1/29, 3.45%), perforation of the proventriculus and heart with a briar branch (1/29, 3.45%) or euthanasia due to a valgus leg deformity that prevented proper animal welfare (1/29, 3.45%). Young animals (i.e., younger than 2 months) died mainly due to infectious diseases (14/16, 87.5%), while stress-related causes were responsible for most adult deaths (7/13, 53.85%). We additionally report that two free-ranging adult males died due to exertional myopathy. This study provides relevant information for reducing mortality in captive capercaillies and improving both living conditions in captivity and the adaptation of these animals to the wild.