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Abstract Background Despite its proven prognostic value in different contexts, the precise implications of left atrial strain (LAS) assessment throughout different phases of the atrial cycle remain uncertain. A direct correlation between left atrial reservoir strain (LARS) and left ventricular global longitudinal strain (GLS) has been consistently demonstrated in several studies involving patients with various heart diseases. The objective of our study is to identify factors directly associated with LARS, left atrial conduction strain (LACS) and left atrial booster strain (LABS) in patients without cardiovascular (CV) disease. Methods Transthoracic echocardiographic examinations in patients without CV disease were prospectively selected in two tertiary hospitals echocardiography labs for clinical purposes. LAS, maximal and minimal left atrial (LA) volumes and left atrial ejection fraction (LAEF) were measured using the two-dimensional strain analysis package provided by the EchoPAC Plugging workstation (AFI LA). Results A total of 196 cases were included, median age of 54 (45–62) with 85 (43%) being men. The mean left ventricular ejection fraction (LVEF) was 61% ± 5, and the median GLS was − 18% (-17 to -20). Median indexed maximum volume of left atrium (LAVI) was 27 ml/m2 (22–31), and LAEF was 64% (58–70). The mean LARS biplane was 35,1% ± 8. Notably, LARS was greater in the 2-chamber view (36,1% ± 10) compared to the 4-chamber view (34,1% ± 8 p

Abstract Background Multiple trauma injuries are the leading cause of death and disability in people under the age of 45 and require prompt and specialised care. However, medical and nursing education programmes do not always include specific training in emergency pre-hospital care, resulting in a lack of basic practical skills in trauma management. Objective To develop and validate two instruments for assessing nursing students’ competence in cervical collar and spinal board application in simulated pre-hospital emergency scenarios. Method This is an instrumental study that involves the development of two assessment instruments and the evaluation of their psychometric properties in a sample of 392 nursing students. Content validity was assessed using expert judgement, by calculating the content validity ratio (CVR) for each item and the scale level content validity index average (S-CVI/Ave) for the instruments. Exploratory factor analysis using the MINRES extraction method and Promax rotation was performed to analyse the performance of the items and structure of the rubrics. Internal consistency was analysed using the Omega coefficient and inter-rater agreement was assessed using Cohen’s Kappa coefficient. Results Initially, two rubrics were obtained: one with six items for cervical collar placement (S-CVI/Ave = 0.86) and one with nine items for spinal board placement (S-CVI/Ave = 0.81). Both had a single-factor structure, with all items having factor loadings greater than 0.34 for the cervical collar rubric and 0.56 for the spinal board rubric, except for item 2 of the cervical collar rubric (λ = 0.24), which was subsequently removed. The final cervical collar rubric (five items) had an overall internal consistency of 0.84 and the spinal board rubric had an overall internal consistency of 0.90, calculated using the Omega statistic. The weighted Kappa coefficient for each item ranged from acceptable (0.32) to substantial (0.79). These results show that we have successfully developed two sufficiently valid instruments to assess the immobilisation competencies proposed in the objective of the study. Conclusion Whilst further research is needed to fully establish their psychometric properties, these instruments offer a valuable starting point for evaluating nursing students' competence in cervical collar and spinal board application in simulated pre-hospital scenarios.

Varón de 53 años con reanimación extracorpórea mediante sistema CARL (controlled automated reperfusión of the whole body; Resuscitec, Alemania) tras una parada intrahospitalaria refractaria por tormenta arrítmica en el contexto de un brote de miocardiopatía inflamatoria. Precisó implante de Impella-CP (Abiomed, EE.UU.) femoral por descarga insuficiente con balón de contrapulsación. Por varias alarmas de succión se sospechó malposición del catéter y, tras los intentos de reposicionamiento, mantuvo flujos < 1 lpm. Se realizaron ecocardiograma transesofágico y radiografía de tórax (figura 1), y se observó que el catéter se encontraba doblado sobre sí mismo (asterisco en la figura) y el pigtail estaba enganchado en el outlet (figura 2), como consecuencia de los intentos de recolocación. Se desplazó hasta la aorta descendente y se decidió la retirada urgente. Se intentó desenroscar el pigtail mediante manipulación femoral, sin éxito (figura 3A y vídeo 1 del material adicional). Mediante acceso radial izquierdo de 7 Fr se avanzó una guía Amplatz Super-Stiff (Boston Scientific, EE.UU.) a través del bucle del Impella, y mediante tracción del catéter desde femoral se consiguió desenganchar el pigtail del outlet (figura 3B). De forma paralela, se introdujo un lazo EN-Snare de 12 × 20 mm (Merit-Medical, EE.UU.) con el que...

A 53-year-old man was treated with extracorporeal cardiopulmonary resuscitation with the controlled automated reperfusion of the whole body (CARL) system (Resuscitec, Germany) after a refractory in-hospital cardiac arrest following an arrhythmic storm in the setting of an episode of inflammatory cardiomyopathy. The patient required Impella-CP device implantation (Abiomed, United States) via femoral access due to insufficient unloading with the intra-aortic balloon pump. Catheter malapposition was suspected after several suction alarms were triggered. Despite repeated attempts at repositioning, flow rates remained < 1 L/min. Transesophageal echocardiography and thoracic x-ray (figure 1) confirmed that the catheter had bent in upon itself (asterisk in the figure), and the pigtail had been caught in the outlet (figure 2) following the multiple attempts at repositioning. The catheter migrated toward the descending aorta and urgent removed was decided. An attempt to unscrew the pigtail through femoral manipulation proved unsuccessful (figure 3A and video 1 of the supplementary data). A 7-Fr Amplatz Super-Stiff guidewire (Boston Scientific, United States) was advanced through the Impella loop via left radial access, and traction on the catheter from the femoral access successfully disengaged the pigtail from the outlet (figure 3B). Concurrently, a 12 mm × 20 mm EN-Snare loop (Merit Medical,...

This work characterises the high-quality white marble used in the bust of Emperor Hadrian found in the Roman villa of Los Torrejones (Yecla, Murcia). The analytical results, compared with the databases pertaining to Hispanic and Mediterranean quarry marbles, reveal its source in the quarries of Göktepe, in Muğla province, Western Turkey. The historical implications of the presence in the villa of an imperial portrait of such quality are discussed. The results also emphasise the importance of undertaking future complete archaeometric analysis of marble materials used in the sculptures of Hispania, only way to certify the provenance of the stone and, in this case, to better understand the distribution reached by the varieties of Göktepe marble in the Iberian Peninsula.

Introducción: el envejecimiento poblacional constituye un reto a nivel mundial por la pluripatología, sobre todo de enfermedades no transmisibles. Objetivo: caracterizar las enfermedades no transmisibles en ancianos del Consultorio Médico 12 del Policlínico Pedro Borras Astorga del municipio Pinar del Río, durante el año 2023. Método: investigación observacional, descriptiva y transversal, con un universo de 269 ancianos y la muestra de 266, según criterios de inclusión y exclusión. Se revisaron las Historias Clínicas Individuales y se aplicó una encuesta a todos los ancianos. Resultados: la mayoría de los ancianos (47,36 %) tenían entre 60 y 69 años, pertenecen al sexo femenino (56,01 %) y son de color blanco de piel (80,82 %). Las enfermedades no transmisibles de mayor incidencia fueron la Hipertensión arterial (71,80 %) y la Diabetes Mellitus en (22,55 %). Las complicaciones más frecuentes resultaron ser las retinopatías (10,52 %) y la enfermedad cardiovascular (5,26 %). Los tratamientos más utilizados por los ancianos fueron los diuréticos (35,07 %), y los hipoglucemiantes orales (70,00 %). En la muestra estudiada el 32,70 %de los ancianos presentan polifarmacia. Conclusiones: las enfermedades no transmisibles constituyen un problema sanitario para los ancianos del consultorio médico 12 del Policlínico Pedro Borras Astorga de Pinar del Río. Las de mayor incidencia fueron la Hipertensión Arterial y la Diabetes Mellitus y sus complicaciones más frecuentes, las retinopatías y la Enfermedad Cardiovascular. Los diuréticos y los hipoglucemiantes orales son los fármacos más usados por la muestra estudiada.

El consumo de pornografía resulta un problema creciente entre adolescentes e incluso niños y niñas, al punto de convertirse, en muchos casos, en una adicción. Estudios recientes indican que la exposición a este contenido se inicia antes de la pubertad, lo que plantea serias preocupaciones sobre su impacto en el desarrollo y bienestar de la juventud, así como en su socialización y concepción respecto a la igualdad entre los sexos. En este artículo se presentarán los resultados de un estudio realizado con 647 estudiantes de la Universidad de La Rioja (España), en el que se evalúan tanto sus patrones de consumo de pornografía como su percepción y satisfacción con la educación sexual recibida. Se manifiesta la ausencia de esta formación, así como el descontento total o parcial generalizado respecto a ella cuando existe. Asimismo, se observa un consumo elevado de pornografía, sobre todo en el caso de los hombres, lo que en ausencia de una adecuada educación sexual se convierte en una fuente de información distorsionada.

En esta editorial el autor reflexiona acerca de la dicotomía teoría/práctica y como la integración de teorías transdisciplinarias pueden contribuir a acercar posturas. Para ello comenta la teoría de la práctica desarrollada por Bourdieu y la interseccionalidad aportando un ejemplo de como su interconexión puede mejorar tanto la teoría como la práctica de la enfermería y por tanto contribuyendo a su vertebración y epistemología.

With an ever-increasing amount of (meta)genomic data being deposited in sequence databases, (meta)genome mining for natural product biosynthetic pathways occupies a critical role in the discovery of novel pharmaceutical drugs, crop protection agents and biomaterials. The genes that encode these pathways are often organised into biosynthetic gene clusters (BGCs). In 2015, we defined the Minimum Information about a Biosynthetic Gene cluster (MIBiG): a standardised data format that describes the minimally required information to uniquely characterise a BGC. We simultaneously constructed an accompanying online database of BGCs, which has since been widely used by the community as a reference dataset for BGCs and was expanded to 2021 entries in 2019 (MIBiG 2.0). Here, we describe MIBiG 3.0, a database update comprising large-scale validation and re-annotation of existing entries and 661 new entries. Particular attention was paid to the annotation of compound structures and biological activities, as well as protein domain selectivities. Together, these new features keep the database up-to-date, and will provide new opportunities for the scientific community to use its freely available data, e.g. for the training of new machine learning models to predict sequence-structure-function relationships for diverse natural products. MIBiG 3.0 is accessible online at https://mibig.secondarymetabolites.org/.

El manejo forestal puede modificar la estructura y la calidad de la madera. En este estudio se evaluó el efecto de un aprovechamiento forestal sobre la formación de madera en árboles remanentes. En un bosque de Abies religiosa (oyamel) intervenido con un aclareo del 50 % de área basal durante 2014, se inventariaron 10 sitios de muestreo (1000 m2). Se analizaron mediante técnicas dendrocronológicas 80 núcleos de crecimiento provenientes de 40 árboles remanentes. Se evaluó la microdensidad y las características celulares de la madera tardía. Los anillos de crecimiento de Abies religiosa (oyamel) presentaron una buena delimitación entre madera temprana y madera tardía en la cronología de 90 años desarrollada. El aprovechamiento forestal incremento en 42,4 % el ancho de anillo; la microdensidad varió de 189 kg·m-3 a 417 kg·m-3 ( = 335 kg·m-3); las traqueidas presentaron una disminución de 8,02 % en el espesor de la pared celular y el diámetro del lumen aumento un 29,8 %. Se identificó una fila de canales traumáticos fechada en 2014, posiblemente relacionados con el estrés de la corta. Las modificaciones en la anatomía de la madera causaron una variación en la microdensidad de la madera, que repercute en la cuantificación volumétrica y de biomasa a nivel del rodal.

This work faces the known problem of negative visión among prospective primary teachers regarding science teaching and learning. This is even more acute if gender is taken into account. To overcome this, the use of ethnobotany as a science of proximity is proposed. Specifically, an educational intervention is described that is based on a combination of active methodologies and the use of ethnobotany as a teaching tool for a subject with physics and chemistry contents. Ninety-two university-based primary education trainee teachers participated in the research. By means of questionnaires, information was collected regarding attitudes toward the subject and the use of ethnobotany as a teaching tool, evaluation of the proposal, sustainability awareness, and affective and emotional dimensions. The data indicated a great impact and acceptability. The results show a significant increase in motivation, an improvement in attitudes toward sustainable behavior and a favorable assessment of the proposed didactic tool. This hybrid methodology demonstrates, in the context used, effectiveness in improving the perception of science.

Introducción: Las arbovirosis constituyen un problema de salud pública, con repercusiones sociales y personales a nivel mundial, en Cuba y de forma específica, en la provincia de Pinar del Río. Objetivo: Evaluar el nivel de conocimientos sobre arbovirosis. Métodos: Se realizó una investigación no observacional, cuasiexperimental, estudio antes-después, sin grupo de control, entre los meses de enero a julio del 2023.El universo fue de 366 pacientes y la muestra de 175 de ellos. Las variables de estudio fueron: la edad, el sexo, el nivel de conocimientos sobre la definición, los factores de riesgo, los síntomas y las medidas de prevención y control sobre arbovirosis. Para la recolección de los datos se confeccionó una encuesta, al efecto de la investigación. Los datos fueron procesados en Microsoft Excel 2016, este permitió el cálculo de las frecuencias absolutas y relativas porcentuales, así como el almacenamiento de la información. Resultados: Predominó el sexo femenino con 99 pacientes, para un 56.57 % con 49 personas, entre las edades de 40 a 49 años con el 28 %. El 96.15 % poseían un nivel de conocimientos inadecuados, sobre los síntomas de las arbovirosis, esto se modificó después de las actividades educativas desarrolladas en el 100 % de ellos. Conclusiones: El nivel de conocimientos sobre arbovirosis, en los pacientes estudiados es inadecuado, este se modifica después de aplicar el plan de comunicación en salud, en adecuado.

Introduction: Recent data are not available on ongoing CPR for emergency services with an onboard physician. The aim of the present study was to identify factors associated with the decision to transport patients to hospital with ongoing CPR and examine their survival to hospital discharge with good neurological status. Methods: An observational study based on a registry of out-of-hospital cardiac arrests attended to by emergency services with an onboard physician. All OHCA cases occurring between the 1st of January and the 31st of December 2022 were included. Patients receiving ongoing CPR during transport to the hospital were compared with patients pronounced dead at the scene following arrival of the care team. The dependent variable was ongoing CPR during transport to the hospital. The main characteristics and the neurological status of patients surviving to discharge were described. Results: A total of 9321 cases were included, of which 350 (3.7%) were transported to hospital with ongoing CPR. Such patients were young (59.9 ± 20.1 years vs 64.6 ± 16.9 years; p

Secondary metabolites are bioactive compounds believed to contribute to the pharmacological properties of plants. MicroRNAs (miRNAs) are small non-coding RNA molecules involved in post-transcriptional regulation and are thought to play an important role in regulating secondary metabolism biosynthesis. Nevertheless, the extent of miRNA involvement in secondary metabolism remains minimal. Nigella sativa (black cumin/black seed) is a popular medicinal and culinary plant known for its pharmaceutical properties; however, its genomic information is scarce. In this study, next-generation sequencing (NGS) technology was employed to obtain the miRNA profile of N. sativa, and their involvement in secondary metabolite biosynthesis was explored. A total of 25,139,003 unique reads ranging from 16 to 40 nucleotides were attained, out of which 240 conserved and 34 novel miRNAs were identified. Moreover, 6083 potential target genes were recognized in this study. Several conserved and novel black cumin miRNAs were found to target enzymes involved in the terpenoid, diterpenoid, phenylpropanoid, carotenoid, flavonoid, steroid, and ubiquinone biosynthetic pathways, among others, for example, beta-carotene 3-hydroxylase, gibberellin 3 beta-dioxygenase, trimethyltridecatetraene synthase, carboxylic ester hydrolases, acetyl-CoA C-acetyltransferase, isoprene synthase, peroxidase, shikimate O-hydroxycinnamoyltransferase, etc. Furthermore, sequencing data were validated through qPCR by checking the relative expression of eleven randomly selected conserved and novel miRNAs (nsa-miR164d, nsa-miR166a, nsa-miR167b, nsa-miR171a, nsa-miR390b, nsa-miR396, nsa-miR159a, nsa-miRN1, nsa-miRN29, nsa-miRN32, and nsa-miRN34) and their expression patterns were found to be corroborated with the sequencing data. We anticipate that this work will assist in clarifying the implications of miRNAs in plant secondary metabolism and aid in the generation of artificial miRNA-based strategies to overproduce highly valuable secondary metabolites from N. sativa.

Background: Chronic heart failure (CHF) is a major health problem, representing the main cause of hospitalization in people over 65 years of age. Several studies have associated the Mediterranean diet with a cardioprotective function, improving prognoses in patients with high cardiovascular risk. Our main objective is to determine whether higher adherence to the Mediterranean diet is associated with a lower severity of CHF, based on the number of decompensations and disease complications. Methods: This study was a single-center retrospective cohort study conducted at the Virgen del Rocío Hospital (Seville). Adherence to a Mediterranean diet was determined by the Mediterranean Diet Adherence Screener (MEDAS) in patients with chronic heart failure in a state of clinical stability, the number of decompensations in the 12 months before inclusion, cardiac biomarkers (NT-proBNP and CA125), evaluation of dyspnea, and quality of life assessment according to NYHA and KCCQ scales and analytical profiles. Results: Seventy-two patients were included (35 with high adherence to the Mediterranean diet and 37 with low adherence). The mean age was 81.29 ± 0.86 years. A trend towards fewer decompensations (1.49 ± 0.14 vs. 1.92 ± 0.17, p = 0.054) and lower NT-proBNP values (2897.02 ± 617.16 vs. 5227.96 ± 1047.12; p = 0.088) was observed in patients with high adherence compared to those with low adherence to the Mediterranean diet. Conclusions: Our results suggest that patients with CHF and high adherence to the Mediterranean diet have a tendency towards an improved cardiac profile, indicated by fewer decompensations and lower NT-proBNP levels. Future clinical trials are needed to substantiate these hypotheses.

A dataset about three topics is provided, as a follow-up to the article “Mexico's forest diversity: common tree species and proposed forest-vegetation provinces” by Ricker et al. [1]. Firstly, 6927 site locations are provided for 22,532 trees of 1452 species. Secondly, measurements of basic wood-densities are reported for 779 tree species, obtained from 5256 trunk-core samples from Mexico's national forest inventory, and ranging from 0.05 to 0.93 g/cm3. Third, the data and maps of the forest-vegetation provinces from [1] were updated with the new cartography of Mexico's vegetation and land use (base year 2018). The maps are available now in an adjusted presentation as a shapefile-set for ArcGIS, as well as map-package and image files.

Background: The aim of the PSICE (Evidence-based Psychology in Educational Contexts) Project is to examine the effectiveness of the Unified Protocol for Transdiagnostic Treatment of Adolescents (UP-A) with symptoms of anxiety and depression in school settings. The goal is to prevent emotional problems and to improve adolescents’ socioemotional adjustment, learning processes, and academic performance. Method: A randomized controlled trial with two groups will be performed: active control (progressive relaxation training) and experimental (UP-A). After screening, participants with subclinical emotional symptomatology will be selected for pre- and post-test evaluation and follow-up at 6, 12, and 18 months. Results: The impact of different indicators at behavioral, cognitive, affective, social and academic functioning levels will be analyzed, as well as their effects in the short, medium and long term. Conclusions: Examining the effectiveness of the UP-A in the Spanish educational context will, among other things, provide data for informed decision-making in the field of educational psychology. In addition, it will ensure that such interventions, using standardized protocols, are accessible to a large population at such an important stage of human development as adolescence. The PSICE project will provide leadership and guidance on the importance of psychology in schools.

The El Cielo Biosphere Reserve (CBR) stands as a vital forested region in eastern Mexico due to its high biodiversity in flora and fauna and provision of environmental services. This study established a network of 10 ring-width chronologies of different species within the CBR and adjacent watersheds. The objective was to analyze their climatic response and reconstruct the seasonal streamflow contribution of each sub-basin to the main stream, utilizing data from a gauge network of eight hydrological stations located at strategic locations of the CBR. With chronologies ranging from 116 to 564 years, most exhibited association with the accumulated streamflow between January and June. Based on the adjusted R2, Akaike Information Criteria, and Variance Inflation Factor, the stepwise regression procedure was selected among different statistical methods for developing the reconstruction model. In spite of differences in the seasonal reconstructed periods, all the species showed potential to develop hydrological reconstructions as indicated by their common response to streamflow variability, as occurred in the wet years of 1976, 1993, 2000, and 2008, and dry years of 1980, 1982, 1996, and 2011. It was found that the response of the chronologies to gauge records increased as a function of the chronologies’ interseries correlation, average mean sensitivity, and distance of the tree-ring series to the gauge station. Streamflow reconstructions at the sub-basin level allowed a better understanding of the hydroclimatic variability characterizing the CBR, but also suggested the need to increase the network of chronologies for some particular sub-basins lacking tree-ring series to improve the reconstructed models.