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The coronavirus disease 2019 (COVID-19) pandemic has significantly affected older adults. Identifying host COVID-19 susceptibility genes in elderly populations remains a challenge. Here, we aimed to identify host genetic factors influencing the susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We genotyped 12 single-nucleotide polymorphisms (SNPs) previously associated with the innate immune response in a total of 97 elderly (age > 65 years) residents of three long-term care facilities located in Barcelona, Spain. Individuals were PCR-tested during the SARS-CoV-2 outbreaks between September and November 2020. SARS-CoV-2 PCR tests revealed infections in 81 residents. Importantly, the 16 uninfected residents remained SARS-CoV-2 seronegative until vaccination (January and February 2021). After adjusting for sex and age, we found that two SNPs were significantly associated with SARS-CoV-2 infection susceptibility—MMS19 nucleotide excision repair protein homolog (MMS19)/rs2236575 (p = 0.029) and interferon-induced helicase C domain-containing 1 (IFIH1)/rs1990760 (p = 0.034). No association with SARS-CoV-2 infection was found for 10 additional genotyped SNPs, which included 4 SNPs on chromosome 12 in the gene encoding oligoadenylate synthetase (OAS). Our results indicate that MMS19/rs2236575_A and IFIH1/rs1990760_TC genetic variants were associated with a resistance to SARS-CoV-2 infection in a cohort of institutionalized seniors.

Abstract Motorized spiral enteroscopy (MSE) enhances small bowel exploration, but the optimal target population for this technique is unknown. We aimed to identify the target population for MSE by evaluating its efficacy and safety, as well as detecting predictors of efficacy. A prospective multicenter observational study was conducted at 9 tertiary hospitals in Spain, enrolling patients between June 2020–2022. Analyzed data included demographics, indications for the procedure, exploration time, depth of maximum insertion (DMI), technical success, diagnostic yield, interventional yield, and adverse events (AE) up to 14 days from enteroscopy. Patients with prior gastrointestinal surgery, unsuccessful balloon enteroscopy and small bowel strictures were analyzed. A total of 326 enteroscopies (66.6% oral route) were performed in 294 patients (55.1% males, 65 years ± 21). Prior abdominal surgery was present in 50% of procedures (13.5% gastrointestinal surgery). Lower DMI (162 vs 275 cm, p = 0.037) and diagnostic yield (47.7 vs 67.5%, p = 0.016) were observed in patients with prior gastrointestinal surgery. MSE showed 92.2% technical success and 56.9% diagnostic yield after unsuccessful balloon enteroscopy (n = 51). In suspected small bowel strictures (n = 49), the finding was confirmed in 23 procedures (46.9%). The total AE rate was 10.7% (1.8% classified as major events) with no differences related to prior gastrointestinal/abdominal surgery, unsuccessful enteroscopy, or suspected small bowel strictures. The study demonstrates that MSE has a lower diagnostic yield and DMI in patients with prior gastrointestinal surgery but is feasible after unsuccessful balloon-enteroscopy and in suspected small bowel strictures without safety concerns.

Los políticos independentistas catalanes condenados por el Tribunal Supremo en 2019 interpusieron demandas contra el Estado ante el Tribunal Europeo de Derechos Humanos (TEDH) alegando la violación de derechos del Convenio Europeo de Derechos Humanos. El examen de estas demandas ha coincidido temporalmente con el debate de la Proposición de Ley de Amnistía en las Cortes Generales. En este contexto, surgen dudas sobre si la amnistía podría conllevar la pérdida del estatus de víctima de los políticos independentistas, lo cual llevaría al TEDH a inadmitir las demandas. Este artículo examina el régimen jurídico del estatus de víctima, mostrando que el TEDH generalmente exige dos condiciones para que una medida como la amnistía pueda suponer la pérdida del estatus de víctima de un demandante: primero, que reconozca y, segundo, que repare la violación de derechos alegada. El análisis también revela que las demandas relativas a derechos del artículo 6 están sujetas a una regla especial menos restrictiva. Aplicando estas reglas, se concluye que la amnistía no hará perder el estatus de víctima de los políticos independentistas, de manera que no impedirá que el TEDH se pronuncie sobre el fondo de sus demandas.

Abstract Introduction Immune checkpoint inhibitors (ICIs) induce acute interstitial nephritis (AIN) in 2–5% of patients, with a clearly higher incidence when they are combined with platinum derivatives. Unfortunately, suitable disease models and non-invasive biomarkers are lacking. To fill this gap in our understanding, we investigated the renal effects of cisplatin and anti-PD-L1 antibodies in mice, assessing PD-1 renal expression and cytokine levels in mice with AIN, and then we compared these findings with those in AIN-diagnosed cancer patients. Methods Twenty C57BL6J mice received 200 µg of anti-PD-L1 antibody and 5 mg/kg cisplatin intraperitoneally and were compared with those receiving cisplatin (n = 6), anti-PD-L1 (n = 7), or saline (n = 6). After 7 days, the mice were euthanized. Serum and urinary concentrations of TNFα, CXCL10, IL-6, and MCP-1 were measured by Luminex. The kidney sections were stained to determine PD-1 tissue expression. Thirty-nine cancer patients with AKI were enrolled (AIN n = 33, acute tubular necrosis (ATN) n = 6), urine MCP-1 (uMCP-1) was measured, and kidney sections were stained to assess PD-1 expression. Results Cisplatin and anti PD-L1 treatment led to 40% AIN development (p = 0.03) in mice, accompanied by elevated serum creatinine and uMCP1. AIN-diagnosed cancer patients also had higher uMCP1 levels than ATN-diagnosed patients, confirming our previous findings. Mice with AIN exhibited interstitial PD-1 staining and stronger glomerular PD-1 expression, especially with combination treatment. Conversely, human AIN patients only showed interstitial PD-1 positivity. Conclusions Only mice receiving cisplatin and anti-PDL1 concomitantly developed AIN, accompanied with a more severe kidney injury. AIN induced by this drug combination was linked to elevated uMCP1, consistently with human AIN, suggesting that uMCP1 can be potentially used as an AIN biomarker.

IntroductionThere is a growing interest in the effect of Long-COVID (LC) on cognition, and neuroimaging allows us to gain insight into the structural and functional changes underlying cognitive impairment in LC. We used multimodal neuroimaging data in combination with neuropsychological evaluations to study cognitive complaints in a cohort of LC patients with mild to moderate severity symptoms.MethodsWe conducted a 3T brain magnetic resonance imaging (MRI) study with diffusion tensor imaging (DTI) and functional MRI (fMRI) sequences on 53 LC patients 1.8 years after acute COVID-19 onset. We administered neuropsychological tests to evaluate cognitive domains and examined correlations with Tract-Based Spatial Statistics (TBSS) and resting state.ResultsWe included 53 participants with LC (mean age, 48.23 years; 88.7% females). According to the Frascati criteria, more than half of the participants had deficits in the executive (59%) and attentional (55%) domains, while 40% had impairments in the memory domain. Only one participant (1.89%) showed problems in the visuospatial and visuoconstructive domain. We observed that increased radial diffusivity in different white matter tracts was negatively correlated with the memory domain. Our results showed that higher resting state activity in the fronto-parietal network was associated with lower memory performance. Moreover, we detected increased functional connectivity among the bilateral hippocampus, the right hippocampus and the left amygdala, and the right hippocampus and the left middle temporal gyrus. These connectivity patterns were inversely related to memory and did not survive false discovery rate (FDR) correction.DiscussionPeople with LC exhibit cognitive impairments linked to long-lasting changes in brain structure and function, which justify the cognitive alterations detected.

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Abstract Background Schistosomiasis is highly endemic in sub-Saharan Africa and frequently imported to Europe. Male urogenital manifestations are often neglected. We aimed to ascertain the prevalence of genitourinary clinical signs and symptoms among long-term African migrants in a non-endemic European country using a serology test. Methods We carried out a prospective, community-based cross-sectional study of adult male migrants from sub-Saharan Africa living in Spain. Schistosoma serology tests and microscopic urine examinations were carried out, and clinical data were obtained from an electronic medical record search and a structured questionnaire. Results We included 388 adult males, mean age 43.5 years [Standard Deviation (SD) = 12.0, range: 18–76]. The median time since migration to the European Union was 17 [Interquartile range (IQR): 11–21] years. The most frequent country of origin was Senegal (N = 179, 46.1%). Of the 338, 147 (37.6%) tested positive for Schistosoma. Parasite eggs were present in the urine of only 1.3%. Nine genitourinary clinical items were significantly associated with positive Schistosoma serology results: pelvic pain (45.2%; OR = 1.57, 95% CI: 1.0–2.4), pain on ejaculation (14.5%; OR = 1.85, 95% CI: 1.0–3.5), dyspareunia (12.4%; OR = 2.45, 95% CI: 1.2–5.2), erectile dysfunction (9.5%; OR = 3.10, 95% CI: 1.3–7.6), self-reported episodes of infertility (32.1%; OR = 1.69, 95% CI: 1.0–2.8), haematuria (55.2%; OR = 2.37, 95% CI: 1.5–3.6), dysuria (52.1%; OR = 2.01, 95% CI: 1.3–3.1), undiagnosed syndromic STIs (5.4%), and orchitis (20.7%; OR = 1.81, 95% CI: 1.0–3.1). Clinical signs tended to cluster. Conclusions Urogenital clinical signs and symptoms are prevalent among male African long-term migrants with a positive Schistosoma serology results. Genital involvement can be frequent even among those with long periods of non-residence in their sub-Saharan African countries of origin. Further research is needed to develop diagnostic tools and validate therapeutic approaches to chronic schistosomiasis. Graphical Abstract

Abstract Background To which extent physical activity is associated with depression independent of older adults’ physical and cognitive functioning is largely unknown. This cohort study using harmonised data by the EU Ageing Trajectories of Health: Longitudinal Opportunities and Synergies consortium, including over 20 countries, to evaluate the longitudinal association of physical activity (light-to-moderate or vigorous intensity) with depression in older adults (aged ≥ 50 years). Results We evaluated 56,818 participants (light-to-moderate models; 52.7% females, age 50–102 years) and 62,656 participants (vigorous models; 52.7% females, age 50–105 years). Compared to never, light-to-moderate or vigorous physical activity was associated with a lower incidence rate ratio (IRR) of depression (light-to-moderate model: once/week: 0.632, 95% CI 0.602–0.663; twice or more/week: 0.488, 95% CI 0.468–0.510; vigorous model: once/week: 0.652, 95% CI 0.623–0.683; twice or more/week: 0.591, 95% CI 0.566–0.616). Physical activity remained associated with depression after adjustment for the healthy ageing scale, which is a scale that incorporated 41 items of physical and cognitive functioning (light-to-moderate model: once/week: 0.787, 95% CI 0.752–0.824; twice or more/week: 0.711, 95% CI 0.682–0.742; vigorous model: once/week: 0.828, 95% CI 0.792–0.866; twice or more/week: 0.820, 95% CI 0.786–0.856). Conclusions Physical activity, of any intensity and weekly frequency, was a strong protective factor against depression, independent of physical and mental functioning. Health policies could stimulate the incorporation of lower physical activity intensity to protect against depression, which might be more feasible at the population level.

Population aging has become a widely known phenomenon in industrialized nations. In 2030, there will be about 1 billion people aged 65 and older globally (1). The growing life expectancy will be associated to an increase of chronic diseases, like osteoporosis and the fractures related to it. Therefore, the incidence of lower extremity fractures around pre-existing fixation hardware will also increase (2, 3).

Background: Despite the implementation of specific exercises to reduce hamstrings strain injuries (HSI) risk, the incidence has remained unchanged over the past 30 years. Therefore, the purpose of the study was to analyze hamstrings muscle activation induced by a novel Flywheel Russian belt Deadlift (FRD) exercise, together with individual muscle-, region- and limb-specific differences. Methods: The activation of hamstring muscles before and immediately after a 10 × 10 FRD training session was assessed by the T2 shift technique through functional magnetic resonance imaging, in one international-level filed hockey male player. The individual use of the biceps femoris long head (BFLH) and short head (BFSH), semitendinosus (ST), and semimembranosus (SM) were analyzed, together with the region-specific activation for each muscle. Results: T2 values significantly increased immediately after exercise in all regions of the hamstring muscles in both dominant and non-dominant lower limb. However, the SM muscle showed a lesser activation, compared to BFLH, BFSH and ST muscles [F(3,106) = 9.557, p < 0.001]. Overall, the most activated muscle by the FRD training session was the biceps femoris (short head +13.8 %, long head, +12.7 %), followed by the ST (+11.3 %), and lastly the SM (+6.9 %). Conclusion: The novel FRD exercise triggers a homogeneous and consistent activation of hamstring muscles. Particularly, the lateral positioning muscles (i.e., BFLH and BFSH) were more activated than the medial positioning muscles (i.e., ST and SM). Therefore, the FRD exercise could enhance training programs to strengthen and activate the hamstring muscles, and specifically, the BFLH, in order to reduce HSI risk.

BackgroundPrevious mobile health (mHealth) studies have revealed significant links between depression and circadian rhythm features measured via wearables. However, the comprehensive impact of seasonal variations was not fully considered in these studies, potentially biasing interpretations in real-world settings. ObjectiveThis study aims to explore the associations between depression severity and wearable-measured circadian rhythms while accounting for seasonal impacts. MethodsData were sourced from a large longitudinal mHealth study, wherein participants’ depression severity was assessed biweekly using the 8-item Patient Health Questionnaire (PHQ-8), and participants’ behaviors, including sleep, step count, and heart rate (HR), were tracked via Fitbit devices for up to 2 years. We extracted 12 circadian rhythm features from the 14-day Fitbit data preceding each PHQ-8 assessment, including cosinor variables, such as HR peak timing (HR acrophase), and nonparametric features, such as the onset of the most active continuous 10-hour period (M10 onset). To investigate the association between depression severity and circadian rhythms while also assessing the seasonal impacts, we used three nested linear mixed-effects models for each circadian rhythm feature: (1) incorporating the PHQ-8 score as an independent variable, (2) adding seasonality, and (3) adding an interaction term between season and the PHQ-8 score. ResultsAnalyzing 10,018 PHQ-8 records alongside Fitbit data from 543 participants (n=414, 76.2% female; median age 48, IQR 32-58 years), we found that after adjusting for seasonal effects, higher PHQ-8 scores were associated with reduced daily steps (β=–93.61, P

Background: Despite the availability of effective antidepressant strategies, numerous people with depressive disorders remain untreated. The Covid-19 pandemic has affected healthcare services, especially the mental health sector. This study aims to explore the coverage of depression treatments in the general Spanish population and the impact of the Covid-19 pandemic. Methods: We used longitudinal data (2018 and 2022) from the general Spanish population: pre-pandemic n = 1512; mean age = 65.43 years ± 14.90; 56 % females; post-pandemic n = 909; mean age = 68.00 years ± 14.24; 54 % women. The International Classification of Disease 10th edition was used to diagnose lifetime depressive episodes and severity. We explored psychological and pharmacological treatment coverage via multiple logistic regressions adjusted for 4 covariates (sex assigned at birth, education level, age, Covid-19 pandemic) for participants with a diagnosis of depression. Results: Treatment coverage for depression in the pre-pandemic and post-pandemic samples was, respectively, 53.3 % and 51.9 %. We observed an association between severe depression and treatment coverage (OR = 2.77, 95%CI 1.05 to 7.75). We found no association between the COVID-19 pandemic and treatment coverage. Conclusions: The pharmacological treatment coverage was associated with severe types of depression. The prevalence rates of treatment coverage were similar in the pre- and post-COVID-19 pandemic attesting to the resilience of the mental health system in Spain.

Antler is one of the primary animal raw materials exploited for technical purposes by the hunter-gatherer groups of the Eurasian Upper Palaeolithic (UP) all over the ecological range of deers, and beyond. It was exhaustively employed to produce one of the most critical tools for the survival of the UP societies: hunting weapons. However, antler implements can be made from diverse deer taxa, with different ecological requirements and ethological behaviours. Identifying the antler's origin at a taxonomic level is thus essential in improving our knowledge of humans' functional, practical and symbolic choices, as well as the human-animal interface during Prehistoric times. Nevertheless, palaeogenetics analyses have focused mainly on bone and teeth, with genetic studies of antler generally focused on modern deer conservation. Here we present the results of the first whole mitochondrial genome ancient DNA (aDNA) analysis by means of in-solution hybridisation capture of antlers from pre-Holocene archaeological contexts. We analysed a set of 50 Palaeolithic and Neolithic (c. 34-8ka) antler and osseous objects from South-Western Europe, Central Europe, South-Western Asia and the Caucasus. We successfully obtained aDNA, allowing us to identify the exploited taxa and demonstrate the archaeological relevance of those finds. Moreover, as most of the antlers were sampled using a minimally-invasive method, further analyses (morphometric, technical, genetic, radiometric and more) remain possible on these objects.

The need to feed an increasing population while limiting the environmental impact of agriculture is currently one of the greatest challenges relating to the food chain. One of the key factors involved in doing this is irrigation, which has a downstream impact that can be minimised if nutrient and water management are efficiently undertaken. The objective of this study was to determine which irrigation management improvements can be done at field scale in modern irrigated areas to reduce its irrigation return flow impact. The study was conducted in the Noguera Ribagorçana River basin, in NE Spain, where almost 6000 ha of land were brought into irrigation from 2000 to 2009. We based our study on a water quality dataset, measured in four different sites along a 29 km2 stretch of the river over a period of 20 years. Our results show an increase in nitrate (from 1.7 mg·L−1 to 10.5 mg·L−1) and salt concentrations (electrical conductivity from 297 to 675 µS·m−1) in the downstream course of the river compared to the most upstream monitoring site. That was exclusively associated with the irrigation return flows from the newly irrigated area. The highest nitrate and salt concentrations are found during the non-irrigation season which corresponds to the local rainy season. To reduce this impact, better irrigation management is required. Autumn leaching could be lowered by reducing irrigation volume applied during the final weeks of crop cycles in order to allow the soil to retain the volume of water received from rainfall. To deal with this issue, we propose a methodology based on soil moisture to determine the end of the irrigation season. In this way, the impact on ecosystems located further downstream would be reduced while crop yields and productivity in the area could be maintained.

BackgroundThe overall pandemic created enormous pressure on long-term care workers (LTCWs), making them particularly vulnerable to mental disorders. Despite this, most of the available evidence on professional well-being during COVID-19 has exclusively focused on frontline health care workers. ObjectiveThis study aimed to identify the long-term psychological needs of LTCWs derived from the COVID-19 pandemic and to explore barriers and facilitators related to digital mental health tools. This is part of a project that seeks to develop a digital mental health intervention to reduce psychological distress in this population group. MethodsWe performed a qualitative study with a rapid research approach. Participants were LTCWs of the autonomous community of Catalonia. We conducted 30 semistructured interviews between April and September 2022. We used a qualitative content analysis method with an inductive-deductive approach. ResultsThe period of the pandemic with the highest mental health burden was the COVID-19 outbreak, with almost all workers having experienced some form of emotional distress. Emotional distress persisted over time in more than half of the participants, with fatigue and nervousness being the main emotions expressed at the time of the interview. High workload, the feeling that pandemic times are not over, and poor working conditions that have remained since then have been the most frequently expressed determinants of such emotions. Potential barriers and facilitators to engagement with digital tools were also identified in terms of previous experience and beliefs of the target population, possibilities for the integration of a digital tool into daily life, preferences regarding the level of guidance, the possibility of social connectedness through the tool, and privacy and confidentiality. The identified factors may become especially relevant in the context of the pandemic remission phase. ConclusionsMore than 2 years after the pandemic outbreak, emotional distress is still relevant. The persistent burden of psychological distress points to a need for institutions to take action to improve working conditions and promote employees’ well-being. Considering factors that act as barriers and facilitators for the use of digital mental health tools, it is important to develop tailored tools that could offer valuable support to this population during and after a pandemic.

La responsabilidad contractual de las plataformas en línea está siendo objeto de un intenso debate. Los operadores normalmente actúan como meros intermediarios y así suelen revelarlo con arreglo al art. 97 bis TRLGDCU, apartado 1, letra d), mientras que una corriente de opinión pretende hacerlos responder por los bienes y servicios subyacentes a partir de la influencia predominante que ejercen sobre los proveedores. El criterio tiene su origen en la jurisprudencia elaborada por el TJUE a propósito de los prestadores de servicios de la sociedad de la información. A falta de una regulación específica en la Unión Europea, el art. 20 de las Reglas modelo sobre intermediación en línea publicadas por el European Law Institute (ELI) constituye un hito importante en el debate. Este artículo se muestra partidario de acudir al Derecho de contratos. A este respecto primero aborda el principio de relatividad de los contratos y tantea si cabe incluir el contrato celebrado entre los dos grupos de usuarios, proveedores y clientes, entre las excepciones a la regla del art. 1257 I CC realizadas por la doctrina jurisprudencial del Tribunal Supremo español con respecto a otros contratos y actividades económicas. A continuación, contrapone una responsabilidad por los bienes y servicios basada en la influencia predominante de las plataformas sobre los proveedores con la posibilidad de «levantar el velo» a partir de una distribución contractual de oportunidades y riesgos.

Abstract Background The COVID-19 pandemic has negatively affected the mental health of international migrant workers (IMWs). IMWs experience multiple barriers to accessing mental health care. Two scalable interventions developed by the World Health Organization (WHO) were adapted to address some of these barriers: Doing What Matters in times of stress (DWM), a guided self-help web application, and Problem Management Plus (PM +), a brief facilitator-led program to enhance coping skills. This study examines whether DWM and PM + remotely delivered as a stepped-care programme (DWM/PM +) is effective and cost-effective in reducing psychological distress, among Polish migrant workers with psychological distress living in the Netherlands. Methods The stepped-care DWM/PM + intervention will be tested in a two-arm, parallel-group, randomized controlled trial (RCT) among adult Polish migrant workers with self-reported psychological distress (Kessler Psychological Distress Scale; K10 > 15.9). Participants (n = 212) will be randomized into either the intervention group that receives DWM/PM + with psychological first aid (PFA) and care-as-usual (enhanced care-as-usual or eCAU), or into the control group that receives PFA and eCAU-only (1:1 allocation ratio). Baseline, 1-week post-DWM (week 7), 1-week post-PM + (week 13), and follow-up (week 21) self-reported assessments will be conducted. The primary outcome is psychological distress, assessed with the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS). Secondary outcomes are self-reported symptoms of depression, anxiety, posttraumatic stress disorder (PTSD), resilience, quality of life, and cost-effectiveness. In a process evaluation, stakeholders’ views on barriers and facilitators to the implementation of DWM/PM + will be evaluated. Discussion To our knowledge, this is one of the first RCTs that combines two scalable, psychosocial WHO interventions into a stepped-care programme for migrant populations. If proven to be effective, this may bridge the mental health treatment gap IMWs experience. Trial registration Dutch trial register NL9630, 20/07/2021, https://www.onderzoekmetmensen.nl/en/trial/27052

Objective: To report the outcomes of intra- and extra-peritoneal robot-assisted radical prostatectomy (RARP) and robot-assisted radical cystectomy (RARC) with Hugo™ robot-assisted surgery (RAS) system (Medtronic, Minneapolis, MN, USA). Methods: Data of twenty patients who underwent RARP and one RARC at our institution between February 2022 and January 2023 were reported. The primary endpoint of the study was to report the surgical setting of Hugo™ RAS system to perform RARP and RARC. The secondary endpoint was to assess the feasibility of RARP and RARC with this novel robotic platform and report the outcomes. Results: Seventeen patients underwent RARP with a transperitoneal approach, and three with an extraperitoneal approach; and one patient underwent RARC with intracorporeal ileal conduit. No intraoperative complications occurred. Median docking and console time were 12 (interquartile range [IQR] 7–16) min and 185 (IQR 177–192) min for transperitoneal RARP, 15 (IQR 12–17) min and 170 (IQR 162–185) min for extraperitoneal RARP. No intraoperative complications occurred. One patient submitted to extraperitoneal RARP had a urinary tract infection in the postoperative period that required an antibiotic treatment (Clavien-Dindo Grade 2). In case of transperitoneal RARP, two minor complications occurred (one pelvic hematoma and one urinary tract infection; both Clavien-Dindo Grade 2). Conclusion: Hugo™ RAS system is a novel promising robotic platform that allows to perform major oncological pelvic surgery. We showed the feasibility of RARP both intra- and extra-peritoneally and RARC with intracorporeal ileal conduit with this novel platform.

Irrigation is the most water consuming activity in the world. Knowing the timing and amount of irrigation that is actually applied is therefore fundamental for water managers. However, this information is rarely available at all scales and is subject to large uncertainties due to the wide variety of existing agricultural practices and associated irrigation regimes (full irrigation, deficit irrigation, or over-irrigation). To fill this gap, we propose a two-step approach based on 15 m resolution Sentinel-1 (S1) surface soil moisture (SSM) data to retrieve the actual irrigation at the weekly scale over an entire irrigation district. In a first step, the S1-derived SSM is assimilated into a FAO-56-based crop water balance model (SAMIR) to retrieve for each crop type both the irrigation amount (Idose) and the soil moisture threshold (SMthreshold) at which irrigation is triggered. To do this, a particle filter method is implemented, with particles reset each month to provide time-varying SMthreshold and Idose. In a second step, the retrieved SMthreshold and Idose values are used as input to SAMIR to estimate the weekly irrigation and its uncertainty. The assimilation approach (SSM-ASSIM) is tested over the 8000 hectare Algerri-Balaguer irrigation district located in northeastern Spain, where in situ irrigation data integrating the whole district are available at the weekly scale during 2019. For evaluation, the performance of SSM-ASSIM is compared with that of the default FAO-56 irrigation module (called FAO56-DEF), which sets the SMthreshold to the critical soil moisture value and systematically fills the soil reservoir for each irrigation event. In 2019, with an observed annual irrigation of 687 mm, SSM-ASSIM (FAO56-DEF) shows a root mean square deviation between retrieved and in situ irrigation of 6.7 (8.8) mm week-1, a bias of +0.3 (−1.4) mm week-1, and a Pearson correlation coefficient of 0.88 (0.78). The SSM-ASSIM approach shows great potential for retrieving the weekly water use over extended areas for any irrigation regime, including over-irrigation.

Research on the reproduction of disdainful and toxic models of heterosexual relationships shows their negative effects on people’s health status. Contrarily, the preventive socialization process illustrates the development of alternative relationships, which are directly related to egalitarian, passionate and non-violent values and have been demonstrated to produce positive effects on health. The present study focuses on the socialization process, analyzing how men choose their affective and sexual relationships and examining the influence of the new alternative masculinities (NAM) approach on these choices. The defining characteristics of these men are self-confidence, solidarity, and strength to face violence and any discrimination. The investigation has used a qualitative methodology with a communicative orientation. Firstly, seven semi-structured interviews with men who follow the NAM’s approach have been conducted. Secondly, a content analysis has been conducted focused on discourses and messages shaped on internet forums and songs about how men explain their choices and interests in their relationships. The results reveal the existence of men who prefer women that get excited with egalitarian men and not with chauvinist and violent men. These kinds of choices show an improvement in heterosexual men’s affective and sexual relations as well as in their health status.

BackgroundParaproteins can interfere with several substances, producing erroneous laboratory measurements. The diagnosis of kidney disease in patients with hematological disorders has important prognosis implications. An elevated creatinine with no other signs of kidney disease should prompt the idea of a spurious creatinine. Communication between the clinical team and the laboratory is key.Case presentationIn this case, we present a 68-year-old woman with an elevated creatinine and an IgM lambda paraprotein. Interestingly, there were no other signs of chronic kidney disease besides the creatinine value, with no albuminuria or microhematuria. A kidney biopsy showed normal parenchyma and ruled out the possibility of paraprotein-related damage. The monoclonal component and creatinine levels raised parallelly during follow-up while maintaining normal urea levels. This prompted the hypothesis of a falsely elevated creatinine. It was confirmed with a normal glomerular filtration rate determined by a radioisotope, a cystatin C measurement and a reduction in creatinine when diluting the sample.ConclusionIt is important to consider the possibility of a falsely elevated creatinine in patients with paraproteinemia and no other signs of kidney disease to avoid unnecessary diagnostic tests and for the prognostic implications.

The global population growth has significantly impacted energy and raw material consumption, unmatched since the Industrial Revolution. Among metals, aluminium ranks second only to steel, with annual production exceeding 69 million tonnes. Due to its high demand, bauxite, the primary ore from which aluminium is extracted, is now classified as a critical material in the EU and the US, given the potential risk of supply shortages for essential applications. Geographical and production challenges surround bauxite, presenting geo-economic and environmental challenges. A critical concern in aluminium production is managing by-products, notably red mud, a bauxite residue, generating over 175 million tonnes annually worldwide. Comprehensive bibliometric research is imperative due to the high amount of bibliographical resources related to this topic, encompassing circular economy, re-valorisation, sustainability, and disposal. This study employs bibliometric methods to assess red mud valorisation, offering insights into research topics, influential authors, and key journals, shedding light on the past, present, and future of red mud research. Such bibliometric analysis not only highlights the current state of the field but also serves as a valuable tool for decision-making, enabling researchers and policymakers to identify trends, gaps, and areas for further exploration, fostering informed and sustainable advancements in the by-products of the aluminium industry.

Human Papillomavirus (HPV) prophylactic vaccination has proven effective in preventing new infections, but it does not treat existing HPV infections or associated diseases. Hence, there is still an important reservoir of HPV in adults, as vaccination programs are mainly focused on young women. The primary objective of this non-randomized, open-label trial is to evaluate if a 3-dose regimen of Gardasil-9 in HPV16/18-positive women could reduce the infective capacity of their body fluids. We aim to assess if vaccine-induced antibodies could neutralize virions present in the mucosa, thus preventing the release of infective particles and HPV transmission to sexual partners. As our main endpoint, the E1^E4-HaCaT model will be used to assess the infectivity rate of cervical, anal and oral samples, obtained from women before and after vaccination. HPV DNA positivity, virion production, seroconversion, and the presence of antibodies in the exudates, will be evaluated to attribute infectivity reduction to vaccination. Our study will recruit two different cohorts (RIFT-HPV1 and RIFT-HPV2) of non-vaccinated adult women. RIFT-HPV1 will include subjects with an HPV16/18 positive cervical test and no apparent cervical lesions or cervical lesions eligible for conservative treatment. RIFT-HPV2 will include subjects with an HPV16/18 positive anal test and no apparent anal lesions or anal lesions eligible for conservative treatment, as well as women with an HPV16/18 positive cervical test and HPV-associated vulvar lesions. Subjects complying with inclusion criteria for both cohorts will be recruited to the main cohort, RIFT-HPV1. Three doses of Gardasil-9 will be administered intramuscularly at visit 1 (0 months), visit 2 (2 months) and visit 3 (6 months). Even though prophylactic HPV vaccines would not eliminate a pre-existing infection, our results will determine if HPV vaccination could be considered as a new complementary strategy to prevent HPV-associated diseases by reducing viral spread. Trial registration: https://clinicaltrials.gov/ct2/show/NCT05334706.

Presentació del volum 3/1 (2024)

The transplant community is focused on prolonging the ex vivo preservation time of kidney grafts to allow for long-distance kidney graft transportation, assess the viability of marginal grafts, and optimize a platform for the translation of innovative therapeutics to clinical practice, especially those focused on cell and vector delivery to organ conditioning and reprogramming. We describe the first case of feasible preservation of a kidney from a donor after uncontrolled circulatory death over a 73-h period using normothermic perfusion and analyze hemodynamic, biochemical, histological, and transcriptomic parameters for inflammation and kidney injury. The mean pressure and flow values were 71.24 ± 9.62 mmHg and 99.65 ± 18.54 mL/min, respectively. The temperature range was 36.7°C–37.2°C. The renal resistance index was 0.75 ± 0.15 mmHg/mL/min. The mean pH was 7.29 ± 0.15. The lactate concentration peak increased until 213 mg/dL at 6 h, reaching normal values after 34 h of perfusion (8.92 mg/dL). The total urine output at the end of perfusion was 1.185 mL. Histological analysis revealed no significant increase in acute tubular necrosis (ATN) severity as perfusion progressed. The expression of KIM-1, VEGF, and TGFβ decreased after 6–18 h of perfusion until 60 h in which the expression of these genes increased again together with the expression of β-catenin, Ki67, and TIMP1. We show that normothermic perfusion can maintain a kidney graft viable ex vivo for 3 days, thus allowing a rapid translation of pre-clinical therapeutics to clinical practice.

The inflammasome regulates the innate inflammatory response and is involved in autoimmune diseases. In this study, we explored the levels of IL-18 and IL-1β in serum and urine and the influence of various single-nucleotide polymorphisms (SNPs) on kidney lesions at diagnosis in patients with ANCA-associated vasculitis (AAV) and their clinical outcomes. Ninety-two patients with renal AAV were recruited, and blood and urine were collected at diagnosis. Serum and urine cytokine levels were measured by ELISA. DNA was extracted and genotyped using TaqMan assays for SNPs in several inflammasome genes. Lower serum IL-18 (p = 0.049) and the IL-18 rs187238 G-carrier genotype (p = 0.042) were associated with severe fibrosis. The IL-18 rs1946518 TT genotype was associated with an increased risk of relapse (p = 0.05), whereas GG was related to better renal outcomes (p = 0.031). The rs187238 GG genotype was identified as a risk factor for mortality within the first year after AAV diagnosis, independent of the requirement for dialysis or lung involvement (p = 0.013). We suggest that decreased cytokine levels could be a surrogate marker of scarring and chronicity of the renal lesions, together with the rs187238 GG genotype. If our results are validated, the rs1946518 TT genotype predicts the risk of relapse and renal outcomes during follow-up.

The main objective of this study was to determine plasma levels of PS and to study SNVs rs41360247, rs4245791, rs4148217, and rs11887534 of ABCG8 and the r657152 SNV at the ABO blood group locus in a sample of a population treated at our hospital, and to determine whether these SNVs are related to plasma PS concentrations. The secondary objective was to establish the variables associated with plasma PS concentrations in adults. Participants completed a dietary habit questionnaire and a blood sample was collected to obtain the following variables: campesterol, sitosterol, sitostanol, lanosterol, stigmasterol, biochemical parameters, and the SNVs. In addition, biometric and demographic variables were also recorded. In the generalized linear model, cholesterol and age were positively associated with total PS levels, while BMI was negatively related. For rs4245791, homozygous T allele individuals showed a significantly lower campesterol concentration compared with C homozygotes, and the GG alleles of rs657152 had the lowest levels of campesterol compared with the other alleles of the SNV. Conclusions: The screening of certain SNVs could help prevent the increase in plasma PS and maybe PNALD in some patients. However, further studies on the determinants of plasma phytosterol concentrations are needed.

ABSTRACT Introduction: Robotic approach has shown its feasibility and safety with respect to open approach for radical cystectomy (1). The performances of Hugo™ RAS system (Medtronic, Minneapolis, USA) have been demonstrated in several clinical scenarios (2-5). We report the feasibility and surgical settings of the first series of robot-assisted radical cystectomy (RARC) with intracorporeal ileal-conduit performed with Hugo™ RAS system. Methods: Two patients were submitted to RARC with ileal conduit at our institution. The trocar placement scheme and the operating room setting with docking angles of the four arms were already described (6). A 12-mm and a 5-mm trocar for the assistant were placed. In both cases, an ileal-conduit with a Wallace type-1 uretero-enteric derivation was performed intra-corporeally. Results: The first patient was a 71-year-old male with a very-high risk non-muscle invasive bladder cancer(BC), and the second patient was a 64-year-old male with a diagnosis of T2 high-grade BC. Operative times were 360 and 420 minutes with a docking time of 12 and 9 minutes, respectively. No intraoperative complications occurred. The estimated blood loss was 200ml and 400ml, respectively. The second patient developed an ileus on postoperative day 4 (Clavien-Dindo grade 2). No positive surgical margins were recorded. No recurrence nor progression occurred during follow-up. Conclusion: RARC with intracorporeal ileal conduit urinary diversion is feasible with Hugo™ RAS system. We provided insight into the surgical setting using this novel robotic platform to help new adopters to face this challenging procedure. These findings may help a wider distribution of robotic programs for BC treatment.

Durant un any i mig aproximadament hi ha hagut una llei de control de lloguers vigent a Catalunya (Llei 11/2020). La Llei 11/2020, que va entrar en vigor el 18 de setembre de 2020, va quedar parcialment anul·lada per una sentència del Tribunal Constitucional del 8 d’abril d’aquest mateix any, amb la qual cosa ja se’n coneix el període complet de vigència i es pot tractar d’avaluar els seus efectes. En aquest article pretenem conèixer la situació del mercat de lloguer a Catalunya, les motivacions que van originar la Llei 11/2020, les seves principals característiques, així com l’evidència empírica internacional que hi ha respecte del control dels lloguers. Finalitzarem l’article analitzant les principals avaluacions científiques que s’han realitzat de l’impacte de la Llei 11/2020. Els resultats mostren una dèbil reducció de preus i una considerable reducció de l’oferta d’habitatges. Com a conclusió s’observa que, tot i que les motivacions per tractar de pal·liar l’evolució del preu del lloguer en relació amb l’evolució dels salaris són ben clares i comprensibles, la limitació de lloguers és una política que equivoca la diagnosi. Controlar preus té sentit en mercats oligopolístics amb importants barreres d’entrada, com pot ser el mercat de l’energia. En canvi, no té sentit en mercats atomitzats sense barres d’entrada. Però el problema es fa més gran quan parlem d’una de les polítiques econòmiques amb major consens dins la comunitat científica econòmica: no funciona. Com a màxim s’aconsegueix un petit efecte en el preu, de curta durada i només en el segment regulat. En canvi, acaba produint un fort efecte negatiu en l’oferta de lloguers. I quan observem un augment de preus dels lloguers, el principal problema que hi ha al darrere és escassetat d’oferta.

Abstract Background The COVID-19 pandemic as a public health crisis has led to a significant increase in mental health difficulties. Smoking is strongly associated with mental health conditions, which is why the pandemic might have influenced the otherwise decline in smoking rates. Persons belonging to socioeconomically disadvantaged groups may be particularly affected, both because the pandemic has exacerbated existing social inequalities and because this group was more likely to smoke before the pandemic. We examined smoking prevalence in a French cohort study, focusing on differences between educational attainment. In addition, we examined the association between interpersonal changes in tobacco consumption and educational level from 2018 to 2021. Methods Using four assessments of smoking status available from 2009 to 2021, we estimated smoking prevalence over time, stratified by highest educational level in the TEMPO cohort and the difference was tested using chi2 test. We studied the association between interpersonal change in smoking status between 2018 and 2021 and educational attainment among 148 smokers, using multinomial logistic regression. Results Smoking prevalence was higher among those with low education. The difference between the two groups increased from 2020 to 2021 (4.8–9.4%, p

Abstract Background The COVID-19 pandemic has had major and potentially long-lasting effects on mental health and wellbeing across populations worldwide. However, these impacts were not felt equally, leading to an exacerbation of health inequalities, especially affecting vulnerable populations such as migrants, refugees and asylum seekers. Aiming to inform the adaptation and implementation of psychological intervention programmes, the present study investigated priority mental health needs in this population group. Methods Participants were adult asylum seekers, refugees and migrants (ARMs) and stakeholders with experience in the field of migration living in Verona, Italy, and fluent in Italian and English. A two-stage process was carried out to examine their needs using qualitative methods including free listing interviews and focus group discussions, according to Module One of the DIME (Design, Implementation, Monitoring, and Evaluation) manual. Data were analyzed using an inductive thematic analyses approach. Results A total of 19 participants (12 stakeholders, 7 ARMs) completed the free listing interviews and 20 participants (12 stakeholders and 8 ARMs) attended focus group discussions. Salient problems and functions that emerged during free listing interviews were discussed during the focus group discussions. During the COVID-19 pandemic, ARMs struggled with many everyday living difficulties in their resettlement country due to social and economic issues, revealing a strong influence of contextual factors in determining mental health. Both ARMs and stakeholders highlighted a mismatch between needs, expectations and interventions as factors that may hamper proper implementation of health and social programmes. Conclusions The present findings could help in the adaptation and implementation of psychological interventions targeting the needs of asylum seekers, refugees and migrants aiming to find a match between needs, expectations, and the corresponding interventions. Trial registration Registration number 2021-UNVRCLE-0106707, February 11 2021.

The implementation of bike-sharing systems (BSSs) is expected to lead to modifications in the travel habits of transport users, one of which is the choice of travel mode. Therefore, this research focuses on the identification of factors influencing the shift of private car users to BSSs based on stated preference survey data from the city of Alexandroupolis, Greece. A binary logit model is employed for this purpose. The estimation results indicate the impacts of gender, income, travel time, travel cost and safety-related aspects on the mode shift, through which behavioural insights are derived. For example, car users are found to be twice as sensitive to the cost of BSSs than to that of car. Similarly, they are highly sensitive to BSS travel time. Based on the behavioural findings, policy measures are suggested under the following categories: (i) finance, (ii) regulation, (iii) infrastructure, (iv) campaigns and (v) customer targeting. In addition, a secondary objective of this research is to obtain insights from the comparison of the specified logit model with a machine learning approach, as the latter is slowly gaining prominence in the field of transport. For the comparison, a random forest classifier is also developed. This comparison shows a coherence between the two approaches, although a discrepancy in the feature importance for gender and travel time is observed. A deeper exploration of this discrepancy highlights the hurdles that often occur when using mathematically more powerful models, such as the random forest classifier.

Abstract Robust and reliable estimates of demographic parameters are essential to understand population dynamics. Natal dispersal is a common process in monitored populations and can cause underestimations of survival and dispersal due to permanent emigration. Here, we present a multistate Bayesian capture-mark-recapture approach based on a joint estimation of natal dispersal kernel and detection probabilities to address biases in survival, dispersal, and related demographic parameters when dispersal information is limited. We implement this approach to long-term data of a threatened population: the Bonelli’s eagle in Catalonia (SW Europe). To assess the method’s performance, we compare demographic estimates structured by sex, age, and breeding status in cases of limited versus large data scales, with those of classical models where dispersal and detection probabilities are estimated separately. Results show substantial corrections of demographic estimates. Natal dispersal and permanent emigration probabilities were larger in females, and consequently, female non-breeder survival showed larger differences between separate and joint estimation models. Moreover, our results suggest that estimates are sensitive to the choice of the dispersal kernel, fat-tailed kernels providing larger values in cases of data limitation. This study provides a general multistate framework to model demographic parameters while correcting permanent emigration biases caused by natal dispersal.

Abstract Background Posttraumatic stress disorder (PTSD) is associated with significant morbidity, but efficacious pharmacotherapy and psychotherapy are available. Data from the World Mental Health Surveys were used to investigate extent and predictors of treatment coverage for PTSD in high-income countries (HICs) as well as in low- and middle-income countries (LMICs). Methods Seventeen surveys were conducted across 15 countries (9 HICs, 6 LMICs) by the World Health Organization (WHO) World Mental Health Surveys. Of 35,012 respondents, 914 met DSM-IV criteria for 12-month PTSD. Components of treatment coverage analyzed were: (a) any mental health service utilization; (b) adequate pharmacotherapy; (c) adequate psychotherapy; and (d) effective treatment coverage. Regression models investigated predictors of treatment coverage. Results 12-month PTSD prevalence in trauma exposed individuals was 1.49 (S.E., 0.08). A total of 43.0% (S.E., 2.2) received any mental health services, with fewer receiving adequate pharmacotherapy (13.5%), adequate psychotherapy (17.2%), or effective treatment coverage (14.4%), and with all components of treatment coverage lower in LMICs than HICs. In a multivariable model having insurance (OR = 2.31, 95 CI 1.17, 4.57) and severity of symptoms (OR = .35, 95% CI 0.18, 0.70) were predictive of effective treatment coverage. Conclusion There is a clear need to improve pharmacotherapy and psychotherapy coverage for PTSD, particularly in those with mild symptoms, and especially in LMICs. Universal health care insurance can be expected to increase effective treatment coverage and therefore improve outcomes.

Abstract Background There are no data on the association between leisure‐time physical activity (LTPA) and sarcopenia in older adults from low‐ and middle‐income countries (LMICs). This study aimed to investigate the association between LTPA and sarcopenia in individuals aged ≥65 years living in six LMICs. Methods Cross‐sectional data from the Study on Global AGEing and Adult Health (China, Ghana, India, Mexico, Russia and South Africa) were analysed. Sarcopenia referred to the presence of both low skeletal muscle mass and weak handgrip strength. LTPA was assessed using the Global Physical Activity Questionnaire and was analysed as a dichotomized variable [high LTPA (>150 min/week of moderate‐to‐vigorous LTPA) or low LTPA (≤150 min/week)]. Multivariable logistic regression analysis was conducted to assess associations. Results There were 14 585 individuals included in this study [mean (SD) age 72.6 (11.5) years; 55.0% women]. The prevalence of high LTPA and sarcopenia was 8.9% and 12.0%, respectively. After adjusting for potential confounders, low LTPA was significantly associated with higher odds for sarcopenia [prevalence odds ratio (POR) = 1.85, 95% confidence interval (CI) = 1.29–2.65] compared with high LTPA. Significant associations were found in women (POR = 3.22, 95% CI = 1.82–5.68) but not in men (POR = 1.52, 95% CI = 0.99–2.35). Conclusions A positive and significant association between low LTPA and sarcopenia was found among older adults from LMICs. The promotion of LTPA among older adults in LMICs may aid in the prevention of sarcopenia, especially among females, pending future longitudinal research.

El texto aborda la importancia del románico del Valle de Arán. Debido a su ubicación geográfica, el Valle de Arán estuvo relativamente aislado, lo que contribuyó a conservar estructuras organizativas antiguas y a la renovación de edificios eclesiásticos entre los siglos XI y XIII. El estudio se enfoca en la clasificación y datación de las iglesias románicas de Arán, y se destacan métodos arqueológicos como el análisis estratigráfico para establecer una cronología relativa y absoluta de las iglesias. El texto concluye con la discusión sobre la cronología de las iglesias del Valle de Arán, agrupándolas según sus características arquitectónicas y técnicas de construcción. Estas agrupaciones se comparan con estudios documentales y se relacionan con periodos específicos, proporcionando una visión detallada de la evolución del románico en esta región.

Durant dècades, la investigació arqueològica duta a terme en algunes de les principals serralades europees ha experimentat un desenvolupament important. Aquest fet ha comportat que finalment es disposi d’un corpus de dades robust per a zones que abans es consideraven marginals i que mostra l’ocupació humana en aquestes àrees de muntanya des del neolític fins als nostres dies. L’obtenció d’informació en aquests espais requereix, però, una metodologia específica, centrada en l’estudi del paisatge. En aquest sentit, en el present article es mostra la metodologia que utilitza el Grup d’Investigació en Arqueologia del Paisatge de l’Institut Català d’Arqueologia Clàssica (GIAP-ICAC) a l’hora d’investigar l’ocupació humana en zones de muntanya del Pirineu oriental situades entre els 1.800 i els 2.800 m s. n. m., més concretament a les capçaleres del Ter i del Segre (el Ripollès, la Cerdanya, Andorra). S’hi discuteixen les estratègies de prospecció i de mostreig, així com els enfocaments paleoambientals que s’hi utilitzen. L’aplicació d’aquesta metodologia interdisciplinària ha permès documentar paisatges humanitzats des d’antic, difícils d’imaginar fa només algunes dècades.

Purpose: We describe the design and development of the European Platform to Promote health and wellbeing in the workplace (EMPOWER) digital intervention that provides an integrative user programme meeting the needs of employees and employers in addressing work stress. Results: A user-centred design process was followed from January 2020 until November 2021. A tailored algorithm was developed to provide support at the individual employee level and the company level. Each element of the digital intervention was developed in English and then translated in Spanish, English, Polish and Finnish. The digital intervention consists of a website and a mobile application (app) that provides algorithm-based personalised content after assessing a user's somatic and psychological symptoms, work functioning, and psychosocial risk factors for work stress. It has a public section and an employer portal that provides recommendations to reduce psychosocial risks in their company based upon clustered input from employees. Usability testing was conducted and showed high ease of use and completion of tasks by participants. Conclusion: The EMPOWER digital intervention is a tailored multimodal intervention addressing wellbeing, work stress, mental and physical health problems, and work productivity. This will be used in a planned RCT in four countries to evaluate its effectiveness.

ABSTRACTGiant Quartz Veins (GQVs) are ubiquitous in different tectonic settings and, besides being often related to hydrothermal ore deposits, also represent large-scale fingerprints of the structural and geochemical history of the rocks in which they are hosted. Here we present detailed geological maps and interpretations of three key areas of the Eastern Pyrenees where GQVs are well exposed. The studied rocks record different styles of deformation and are representative of common settings of the Pyrenees where GQVs are present: pre-Variscan metasedimentary and metavolcanic rocks, late Variscan granitoids, and Mesozoic and Cenozoic sedimentary rocks. GQVs in the study areas formed along pre-existing brittle and ductile structures or at locations with lithological heterogeneities, and have alteration haloes of silicified host rocks. The geological maps and interpretations presented here contribute to gain insights into the formation mechanisms of GQVs and into the structural constraints on fluid flow and mineral reactions at different depths of the Earth’s crust.

Objetivo Evaluar la eficacia de un protocolo de tratamiento en terapia de mano tras la reconstrucción artroscópica del ligamento escafosemilunar dorsal, siguiendo la técnica de Corella.

BackgroundToday’s young people have long been demanding a paradigm shift in the emotional and sexual education they receive. While for them, affective-sexual and gender diversity is already a reality, the sexual and reproductive health professionals they encounter lack sufficient training. The digital devices and affective-sexual education websites aimed at today’s young people must also be thoroughly evaluated. The website Sexe Joves is a website on sexuality by the Department of Health of the Government of Catalonia (Spain). It is designed for people aged 14 to 25 years. It currently needs to undergo a process of evaluation. Affective-sexual education aimed at young people must stem from their participation and the whole range of sexual and gender diversity in order to reach the entire population equally. ObjectiveThe aim of this study was to evaluate the website Sexe Joves as a source of affective-sexual health information, education, and communication for young people. It takes into account sex, gender identity, sexual orientation, socioeconomic status, and location within Catalonia (urban, semiurban, and rural areas). MethodsThis was an observational, descriptive, and cross-sectional study that forms part of a larger mixed methods study. An ad hoc questionnaire was used to collect data. In total, 1830 participants were included. The study was carried out simultaneously in all the territorial administrations of Catalonia. ResultsAlmost 30% of the sample obtained were young people who experience affective-sexual and gender diversity. Of those surveyed, only 14.2% (n=260) said they were familiar with the website and of these, 6.5% said they used it (n=114). The website content rated most indispensable was on sexual abuse, harassment, and violence, followed by sexually transmitted infections; 70.5% (n=1200) reported that they visit pornographic websites. ConclusionsThe results of this study will contribute to the design of new strategies for the website Sexe Joves, a public health resource, in order to improve affective sexual education for young people. International Registered Report Identifier (IRRID)RR2-10.3390/ijerph192416586

La categoria de passivitat és tan nuclear en la filosofia d’Emmanuel Levinas com en la de Paul Ricoeur. Aquesta categoria està intrínsecament vinculada a una altra que també és crucial: la d’alteritat. Per entendre la proximitat entre aquests dos autors, alhora que per veure’n la distància que els separa, resulta molt revelador prestar atenció, primer, a la manera com cadascun d’ells concep les dues categories i, després, al motiu pel qual mentre en el cas de Levinas el lloc de la passivitat és exclusivament un —la relació amb l’altre—, en el de Ricoeur és triple: la carn o el cos propi, l’altre i la consciència.

Background Evidence-based mental health interventions to support healthcare workers (HCWs) in crisis settings are scarce.Objective To evaluate the capacity of a mental health intervention in reducing anxiety and depression symptoms in HCWs, relative to enhanced care as usual (eCAU), amidst the COVID-19 pandemic.Methods We conducted an analyst-blind, parallel, multicentre, randomised controlled trial. We recruited HCWs with psychological distress from Madrid and Catalonia (Spain). The intervention arm received a stepped-care programme consisting of two WHO-developed interventions adapted for HCWs: Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+). Each intervention lasted 5 weeks and was delivered remotely by non-specialist mental health providers. HCWs reporting psychological distress after DWM completion were invited to continue to PM+. The primary endpoint was self-reported anxiety/depression symptoms (Patient Health Questionnaire-Anxiety and Depression Scale) at week 21.Findings Between 3 November 2021 and 31 March 2022, 115 participants were randomised to stepped care and 117 to eCAU (86% women, mean age 37.5). The intervention showed a greater decrease in anxiety/depression symptoms compared with eCAU at the primary endpoint (baseline-adjusted difference 4.4, 95% CI 2.1 to 6.7; standardised effect size 0.8, 95% CI 0.4 to 1.2). No serious adverse events occurred.Conclusions Brief stepped-care psychological interventions reduce anxiety and depression during a period of stress among HCWs.Clinical implications Our results can inform policies and actions to protect the mental health of HCWs during major health crises and are potentially rapidly replicable in other settings where workers are affected by global emergencies.Trial registration number NCT04980326.

Abstract Recent growth in digital technologies has enabled the recruitment and monitoring of large and diverse populations in remote health studies. However, the generalizability of inference drawn from remotely collected health data could be severely impacted by uneven participant engagement and attrition over the course of the study. We report findings on long-term participant retention and engagement patterns in a large multinational observational digital study for depression containing active (surveys) and passive sensor data collected via Android smartphones, and Fitbit devices from 614 participants for up to 2 years. Majority of participants (67.6%) continued to remain engaged in the study after 43 weeks. Unsupervised clustering of participants’ study apps and Fitbit usage data showed 3 distinct engagement subgroups for each data stream. We found: (i) the least engaged group had the highest depression severity (4 PHQ8 points higher) across all data streams; (ii) the least engaged group (completed 4 bi-weekly surveys) took significantly longer to respond to survey notifications (3.8 h more) and were 5 years younger compared to the most engaged group (completed 20 bi-weekly surveys); and (iii) a considerable proportion (44.6%) of the participants who stopped completing surveys after 8 weeks continued to share passive Fitbit data for significantly longer (average 42 weeks). Additionally, multivariate survival models showed participants’ age, ownership and brand of smartphones, and recruitment sites to be associated with retention in the study. Together these findings could inform the design of future digital health studies to enable equitable and balanced data collection from diverse populations.