Search

Abstract Objective To analyze the sociostructural determinants associated with mental health problems during the lockdown period among populations residing in Brazil, Chile, Ecuador, Mexico, Peru, and Spain who lived with minors or dependents, approached from a gender perspective. Methods A cross-sectional study was conducted in six participating countries via an adapted, self-managed online survey. People living with minors and/or dependents were selected. Multivariate logistic regression models were estimated to assess the associations between sociostructural variables and mental health problems (anxiety (GAD-7) and/or depression (PHQ-9)). The analyses were stratified by sex and country. Results Out of a total of 39,006 people, 18,040 reported living with minors and/or dependents (73% women). In all countries, women reported worse mental health, with Spain having a lower prevalence. The risks of mental health problems in women in most countries are associated with poor housing conditions and performing care work. University education was associated with a protective factor. For men, risks were related to being younger, worsening working conditions and concerns about living together at home. Conclusions Women in Latin America who lived with dependents had worse outcomes than those in Spain did. It is necessary to develop intersectoral and social determinants strategies to prevent, protect and support the mental health of those who live with dependents and minors.

Abstract This study examines remaining life expectancy (RLE) after a cancer diagnosis, focusing on age, sex, cancer type, and metabolic syndrome (MS) components, using data from the SIDIAP database in Catalonia (2006–2017). RLE was analyzed for 13 cancer types, stratified by sex and MS components. The cohort study includes 183,364 individuals followed from diagnosis until death, transfer, or study end (December 2017). RLE at age 68 (median diagnosis age) was calculated based on MS components (0, 1, 2, and ≥ 3). Men aged 68 with 0 MS components had an RLE of 13.2 years, compared to 8.9 years for those with ≥ 3 MS. Women had an RLE of 15.9 years with 0 MS components versus 11.4 years with ≥ 3 MS. RLE varied by cancer type, with the highest RLE in men seen in prostate cancer and in women in non-Hodgkin lymphoma. The lowest RLE for both sexes was in pancreatic cancer. The largest differences between 0 and ≥ 3 MS components were observed in non-Hodgkin lymphoma and the smallest in pancreatic cancer. Increased MS components were associated with reduced RLE in at least 8 cancer types for men and 9 for women. Prevention strategies targeting MS components could increase RLE in cancer patients.

Key Clinical Message The coexistence of rheumatoid arthritis (RA) and PLA2R‐associated membranous nephropathy (MN) is uncommon. It is difficult to demonstrate whether the mechanisms of renal pathology are triggered by RA, but it has been observed that the pro‐inflammatory molecules present in RA increase the expression of PLA2R. Rituximab could be effective in both conditions. Abstract RA affects 0.5% of adults in our country. It is an inflammatory disease that predominantly affects the joints causing destruction of the articular cartilage. Approximately 50% of patients present extra‐articular manifestations. Renal involvement is relatively frequent and clinically significant because it worsens the course and mortality of the primary disease. The histological renal damage observed in these patients includes a wide variety of entities and histological patterns with both glomerular and tubulointerstitial involvement, with secondary MN being one of the most frequent. Coexistence with primary MN is rare. We present the case of a 46‐year‐old male recently diagnosed with RA who was referred to the nephrology department for renal function deterioration and subnephrotic proteinuria. The autoimmune study showed positive anti‐PLA2R. Due to the unusual association between both entities, it was decided to perform a renal biopsy which showed abundant spikes. The immunofluorescence study showed contiguous parietal IgG positivity (3+). Immunohistochemistry showed positive granular IgG4, confirming the diagnosis of PLA2R‐associated MN. MN is one of the most common causes of nephrotic syndrome in adults. The determination of anti‐PLA2R has been a great advance in the rapid differential diagnosis of MN. In recent years, new target antigens associated with certain underlying pathologies have been discovered. However, PLA2R is not associated with any disease or exposure and therefore remains the antigen responsible for 80% of primary NMs. Anti‐PLA2R antibodies can be produced by loss of central or peripheral tolerance. Whether these mechanisms are triggered by RA itself is difficult to prove. The cytokine TNF‐like weak inducer of apoptosis (TWEAK) has been associated with RA. This proinflammatory molecule increases the expression of PLA2R in podocytes, sensitizing them to the damaging action of anti‐PLA2Rs, which could justify a causal relationship between the two pathologies. The anti‐PLA2R positivity in a patient with membranous nephropathy should not be sufficient to refrain from searching for a secondary cause, as a kidney biopsy is mandatory when another underlying disease coexists. Treatment should be tailored to the individual risk profile for progression. Rituximab could be an optimal option for both entities.

En el contexto del cambio climático y el aumento de la demanda de alimentos y energía, la sostenibilidad agrícola y energética enfrenta retos económicos, logísticos y ambientales. En la producción de alimentos y energía eléctrica de manera tradicional se compite por el uso de recursos limitados como el agua y el suelo, y no se consideran factores de mitigación de su impacto ambiental. En este contexto, la sustitución de combustibles fósiles por fuentes de energía renovables se presenta como una alternativa crucial para reducir las emisiones de gases de efecto invernadero. La tecnología agrivoltaica (AgroPV) se posiciona como una mediadora efectiva entre los sectores energético y agrícola, al permitir el uso compartido del suelo para la producción de energía y alimentos. Esta innovación no solo incrementa la eficiencia del uso del suelo y reduce el consumo de agua, sino que también fortalece la resiliencia de los cultivos al cambio climático y ofrece una nueva fuente de ingresos para los agricultores. Por lo tanto, en este artículo se propone una metodología para el diseño de sistemas AgroPV en zonas agrícolas de Colombia, abordando la selección de la zona de estudio, su caracterización técnica y económica, la identificación de impactos, oportunidades y barreras, y su potencial de masificación. Los resultados destacan que el sistema AgroPV diseñado puede diversificar los ingresos agrícolas, contribuir a la neutralidad de carbono, aumentar la resiliencia de los cultivos ante el cambio climático, mejorar la seguridad alimentaria y optimizar el uso del suelo.

El presente artículo científico se enfoca en el estado de la transformación digital del periodismo en América Latina postpandemia, con un análisis que abarca hasta el año 2022. Se comienza con una introducción que contextualiza la pandemia y su impacto en la industria periodística, seguida por una revisión del marco teórico que aborda la transformación digital y su aplicación al periodismo. Se describe la metodología utilizada para la recolección y análisis de datos, que incluye tanto datos cuantitativos como cualitativos, fruto de una encuesta realizada por la Sociedad Interamericana de Prensa [SIP] a sus socios en la región. Los resultados del estudio muestran la adopción de tecnologías digitales por los medios de comunicación en la región, así como las estrategias de transformación digital utilizadas. Se discuten los hallazgos del estudio y se reflexiona sobre las implicaciones para la práctica y la investigación del periodismo digital en América Latina. Este estudio evidencia las fortalezas y debilidades de la transformación digital del periodismo en América Latina.

El aumento de la población extranjera en los municipios con menor población de la Comunidad Valenciana se produjo tras un intenso flujo migratorio anterior a la crisis inmobiliaria y financiera. Este proceso albergó la esperanza de frenar la regresión demográfica que sufre el medio rural. Tras un periodo de pérdida de población se está volviendo de nuevo en los últimos años a una recuperación demográfica de ciertos municipios intermedios y pequeños. El objetivo del presente artículo ha sido establecer la analogía entre el aumento de la población de extranjeros y la diversificación económica en estos municipios de destino para favorecer el crecimiento poblacional. A partir de la utilización de una base de datos de población y empleo por sectores de actividad a escala municipal se han hallado indicadores como las tasas evolutivas, el Índice Gibbs-Martin y diferentes diagramas de dispersión para alcanzar los objetivos planteados. La investigación demuestra que se está produciendo un nuevo aumento de la población extranjera en los municipios intermedios, aquellos que poseen entre 2.000 y 10.000 habitantes y que al contrario que en el periodo previo a la crisis, su distribución coincide con la diversificación económica y del mercado laboral local y no en torno a la especialización productiva.

Objective To evaluate the impact of coadministering statins with direct oral anticoagulants (DOACs) on the risk of major bleeding events in patients with venous thromboembolism (VTE).Design Observational cohort analysis based on a multicentre international registry.Setting Data were extracted from the Registro Informatizado de Enfermedad TromboEmbolica Registry, which involves 205 centres across 27 countries.Participants A total of 73 659 patients diagnosed with VTE were classified based on their anticoagulant therapy (DOACs) versus low-molecular-weight heparin (LMWH) or vitamin K antagonists (VKAs) and concurrent use of statins.Methods Multivariable Cox proportional hazards models adjusted for confounding variables to assess the risk of major bleeding events stratified by the type of anticoagulant use and statin use.Results From October 2013 to February 2023, 73 659 patients were recruited: 2573 were statin users on DOACs, 14 090 were statin users on LMWH or VKA therapy, 10 088 were non-statin users on DOACs and 46 908 were non-statin users on LMWH or VKA therapy. Statin users were 10 years older and more likely to have hypertension, diabetes, renal failure or prior artery disease. During anticoagulation (median, 187 days), 1917 patients (2.6%) suffered major bleeding. Rates of major bleeding per 100 patient-years were 2.33 (95% CI 1.72 to 3.09), 3.75 (95% CI 3.43 to 4.10), 1.39 (95% CI 1.13 to 1.69) and 3.10 (95% CI 2.93 to 3.27), respectively. On multivariable analysis, patients treated with DOACs had a significantly lower risk of major bleeding compared with those on LMWH or VKA therapy (adjusted HR 0.59; 95% CI 0.48 to 0.74). The adjusted HR in statin users versus non-users was 1.03 (95% CI 0.92 to 1.14), while in statin users on DOACs versus the rest of patients, it was 1.18 (95% CI 0.79 to 1.76).Conclusions In patients with VTE receiving statins, long-term anticoagulation with DOACs was associated with a reduced risk of major bleeding, regardless of the statin use. These findings support the safety profile of DOACs over VKAs or LMWH in the management of VTE in patients requiring statins.

Abstract Background Metabolic syndrome (MS) has emerged as a significant global health concern. The relationship between MS and the risk of cancer doesn‘t seem clear, whether examining by components or in combination. The objective of this study is to examine the relationship between MS, its components, and the overall risk of cancer, including the risk of 13 specific cancer types. Methods We included 3,918,781 individuals aged 40 years or older sourced from the SIDIAP database between 2008 and 2017. Cox models were employed with MS components and their combinations. A subsample was created using a matched cohort (by age and sex). Incidence curves were computed to determine the time elapsed between the date of having 1–5 MS components and cancer incidence, compared to matched participants with no MS components, which showed that individuals who had one MS component experienced a greater incidence of cancer over 5 and 10 years than individuals with no MS, and the incidence rose with an increase in the number of MS components. Results Individuals exposed to MS components were diagnosed with cancer earlier than those who were not exposed to them. In the Cox model, HDL (HR 1.46, 95% CI: 1.41–1.52) and Glycemia (HR 1.40, 95% CI: 1.37–1.44) were the individual combinations with the highest risk of overall cancer. In combinations with two components, the highest HR was HDL+Glycemia (HR 1.52, 95% CI: 1.45–1.59) and Glycemia+HBP (HR 1.48, 95% CI: 1.45–1.50). In combinations with three components, the highest HR was HDL+Glycemia+HBP (HR 1.58, 95% CI: 1.55–1.62). Conclusion In summary, having one or more MS components raises the risk of developing at least 11 cancer types and these risk differ according to type of component included. Some sex differences are also observed. Our findings suggest that implementing prevention measures aimed at specific MS components may lower the risk of various cancer types.

Summary: Background: The clinical relevance of recurrent venous thromboembolism (VTE) after discontinuing anticoagulation in patients with COVID-19-associated VTE remains uncertain. We estimated the incidence rates and mortality of VTE recurrences developing after discontinuing anticoagulation in patients with COVID-19-associated VTE. Methods: A prospective, multicenter, non-interventional study was conducted between March 25, 2020, and July 26, 2023, including patients who had discontinued anticoagulation after at least 3 months of therapy. All patients from the registry were analyzed during the study period to verify inclusion criteria. Patients with superficial vein thrombosis, those who did not receive at least 3 months of anticoagulant therapy, and those who were followed for less than 15 days after discontinuing anticoagulation were excluded. Outcomes were: 1) Incidence rates of symptomatic VTE recurrences, and 2) fatal PE. The rate of VTE recurrences was defined as the number of patients with recurrent VTE divided by the patient-years at risk of recurrent VTE during the period when anticoagulation was discontinued. Findings: Among 1106 patients with COVID-19-associated VTE (age 62.3 ± 14.4 years; 62.9% male) followed-up for 12.5 months (p25-75, 6.3–20.1) after discontinuing anticoagulation, there were 38 VTE recurrences (3.5%, 95% confidence interval [CI]: 2.5–4.7%), with a rate of 3.1 per 100 patient-years (95% CI: 2.2–4.2). No patient died of recurrent PE (0%, 95% CI: 0–7.6%). Subgroup analyses showed that patients with diagnosis in 2021–2022 (vs. 2020) (Hazard ratio [HR] 2.86; 95% CI 1.45–5.68) or those with isolated deep vein thrombosis (vs. pulmonary embolism) (HR 2.31; 95% CI 1.19–4.49) had significantly higher rates of VTE recurrences. Interpretation: In patients with COVID-19-associated VTE who discontinued anticoagulation after at least 3 months of treatment, the incidence rate of recurrent VTE and the case-fatality rate was low. Therefore, it conceivable that long-term anticoagulation may not be required for many patients with COVID-19-associated VTE, although further research is needed to confirm these findings. Funding: Sanofi and Rovi, Sanofi Spain.

The value of quantitative immunoprecipitation mass spectrometry (QIP-MS) to identify the M-protein is being investigated in patients with monoclonal gammopathies but no data are yet available in high-risk smoldering myeloma (HRsMM). We have therefore investigated QIP-MS to monitor peripheral residual disease (PRD) in 62 HRsMM patients enrolled in the GEM-CESAR trial. After 24 cycles of maintenance, detecting the M-protein by MS or clonal plasma cells by NGF identified cases with a significantly shorter median PFS (mPFS; MS: not reached vs 1,4 years, p=0.001; NGF: not reached vs 2 years, p=0.0002) but reaching CR+sCR did not discriminate patients with different outcome. With NGF as a reference, the combined results of NGF and MS showed a high negative predictive value (NPV) of MS: 81% overall and 73% at treatment completion. When sequential results were considered, sustained negativity by MS or NGF was associated with a very favorable outcome with a mPFS not yet reached vs 1.66 years and 2.18 years in cases never attaining PRD or minimal residual disease (MRD) negativity, respectively. We can thus conclude that 1) the standard response categories of the IMWG do not seem to be useful for treatment monitoring in HRsMM patients, 2) MS could be used as a non-invasive, clinical valuable tool with the capacity of guiding timely bone marrow evaluations (based on its high NPV with NGF as a reference) and 3) similarly to NGF, sequential results of MS are able identify a subgroup of HRsMM patients with long-term disease control. This study was registered at www.clinicaltrials.gov (ClinicalTrials.gov identifier: NCT02415413).

¿Qué competencias necesita un directivo del siglo XXI? ¿Estamos preparando a nuestros directivos para los retos y cambios constantes de la era digital y globalizada? (Levy, 2007). Las escuelas de negocios se están enfocando más en el liderazgo y el desarrollo personal a medida que se reconoce la importancia de estas habilidades. Pero ¿es suficiente? Sin lugar a duda los desafíos que presenta la nueva era están poniendo a prueba las habilidades directivas, no solo por la compleja dirección de las personas (Pérez, 2018), que demandan cada vez más satisfacciones personales a la hora de trabajar, sino por la rapidez de los cambios (Tapscott, 1995) y la necesidad de tomar decisiones al mismo ritmo. La pregunta final es si los líderes actuales tendrán la capacidad ética de adaptarse a estos cambios disruptivos (Echevarría, 2008), o si estamos al frente de una utopía que jamás tendrá solución, enfrentándonos a una nueva era dominada por la inteligencia artificial donde primará la lógica pragmática por encima del corazón.

Saffron (Crocus sativus L.), a historically significant crop valued for its nutraceutical properties, has been poorly explored from a phytosanitary perspective. This study conducted a thorough examination of viruses affecting saffron samples from Spanish cultivars, using high-throughput sequencing alongside a systematic survey of transcriptomic datasets from Crocus sativus at the Sequence Read Archive. Our analysis unveiled a broad diversity and abundance, identifying 17 viruses across the 52 analyzed libraries, some of which were highly prevalent. This includes known saffron-infecting viruses and previously unreported ones. In addition, we discovered 7 novel viruses from the Alphaflexiviridae, Betaflexiviridae, Potyviridae, Solemoviridae, and Geminiviridae families, with some present in libraries from various locations. These findings indicate that the saffron-associated virome is more complex than previously reported, emphasizing the potential of phytosanitary analysis to enhance saffron productivity.

Resumen: La tradición del consumo de tamales entre los choles de Palenque está ligado al conocimiento y manejo ancestral de las plantas, así como al calendario de fiestas y ceremonias relacionadas con las fechas de días de muertos y de la Santa Cruz, entre otras. En este trabajo, hablaremos de este tamal (Pa´ts Petejul), que es propio de la región de Palenque, su relación con dos de las tradiciones más importantes de México y cuáles son los cambios o la evolución que ha tenido en la comunidad chol de Palenque desde tiempos muy remotos. Los tamales, por supuesto, tienen su origen desde la antigüedad y a veces se les han añadido nuevos ingredientes, sin embargo, hay otros, como el que presentamos aquí que seguramente tiene pocas variaciones. Existe la supervivencia de sabores y creencias a través del tiempo. Abstract: The tradition of tamale consumption among the Choles of Palenque is linked to the ancestral knowledge and management of plants, as well as to the calendar of festivities and ceremonies related to the dates of the Day of the Dead and the Holy Cross, among others. In this paper, we will talk about this tamale (Pa'ts Petejul), which is typical of the region of Palenque, its relationship with two of the most important traditions of Mexico, and the changes or evolution it has had in the Chol community of Palenque since ancient times. Tamales have their origin during ancient times and sometimes new ingredients have been added, however, there are others, such as the one presented here that surely have few variations. In Pa’ts Petejul, flavors and beliefs survive through time. This article is written in Spanish.