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Abstract Background A prerequisite for understanding temporal changes in road crash severity is an unbiased description of this phenomenon. The aim of this study was to estimate the independent association trends of age, period and cohort with severity, encompassing the risk of death (RD) and the risk of death or hospitalisation (RDH) within 24 h, for drivers of passenger cars involved in road crashes with casualties in Spain from 1993 to 2020. Methods The study population comprised 2,453,911 drivers of passenger cars aged 18 to 98 years involved in road crashes included in the registers of the General Directorate of Traffic. Crash- and driver-related variables with sufficient continuity over time were included, establishing RD and RDH as study outcomes. Temporal trends of both outcomes were analysed using multivariable Poisson regression and multivariable age-period-cohort intrinsic estimator models. An additional sensitivity analysis was performed for the subset of single crashes. Results Severity estimates showed some variation across strategies. The APC model identified: (1) a J-shaped pattern for the effect of age on severity, (2) a decline in severity between 2001 and 2004 and 2013–2016, and (3) a birth cohort effect for both RD and RDH. In particular, the 1952–1958 cohort had the highest risk (RD = 1.17; 95%CI = 1.11–1.24 and RDH = 1.16; 95%CI = 1.13–1.19), followed by a decreasing trend in subsequent cohorts. Restricting the analysis to single crashes yielded similar results, with the exception of the age effect (severity increased with age). Furthermore, sex differences were observed–female sex was inversely associated with severity, especially for RD. Conclusions RD and RDH decreased during the first decade of the 21st century, but seemed to stabilise from 2013 onwards. Evidence from this study support that birth cohort is associated with road crash severity, independent of age and period. This cohort effect might be due, at least partially, to improvements in general and road safety education. Further studies are needed to elucidate the causes of our findings and to identify factors accounting for sex differences.

PTEN (phosphatase and tensin homolog) is a frequently lost tumor suppressor gene in prostate cancer, leading to aggressive tumor behavior and poor clinical outcomes. PTEN loss results in aberrant activation of the PI3K/AKT/mTOR pathway, promoting oncogenesis. These alterations also lead to an immunosuppressive tumor microenvironment with altered immune cell infiltration, cytokine profiles, and immune checkpoint regulation. This review aims to provide a comprehensive overview of the mechanisms underlying PTEN loss in prostate cancer and the consequent immune alterations observed in this subtype, thus underscoring the importance of understanding PTEN-mediated immune modulation for the development of effective therapeutic interventions in prostate cancer.

La incorporación de actividades de trabajo en equipo en los programas de formación universitaria es esencial, ya que es una de las habilidades más valoradas para los profesionales en el campo de la ingeniería. La selección de los grupos de trabajo por parte del profesor es una estrategia que puede conducir a un mejor desempeño en las tareas colaborativas. Este estudio presenta los resultados de una investigación sobre los criterios conscientes para la selección de grupos de trabajo basados en los roles de los estudiantes. La investigación tuvo como objetivo analizar las dinámicas de trabajo en equipo entre estudiantes de diversas disciplinas dentro de los cursos de ingeniería. Se examinaron las opiniones de más de 600 estudiantes matriculados en 10 programas de grado y posgrado. Los resultados indican que los estudiantes de cursos avanzados se sienten más cómodos asumiendo el papel de líder, mientras que los estudiantes de primer año no tienen un perfil claramente definido. La evaluación de los estudiantes con esta metodología también muestra ciertas variaciones dependiendo del año y el tipo de actividad. En general, en los grupos con mejor rendimiento, la mayoría de los miembros reciben evaluaciones similares de sus compañeros. Abstract The incorporation of teamwork activities in university training programs is essential, as it is one of the most valued skills for professionals in the field of engineering. The selection of working groups by the teacher is a strategy that can lead to better performance in collaborative tasks. This study presents the results of research on the conscious selection criteria for group work based on students’ roles. The research aimed to analyze teamwork dynamics among students from various disciplines within engineering courses. The opinions of over 600 students enrolled in 10 undergraduate and postgraduate programs were examined. The results indicate that students in advanced courses feel more comfortable taking on the role of leader, while first-year students do not have a well-defined profile. The evaluation of students using this methodology also shows certain variations depending on the year and type of activity. Overall, in the highest-performing groups, most members receive similar evaluations from their peers.

Planteamos el siguiente trabajo como un estudio basado en categorías conceptuales, siendo un proyecto de investigación, sustentado en pilares de valores axiomáticos bajo los que se visualice y ponga en valor la percepción de un paciente antes de ser intervenido quirúrgicamente y la misma capacidad de percepción tras introducir de forma objetiva información al respecto sobre todo el mundo sanitario que va a rodearle en el área quirúrgica de un centro sanitario, del modo más fehacientemente posible, con la implicación de las nuevas tecnologías de la información (TIC´s).Estamos por tanto ante un escenario novedoso en el que desarrollar un proyecto que pueda dar respuesta a ese escenario de incertidumbre ante una intervención quirúrgica, puede añadir un valor ético, al trabajo diario que realiza el personal sanitario y no sanitario de las diferentes áreas quirúrgicas.Este proyecto se visualiza como proceso colaborativo entre profesionales de enfermería, de telecomunicaciones, de diseño gráfico, y de los propios pacientes y sus necesidades previamente detectadas. Se hace necesario documentar el estrés que sufre de forma preoperatoria los pacientes. Ello es una necesidad ética no solo cuestión de efectividad y eficiencia clínica, la garantía de la salud mental a los pacientes que van a ser sometidos a una intervención quirúrgica, es un acto ad hoc a la profesionalidad sanitaria.

A finales del siglo XV, la Corona de Castilla empleó de manera asidua en el reclutamiento de tropas para sus diversas campañas militares a los homicianos, delincuentes que, generalmente por delitos de sangre, buscaban en el servicio a los Reyes Católicos el perdón del crimen cometido. Los homicianos aparecieron en la conquista de las islas de Gran Canaria, Tenerife y Las Palmas, y en la campaña de 1500 del Gran Capitán, acantonándose antes entre Sevilla y Jerez de la Frontera. A través de las disposiciones reales y las cartas de perdón emitidas, conceptualizamos el término homiciano, diferenciándolo del homicida, y situamos a este colectivo en la confluencia de la violencia y el crimen medievales.

Background Increased vascular CaV1.2 channel function causes enhanced arterial tone during hypertension. This is mediated by elevations in angiotensin II/protein kinase C signaling. Yet, the mechanisms underlying these changes are unclear. We hypothesize that α1C phosphorylation at serine 1928 (S1928) is a key event mediating increased CaV1.2 channel function and vascular reactivity during angiotensin II signaling and hypertension. Methods and Results The hypothesis was examined in freshly isolated mesenteric arteries and arterial myocytes from control and angiotensin II‐infused mice. Specific techniques include superresolution imaging, proximity ligation assay, patch‐clamp electrophysiology, Ca2+ imaging, pressure myography, laser speckle imaging, and blood pressure telemetry. Hierarchical “nested” and appropriate parametric or nonparametric t test and ANOVAs were used to assess statistical differences. We found that angiotensin II redistributed the CaV1.2 pore‐forming α1C subunit into larger clusters. This was correlated with elevated CaV1.2 channel activity and cooperativity, global intracellular Ca2+ and contraction of arterial myocytes, enhanced myogenic tone, and altered blood flow in wild‐type mice. These angiotensin II‐induced changes were prevented/ameliorated in cells/arteries from S1928 mutated to alanine knockin mice, which contain a negative modulation of the α1C S1928 phosphorylation site. In angiotensin II‐induced hypertension, increased α1C clustering, CaV1.2 activity and cooperativity, myogenic tone, and blood pressure in wild‐type cells/tissue/mice were averted/reduced in S1928 mutated to alanine samples. Conclusions Results suggest an essential role for α1C S1928 phosphorylation in regulating channel distribution, activity and gating modality, and vascular function during angiotensin II signaling and hypertension. Phosphorylation of this single vascular α1C amino acid could be a risk factor for hypertension that may be targeted for therapeutic intervention.

Objectives: Adherence to healthy lifestyle recommendations has been reported to improve health-related quality of life (HRQL) in breast cancer (BC) patients, but the influence of long-term behavioral changes remains unknown. We evaluated the association between adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations and HRQL both, at BC diagnosis and the change 7−12 years later. Design: Prospective cohort study. Settings and participants: A total of 406 breast cancer survivors, from the EpiGEICAM study, were recruited in 16 Spanish hospitals. Measurements: Epidemiological, clinical, dietary, physical activity and HRQL information was collected both at recruitment and 7−12 years later. A 7-item score to measure compliance with recommendations was assessed according to the 2018 WCRF/AICR scoring criteria. HRQL was evaluated using SF-36 questionnaire. Linear mixed models for longitudinal data were used to assess the cross-sectional and longitudinal association between adherence score and the physical and mental component summary scores. Results: At diagnosis, for each unit increase in WCRF/AICR score adherence, the HRQL physical domain increased 0.78 points (95%CI: −0.04 to 1.60; P trend:0.06). The mean change in physical HRQL from diagnosis to follow-up per unit increase in within-subject adherence score was 0.73 points (95%CI: −0.18 to 1.65; P trend: 0.12). For the mental domain, no association was observed with compliance with the recommendations at diagnosis, nor with changes in adherence over time. Conclusions: Our results suggest that Increased adherence to WCRF/AICR cancer prevention recommendations over time could contribute to slightly improved long-term physical HRQoL in BC survivors.

BackgroundL-type CaV1.2 channels undergo cooperative gating to regulate cell function, although mechanisms are unclear. This study tests the hypothesis that phosphorylation of the CaV1.2 pore-forming subunit α1C at S1928 mediates vascular CaV1.2 cooperativity during diabetic hyperglycemia.MethodsA multiscale approach including patch-clamp electrophysiology, super-resolution nanoscopy, proximity ligation assay, calcium imaging' pressure myography, and Laser Speckle imaging was implemented to examine CaV1.2 cooperativity, α1C clustering, myogenic tone, and blood flow in human and mouse arterial myocytes/vessels.ResultsCaV1.2 activity and cooperative gating increase in arterial myocytes from patients with type 2 diabetes and type 1 diabetic mice, and in wild-type mouse arterial myocytes after elevating extracellular glucose. These changes were prevented in wild-type cells pre-exposed to a PKA inhibitor or cells from knock-in S1928A but not S1700A mice. In addition, α1C clustering at the surface membrane of wild-type, but not wild-type cells pre-exposed to PKA or P2Y11 inhibitors and S1928A arterial myocytes, was elevated upon hyperglycemia and diabetes. CaV1.2 spatial and gating remodeling correlated with enhanced arterial myocyte Ca2+ influx and contractility and in vivo reduction in arterial diameter and blood flow upon hyperglycemia and diabetes in wild-type but not S1928A cells/mice.ConclusionsThese results suggest that PKA-dependent S1928 phosphorylation promotes the spatial reorganization of vascular α1C into "superclusters" upon hyperglycemia and diabetes. This triggers CaV1.2 activity and cooperativity, directly impacting vascular reactivity. The results may lay the foundation for developing therapeutics to correct CaV1.2 and arterial function during diabetic hyperglycemia.

Summary: Background: Mobile health (mHealth) systems are a promising alternative for rehabilitation of hip fracture, addressing constrained healthcare resources. Half of older adults fails to recover their pre-fracture routines, which imposes a burden on caregivers. We aimed to test the effectiveness of the 3-month ActiveHip + mHealth intervention on physical and psychological outcomes of older adults with hip fracture and their family caregivers. Methods: In a multicentre open-label randomised controlled trial conducted across 3 hospitals in Andalusia (Spain), patients older than 65 with a hip fracture, who were previously independent and lacked cognitive impairment were recruited alongside with their caregivers. Participants were randomly allocated (1:1) to the intervention group (ActiveHip+) or control (usual care) group. The intervention group underwent a 12-week health education and tele-rehabilitation programme through the ActiveHip + mHealth intervention. The primary outcome, physical performance, was assessed using the Short Physical Performance Battery at three time points: at hospital discharge (baseline), 3-month after surgery (post intervention) and 1-year after surgery follow-up. Primary analyses of primary outcomes and safety data followed an intention-to-treat approach. This study is registered at ClinicalTrials.gov, NCT04859309. Findings: Between June 1st, 2021 and June 30th, 2022 data from 105 patients and their caregivers were analysed. Patients engaged in the ActiveHip + mHealth intervention (mean 7.11 points, SE 0.33) showed higher physical performance compared with patients allocated in the control group (mean 5.71 points, SE 0.32) at 3 months after surgery (mean difference in change from baseline 1.40 points, SE 0.36; puncorrected = 0.00011). These benefits were not maintained at 1-year after surgery follow-up (mean difference in change from baseline 0.19 points, SE 0.47; puncorrected = 0.68). No adverse events, including falls and refractures, were reported during the tele-rehabilitation sessions. At 3-months, the intervention group had 2 falls, compared to 4 in the control group, with no observed refractures. At the 1-year follow-up, the intervention group experienced 7 falls and 1 refracture, while the control group had 13 falls and 2 refractures. Interpretation: This study suggests that the ActiveHip + mHealth intervention may be effective for recovering physical performance in older adults with hip fracture. Importantly, the implementation of ActiveHip + into daily clinical practice may be feasible and has already been adopted in 18 hospitals, mostly in Spain but also in Belgium and Portugal. Thus, ActiveHip + could offer a promising solution when rehabilitation resources are limited. However, its dependence on caregiver support and the exclusion of participants with cognitive impairment makes it necessary to be cautious about its applicability. In addition, the non-maintenance of the effectiveness at 1-year follow-up highlights the need of refinement the ActiveHip + intervention to promote long-lasting behavioural changes. Funding: EIT Health and the Ramón y Cajal 2021 Excellence Research Grant action from the Spanish Ministry of Science and Innovation.

Aim: The aim of the study is to quantify the main ways in which the sex of the driver/occupant of a passenger car affects the severity of road crashes. Methods: All 171 230 cars occupied by the driver and one or more passengers included in the Spanish Register of Victims of Road Crashes from 2014 to 2020 were included. We designed two cohort studies: In the first one, we estimated the Incidence Rate Ratios (IRR) between the sex of the drivers and the occurrence of any death and/or severe injuries among their passengers. In the second one we estimated the conditioned IRR between the sex of the occupants of the same car and their risk of death and/or severe injuries. We used fixed Poisson models to obtain IRR estimates, crude and adjusted by individual- environment- and vehicle-related variables. Results: A consistent inverse relationship between driver's female sex and passenger's severity was found, (IRR 0.72, 95 % CI 0.68–0.77), stronger for single crashes (IRR 0.67, 95 % CI 0.60–0.65). The magnitude decreased after adjusting for vehicle- and environment-related variables (IRR 0.82, 95 % CI 0.73–0.92). In the second study, the risk of death or hospitalization was higher for occupants of female sex (IRR 1.23, 95 % CI 1.17–1.30). Conclusions: The risk of death or severe injuries among passengers of cars involved in single crashes is lower for female drivers, probably due to safer driving. On the contrary, in similar crashes, the risk of injuries leading to hospitalization is higher for females.

Nasopharyngeal carcinoma typically originates in the fossa of Rosenmüller within the mucosal epithelium directly underlying the lymphatic tissue, and commonly presents clinically with symptoms such as headache, dizziness, and rhinorrhea. In this case study, we describe a 61-year-old man diagnosed with nasopharyngeal carcinoma who underwent radiation therapy with a total dose of 50 Gy administered at a rate of 2 Gy per day, along with chemotherapy consisting of cisplatin at a dose of 100 mg/m2. Surgical intervention was deemed unsuitable due to the size of the tumors. Five months later, the patient developed a tension pneumocephalus due to a clival fistula “corking effect,” which resulted in the infiltration of air bubbles into the brain and culminating in his death 2 weeks after admission to the intensive care unit.

Objectives To measure the CSA of the HST musculature measured with ultrasonography in soccer players undergoing ACLR and compare limb differences with healthy controls. Methods A case-control study was performed with patients after anterior cruciate ligament repair (ACLR) and healthy controls in which cross-sectional areas (CSA) obtained using a model TE7 ultrasound machine (MINDRAY ®, USA) in B mode (4.2 to 13 MHz) with a multifrequency linear array transducer (L12-4S). Three CSA images were taken of the semitendinosus muscle (ST) and the long head of the biceps femoris (BFlh), at a distance of 30% and 70% of the ischial tuberosity insertion. Mean differences between groups were analyzed using SPSS v.20 (IBM®, USA), and statistical analyses were performed using non-parametric techniques to determine differences between groups (Student's t-test) and Cohen's correlation coefficient to quantify effect size. Results 14 ACLR operated 17 ± 5.4 months ago and 12 healthy controls (W = 6; M = 20M; 24.5 ± 3.92 years; BMI = 25.1 ± 2.32 kg/m2) were recruited. There were differences between groups in CSA-ST70 (Post-ACLR = 1.43 ± 1.029 cm2 vs Control 2.65 ± 0.664 cm2, T Student = -3.68, 95% CI [-Inf, -0.648], P < 0. 001, ES = -1.418), but not in CSA-ST30 (Post-ACLR = 8.42 ± 1.596 cm2 vs Control 9.16 ± 0.945 cm2, T Student = -1.535; 95% CI [-Inf, -0.0793], P = 0. 068, ES = -0.5607), CSA-BFlh30 (Post-ACLR = 8.79 ± 1.47 cm2 vs Control 8.87 ± 2.312 cm2, T Student = -0.123; 95% CI [-Inf, 1.1049], P = 0.452, ES = -0. 049) or CSA-BFlh70 (Post-ACLR = 6.91 ± 1.011 cm2 vs Control 7.01 ± 1.453 cm2, T Student = -0.214; 95% CI [-Inf, 0.6795], P = 0.416, ES = -0.0783). Conclusion Ultrasound measurement of the CSA can be an image marker to identify muscle weakness or atrophy that predicts functional loss early.

El art. 7 de la Ley 7/2012, de 29 de octubre, introdujo en nuestro ordenamiento la limitación de pagos en efectivo, régimen modificado a través de la Ley 11/2021, de 9 de julio. Apenas unos meses después el TJUE se pronunció por primera vez sobre la adecuación al ordenamiento comunitario del régimen de limitación de pagos en efectivo de un Estado miembro (Bulgaria) en la STJUE de 6 de octubre de 2021, ECOTEX Bulgaria, asunto C-544/19. En este estudio, tras examinar la posición del TJUE y de otras instituciones comunitarias, valoramos si nuestro régimen interno es compatible con esta jurisprudencia.

Abstract Background Women with Fibromyalgia Syndrome (FMS) can benefit form adequate social support to fight the consequences of their illness, but the extent to which this is available to those with low incomes who live in depressed areas of Tenerife (Canary Islands, Spain) is currently unknown. The purpose of this study was to explore social support in low-incomes women with FMS in sub-urban and peri-urban areas of Tenerife. Methodology A sequential exploratory mixed method study was carried out from January 20, 2023, to June 10, 2023, at the Fibromyalgia and Chronic Fatigue Association of Tenerife (AFITEN) using non-probability convenience sampling. Social support was analyzed quantitatively through MOS-SSS survey and Duke-UNC-11 questionnaire, while qualitative data were obtained through semi-structured interviews to identify social support providers and analyze their satisfactions levels. Results A total of 49 women, with a mean age of 57.80 years-old (SD = 13.25) were finally included in this study. MOSS-SSS and Duke-UNC-11 both indicated lower social support levels at 68.6 (SD =16.3) and 38.0 (SD = 9.74), respectively. The qualitative analysis revealed that partners and friends provided the most significant support with the highest satisfaction scores. Conclusions The socioeconomic status of low-income women with FMS living in sub-urban and peri-urban areas of Tenerife (Canary Islands, Spain) influences on their social support, with the affective support and confidentiality being the most affected dimensions.

Ion channels that influence membrane potential and intracellular calcium concentration control vascular smooth muscle excitability. Voltage-gated calcium channels (VGCC), transient receptor potential (TRP) channels, voltage (KV), and Ca2+-activated K+ (BK) channels are key regulators of vascular smooth muscle excitability and contractility. These channels are regulated by various signaling cues, including protein kinases and phosphatases. The effects of these ubiquitous signaling molecules often depend on the formation of macromolecular complexes that provide a platform for targeting and compartmentalizing signaling events to specific substrates. This manuscript summarizes our current understanding of specific molecular complexes involving VGCC, TRP, and KV and BK channels and their contribution to regulating vascular physiology.

Abstract Background Our aim was to evaluate Spanish family doctors’ knowledge about medications that increase the risk of traffic accidents involving older drivers, and to obtain data about the involvement of family doctors in accident prevention activities and the associations between these factors and their demographic and workplace characteristics. Methods A cross-sectional study of 1888 family doctors throughout Spain was carried out from 2016 to 2018. Participants completed a previously validated self-administered questionnaire that explored whether family doctors distinguished between medications associated with a high or low risk of involvement in a traffic accident, investigated the appropriateness of advice given to older patients, and physicians’ involvement in preventive activities. Multiple regression models were used to estimate the adjusted association of these variables with each other and with characteristics of family doctors in the sample. Results On a scale of 1 (never or hardly ever) to 4 (always), the indexes constructed to evaluate how often family doctors believed they should oversee the use of high-risk and low-risk medications yielded values of 3.38 for the former and 2.61 for the latter (p

The crisis of neoliberalism is the crisis of the West, unable to redirect its course and threatened by internal and external contradictions. The emergence of the postmodernism has generated a new uncritical ethos that relativises Western rights and freedoms. The invasion of capitalist mercantile logic into the school, under the neoliberal paradigm, has displaced any political training from the school, contributing to contemporary cultural relativity. In the present work we will review the course of neoliberalism from its origins to the present day, and we will analyse its impact on the Western school. This journey is carried out from a critical approach. Two main consequences are detected: the substitution of knowledge by labour competences, and the promotion of a homogeneity that benefits competitiveness, but deteriorates democratic culture. We conclude with the requirement for schools to abandon relative narratives and embrace democratic values in order to improve the coexistence and the political participation.

In this paper we study a generalized Klausmeier model replacing the integer derivative by a local fractional derivative. This derivative enables us to consider a wide range of systems with already well-known derivatives. We analyze the stability of this new model as well as the homotopic perturbation method. Finally, an inverse problem associated with a real data set is solved.

Background: The diagnosis of left dominant arrhythmogenic cardiomyopathy (LDAC) is sometimes complex. The Padua group recently published a document with criteria to identify patients with LDAC, requiring a compatible genetic variant for diagnosis. Due to the gaps in the knowledge of the role of genetics in its pathogenesis, our objective is to describe the findings of the genetic test in patients with LDAC in our center and its prognostic impact. Methods: Single-center prospective cohort study, in which we recruited 77 patients diagnosed with LDAC or biventricular arrhythmogenic cardiomyopathy according to the criteria of Sen-Chowdhry et al. Results: We obtained a positive result in the genetic test in 53.2 %. The desmoplakin gene was the most affected (16.9 %). The mean value of left ventricular (LV) ejection fraction was 45.6 ± 13.1 %, with no significant differences in the severity of the dysfunction according to genetics (p = 0.187). Among the patients with positive genetics there was a greater number of segments in the LV affected by fibrosis (p = 0.043). Regarding fatty infiltration in the LV and number of affected segments, there were no significant differences between groups (p = 0.144). MACE was recorded in 23 patients (29.9 %). The positive result in the genetic test was not significantly associated with the occurrence of MACE (p = 0.902). Conclusion: In our study, we did not find mutations responsible for the disease in practically half of the cases. Despite the existence of a high proportion of MACE during follow-up, there were no prognostic differences according to the result of the genetic test.

Cigarette smoke, including secondhand smoke (SHS), has significant detrimental vascular effects, but its effects on myogenic tone of small resistance arteries and the underlying mechanisms are understudied. Although it is apparent that SHS contributes to endothelial dysfunction, much less is known about how this toxicant alters arterial myocyte contraction, leading to alterations in myogenic tone. The study's goal is to determine the effects of SHS on mesenteric arterial myocyte contractility and excitability. C57BL/6J male mice were randomly assigned to either filtered air (FA) or SHS (6 h/d, 5 d/wk) exposed groups for a 4, 8, or 12-weeks period. Third and fourth-order mesenteric arteries and arterial myocytes were acutely isolated and evaluated with pressure myography and patch clamp electrophysiology, respectively. Myogenic tone was found to be elevated in mesenteric arteries from mice exposed to SHS for 12 wk but not for 4 or 8 wk. These results were correlated with an increase in L-type Ca2+ channel activity in mesenteric arterial myocytes after 12 wk of SHS exposure. Moreover, 12 wk SHS exposed arterial myocytes have reduced total potassium channel current density, which correlates with a depolarized membrane potential (Vm). These results suggest that SHS exposure induces alterations in key ionic conductances that modulate arterial myocyte contractility and myogenic tone. Thus, chronic exposure to an environmentally relevant concentration of SHS impairs mesenteric arterial myocyte electrophysiology and myogenic tone, which may contribute to increased blood pressure and risks of developing vascular complications due to passive exposure to cigarette smoke.

Introducción: El ECOE es una herramienta de evaluación de competencias clínicas prácticas en Fisioterapia, hasta ahora no empleada para examinar las habilidades de los especialistas en Terapia Manual Ortopédica. Objetivo: El objetivo de este trabajo es evaluar la competencia a través de las calificaciones, la satisfacción y el desempeño percibido de los estudiantes del Máster de Terapia Manual Ortopédica en el Tratamiento del Dolor de la Universidad Europea de Canarias. Métodos: Se realizó un estudio descriptivo en una muestra de estudiantes de posgrado (n=21, M=10, V=11, 24,61 años) entre el 1 de febrero y el 31 de julio de 2023 en el Hospital Simulado de la Universidad Europea de Canarias (Tenerife, España). Resultados: Las calificaciones obtenidas por los participantes fueron mayoritariamente altas (media = 8,54 /10, DT= 0.612), aunque en Anatomía e interpretación de pruebas complementarias registraron los resultados más bajos. El 95,1% (n=20) expresó una alta satisfacción con el ECOE. Respecto a la interpretación de pruebas complementarias, un 19,1% (n=4) consideró su desempeño como deficiente y un 4,8% (n=1) muy deficiente. Conclusión: En síntesis, a pesar de las calificaciones más bajas en ciertas áreas, los resultados de la evaluación de competencias clínicas prácticas a través del ECOE son positivos. Además, se observa un elevado grado de satisfacción y percepción positiva del desempeño por parte del especialista.

The past decade's development of UV LEDs has fueled significant research in water disinfection, with widespread debate surrounding the potential synergies of multiple UV wavelengths. This study analyses the use of three UV sources (265, 275, and 310 nm) on the inactivation of Escherichia coli bacteria in two water matrixes. At maximum intensity in wastewater, individual inactivation experiments in a single pass set-up (Flow rate = 2 L min−1, Residence time = 0.75 s) confirmed the 265 nm light source to be the most effective (2.2 ± 0.2 log units), while the 310 nm led to the lowest inactivation rate (0.0003 ± 7.03×10−5 log units). When a combination of the three wavelengths was used, an average log reduction of 4.4 ± 0.2 was observed in wastewater. For combinations of 265 and 275 nm, the average log reductions were similar to the sum of individual log reductions. For combinations involving the use of 310 nm, a potential synergistic effect was investigated by the use of robust statistical analysis techniques. It is concluded that combinations of 310 nm with 265 nm or 275 nm devices, in sequential and simultaneous mode, present a significant synergy at both intensities due to the emission spectra of the selected LEDs, ensuring the possibility of two inactivation mechanisms. Finally, the electrical energy per order of inactivation found the three-wavelength combination to be the most energy efficient (0.39 ± 0.05, 0.36 ± 0.01 kWh m−3, at 50% and 100% dose, respectively, in wastewater) among the synergistic combinations.

The sustainable use and protection of water resources are urgently needed. Human activity and climate change are exacerbating water-related problems and worsening the quality of riparian and wetland ecosystems, rendering them unable to provide services which are basic to human well-being and socioeconomic development. The most affected communities are those that rely on natural aquatic environments, thus suffering the worst consequences of its degradation.This is the case of the Colombian Embera indigenous people, whose populations have been forced to migrate, due to armed conflicts, to peripheral urban areas without access to safe water and sanitation. For this reason, the international cooperation project ''Baña Do Bari'' was set up to design and implement treatment wetlands (TWs) for the treatment of wastewater mainly produced in sanitary infrastructure, with the purpose of guaranteeing adequate living conditions and improved basic hygiene to indigenous communities. The sanitary infrastructure was designed collectively with the participation of the community.In this paper, the above-mentioned project is analyzed to determine if its actions can be considered Nature-based Solutions (NBS) and to identify opportunities for improvement. To this end, the IUCN Global Standard for NBS and other technical criteria were used. The main results indicate that TWs built within the ''Baña Do Bari'' project can be considered a NBS according to the technical criteria used for self-assessment. Regarding the Standard, the project strongly resolves social challenges. The criteria that could be improved are mainly related to the collection of environmental data on the biodiversity conservation status in the area.

Objective @ctivehip is a home-based multidisciplinary telerehabilitation programme for older adults with hip fracture, conducted with the assistance of their family caregivers. This programme was useful in improving their functional recovery. Nevertheless, we were concerned about how the programme might have affected caregivers, whose assistance was essential for supporting older adults in using new technologies and ensuring their safety during the exercises and activities at home. The aim of the present study was to compare the burden, psychological factors and physical fitness of the family caregivers of older adults who opted the @ctivehip telerehabilitation programme versus those family caregivers of older adults who received the face-to-face rehabilitation provided by the Andalusian Public Healthcare System (in Spain). Methods In this single-blinded, non-randomized clinical trial, participants were older adults with hip fracture and their family caregivers. The telerehabilitation group (n = 30) underwent a 12-week multidisciplinary telerehabilitation programme, and the comparative group (n = 32) received face-to-face rehabilitation. Caregivers outcomes measured were (i) the burden using the Zarit Burden Interview, (ii) the anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), and (iii) the Physical Fitness with the International Fitness Scale (IFIS). Results There were not statistically significant differences on caregiver burden between family caregivers in the @ctivehip and the comparative group, although there was a trend towards lower values [[Mean (95%CI); 14.73 (9.09 to 20.37) vs 16.03 (10.63 to 21.43); p = 0.771] as well as for anxiety and depression [5.66 (3.21 to 8.78) vs 11.19 (8.52 to 13.86); p = 0.022]. Likewise achieved better, though not statistically significant, scores in physical fitness [19.37 (17.94 to 20.81) vs 17.15 (15.77 to 18.53); p = 0.055]. Conclusion Caregiver burden is not associated with telerehabilitation. In addition, telerehabilitation is associated with lower anxiety and depression levels among family caregivers who opt for this programme. Physical fitness is not related with telerehabilitation.

Diabetes affects millions of people worldwide. This devastating disease dramatically increases the risk of developing cardiovascular disorders. A hallmark metabolic abnormality in diabetes is hyperglycemia, which contributes to the pathogenesis of cardiovascular complications. These cardiovascular complications are, at least in part, related to hyperglycemia-induced molecular and cellular changes in the cells making up blood vessels. Whereas the mechanisms mediating endothelial dysfunction during hyperglycemia have been extensively examined, much less is known about how hyperglycemia impacts vascular smooth muscle function. Vascular smooth muscle function is exquisitely regulated by many ion channels, including several members of the potassium (K+) channel superfamily and voltage-gated L-type Ca2+ channels. Modulation of vascular smooth muscle ion channels function by hyperglycemia is emerging as a key contributor to vascular dysfunction in diabetes. In this review, we summarize the current understanding of how diabetic hyperglycemia modulates the activity of these ion channels in vascular smooth muscle. We examine underlying mechanisms, general properties, and physiological relevance in the context of myogenic tone and vascular reactivity.

Abstract Peripheral inflammatory immune responses are thought to play a major role in the pathogenesis of Parkinson’s disease (PD). The neutrophil-to-lymphocyte ratio (NLR), a biomarker of systemic inflammation, has been reported to be higher in patients with PD than in healthy controls (HCs). The present study was aimed at determining if the peripheral inflammatory immune response could be influenced by the genetic background of patients with PD. We included a discovery cohort with 222 patients with PD (132 sporadic PD, 44 LRRK2-associated PD (with p.G2019S and p.R1441G variants), and 46 GBA-associated PD), as well as 299 HCs. Demographic and clinical data were recorded. Leukocytes and their subpopulations, and the NLR were measured in peripheral blood. Multivariate lineal regression and post-hoc tests were applied to determine the differences among the groups. Subsequently, a replication study using the Parkinson’s Progression Markers Initiative cohort was performed which included 401 patients with PD (281 sPD patients, 66 LRRK2-PD patients, 54 GBA-PD patients) and a group of 174 HCs. Patients with sporadic PD and GBA-associated PD showed a significantly lower lymphocyte count, a non-significantly higher neutrophil count and a significantly higher NLR than HCs. The peripheral inflammatory immune response of patients with LRRK2-associated PD did not differ from HCs. Our study supports the involvement of a peripheral inflammatory immune response in the pathophysiology of sPD and GBA-associated PD. However, this inflammatory response was not found in LRRK2-associated PD, probably reflecting different pathogenic inflammatory mechanisms.

Abstract Background Depression is a common condition among cancer patients, across several points in the disease trajectory. Although presenting higher prevalence rates than the general population, it is often not reported or remains unnoticed. Moreover, somatic symptoms of depression are common in the oncological context and should not be dismissed as a general symptom of cancer. It becomes even more challenging to track psychological distress in the period after the treatment, where connection with the healthcare system typically becomes sporadic. The main goal of the FAITH project is to remotely identify and predict depressive symptoms in cancer survivors, based on a federated machine learning (ML) approach, towards optimization of privacy. Methods FAITH will remotely analyse depression markers, predicting their negative trends. These markers will be treated in distinct categories, namely nutrition, sleep, activity and voice, assessed in part through wearable technologies. The study will include 300 patients who have had a previous diagnosis of breast or lung cancer and will be recruited 1 to 5 years after the end of primary cancer. The study will be organized as a 12-month longitudinal prospective observational cohort study, with monthly assessments to evaluate depression symptoms and quality of life among cancer survivors. The primary endpoint is the severity of depressive symptoms as measured by the Hamilton Depression Rating Scale (Ham-D) at months 3, 6, 9 and 12. Secondary outcomes include self-reported anxiety and depression symptoms (HADS scale), and perceived quality of life (EORTC questionnaires), at baseline and monthly. Based on the predictive models gathered during the study, FAITH will also aim at further developing a conceptual federated learning framework, enabling to build machine learning models for the prediction and monitoring of depression without direct access to user’s personal data. Discussion Improvements in the objectivity of psychiatric assessment are necessary. Wearable technologies can provide potential indicators of depression and anxiety and be used for biofeedback. If the FAITH application is effective, it will provide healthcare systems with a novel and innovative method to screen depressive symptoms in oncological settings. Trial registration Trial ID: ISRCTN10423782 . Date registered: 21/03/2022.

Abstract Background The aim of this study is to evaluate the short- and long-term effects of the universal mental health literacy intervention “EspaiJove.net” in increasing mental health knowledge, help seeking and reducing stigma attitudes in the adolescent population. We also examine whether these effects depend on the intervention intensity. Methods A clustered school-based randomised controlled trial (cRCT) design. Subjects: 1,298 secondary pupils aged 13 and 14 were recruited from 18 schools in Barcelona (Spain) between September 2016 and January 2018. Intervention: Three programmes were assessed: 1) Sensitivity Programme (SP; 1 h); 2) Mental Health Literacy (MHL; 6 h); 3) MHL plus a first-person Stigma Reduction Programme (MHL + SR; 7 h); 4) Control group (CG): waiting list. Outcome measures: 1) MHL: EspaiJove.net EMHL Test (First part and Second Part); 2) Stigma: RIBS and CAMI; 3) Help-seeking and use of treatment: GHSQ. Analysis: The data was collected at baseline, post-intervention and 6 and 12 months later. An intention-to-treat analysis and imputation method was used to analyse the missing data. Intervention effects were analysed using multilevel modelling. Results One thousand thirty-two students were included (SP = 225; MHL = 261; MHL + SR = 295 and CG = 251). The MHL and MHL + SR interventions showed short- and long-term an increase in knowledge compared to SP and CG, but no significant change post-intervention or over time (First part p = 0.52 and Second part p = 0.62) between intervention groups and CG. No significant changes were found in stigma scores post-intervention or over time (CAMI p = 0.61 and RIBS p = 0.98) or in help-seeking scores (parent p = 0.69; teacher p = 0.23 and healthcare professional p = 0.75). The MHL + SR intervention was the best valued and recommended (p

Abstract Background The aim of this study is to investigate the attitudes and beliefs of Spanish physiotherapists towards the diagnosis and management of low back pain (LBP). A descriptive, cross-sectional study was conducted according to STROBE guidelines from December 18, 2021, to May 2022. An online survey was developed based on Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT), a reliable and validated self-administered instrument developed to assess the strength of two possible treatment orientations of physiotherapists towards the diagnosis and management of LBP. Respondents were selected through a non-probabilistic convenience sampling technique, and the selection criteria were (1) active physiotherapists with no restrictions on gender and length of service, (2) physical therapists who have worked in both public and private environments, and (3) physiotherapists who have been officially registered with no restriction on the place of practice in Spain. Survey data was obtained and analyzed using the SPSS Statistic 28 (IBM®) statistical software. Results Three hundred eighty-one questionnaires were finally included (F;n=151, M;n=230). In relation to the diagnosis, the respondents indicated that the tissue damage was sufficient to explain widespread and lasting pain, but rather that it was due to psychological factors. In addition, for those surveyed, the diagnosis should not focus exclusively on imaging tests but on clinical symptoms and signs. However, the weak relationship between objective damage and perceived pain intensity, as well as the weak relationship between posture and the development or worsening of LBP, did not seem to be clear to physiotherapists. From the point of view of treatment, we can indicate that professionals are committed to maintaining adequate and individualized physical activity as a first-line treatment in pain management. Conclusions Most physiotherapists in Spain have up-to-date knowledge of the biopsychosocial model of pain care. However, regarding attitudes and beliefs towards LBP, there are still contents and behaviors based on spine protective paradigms that are not conducive to active pain management.

Book review

Reading, as complex cognitive activity, has become the focus of numerous national and international studies from a comparative perspective. This research analyses the Programme for International Student Assessment (PISA) over the last few years due to, according to the results, the low performance presented by Spanish students in reading skills. This low result is shown in the different stages analysed and it is even worse if it is considered the 2006 and 2018 reports since in those years worst results were achieved (461 and 477 points respectively). In order to do this, different factors that have an influence on reading skills are analysed. It is done a comparative and longitudinal research from 2000 to 2018 that considers all the results provided by OECD. With that data in mind and the purpose of understanding them and contextualize those factors that could rise to them, other elements are studied, such as the presence of the reading skills in the Spanish legislation, the investment made in Secondary Education, the rate of students who finish Compulsory Secondary School, as well as the evolution that school libraries have had in terms of number, uses or the participation of families and the environment in them. These aspects are analysed in a way that is compared with the reading performance obtained throughout the PISA studies. Finally, the approach of the PISA reports justifies its use as a reference for a qualitative and global understanding of the aspects that interfere with appropriate reading skills in fifteen-year-old students. This goes beyond numerical results.

IntroductionPrevious studies measuring intervals on the oral cancer care pathway have been heterogenous, showing mixed results with regard to patient outcomes. The aims of this research were (1) to calculate pooled meta-analytic estimates for the duration of the patient, diagnostic and treatment intervals in oral cancer, considering the income level of the country, and (2) to review the evidence on the relationship of these three intervals with tumor stage at diagnosis and survival.Materials and methodsWe conducted a systematic review with meta-analysis following PRISMA 2020 guidelines (pre-registered protocol CRD42020200752). Following the Aarhus statement, studies were eligible if they reported data on the length of the patient (first symptom to first presentation to a healthcare professional), diagnostic (first presentation to diagnosis), or treatment (diagnosis to start of treatment) intervals in adult patients diagnosed with primary oral cancer. The risk of bias was assessed with the Aarhus checklist.ResultsTwenty-eight studies reporting on 30,845 patients met the inclusion criteria. The pooled median duration of the patient interval was 47 days (95% CI = 31–73), k = 18, of the diagnosis interval 35 days (95% CI = 21–38), k = 11, and of the treatment interval 30 days (95% CI = 23–53), k = 19. In lower-income countries, the patient and treatment intervals were significantly longer, and longer patient intervals were related to later stage at diagnosis. In studies with a lower risk of bias from high-income countries, longer treatment intervals were associated with lower survival rates.ConclusionInterval duration on the oral cancer care pathway is influenced by the socio-economic context and may have implications for patient outcomes.

Los sistemas de pavimento permeable son una de las técnicas de drenaje urbano sostenible mejor consideradas para la gestión sostenible de las aguas pluviales. El presente trabajo tiene como objetivos destacar y analizar las referencias internacionales y nacionales más importantes para el diseño de sistemas de pavimento permeable, llevándose a cabo una exhaustiva revisión del estado del arte de los criterios de diseño hidrológico e hidráulico, ambiental y estructural de estas estructuras, así como de las recomendaciones para su operación y mantenimiento, propuestos en las guías españolas. Innovaciones recientes desarrolladas en España, reflejan que el ajuste y la mejora del diseño de los sistemas de pavimento permeable puede ayudar a optimizar su funcionamiento. Por ejemplo, la consideración de volúmenes de gestión de lluvia adaptados a las condiciones climatológicas del lugar de instalación, la incorporación de materiales reactivos para el control de contaminantes, la elección de superficies permeables más apropiadas o la ejecución de un proceso de mantenimiento mejorado. El conocimiento generado por la investigación, apoyado con información gráfica adaptada a la normativa municipal, debe promover el desarrollo de manuales y guías de diseño, exclusivas de sistemas de pavimento permeable, adaptadas a las singularidades de cada municipio.

Este trabajo abordará el impacto del bando de gobierno promulgado por el virrey Venegas el 25 de junio de 1812 entre diferentes sectores letrados. Produjo disputas donde se inmiscuyeron juristas e integrantes del clero novohispano que mostraron discrepancias sobre los costes de ciertas políticas encaminadas al mantenimiento del statu quo virreinal. Se analizarán textos producidos en el seno del debate por la conservación o no del fuero eclesiástico frente a una nueva cultura de orden tras el estallido de la rebelión insurgente y el inicio del conflicto armado.

IntroductionHemolytic uremic syndrome (HUS) is a condition that results in acute kidney failure mainly in children, which is caused by Shiga toxin–producing Escherichia coli and inflammatory response. Although anti-inflammatory mechanisms are triggered, studies on the implication in HUS are scarce. Interleukin-10 (IL-10) regulates inflammation in vivo, and the interindividual differences in its expression are related to genetic variants. Notably, the single nucleotide polymorphism (SNP) rs1800896 −1082 (A/G), located in the IL-10 promoter, regulates cytokine expression.MethodsPlasma and peripheral blood mononuclear cells (PBMC) were collected from healthy children and HUS patients exhibiting hemolytic anemia, thrombocytopenia, and kidney damage. Monocytes identified as CD14+ cells were analyzed within PBMC by flow cytometry. IL-10 levels were quantified by ELISA, and SNP −1082 (A/G) was analyzed by allele-specific PCR.ResultsCirculating IL-10 levels were increased in HUS patients, but PBMC from these patients exhibited a lower capacity to secrete this cytokine compared with those from healthy children. Interestingly, there was a negative association between the circulating levels of IL-10 and inflammatory cytokine IL-8. We observed that circulating IL-10 levels were threefold higher in HUS patients with −1082G allele in comparison to AA genotype. Moreover, there was relative enrichment of GG/AG genotypes in HUS patients with severe kidney failure.DiscussionOur results suggest a possible contribution of SNP −1082 (A/G) to the severity of kidney failure in HUS patients that should be further evaluated in a larger cohort.