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AIM: To determine changes in the prevalence of tobacco use among students of nursing and associated factors. BACKGROUND: The prevalence and distribution of smokers among nursing students varies according to the country and period of study. METHOD: Transversal descriptive study by self-answered questionnaire. Eight hundred and fifty four subjects (94.9%) were questioned in the period 2004-2006. FINDINGS: Twenty eight percent of the students declared themselves to be smokers. The habit began before the students started university. The tendency of prevalence by year of survey and by graduation year was downward. The students shown a low nicotine dependency according to Fagerström and little motivation to give up. The average age at the onset of consumption was 14.6 (1.8) years. From the logistical regression analysis, the model best explaining the prevalence of tobacco consumption included the variable of year surveyed and academic background, those coming from the baccalaureate showing a lesser prevalence and tendency to smoke. CONCLUSIONS: Tobacco consumption among students of health sciences was less than in the general population of the same age but high given their future profession. The tendency to smoke is decreasing and most started smoking before joining the university. We recommend an intensification of actions directed at teenagers and the promotion of anti-tobacco campaigns in universities. [ABSTRACT FROM AUTHOR]

BACKGROUND: Preventing tobacco consumption and promoting cessation among health professionals are of great significance as their habits can influence their patients' attitudes. Knowledge of the prevalence and characteristics of tobacco use in a specific population is important for the design of efficient strategies for preventing people from acquiring the habit and persuading them to stop. Self-administered questionnaires are a very common method for determining tobacco use, but assessment is needed of their validity for specific groups, such as occasional smokers or students of health sciences. OBJECTIVES: The aim of this study was to determine the sensitivity and specificity of a self-administered questionnaire for determining tobacco use among a population of young female students of health sciences. As a gold standard, we used a measure of the concentration of cotinine in saliva with different cut-off points. We also analysed the influence on sensitivity and specificity of the questionnaire of nicotine dependence and exposure to secondary smoke. DESIGN: This is an internal validity study (sensitivity and specificity) of a self-administered questionnaire. SETTINGS: The study was carried out in the School of Health Sciences of the University of León, at its centres in León and Ponferrada. PARTICIPANTS: Data were collected on 432 of a total of 480 women aged under 25 who were studying Health Sciences at the University of León in 2007. METHODS: The self-administered questionnaire included data concerning demography, education, tobacco habits and exposure to environmental smoke. Saliva cotinine concentration was determined with an EIA kit. RESULTS: The questionnaire used showed high values of sensitivity and specificity (85.3% and 95.3%) and a very good correlation (Kappa=81.0%) with cotinine values of 10ng/ml or higher. Discrepancies in the test results for those who declared themselves to be smokers only occurred in women with a low nicotine dependency. Among those who did not declare themselves smokers, those exposed to second-hand smoke were 7 times more frequently classified erroneously as smokers than those who had not been exposed. CONCLUSION: The self-administered questionnaire used showed a very good internal validity and a good correlation with cotinine levels of 10ng/mg, and therefore seems to be a good instrument for measuring tobacco use in this population. The availability of information on passive smoking and nicotine dependence is essential for the correct interpretation of the discrepancies. [ABSTRACT FROM AUTHOR]

Objective: Previous studies have reported that beta-cell mitochondria exist as discrete organelles that exhibit heterogeneous bioenergetic capacity. To date, networking activity, and its role in mediating beta-cell mitochondrial morphology and function, remains unclear. In this article, we investigate beta-cell mitochondrial fusion and fission in detail and report alterations in response to various combinations of nutrients.Research Design and Methods: Using matrix-targeted photoactivatable green fluorescent protein, mitochondria were tagged and tracked in beta-cells within intact islets, as isolated cells and as cell lines, revealing frequent fusion and fission events. Manipulations of key mitochondrial dynamics proteins OPA1, DRP1, and Fis1 were tested for their role in beta-cell mitochondrial morphology. The combined effects of free fatty acid and glucose on beta-cell survival, function, and mitochondrial morphology were explored with relation to alterations in fusion and fission capacity.Results: beta-Cell mitochondria are constantly involved in fusion and fission activity that underlies the overall morphology of the organelle. We find that networking activity among mitochondria is capable of distributing a localized green fluorescent protein signal throughout an isolated beta-cell, a beta-cell within an islet, and an INS1 cell. Under noxious conditions, we find that beta-cell mitochondria become fragmented and lose their ability to undergo fusion. Interestingly, manipulations that shift the dynamic balance to favor fusion are able to prevent mitochondrial fragmentation, maintain mitochondrial dynamics, and prevent apoptosis.Conclusions: These data suggest that alterations in mitochondrial fusion and fission play a critical role in nutrient-induced beta-cell apoptosis and may be involved in the pathophysiology of type 2 diabetes. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the possible impact of the COVID-19 pandemic on prevalence rates and self-reported changes in patterns of alcohol use among first-year university students in Spain, considering the risk of problematic alcohol use. A serial cross-sectional study based on the uniHcos project was carried out. Data from 10 518 first-year university students (73.3% female, mean age 19 (SD = 1.6)) collected between 2012 and 2022 were analysed. The evolution of the pooled prevalence rates during the time series was analysed and the risk of problematic alcohol consumption was assessed using the AUDIT. Also, self-reported changes in alcohol use patterns during the pandemic were assessed. According to the results, during the COVID-19 pandemic, the prevalence of alcohol use in the past 30-days was reduced (76.3% in 2019 vs. 63.7% in COVID-19) increasing again in the New Normal period. Thus, a similar pattern in the practice of binge drinking was observed. Regarding the AUDIT score, 21.7% (95%CI 20.9, 22.6) of the students had harmful alcohol consumption, with a higher proportion among males. In the multivariable logistic models, a higher AUDIT score was significantly associated (p-value < 0.001) with being male and living with roommates. According to self-reported changes in consumption patterns during the COVID-19 pandemic, a higher proportion of participants with harmful use reported an increase in alcohol consumption compared to those at low-risk (43% vs 19%). Finally, despite the overall reduction in drinking prevalence during COVID-19, changes were not equal for all students and depended on their previous level of problematic drinking, highlighting that this should be considered in the development of strategies against alcohol use in this population., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: The fractal dimension (FD) is a valuable tool for analysing the complexity of neural structures and functions in the human brain. To assess the spatiotemporal complexity of brain activations derived from electroencephalogram (EEG) signals, the fractal dimension index (FDI) was developed. This measure integrates two distinct complexity metrics: 1) integration FD, which calculates the FD of the spatiotemporal coordinates of all significantly active EEG sources (4DFD); and 2) differentiation FD, determined by the complexity of the temporal evolution of the spatial distribution of cortical activations (3DFD), estimated via the Higuchi FD [HFD(3DFD)]. The final FDI value is the product of these two measurements: 4DFD × HFD(3DFD). Although FDI has shown utility in various research on neurological and neurodegenerative disorders, existing literature lacks standardized implementation methods and accessible coding resources, limiting wider adoption within the field., Methods: We introduce an open-source MATLAB software named FDI for measuring FDI values in EEG datasets., Results: By using CUDA for leveraging the GPU massive parallelism to optimize performance, our software facilitates efficient processing of large-scale EEG data while ensuring compatibility with pre-processed data from widely used tools such as Brainstorm and EEGLab. Additionally, we illustrate the applicability of FDI by demonstrating its usage in two neuroimaging studies. Access to the MATLAB source code and a precompiled executable for Windows system is provided freely., Conclusions: With these resources, neuroscientists can readily apply FDI to investigate cortical activity complexity within their own studies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Measures of life outlook in older adults have been investigated in connection to pain, as both pain management and outlook are important factors of successful aging. We hypothesized that higher pain is associated with lower optimism among community-dwelling older adults. We utilized data from the UC San Diego Successful Aging Evaluation (SAGE), a prospective longitudinal cohort study initiated in 2010, to evaluate the relationship between pain and optimism in 378 community-dwelling adults aged ≥50 years. We used the revised Life Orientation Test (LOT-R) to measure optimism and three pain subscales-PROMIS Pain Interference, PROMIS Pain Intensity, and MOS 36-Item Short-Form Health Survey (SF-36)-as pain measures. Regression analyses reveal negative relationships between pain and optimism for all three pain scales, with regression coefficients of -0.277 ( p  < .0001), -0.246 ( p  < .0001), and 0.269 ( p  < .0001) respectively. This indicates value in considering physical and psychological elements in future intervention research to promote healthy aging., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Cardiorespiratory fitness and mitochondrial oxidative capacity are associated with reduced walking speed in older adults, but their impact on walking speed in older adults with diabetes has not been clearly defined. We examined differences in cardiorespiratory fitness and skeletal muscle mitochondrial oxidative capacity between older adults with and without diabetes, as well as determined their relative contribution to slower walking speed in older adults with diabetes. Participants with diabetes (n = 159) had lower cardiorespiratory fitness and mitochondrial respiration in permeabilized fiber bundles compared with those without diabetes (n = 717), following adjustments for covariates including BMI, chronic comorbid health conditions, and physical activity. Four-meter and 400-m walking speeds were slower in those with diabetes. Mitochondrial oxidative capacity alone or combined with cardiorespiratory fitness mediated ∼20-70% of the difference in walking speed between older adults with and without diabetes. Additional adjustments for BMI and comorbidities further explained the group differences in walking speed. Cardiorespiratory fitness and skeletal muscle mitochondrial oxidative capacity contribute to slower walking speeds in older adults with diabetes., (© 2024 by the American Diabetes Association.)

In this chapter, we review the research that has applied fractal measures to the study of the most common psychological disorders, that is, affective and anxiety disorders. Early studies focused on heart rate, but diverse measures have also been examined, from variations in subjective mood, or hand movements, to electroencephalogram or magnetoencephalogram data. In general, abnormal fractal dynamics in different physiological and behavioural outcomes have been observed in mental disorders. Despite the disparity of variables measured, fractal analysis has shown high sensitivity in discriminating patients from healthy controls. However, and because of this heterogeneity in measures, the results are not straightforward, and more studies are needed in this promising line., (© 2024. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

We investigated the metabolomic profile associated with exposure to trihalomethanes (THMs) and nitrate in drinking water and with colorectal cancer risk in 296 cases and 295 controls from the Multi Case-Control Spain project. Untargeted metabolomic analysis was conducted in blood samples using ultrahigh-performance liquid chromatography-quadrupole time-of-flight mass spectrometry. A variety of univariate and multivariate association analyses were conducted after data quality control, normalization, and imputation. Linear regression and partial least-squares analyses were conducted for chloroform, brominated THMs, total THMs, and nitrate among controls and for case-control status, together with a N-integration model discriminating colorectal cancer cases from controls through interrogation of correlations between the exposure variables and the metabolomic features. Results revealed a total of 568 metabolomic features associated with at least one water contaminant or colorectal cancer. Annotated metabolites and pathway analysis suggest a number of pathways as potentially involved in the link between exposure to these water contaminants and colorectal cancer, including nicotinamide, cytochrome P-450, and tyrosine metabolism. These findings provide insights into the underlying biological mechanisms and potential biomarkers associated with water contaminant exposure and colorectal cancer risk. Further research in this area is needed to better understand the causal relationship and the public health implications.

Monitoring of the mental health status of the population and assessment of its determinants are 2 of the most relevant pillars of public mental health, and data from population health surveys could be instrumental to support them. Although these surveys could be an important and suitable resource for these purposes, due to different limitations and challenges, they are often relegated to the background behind other data sources, such as electronic health records. These limitations and challenges include those related to measurement properties and cross-cultural validity of the tools used for the assessment of mental disorders, their degree of representativeness, and possible difficulties in the linkage with other data sources. Successfully addressing these limitations could significantly increase the potential of health surveys in the monitoring of mental disorders and ultimately maximize the impact of the relevant policies to reduce their burden at the population level. The widespread use of data from population health surveys, ideally linked to electronic health records data, would enhance the quality of the information available for research, public mental health decision-making, and ultimately addressing the growing burden of mental disorders., (©Jorge Arias de la Torre, Gemma Vilagut, Amy Ronaldson, Ioannis Bakolis, Alex Dregan, Fernando Navarro-Mateu, Katherine Pérez, Anna Szücs, Xavier Bartoll-Roca, Antonio J Molina, Matilde Elices, Víctor Pérez-Solá, Vicente Martín, Antoni Serrano-Blanco, Jose M Valderas, Jordi Alonso. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 23.11.2023.)

Purpose: To build models combining circulating microRNAs (miRNAs) able to identify women with breast cancer as well as different types of breast cancer, when comparing with controls without breast cancer., Method: miRNAs analysis was performed in two phases: screening phase, with a total n = 40 (10 controls and 30 BC cases) analyzed by Next Generation Sequencing, and validation phase, which included 131 controls and 269 cases. For this second phase, the miRNAs were selected combining the screening phase results and a revision of the literature. They were quantified using RT-PCR. Models were built using logistic regression with LASSO penalization., Results: The model for all cases included seven miRNAs (miR-423-3p, miR-139-5p, miR-324-5p, miR-1299, miR-101-3p, miR-186-5p and miR-29a-3p); which had an area under the ROC curve of 0.73. The model for cases diagnosed via screening only took in one miRNA (miR-101-3p); the area under the ROC curve was 0.63. The model for disease-free cases in the follow-up had five miRNAs (miR-101-3p, miR-186-5p, miR-423-3p, miR-142-3p and miR-1299) and the area under the ROC curve was 0.73. Finally, the model for cases with active disease in the follow-up contained six miRNAs (miR-101-3p, miR-423-3p, miR-139-5p, miR-1307-3p, miR-331-3p and miR-21-3p) and its area under the ROC curve was 0.82., Conclusion: We present four models involving eleven miRNAs to differentiate healthy controls from different types of BC cases. Our models scarcely overlap with those previously reported., (© 2023. The Author(s).)

Background: Assessing the prevalence of clinically relevant depressive symptoms and their possible variation by country and over time could be a valuable resource to inform the development of public health policies and preventive resources to reduce mental health burden. We aimed to assess cross-national differences in the point prevalence of clinically relevant depressive symptoms in Europe in 2018-20, and to evaluate point prevalence differences between countries and over time between 2013-15 and 2018-20., Methods: In this population-based study, data from participants in the second and third waves of the European Health Interview Survey (EHIS-2 from 2013 to 2015 and EHIS-3 from 2018 to 2020) from 30 European countries were used (n=542 580). From the total sample, 283 692 participants belonging to EHIS-3 were included in the study (52·4% women and 47·5% men). The non-response in EHIS-3 ranged by country, from 12% to 78%. Point prevalence of clinically relevant depressive symptoms was evaluated using a cutoff score of 10 or more for the 8-item version of the Patient Health Questionnaire. Crude prevalence ratios and adjusted prevalence ratios (aPRs) were obtained to assess differences in the prevalence between countries and over time within countries., Findings: The point prevalence of clinically relevant depressive symptoms in Europe in 2018-20 was 6·54% (95% CI 6·34-6·73), ranging across countries from 1·85% (1·53-2·17) in Greece to 10·72% (10·04-11·40) in Sweden. Compared with the other European countries, those with the lowest aPRs were Greece, Serbia, and Cyprus and those with the highest aPRs were Belgium, Slovenia, and Croatia. A small but significant increase in the prevalence between EHIS-2 and EHIS-3 was observed (aPR 1·11 [1·07-1·14]). A wide variability over time in the point prevalence within countries was observed, ranging from an aPR of 0·63 (0·54-0·74) in Hungary to 1·88 (1·53-2·31) in Slovenia., Interpretation: This study, based on large and representative datasets and a valid and reliable screening tool for the assessment of depression, indicates that the point prevalence of clinically relevant depressive symptoms in Europe from 2013 to 2020 remains relatively stable, with wide variability between countries. These findings could be considered a baseline for monitoring the prevalence of clinically relevant depressive symptoms in Europe, and could inform policy for the development of preventive strategies for depression both at a country and European level., Funding: Center for Biomedical Research in Epidemiology and Public Health Network and AGAUR., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Schizophrenia (SZ) is a complex disorder characterized by a range of symptoms and behaviors that have significant consequences for individuals, families, and society in general. Electroencephalography (EEG) is a valuable tool for understanding the neural dynamics and functional abnormalities associated with schizophrenia. Research studies utilizing EEG have identified specific patterns of brain activity in individuals diagnosed with schizophrenia that may reflect disturbances in neural synchronization and information processing in cortical circuits. Considering the temporal dynamics of functional connectivity provides a more comprehensive understanding of brain networks' organization and how they change during different cognitive states. This temporal perspective would enhance our understanding of the underlying mechanisms of schizophrenia. In the present study, we will use measures based on graph theory to obtain dynamic and static indicators in order to evaluate differences in the functional connectivity of individuals diagnosed with SZ and healthy controls using an ecologically valid task. At the static level, patients showed alterations in their ability to segregate information, particularly in the default mode network (DMN). As for dynamic measures, patients showed reduced values in most metrics (segregation, integration, centrality, and resilience), reflecting a reduced number of dynamic states of brain networks. Our results show the utility of combining static and dynamic indicators of functional connectivity from EEG sensors.

Fractal dimension (FD) has been revealed as a very useful tool in analyzing the changes in brain dynamics present in many neurological disorders. The fractal dimension index (FDI) is a measure of the spatiotemporal complexity of brain activations extracted from EEG signals induced by transcranial magnetic stimulation. In this study, we assess whether the FDI methodology can be also useful for analyzing resting state EEG signals, by characterizing the brain dynamic changes in different functional networks affected by schizophrenia, a mental disorder associated with dysfunction in the information flow dynamics in the spontaneous brain networks. We analyzed 31 resting-state EEG records of 150 s belonging to 20 healthy subjects (HC group) and 11 schizophrenia patients (SCZ group). Brain activations at each time sample were established by a thresholding process applied on the 15,002 sources modeled from the EEG signal. FDI was then computed individually in each resting-state functional network, averaging all the FDI values obtained using a sliding window of 1 s in the epoch. Compared to the HC group, significant lower values of FDI were obtained in the SCZ group for the auditory network ( p  < 0.05), the dorsal attention network ( p  < 0.05), and the salience network ( p  < 0.05). We found strong negative correlations ( p  < 0.01) between psychopathological scores and FDI in all resting-state networks analyzed, except the visual network. A receiver operating characteristic curve analysis also revealed that the FDI of the salience network performed very well as a potential feature for classifiers of schizophrenia, obtaining an area under curve value of 0.83. These results suggest that FDI is a promising method for assessing the complexity of the brain dynamics in different regions of interest, and from long resting-state EEG signals. Regarding the specific changes associated with schizophrenia in the dynamics of the spontaneous brain networks, FDI distinguished between patients and healthy subjects, and correlated to clinical variables., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ruiz de Miras, Ibáñez-Molina, Soriano and Iglesias-Parro.)

While growing evidence supports that dispositional mindfulness relates to psychological health and cognitive enhancement, to date there have been only a few attempts to characterize its neural underpinnings. In the present study, we aimed at exploring the electrophysiological (EEG) signature of dispositional mindfulness using quantitative and complexity measures of EEG during resting state and while performing a learning task. Hundred twenty participants were assessed with the Five Facet Mindfulness Questionnaire and underwent 5 min eyes-closed resting state and 5 min at task EEG recording. We hypothesized that high mindfulness individuals would show patterns of brain activity related to (a) lower involvement of the default mode network (DMN) at rest (reduced frontal gamma power) and (b) a state of 'task readiness' reflected in a more similar pattern from rest to task (reduced overall q-EEG power at rest but not at task), as compared to their low mindfulness counterparts. Dispositional mindfulness was significantly linked to reduced frontal gamma power at rest and lower overall power during rest but not at task. In addition, we found a trend towards higher entropy during task performance in mindful individuals, which has recently been reported during mindfulness meditation. Altogether, our results add to those from expert meditators to show that high (dispositional) mindfulness seems to have a specific electrophysiological pattern characteristic of less involvement of the DMN and mind-wandering processes., (© 2023 The Authors. British Journal of Psychology published by John Wiley & Sons Ltd on behalf of The British Psychological Society.)

Background: The 8-item version of the Patient Health Questionnaire (PHQ-8) is one of the self-reported questionnaires most frequently used worldwide for the screening and severity assessment of depression. However, in some European countries its reliability is unknown, and it is unclear whether its psychometric properties vary between European countries. Therefore, the aim of this study was to assess the internal structure, reliability and cross-country equivalence of the PHQ-8 in Europe., Methods: All participants from the 27 countries included in the second wave of the European Health Interview Survey (EHIS-2) between 2014 and 2015 with complete information on the PHQ-8 were included (n = 258,888). The internal structure of the PHQ-8 was assessed using confirmatory factor analyses (CFA) for categorical items. Additionally, the reliability of the questionnaire was assessed based on the internal consistency, Item Response Theory information functions, and item-discrimination (using Graded Response Models), and the cross-country equivalence based on multi-group CFA., Findings: The PHQ-8 shows high internal consistency for all countries. The countries in which the PHQ-8 was more reliable were Romania, Bulgaria and Cyprus and less reliable were Iceland, Norway and Austria. The PHQ-8 item with highest discrimination was item 2 (feeling down, depressed, or hopeless) in 24 of the 27 countries. Measurement invariance between countries in Europe was observed from multigroup CFA at the configural, metric and scalar levels., Interpretation: The results from our study, likely the largest study to the date assessing the internal structure, reliability and cross-country comparability of a self-reported mental health assessment measure, shows that the PHQ-8 has an adequate reliability and cross-country equivalence across the 27 European countries included. These results highlight the suitability of the comparisons of the PHQ-8 scores in Europe. They could be helpful to improve the screening and severity assessment of depressive symptoms at the European level., Funding: This work was partially funded by CIBER Epidemiology and Public Health (CIBERESP) as part of the Intramural call of 2021 (ESP21PI05)., Competing Interests: All authors declare that they have no conflict of interest. Data of EHIS-2 is publicly available for different purposes under request to Eurostat., (© 2023 The Author(s).)

The objective of this research was to study the relationship between the body weight and diet, physical activity, and other habits among freshmen students by sex, and to determine whether these habits have changed during the post-era of the COVID-19 pandemic. A serial cross-sectional study with data from 11 Spanish universities was carried out. In total, 10,096 first-year university students (73.2% female, mean age = 19.0 ± 1.5 years) completed an online self-administered questionnaire between 2012 and 2022. For some analyses, questionnaires were categorized by the year in which the survey was filled out as Before COVID-19, Lockdown, and New Normal. In total, 72.9% of participants were within the normal weight range, and 17.7% of men and 11.8% of women were overweight ( p < 0.001). The students who did not meet the WHO criteria of physical activity, spent more than 7 h per day sitting, and skipped breakfast had a higher prevalence of obesity ( p < 0.05). According to the period of study, the prevalence of overweight/obesity Before COVID-19 was 16.1% (95% CI: 15.4-16.9%), while in Lockdown the prevalence was significantly higher (20.2, 95% CI: 17.1-23.8) and in New Normal it was 18.9% (CI: 15.7-22.5). Moreover, the study suggests that during the Lockdown period, there was a reduction in the practice of physical activity and an increase in the prevalence of a healthy diet. For all these, it is necessary to propose public health interventions that improve the lifestyles of university students.

Schizophrenia has been associated with dysfunction in information integration/segregation dynamics. One of the neural networks whose role has been most investigated in schizophrenia is the default mode network (DMN). In this study, we have explored the possible alteration of integration and segregation dynamics in individuals diagnosed with schizophrenia with respect to healthy controls, based on the study of the topological properties of the graphs derived from the functional connectivity between the nodes of the DMN in the resting state. Our results indicate that the patients show a diminution of the modularity of the DMN and a higher global efficiency, in sparse graphs. Our data emphasise the interest in studying temporal changes in network measures and are compatible with the hypothesis of randomization of functional networks in schizophrenia., (© 2023 The Authors. European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)

Transcription factors have a pivotal role in synaptic plasticity and the associated modification of neuronal networks required for memory formation and consolidation. The nuclear receptors subfamily 4 group A (Nr4a) have emerged as possible modulators of hippocampal synaptic plasticity and cognitive functions. However, the molecular and cellular mechanisms underlying Nr4a2-mediated hippocampal synaptic plasticity are not completely known. Here, we report that neuronal activity enhances Nr4a2 expression and function in cultured mouse hippocampal neurons (both sexes) by an ionotropic glutamate receptor/Ca 2+ /cAMP response element-binding protein/CREB-regulated transcription factor 1 (iGluR/Ca 2+ /CREB/CRTC1) pathway. Nr4a2 activation mediates BDNF production and increases expression of iGluRs, thereby affecting LTD at CA3-CA1 synapses in acute mouse hippocampal slices (both sexes). Together, our results indicate that the iGluR/Ca 2+/ CREB/CRTC1 pathway mediates activity-dependent expression of Nr4a2, which is involved in glutamatergic synaptic plasticity by increasing BDNF and synaptic GluA1-AMPARs. Therefore, Nr4a2 activation could be a therapeutic approach for brain disorders associated with dysregulated synaptic plasticity. SIGNIFICANCE STATEMENT A major factor that regulates fast excitatory synaptic transmission and plasticity is the modulation of synaptic AMPARs. However, despite decades of research, the underlying mechanisms of this modulation remain poorly understood. Our study identified a molecular pathway that links neuronal activity with AMPAR modulation and hippocampal synaptic plasticity through the activation of Nr4a2, a member of the nuclear receptor subfamily 4. Since several compounds have been described to activate Nr4a2, our study not only provides mechanistic insights into the molecular pathways related to hippocampal synaptic plasticity and learning, but also identifies Nr4a2 as a potential therapeutic target for pathologic conditions associated with dysregulation of glutamatergic synaptic function., (Copyright © 2023 the authors.)

Objective: Heat exposure and heat stress/strain is a concern for many workers. There is increasing interest in potential chronic health effects of occupational heat exposure, including cancer risk. We examined potential associations of occupational heat exposure and colorectal cancer (CRC) risk in a large Spanish multi-case--control study., Methods: We analyzed data on 1198 histologically confirmed CRC cases and 2690 frequency-matched controls. The Spanish job-exposure matrix, MatEmEsp, was used to assign heat exposure estimates to the lifetime occupations of participants. Three exposure indices were assessed: ever versus never exposed, cumulative exposure and duration (years). We estimated odds ratios (OR) and 95% confidence intervals (CI) using unconditional logistic regression adjusting for potential confounders., Results: Overall, there was no association of ever, compared with never, occupational heat exposure and CRC (OR 1.09, 95% CI 0.92-1.29). There were also no associations observed according to categories of cumulative exposure or duration, and there was no evidence for a trend. There was no clear association of ever occupational heat exposure and CRC in analysis conducted among either men or women when analyzed separately. Positive associations were observed among women in the highest categories of cumulative exposure (OR 1.81, 95% CI 1.09-3.03) and duration (OR 2.89, 95% CI 1.50-5.59) as well as some evidence for a trend (P<0.05)., Conclusion: Overall, this study provides no clear evidence for an association between occupational heat exposure and CRC.

Background and Objectives: The main clinical practice guidelines recommend adequate periprocedural withdrawal and reintroduction of antithrombotic drugs in case of invasive techniques. The main objective of this study was to assess whether, in patients receiving anticoagulant or antiplatelet therapy, the suppression or reduction of the pharmacological dose for the performance of endoscopic retrograde cholangiopancreatography (ERCP) implies a greater risk of thromboembolic events., Patients and Methods: A prospective observational study was carried out, which included 644ERCP performed with therapeutic intention during 2019 at the Reina Sofía University Hospital with follow-up during the 30days after the endoscopic intervention., Results: Six patients presented a thromboembolic event, finding no differences between the incorrect withdrawal/reintroduction of antithrombotic treatment and a higher proportion of thromboembolic or hemorrhagic events after the procedure (P>.05). The incidence of thrombotic events was significantly higher in patients treated with heparin or apixaban (P=.001), as well as with a history of atrial fibrillation (P=.05), rheumatic valve disease (P=.037) and recurrent pulmonary embolism (P=.035), this being also an independent risk factor. Likewise, the incidence of hemorrhage in the 30days post-sphincterotomy was significantly lower in those with implantation of a biliary prosthesis (P=.04)., Conclusions: Inadequate periprocedural management of antithrombotic therapy is not associated with a significant increase in the incidence of thromboembolic events in the 30days after ERCP. However, close follow-up and surveillance during the days after this is essential in those patients with a condition that significantly increases the risk of thrombosis., (Copyright © 2022 Elsevier España, S.L.U. All rights reserved.)

Inferential analysis using null hypothesis significance testing (NHST) allows accepting or rejecting a null hypothesis. Nevertheless, rejecting a null hypothesis and concluding there is a statistical effect does not provide a clue as to its practical relevance or magnitude. This process is key to assessing the effect size (ES) of significant results, be it using context (comparing the magnitude of the effect to similar studies or day-to-day effects) or statistical estimators, which also should be sufficiently interpreted. This is especially true in clinical settings, where decision-making affects patients' lives. We carried out a systematic review for the years 2015 to 2020 utilizing Scopus, PubMed, and various ProQuest databases, searching for empirical research articles with inferential results linking spirituality to substance abuse outcomes. Out of the 19 studies selected, 11 (57.9%) reported no ES index, and 9 (47.4%) reported no interpretation of the magnitude or relevance of their findings. The results of this review, although limited to the area of substance abuse and spiritual interventions, are a cautionary tale for other research topics. Gauging and interpreting effect sizes contributes to a better understanding of the subject under scrutiny in any discipline.

Physical function is one of the most important constructs assessed in health-related quality of life (HRQOL), and it could be very useful to assess movement ability from the perspective of the patient. The objective of this study was to compare the content of the domains related to mobility covered by the HRQOL questionnaires based on the International Classification of Functioning, Disability and Health (ICF) and to evaluate their quality according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance. For this, a systematic review was carried out in the databases Scopus, Web of Science and Science Direct. The inclusion criteria were development and/or validation studies about generic HRQOL measures, and the instruments had to include items related to mobility and studies written in English or Spanish. The comparison of content was performed using the ICF coding system. A total of 3614 articles were found, 20 generic HRQOL instruments were identified and 120 (22.4%) mobility-related items were found. Walking was the most represented category. Low-quality evidence on some measurement properties of the generic HRQOL instruments was revealed. The CAT-Health is a useful questionnaire to be used in rehabilitation due to its psychometric properties and its content.

Objective: To extend knowledge about the long-term use of hormones in hormone therapy or oral contraception as prognostic factors in breast cancer., Methods: The MCC-Spain project is a cohort of 1,685 women with incident breast cancer recruited in Spain. Recruitment was carried out between 2007 and 2010, and the follow-up finished in December 2017. The impact of hormone therapy or oral contraception on breast cancer prognosis was analyzed considering year of birth and menopausal status (1,095 women [65%] were postmenopausal). Hazard ratios (HRs) were estimated using Cox regression models. Death by any cause was considered as the event, and hormone therapy or oral contraception were analyzed as regressors., Results: Oral contraception use for less than 5 years shows an HR of 1.10 (95% CI, 0.75 to 1.62), whereas use for 5 or more years shows an HR of 1.46 (95% CI, 0.95 to 2.25), with a P trend of 0.01, showing a dose-dependent response. Regarding hormone therapy and restricting the analysis to postmenopausal women born between1940 and 1959, where most hormone therapy (consumption) is concentrated, the results did not show any trend., Conclusion: Concerning oral contraception use, our results demonstrate that their use is related to poor prognosis in breast cancer. However, research in this field is limited and controversial, indicating the need for more research in this area. Regarding hormone therapy consumption, our results indicate no association with better prognosis, which contradicts what has previously been published., Competing Interests: Financial disclosure/conflicts of interest: N.A.'s institution has received funding from Instituto de Salud Carlos III and Fundación para la Investigación e Innovación Biosanitaria de Atención Primaria. The other authors have nothing to declare., (Copyright © 2022 by The North American Menopause Society.)