Search

Background: During accommodation, the eye undergoes significant structural changes, altering wavefront aberrations. So, this study aimed to evaluate changes in Zernike coefficients up to the 6th order with different accommodation demands and ages in a large cohort of young adults, considering the decrease in pupil size with the accommodation., Methods: Aberrometric measurements for 210 healthy subjects aged 18-40 were performed with the irx3 (Imagine Eyes, Orsay, France), stimulating accommodation with the Badal system of the instrument, from 0 to 5 D. Each wavefront was rescaled to a standardized pupil size for each accommodative vergence. Variations of Zernike coefficients were analyzed for each accommodative demand, and the change of Zernike coefficients with age., Results: The most notable changes observed during accommodation was the increase in C(2,0). Both C(2,±2) astigmatism showed a reduction in magnitude during accommodation. C(4,0) became less positive, or more negative, as accommodation increased. C(3,-1) remained constant as the accommodation demand increased, while C(3,1) showed an increase. Changes were observed with accommodation and age, where C(2,0) had a negative linear relationship. The C(4,0) changed gradually with age only for accommodative demands below 3 D. C(3,±1) decreased with age., Conclusions: Wavefront aberration coefficients presented changes during accommodation in people aged 20-40 years. C(2,0) underwent the most pronounced changes and C(4,0) changed more with accommodation than other higher-order aberrations. Zernike coefficients C(2,0), C(4,0) and C(3,±1) decreased with age, and C(2,±2) astigmatisms showed an increase in magnitude with age. These findings were made considering the decrease in pupil size with accommodation, highlighting the importance of accounting for pupil diameter variations when evaluating wavefront aberrations., Competing Interests: Declarations. Ethics approval and consent to participate: The study adhered to the tenets of the Declaration of Helsinki and received approval from the Ethics Subcommittee for Life and Health Sciences of the University of Minho (Ref. 081/2022), the Clinical Research Ethics Committee of Aragón (CEICA) (Ref. PI21-074) and the Ethics Committee of the University of Murcia. All participants signed informed consent forms after receiving an explanation of the purpose of the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Immune thrombocytopenia (ITP) is a rare acquired disorder where thrombopoietin-receptor agonists have become mainstays of ITP treatment. With the recent approval of avatrombopag (AVA), real-world studies are essential to evaluate its efficacy and safety. Our study of 66 adult ITP patients treated with AVA showed a high response rate. After starting AVA, 74.2% did not require rescue medications, with minimal adverse effects. Additionally, 56.0% of patients reduced other ITP medications, and all patients aged ≥65 years responded to AVA. Results should be confirmed in larger studies, but AVA appears to be an effective and safe treatment for ITP patients., (© 2025 The Author(s). British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.)

Alzheimer's is a progressive and degenerative disease affecting millions worldwide, incapacitating them physically and cognitively. This study aims to perform a comparative analysis of Machine Learning models to determine the model with the best performance in predicting Alzheimer's disease. The models used were Random Forest (RF), Adaptive Boosting (AdaBoost), Support Vector Machine (SVM), K-nearest Neighbors (KNN), and Logistic Regression (LR). Two datasets called OASIS were used to train the models, the first one had a total of 436 records and 12 variables, while the second one stored 373 records and 15 variables. The article's content is divided into six main sections: introduction, literature review, methodological approach, results, discussions, and conclusions. After processing and pooling the datasets, RF, SVM, and LR proved the best predictors, achieving 96% accuracy, precision, sensitivity, and F1 score. This study highlights the efficacy of RF, SVM, and LR in predicting Alzheimer's disease, offering a significant advance toward understanding and management of this disease, which supports the relevance of implementing these models in future research and clinical applications., Competing Interests: 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., (© 2025 The Authors.)

Purpose: To evaluate the repeatability of the Zernike coefficients in healthy eyes when monocular accommodation was stimulated at different vergences demands., Methods: A total of 36 right eyes from healthy volunteers were prospectively and consecutively recruited for this study. Wavefront aberrometry was conducted to objectively characterize the ocular optical quality during accommodation, from the individual's far point to a 5 D accommodation demand in steps of 0.5 D. The repeatability of Zernike coefficients up to the fourth order was assessed by calculating the within-eye repeatability ( Sw ), the coefficient of repeatability ( CR ), the coefficient of variation ( CV ), and the intraclass correlation coefficient ( ICC ) as an indicator of measurement reliability., Results: Correlation among repeated measurements showed high reliability (ICC > 0.513) for all parameters measured except some fourth-order Zernike coefficients, C(4, -4) (ICC < 0.766), C(4, -2) (ICC < 0.875), C(4, 2) (ICC < 0.778) and C(4, 4) (ICC < 0.811). Greater repeatability and less variability were obtained for high-order Zernike coefficients (CR < 0.154), although an increase in CR in the coefficients analyzed was observed with increasing accommodative demand. No clear trend was evident in CV; however, it was observed that the low-order Zernike coefficients exhibit lower CV (CV < 1.93) compared to the high-order Zernike coefficients (CV > 0)., Conclusions: The reliability of Zernike coefficients up to the fourth order in healthy young individuals demonstrated a strong consistency in measuring terms up to the fourth order, with more variability observed for high-order terms. The Zernike coefficients up to the third order exhibited the highest level of repeatability.

Retinal morphology, specifically in its curvature, and ocular aberrations change when the eye adapts to different lighting conditions, including photopic, scotopic, mesopic, blue light, and red light. Sixty healthy young subjects with refractive error less than ±4.00 D of sphere and 3.00 D of cylinder, not suffering from accommodative problems, ocular or systemic pathology, and not having used electronic devices half an hour before or having taken substances that alter the retina during the 2 h prior to the study were included. The subjects adapted to five lighting conditions, each for 5 min, in a controlled environment. Ocular aberrometry and Optical Coherence Tomography (OCT) were taken to capture images of the central and peripheral retina before (baseline measurements) and after adaptation to each lighting condition. The OCT images were exported and processed to analyze retinal curvature, obtaining parameters such as eccentricity, asphericity and shape factor. The results showed that the shape of the retina was hyperbolic prolate, becoming flatter in scotopic and blue light conditions, and more curved in mesopic conditions. Retinal curvature was closest to baseline under red light and photopic conditions. Aberrometric differences, particularly in the C(2,0) polynomial for defocus, showed higher values in mesopic, baseline, and scotopic conditions, and lower values in photopic, blue light, and red light. Significant differences were also observed in spherical aberrations C(4,0) and C(6,0), vertical coma C(3,-1), and trefoil C(3,-3). The spherical equivalent indicated more myopic values in mesopic, baseline, and scotopic conditions, and more hyperopic values in blue, photopic, and red light, suggesting a link between myopia and lower luminosity. This study concludes that illumination affects retinal curvature and ocular refraction, influencing myopia., 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.)

Avatrombopag is the newest thrombopoietin receptor agonist (TPO-RA) approved to treat immune thrombocytopenia (ITP). Real-world evidence regarding effectiveness/safety is limited. The Spanish ITP Group (GEPTI) performed a retrospective study with patients starting avatrombopag for the first time. A total of 268 ITP patients were recruited. The median (interquartile range [IQR]) follow-up time was 47.5 (30.4-58.9) weeks. Among the 193 patients with baseline platelet counts <50 × 10 9 /L, 174 (90.1%) of them achieved response (PC ≥50 × 10 9 /L), and 113 (87.6%) of the 129 who persisted on avatrombopag at last visit had platelet levels above such threshold. Results were similar when only those patients switching to avatrombopag due to previous treatment failure were considered (n = 104). Patients reached response in 13 (7-21) days. Among patients with baseline levels ≥50 × 10 9 /L, 73/75 (97.3%) reported response, which was maintained by 53 (94.6%) of the 56 who continued on avatrombopag at the end of the study. Loss-of-response was always <10%. ITP duration did not influence response. Approximately 79% (34/43) of heavily pretreated (≥4 lines) patients with baseline platelet counts <50 × 10 9 /L switching after previous failure achieved PC ≥50 × 10 9 /L. Previous use of eltrombopag and/or romiplostim did not influence response, regardless of whether previous TPO-RA(s) succeeded or failed. Avatrombopag allowed dose-reduction/suspension of corticosteroids in 40/50 (80.0%) patients with baseline platelet counts <50 × 10 9 /L. Overall, 40/268 (14.9%) thrombocytosis and 12/268 (4.5%) thromboembolic events were reported. Our real-world cohort supports the use of avatrombopag to manage ITP, regardless of disease severity and treatment history., (© 2024 The Author(s). American Journal of Hematology published by Wiley Periodicals LLC.)

Despite that the SARS-CoV-2 pandemic has been controlled, it has affected a large proportion of the population, raising some concerns about potential sequelae in men at reproductive age. To contribute to the clarification of this issue, we performed a retrospective study comparing semen parameters values before and after confirmed SARS-CoV-2 infection in a large cohort of infertile men, compared to a control group that did not undergo SARS-CoV-2 infection. Wilcoxon test on paired samples and general linear regression model showed that SARS-CoV-2 infection has a detrimental effect on semen volume values ( p  < 0.005). However, semen volume seems to be significantly lower only during the first spermatogenic cycle after SARS-COV-2 infection ( p  < 0.005) and mainly in unvaccinated patients ( p  < 0.05). In addition, we detected alterations in progressive motility in patients infected with the alpha SARS-COV-2 strain ( p  < 0.05). In conclusion, our results show that although SARS-CoV-2 has a small effect on semen volume and sperm motility in infertile men, depending on the infectious strain or vaccination status, pre-infection values of semen parameters appear to be restored over one spermatogenic cycle after infection.

Purpose: The purpose of this study was to determine the minimum number of orthonormal basis functions, applying Principal Component Analysis (PCA), to represent the most wavefront aberrations at different accommodation stages. The study also aims to generate synthetic wavefront data using these functions., Methods: Monocular wavefront data from 191 subjects (26.15 ± 5.56 years old) were measured with a Hartmann-Shack aberrometer, simulating accommodation from 0 diopters (D) to 5 D in 1 D steps. The wavefronts for each accommodative demand were rescaled for different pupil sizes: 4.66, 4.76, 4.40, 4.09, 4.07, and 3.68 mm. PCA was applied to 150 wavefront parameters (25 Zernike coefficients × 6 accommodation levels) to obtain eigenvectors for dimensional reduction. A total of 49 eigenvectors were modeled as a sum of 2 multivariate Gaussians, from which 1000 synthetic data sets were generated., Results: The first 49 eigenvectors preserved 99.97% of the original data variability. No significant differences were observed between the mean values and standard deviation of the generated and original 49 eigenvectors (two one-sided test [TOST], P > 0.05/49) and (F-test, P > 0.05/49), both with Bonferroni correction. The mean values of the generated parameters (1000) were statistically equal to those of the original data (TOST, P > 0.05/150). The variability of the generated data was similar to the original data for the most important Zernike coefficients (F-test, P > 0.05/150)., Conclusions: PCA significantly reduces the dimensionality of wavefront aberration data across 6 accommodative demands, reducing the variable space by over 66%. The synthetic data generated by the proposed wavefront model for accommodation closely resemble the original clinical data.

Objectives: To test the psychometric properties of several dementia care-related scales among Latinos in the US., Design: We leveraged secondary baseline data from a one-arm mHealth trial on dementia caregiver support. We included 100 responses for caregiver-focused scales and 88 responses for care recipient-focused scales. Scales included the Neuropsychiatric Inventory Questionnaire Severity and Distress scales, six-item Zarit Burden Inventory, Ten-item Center for Epidemiologic Studies Depression Scale, Geriatric Depression Inventory, Quality of Life in Alzheimer's Disease, and Single-item Satisfaction With Life Scale. We calculated concurrent validity using Pearson and Spearman correlations and expected correlations amongst all variables in line with the Stress Process Framework. We calculated internal consistency reliability using Cronbach's alpha., Results: All concurrent validity correlations followed the expected directionality, with 19/21 inter-scale correlations in the total sample reaching statistical significance (p<0.05), and 17/21 reaching at least a low correlation (0.3). Cronbach's alpha ranged from 0.832 to 0.879 in all scales in the total sample., Conclusion: The English and Spanish caregiver-administered scales tested in this manuscript have good psychometric properties., Clinical Implications: The dementia care-related scales are now appropriately available for use among US Latinos in research and clinical contexts., Competing Interests: Disclosure statement: The authors declare that they have no conflict of interest.

Purpose: High-pressure balloon dilatation (HPBD) of the ureterovesical junction with double-J stenting is a minimally invasive alternative to ureteral reimplantation or cutaneous ureterostomy for first-line surgical treatment of primary obstructive megaureter (POM). The aim of our study was to identify the risk factors associated with the need for secondary procedures due to HPBD failure., Methods: Prospective data were collected from patients who underwent HPBD for POM between 2007 and 2021 at a single institution. The collected data included patient demographics, diagnostic modalities, surgical details, results, and follow-up. Multivariate logistic regression analysis was performed., Results: Fifty-five ureters underwent HPBD for POM in 50 children, with a median age of 6.4 months (IQR: 4.5-13.8). Nineteen patients (37.25%) underwent secondary ureteric reimplantation, with a median of 9.8 months after primary HBPD (95% CI 6.2-9.9). The median follow-up was 29.4 months (IQR: 17.4-71). Independent risk factors for redo-surgery in a multivariate logistic regression model were: progressive ureterohydronephrosis (OR = 7.8; 95% CI 0.77-78.6) and early removal of the double-J stent. A risk reduction of 7% (95% CI 2.2%-11.4%) was observed per extra-day of catheter maintenance. The optimal cut-off point is 55 days, ROC curve area: 0.77 (95% CI 0.62-0.92). Gender, distal ureteral diameter, pelvis diameter, dilatation balloon diameter and preoperative differential renal function did not affect the need for reimplantation., Conclusions: The use of a double-J stent for at least 55 days seems to avoid the need for a secondary procedure. Therefore, we recommend removing the double-J catheter at least 2 months after the HBPD., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Chronic back pain is a frequent and disabling health problem. There is evidence that ignorance and erroneous beliefs about chronic low back pain among health professionals interfere in the treatment of people who suffer from it. The Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) has been one of the most used scale to assess these misbeliefs, but no studies have been reported in Latin America. Method: We studied the factorial structure of the HC-PAIRS in health personnel and health sciences university students in two Latin American countries: Colombia (n = 930) and Chile (n = 190). Spain's data was taken of the original study of the Spanish version of the HC-PAIRS (171 Physiotherapy students). Additionally, the measurement invariance of this scale among Chile, Colombia and Spain was evaluated by calculating three nested models: configural, metric and scalar. We used a Confirmatory Factor Analysis (CFA) in both Latin American samples, with Maximum Likelihood Robust (MLR) estimation to estimate the parameters. For the final model in each sample, reliability was assessed with the Composite Reliability (CR) index, and to obtain the proportion of variance explained by the scale the Average Variance Extracted (AVE) was calculated., Results: The one-factor solution shows an acceptable fit in both countries after deleting items 1, 6, and 14. For the resulting scale, the CR value is adequate, but the AVE is low. There is scalar invariance between Chile and Colombia, but not between these two countries and Spain., Conclusions: HC-PAIRS is useful for detecting misconceptions about the relationship between chronic low back pain that would cause health personnel to give wrong recommendations to patients. However, it has psychometric weaknesses, and it is advisable to obtain other evidence of validity., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Begoña Espejo and Dr. Irene Checa, co-authors of this manuscript, hold an editor position at Heliyon., (© 2024 The Authors.)

Partially ionized plasmas constitute an essential ingredient of the solar atmosphere, and ground- and space-based observations have pointed out the presence of oscillations in partially ionized solar plasmas such as chromosphere, photosphere, prominences or spicules, which have been interpreted in terms of magnetohydrodynamic waves. Our aim is to study the spatial behaviour of propagating weakly and fully nonlinear Alfvén waves, and the subsequent excitation of field-aligned motions and perturbations, when dissipative mechanisms, such as ambipolar diffusion and radiative losses, together with parametrized heating mechanisms, are taken into account. When only ambipolar diffusion is taken into account, first-order Alfvén waves as well as ponderomotive-driven perturbations are spatially damped, while field-aligned motions and perturbations representing propagating slow waves are undamped. These perturbations are damped when thermal effects are also considered and their damping lengths can be longer or shorter than those of ponderomotive-driven perturbations. Therefore, after the initial excitation, Alfvén waves and ponderomotive-driven perturbations could be quickly damped while slow waves still remain in the plasma, and vice versa. This article is part of the theme issue 'Partially ionized plasma of the solar atmosphere: recent advances and future pathways'.

Purpose: Accommodation mainly affects the lens, a structure of the eyeball that degrades with age. The aim of this work was to study the morphological changes of different ocular structures during accommodation, both in the anterior pole and the posterior pole, which may also be involved in the accommodation process., Methods: The study will be carried out by stimulating accommodation through lenses of -1.00, -3.00 and -5.00 D starting from the spherical equivalent (M) of each participant in different age groups, from 18 to 66 years. To obtain the M value, aberrometry was achieved, and retinal optical coherence tomography and anterior pole tomography were performed to evaluate the possible structural modifications (central and peripheral), while accommodation was progressively stimulated., Results: It showed that as the accommodative demand increased, morphological changes were produced in retinal thickness, both in the central and peripheral retina, in all age groups. A thinning of the retina was observed in the central 3 mm, while significant progressive thickening was observed closer to the periphery (up to 6 mm from the fovea) as the required accommodative power increased. A decrease in the anterior chamber depth (ACD) and anterior chamber volume (ACV) was observed with increasing lens power., Conclusion: Structural changes were observed in the central and peripheral retina, as well as in the ACD and ACV, while progressively greater accommodation was stimulated, showing that these structures were modified in the accommodation process even in advanced presbyopes.

Introduction: The increase in the number of patients with hemoglobinopathies in Europe in recent decades highlights the need for more detailed epidemiological information in Spain. To fulfil this need, the Spanish Society of Pediatric Hematology and Oncology (SEHOP) sponsored the creation of a national registry of hemoglobinopathies known as REHem-AR (Spanish Registry of Hemoglobinopathies and Rare Anemias). Data from the transfusion-dependent (TDT) and non-transfusion-dependent (NTDT) β-thalassemia cohorts are described and analyzed., Methods: We performed an observational, multicenter, and ambispective study, which included patients of any age with TDT and NTDT, registered up to December 31, 2021., Results: Among the 1741 patients included, 168 cases of thalassemia were identified (103 TDT and 65 NTDT-patients). Survival at 18 years was 93% for TDT and 100% for NTDT. Regarding management, 80 patients with TDT (77.7%) and 23 patients with NTDT (35.4%) started chelation treatment during follow-up, with deferasirox being the most widely used. A total of 76 patients within the TDT cohort presented at least 1 complication (73.8%), the most frequent being hemosiderosis and osteopenia-osteoporosis. Comparison of both cohorts revealed significant differences in the diagnosis of hepatic hemosiderosis (p = 0.00024), although these were not observed in the case of cardiac iron overload (p = 0.27)., Discussion: Our registry enabled us to describe the management of β thalassemia in Spain and to analyze the morbidity and mortality of the cohorts of patients with TDT and NTDT. Complications related to iron overload in TDT and NTDT account for most of the morbidity and mortality of the disease, which is associated with a considerable social, psychological, and economic impact, although cardiac, osteopathy and endocrinological complications requiring more attention. The convenience and simplicity of online registries make it possible to homogenize variables and periodically update data, thus providing valuable information on these diseases., (© 2024. The Author(s).)

Pathogenesis of P. expansum involved different processes and one of them is the recognition between pathogen-host, which in the case of P. expansum is preferably pome fruit. In this work, the possible mechanisms connected to host recognition are addressed through the generation of a subtractive library carried out during the incompatible P. expansum -orange interaction in the initial stages of infection. The generated library was analyzed by massive sequencing and bioinformatic analysis. Of the identified genes, a total of 24 were selected for subsequent expression analysis by RT-qPCR in two incompatible interaction situations. The characterization of the overexpressed genes revealed the presence of CWDEs, ATPases, aldolases, detoxifying enzymes and virulent determinants that could act as effectors related to fungal virulence independently of the host. However, several identified genes, which could not be associated with the virulence of P. expansum under compatible conditions, were related to enzymes to obtain the nutrients necessary for the growth and development of the pathogen under stress conditions through basal metabolism that contributes to expand the range of adaptation of the pathogen to the environment and different hosts., Competing Interests: 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., (© 2024 Published by Elsevier Ltd.)

Idiopathic urethritis (IU) is difficult to manage and there is no standarized therapy. The technique of local steroid injection (LSI) for the treatment of IU in children and the results of the patients undergoing LSI from 2020 to 2021 in a single center are presented. Seven patients with IU underwent LSI. An internal urethrotomy was also performed in two patients with stricture. Complete resolution of symptoms and signs occurred in six patients. The remaining patient did not achieve total remission but did substantially improve symptoms. LSI seems to be an effective alternative for treatment of IU in children., Competing Interests: Conflict of interest None., (Copyright © 2023 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)

Coronavirus Anxiety Scale (CAS) is a widely used measure that captures somatic symptoms of coronavirus-related anxiety. In a large-scale collaboration spanning 60 countries ( N total = 21,513), we examined the CAS's measurement invariance and assessed the convergent validity of CAS scores in relation to the fear of COVID-19 (FCV-19S) and the satisfaction with life (SWLS-3) scales. We utilized both conventional exact invariance tests and alignment procedures, with results revealing that the single-factor model fit the data well in almost all countries. Partial scalar invariance was supported in a subset of 56 countries. To ensure the robustness of results, given the unbalanced samples, we employed resampling techniques both with and without replacement and found the results were more stable in larger samples. The alignment procedure demonstrated a high degree of measurement invariance with 9% of the parameters exhibiting noninvariance. We also conducted simulations of alignment using the parameters estimated in the current model. Findings demonstrated reliability of the means but indicated challenges in estimating the latent variances. Strong positive correlations between CAS and FCV-19S estimated with all three different approaches were found in most countries. Correlations of CAS and SWLS-3 were weak and negative but significantly differed from zero in several countries. Overall, the study provided support for the measurement invariance of the CAS and offered evidence of its convergent validity while also highlighting issues with variance estimation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: It is recommended that continued education in pain should be supported using information and communication technologies (ICTs), but there are gaps about the previous competencies of health professionals, especially in low- and middle-income countries. This study characterized the competencies of professionals in the Colombian Caribbean, the circumstances that favor and hinder the development of appropriate care, as well as the preferences, expectations and attitudes toward an educational intervention supported by ICTs., Methods: We used a qualitative, phenomenological approach, combining documentary review and data obtained through observation, an online survey and two focus groups involving 55 healthcare professionals (physicians, nurses and psychologists) of varying experience. For the analysis and integration of results, the Capacity, Opportunity, Motivation and Behavior model and the Theoretical Domains Framework were used as references. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist guided the reporting of this study., Results: Competency deficits were found regardless of the profession and experience, which are related to inadequacies in undergraduate and post-graduate training. Structural problems in Colombian society and healthcare service organization were also discovered, which were considered unmodifiable barriers and have been aggravated by the social, economic and health effects of the pandemic. The main modifiable barriers found were as follows: pain underestimation and under-treatment of older adults, as well as stereotypes regarding old age and pain, lack of knowledge of the psychosocial determinants of pain and of techniques for its assessment and treatment, overestimation of pharmacological treatment and failure to update pharmacological and non-pharmacological techniques., Conclusions: Recommendations for the design of the educational intervention were established as follows: favoring non-synchronous resources, facilitating synchronous activities of short duration, facilitating permanent access to information and resources and generating incentives for continuing education, such as certification, institutional recognition and encouraging popular recognition.

Background: Longitudinal cohort data of patients with tuberculosis (TB) and coronavirus disease 2019 (COVID-19) are lacking. In our global study, we describe long-term outcomes of patients affected by TB and COVID-19., Methods: We collected data from 174 centres in 31 countries on all patients affected by COVID-19 and TB between 1 March 2020 and 30 September 2022. Patients were followed-up until cure, death or end of cohort time. All patients had TB and COVID-19; for analysis purposes, deaths were attributed to TB, COVID-19 or both. Survival analysis was performed using Cox proportional risk-regression models, and the log-rank test was used to compare survival and mortality attributed to TB, COVID-19 or both., Results: Overall, 788 patients with COVID-19 and TB (active or sequelae) were recruited from 31 countries, and 10.8% (n=85) died during the observation period. Survival was significantly lower among patients whose death was attributed to TB and COVID-19 versus those dying because of either TB or COVID-19 alone (p<0.001). Significant adjusted risk factors for TB mortality were higher age (hazard ratio (HR) 1.05, 95% CI 1.03-1.07), HIV infection (HR 2.29, 95% CI 1.02-5.16) and invasive ventilation (HR 4.28, 95% CI 2.34-7.83). For COVID-19 mortality, the adjusted risks were higher age (HR 1.03, 95% CI 1.02-1.04), male sex (HR 2.21, 95% CI 1.24-3.91), oxygen requirement (HR 7.93, 95% CI 3.44-18.26) and invasive ventilation (HR 2.19, 95% CI 1.36-3.53)., Conclusions: In our global cohort, death was the outcome in >10% of patients with TB and COVID-19. A range of demographic and clinical predictors are associated with adverse outcomes., Competing Interests: Conflict of interest: The authors have no potential conflicts of interest to disclose., (Copyright ©The authors 2023.)

Single-cell RNA sequencing (scRNA-seq) provides a powerful tool to evaluate the transcriptomic landscape and heterogeneity of thousands of cells in parallel. However, complex study designs or the unavailability of in-house instruments require the temporal disconnection between sample preparation and library construction, raising the need for efficient sample preservation methods which are compatible with scRNA-seq downstream analysis. Several studies evaluated the effect of methanol fixation as preservation method, yet none of them deeply assessed its effect on adult primary dissociated brain tissue. Here, we evaluated its effect on murine dentate gyrus (DG) single cell suspensions and on subsequent scRNA-seq downstream analysis by performing SOrting and Robot-assisted Transcriptome SEQuencing (SORT-seq), a partially robotized version of the CEL-seq2 protocol. Our results show that MeOH fixation preserves RNA integrity and has no apparent effects on cDNA library construction. They also suggest that fixation protects from sorting-induced cell stress and increases the proportion of high-quality cells. Despite evidence of mRNA leakage in fixed cells, their relative gene expression levels correlate well with those of fresh cells and fixation does not significantly affect the variance of the dataset. Moreover, it allows the identification of all major DG cell populations, including neural precursors, granule neurons and different glial cell types, with a tendency to preserve more neurons that are underrepresented in fresh samples. Overall, our data show that MeOH fixation is suitable for preserving primary neural cells for subsequent single-cell RNA profiling, helping to overcome challenges arising from complex workflows, improve experimental flexibility and facilitate scientific collaboration., 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 Sánchez-Carbonell, Jiménez Peinado, Bayer-Kaufmann, Hennings, Hofmann, Schmidt, Witte and Urbach.)

Introduction: Our hypothesis was that delayed cord clamping (DCC) (not earlier than 30 s; at 30-60 s) in premature neonates (born between 26.0 and 32.6 weeks of gestation), as compared with the usual early cord clamping (ECC), significantly reduces the need for blood transfusions and incidence of intraventricular haemorrhage (IVH) without an increased rate of maternal postpartum haemorrhage., Material and Methods: A prospective, open-label, randomized, controlled trial was conducted at Vall d'Hebron Hospital from July 2014 to December 2018. All pregnant women at risk of impending preterm birth (≥26.0-<33.0 weeks of gestation) who were admitted to the obstetrics emergency department were evaluated for eligibility. If they met the eligibility criteria, they were invited to participate in the study and, if they agreed, they signed an informed consent. Patients were randomly assigned to one of two groups: ECC group and DCC group., Results: Our study included a total of 57 patients: 30 in the ECC group and 27 in the DCC group. Due to a lack of funding and low recruitment rates, the study was discontinued in 2018. Maternal characteristics and obstetric outcomes were similar between both groups. The intention-to-treat analysis did not reveal any differences between groups for neonatal red blood cell transfusions, neonatal IVH or maternal postpartum haemorrhage. There were no differences for secondary outcomes. Similarly, no differences were observed in the as-treated analysis., Conclusion: The primary and secondary outcomes of our study were not achieved. Therefore, more meta-analysis and trials are needed to evaluate the appropriate timing of cord clamping in preterm birth., 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 © 2023 Elsevier B.V. All rights reserved.)

Background: Multiple benefits for both, mother and baby have been reported from immediate skin-to-skin care (SSC). The aim of this study was to analyze the influence of SSC on operative time and blood loss in primary cesarean births for breech presentation., Methods: A SSC protocol for cesarean birth was implemented in our institution on February 25, 2019. In this single-center retrospective cohort study, we compared the outcomes of planned primary cesarean births for breech presentation at term before and after its implementation., Results: Data from 110 women who had a cesarean birth for breech presentation at term were analyzed, 55 in each group. Group 1 were women who had immediate SSC and Group 2 were women without immediate SSC. Maternal and surgical characteristics, and neonatal outcomes were similar in both groups. The mean operative time was 3.22 minutes shorter in the immediate SSC group compared with the not immediate SSC group (37.13 ± 12.27 vs 40.35 ± 12.23 minutes; P = 0.171)., Conclusions: In conclusion, immediate SSC following a low-risk cesarean birth for breech presentation neither prolongs the operative time nor increases blood loss during the procedure. Although we were unable to demonstrate a significant reduction in the operative time with the immediate SSC protocol, a decrease of 3 minutes was noted., (© 2022 The Authors. Birth published by Wiley Periodicals LLC.)

Background: the association between ovarian endometriosis (OE) and endometriosis-associated ovarian cancer (EAOC) is extensively documented, and misfunction of the immune system might be involved. The primary objective of this study was to identify and compare the spatial distribution of tumour-infiltrating lymphocytes (TILs) and tumour-associated macrophages (TAMs) in OE and EAOC. Secondary objectives included the analysis of the relationship between immunosuppressive populations and T-cell exhaustion markers in both groups., Methods: TILs (CD3, CD4, and CD8) and macrophages (CD163) were assessed by immunochemistry. Exhaustion markers (PD-1, TIM3, CD39, and FOXP3) and their relationship with tumour-associated macrophages (CD163) were assessed by immunofluorescence on paraffin-embedded samples from n = 43 OE and n = 54 EAOC patients., Results: we observed a predominantly intraepithelial CD3+ distribution in OE but both an intraepithelial and stromal pattern in EAOC ( p < 0.001). TILs were more abundant in OE ( p < 0.001), but higher TILs significantly correlated with a longer overall survival and disease-free survival in EAOC ( p < 0.05). CD39 and FOXP3 significantly correlated with each other and CD163 ( p < 0.05) at the epithelial level in moderate/intense CD4 EAOC, whereas in moderate/intense CD8+, PD-1+ and TIM3+ significantly correlated ( p = 0.009). Finally, T-cell exhaustion markers FOXP3-CD39 were decreased and PD-1-TIM3 were significantly increased in EAOC ( p < 0.05)., Conclusions: the dysregulation of TILs, TAMs, and T-cell exhaustion might play a role in the malignization of OE to EAOC.

Early detection of diabetes is essential to prevent serious complications in patients. The purpose of this work is to detect and classify type 2 diabetes in patients using machine learning (ML) models, and to select the most optimal model to predict the risk of diabetes. In this paper, five ML models, including K-nearest neighbor (K-NN), Bernoulli Naïve Bayes (BNB), decision tree (DT), logistic regression (LR), and support vector machine (SVM), are investigated to predict diabetic patients. A Kaggle-hosted Pima Indian dataset containing 768 patients with and without diabetes was used, including variables such as number of pregnancies the patient has had, blood glucose concentration, diastolic blood pressure, skinfold thickness, body insulin levels, body mass index (BMI), genetic background, diabetes in the family tree, age, and outcome (with/without diabetes). The results show that the K-NN and BNB models outperform the other models. The K-NN model obtained the best accuracy in detecting diabetes, with 79.6% accuracy, while the BNB model obtained 77.2% accuracy in detecting diabetes. Finally, it can be stated that the use of ML models for the early detection of diabetes is very promising.

The mitogen-activated protein kinase organizer 1 (MORG1) is a scaffold molecule for the ERK signaling pathway, but also binds to prolyl-hydroxylase 3 and modulates HIFα expression. To obtain further insight into the role of MORG1, knockout-mice were generated by homologous recombination. While Morg1+/- mice developed normally without any apparent phenotype, there were no live-born Morg1-/- knockout offspring, indicating embryonic lethality. The intrauterine death of Morg1-/- embryos is caused by a severe failure to develop brain and other neuronal structures such as the spinal cord and a failure of chorioallantoic fusion. On E8.5, Morg1-/- embryos showed severe underdevelopment and proliferative arrest as indicated by absence of Ki67 expression, impaired placental vascularization and altered phenotype of trophoblast giant cells. On E9.5, the malformed Morg1-/- embryos showed defective turning into the final fetal position and widespread apoptosis in many structures. In the subsequent days, apoptosis and decomposition of embryonic tissue progressed, accompanied by a massive infiltration of inflammatory cells. Developmental aberrancies were accompanied by altered expression of HIF-1/2α and VEGF-A and caspase-3 activation in embryos and extraembryonic tissues. In conclusion, the results suggest a multifactorial process that causes embryonic death in homozygous Morg1 mutant mice, described here, to the best of our knowledge, for the first time.

Background: In health professionals, negative stereotypes toward older adulthood have been associated with the difficulty in recognizing pathological processes and the refusal to care for older patients because of assuming that communication with them will be uncomfortable and frustrating. For these reasons, research on stereotypes in these groups has acquired growing importance. The usual strategy to identify and evaluate agist stereotypes is to use scales and questionnaires. Although multiple scales are currently used, in Latin America, the Questionnaire for the Evaluation of Negative Stereotypes Toward Older Adulthood (Cuestionario de Estereotipos Negativos sobre la Vejez [CENVE]), developed in Spain, is widely used but without evidence of construct validity in our context. In addition, although in the original version, a factorial structure of 3 factors was found, in later studies, a unifactorial structure was obtained., Objective: The objective is to study the construct validity of the CENVE in a sample of Colombian health personnel to clarify its factorial structure and concurrent validity. Likewise, the measurement invariance according to gender and age was studied., Methods: A nonprobabilistic sample of 877 Colombian health professionals and intern health students was obtained. The data were collected online using the LimeSurvey tool. To study the factor structure of the CENVE, 2 confirmatory factor analysis (CFA) models were carried out, one to test a single factor and the other to test the 3-related-factor structure. The factor measurement reliability was evaluated with the composite reliability index (CRI) and the average variance extracted (AVE). The measurement invariance was studied according to gender (men and women) and age (emerging adults, 18-29 years old, and adults, 30 years old or older). Using a structural equation model, the relationship between age and the latent CENVE total score was studied to obtain evidence of concurrent validity, since studies indicate that the younger the age, the greater the number of stereotypes., Results: The 1-factor structure was confirmed. The reliability results indicated that both indices show adequate values. Likewise, the existence of a strong invariance in measurement by gender and age group was verified. After contrasting the means of the groups, the results showed that men show more negative stereotypes toward old age than women. Likewise, emerging adults also showed more stereotypes than adults. We also verified that age is inversely related to the latent score of the questionnaire, such that the younger the age, the greater the stereotype. These results are in agreement with those obtained by other authors., Conclusions: The CENVE shows good construct and concurrent validity, as well as good reliability, and it can be used to assess stereotypes toward older adulthood in Colombian health professionals and health sciences college students. This will allow us to better understand the effect of stereotypes on agism., (©Marta Martín-Carbonell, Begoña Espejo, Greys Patricia Castro-Melo, Doris Sequeira-Daza, Irene Checa. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 09.03.2023.)

Monkeypox is a rare disease caused by the monkeypox virus. This disease was considered eradicated in 1980 and was believed to affect rodents and not humans. However, recent years have seen a massive outbreak of monkeypox in humans, setting off worldwide alerts from health agencies. As of September 2022, the number of confirmed cases in Peru had reached 1964. Although most monkeypox patients have been discharged, we cannot neglect the monitoring of the population with respect to the monkeypox virus. Lately, the population has started to express their feelings and opinions through social media, specifically Twitter, as it is the most used social medium and is an ideal space to gather what people think about the monkeypox virus. The information imparted through this medium can be in different formats, such as text, videos, images, audio, etc. The objective of this work is to analyze the positive, negative, and neutral feelings of people who publish their opinions on Twitter with the hashtag #Monkeypox. To find out what people think about this disease, a hybrid-based model architecture built on CNN and LSTM was used to determine the prediction accuracy. The prediction result obtained from the total monkeypox data was 83% accurate. Other performance metrics were also used to evaluate the model, such as specificity, recall level, and F1 score, representing 99%, 85%, and 88%, respectively. The results also showed the polarity of feelings through the CNN-LSTM confusion matrix, where 45.42% of people expressed neither positive nor negative opinions, while 19.45% expressed negative and fearful feelings about this infectious disease. The results of this work contribute to raising public awareness about the monkeypox virus.

Our aim was to study the advantages, complications and obstetrical outcomes of laparoscopic myomectomy (LM) compared with abdominal myomectomy (AM). We conducted a retrospective cohort study at La Paz University Hospital that included LMs and AMs performed between 2012 and 2018, analyzing 254 myomectomies (142 AMs [55.7%] and 112 LMs [43.9%]). The mean number of fibroids was 1.8 ± 1.5 and 3 ± 2.9 for the LM and AM groups, respectively ( p  < 0.006). The mean size of the largest myoma was 7.6 cm ± 2.7 cm and 10.2 cm ± 5.4 cm for the LM and AM groups, respectively ( p  < 0.001). LMs were associated with longer surgical times ( p  < 0.001) and shorter hospitalizations ( p  = 0.001). There were no significant differences in the intraoperative and postoperative complication rates ( p  = 0.075 and p  = 0.285 for LM and AM, respectively). The subsequent pregnancy rate was higher for the LM group (30.8% vs. 16.8%, p  = 0.009), with a vaginal delivery rate of 69% and no cases of uterine rupture., 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., (© 2022 Ordás, Spagnolo, Fernández, Diestro Tejeda, Lafuente, Salas, Lopez Carrasco, Carbonell and Hernández.)

The discovery and improvements of antimicrobial peptides (AMPs) have become an alternative to conventional antibiotics. They are usually small and heat-stable peptides, exhibiting inhibitory activity against Gram-negative and Gram-positive bacteria. In this way, studies on broad-spectrum AMPs found in amphibians with the remarkable capability to regenerate a wide array of tissues are of particular interest in the search for new strategies to treat multidrug-resistant bacterial strains. In this work, the use of bioinformatic approaches such as sequence alignment with Fasta36 and prediction of antimicrobial activity allowed the identification of the Ramosin peptide from the de novo assembled transcriptome of the plethodontid salamander Bolitoglossa ramosi obtained from post-amputation of the upper limb tissue, heart, and intestine samples. BLAST analysis revealed that the Ramosin peptide sequence is unique in Bolitoglossa ramosi. The peptide was chemically synthesized, and physicochemical properties were characterized. Furthermore, the in vitro antimicrobial activity against relevant Gram-positive and Gram-negative human pathogenic bacteria was demonstrated. Finally, no effect against eukaryotic cells or human red blood cells was evidenced. This is the first antibacterial peptide identified from a Colombian endemic salamander with interesting antimicrobial properties and no hemolytic activity.

Objective: To assess the value of preoperative 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) scan, combined with clinical variables, in predicting complete cytoreduction in selected patients with advanced ovarian cancer., Methods: We carried out a multicenter, observational, retrospective study evaluating patients who underwent primary cytoreductive surgery for advanced ovarian cancer in two Spanish centers between January 2017 and January 2022. Inclusion criteria were histological confirmation of invasive epithelial ovarian carcinoma; preoperative International Federation of Gynecology and Obstetrics (FIGO) stage III or IV; upfront cytoreductive surgery; and 18 F-FDG PET/CT performed 1 month prior to surgery. A modified 18 F-FDG PET/CT peritoneal cancer index score was calculated for all patients. Clinical variables and preoperative 18 F-FDG PET/CT findings were analyzed and a multivariate model was constructed. A predictive score based on the odds ratio of the variables was calculated to determine patient selection., Results: A total of 45 patients underwent primary cytoreductive surgery. Complete resection was achieved in 36 (80%) patients. On multivariate analysis, two clinical variables (age ≥58 years and American Society of Anesthesiology score ≥3) and two preoperative 18 F-FDG PET/CT scan findings (presence of extra-abdominal lymph node involvement and modified peritoneal cancer index value of 6 or more) were associated with gross residual disease. For this multivariate model predictive of non-complete cytoreduction, the area under the curve was 0.881. A predictive value of ≥5 was the most predictive cut-off for gross residual disease. Complete resection rate was 91.7% in patients with a score of ≤4 and 33.3% in patients with a score of ≥5 points on the predictive score., Conclusions: In selected patients, a predictive score value ≥5 may be consider as a cut-off point for triaging patients to diagnostic laparoscopy before the primary surgery or neoadjuvant chemotherapy., Competing Interests: Competing interests: None declared., (© IGCS and ESGO 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: To study the retinal and choroidal layers in type 1 diabetes mellitus (DM1) without diabetic retinopathy (DR), using speckle contrast of optical coherence tomography (OCT) images as a tissue biomarker in comparison with healthy subjects., Methods: OCT Spectralis images of 148 eyes, 84 from DM1 patients without DR signs, and 64 belonging to the control group, were collected. The speckle contrast and thickness of the inner retinal layer (IRL), the outer retinal layer (ORL), and the choroidal layer in the nasal parafoveal area (N3), were prospectively analyzed., Results: A statistically significant difference ( p = 0.001) in the IRL thickness between groups was observed, being thicker in the DM1 group. There were no differences in the ORL and choroidal thicknesses between groups. A statistically significant difference ( p = 0.02) in the IRL speckle contrast was obtained, being lower in the DM1 group. The maximum speckle contrast was reached in the ORL for both groups, although in the DM1 group, it occurs closer to the choroid, at 64 ± 8 μm ( p = 0.008)., Conclusions: Statistically significant differences were found in speckle contrast and thickness between the control and the DM1 group, suggesting an IRL alteration of DM1 patients, supporting the retinal neurodegeneration before DR signs are observed.

The Scale of Positive and Negative Experience (SPANE) is widely used to measure emotional experiences, but not much is known about its cross-cultural utility. The present study evaluated the measurement invariance of the SPANE across adult samples ( N = 12,635; age range = 18-85 years; 58.2% female) from 13 countries (China, Colombia, Germany, Greece, India, Italy, Japan, Poland, Portugal, Serbia, Spain, Turkey, and the United States). Configural and partial scalar invariance of the SPANE were supported. Three items capturing specific negative emotions (sad, afraid, and angry) were found to be culturally noninvariant. Our findings suggest that the SPANE's positive emotion terms and general negative emotion terms (e.g., negative and unpleasant) might be more suitable for cross-cultural studies on emotions and well-being, whereas caution is needed when comparing countries using the SPANE's specific negative emotion items.

This study aimed to assess whether the advanced characteristics of serum lipoprotein subclasses could better predict the risk of developing diabetic retinopathy (DR) and its severity compared to other established risk factors in subjects with type 1 (T1D) and type 2 (T2D) diabetes. This observational, cross-sectional substudy analyzed DR-related data from 309 T1D and 264 T2D subjects. The advanced lipoprotein and glycoprotein profile was determined by nuclear magnetic resonance (NMR) spectroscopy (Liposcale test). NMR analysis of lipoproteins revealed that T1D subjects with DR showed standard non-HDL particles, despite higher IDL lipid concentrations. Notably, IDL lipids were elevated in T1D subjects with worsened DR. VLDL and LDL were smaller, whereas HDL triglycerides were increased in DR compared with non-DR. On the other hand, the T2D subjects with DR showed altered characteristics in the LDL fraction, mainly revealed by a significant decrease in smaller LDL and a reduction in LDL-C. Moreover, the glycoprotein profile did not reveal significant changes among DR groups, regardless of the type of diabetes. However, lipoprotein characteristics and glycoproteins unveiled by NMR analysis did not improve the predictive value of conventional lipids or other traditional, well-established biomarkers of DR in our cohorts.

In these times of pandemic, the acceptance or rejection of vaccines has become increasingly clear, with a considerable rise in the anti-vaccine movement in Spain. It is important to understand the attitudes that lead a person to refuse vaccination in order to develop more effective public health campaigns. The objective of this study has been to study the psychometric properties and measurement invariance of the Vaccination Attitudes Examination (VAX) scale in a Spanish sample. Confirmatory factor analysis and structural equation modelling have been used to study the psychometric properties of the VAX. Likewise, the measurement invariance by gender and educational level has been studied. The structure of four related factors for VAX is confirmed, as well as its predictive value, since the factor "trust in the benefit of the vaccine" clearly predicts the choice to be vaccinated. The strong measurement invariance by gender and educational level is also confirmed. The comparison of latent means between groups indicates that there are no differences by gender in any factor. However, people with a high educational level present higher scores in factors "concern about unforeseen future effects", "concern about commercial effects and speculation" and "preference for natural immunity". The VAX is presented as a reliable and valid tool to assess four different factors related to attitudes towards vaccines in Spain. Future studies of its cross-cultural invariance may help to determine the main factors that lead people not to be vaccinated in order to develop more effective public health campaigns., (© 2022. The Author(s).)

Introduction and Objectives: The outbreak of COVID-19 has overwhelmed healthcare systems all over the world. The aim of this article is to describe the process of transforming the Vall d'Hebron University Hospital, the second largest hospital in Spain, into a COVID-19 centre coordinating response to the pandemic in its reference area., Materials and Methods: The study draws on the experience of the authors in transforming the hospital into a comprehensive resource in response to the COVID-19 pandemic. The strategy is based on four central strategies: early planning, coordination of all healthcare agents in its reference area, definition of clear leadership roles, and the organisation of care based on multidisciplinary teams with minimal recruitment of new staff., Results: The transformation strategy enabled the hospital to cope with the surge in patients without exceeding its capacity. During the response phases, which amounted to a period of 57 days, 3106 patients consulted the ER and 2054 were admitted, 346 of whom were treated at the ICU. To accommodate the number of adult COVID-19 patients, adult ICU availability was progressive increased by 371%, and ordinary beds increased by 240. A total of 671 staff members went on sick leave after testing positive for COVID-19., Conclusion: The transformation experience of the hospital provides insight into how effectively adapt the structures and functioning of large hospitals. The relevance of territorial coordination during the pandemic is stressed as an effective strategy that contributed coping the pandemic., (Copyright © 2022 FECA. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Reactive oxygen species (ROS) represent molecules of great interest in the field of regenerative biology since several animal models require their production to promote and favor tissue, organ, and appendage regeneration. Recently, it has been shown that the production of ROS such as hydrogen peroxide (H 2 O 2 ) is required for tail regeneration in Ambystoma mexicanum . However, to date, it is unknown whether ROS production is necessary for limb regeneration in this animal model. Methods: forelimbs of juvenile animals were amputated proximally and the dynamics of ROS production was determined using 2'7- dichlorofluorescein diacetate (DCFDA) during the regeneration process. Inhibition of ROS production was performed using the NADPH oxidase inhibitor apocynin. Subsequently, a rescue assay was performed using exogenous hydrogen peroxide (H 2 O 2 ). The effect of these treatments on the size and skeletal structures of the regenerated limb was evaluated by staining with alcian blue and alizarin red, as well as the effect on blastema formation, cell proliferation, immune cell recruitment, and expression of genes related to proximal-distal identity. Results: our results show that inhibition of post-amputation limb ROS production in the A. mexicanum salamander model results in the regeneration of a miniature limb with a significant reduction in the size of skeletal elements such as the ulna, radius, and overall autopod. Additionally, other effects such as decrease in the number of carpals, defective joint morphology, and failure of integrity between the regenerated structure and the remaining tissue were identified. In addition, this treatment affected blastema formation and induced a reduction in the levels of cell proliferation in this structure, as well as a reduction in the number of CD45 + and CD11b + immune system cells. On the other hand, blocking ROS production affected the expression of proximo-distal identity genes such as Aldha1a1 , Rarβ , Prod1 , Meis1 , Hoxa13, and other genes such as Agr2 and Yap1 in early/mid blastema. Of great interest, the failure in blastema formation, skeletal alterations, as well as the expression of the genes evaluated were rescued by the application of exogenous H 2 O 2 , suggesting that ROS/H 2 O 2 production is necessary from the early stages for proper regeneration and patterning of the limb., 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 © 2022 Carbonell-M, Zapata Cardona and Delgado.)

Background: Having a valid tool to assess attitudes toward vaccination and identify the concerns that drive vaccine refusal can facilitate population studies and help guide public health interventions. The objective of this study has been to adapt the Vaccination Attitudes Examination (VAX) scale in Colombian university students and to study its psychometric properties in a non-probabilistic sample of 1074 Colombian university students., Methods: A confirmatory factor analysis was used to study the factorial structure. A structural equation model was tested to study concurrent validity and to check whether the factors predicted having received the coronavirus vaccine. Gender-based measurement invariance was also studied for the best model., Results: The results support the structure of four related factors. The composite reliability index was good for all the factors, but the average variance extracted was not as good for the second factor. There was strong measurement invariance by gender, and two factors are good predictors of being vaccinated or not., Conclusions: The VAX has shown construct and concurrent validity and is a reliable tool for evaluating attitudes towards vaccines in university students in Colombia. It may help guide the implementation of actions for the National Vaccination Plan and institutional policies.

Introduction: The covid-19 pandemic has meant a change in working protocols, as well as in Personal Protective Equipment (PPE). Obstetricians have had to adapt quickly to these changes without knowing how they affected their clinical practice. The aim of the present study was to evaluate how COVID-19 pandemic and PPE can affect operative time, operating room time, transfer into the operating room to delivery time and skin incision to delivery time in cesarean section., Methods: This is a single-center retrospective cohort study. Women with confirmed or suspected SARS-CoV-2 infection having a cesarean section after March 7th, 2020 during the COVID-19 pandemic were included in the study. For each woman with confirmed or suspected SARS-CoV-2 infection, a woman who had a cesarean section for the same indication during the COVID-19 pandemic and with similar clinical history but not affected by SARS-CoV-2 was included., Results: 42 cesarean sections were studied. The operating room time was longer in the COVID-19 confirmed or suspected women: 90 (73.0 to 110.0) versus 61 (48.0 to 70.5) minutes; p  < .001. The transfer into the operating room to delivery time was longer, but not statistically significant, in urgent cesarean sections in COVID-19 confirmed or suspected women: 25.5 (17.5 to 31.75) versus 18.0 (10.0 to 26.25) minutes; p  = .113., Conclusions: There were no significant differences in the operative time, transfer into the operating room to delivery time and skin incision to delivery time when wearing PPE in cesarean section. The COVID-19 pandemic and the use of PPE resulted in a significant increase in operating room time.

Bluetongue (BT) is an emerging and re-emerging communicable vector-borne disease of animal health concern. A serosurvey was performed to assess exposure to BT virus (BTV) in zoo animals in Spain and to determine the dynamics of seropositivity in longitudinally sampled individuals during the study period. Serum samples were collected from 241 zoo animals belonging to 71 different species in five urban zoos (A-E) in Spain between 2007 and 2019. Twenty-four of these animals were longitudinally surveyed at three of the sampled zoos (zoos B, C and E) during the study period. Anti-BTV antibodies were found in 46 (19.1%; 95% CI: 14.1-24.1) of the 241 captive animals analysed by commercial ELISA. A virus neutralization test confirmed specific antibodies against BTV-1 and BTV-4 in 25 (10.7%; 95% CI: 6.7-14.6) and five (3.0%; 95% CI: 0.3-4.0) animals, respectively. Two of the 24 longitudinally sampled individuals (one African elephant (Loxodanta africana) and one aoudad (Ammotragus lervia)) showed anti-BTV antibodies at all samplings, whereas seroconversions were detected in one mouflon (Ovis aries musimon) in 2016, and one Asian elephant (Elephas maximus) in 2019. To the best of the authors' knowledge, this is the first large-scale survey on BTV conducted in both artiodactyl and non-artiodactyl zoo species worldwide. The results confirm BTV exposure in urban zoo parks in Spain, which could be of animal health and conservation concern. Circulation of BTV was detected in yearling animals in years when there were no reports of BTV outbreaks in livestock. Surveillance in artiodactyl and non-artiodactyl zoo species could be a valuable tool for epidemiological monitoring of BTV., (© 2021 Wiley-VCH GmbH.)

This study examined the background before admission to a nursing home and the conditions for the continuity of care, of the relatives of older adults of Colombia and Spain. The study sample comprised 546 participants: 278 and 268 from Colombia and Spain, respectively. Structured interviews were conducted with the older adults' relatives. Sociodemographic similarities predominated, although in the Colombian sample there were significantly more unrelated people. Similarities in previous and current care conditions also predominated too. Cluster 1 included all the cases of Colombian low-resource nursing homes, and Cluster 2 included all the relatives of Colombian high-resource nursing homes and all the Spanish centers. The type of nursing home was the variable more important to identify the abovementioned clusters. Conclusions: Family members from Colombia and Spain continue to care for the elderly admitted to geriatric homes. The type of geriatric center is what establishes the differences in the users., Competing Interests: The authors declare no conflict of interest., (© 2022 Published by Elsevier Ltd.)

Background: Hydrogen peroxide (H 2 O 2 ) is a key reactive oxygen species (ROS) generated during appendage regeneration among vertebrates. However, its role during tail regeneration in axolotl as redox signaling molecule is unclear., Results: Treatment with exogenous H 2 O 2 rescues inhibitory effects of apocynin-induced growth suppression in tail blastema cells leading to cell proliferation. H 2 O 2 also promotes recruitment of immune cells, regulate the activation of AKT kinase and Agr2 expression during blastema formation. Additionally, ROS/H 2 O 2 regulates the expression and transcriptional activity of Yap1 and its target genes Ctgf and Areg., Conclusions: These results show that H 2 O 2 is necessary and sufficient to promote tail regeneration in axolotls. Additionally, Akt signaling and Agr2 were identified as ROS targets, suggesting that ROS/H 2 O 2 is likely to regulate epimorphic regeneration through these signaling pathways. In addition, ROS/H 2 O 2 -dependent-Yap1 activity is required during tail regeneration., (© 2021 American Association for Anatomy.)

Adequate surgical management of malignant endometriosis remains a clinical challenge in gynecology. Age, sonography variables, and tumor biomarkers have been reported as candidates in the clinical decision. This study aims were to analyze the factors of women’s age, body mass index, ultrasound features, and tumor biomarkers to predict endometriosis-associated ovarian cancer in a large series of endometriomas and to study the surgical treatment performed in this cohort. In this retrospective study, we reviewed the medical records of patients with ultrasound diagnosis of ovarian cyst classified as endometrioma (benign as well as with risk of malignancy), surgically treated in the endometriosis unit of Hospital Universitario La Paz (Madrid, Spain) between January 2019 and July 2021. According to the final histology examination, the women were clustered as non-endometriosis-associated ovarian cancer (OE, benign endometriomas, n = 59) and endometriosis-associated ovarian cancer (EAOC) (n = 17). Demographic, clinical, and surgical data were collected from these women. International Ovarian Tumor Analysis (IOTA) criteria were assessed for the ultrasound examination. The age of the women in the EAOC group was 50.0 [43.0; 63.0] years, which was significantly higher than OE (39.0 [34.0; 46.0] years; p-value < 0.001). In addition, the body mass index for the OE group (24.9 ± 5.3 kg/m2) was significantly higher than for the EAOC group (23.3 ± 4.6 kg/m2; p-value < 0.001). However, the tumor biomarker levels (CA 125, CA 19.9 and He4) were not significantly different among the groups. We performed 51.4% cystectomies and 48.6% adnexectomies, with an association between the adnexectomy and EAOC group (p-value < 0.001). In addition, a significant association was found between ultrasound features suspicious for malignancy and the EAOC group. Conclusively, women’s age and ultrasound features, such as papillary projections, septa, and positive echo-Doppler, were the main factors to consider when evaluating the malignancy risk associated with endometriosis.

(1) Background: The need to offer brief scales with items that can be answered with few response options is increasingly important in order to be able to access a broad range of the population. The three-item version of Diener's Satisfaction with Life Scale has recently been proposed. The objective of this study is to study the psychometric properties of the three-item version of this Scale with five response options, as well as the measurement invariance by gender, in a Colombian sample; (2) Methods: A confirmatory factor model of the three items of the scale together with the Flourishing Scale has been tested, and the measurement invariance by gender of the model has been studied. The results offer a very satisfactory fit of the model, showing good evidence of construct and criterion validity, good indicators of reliability and measurement invariance by gender; (4) Conclusions: The three-item version of the Life Satisfaction Scale, previously adapted to the Colombian population with five response options, is presented as a valid and reliable measurement tool. In future studies, it would be convenient to study the test-retest reliability, as well as its psychometric properties in different samples and at a cross-cultural level.

Introduction: The Satisfaction with Life Scale (SWLS), developed by Diener, Emmons, Larsen, and Griffin in 1985, comprises five items with seven response options in terms of agreement-disagreement. Recently, there has been a suggestion to reduce the response options of the SWLS to optimize its applicability in different cultural contexts. Objective: The study aims to assess the psychometric properties of the SWLS with five response options in the Colombian population. Specifically, we studied the dimensionality, invariance by gender and age (among a group of adolescents and emerging adults under 25 years and a group of adults of intermediate age and established adulthood under 59 years), convergent validity (with optimism), and divergent (with pessimism) and concurrent validity with other measures of well-being (flourishing, positive, and negative affects). Methodology: This project was a cross-sectional study using a non-probabilistic sample of the general population. Participants were included if they identified themselves as Colombian and were at least 18 years of age. The final sample comprised 1,255 participants. The average age was 25.62 years (SD = 8.60) ranging from 18 to 67 years of age, and 35.8% of the participants were men. In addition to SWLS, we used the Flourishing Scale (FS), Life Orientation Test-Revised (LOT-R), and Scale of Positive and Negative Experience (SPANE). Results: Cronbach's alpha coefficient (0.842), composite reliability (0.851), and average variance extracted (0.537) showed very good values. CFA was conducted to test the one-dimensional structure of FS, showing excellent goodness of fit [ χ ( 5 ) 2 = 15.774, p < 0.001, CFI = 0.992, TLI = 0.985, RMSEA = 0.042, 90% RMSEA CI (0.020, 0.066), and SRMR = 0.016]. The correlations calculated among life satisfaction (SWLS) with flourishing (FS), positive and negative affects (SPANE), optimism, and pessimism (LOT-R) were statistically significant and as expected. Configural, metric, and scalar invariance across gender and age were confirmed. Percentiles were provided for the total score and for age. Conclusions: The SWLS with five response options has adequate psychometric properties in the Colombian population, and the use of this version (with 5 response options) is recommended due to its greater applicability., 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 © 2022 Espejo, Martín-Carbonell, Checa, Paternina, Fernández-Daza, Higuita, Albarracín and Cerquera.)

We investigated emotion classification from brief video recordings from the GEMEP database wherein actors portrayed 18 emotions. Vocal features consisted of acoustic parameters related to frequency, intensity, spectral distribution, and durations. Facial features consisted of facial action units. We first performed a series of person-independent supervised classification experiments. Best performance (AUC = 0.88) was obtained by merging the output from the best unimodal vocal (Elastic Net, AUC = 0.82) and facial (Random Forest, AUC = 0.80) classifiers using a late fusion approach and the product rule method. All 18 emotions were recognized with above-chance recall, although recognition rates varied widely across emotions ( e.g ., high for amusement, anger, and disgust; and low for shame). Multimodal feature patterns for each emotion are described in terms of the vocal and facial features that contributed most to classifier performance. Next, a series of exploratory unsupervised classification experiments were performed to gain more insight into how emotion expressions are organized. Solutions from traditional clustering techniques were interpreted using decision trees in order to explore which features underlie clustering. Another approach utilized various dimensionality reduction techniques paired with inspection of data visualizations. Unsupervised methods did not cluster stimuli in terms of emotion categories, but several explanatory patterns were observed. Some could be interpreted in terms of valence and arousal, but actor and gender specific aspects also contributed to clustering. Identifying explanatory patterns holds great potential as a meta-heuristic when unsupervised methods are used in complex classification tasks., Competing Interests: The authors declare that they have no competing interests., (© 2021 Fernández Carbonell et al.)

Institutionalization to a nursing home can be one of the most significant and traumatic events in a senior's life, and for their family. For this reason, it is especially important to have validated instruments that evaluate the family member's adaptation to admitting the senior to a nursing home. The study included 139 family members recruited equally in two types of institutions (low-income nursing home (LINH) vs. high-income nursing home (HINH)). A sociodemographic questionnaire with questions to study antecedents and conditions for care and the Questionnaire for Admitting an Older Adult to a Nursing Home (CAFIAR-15) were used. Examining the communalities indicated that four of the five items in factor 3 presented communalities lower than 0.30 and differences in the factorial structure of the CAFIAR-15 were found. There were differences in the antecedents and conditions for care between the relatives of the older adults at LINH and HINH. Cultural differences and differences between LINH and HINH may be the basis for flaws in the conceptual validity of the CAFIAR-15 in the Colombian sample.

Zn 2 Cys 6 transcription factors are unique to fungi and are involved in different regulatory functions. In this study, we have identified the Penicillium digitatum PdMut3 gene, which encodes a putative Zn (II) 2Cys6 DNA-binding protein. Elimination of PdMut3 in Pd1 strain caused increased virulence during citrus infection. The transcription of the PdMut3 gene showed a higher expression rate during fungal growth and less transcription during fruit infection. Furthermore, the deletion of the gene in the wild-type isolate of P. digitatum did not produce any modification of the sensitivity to different fungicides, indicating that the gene is not associated with resistance to fungicides. In contrast, PdMut3 null mutants showed a reduction in growth in minimal media, which was associated with severe alterations in conidiophore development and morphological alterations of the hyphae. Mutants showed greater sensitivity to compounds that interfere with the cell wall and an invasive growth block. Thus, PdMut3 might have an indirect role in fungi virulence through metabolism and peroxisomes development.