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Antecedentes: La violencia de pareja (VP) es un fenómeno social complejo ampliamente estudiado. Sin embargo, pocos de estos estudios consideran el capital social y la interseccionalidad. Nuestro objetivo fue describir el efecto del capital social en la victimización por VP entre estudiantes de secundaria, considerando tres factores de interseccionalidad (sexo asignado al nacer, orientación sexual y origen migratorio) en dos ciudades de España en 2019-2020. Métodos: Se analizó una muestra transversal de 640 adolescentes con pareja, de 13 a 16 años, de un programa de promoción de relaciones equitativas en Alicante y Terrassa. La variable resultado fue haber sufrido violencia en la pareja (control, miedo, física o sexual) en algún momento de la vida. Se utilizaron variables individuales y relacionales para calcular la razón de prevalencia ajustada (RPa) a partir de modelos multivariable construidos mediante regresión robusta de Poisson, y estratificados por sexo, orientación sexual y origen migratorio. Resultados: La mayor prevalencia de VP (56,25%) se encontró en adolescentes lesbianas, gays o bisexuales (LGB) sin actividad social. La orientación LGB se asoció significativamente con la victimización por VP en los adolescentes con origen en países de bajos ingresos (PBI) (aPR: 1,93) y en las chicas (aPR: 1,53). Por último, la procedencia de un PBI fue un determinante significativo de la VP en los chicos (aPR: 1,76) y en los estudiantes, independientemente de la orientación sexual. Una mayor actividad social mostró un efecto protector para los estudiantes de origen en países de altos ingresos (PAI) y de orientación sexual LGB, independientemente del sexo y la orientación sexual. Conclusiones: La actividad social se asocia de forma desigual con una menor victimización por violencia de la pareja en algún momento de la vida adolescente. La fuerte asociación del origen migratorio y la orientación sexual con la VPI refuerza el enfoque de su prevención en los adolescentes desde una perspectiva de interseccionalidad. Background: Intimate partner violence (IPV) is a complex social phenomenon widely studied. However, few of these studies consider social capital and intersectionality. Our aim was to describe the effect of social capital in IPV victimisation among secondary students, considering three factors of intersectionality (sex assigned at birth, sexual orientation and migration background) in two cities of Spain in 2019-2020. Methods: We analysed a cross-sectional sample of 640 ever-partnered adolescents aged 13–16 years who had taken part in a programme for positive relationship. The main outcome was lifetime IPV (control, fear, physical or sexual violence). Individual and relational variables (bonding social capital) were used to calculate adjusted prevalence ratios (aPR) from multivariate Robust Poisson regression models stratified by sex assigned at birth, sexual orientation and migration background (factors of intersectionality). Results: The highest IPV prevalence (56.25%) was found in lesbian, gay or bisexual (LGB) adolescents without social activity. LGB orientation was significantly associated with IPV victimisation in adolescents with low-income country (LIC) backgrounds (aPR: 1.93) and in girls (1.53). Finally, a LIC background was a significant determinant of IPV in boys (aPR: 1.76) and in students independently of sexual orientation. Higher social activity showed a protective effect for students with HIC backgrounds and LGB-sexual orientations. A possible protective effect of social support in HIC backgrounds and regardless of sex and sexual orientation must be considered. Conclusions: Social activity is unequally associated with less lifetime IPV. The strong association of migration background and sexual orientation with IPV reinforces the approach to its prevention in adolescents from an intersectionality perspective. This study was funded by the multi-centre project "Promotion of protective assets against gender violence in adolescence and preadolescence" (Grant reference PI18/00590 and PI18/00544) of the Carlos III Institute of Health, as an intermediary body of the European Regional Development Fund (ERDF) and the European Social Fund (ESF). The project was also supported by the Centro de Investigación Biomédica en Red de Epidemiología Salud Pública (CIBERESP) through the subprogramme on Prevention of Gender Violence of the Programme on Social Determinants of Health (no grant award number specified).

Despite the increase in sexual violence (SV) amongst young people, the use of formal services is poor. Effective coverage of health services is related to a satisfactory and quality care for the people who need a specific intervention. The aim of this study is to identify the factors that influence effective coverage of SV services from the perspective of young people and professionals in Spain. A qualitative study was conducted using an inductive thematic analysis approach based on 38 semistructured interviews with young people and professionals working in SV resource services and/or youth services in Spain, from September 2020 to October 2021. A content analysis was carried out. Both the professionals and young people referred to the fact that effective coverage is limited by the factors related to SV normalization and stigma, the lack of training of professionals, and the lack of human and economic resources. Furthermore, the young interviewees perceive sexual education as more biological and not focused on SV, as well as excessive bureaucracy, medicalization of processes, and the lack of trust in resources. However, the professionals mentioned the excessive specialization of psychological recovery accompaniment programmes and the lack of specialization of judicial institutions. To conclude, both the young people and professionals identified factors that reduce effective coverage of the services related to the social construction of the problem, training, and availability of resources. The young people also perceive other factors related to care and services, while the professionals place more emphasis on factors related to the user population. The CIBER of Epidemiology and Public Health (CIBERESP) with the project “Sexual Violence Associated Factors and Perceptions among Youth: A Mixed Method Approach” (Ref. ESP20PI02).

Objective The purpose of the study is to translate the Aberdeen Varicose Vein Questionnaire (AVVQ) into Spanish and evaluate the feasibility and reliability of the Spanish-translated AVVQ in patients with chronic venous disease. Methods Reliability was assessed by test and retest of the Spanish translated AVVQ in a sample of 77 patients. The questionnaires were answered within a 2-week interval. Results There was a 100% test and retest response. The AVVQ showed 6.5% of missing responses. Cronbach’s alpha was 0.71 indicating an adequate level of internal consistency. Spearman’s rho showed a significant strong association between test and retest scores (rho = 0.84, p < 0.0001). Conclusions The Spanish-translated AVVQ is a reliable tool in our daily clinical practice in order to measure the impact of venous disease in the quality of life.

Nos proponemos investigar cómo se entrelazan el medio visual y el textual tanto en el espacio del libro como en su materialidad a través del análisis de La vuelta al día en ochenta mundos (1967) y Último round (1969), que el escritor Julio Cortázar realizó en colaboración con el artista plástico Julio Silva. Partiremos, en primer lugar, de la noción de dispositivo, acuñada por Foucault y ampliada por Agamben; seguidamente, de las relaciones que estos almanaques, así denominados por el autor, tienen con el campo intelectual latinoamericano de esos años; por último, de las operaciones de lectura no secuenciales que se proponen en estos volúmenes. Con ello, concluiremos que estas obras intentan fusionar vanguardia estética y política y que la producción de significado que pretenden se puede tomar como ejemplo para comprender el resto de la producción cortazariana.

Los territorios de La Florida española constituyeron la frontera norte de las posesiones hispanas en el Nuevo Mundo desde 1513 hasta 1821. Situados al margen de las principales estructuras administrativas del Imperio, el Cuerpo de Ingenieros del Ejército se estableció como el único cuerpo especializado capacitado para el diseño y construcción, no solo de las estructuras defensivas y fortalezas, sino que bajo su responsabilidad recayeron también el control de la forma urbana y de la estructura territorial en su conjunto. El presente artículo analiza el papel del ingeniero militar en la ciudad de San Agustín, capital española de La Florida, a partir de las fuentes documentales conservadas en archivos españoles, británicos y franceses, analizando las características de las defensas erigidas entre los siglos XVI y XVIII, así como su relación con la tratadística impresa y con las bases conceptuales que constituían la base de su formación teórica.

The aim of this study is to analyze the formal and graphic elements around the hegemonic masculinities and femininities of the packaging of industrial bakery and biscuit products aimed at children and young people. A content analysis was conducted on 10 of the most widely consumed brands of industrial bakery and biscuit products in Spain and widely present on the international market. In addition, a scale of dominant masculinity was developed as a tool to analyze the most egalitarian narratives on the packaging. The results suggest that there are unequal narratives linked to hegemonic masculinity and femininity. The use of blue and yellow, the latter not having a traditional link to masculinity, is related to men in terms of aggressiveness and bravery stereotypes. The women represented on packaging with these same colours are presented in terms of sympathy or kindness, as well as stereotypes connected to beauty. The products contain homogeneous stereotypes and are associated more with men than with women. However, 2 out of 10 brands do not insert characters linked to sexual attributes or gender stereotypes. Therefore, our findings suggest that hegemonic gender scripts are inscribed on packaging less obviously than in other traditional media. The work was supported by the University of Alicante (Vice Rectorate for Research) [Aii20-07]; Valencian Regional Ministry of Innovation, Universities, Science and Digital Society [ACIF/2021/119]; AICO, Generalitat Valenciana (2022- 2024) [CIAICO/2021/019].

To determine the degree and factors related to non-insulin antidiabetic drug (NIAD) adherence in people with type 2 diabetes mellitus (DM2) treated in primary carecentres in Spain.We did a cross-sectional study. During the study visit, variables related todifferent clinical characteristics, Adherence to Refills and Medications Scale Spanishversion (ARMS-e) and usage of NIAD were collected. We estimated the adherence toNIADs using the proportion of days covered (PDC) equation.In total, 515 participants were included in the study. The mean PDC ratio was70.6 ( ± 28.9), and 50.5% (260) were classified as good adherent (PDC ≥80). Good adherence was highest among users of metformin (67.3%) and lowest among the participants using thiazolidinedione (0.8%). The score for ARMS-e was higher in the poor adherence group. In the multivariable analysis, HbA1c and the use of GLP1-RA or SGLT-2i were negatively associated with good adherence (odds ratio [OR]: 0.67, 95% confidence interval [CI]: 0.54, 0.82, OR: 0.20, 95%CI: 0.08, 0.46; OR: 0.56, 95%CI: 0.35, 0.89, respectively).Adherence to NIADs observed in our study is far from optimal. HbA1c and ARMS-e items could be used as adherence indicators to encourage treatment changes to improve T2DM control.

Desde que Chomsky publicara la Teoría de Principios y Parámetros (1981), donde propone varios parámetros lingüísticos, uno de los más estudiados es el denominado Parámetro pro-drop o Parámetro del sujeto nulo, que describe los idiomas que admiten la presencia o elisión del pronombre personal o sujeto en las oraciones versus el Parámetro no pro-drop, que obliga a la inclusión del sujeto expreso. Sin embargo, la no obligatoriedad del sujeto léxico solo se dará en caso de que la información que debe facilitar se dé por otro elemento oracional, que suele ser la flexión verbal (Chomsky, 1981; Rizzi, 1982). La causa de que un idioma sea o no pro-drop se sustenta, según el Principio de Uniformidad Morfológica (PUM) (Jaeggli y Safir, 1989), en que la lengua se muestre uniforme en su flexión verbal. Entre los lenguajes pro-drop se incluyen la mayoría de las lenguas romances, siendo el francés una excepción (Dryer, 2013). El género de estos sujetos elípticos (él-ella, nosotros-nosotras, etc.), sin embargo, queda en suspense y se deduce únicamente por el contexto, no por la oración en sí. Esto conforma un obstáculo para la traducción automática neuronal (TAN) que, con frecuencia, analiza la oración como unidad. En el presente trabajo vamos a analizar el tratamiento que DeepL, programa gratuito para la TAN, da a los sujetos nulos del español hacia dos idiomas romances: francés e italiano, el primero no pro-drop y el segundo pro-drop. Para ello, hemos usado como corpus el primer capítulo del libro «La ciudad y los perros» del premio Nobel de Literatura Mario Vargas Llosa. Este análisis, dividido en casos de sujetos/pronombres nulos en sintagma nominal (SN) y en sintagma verbal (SV), permitirá a los usuarios de este programa ser conscientes de los errores que comete en los casos de ambigüedad por sujeto nulo y, por ende, comprender mejor el funcionamiento de este.

Encapsulation of biomolecules using metal–organic frameworks (MOFs) to form stable biocomposites has been demonstrated to be a valuable strategy for their preservation and controlled release, which has been however restricted to specific electrostatic surface conditions. We present a Lewis-acid-mediated general in situ strategy that promotes the spontaneous MOF growth on a broad variety of proteins, for the first time, regardless of their surface nature. We demonstrate that MOFs based on cations exhibiting considerable inherent acidity such as MIL-100(Fe) enable efficient biomolecule encapsulation, including elusive alkaline proteins previously inaccessible by the well-developed in situ azolate-based MOF encapsulation. Specifically, we prove the MIL-100(Fe) scaffold for the encapsulation of a group of proteins exhibiting very different isoelectric points (5 < pI < 11), allowing triggered release under biocompatible conditions and retaining their activity after exposure to denaturing environments. Finally, we demonstrate the potential of the myoglobin-carrying biocomposite to facilitate the delivery of O2 into hypoxic human lung carcinoma A549 cells, overcoming hypoxia-associated chemoresistance.

Airway obstruction; Cryobiopsy; Paediatric bronchoscopy Obstrucción de las vías respiratorias; Criobiopsia; Broncoscopia pediátrica Obstrucció de les vies respiratòries; Criobiòpsia; Broncoscòpia pediàtrica Background and objective Cryotherapy in interventional bronchoscopy is a new treatment modality, which has recently been made available for the paediatric airway. Lack of experience and safety concerns have led to hesitant adaptation. The aim of this study was to assess indications, success rates and complications of airway cryotherapy in children. Methods Bronchoscopists from medical centre performing cryotherapy in patients between 0 and 18 years were invited to participate in a prospective study based on an online questionnaire. Patient and participant data were collected between June 2020 and June 2021. Results A total of 69 cryotherapy procedures were performed in 57 patients a for three main indications: Biopsy (30), restoration of airway patency (23) and foreign body aspiration (16). The overall success rate was 93%, the remaining 7% were performed for foreign body removal and required a switch of technique. Restoration of airway patency was successfully applied in various pathologies, including mucus plugs, bronchial casts and post traumatic stenosis. The diagnostic yield of transbronchial biopsies was 96%. No severe complications were encountered; one pneumothorax following a cryobiopsy required a chest drain for 48 h. No child was admitted to intensive care or died from a procedural complication. Conclusion In this largest paediatric case collection to date, cryotherapy was safe and carried a high success rate. Cryobiopsy compares favourably to the widely used forceps biopsy and could replace it in the future. Paediatric bronchoscopists are encouraged to add cryotherapy to their armamentarium of airway interventions. Open Access funding enabled and organized by Projekt DEAL.

The paper explores the content of 61 video capsules, presenting stories about unhealthy relationships invented, performed and filmed by 534 adolescents, from Spain, Portugal, Romania and Italy. The purpose is to analyse, through a thematic analysis of the video capsules, youth perspectives on what factors, myths and beliefs turn healthy relationships into unhealthy relationships, and what positive assets are managed to solve them. The results show common youth's perspectives on the idealization of romantic love, based on gender stereotypes, identified as a common characteristic of unhealthy relationships. Individuality is misinterpreted as a threat to the stability of dating relationships. Positive assets used by victims to face dating violence (DV) are assertiveness, communication abilities and management of emotions, whereas offenders used assertiveness, empathy and critical thinking. The paper debates the efficacy of intervention programs combining youth positive development and DV prevention approaches based on filmmaking. The materials used (video capsules and short films) for this paper come from the project ‘Camera and Action Against Dating Violence (Lights4Violence)’. The project was funded by the European Union's Rights, Equality and Citizenship Programme (2014–2020), under grant agreement No. 776905.

Volume-regulated anion channels (VRACs) are heterohexamers of LRRC8A with LRRC8B, -C, -D, or -E in various combinations. Depending on the subunit composition, these swelling-activated channels conduct chloride, amino acids, organic osmolytes, and drugs. Despite VRACs' role in cell volume regulation, and large osmolarity changes in the kidney, neither the localization nor the function of VRACs in the kidney is known.Mice expressing epitope-tagged LRRC8 subunits were used to determine the renal localization of all VRAC subunits. Mice carrying constitutive deletions ofThe kidney expresses all five VRAC subunits with strikingly distinct localization. Whereas LRRC8C is exclusively found in vascular endothelium, all other subunits are found in the nephron. LRRC8E is specific for intercalated cells, whereas LRRC8A, LRRC8B, and LRRC8D are prominent in basolateral membranes of proximal tubules. Conditional deletion of LRRC8A in proximal but not distal tubules and constitutive deletion of LRRC8D cause proximal tubular injury, increased diuresis, and mild Fanconi-like symptoms.VRAC/LRRC8 channels are crucial for the function and integrity of proximal tubules, but not for more distal nephron segments in spite of their larger need for volume regulation. LRRC8A/D channels may be required for the basolateral exit of many organic compounds, including cellular metabolites, in proximal tubules. Proximal tubular injury likely results from combined accumulation of several transported molecules in the absence of VRAC channels.

Background: Acute interstitial nephritis (AIN) is one of the chief causes of acute kidney injury (AKI). AIN might be produced by drugs, infections, autoimmune diseases, or can be idiopathic. Among these etiologies, drug-induced AIN (DI-AIN) is the dominant one in many countries. Even when DI-AIN is suspected, identification of the putative drug is challenging. Summary: DI-AIN is an increasingly common cause of AKI. Diagnosis continues to pose a challenge for physicians due to nonspecific clinical symptoms, and the fact that it can be triggered by a wide variety of medications. Furthermore, the gold standard for the diagnosis is kidney biopsy. All these aspects render the diagnosis more difficult. The withdrawal of the causative drug of DI-AIN is the centerpiece of the treatment, and if early restoration of original kidney function is not obtained, several studies support the treatment with steroids especially when they are started quickly. Key Messages: Almost all drugs have the potential to produce drug-induced acute interstitial nephritis (DI-AIN); however, antibiotics, nonsteroidal anti-inflammatory agents, and proton pump inhibitors account for the majority of the reported cases. DI-AIN is produced by an idiosyncratic delayed type IV hypersensitivity reaction, but the precise pathophysiological mechanism remains to be elucidated. DI-AIN symptoms are nonspecific, and most of the patients will present mild symptoms including malaise, nausea, and vomiting. The classical triad, associating fever, rash, and eosinophilia, is seldom present. Nonoliguric acute kidney injury is the main renal manifestation of DI-AIN. Tubular nonnephrotic range proteinuria is usually present. Diagnosis of DI-AIN relies on maintaining a high index of suspicion in those patients at greater risk, but kidney biopsy is required to confirm diagnosis. Histologically, AIN is characterized by the presence of an extensive interstitial infiltrate, mainly composed of lymphocytes and monocytes, but eosinophils, plasma cells, histiocytes, and polymorphonuclear cells can also be found. The withdrawal of the presumed causative drug of DI-AIN is the mainstay of the treatment. When there is no evidence of kidney function recovery after an interval of 5–7 days since interrupting the treatment with the suspected drug, several studies support the treatment with steroids, especially when they are promptly started. Early corticosteroids would decrease the inflammatory infiltrates of the kidney interstitium, thus preventing the risk of subsequent fibrosis.

This work presents the evaluation of a new dual-core lockstep hybrid approach aimed to improve the fault tolerance in microprocessors. Our approach takes advantage of modern multicore processor resources to combine software-based lockstep with a custom hardware observer. The first is used to duplicate data and instruction flows; meanwhile, the second is in charge of the control-flow monitoring. The proposal has been implemented in a dual-core ARM microprocessor and validated with low-energy proton irradiation and emulated fault injection campaigns. The results show an improvement of one order of magnitude in the cross section of the benchmarks tested, even considering the worst case scenario., 10.13039/501100004837-Ministerio de Ciencia e Innovación (Grant Number: PID2019-106455GB-C22 and PID2019-106455GB-C21). 10.13039/100012818-Comunidad de Madrid (Grant Number: IND2017/TIC-7776)

In the present work, the interactions and associations between low denatured pea globulins (PPI) and purified main egg white proteins (ovalbumin (OVA), ovotransferrin (OVT), and lysozyme (LYS)) were studied at pH 7.5 and 9.0 by using isothermal titration calorimetry (ITC), dynamic light scattering (DLS), laser granulometry and confocal laser scanning microscopy (CLSM). From ITC, we detected strong exothermic interactions between PPI and LYS at both pHs, which led to aggregation. At these pH values, the net positive charge of lysozyme favored electrostatic interactions with negative charges of pea proteins, and oligomers were formed during titration experiments. Furthermore, DLS, laser granulometry, and CLSM data showed that the particle size of the mixture increased with increasing LYS to PPI molar ratio (from 0.8 to 20). Large irregular aggregates up to 20–25 µm were formed at high molar ratios and no complex coacervate was observed. No or very weak interactions were detected between OVT or OVA and PPI whatever the pH. These results suggest the role of electrostatic interactions between LYS and PPI when considering protein mixtures.

IntroductionClinical practice guidelines are helpful for clinicians, and their proper implementation could improve the quality of care and management of participants with diabetes. This study aimed to evaluate the degree of adherence to the Clinical Practice Guidelines (CPG) recommendations among obese, frail, or recently diagnosed type 2 diabetes mellitus (T2DM) participants in primary care centers in Spain.MethodsWe perform a cross-sectional study on a national level in two phases. In the first phase, study participants were recruited, and their clinical data were collected. In the second phase, data related to the participating physicians were collected.ResultsIn total, 882 participants from 240 physicians were analyzed. According to the study questionnaire, most participants from all three clinical groups had adequate adherence to the CPG. This percentage was highest among the recently diagnosed T2DM (91.6%) and lowest percent of frail T2DM persons (74.7%). The inadequate adherence to the guidelines was observed mainly among the obese and frail participants with T2DM from medical doctors with low CPG knowledge (3.4% and 3.5%, respectively). Regarding the patient's characteristics and degree of adherence to the guidelines, the participants with inadequate adherence were generally older, with higher BMI, poorer HbA1c control, and fewer visits with primary care physicians. Most (57%) primary care physicians had moderate CPG knowledge. In our multivariable logistic model, we did not observe statistically significant odds ratios for different characteristics related to the physicians/consultation and low CPG knowledge.DiscussionThe results of our cross-sectional study observe adequate adherence to the clinical guidelines by the primary care physicians for the majority of the participants with obesity, frailty, or newly diagnosed with T2DM.

Resumen Antecedentes El cierre percutaneo de la orejuela izquierda (CPOI) se ha propuesto como una alternativa al tratamiento anticoagulante en pacientes con fibrilacion auricular no valvular para disminuir el riesgo tromboembolico, evitando los riesgos de la anticoagulacion. Esta opcion puede ser atractiva en pacientes con fibrilacion auricular no valvular y enfermedad renal cronica (ERC), ya que presentan un alto riesgo tanto tromboembolico como hemorragico. Objetivo Determinar el papel pronostico de la presencia de ERC en pacientes con fibrilacion auricular sometidos a un CPOI periprocedimiento y durante el seguimiento comparado con los pacientes con funcion renal preservada. Metodos Estudio retrospectivo, observacional de muestreo consecutivo que incluyo 124 pacientes sometidos a CPOI por fibrilacion auricular en un hospital universitario y se compararon los resultados segun la funcion renal basal. Resultados La mediana de edad fue 75,5 anos (RIQ 67,6-80), el 62,1% eran hombres, la mediana de CHA2DS2-Vasc y HASBLED era de 4 (RIQ 3-4) para ambas escalas. El 57,3% de la muestra tenia ERC. Las caracteristicas basales eran similares entre ambos grupos, salvo una media de edad y un score de HASBLED superiores en los pacientes con ERC. Durante el procedimiento, no se observo ningun evento tromboembolico, de sangrado o muerte. Durante el tiempo de hospitalizacion y de seguimiento combinados, no hubo diferencias significativas entre grupos en la tasa anual de episodios tromboembolicos (0,97/100 pacientes-ano [100PA] vs. 4,06/100PA, p = 0,092), pero si se observo una mayor tasa de sangrados (5,67/100PA vs. 13,3/100PA, p = 0,033), y de mortalidad (6,50/100PA vs. 17,2/100PA, p = 0,009) en el grupo de ERC, con una odds ratio para mortalidad de 2,711 (IC95% 1,96-6,95). En el analisis multivariante, el FGe preservado se asocio independientemente con una menor mortalidad. Conclusiones El CPOI es una alternativa valida a la anticoagulacion oral en pacientes con ERC y fibrilacion auricular, con una baja tasa de eventos peri- y posprocedimiento. No obstante, los pacientes con ERC presentan mayor riesgo de sangrado y de mortalidad durante el seguimiento. Aunque estas mayores tasas no estan necesariamente relacionadas con el procedimiento.

Type 2 diabetes and its associated comorbidities are growing more prevalent, and the complexity of optimising glycaemic control is increasing, especially on the frontlines of patient care. In many countries, most patients with type 2 diabetes are managed in a primary care setting. However, primary healthcare professionals face the challenge of the growing plethora of available treatment options for managing hyperglycaemia, leading to difficultly in making treatment decisions and contributing to treatment and therapeutic inertia. This position statement offers a simple and patient-centred clinical decision-making model with practical treatment recommendations that can be widely implemented by primary care clinicians worldwide through shared-decision conversations with their patients. It highlights the importance of managing cardiovascular disease and elevated cardiovascular risk in people with type 2 diabetes and aims to provide innovative risk stratification and treatment strategies that connect patients with the most effective care.

Aims/hypothesis Mortality has declined in people with type 1 diabetes in recent decades. We examined how the pattern of decline differs by country, age and sex, and how mortality trends in type 1 diabetes relate to trends in general population mortality. Methods We assembled aggregate data on all-cause mortality during the period 2000–2016 in people with type 1 diabetes aged 0–79 years from Australia, Denmark, Latvia, Scotland, Spain (Catalonia) and the USA (Kaiser Permanente Northwest). Data were obtained from administrative sources, health insurance records and registries. All-cause mortality rates in people with type 1 diabetes, and standardised mortality ratios (SMRs) comparing type 1 diabetes with the non-diabetic population, were modelled using Poisson regression, with age and calendar time as quantitative variables, describing the effects using restricted cubic splines with six knots for age and calendar time. Mortality rates were standardised to the age distribution of the aggregate population with type 1 diabetes. Results All six data sources showed a decline in age- and sex-standardised all-cause mortality rates in people with type 1 diabetes from 2000 to 2016 (or a subset thereof), with annual changes in mortality rates ranging from −2.1% (95% CI −2.8%, −1.3%) to −5.8% (95% CI −6.5%, −5.1%). All-cause mortality was higher for male individuals and for older individuals, but the rate of decline in mortality was generally unaffected by sex or age. SMR was higher in female individuals than male individuals, and appeared to peak at ages 40–70 years. SMR declined over time in Denmark, Scotland and Spain, while remaining stable in the other three data sources. Conclusions/interpretation All-cause mortality in people with type 1 diabetes has declined in recent years in most included populations, but improvements in mortality relative to the non-diabetic population are less consistent. Graphical abstract

Given the increased COVID-19 observed in kidney transplant recipients (KTRs) and haemodialysis patients, several studies have tried to establish the efficacy of mRNA vaccines in these populations by evaluating their humoral and cellular responses. However, there is currently no information on clinical protection (deaths and hospitalizations), a gap that this study aims to fill.Observational prospective study involving 1,336 KTRs and haemodialysis patients from three dialysis units affiliated to Hospital Clínic of Barcelona, Spain, vaccinated with two doses of mRNA-1273 (Moderna) or BNT162b2 (Pfizer-BioNTech) SARS-CoV-2 mRNA vaccines. The outcomes measured were SARS-CoV-2 infection diagnosed by a positive RT-PCR fourteen days after the second vaccine dose, hospital admissions derived from infection, and a severe COVID-19 composite outcome, defined as either ICU admission, invasive and non-invasive mechanical ventilation, or death.Six per cent (18/302) of patients on haemodialysis were infected, of whom four required hospital admission (1.3%), only one (0.3%) had severe COVID-19, and none of them died. In contrast, 4.3% (44/1034) of KTRs were infected, and presented more hospital admissions (26 patients, 2.5%), severe COVID-19 (11 patients, 1.1%) or death (4 patients, 0.4%). KTRs had a significantly higher risk of hospital admission than HD patients, and this risk increased with age and male sex (HR 3.37 and 4.74, respectively).The study highlights the need for booster doses in KTRs. In contrast, the haemodialysis population appears to have an adequate clinical response to vaccination, at least up to four months from its administration.

Resumen Objetivo Examinar el patron de prescripcion de los distintos inhibidores de la dipeptidil-peptidasa 4 (iDPP4) en funcion del filtrado glomerular estimado (FGe) en condiciones de practica clinica real. Metodologia Estudio descriptivo observacional con base de datos poblacional (SIDIAP Catalunya). Se incluyeron sujetos diagnosticados de diabetes mellitus tipo 2 (DM2) con evaluacion de su funcion renal y tratamiento activo con iDPP4. Se incluyeron pacientes en el momento de la determinacion del FGe (CKD-EPI), con un periodo de observacion de 6 meses posterior a su inclusion. Para cada sujeto se estimo la dosis diaria prescrita (DDP) de iDPP4, su dosis teorica segun su nivel de insuficiencia renal que establecen las recomendaciones de la ficha tecnica (DDD-aj) y el ratio RDP (DDP/DDD-aj). Se considero que un sujeto estaba sobretratado si su RDP era superior a 1,2 (> 20%). Resultados La muestra estudiada fue de 72.135 sujetos con una edad media de 69,7 (± 11,6) anos y un 55,9% de varones. El porcentaje de pacientes con sobretratamiento varia segun el tipo de farmaco iDPP4 y el estadio de la funcion renal. Globalmente la sobredosificacion se registro en el 7,15% de todos los tratamientos con iDPP4. En estadios avanzados (IIIb, IV y V) la sobredosificacion fue muy superior (del 36,8% para todos los iDPP4 y si excluimos la linagliptina del 58,7%). Discusion En condiciones de practica clinica real, mas de un tercio de los pacientes con DM2 con insuficiencia renal avanzada presentaban una sobredosificacion de los iDPP4, puesto que no se ajustan correctamente las dosis al filtrado glomerular de cada paciente.

Introduction: This study examines factors associated with erythropoiesis-stimulating agent (ESA) hyporesponsiveness, the duration of ESA hyporesponsiveness, the frequency of new episodes, and variation across countries. Methods: We used international Dialysis Outcomes and Practice Patterns Study data from 2015 to 2018 (N = 26,656) to investigate changes in ESA Resistance Index (ERI), calculated as epoetin dose divided by [hemoglobin × body weight] in patients on hemodialysis. We illustrated the proportion of patients who moved to other ERI quintiles over 12 months, and we studied the incidence and duration of ESA resistance. We examined case-mix factors associated with quintiles of ERI. Results: Most patients migrated out of their original ERI quintile within 4 months. Only 22% of patients in the top quintile of ERI at baseline (4.4% of all patients) remained in the top quintile during all 12 months of follow-up. A total of 42% of patients manifested an upper-quintile ERI during at least 1 month. Median duration of a new episode of ESA resistance was 2 months. Catheter hemoaccess, elevated C-reactive protein, lower transferrin saturation, lower serum albumin concentration, and recent hospitalization occurred more frequently among patients in the highest ERI quintile at baseline. ERI values were highest in the USA, Italy, and Mideastern nations and lowest in Russia and Japan. Discussion/Conclusion: It is a misconception to envision a sizable, fixed segment of the population with permanent resistance to ESA – resistance fluctuates frequently. The implications of these findings for prescription of ESAs and of hypoxia-inducible factor-prolyl hydroxylase inhibitors are discussed.

We used acoustic telemetry to investigate the roles of depth and temperature in the daytime foraging behaviours of 13 tagged pelagic thresher sharks by monitoring their fine scale vertical movements in the Philippines. Cumulatively, pelagic thresher shark dives traversed the entire water column where they encountered temperatures that ranged from 33°C at the surface to 12°C at 250 m depths throughout the day, but the movements of individuals varied in the extent of both their deep and shallow water limits. Dives were not synchronized to diurnal cycles, and periodicity reflected cycles of similar dives, the dives themselves, deviations, cruising, and individuality. Pelagic thresher shark movements between the warm surface layer and cooler waters below the thermocline (155 – 175 m) may reflect a common Alopiid strategy that balances maintaining tolerable ambient water temperatures with opportunities to search for and forage on spatially patchy distributions of prey.

Supplemental material, sj-docx-1-tva-10.1177_15248380231176059 for Examining Cybersexism in Online Gaming Communities: A Scoping Review by Pablo Vergel, Daniel La parra-Casado and Carmen Vives-Cases in Trauma, Violence, & Abuse

Supplemental material, participants_overview for The Position of the Child in the Life Experiences of Immigrant Survivors of Intimate Partner Violence: A Study of Service Providers’ Perspectives in Spain by Raquel Herrero-Arias, Gaby Ortiz-Barreda, Ragnhild Hollekim, Erica Briones-Vozmediano and Carmen Vives-Cases in Journal of Interpersonal Violence

En 1757 Robert-François Damiens hirió de un navajazo a Luis XV. Las autoridades y la prensa presentaron el atentado como un suceso extraordinario perpetrado por un fanático, que nada tenía que ver con las tensiones que sacudían el país. Sin embargo, la lectura oficial del acontecimiento no silenció los numerosos malos discursos que aplaudían la osadía del frustrado regicida. El fallido magnicidio puede ser inscrito en una historia de larga duración que muestra cómo algunas de las opciones estratégicas de las autoridades del Antiguo Régimen fueron minando paulatinamente su poderío, como el traslado de Luis XIV a Versalles o la política antijansenista de la Corona. La desacralización de la monarquía posibilitó la aparición de una nueva elite intelectual, los philosophes, quienes se postularon como los abande- rados de la emergente opinión pública, que a su juicio convenía distinguir de la «estúpida y miserable» opinión popular, a la que pertenecía Damiens

En la Francia del siglo XVIII, tanto la opinión pública como los philosophes adquieren una presencia cada vez más destacada. En buena medida, ambas figuras van de la mano, pues los hombres de letras reivindican el decisivo papel que juegan en la consolidación de ese nuevo “tribunal” al que nadie puede sustraerse. Para ello, desarrollan una distinción fundamental entre la opinión pública y la opinión popular, el parecer de “esa multitud ciega y ruidosa” –afirma d’Alembert– contra la que se define el arrogante philosophe. Éste puede presumir de una autonomía y una capacidad de reflexión impensables en el pueblo llano, cuya presunta humanidad es puesta en tela de juicio por los philosophes, quienes se presentan como los nuevos mesías cuya verdad termina imponiéndose.

This study screened for Fabry disease (FD) in patients in hemodialysis (HD) in the region of Madrid (CAM) with a cross-sectional design to evaluate HD-prevalent patients, followed by a three-year period prospective design to analyze HD-incident patients.patients older than 18 years on HD in the CAM, excluding patients diagnosed with any other hereditary disease with renal involvement different from FD, that sign the Informed Consent (IC).underaged patients or not agreeing or not being capable of signing the IC.3470 patients were included, 63% males and with an average age of 67.9±9.7 years. 2357 were HD-prevalent patients and 1113 HD-incident patients. For HD-prevalent patients, average time in HD was 45.2 months (SD 51.3), in HD-incident patients proteinuria was present in 28.4%. There were no statistical differences in plasmatic alpha-galactosidase A (α-GAL-A) activity or Lyso-GL-3 values when comparing HD-prevalent and HD-incident populations and neither between males and females. A genetic study was performed in 87 patients (2.5% of patients): 60 male patients with decreased enzymatic activity and 27 female patients either with a decreased GLA activity, increased Lyso-Gl3 levels or both. The genetic variants identified were: p.Asp313Tyr (4 patients), p.Arg220Gln (3 patients) and M290I (1 patient). None of the identified variants is pathogenic.76% of HD Centers of the CAM participated in the study. This is the first publication to describe the prevalence of FD in the HD-population of a region of Spain as well as its average α-GAL-A-activity and plasmatic Lyso-Gl3 levels. It is also the first study that combines a cross-sectional design with a prospective follow-up design. This study has not identified any FD patient.

Pathological response to neoadjuvant therapy with chemotherapy vs chemoradiotherapy in stage III NSCLC. Contribution of IASLC recommendations

PURPOSE This prospective study assessed the effects of low-dose radiotherapy in patients diagnosed with greater trochanteric pain syndrome (GTPS) with recurrent symptoms or refractory to previous conservative measures. METHODS We evaluated a total of 155 patients (90.3% women, mean age 69 years). Most patients (n = 136) received 10 Gy (1 Gy/day/3 fractions per week on alternate days), but after recommendations of DEGRO guidelines published in 2015, the remaining 19 patients (12.2%) received 6 Gy (1 Gy/day/3 fractions per week on alternate days). RESULTS At the pre-treatment visit, the mean (standard deviation, SD) visual analog scale (VAS) score was 8), which decreased to 5 (SD 2.2) after 1 month of the end of treatment and to 4 (SD 2.3) after 4 months. An objective symptom response with increased mobility, better sleep quality, and reduction of analgesic medication was found in 56% of patients at 1 month. In 129 patients (83.2%), there was a decrease of at least 1 point in the VAS score, and in 49 patients (29.0%), the VAS score was lower than 3. The mean length of follow-up was 45 months. The probability of maintaining the analgesic response estimated by the Kaplan-Meier method was 53% at 5 years. CONCLUSION Low dose radiotherapy effectively improved pain in the trochanteric area in most patients with recurrent or refractory GTPS, allowing a reduction in the need for analgesic medications and, more, importantly, better functioning and mobility. Further randomized studies in selected populations of GTPS are needed to define the treatment position of low-dose radiotherapy in this clinical setting.

Physiological aging is characterized by an imbalance of pro-inflammatory and anti-inflammatory mediators leading to neuroinflammation. Microglial cells, which are highly regulated by the local microenvironment, undergo specific changes depending upon the brain area during aging. The aim of this study was to evaluate the influence of age over microglial cells along different brain areas and microenvironments. For this purpose, transgenic mice with overproduction of either the anti-inflammatory IL-10 cytokine or the pro-inflammatory IL-6 cytokine were used. Our results show that, during aging, microglial cells located in white matter (WM) areas maintain their phagocytic capacity but present a specific phagocytic phenotype with receptors involved in myelin recognition, arguing for aging-derived myelin damage. Whereas IL-10 overproduction anticipates the age-related microglial phagocytic phenotype, maintaining it over time, IL-6 overproduction exacerbates this phenotype in aging. These modifications were linked with a higher efficiency of myelin engulfment by microglia in aged transgenic animals. Moreover, we show, in a novel way, lower lipid oxidation during aging in WM areas, regardless of the genotype. The novelty of the insights presented in this study open a window to deeply investigate myelin lipid oxidation and the role of microglial cells in its regulation during physiological aging.

BackgroundDiabetes mellitus (DM) is one of the leading chronic diseases globally and one of the most common causes of death, morbidity, and poor quality of life. According to the WHO, DM is also one of the main risk factors for developing active tuberculosis (TB). Subjects with DM are at a higher risk of infections, in addition to frequent micro and macrovascular complications, and therefore sought to determine whether poor glycemic control is linked to a higher risk of developing TB.MethodsWe used a retrospective cohort of diabetic subjects to predict the incidence of TB. All DM patients were recruited from Ciutat Vella (the inner-city of Barcelona) from January 2007 until December 2016, with a follow-up period until December 2018 (≥2 years). Data were extracted from Barcelona's Primary Care medical record database - SIDIAP, and linked to the Barcelona TB Control Program. The incidence of TB and the impact of glycemic control were estimated using time-to-event curves analyzed by Cox proportional hazard regression. Hazard ratios (HRs) and 95% confidence intervals (CIs), unadjusted and adjusted by potential confounding variables, were also assessed, which included age, sex, diabetes duration, macrovascular and microvascular signs, BMI, smoking habit, alcohol consumption and geographical origin.ResultsOf 8,004 DM patients considered for the study (equating to 68,605 person-years of follow-up), 84 developed TB [incidence rate = 70 (95% CI: 52–93) per 100,000 person-years]. DM subjects with TB were younger (mean: 52.2 vs. 57.7 years old), had higher values of glycosylated hemoglobin (HbA1c) (7.66 vs. 7.41%) and total triglycerides (122 vs. 105 mg/dl), and had twice the frequency of diabetic nephropathy (2.08 vs. 1.18%). The calculated incidence rate increased with increasing HbA1c: 120.5 (95% CI 77.2–179.3) for HbA1c ≥ 7.5%, 143 (95% CI 88.3–218.1) for HbA1c ≥ 8% and 183.8 (95% CI 105–298) for HbA1c ≥ 9%. An increase in the risk of TB was also observed according to a poorer optimization of glycemic control: adjusted HR 1.80 (95% CI 0.60–5.42), 2.06 (95% CI 0.67–6.32), and 2.82 (95% CI 0.88–9.06), respectively.ConclusionDiabetic subjects with worse glycemic control show a trend toward a higher risk of developing TB.

Control of gene expression in specific tissues and/or at certain stages of development allows the study and manipulation of gene function with high precision. Site-specific genome recombination by the flippase (FLP) and cyclization recombination (Cre) enzymes has proved particularly relevant. Joint efforts of many research groups have led to the creation of efficient FLP and Cre drivers to regulate gene expression in a variety of tissues in Caenorhabditis elegans. Here, we extend this toolkit by the addition of FLP lines that drive recombination specifically in distal tip cells, the somatic gonad, coelomocytes, and the epithelial P lineage. In some cases, recombination-mediated gene knockouts do not completely deplete protein levels due to persistence of long-lived proteins. To overcome this, we developed a spatiotemporally regulated degradation system for green fluorescent fusion proteins based on FLP-mediated recombination. Using 2 stable nuclear pore proteins, MEL-28/ELYS and NPP-2/NUP85 as examples, we report the benefit of combining tissue-specific gene knockout and protein degradation to achieve complete protein depletion. We also demonstrate that FLP-mediated recombination can be utilized to identify transcriptomes in a C. elegans tissue of interest. We have adapted RNA polymerase DamID for the FLP toolbox and by focusing on a well-characterized tissue, the hypodermis, we show that the vast majority of genes identified by RNA polymerase DamID are known to be expressed in this tissue. These tools allow combining FLP activity for simultaneous gene inactivation and transcriptomic profiling, thus enabling the inquiry of gene function in various complex biological processes., This project was funded by the Spanish State Research Agency, the European Union, and the European Regional Development Fund (BFU2016-79313-P, CEX2020-001088-M, and PID2019-105069GB-I00; doi:10.13039/501100011033).