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The impact of patient sex on the presentation of inflammatory bowel disease (IBD) has been poorly evaluated. Our aims were to assess potential disparities in IBD phenotype and progression between sexes. We performed an observational multicenter study that included patients with Crohn's disease (CD) or ulcerative colitis from the Spanish Estudio Nacional en Enfermedad Inflamatoria intestinal sobre Determinantes genéticos y Ambientales registry. Data extraction was conducted in July 2021. A total of 51,595 patients with IBD were included, 52% were males and 25,947 had CD. The median follow-up period after diagnosis was 9 years in males and 10 years in females. In CD, female sex was an independent risk factor for medium disease onset (age, 17–40 y) (relative risk ratio, 1.45; 95% CI, 1.31–1.62), later disease onset (age, >40 y) (relative risk ratio, 1.55; 95% CI, 1.38–1.73), exclusive colonic involvement (odds ratio, 1.24; 95% CI, 1.14–1.34), inflammatory behavior (odds ratio, 1.14; 95% CI, 1.07–1.21), and extraintestinal manifestations (odds ratio, 1.48; 95% CI, 1.38–1.59). However, female sex was a protective factor for upper gastrointestinal involvement (odds ratio, 0.84; 95% CI, 0.79–0.90), penetrating behavior (odds ratio, 0.76; 95% CI, 0.70–0.82), perianal disease (odds ratio, 0.77; 95% CI, 0.71–0.82), and complications (odds ratio, 0.73; 95% CI, 0.66–0.80). In ulcerative colitis, female sex was an independent risk factor for extraintestinal manifestations (odds ratio, 1.48; 95% CI, 1.26–1.61). However, female sex was an independent protective factor for disease onset from age 40 onward (relative risk ratio, 0.76; 95% CI, 0.66–0.87), left-sided colonic involvement (relative risk ratio, 0.72; 95% CI, 0.67–0.78), extensive colonic involvement (relative risk ratio, 0.59; 95% CI, 0.55–0.64), and abdominal surgery (odds ratio, 0.78; 95% CI, 0.69–0.88). There is sexual dimorphism in IBD. The patient's sex should be taken into account in the clinical management of the disease. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Some evidence suggests that fluid resuscitation with lactated Ringer's solution (LR) may have an anti-inflammatory effect on acute pancreatitis (AP) when compared to normal saline (NS) and may be associated with a decrease in severity, but existing single-center randomized controlled trials showed conflicting results. The WATERLAND trial aims to investigate the efficacy and safety of fluid resuscitation using LR compared to NS in patients with AP. Methods: The WATERLAND trial is an international multicenter, open-label, parallel-group, randomized, controlled, superiority trial. Patients will be randomly assigned in a 1:1 ratio to receive LR versus NS-based fluid resuscitation for at least 48 h. The primary outcome will be moderately severe or severe AP, according to the revision of the Atlanta classification. The secondary objectives of the WATERLAND trial are to determine the effect of LR versus NS fluid resuscitation on several efficacy and safety outcomes in patients with AP. A total sample of 720 patients, 360 in the LR group and 360 in the NS group, will achieve 90% power to detect a difference between the group proportions of 10%, assuming that the frequency of moderately severe or severe AP in the LR group will be 17%. A loss to follow-up of 10% of patients is expected, so the total sample size will be 396 patients in each treatment arm (792 patients overall). The test statistic used is the two-sided Z test with pooled variance set at a 0.05 significance level. Discussion: The WATERLAND study aims to improve the early management of AP. Fluid resuscitation is an inexpensive treatment available in any hospital center worldwide. If a better evolution of pancreatitis is demonstrated in one of the treatment arms, it would have important repercussions in the management of this frequent disease. Trial registration: ClinicalTrials.gov, NCT05781243. Registration date on January 4, 2023. EudraCT number 2023–000010-18, first posted March 23, 2023. [ABSTRACT FROM AUTHOR]

Background: Physical restraint is applied in pediatric intensive care units to carry out certain painful procedures and to ensure the maintenance and continuity of life support devices. There is a need to analyse the factors that influence the behaviour or intention to use physical restraint. Aim: To create and test psychometrically a paediatric version of the Physical Restraint‐Theory of Planned Behaviour Questionnaire to assess paediatric critical care nurses' intention to use physical restraint. Study Design: A psychometric study. Five medical‐surgical Paeditric Intensive care Units from five hospitals in Spain. The study took place in three phases. In phase 1, the questionnaire was adapted. In phase 2, the content validity of each item was determined, and a pilot test was conducted. In phase 3, we administered the questionnaire and determined its psychometric properties. Results: The assessment of the intention to use physical restraint was extended to all critical paediatric patients, two items were eliminated from the initial questionnaire, four new items were included, and the clinical scenarios of the intention subscale were expanded from three to six. Overall content validity index for the full instrument of 0.96 out of 1. The Paediatric Physical Restraint‐Theory of Planned Behaviour Questionnaire is made up of four subscales (attitude, subjective norms (SN), perceived behavioural control (PBC), and intention) subdivided into 7 factors and 51 items. The internal consistency for the attitude subscale obtained a Cronbach's Alpha of 0.80 to 0.73, for the SN it was 0.72 to 0.89, for the PBC it was from 0.80 to 0.73 and for the intention subscale it was 0.75. Conclusions: The Paediatric Physical Restraint‐Theory of Planned Behaviour Questionnaire is an instrument composed of seven factors and 51 items that validly and reliably assesses the intention of paediatric nurses to apply PR in PICUs. Relevance for Clinical Practice: Having this instrument will help health centres move towards restraint‐free care by allowing managers to assess professionals' attitudes, beliefs, and intentions around the use of PR in PICUs. [ABSTRACT FROM AUTHOR]

Summary: Considering the current prevalence in obesity and sarcopenia globally, this study aimed to summarize the development of sarcopenic obesity research to establish the topic's past, present, and future research direction using a bibliometric analysis. A comprehensive search for publications on sarcopenia and obesity was conducted in the Web of Science (WoS) database until the 31st of December 2023. We performed a detailed descriptive analysis, considering metrics like sources, authors, and documents, along with analyzing conceptual and social structures to map sarcopenic obesity research. Between 1993 and 2023, there were 4978 publications on sarcopenic obesity, representing 22.6% of the whole sarcopenia research (22070). Most published articles were originals (74.6%), and one of the highest increments in the fields was seen after 2010. The most significant contribution in this research area falls under the categories of Nutrition & Dietetics, Gerontology, and Geriatrics & Gerontology. Among regions, scientific production was located in 93 different countries. The United States, China, and South Korea had the highest contributions. The most relevant keywords were sarcopenia, obesity, and body composition. Research on sarcopenic obesity primarily focuses on epidemiology and identifying risk factors and outcome predictors. Yet, there is a shortage of research addressing prevention, early detection, and treatments to enhance the health of individuals with sarcopenia. [ABSTRACT FROM AUTHOR]

This study explored the association between parental employment status and education level and the prevalence of sensory reactivity (SR) in population-based sample of school-aged children. SR was assessed in 495 children using the parent-reported Short Sensory Profile (SSP) questionnaire. Children with SR were identified based on probable or definitive differences in total SSP and subscales. Association between parental employment and education level were explored using multiple Poisson regression models with robust variance, adjusted for potential confounders. The main findings showed that a mother's unemployment status was associated with higher prevalence of SR for the taste/smell sensitivity subscale (PR = 1.66, 95%CI: 1.08–2.56), and the low energy/weak (PR = 2.18, 95%CI: 1.31–3.49) subscale. A lower education level of a father was also associated with a higher prevalence of sensory problems on the tactile sensitivity subscale (PRprimary education = 2.68, 95%CI: 1.27–5.61; PRsecondary education = 1.96, 95%CI: 1.004–3.66) and the low energy/weak subscale (PRsecondary education = 1.95, 95%CI: 1.02–3.73). This study underscores the impact of parental employment and education on SR in school-aged children, offering insights for interventions and support systems aimed at improving their sensory functioning and overall well-being. [ABSTRACT FROM AUTHOR]

Safe and effective severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are crucial to fight against the coronavirus disease 2019 pandemic. Most vaccines are based on a mutated version of the Spike glycoprotein [K986P/V987P (S-2P)] with improved stability, yield and immunogenicity. However, S-2P is still produced at low levels. Here, we describe the V987H mutation that increases by two-fold the production of the recombinant Spike and the exposure of the receptor binding domain (RBD). S-V987H immunogenicity is similar to S-2P in mice and golden Syrian hamsters (GSH), and superior to a monomeric RBD. S-V987H immunization confer full protection against severe disease in K18-hACE2 mice and GSH upon SARS-CoV-2 challenge (D614G or B.1.351 variants). Furthermore, S-V987H immunized K18-hACE2 mice show a faster tissue viral clearance than RBD- or S-2P-vaccinated animals challenged with D614G, B.1.351 or Omicron BQ1.1 variants. Thus, S-V987H protein might be considered for future SARS-CoV-2 vaccines development.In this study, the authors report a mutation that increases the production of recombinant SARS-CoV-2 Spike and exposure of the RBD. In animal models, a Spike-based vaccine containing the mutation induces strong immunogenicity, provides protection from disease and results in faster tissue viral clearance. [ABSTRACT FROM AUTHOR]

We assess the prenatal and postnatal effect of the High-Risk Pregnancy and Baby Parenting programme, which is complemented with two mHealth (app-based) resources. The GLM Repeated Measures Model technique was used to explore differences in the emotional health of the participants and in their infants’ neurodevelopment, comparing programme versus usual care groups, composed of 150 and 195 participants, respectively. The mothers presented lower levels of depression (mean difference 1.74, p = 0.04, 95% CI 0.07, 3.40) and higher levels of resilience (mean difference 4.09, p = 0.004, 95% CI 1.40, 6.78). For the fathers, positive effects on resilience were recorded (p < 0.001). A positive treatment effect was perceived in the infants’ cognitive (p = 0.014), language (p < 0.001) and motor (p = 0.006) development. These findings suggest application of the programme can benefit maternal emotional health and infant neurodevelopment. M-Health technology could make this programme more accessible. [ABSTRACT FROM AUTHOR]

Importance: The Cognitive Orientation to daily Occupational Performance (CO-OP) is an evidence-based intervention approach that has significantly increased in popularity over the past two decades. However, how the research literature on this topic is patterned is still unknown, so it is difficult to identify potential areas for research and clinical interest., Aims: To analyze the literature published on the CO-OP approach to provide a detailed and structured analysis of the publication patterns., Data Sources: All literature related to CO-OP included in the Web of Science database through June 15, 2024., Study Selection and Data Collection: All published studies related to CO-OP were included in the bibliometric analysis, which was conducted on the raw data retrieved from the Web of Science database using the Bibliometrix R package., Findings: The annual growth rate in CO-OP research has been 0.8%, significantly increasing from 2015 onward. Most of the research has been published in occupational therapy and rehabilitation journals by English-speaking research teams, and its scope has expanded from developmental coordination disorder to a wide range of health conditions. In addition, two main lines of research have emerged: one focusing on understanding the underlying cognitive processes involved in CO-OP and the other focusing on its clinical effectiveness., Conclusions and Relevance: Research on CO-OP has significantly increased over the past decade, and it currently encompasses a wide range of areas. This analysis may facilitate the advancement of research on and the clinical practical application of CO-OP. Plain-Language Summary: The Cognitive Orientation to daily Occupational Performance (CO-OP) is an evidence-based intervention approach that has significantly increased in popularity over the past two decades. Occupational therapists use it to improve the occupational performance of both children and adults with movement difficulties. However, it is unknown how the research literature on this topic is patterned, so it is difficult to identify potential areas for research and clinical interest. This study found that scientific literature on CO-OP has significantly increased in the past decade and that its scope has expanded from developmental coordination disorder to a wider range of health conditions, such as cerebral palsy. Moreover, research is now focused on two main questions: What are the underlying cognitive processes involved during intervention, and how effective is the CO-OP approach? These findings can be used to further improve occupational performance and participation among occupational therapy clients who struggle with motor performance and planning., (Copyright © 2024 by the American Occupational Therapy Association, Inc.)

Background: Current evidence suggests a potential detrimental effect of increased television viewing on children's health, including sensory processing issues. Therefore, this study examined the association between television viewing time and atypical sensory reactivity (SR) in children aged from three to seven years., Methods: We evaluated data from the InProS cross-sectional study (n = 545). Daily television viewing was categorized into tertiles: ≤1.5, 1.5 to 2.5, and ≥2.5 hours. SR was evaluated using the Short Sensory Profile (SSP). Children with atypical SR were those with a global SSP score below 155, 30 for tactile sensitivity, 15 for taste/olfactory sensitivity, 13 for movement sensitivity, 27 for under-responsive/seeks sensation, 23 for auditory filtering, 26 for low energy/weak, and 19 for visual/auditory sensitivity. We used multiple Poisson regression models with robust variance to explore associations., Results: After adjusting for covariates, children who watched television 1.5 to 2.5 and ≥2.5 hours/day showed a higher prevalence of atypical global SR (prevalence ratio [PR]: 1.54; 95% confidence interval [CI]: 1.03 to 2.30; PR: 1.81; 95% CI: 1.19 to 2.76, respectively) and auditory filtering (PR: 1.50; 95% CI: 1.15 to 1.96; PR: 1.36; 95% CI: 1.01 to 1.83, respectively), compared with children who watched ≤1.5 hours/day. In addition, watching television ≥2.5 hours/day, compared with watching ≤1.5 hours/day, was associated with having atypical SR in movement sensitivity (PR: 1.73; 95% CI: 1.06 to 2.83), under-responsive/seeks sensation (PR: 1.31; 95% CI: 1.02 to1.69), and low energy/weak (PR: 2.02; 95% CI: 1.01 to 4.06)., Conclusions: The findings showed that television viewing ≥1.5 hours/day was associated with a higher prevalence of atypical SR in childhood. However, further longitudinal studies are required to confirm these results., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Rocio Munoz-Sanchez reports financial support was provided by Vice Rector for Research of Miguel Hernández University., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background The Box and Block Test (BBT) is a highly recommended outcome measure to assess unilateral gross motor activity of the upper limbs. The BBT has not previously been available in a version adapted to the Spanish context. Thus, this study aimed to cross-culturally adapt and translate the BBT's instructions and pilot test the Spanish version of BBT in adults with acquired brain injury (ABI). Methods The BBT was translated and cross-culturally adapted following standard procedures. An expert committee approved the final Spanish version of BBT and it was conceptually validated by four therapists with expertise in ABI. The tool was tested on 14 adults with ABI. Results The Spanish version of BBT included a new section of materials for the test and a record to count the number of blocks transferred from one compartment of the box to the other. Following the pilot study, a modification in terminology was implemented for referring to the dominant and non-dominant hands. Conclusions Our results suggest that the Spanish version of BBT is suitable for assessing manual dexterity in Spanish-speaking adults with ABI.

The need for the public to take an active role in scientific research is becoming increasingly important, particularly in health-related research. However, the coexistence and alignment of scientific and citizen interests, needs, knowledge and timing is not straightforward, especially when involving migrant populations. To conduct impactful research, it becomes also essential to consider the perspectives of policymakers, thereby adding a layer of complexity to the processes.In this article we address the experience of a living lab created in a research institution and supported by the city council and a local foundation, in which we developed three experiences of patient and public involvement (PPI): (1) accessing to comprehensive care for people at risk of Chagas disease; (2) strategies towards improving access and quality of mental healthcare services in migrants; (3) promoting healthy and safe school environments in vulnerable urban settings.These three challenges provided an opportunity to delve into diverse strategies for involving key stakeholders, including migrant populations, expert researchers and political actors in health research. This article offers insights into the successes, challenges, and valuable lessons learnt from these endeavours, providing a vision that can be beneficial for future initiatives. Each living lab experience crafted its unique governance system and agenda tailored to specific challenge scenarios, giving rise to diverse methods and study designs.We have found that the management of the cocreation of the research question and the institutional support are key to building robust PPI processes with migrant groups., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)