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Sub-Saharan Africa is under-represented in global biodiversity datasets, particularly regarding the impact of land use on species population abundances. Drawing on recent advances in expert elicitation to ensure data consistency, 200 experts were convened using a modified-Delphi process to estimate intactness scores: the remaining proportion of an intact reference population of a species group in a particular land use, on a scale from 0 (no remaining individuals) to 1 (same abundance as the reference) and, in rare cases, to 2 (populations that thrive in human-modified landscapes). The resulting bii4africa dataset contains intactness scores representing terrestrial vertebrates (tetrapods: ±5,400 amphibians, reptiles, birds, mammals) and vascular plants (±45,000 forbs, graminoids, trees, shrubs) in sub-Saharan Africa across the regions major land uses (urban, cropland, rangeland, plantation, protected, etc.) and intensities (e.g., large-scale vs smallholder cropland). This dataset was co-produced as part of the Biodiversity Intactness Index for Africa Project. Additional uses include assessing ecosystem condition; rectifying geographic/taxonomic biases in global biodiversity indicators and maps; and informing the Red List of Ecosystems.

Abstract Background Recently, the countries in the Mediterranean basin (which share cultural ties) have been showing a common trend of declining social support for the elderly, with deficiencies in social care models for this demographic. Thus, this Delphi panel study analyzed the gaps in social and integrated care among the participating countries in a European research project. Methods This three-round Delphi panel study focused on the European countries of Greece and Spain and the non-European countries of Egypt, Lebanon, and Tunisia. In this project, experts were identified according to their level of expertise in the subject matter, their gender, and their membership in different social groups. Subsequently, they were asked to identify the current situation of social care, set future goals, and locate the gaps regarding the social and healthcare models for older people in the participating countries. The median score (Mdn) and interquartile range (IQR) were calculated to assess the degree of consensus on the different priorities. Results Among the participating countries, there was a lack of state agreements to maintain social care models, a lack of coordination between public and private institutions to provide social care services, territorial inequalities in terms of access and coverage of rights, and job insecurity for professionals. The desired situation was to integrate social and healthcare services with a person-centered social care model, thus promoting autonomy and empowering users and families in participation and decision-making. Conclusions This Delphi study reveals significant disparities in social and healthcare policies for older adults across Mediterranean countries, highlighting shared challenges and specific national needs. European nations like Greece and Spain face fragmented systems, while non-European countries such as Lebanon, Egypt, and Tunisia lack specialized geriatric services and social security. All countries urgently need better professional training, social and economic empowerment of older adults, and integrated national strategies. These findings offer key insights for policymakers to develop equitable, sustainable solutions for aging populations.

During the Late Pleistocene, stadial and interstadial fluctuations affected vegetation, fauna, and human groups that were forced to cope with these pronounced spatial–temporal climatic and environmental changes. These changes were especially abrupt during Marine Isotope Stage (MIS) 3. Here, we reconstruct the climatic trends in northern Iberia considering the stable isotopic composition of ungulate skeletal tissue found in archaeological deposits dated between 80 and 15 ka cal BP. The carbon and oxygen isotopic composition preserved in the carbonate fraction of tooth enamel provides a reliable and high-resolution proxy of the food and water consumed by these animals, which is indirectly related to the local vegetation, environment, and climate, allowing us to estimate palaeotemperatures and rainfall intensity. This study presents new isotope data from 44 bovine, equid, and cervid teeth from five archaeological sites in the Vasco-Cantabrian region (El Castillo, Axlor, Labeko Koba, Aitzbitarte III interior, and El Otero) and one in northeastern Iberia (Canyars), where human evidence is attested from the Mousterian to the Magdalenian. The carbon isotope values reflect animals feeding on diverse C3 plants in open environments and point to differentiated ecological niches for equids and bovines, especially during the Aurignacian in the Vasco-Cantabrian region. Temperature estimations based on oxygen isotopic compositions and rainfall obtained from carbon isotopic compositions indicate colder and more arid conditions than nowadays for the human occupations from the Late Mousterian to the Aurignacian. The contemporary northeastern Iberian site shows slightly lower temperatures related to an arid period when animals mainly grazed in open landscapes. In the Vasco-Cantabrian region, during MIS 2, the Gravettian data reflect a landscape opening, whereas the Magdalenian points to warmer (but still arid) conditions.

In keeping with the principles of positive parenting, understood as parental actions based on the best interests of children and aimed at their overall development, self-determination theory (SDT) posits that it is the family that must satisfy three basic psychological needs: autonomy, relatedness, and competence. Owing to migratory movement, the wide range of cultures present in Spain, and the fact that the family is the preferred place to experience human relationships, this context seems to be an ideal setting for testing the apparent universality of SDT. Hence, the main objective of this study was to examine the parenting dimensions: autonomy (autonomy support vs psychological control), relatedness (warmth vs rejection), and competence (structure vs chaos) and their influence on children’s behaviors in families from a wide range of international backgrounds. The sample comprised a total of 3428 parents and 1785 children attending primary education (7-13 years old) in eight autonomous communitie in Spain. Information was collected using three standardized questionnaires, adapted and validated for the Spanish context. The results show that, regardless of family origin, there were higher scores in positive parenting dimensions (autonomy support, warmth, and structure) than negative dimensions (psychological control, rejection and chaos). The findings also indicate that warmth had a positive effect on children’s behaviors while psychological control had a negative effect, as well as that there were some differences between certain geographical zones in warmth, structure, and chaos. Our study provides confirmation of the universality of the precepts of SDT and positive parenting in families from a wide range of geographical and cultural backgrounds in the Spanish context.

Objective: The present study examined the antecedents and consequences of perceived parental autonomy support and psychological control. More specifically, we had three aims: a) to investigate the associations between parents' expectations and beliefs about parenting and perceived parental autonomy support and psychological control; b) to analyse the relationships between the perceived parenting strategies (autonomy support and psychological control) and children's outcomes: prosocial competence, emotional stability, and verbal and physical aggression and c) to test differences based on parents' and children's gender. Method: The participants comprised 2,396 parents from Spain (1,164 fathers and 1,232 mothers) with diverse levels of qualification, professional and civil status and 1,325 children (637 boys and 685 girls) aged between 7 and 13 years old. Results: Perceive parental autonomy support was positively correlated with children's prosocial behaviour and competence: being more likely to engage in behaviours to achieve other people's improvement or well-being. In contrast, perceived parental psychological control was positively correlated with emotional instability, and physical and emotional aggression, that is children will be more likely to develop emotional adjustment problems. Besides, we found a positive association between some negative parenting beliefs and perceived parental psychological control, and we found positive association between some positive parenting beliefs and perceived parental autonomy support. Women scoring significantly higher than men in all associations between parenting beliefs and perceived parenting autonomy support and psychological control. No relationship was found between parental separation anxiety and perceived parental autonomy support or control. Conclusions: The results confirmed the importance of the role of parenting practices defined by SDT in children's development.

Abstract Background SARS-CoV-2 pneumonia can cause significant long-term radiological changes, even resembling pulmonary fibrosis. However, the risk factors for these long-term effects are unknown. This study aims to assess radiological abnormalities and their possible risk factors six months after hospital discharge due to COVID-19 pneumonia. Material and methods This cross-sectional study in a tertiary hospital included adults admitted for COVID-19 pneumonia from March 2020 to February 2021, who underwent high-resolution computed tomography (HRCT) scans of the chest six months after hospital discharge. The primary outcome was radiological abnormalities on HRCT, while the main explanatory variables were drawn from the patient’s medical history along with the disease course, analytical indicators, and the treatment received during admission. Results The 189 included patients had a mean age of 61.5 years; 70.9% were male, and hypertension was the main comorbidity (45%). About two-thirds (67.2%) presented acute respiratory distress syndrome (ARDS). Most (97.9%) received systemic corticosteroid therapy, and 81% presented pathological findings on HRCT, most commonly ground glass (63.5%), followed by bronchial dilatation (36%) and subpleural bands (25.4%). The multivariable analysis showed that age was the main risk factor, associated with most radiological changes. Other factors were the duration of corticosteroid therapy for ground glass (adjusted odds ratio [aOR] 1.020) as well as a longer stay in the intensive care unit (ICU) (aOR 1.290) and high levels of IL-6 for bronchial dilation (aOR 1.002). Conclusion Radiological involvement of the lungs six months after COVID-19 pneumonia is frequent, especially ground glass. Elderly patients with prolonged ICU admission and a significant inflammatory response measured by IL-6 are more likely to present worse radiological evolution and are candidates for radiological follow-up after COVID-19 pneumonia.

Abstract Aging involves the deterioration of organismal function, leading to the emergence of multiple pathologies. Environmental stimuli, including lifestyle, can influence the trajectory of this process and may be used as tools in the pursuit of healthy aging. To evaluate the role of epigenetic mechanisms in this context, we have generated bulk tissue and single cell multi-omic maps of the male mouse dorsal hippocampus in young and old animals exposed to environmental stimulation in the form of enriched environments. We present a molecular atlas of the aging process, highlighting two distinct axes, related to inflammation and to the dysregulation of mRNA metabolism, at the functional RNA and protein level. Additionally, we report the alteration of heterochromatin domains, including the loss of bivalent chromatin and the uncovering of a heterochromatin-switch phenomenon whereby constitutive heterochromatin loss is partially mitigated through gains in facultative heterochromatin. Notably, we observed the multi-omic reversal of a great number of aging-associated alterations in the context of environmental enrichment, which was particularly linked to glial and oligodendrocyte pathways. In conclusion, our work describes the epigenomic landscape of environmental stimulation in the context of aging and reveals how lifestyle intervention can lead to the multi-layered reversal of aging-associated decline.

Abstract Background Examination and understanding of neural hyperactivity are some of the greatest scientific challenges faced in the present day. For this reason, the present study aimed to examine this phenomenon in the context of higher education. Method Likewise, this work will enable an instrument to be created to appropriately and reliably estimate neural hyperactivity associated with chronic stress in university students undertaking a Physiotherapy degree. Results Analysis of content validity was carried out according to agreement and consensus between nineteen experts with Education Science or Psychology degrees, via the Delphi method. On the other hand, face validity was established by administering the questionnaire to a sample of 194 university students aged between 18 and 45 years (M = 30.48%; SD = 13.152). Conclusion The final self-report measure, denominated mental hyperactivity, was composed of 10 items which showed adequate fit with regards to face and content validity (α = 0.775). Confirmatory factor analysis confirmed that the questionnaire was unidimensional.

Abstract Rhythmic entrainment is a fundamental aspect of musical behavior, but the skills required to accurately synchronize movement to the beat seem to develop over many years. Motion capture studies of corporeal synchronization have shown immature abilities to lock in to the beat in children before age 5, and reliable synchronization ability in adults without musical training; yet there is a lack of data on full-body synchronization skills between early childhood and adulthood. To document typical rhythmic synchronization during middle childhood, we used a wireless motion capture device to measure period- and phase-locking of full body movement to rhythm and metronome stimuli in 6 to 11 year-old children in comparison with adult data. Results show a gradual improvement with age; however children’s performance did not reach adult levels by age 12, suggesting that these skills continue to develop during adolescence. Our results suggest that in the absence of specific music training, full-body rhythmic entrainment skills improve gradually during middle childhood, and provide metrics for examining the continued maturation of these skills during adolescence.

El acompañamiento pedagógico en la labor educativa es una estrategia de formación continua que tiene como propósito la mejora de los procesos pedagógicos en el desempeño de los docentes y los aprendizajes de los estudiantes. La investigación tuvo como objetivo analizar las experiencias del acompañamiento pedagógico en los Liceos Onésimo Jiménez y Politécnico Nuestra Señora de las Mercedes de Santiago de los Caballeros, año 2022-2023 para determinar el tipo de acompañamiento docente, identificar los cambios que genera y el nivel de satisfacción. La metodología utilizada responde al enfoque cuantitativo y diseño no experimental de corte básico. La técnica e instrumento utilizado para la recolección de los datos fue el cuestionario ad hoc. Los resultados fueron: el tipo de acompañamiento pedagógico es formativo y está decidido por la política institucional; genera cambios de mejora en componentes pedagógicos, ayuda en la gestión del aula, autoevaluación, toma de decisiones, aprendizaje de los alumnos, calidad de los trabajos y participación e integración de los estudiantes, y las técnicas e instrumentos de la observación de clases, revisión de planificación, rúbrica o lista de cotejo y ficha de observación son esenciales para lograr el acompañamiento.

Abstract Background Primary Health Care (PHC) plays a crucial role in managing the COVID-19 pandemic, with only 8% of cases requiring hospitalization. However, PHC COVID-19 data often goes unnoticed on European government dashboards and in media discussions. This project aims to examine official information on PHC patient care during the COVID-19 pandemic in Europe, with specific objectives: (1) Describe PHC’s clinical pathways for acute COVID-19 cases, including long-term care facilities, (2) Describe PHC COVID-19 pandemic indicators, (3) Develop COVID-19 PHC activity indicators, (4) Explain PHC’s role in vaccination strategies, and (5) Create a PHC contingency plan for future pandemics. Methods A mixed-method study will employ two online questionnaires to gather retrospective PHC data on COVID-19 management and PHC involvement in vaccination strategies. Validation will occur through focus group discussions with medical and public health (PH) experts. A two-wave Delphi survey will establish a European PHC indicators dashboard for future pandemics. Additionally, a coordinated health system action plan involving PHC, secondary care, and PH will be devised to address future pandemic scenarios. Analysis: Quantitative data will be analysed using STATA v16.0 for descriptive and multivariate analyses. Qualitative data will be collected through peer-reviewed questionnaires and content analysis of focus group discussions. A Delphi survey and multiple focus groups will be employed to achieve consensus on PHC indicators and a common European health system response plan for future pandemics. The Eurodata research group involving researchers from 28 European countries support the development. Discussion While PHC manages most COVID-19 acute cases, data remains limited in many European countries. This study collects data from numerous countries, offering a comprehensive perspective on PHC’s role during the pandemic in Europe. It pioneers the development of a PHC dashboard and health system plan for pandemics in Europe. These results may prove invaluable in future pandemics. However, data may have biases due to key informants’ involvement and may not fully represent all European GP practices. PHC has a significant role in the management of the COVID-19 pandemic, as most of the cases are mild or moderate and only 8% needed hospitalization. However, PHC COVID-19 activity data is invisible on governments’ daily dashboards in Europe, often overlooked in media and public debates.

Objective: The objective of this study was to analyze the evolution in the diagnosis and management of indeterminate thyroid nodules over three time periods. Methods: In total, 3020 patients with thyroid nodules underwent cytological evaluation during three periods (2006– 2008, 2012–2014, 2017–2019). The distribution of diagnostic cytology, risk of malignancy, diagnostic performance indices of fine needle aspiration (FNA), and cytologic–histologic correlation in indeterminate cytology were analyzed. Results: Only 2.2% of cytology tests were insufficient for a diagnosis. About 86.9% cytology was benign, 1.7% malignant, and 11.4% indeterminate. Indeterminate cytology rates were 15.9% (2006–2008), 10.1% (2012–2014), and 10% (2017–2019). Surgery was performed in 13% of benign cytology, resulting in malignant histology in 2.7%. All malignant and suspicious cytology underwent surgery, with malignancy confirmed in 98% and 77% of cases, respectively. All ‘indeterminate with atypia’ cytology (2006–2008) and Bethesda IV (2012–2014; 2017–2019) underwent surgery, with malignancy confirmed in 19.6%, 43.8%, and 25.7%, respectively. In the ‘indeterminate without atypia’ category (2006–2008) and Bethesda III (2012–2014; 2017–2019), diagnostic surgery was performed in 57.7%, 78.6%, and 59.4%, respectively, with malignancy confirmed in 3.3%, 20.5%, and 31.6%. The FNA sensitivity was 91.6%, with a negative predictive value greater than 96% in all periods. The specificity exceeded 75% in the last two periods. Conclusion: The Bethesda system reduces indeterminate cytology and improves the accuracy of FNA diagnosis. We reported a higher proportion of malignancy than expected in Bethesda III, underscoring the importance of having institution-specific data to guide decision-making. However, there is a need for risk stratification tools that allow for conservative management in low-risk cases.

Contact tracing of individual exposed to any infectious measles case deserves special attention when in the country the disease is mostly imported. We present the coordinated public health actions triggered after reporting a suspected measles case in an aircraft. Spanish public health authorities and airlines responded promptly to allow a rapid contact tracing. Even one secondary measles case was reported no further transmission was identified, revealing that giving PEP and appropriate information help to avoid transmission and to maintain measles elimination in Spain.

This paper evaluates the potential effect that operation lifetime could have on the accuracy and reproducibility of the Condor reflectometer. For this purpose, three Condors with different operation lifetimes have been used and compared in this study. In addition to the device’s operation lifetimes, reproducibility and the repeatability of the measurements have also been evaluated. Silvered glass mirrors at different states have been used, e.g., clean, soiled and eroded in order to evaluate the effect of the surface properties on the difference reported using different devices. The obtained results have shown that the difference in specular reflectance reported by the three different Condors is more noticeable in case of soiled and eroded glass mirrors compared to clean sample. This could be linked to the surface roughness more than to the years of operation of the device itself.

BackgroundIntraoperative identification of subsolid or small pulmonary nodules during minimally invasive procedures is challenging. Recent localization techniques show varying success and complications. Hybrid operating rooms (HORs), equipped with radiological tools, facilitate intraoperative imaging. This study compares the accuracy and safety of marking pulmonary nodules using electromagnetic navigation bronchoscopy (ENB) combined with Cone Beam Computed Tomography (CBCT) vs. CBCT-guided percutaneous marking (PM).MethodsThis retrospective cohort study included patients with pulmonary nodules scheduled for minimally invasive resection in a HOR. Marking techniques included ENB assisted by CBCT and PM guided by CBCT. The study compared the success rate, procedure time, intraoperative complications and radiation dose of both techniques.ResultsA total of 104 patients with 114 nodules were included (October 2021—July 2024). Thirty nodules were marked using ENB, and 84 with PM. One case used both techniques due to ENB failure. No differences among groups were found in nodule characteristics. Success rates were similar (93.3% in ENB group vs. 91.7% in PM group, p = 1). Marking took significantly longer time in the ENB group (median 40 min) compared to PM group (25 min, p = 0.007). Five (6%) patients in the PM group experienced intraoperative complications compared to none in the ENB (p = 0.323). Radiation dose was significantly higher in the ENB group (p = 0.002).ConclusionsENB assisted by CBCT is a safe and effective technique, with success rates comparable to CBCT-guided PM, though it may result in longer procedural times and higher radiation doses.

PurposeThe identification of patients with chronic hypoparathyroidism who are adequately (AC) or not adequately controlled (NAC) has clinical interest, since poor disease control is related to complications and mortality. We aimed to assess the prevalence of NAC patients in a cohort of subjects with postsurgical hypoparathyroidism.MethodsWe performed a multicenter, retrospective, cohort study including patients from 16 Spanish hospitals with chronic hypoparathyroidism lasting ≥3 years. We analyzed disease control including biochemical profile and clinical wellness. For biochemical assessment we considered three criteria: criterion 1, normal serum calcium, phosphorus and calcium x phosphorus product; criterion 2, the above plus estimated glomerular filtration rate ≥60 ml/min/1.73 m2; and criterion 3, the above plus normal 24-hour urinary calcium excretion. A patient was considered AC if he or she met the biochemical criteria and was clinically well.ResultsWe included 337 patients with postsurgical hypoparathyroidism (84.3% women, median age 45[36-56] years, median time of follow-up 8.9[6.0-13.0] years). The proportions of NAC patients with criteria 1, 2 and 3 were, respectively, 45.9%, 49.2% and 63.1%. Patients who had dyslipidemia at the time of diagnosis presented a significantly higher risk of NAC disease (criterion 3; OR 7.05[1.44-34.45]; P=0.016). NAC patients (criterion 2) had a higher proportion of subjects with incident chronic kidney disease and eye disorders, and NAC patients (criterion 3) had a higher proportion of incident chronic kidney disease, nephrolithiasis and dyslipidemia than AC patients.ConclusionThe present study shows a strikingly high prevalence of NAC patients in the clinical practice of Spanish endocrinologists. Results suggest that NAC disease might be associated with some prevalent and incident comorbidities.

Objetivos: el presente trabajo aborda el debate jurídico que suscita el encaje de las instalaciones eólicas en el territorio, a fin de identificar mecanismos de ordenación coordinada de esta actividad con otras políticas sectoriales. Metodología: la investigación realizada se orienta a dar solución a los problemas reales que plantea la aplicación del derecho en esta materia, empleando para ello la metodología habitual de las ciencias jurídicas (especialmente, el análisis normativo y doctrinal). Resultados: se ha conseguido precisar la forma en la que los planes urbanísticos han de llevar a cabo esa labor integradora, clarificando previamente los trámites administrativos exigidos para la implantación de este tipo de infraestructuras. Conclusiones: la implantación de un parque eólico debe conllevar un nuevo ordenamiento urbanístico del área en la que se ubica, a fin de que las servidumbres impuestas por la instalación de dichas infraestructuras sean contempladas en los regímenes de uso de los suelos situados en torno a las mismas. Con el fin de acometer esa función, la ordenación del territorio, la zonificación y los planes especiales se erigen en las tres piezas esenciales del sistema.

Introduction Compared with the operating room, tracheal intubations in the intensive care unit (ICU) are associated with worsened glottic view, decreased first-time success rate and increase in the technical difficulty of intubation and incidence of complications. Videolaryngoscopes (VLs) have been proposed to improve airway management, and while recent studies have confirmed that VLs improve intubation conditions in this patient population, there remains a lack of clarity regarding the selection between a standard Macintosh blade or a hyperangulated one, to determine which yields the best outcomes. The purpose of this study was to compare successful intubation on the first attempt with the Macintosh VL versus the hyperangulated VL during tracheal intubation in ICU patients. We hypothesise that tracheal intubation using the hyperangulated VL will improve the frequency of successful intubation on the first attempt.Methods and analysis The INtubation VIdeolaryngoscopy BLADE-ICU trial is a prospective, multicentre, open-label, interventional, randomised, controlled superiority study conducted in 29 ICUs in Spain. Patients will be randomly assigned in a 1:1 ratio to undergo intubation using a Macintosh VL (control group) or a hyperangulated VL (experimental group) for the first intubation attempt. The primary outcome is successful intubation on the first attempt. The secondary outcomes include the time to intubation, attempts for successful intubation, laryngoscopic vision assessed with the modified Cormack-Lehane scale, the need for adjuvant airway devices for intubation, difficulty assessed by the anaesthesiologist and complications during tracheal intubation. Enrolment began on 1 May 2024 and is expected to be completed in 2025.Ethics and dissemination The study protocol was approved on 29 February 2024, by the Ethics Committee of Galicia (CEImG, code No. 2024-031).The results will be submitted for publication in a peer-reviewed journal.Trial registration number NCT06322719.