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Chromosome territoriality is not random along the cell cycle and it is mainly governed by intrinsic chromosome factors and gene expression patterns. Conversely, very few studies have explored the factors that determine chromosome territoriality and its influencing factors during meiosis. In this study, we analysed chromosome positioning in murine spermatogenic cells using three-dimensionally fluorescence in situ hybridization-based methodology, which allows the analysis of the entire karyotype. The main objective of the study was to decipher chromosome positioning in a radial axis (all analysed germ-cell nuclei) and longitudinal axis (only spermatozoa) and to identify the chromosomal factors that regulate such an arrangement. Results demonstrated that the radial positioning of chromosomes during spermatogenesis was cell-type specific and influenced by chromosomal factors associated to gene activity. Chromosomes with specific features that enhance transcription (high GC content, high gene density and high numbers of predicted expressed genes) were preferentially observed in the inner part of the nucleus in virtually all cell types. Moreover, the position of the sex chromosomes was influenced by their transcriptional status, from the periphery of the nucleus when its activity was repressed (pachytene) to a more internal position when it is partially activated (spermatid). At pachytene, chromosome positioning was also influenced by chromosome size due to the bouquet formation. Longitudinal chromosome positioning in the sperm nucleus was not random either, suggesting the importance of ordered longitudinal positioning for the release and activation of the paternal genome after fertilisation.

Background: COVID-19 serologic response in patients with cancer may be lower than in the general population and may be influenced by the type of tumor or anticancer treatment. This study aims to analyze serological response prior and after vaccination of COVID-19 within the oncological population in Andorra. We set out to identify risk factors for a higher or lower serological response. Patients and methodsObservational, unicentric, prospective cohort study of oncologic patients in Andorra. We calculated seroprevalence of antibodies against SARS-CoV-2 (May 2020-June 2021) and analyzed the main demographic, oncologic features and factors associated with being seropositive. ResultsA total of 373 patients were analyzed, mainly with solid malignancies (n = 334, 89.5%). At baseline, seroprevalence was 13%, increasing during follow-up to 19%; lower seroprevalence was observed in patients with hematologic malignancies (2.6% vs 14.2%; p= 0.041) and patients receiving biological therapies (0% vs 15%, p=0.005). In the overall seroprevalence analysis, women (23% vs 11.9%; p=0.006) and tumour-free patients (p=0.034) showed higher seroprevalence. The multivariable analysis showed that odds of being seropositive were higher among women (OR: 2.44, 95% CI: 1.28-4.64), and patients who underwent a surgery (OR: 3.35, 95% CI: 1.10-10.20). About 80% of the cohort received at least one dose of COVID-19 vaccination, showing a higher seroprevalence of patients who received ChAdOx1-S than those who received BNT162b2 (24.4% vs 6.4%: p=0.001). ConclusionThe seroprevalence of antibodies against SARS-COV-2 in oncologic patients in Andorra was higher among females and patients who received hormonal therapy and surgery while patients with hematologic malignancies and biologic therapies showed lower seropositivity without finding differences in the type of tumour or anticancer treatment.

To analyse the evolution of state of mind in adolescents in the province of Barcelona for the last six years and the specific impact of the pandemic and its experience. Likewise, analyse the associated factors both in pre-pandemic period and during.Since 2015/2016 a Questionnaire on health related habits was carried out among 4The pandemic significantly intensified the trend of worsening the state of mind adolescents, and widened the gender gap. Boys went from 17.9% (pre-pandemic) to 25.7% (during pandemic) with a negative mood, while girls from 31.9% to 52.9%. In modelling during pandemic, socioeconomic and family factors appeared relevant and significant. Sex, perceived poor health, being victim of harassment, self-perception of weight, excessive use of the internet and a poor perception of the residential environment remained significant as in the pre-pandemic model.The specific negative impact of the pandemic on adolescents' mental well-being is perceived, but it is too early to tell whether it is reversible or not and to assess the effectiveness of interventions to tackle it.Se considera relevante analizar la evolución del estado anímico en adolescentes de la provincia de Barcelona en los últimos seis años y el impacto específico de la pandemia y su vivencia. Así como los factores asociados tanto en el periodo prepandemia como durante.Desde 2015/2016 se realizó una encuesta de hábitos relacionados con la salud a alumnos de 4º de Enseñanza Secundaria Obligatoria (ESO). En el curso 2020/2021 se le añadió un bloque sobre la COVID-19. Hubo una muestra representativa provincial prepandemia (N=15.118) y una muestra durante la pandemia (N=4.966). A partir de seis ítems específicos se construyó la variable agregada dicotómica de estado anímico positivo/negativo a la que se realizaron los análisis bivariados y multivariantes a cada periodo. Análisis realizados con SAS.La pandemia intensificó significativamente la tendencia de empeoramiento en el estado anímico de la población adolescente y agrandó la brecha de género. Los chicos pasaron del 17,9% (prepandemia) al 25,7% (durante pandemia), con estado anímico negativo, mientras que las chicas variaron del 31,9% al 52,9%. En la modelización durante pandemia aparecieron relevantes y significativos los factores socioeconómicos y familiares, mientras que se mantuvieron como en prepandemia el sexo, la mala salud percibida, ser víctima de acoso, la autopercepción del peso, el uso excesivo de internet y la mala percepción del entorno residencial.El impacto negativo específico de la pandemia en el estado anímico de los adolescentes es apreciable, pero aún es pronto para saber si es o no reversible y para conocer la efectividad de las intervenciones al respecto.

Background and objectives Primary biliary cholangitis (PBC) is an autoimmune disease that affects the small bile ducts. The only treatments currently approved in our country are ursodeoxycholic acid (UDCA) and obeticholic acid. Different indices evaluate the response after 1 year of treatment. The aim of our study was to evaluate the different predictive scores and prognostic factors of response to UDCA. Material and methods Retrospective single-centre study in which clinical and analytical data of patients diagnosed with PBC were collected from January 1987 to December 2015. The response after 1 year of treatment was evaluated using the different response scores and their concordance degree using the Kappa index. The area under the receiver operating characteristic curve (AUROC) was calculated to determine the predictive capacity of the scores. Likewise, the prognostic factors of response to treatment were analysed. Results We included 153 patients. The bivariate analysis showed a statistically significant relationship between the initial high levels of alkaline phosphatase and cholesterol and the poor response to treatment. The best AUROC was in Paris-I score (0.81). The concordance between the different scores was low. The GLOBE score was valid to evaluate the prognosis. Conclusion Basal alkaline phosphatase and cholesterol were predictors of poor outcome. The best predictive qualitative score in our cohort patients was Paris-I. There was a poor concordance between the different predictive scores. GLOBE score is valid to evaluate prognosis.

Resumen Antecedentes y objetivos La colangitis biliar primaria (CBP) es una enfermedad autoinmunitaria que afecta a los conductos biliares de pequeno y mediano tamano. Los unicos tratamientos aprobados actualmente en nuestro pais son el acido ursodeoxicolico (AUDC) y el acido obeticolico. Diversos indices evaluan la respuesta al ano de tratamiento. El objetivo de nuestro estudio fue evaluar los diferentes indices predictivos de respuesta al tratamiento con AUDC. Material y metodos Estudio unicentrico retrospectivo en el que se recogieron los datos clinicos y analiticos de los pacientes diagnosticados de CBP desde enero de 1987 hasta diciembre de 2015. Se calculo la respuesta al ano de inicio del tratamiento utilizando los diferentes indices de respuesta y se evaluo su grado de concordancia mediante el indice Kappa. Se calculo el area under the receiver operating characteristic curve (AUROC, «area bajo la curva ROC») para determinar la capacidad predictiva de los indices. Asimismo, se analizaron los factores pronosticos basales. Resultados Se incluyeron 153 pacientes. El analisis bivariante demostro una relacion estadisticamente significativa entre los niveles altos iniciales de fosfatasa alcalina y colesterol y la mala respuesta al tratamiento. La mejor AUROC fue del indice Paris-I (0,81). La concordancia entre los diferentes indices fue baja. El indice pronostico GLOBE fue valido para evaluar el pronostico. Conclusion La fosfatasa alcalina y el colesterol basales fueron factores predictores de mala evolucion. El indice cualitativo que mejor predijo la supervivencia fue el Paris-I. Se obtuvo una mala concordancia entre los diferentes indices predictivos. El indice GLOBE es valido para evaluar el pronostico de la CBP.

In a cohort of early rheumatoid arthritis (RA) patients, we aimed to determine and characterise fatigue trajectories over 10 years of follow-up and identify predictors of trajectory membership.Methods: We selected patients fulfilling the 2010 ACR/EULAR criteria for RA included in the ESPOIR cohort. We used a cluster analysis to obtain fatigue (assessed by fatigue visual analogue scale) trajectories over the course of 10 years from enrolment. Chi-square tests or ANOVA were performed to evaluate differences of baseline variables between fatigue trajectories. Using a multinomial logistic regression we were able to identify predictors of trajectory membership.Results: We analysed 598 patients with mean disease duration at enrolment of 26.2±40.9 days. Cluster analysis revealed 3 trajectories: high (18%), moderate (52%) and low fatigue (30%). Compared to patients with moderate or low fatigue trajectory, patients with high fatigue trajectory were predominantly women and reported significantly higher duration and intensity of morning stiffness, HAQ score, tender joints count, levels of pain, number of awakenings due to arthritis, frequency of fibromyalgic RA, levels of physician and patient global assessment, more frequent sleep problems, and increased psychological distress. Female patients with pain, psychological distress and presence of sicca symptoms had a higher risk of being in the high trajectory group.Conclusions: These findings suggest that levels of fatigue are rather stable over time in each trajectory. Baseline clinical measures and baseline patient-reported measures of functional status better distinguished the three fatigue trajectories. We did not find any differences between trajectories in baseline laboratory measures. Inflammatory activity was not a predictor of being in the high trajectory fatigue group.

Key summary points Aim COVID-19 mortality risk factors in older people from a long term care center. Findings Male gender, low Barthel index, no pharmacological treatment and lymphocytopenia are independent mortality risk factors. Message The independent prognostic factors identified in the present study can help to adjust the healthcare resources in this population in case of new outbreaks of the COVID-19 pandemic., Purpose Despite high rates of COVID-19 infection and increased related mortality have been reported among older adults admitted in long-term care facilities, a limited amount of information is available about the natural course of this pandemic and prognostic factors in such population. In the current study, we aimed to investigate the epidemiologic, demographics, clinical, or therapeutic factors that may predict the prognosis in a cohort of COVID-19 infected institutionalized older in a nursing home. Methods We conducted a retrospective analysis of all COVID-19 confirmed institutionalized older in a nursing home from March 15 to June 5, 2020. Epidemiological, demographic, and frailty status before infection, and clinical, laboratory, treatment, and outcome data during infection were collected. We used bivariate analysis and multivariate logistic regression to identify risk factors for mortality. Results The analysis comprised all 100 COVID-19 confirmed cases during the study period. The median age was 85 years; 62% were female. The case fatality rate was 20%. In the bivariate analysis, male gender, fever, respiratory symptoms, severe cognitive decline, a low Barthel index, and lymphocytopenia were significantly associated with mortality. Patients treated with hydroxychloroquine plus azithromycin were related to a higher chance of survival than those without pharmacological treatment. Multivariate logistic regression analysis identified male gender, low Barthel index, no pharmacological treatment, and lymphocytopenia as independent risk factors associated with mortality. Conclusions Male gender, low Barthel index, and lymphocytopenia are independent risk factors for COVID-19 mortality in institutionalized older patients in long-term care nursing homes. Treatment with hydroxychloroquine and azithromycin was associated with lower mortality in these patients.

International audience; Objective: To determine, in a cohort of patients with early rheumatoid arthritis (RA), factors associated with fatigue at baseline, describe its evolution over 5 years of follow-up, and determine baseline predictors of persistent fatigue.Method: We selected patients fulfilling the 2010 American College of Rheumatology/European League Against Rheumatism criteria for RA included in the ESPOIR cohort. Using bivariable and multivariable logistic regression models, we examined baseline variables associated with baseline fatigue (defined by visual analogue scale fatigue > 20) and baseline predictors of persistent fatigue (if the patient experienced fatigue at all visits during the 5 year follow-up period).Results: We analysed 673 patients; 80.7% reported fatigue at baseline. At baseline, fatigue was associated with female gender, younger age, greater severity of morning stiffness, sleep problems, higher Health Assessment Questionnaire levels, presence of sicca symptoms, history of thyroid problems, and presence of psychological distress (depressive or anxiety symptoms). At 5 years of follow-up, the percentage of fatigued patients who reported fatigue at all time-points since baseline was 24.6% (referred to as 'persistent fatigue'). Independent baseline predictors were presence of sicca symptoms, greater severity of morning stiffness, and psychological distress.Conclusions: Fatigue is a frequent symptom in RA. The presence of sicca symptoms, greater severity of morning stiffness, and presence of psychological distress at baseline were associated with baseline fatigue and persistent fatigue at 5 years. We did not observe any association between baseline fatigue or persistent fatigue and the Disease Activity Score based on 28-joint count-erythrocyte sedimentation rate.

The worldwide burden of chronic illnesses, constitutes a major public health concern and a serious challenge for health systems. In addition to the strategies of self-management support developed by nursing and health organizations, an individual&rsquo, s personal network represents a major resource of social support in the long-term. Adopting a cross-sectional design based on personal network analysis methods, the main aim of this study is to explore the relationship between satisfaction with the social support received by individuals suffering chronic pain and the structure, composition, and functional content in social support of their personal networks. We collected personal and support network data from 30 people with chronic pain (20 person&rsquo, s contacts (alters) for each individual (ego), 600 relationships in total). Additionally, we examined the level of satisfaction with social support in each of the 600 relationships. Bivariate and multivariate tests were performed to analyze the satisfaction with the social support received. Using cluster analysis, we established a typology of the 600 relationships under study. Results showed that higher satisfaction was associated with a balance between degree centrality and betweenness (i.e., measures of network cohesion and network modularity, respectively). Finally, new lines of research are proposed in order to broaden our understanding of this subject.

The current paper presents a histological analysis of the cell death in the cerebellar external granular layer (EGL) following the treatment with a single dose (2 mg/g) of hydroxyurea (HU). The rats were examined at postnatal days (P) 5, 10, and 15, and sacrificed at appropriate times ranging from 6 to 48 h after treatment administration. Studies were done in each cortical lobe (anterior, central, posterior, and inferior). The quantification of several parameters, such as density of 5-bromo-2'-deoxyuridine, TUNEL, vimentin, and tomato lectin-stained cells, revealed that HU compromises the viability of EGL cells. Our results indicate that P10 is a time of high vulnerability to injury. We also show here that the anterior and central lobes are the cortical regions most susceptible to the action of the HU. Additionally, our data also indicate that from 6 to 24 h after HU-exposure is a time-window of high sensibility to this agent. On the other hand, our ultrastructural analysis confirmed that HU administration produces the activation of apoptotic cellular events in the EGL, resulting in a substantial number of dying cells. Different stages of apoptosis can be observed in all cortical lobes at all investigated postnatal ages and survival times. Moreover, we observed that dying neuroblasts were covered by laminar processes of Bergmann glia, and that these unipolar astrocytes presented cytological features of phagocytes engulfing apoptotic bodies and cell debris. The electron microscopy study also revealed the participation of ameboid microglial cells in the phagocytosis of apoptotic cells in the regions of the EGL with extensive cell death.

Rationale & Objective Autosomal dominant tubulointerstitial kidney disease (ADTKD) is a rare underdiagnosed cause of end-stage renal disease (ESRD). ADTKD is caused by mutations in at least 4 different genes: MUC1, UMOD, HNF1B, and REN. Study Design Retrospective cohort study. Setting & Participants 56 families (131 affected individuals) with ADTKD referred from different Spanish hospitals. Clinical, laboratory, radiologic, and pathologic data were collected, and genetic testing for UMOD, MUC1, REN, and HNF1B was performed. Predictors Hyperuricemia, ultrasound findings, renal histology, genetic mutations. Outcomes Age at ESRD, rate of decline in estimated glomerular filtration rate. Results ADTKD was diagnosed in 25 families (45%), 9 carried UMOD pathogenic variants (41 affected members), and 16 carried the MUC1 pathogenic mutation c.(428)dupC (90 affected members). No pathogenic variants were identified in REN or HNF1B. Among the 77 individuals who developed ESRD, median age at onset of ESRD was 51 years for those with ADTKD-MUC1 versus 56 years (P=0.1) for those with ADTKD-UMOD. Individuals with the MUC1 duplication presented higher risk for developing ESRD (HR, 2.24; P=0.03). The slope of decline in estimated glomerular filtration rate showed no significant difference between groups (−3.0mL/min/1.73m2 per year in the ADTKD-UMOD group versus −3.9mL/min/1.73m2 per year in the ADTKD-MUC1 group; P=0.2). The prevalence of hyperuricemia was significantly higher in individuals with ADTKD-UMOD (87% vs 54%; P=0.006). Although gout occurred more frequently in this group, the difference was not statistically significant (24% vs 7%; P=0.07). Limitations Relatively small Spanish cohort. MUC1 analysis limited to cytosine duplication. Conclusions The main genetic cause of ADTKD in our Spanish cohort is the MUC1 pathogenic mutation c.(428)dupC. Renal survival may be worse in individuals with the MUC1 mutation than in those with UMOD mutations. Clinical presentation does not permit distinguishing between these variants. However, hyperuricemia and gout are more frequent in individuals with ADTKD-UMOD.

An important step in bromodeoxyuridine (BrdU) immunohistochemistry is the production of single-stranded DNA to make the incorporated BrdU accessible to the antibodies. This paper examines the effect of distinct DNA denaturation pretreatments (DNase I, sodium citrate buffer, endonuclease Eco RI and exonuclease III, and HCl hydrolysis) on detection of BrdU. We found that all the methods used in the partial denaturation of DNA combined good nuclear immunostaining with acceptable tissue integrity. We also observed that these immunohistochemical protocols revealed a spatial pattern in the distribution of DNA-synthesizing cells within the cerebellar external granular layer (EGL) of 10-day-old rats, allowing us to estimate the fraction of S-phase cells. Our results indicate that detection of BrdU-stained cells is affected by the distinct histological procedures used in such detection. Additionally, as the duration and phases of the cell cycle in EGL neuroblasts are estimated in accordance with BrdU detection, an effect on this detection can render the measurement of cell cycle inaccurate. The present work shows that DNase I and citrate buffer, at appropriate conditions, may be good alternatives for acid denaturation. However, they are less sensitive than autoradiographic techniques that use 3H-thymidine administration. Finally, current data reveal that short survival times after a single BrdU exposure do not seem to affect the cell cycle progression of the EGL neuroblasts.

[This corrects the article DOI: 10.1371/journal.pone.0208112.].

BackgroundPatient empowerment is a key factor in improving health outcomes.ObjectiveTo evaluate the psychometric properties of the Spanish version of the questionnaire on Patient Empowerment in Long-Term Conditions (PELC) that evaluates the degree of empowerment of patients with chronic diseases.MethodsThree measurements were made (at baseline, 2 weeks and 12 weeks) of quality of life (QoL), self-care, self-efficacy and empowerment. Reliability was evaluated as internal consistency for the entire sample. Test-retest reproducibility was evaluated for patients who were stable from baseline to week 2 (n = 70). Validity was analysed (n = 124) as baseline correlations with QoL, self-care, self-efficacy, clinical data and psychosocial variables. Sensitivity to change was analysed in terms of effect size for patients who had improved between baseline and week 12 (n = 48).ResultsThe study was carried out with 124 patients with a diagnosis of heart failure. Cronbach's alpha was high, at >0.9, and the interclass correlation coefficient was low, at 0.47. PELC questionnaire scores showed differences depending on New York Heart Association functional class (pConclusionsThe results suggest that the Spanish version of the PELC questionnaire has appropriate psychometric properties in terms of internal consistency and validity and is low in terms of reproducibility and sensitivity to change.

Background:Fatigue is one of the most prevalent symptom reported by persons with RA. RA-related fatigue is a complex concept with biological, psychological and social interactions.Objectives:In a cohort of early RA patients, to determine and characterize fatigue trajectories over 10 years of follow-up and identify predictors of trajectory membership.Methods:Patients fulfilling the 2010 ACR/EULAR criteria for RA included in the ESPOIR cohort. We used a cluster analysis to obtain fatigue (assessed by fatigue visual analogue scale) trajectories over the course of 10 years from enrolment. Chi-square tests or ANOVA were performed to evaluate differences of baseline variables between fatigue trajectories. Using a multinomial logistic regression we could identify predictors of trajectory membership.Results:We analysed 598 patients with mean disease duration at enrolment of 26.2 ± 40.9 days. Cluster analysis revealed 3 trajectories: high (18%), moderate (52%) and low fatigue (30%). Compared to patients with moderate or low fatigue trajectory, patients with high fatigue trajectory were predominantly women and reported significantly higher duration and intensity of morning stiffness, HAQ score, number of tender joints, levels of pain, number of awakenings due to arthritis, levels of physician and patient global assessment and more frequent sleep problems, and increased psychological distress. Female patients with pain, psychological distress and presence of sicca symptoms had higher risk of being in high trajectory group.Conclusion:These findings suggest that levels of fatigue are rather stable over time in each trajectory. Baseline clinical measures and baseline patient-reported measures of functional status better distinguished the three fatigue trajectories. We did not find differences between trajectories in baseline laboratory measures. Inflammatory activity was not a predictor of being in high trajectory fatigue group.References:[1]Pollard LC, Choy EH, Gonzalez J, Khoshaba B, Scott DL. Fatigue in rheumatoid arthritis reflects pain, not disease activity. Rheumatology (Oxford) 2006;45:885–9[2]Repping-Wuts H, van Riel P, van Achterberg T. Fatigue in patients with rheumatoid arthritis: what is known and what is needed. Rheumatology (Oxford) 2009;48:207–9.[3]Pilgaard T, hagelund L, Stallknecht SE, jensen HH, Esbensen BA. Severity of fatigue in people with rheumatoid arthritis, psoritic artrhitis and spondyoarthritis- Results of cross-sectional study. Plos One. 2019;14:e0211831[4]Feldthusen C, Grimby-Ekman A, Forsblad-d’Elia H, Jacobsson L, Mannerkorpi K. Explanatory factors and predictors of fatigue in persons with rheumatoid arthritis: a longitudinal study. J Rehabil Med 2016 28;48:469–76.[5]Madsen SG, Danneskiold-Samsøe B, Stockmarr A, Bartels EM. Correlations between fatigue and disease duration, disease activity, and pain in patients with rheumatoid arthritis: a systematic review. Scand J Rheumatol. 2016;45:255-61.[6]Olsen CL, Lie E, Kvien TK, Zangi HA. Predictors of fatigue in rheumatoid arthritis patients in remission or in a low disease activity state. Arthritis Care Res (Hoboken) 2016;68:1043–8.[7]Druce K, Jones GT, Macfarlane GJ, Verstappen SMM, Basu N. The longitudinal course of fatigue in rheumatoid arthritis: results from the Norfolk Arthritis Register. J Rheumatol 2015;42:2059–65.Disclosure of Interests:None declared

The study aims to determine whether there is an altered bivalent positioning in metaphase I human spermatocytes from Robertsonian translocation carriers.Metaphase I human spermatocytes from three 45,XY,der(13;14)(q10;q10) individuals and a 45,XY,der(14;15)(q10;q10) individual were analyzed. Proximity relationships of bivalents were established by analyzing meiotic preparations combining Leishman staining and multiplex-FISH procedures. Poisson regression model was used to determine proximity frequencies between bivalents and to assess associations with chromosome size, gene density, acrocentric morphology, and chromosomes with heterochromatic blocks. The hierarchical cluster Ward method was used to characterize the groups of bivalents with preferred proximities in a cluster analysis. Bivalent groups obtained were individually compared with those obtained in normal karyotype individuals evaluated in a previous study.A total of 1288 bivalents were examined, giving a total of 2289 proximity data. Only four positive significant proximities were detected for each type of Robertsonian translocation. Significant bivalent associations were only observed by small-size chromosomes for MI,22,XY,III(13q14q). These results were clearly divergent from 46,XY individuals. Moreover, cluster analysis revealed that about 30 % of the bivalents showed changes in their proximity relationships in metaphase I.The territorial organization of bivalents in metaphase I human spermatocytes changes in the presence of a Robertsonian translocation.

To analyse the prevalence of energy drinks consumption among 4th year high school students in the province of Barcelona (Spain), and its association to sociodemographic characteristics and health related habits.Cross-sectional study including 8078 students from randomly selected high schools in 41 municipalities. Sociodemographic and health characteristics were collected from the Questionnaire on health related habits. Studied variables: energy drinks consumption, sociodemographic characteristics, health related habits and risk behaviours. Descriptive and bivariate analyses were performed. To analyse the factors associated with energy drinks consumption, logistic regression models were used, adjusting by sex and age and considering significance at p-value0.05.30.9% of the sample consumed energy drinks during the last week. According to the model, consumption was higher among men (odds ratio [OR]: 3.29; 95% confidence interval [95%CI]: 2.82-3.83), first generation migrants (OR: 2.46; 95%CI: 2.01-3.03), and children of parents without studies (OR: 3.15; 95%CI: 2.08-4.77). Not having breakfast (OR: 1.53; 95%CI: 1.17-2.00), practising sport (OR: 1.40; 95%CI: 1.11-1.75), regular alcohol (OR: 1.51; 95%CI: 1.19-1.91) and tobacco (OR: 1.79; 95%CI: 1.33-2.41) consumption, and a worse school performance (OR: 2.21; 95%CI: 1.47-3.32), were also risk factors for energy drinks use.Energy drinks consumption is a prevalent habit among adolescents. Its pattern varies depending on sociodemographic characteristics, with gender playing a relevant role. Health related habits and risk behaviours have been associated too to energy drinks use. Further evidence regarding consumption and its risk factors will allow the development of effective preventive strategies.

Aquest estudi analitza els efectes de l’entrenament de força en les extremitats inferiors en un grup de persones grans i les seves repercussions en la qualitat de vida en relació amb la força, flexibilitat, símptomes depressius i percepció de la salut. La mostra, composta per 35 persones, es va dividir en dos grups: l’exercici i el de control. Després de 24 setmanes d’entrenament les participants van ser novament avaluades amb dos salts verticals, el test chair estand, step 2 minuts, chair sit and reach, back scratch, el test Geriatric Depression Scale i el test SF-12. Els resultats en el grup exercici van mostrar una influència positiva del programa de força en els nivells de percepció de salut, símptomes depressius i flexibilitat, mentre que en el grup control van disminuir o es van mantenir, la qual cosa suggereix una relació directa entre l’augment de força i la millora de la qualitat de vida relacionada amb la salut de les persones grans.

Altres ajuts: Universitat Autònoma de Barcelona (CF-180034)

Background Fatigue is a multifactorial and persistent symptom reported by patients with rheumatoid arthritis (RA). It is considered as frequent as pain. It would be of value to identify potential predictive factors of fatigue that can influence on its evolution. Objectives To identify predictive factors of fatigue and of persistent fatigue in a large prospective cohort of early RA patients. Methods The Etude et Suivi des polyarthrites Indifferenciees Recentes (ESPOIR) is a multicenter French cohort of patients with early arthritis. We selected patients fulfilling the 2010 ACR/EULAR criteria for RA during the first year of follow-up. We recorded sociodemographic and clinical characteristics, the SF-36 vitality score, Health Assessment Questionnaire (HAQ) score and 28-joint Disease Activity Score (DAS28) at baseline and every 6 months up to 5 years. The association of fatigue (SF vitality score ≤40) or persistent fatigue (SF vitality score ≤40 at the end of the study and at least in 50% of visits in the 5 years follow up) with other characteristics were evaluated by bivariate logistic regression models/tests (chi-squared test for qualitative variables and t-test/Mann-Whitney test for quantitative variables). A multivariate logistic regression model was used to determine independent predictors of persistent fatigue. Results We included 677 patients (73.4% women, mean ±SD age 48.6±12 years); 46.5%, 28% and 22% of RA patients presented fatigue at baseline, 6 months and 5 years of follow up respectively. At baseline, fatigue was independently and significantly associated with single patients (OR=2.5 95% CI [0.30–0.70] p 3 comorbidity (OR=2.1 95% CI [1.23–3.73] p=0.007), dry syndrome (OR=2.4 95% CI [1.39–4.17] p=0.002), and negativity in RF (OR=1.85 95% CI [1.07–3.21] p=0.027). Conclusions Fatigue was frequent in this cohort of early RA patient, its presence decreased at 6 months and remained stable over time. Baseline fatigue and persistent fatigue were both predicted by functional impairment, negativity of RF and history of depression or anxiety. Disease activity measured by DAS28 was strongly associated to fatigue at baseline but it was not a predictor of persistent fatigue. Disclosure of Interest None declared

Primary biliary cholangitis (PBC) is an autoimmune disease that affects the small bile ducts. The only treatments currently approved in our country are ursodeoxycholic acid (UDCA) and obeticholic acid. Different indices evaluate the response after one year of treatment. The aim of our study was to evaluate the different predictive scores and prognostic factors of response to UDCA.Retrospective single-centre study in which clinical and analytical data of patients diagnosed with PBC were collected from January 1987 to December 2015. The response after one year of treatment was evaluated using the different response scores and their concordance degree using the Kappa index. The area under the receiver operating characteristic curve (AUROC) was calculated to determine the predictive capacity of the scores. Likewise, the prognostic factors of response to treatment were analysed.We included 153 patients. The bivariate analysis showed a statistically significant relationship between the initial high levels of alkaline phosphatase and cholesterol and the poor response to treatment. The best AUROC was in Paris-I score (0.81). The concordance between the different scores was low. The GLOBE score was valid to evaluate the prognosis.Basal alkaline phosphatase and cholesterol were predictors of poor outcome. The best predictive qualitative score in our cohort patients was Paris-I. There was a poor concordance between the different predictive scores. GLOBE score is valid to evaluate prognosis.

The present study describes the virological and serological profiles of PCV2 vaccinated (V) and non-vaccinated (NV) piglet subpopulations coming from V and NV sows in a PCV2 subclinically infected farm. Four hundred seventy-six piglets born from V or NV sows were further subdivided in a total of four groups: NV sows–NV pigs (NV–NV), NV sows–V pigs (NV–V); V sows–NV pigs (V–NV) and V sows–V pigs (V–V). Seventy-five pigs were randomly selected at the beginning of the trial from each group and they were bled at 4, 8, 12, 16, 21 and 25 weeks of age. All animals included in the trial were weighed at 4 and 25 weeks of age and their average daily weight gain (ADWG) was calculated. Serum samples obtained at different time points were used to assess PCV2 infection (viremia) and the level of antibodies by means of immunoperoxidase monolayer assay (IPMA) against this pathogen. IPMA titers (classified in high, medium or low) and PCR results (positive or negative) were analyzed using a multiple correspondence and K-means cluster analysis. According to these tests, animals included in the study were classified into the following four clusters: (1) 93 piglets that were viremic mainly from 12 to 25 weeks of age and with PCV2 antibody titers increasing over time; (2) 75 piglets with late PCV2 infection and seroconversion (later than 16 weeks of age); (3) 26 piglets with high but decreasing PCV2 antibody titers and low percentages of PCV2 PCR positive serum samples; and (4) 105 piglets with medium and high IPMA titers throughout the trial and sporadic PCR positive samples. The defined subpopulations of piglets were observed in all experimental groups (NV–NV, NV–V, V–NV and V–V) although in variable percentages. Thus, animals from clusters 1 and 2 belonged mainly to the NV–NV and V–NV groups and animals from clusters 3 and 4 were distributed mainly into the NV–V and V–V groups. Finally, the ADWG of pigs belonging to clusters 3 and 4 was significantly higher (p = 0.02) than that of pigs belonging to clusters 1 and 2. Within each cluster, no statistically significant differences were found in ADWG between treatment groups. The field study was supported by MSD Animal Health and the experimental design as well as the results were discussed together with scientists at MSD Animal Health and CReSA.

Background and aim Treatment of hepatitis C with direct-acting antiviral agents (DAA) has few side effects. Although pivotal studies suggested that DAA were safe in patients with psychiatric diseases who could not be treated with previous antiviral therapies, their effects on anxiety and depression have not yet been analysed in clinical practice. The aim of our study was to analyse anxiety and depression in the setting of DAA treatment in a clinical practice series. Methods All patients starting DAA treatment between November 1, 2014 and October 31, 2015 were eligible. Patients completed the Hospital Anxiety and Depression scale at different times during treatment. The results were plotted on line graphs and evaluated using a linear regression model with repeated measures. Results One hundred and forty-five patients were included (11% with major psychiatric disorders; 32% on psychiatric treatment). Sustained virologic response (SVR) was achieved in 97.3% of cases. Anxiety and depression measures did not differ between time points. No differences between patients on psychiatric treatment or with advanced fibrosis or cirrhosis were found at any time point analysed. Conclusion DAA treatment had no impact on anxiety or depression during or after chronic hepatitis C infection treatment, even in high-risk patients with major psychiatric disorders.

In the context of chronic illness, the individual&rsquo, s social and relational environment plays a critical role as it can provide the informal support and care over time, beyond healthcare and social welfare institutions. Social Network Analysis represents an appropriate theoretical and methodological approach to study and understand social support since it provides measures of personal network structure, composition and functional content. The aim of this mixed method study is to present the usefulness of Personal Network Analysis to explore social support in the context of chronic pain. Personal and support network data of 30 people with chronic pain (20 alters for each ego, 600 relationships in total) were collected, obtaining measures of personal network structure and composition as well as information about social support characteristics. Also, semi-structured interviews with participants were conducted to identify the context of their experience of pain, their limitations as regards leading an autonomous life, their social support needs and other aspects concerning the effect of pain on their social and relational lives. This approach shows the importance of non-kin social support providers and the significant role of non-providers in the personal networks of people suffering chronic pain.

BACKGROUND: Osteoarthritis (OA) is the most prevalent joint pathology and an important cause of disability among people over 65 years of age. Following total knee replacement (TKR), which may be the only curative intervention, function is mainly affected by quadriceps weakness whose extent can accurately be assessed using isokinetic dynamometry. AIM: To evaluate the association between the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Hospital for Special Surgery Score (HSS) scores and knee muscle isokinetic strength and fatigue findings in TKR patients 2–5 years postoperatively as well as assess the reproducibility and validity of the isokinetic test findings in this cohort. DESIGN: Twenty-four women who underwent TKR filled in the WOMAC and HSS questionnaires. The isokinetic test was carried out at 120 and 180 ◦ /s in concentric flexion/extension. The maximal isokinetic strength was evaluated as the peak torque (PT). Isokinetic fatigue was measured using the fatigue index and calculated based on 40 repetitions at 120 ◦ /s. The same protocol was performed 7 days apart. Test-retest reproducibility was analyzed using intraclass correlation coefficient (ICC), the standard error of measurement (SEM) and Bland Altman plots. HSS and WOMAC internal consistency was tested with Cronbach’s alpha; questionnaire validity and correlations were obtained using Spearman’s rho. RESULTS: The HSS Function sub-score was significantly correlated with quadriceps PT but not with fatigue isokinetic scores. Excellent reproducibility was indicated for all outcome measures, with the exception of the HSS Knee subscore and the fatigue index. CONCLUSIONS: Isokinetic dynamometry of the quadriceps can provide objective and useful information regarding the functional status of patients following TKR due to OA of the knee.

Introducción: Los programas de fuerza han demostrado ser beneficiosos para minimizar los efectos de lasarcopenia, aunque los protocolos de intervención presentan características y contenidos en ocasionesmuy diferentes. El objetivo de este estudio fue verificar la influencia de un determinado protocolo defuerza en ancianos.Material y métodos: Treinta y cinco sujetos participaron en el estudio, 18 en el grupo ejercicio (4 varones y14 mujeres) y 17 en el grupo control (4 varones y 13 mujeres), con una media de edad de 73 a˜nos. Los delgrupo ejercicio realizaron un entrenamiento de fuerza a velocidad moderada-alta durante 24 semanas. Sevaloró la fuerza mediante el test chair stand, step de 2 min, y 2 saltos verticales, la fuerza explosiva o squatjump (SJ) y la fuerza elástico-explosiva o countermovement jump (CMJ). Adicionalmente se compararonlas caídas de los 2 grupos, antes y después de la intervención, y su relación con la variable chair stand.Resultados: Se observó una tendencia de mejora en todas las pruebas a excepción del CMJ, mientras queen el grupo control la tendencia fue en el sentido contrario. Al final de la intervención la comparaciónentre grupos es significativa en todas las pruebas. Se evidenciaron relaciones inversas entre la variablede fuerza chair stand y el número de caídas.Conclusiones: Según con los resultados obtenidos se observó una influencia positiva del entrenamientotanto en la fuerza de los ancianos como en la reducción del número de caídas, aumentado al final de laintervención, la distancia que separa el grupo que entrenó y el grupo control. Introduction: Strength programs have been seen to be useful in minimizing the effects of sarcopenia,although intervention protocols may vary in their content and characteristics. The aim of this study wasto demonstrate the influence of a particular strength protocol for the elderly.Material ans methods: A total of 35 individuals took part in the study, with 18 in the exercise group(4 men and 14 women), and 17 in the control group (4 men and 13 women). The average age was 73.The exercise group carried out a strength training program at moderate to high intensity over 24 weeks.Strength was evaluated using the chair stand test, 2-minute step and 2 vertical jumps-squat jump (SJ), andcountermovement jump (CMJ). Falls in both groups were also compared before and after the intervention,as well as their relationship with the chair stand variable.Results: A tendency towards improvement was observed in all tests, with the exception of CMJ; while thecontrol group showed a tendency in the opposite direction. Contrast between the two groups at the endof the intervention was notable in all the tests. An inverse relationship between the chair stand strengthvariable and the number of falls was evident.Conclusions: According to the results achieved, the training was perceived to exercise a positive influenceon both the strength of the elderly people and a reduction of the number of falls. The gap between thetwo groups widened towards the end of the intervention.

Background Suicide is the primary cause of unnatural death in Spain, and suicide re-attempts a major economic burden worldwide. The risk factors for re-attempt and suicide after an index suicide attempt are different. This study aims to investigate risk factors for re-attempt and suicide after an index suicide attempt. Methods This observational study is part of a one-year telephone management program. We included all first-time suicide attempters evaluated in the emergency department at Parc Taulí-University Hospital (n = 1241) recruited over a five-year period (January 2008 to December 2012). Suicide attempters were evaluated at baseline using standardized instruments. Bivariate logistic regression models were used to identify risk factors. Kaplan-Meier curves were used to compare the time to re-attempt between categorical variables. Comparisons were performed using Log-Rank and Wilcoxon tests. Variables with a p-value lower than 0.2 were included in a multivariate Cox regression model. Bivariate logistic regression models were considered to identify risk factors for suicide. The significance level was set to 0.05. Results Suicide re-attempters were more likely diagnosed with cluster B personality disorders (36.8% vs. 16.6%; p

Imaging devices such as the Heidelberg retinal tomograph-3 (HRT3), scanning laser polarimetry (GDx), and optical coherence tomography (OCT) play an important role in glaucoma diagnosis. A systematic search for evidence-based data was performed for prospective studies evaluating the diagnostic accuracy of HRT3, GDx, and OCT. The diagnostic odds ratio (DOR) was calculated. To compare the accuracy among instruments and parameters, a meta-analysis considering the hierarchical summary receiver-operating characteristic model was performed. The risk of bias was assessed using quality assessment of diagnostic accuracy studies, version 2. Studies in the context of screening programs were used for qualitative analysis. Eighty-six articles were included. The DOR values were 29.5 for OCT, 18.6 for GDx, and 13.9 for HRT. The heterogeneity analysis demonstrated statistically a significant influence of degree of damage and ethnicity. Studies analyzing patients with earlier glaucoma showed poorer results. The risk of bias was high for patient selection. Screening studies showed lower sensitivity values and similar specificity values when compared with those included in the meta-analysis. The classification capabilities of GDx, HRT, and OCT were high and similar across the 3 instruments. The highest estimated DOR was obtained with OCT. Diagnostic accuracy could be overestimated in studies including prediagnosed groups of subjects.

The objective of the present work was to elucidate the potential relationship between Mycoplasma hyopneumoniae infection and seroconversion dynamics and climatological conditions in four groups of pigs from the same farm born in different seasons of the year. Nasal swabs and blood samples were taken from 184 pigs at 1, 3, 6, 9, 12, 15, 18, 22 and 25 (slaughter age) weeks of age. Outside climatologic parameters, including temperature (°C), relative humidity (%), precipitation (l/m(2)) and wind speed (m/s) were recorded weekly from January 2003 to June 2004. Percentage of nPCR detection of M. hyopneumoniae in nasal swabs was associated significantly with the weekly precipitation rate [P = 0.0018, OR = 1.31 (IC = 1.11-1.55)]; the higher the precipitation rate, the higher the probability of being M. hyopneumoniae nPCR-positive. On the other hand, the percentage of seropositive pigs had a significant association with mean weekly temperature rate [P = 0.0012, OR = 0.89 [IC = 0.84-0.95]); the lower the temperature, the higher the probability of being M. hyopneumoniae seropositive. Animals born in autumn (when higher precipitations rates were recorded), entering finishing units in winter (when lower temperatures were recorded), and reaching slaughter in spring, had the highest probability of being infected by M. hyopneumoniae and the highest probability of being M. hyopneumoniae seropositive.

The purpose of this study was to evaluate the use of a compression garment as DOMS prevention. This was accomplished by provoking a DOMS in 15 athletes, running on a treadmill at 73% of their maximal aerobic velocity, during 40 minutes with a 10% negative slope; wearing the compression garments on one thigh, protected thigh (PT), and not in the contralateral thigh, control thigh (CT). A clinical and MRI diagnosis of DOMS was performed. Biopsies in both vastus lateralis were done, and the amount and severity of the DOMS was estimated by measuring intracellular albumin, and lymphocytes CD3+ and neutrophils intra/interfibrilar infiltrates, 48h after the induced damaging exercise. There was less total injury in the PT than in the CT, a 26.7% average. These data indicate that this compression garment is an effective method to reduce the histological injury in DOMS.

A serosurvey on porcine reproductive and respiratory syndrome virus (PRRSV), swine influenza virus (SIV), Aujeszky's disease virus gE protein (ADV gE), porcine parvovirus (PPV) and porcine circovirus type 2 (PCV2) was carried out in Spanish pig herds. The serosurvey consisted of two studies. First, a retrospective study assessed the proportion of seropositive boar, sow and fattening pig herds and their seroprevalences to PRRSV, SIV, ADV gE and PPV from 2003 to 2005 and to PCV2 from 2000 to 2005. Such information was obtained from routine serologic analyses from two veterinary diagnostic laboratory services. Second, a cross-sectional study in sow and fattening pig herds from 44 farms (without vaccination interferences on serologic analyses) was performed to provide information on seroprevalences and co-seropositivity to PRRSV, SIV, ADV gE and PCV2 (PPV was excluded because of widespread vaccination) and to elucidate their relationships with farm characteristics, management and productive parameters. Similar seroprevalences were observed in both studies, although some variations were obtained, probably because of vaccination schedules, number of tested sera, sampling age and regional variations. Percentage of PRRSV and SIV seropositive herds was over 85% for sows, around 80% for fatteners and around 50% for boar studs. The proportion of ADV gE seropositive sow herds decreased from 41% to 30% between 2003 and 2005, whereas such decrease was from 41% to 33% in fattening pig herds and from 13% to 4% in boar studs PCV2 antibodies were widespread as well as those against PPV; in the latter case, if antibodies were elicited by infection and/or vaccination was not assessed. Concurrent presence of PCV2, PRRSV and SIV antibodies was found in 89% and 66% sow and fattening herds, respectively. No statistical associations were obtained between seroprevalences or co-seropositivity and farm characteristics, management or productive parameters.

A meta-analysis was performed with the aim to identify factors with a relevant influence on the expression of clinical postweaning multisystemic wasting syndrome (PMWS) under experimental conditions. Data from 44 studies were included in the analysis. Several variables were studied: number of pigs in the experiment, intake of colostrum, serological status against porcine circovirus type 2 (PCV2), strain of PCV2 used for inoculation, the route and dose of inoculation, and use of potential triggering factors (such as co-infections, vaccinations, or immunomodulator products). Multiple correspondence analysis and log-linear regression methods were used to establish the relationships between the studied variables and the number of PCV2 infected pigs that developed PMWS. Based on the results of the meta-analysis, the most successful animal experiment aimed to develop PMWS should include: (1) colostrum-deprived pigs, (2) age of inoculation below 3 weeks, (3) high doses of PCV2 inoculum, (4) PCV2 strain from genotype 1, and (5) co-infection with another swine pathogen as a triggering factor.

A field trial was conducted to study Mycoplasma hyopneumoniae (Mh) infection dynamics by nested polymerase chain reaction (nPCR) and serology in pigs of a farm affected by enzootic pneumonia (EP). Moreover, correlation of Mh detection at different respiratory tract sites with presence of EP gross and microscopic lung lesions was assessed. These parameters were studied and compared between vaccinated (two doses at 1 and 3 weeks of age versus one dose at 6 weeks of age) and non-vaccinated pigs. Animals were monitored from birth to slaughter by nPCR from nasal swabs and by serology. From 3 to 22 weeks of age, an average of three pigs per treatment and per batch were necropsied (n = 302). The remaining pigs were sent to the slaughter (n = 103). Nasal, bronchial and tonsillar swabs were taken from the necropsied/slaughtered pigs; gross and microscopic EP-suggestive lung lesions were also assessed. Single and double vaccination resulted in earlier seroconversion and higher percentage of Mh seropositive pigs compared to control group. At slaughter, double vaccinated pigs showed lower percentage of EP-compatible gross lung lesions and lower Mh prevalence at upper respiratory tract sites (nasal cavity and tonsil) than control pigs.