Search

Abstract The access of public omics-based datasets is of paramount importance in brain cancer research as allows the proposal and validation of both biomarkers and therapeutic targets in gliomas, especially in the most prevalent and aggressive glioblastomas. Taking profit of current advances in next generation sequencing and DNA methylation profiling, we have created datasets from approximately 150 formalin-fixed paraffin embedded (FFPE) tumours. These datasets enable for the first time integrative transcriptional and epigenetics studies in a context that consider the degradation and fixation-derived chemical alterations of the most extended archiving format in hospitals, and provide an independent cohort from current public databases for further validation of putative novel biomarkers. Alongside with the most profusely known glioblastomas, astrocytomas and oligodendrogliomas, we have also included for comparison purposes few examples of rare tumours that are often neglected in brain cancer research. Taken together, we provide a valuable tool to explore combined gene expression and DNA methylation patterns in the study of gliomas and glioneuronal tumours.

En el presente trabajo se ofrece una aproximación a los efectos del cambio climático en Almansa. Esta se realiza contando con diferentes aspectos, entre los que destacan una serie de objetivos que se desarrollan a lo largo de todo el documento así como otros conceptos relacionados con el cambio climático. Asimismo, se consideran elementos importantes como la legislación vigente aplicada a diferentes escalas (europea, nacional, regional y local) y sus propuestas de adaptación y mitigación frente a los impactos del cambio climático. Todo ello se explica teniendo en cuenta el clima local de Almansa y su evolución, además de las zonas verdes que presenta. Finalmente, se muestra cuál es la situación actual de la localidad albaceteña en términos de infraestructura verde y la posible concreción de algunas de las medidas indicadas en los documentos estratégicos y legislativos de escalas superiores.

En este trabajo profundizamos en el examen y sistematización de algunos aspectos de la protohistoria de la Historia del Arte como disciplina escolar para que pueda rastrearse posteriormente su cambio y continuidad en su devenir propiamente escolar. Para ello nos retrotraemos a la Ilustración y la enseñanza de la Historia del Arte en las Academias de Bellas Artes, cuyos productos derivados tendrán una destacada influencia en la conformación de toda una serie de discursos, usos y prácticas que pasarán a ser definidores de una tradición (posteriormente) escolar. El artículo, así, trata de integrar algunos de los estudios previos que se han ocupado del particular y profundiza en algunas de sus fuentes de referencia, especialmente en el manual de José de Manjarrés y Bofarull (1859) dirigido a la formación de los futuros artistas. La conclusión apunta una incipiente enseñanza de la Historia del Arte caracterizada por una visión teleológica tendente a la canonización de ciertos contenidos, con un discurso construido sobre la base de determinados etnocentrismos.

Abstract The heterogeneity of systemic lupus erythematosus (SLE) can be explained by epigenetic alterations that disrupt transcriptional programs mediating environmental and genetic risk. This study evaluated the epigenetic contribution to SLE heterogeneity considering molecular and serological subtypes, genetics and transcriptional status, followed by drug target discovery. We performed a stratified epigenome-wide association studies of whole blood DNA methylation from 213 SLE patients and 221 controls. Methylation quantitative trait loci analyses, cytokine and transcription factor activity - epigenetic associations and methylation-expression correlations were conducted. New drug targets were searched for based on differentially methylated genes. In a stratified approach, a total of 974 differential methylation CpG sites with dependency on molecular subtypes and autoantibody profiles were found. Mediation analyses suggested that SLE-associated SNPs in the HLA region exert their risk through DNA methylation changes. Novel genetic variants regulating DNAm in disease or in specific molecular contexts were identified. The epigenetic landscapes showed strong association with transcription factor activity and cytokine levels, conditioned by the molecular context. Epigenetic signals were enriched in known and novel drug targets for SLE. This study reveals possible genetic drivers and consequences of epigenetic variability on SLE heterogeneity and disentangles the DNAm mediation role on SLE genetic risk and novel disease-specific meQTLs. Finally, novel targets for drug development were discovered.

Abstract Emergency medical services (EMSs) face critical situations that require patient risk classification based on analytical and vital signs. We aimed to establish clustering-derived phenotypes based on prehospital analytical and vital signs that allow risk stratification. This was a prospective, multicenter, EMS-delivered, ambulance-based cohort study considering six advanced life support units, 38 basic life support units, and four tertiary hospitals in Spain. Adults with unselected acute diseases managed by the EMS and evacuated with discharge priority to emergency departments were considered between January 1, 2020, and June 30, 2023. Prehospital point-of-care testing and on-scene vital signs were used for the unsupervised machine learning method (clustering) to determine the phenotypes. Then phenotypes were compared with the primary outcome (cumulative mortality (all-cause) at 2, 7, and 30 days). A total of 7909 patients were included. The median (IQR) age was 64 (51–80) years, 41% were women, and 26% were living in rural areas. Three clusters were identified: alpha 16.2% (1281 patients), beta 28.8% (2279), and gamma 55% (4349). The mortality rates for alpha, beta and gamma at 2 days were 18.6%, 4.1%, and 0.8%, respectively; at 7 days, were 24.7%, 6.2%, and 1.7%; and at 30 days, were 33%, 10.2%, and 3.2%, respectively. Based on standard vital signs and blood test biomarkers in the prehospital scenario, three clusters were identified: alpha (high-risk), beta and gamma (medium- and low-risk, respectively). This permits the EMS system to quickly identify patients who are potentially compromised and to proactively implement the necessary interventions.

Objectives Point-of-care testing available in prehospital settings requires the establishment of new medical decision points. The aim of the present work was to determine the cut-off of the lactate threshold that activates alert triggers for all-cause 2-day mortality.Design Multicentre, prospective, ambulance-based, observational study.Setting Patients treated via emergency medical services (EMSs) and delivered to the emergency department between 2019 and 2023 were selected in Spain.Participants Adults with any acute disease.Primary and secondary outcome measures Epidemiological data, vital signs and prehospital point-of-care glucose and lactate levels were obtained. The outcome was all-cause 2-day in-hospital mortality. The cut-offs were obtained via three different methods: (i) indirect (which considers survivors and non-survivors), direct (which considers only survivors) assessment and lactate quartile. Additionally, the quartile approach was used to determine the differences in lactate distribution between survivors and non-survivors. Three different back-to-back studies with the same methodology were used.Results A total of 11 713 patients fulfilled the inclusion criteria. The mortality rate was 4.6% (542 patients). The difference in the median prehospital lactate concentration (mmol/L) between survivors and non-survivors was statistically significant (p

La ética, la filosofía y la ciencia han permitido a la humanidad resolver los desafíos más complejos a lo largo de su historia. La dignidad humana es el fin ulterior de una civilización, tanto el Renacimiento como la Ilustración sintetizan lo mejor de la ciencia y el pensamiento. Por la ciencia y la dignidad humana llegaron la genética, la digitalización, la neurociencia y la computación cognitiva, que trasladan hoy la civilización humana hacia la cuarta revolución industrial. En la dignidad humana se hace imperativo reconocer el legado auténtico de Adam Smith. Sus mayores críticos no han leído su teoría del sentimiento moral, y sus mayores defensores desacreditan que Smith fuera ante todo humanista, luego economista. Los directivos más avezados abrazarán un capitalismo comprometido con la dignidad humana, sin complejos. Este ensayo enlaza capitalismo y tecnología, para enaltecer la privacidad y el trabajo digno. Recibido: 30 mayo 2024 Aceptado: 07 septiembre 2024

Summary: Background: The World Health Organisation (WHO) has identified a range of symptomatic manifestations to aid in the clinical diagnosis of post-COVID conditions, herein referred to as post-acute COVID-19 symptoms. We conducted an international network cohort study to estimate the burden of these symptoms in North American, European, and Asian populations. Methods: A federated analysis was conducted including 10 databases from the United Kingdom, Netherlands, Norway, Estonia, Spain, France, South Korea, and the United States, between September 1st 2020 and latest data availability (which varied from December 31st 2021 to February 28th 2023), covering primary and secondary care, nationwide registries, and claims data, all mapped to the Observational Medical Outcomes Partnership Common Data Model (OMOP CDM). We defined two cohorts for the main analyses: a SARS-CoV-2 infection cohort [positive polymerase chain reaction (PCR) or rapid lateral flow test (LFT) result or clinical COVID-19 diagnosis] and a general population cohort. Individuals with less than 365 days of prior history or 120 days of follow-up were excluded. We estimated incidence rates (IRs) of the 25 WHO-proposed post-acute COVID-19 symptoms, considering symptoms that occurred ≥90 and ≤365 days after index date, excluding individuals with the respective symptoms 180 days prior to the index event. Stratified analyses were conducted by age and sex. Incidence rate ratios (IRRs) were calculated comparing rates in the infected cohort versus the general population. Results from the different databases were combined using random-effects meta-analyses. Findings: 3,019,408 individuals were included in the infection cohort. 1,585,160 of them were female and 1,434,248 of them male. 929,351,505 individuals were included in the general population group. 461,195,036 of them were female and 466,022,004 of them male. The 1-year IR of any post-acute COVID-19 symptom in the COVID-19 infection cohort varied significantly across databases, from 4.4 (95% CI 3.8–5.1) per 100 person-years to 103.9 (95% CI 103.2–104.7). The five most common symptoms were joint pain (from 1.6 (95% CI 1.3–1.9) to 14.3 (95% CI 14.1–14.6)), abdominal pain (from 0.3 (95% CI 0.1–0.5) to 9.9 (95% CI 9.7–10.1)), gastrointestinal issues (from 0.6 (95% CI 0.4–0.9) to 13.3 (95% CI 13.1–13.6)), cough (from 0.3 (95% CI 0.2–0.5) to 9.1 (95% CI 8.9–9.3)), and anxiety (from 0.8 (95% CI 0.6–1.2) to 11.4 (95% CI 11.2–11.6)); whereas muscle spasms (from 0.01 (95% CI 0.008–0.2) to 1.7 (95% CI 1.6–1.8)), pins and needles (from 0.05 (95% CI 0.03–0.0.9) to 1.5 (95% CI 1.4–1.6)), memory issues (from 0.03 (95% CI 0.02–0.06) to 0.8 (95% CI 0.7–0.8)), cognitive dysfunction (from 0.007 (95% CI 0.004–0.01) to 0.6 (95% CI 0.4–0.8)), and altered smell and/or taste (from 0.04 (95% CI 0.03–0.04) to 0.7 (95% CI 0.6–0.8)) were least common. Incidence rates of any post-acute COVID-19 symptoms generally increased with age, with certain symptoms peaking in middle-aged adults (anxiety, depressive disorders, headache, altered smell and taste) and others in pre-school children (gastrointestinal issues and cough). Females had higher incidence rates for most symptoms. Based on the random-effects model, the infected cohort had a higher incidence of any post-acute COVID-19 symptom than the general population, with a meta-analytic incidence rate ratio (meta-IRR) of 1.4 (1–2). A similar pattern was seen for all individual symptoms. The highest meta-IRRs were depressive disorder, 2.6 (1.7–3.9); anxiety, 2.3 (1.4–3.8); allergy, 2.1 (1.7–2.8) and sleep disorders, 2.1 (1.5–2.6). The meta-IRR for altered smell and/or taste was 1.9 (1.3–2.8). Interpretation: Post-acute COVID-19 symptoms, as listed by the WHO, were commonly observed following COVID-19 infection. However, even after standardising research methods, there was significant heterogeneity in the incidence rates from different healthcare settings and geographical locations. This is the first international study of the epidemiology of post-acute COVID-19 symptoms using the WHO-listed symptoms. Its findings contibute to understand the epidemiology of this condition from a multinational approach. Limitations of this study include the lack of consensus of the post-acute COVID-19 definition, as well as the difficulty to capture the impact on daily life of the post-acute COVID-19 symptoms in the available datasets. Funding: This work has been funded by the European Health Data Evidence Network (EHDEN) through an Evidence Generation Fund Grant and by the National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre (BRC).

Abstract This study aimed to investigate the dementia risk associated with mild behavioral impairment (MBI) and its domains in older community‐dwelling individuals. A total 4803 community‐dwelling individuals aged over 55 years were followed for 4.5 years (ZARADEMP study). MBI was assessed according to the International Society to Advance Alzheimer's Research and Treatment (ISTAART) diagnostic criteria using the Geriatric Mental State (GMS). Odds ratios (OR) for incident dementia and Alzheimer's disease (AD) were determined using logistic regression models adjusted for potential confounders (such as age, disability, or vascular disease). In cognitively normal individuals, decreased motivation was the only MBI domain that was associated with an increased risk of all‐cause dementia (OR: 2.30 [95% confidence interval {CI}: 1.16‐4.61]) in multivariable analyses, although the increase in the risk of AD was not statistically significant. Our findings suggest that decreased motivation may be a phenotypic marker for individuals at risk of dementia. Further research is required to evaluate the association between MBI domains and different types of dementia.

The Break4Brain project aims to elucidate the effects of both acute and chronic physical activity (PA) on educational achievement in children with and without Attention Deficit Hyperactivity Disorder (ADHD). This study will be conducted in two phases: a cross-over design followed by a hybrid type 1 implementation-effectiveness trial, which includes both a cluster randomized controlled trial (RCT) and a qualitative study. In phase I, 60 children aged 10–12, with 30 each from ADHD and non-ADHD groups, will participate in a laboratory-based study over 4 days within 1 month. They will participate in three counterbalanced experimental conditions: (i) PA with cognitive engagement, (ii) PA without cognitive engagement, and (iii) a cognitively engaging control. This phase will assess acute changes in brain function, academic performance, working memory, inhibitory control, and sustained attention. Phase II will involve 600 children aged 10–12, randomly assigned to either a video-based PA program or a control group (300 children per group) in an 8-week cluster RCT. This phase will also incorporate a qualitative approach to explore the implementation context through pre- and post-intervention semi-structured interviews with teachers and school staff, and questionnaires for students. The outcomes of interest in this phase will include working memory, cognitive flexibility, selective attention, and academic performance. For the cross-over study, we hypothesize that PA conditions will enhance the studied outcomes compared to the control condition. In the RCT, we anticipate that the 8-week active breaks program will result in significant improvements in the selected outcomes compared to the control group. This study is expected to make pioneering contributions by including novel variables and focusing on the ADHD population. Furthermore, if the cluster RCT proves effective, it could offer a practical and cost-effective resource for integrating active breaks into daily school routines.

Resumen Son ya numerosos los heurísticos que han servido al estudio sociogenético de la realidad escolar y de las materias enseñadas. Para sistematizar el potencial conjunto de los mismos se hace necesario realizar un balance y repensar, a partir de sus aportaciones, un marco teórico-metodológico que permita avanzar en el desarrollo del campo de estudio, contemplando la complejidad de relaciones que se dan en la existencia y devenir de las asignaturas escolares y relacionándola con la posibilidad de cambio educativo. El presente artículo ha revisado, pues, los estudios fundacionales y reflexiones posteriores en torno a algunos de estos heurísticos, señalando su naturaleza, debilidades, potencialidades y posibilidades de interrelación.

Reseñas iberoamericanas

Los recursos didácticos digitales son facilitares del proceso de enseñanza aprendizaje a los cuales se les deriva una analítica del aprendizaje que corrobore sus ponderaciones de crecimiento en los estudiantes. El objetivo de la investigación es aplicar la analítica del aprendizaje utilizando el recurso didáctico digital, Canva, para la transformación de la calidad académica en la asignatura de Estudios Sociales. Se utilizó una metodología cuantitativa por la finalidad que persigue la investigación la cual demuestra que el recurso didáctico digitales mejora la calidad de la docencia, los métodos teóricos fueron el analítico sintético y el inductivo deductivo y desde la empírea, los métodos estadísticos matemáticos. Los resultados fundamentales fueron que las actividades donde se utilizó, Canva, como recurso didáctico digital los resultados en la calidad de las evaluaciones fueron superior a los obtenidos cuando se utilizó la metodología tradicional, debido a la motivación y a los métodos activos de enseñanza utilizados con el medio de enseñanza.

La Osteología como asignatura necesita de las mediciones sistemáticas a través de la analítica del aprendizaje con el uso de los recursos didácticos digitales en función del seguimiento individual de los estudiantes. El objetivo de la presente investigación es evaluar los resultados académicos obtenidos por la plataforma interactiva (Moodle) utilizando la analítica del aprendizaje para la mejora del proceso de enseñanza aprendizaje de la osteología. La investigación se sustenta en un paradigma de investigación educativa positivista, donde la metodología utilizada fue la cuantitativa. Los resultados fundamentales están dados, a partir del análisis de los datos, que el estadístico de la media esta desde el punto de vista descriptivo por encima en todas las actividades donde se ha utilizado metodología aplicando los recursos didácticos digitales versus (vs) metodología tradicional lo cual fue corroborado por los gráficos utilizados y desde el punto de vista inferencial, pues en todas las comparaciones de ambas distribuciones, bajo el supuesto normalidad, existió diferencias significativas entre ambas. Se ha podido concluir la investigación que al evaluar los resultados académicos obtenidos con el uso de los recursos didácticos digitales ha sido superior que utilizando la metodología tradicional.

At this moment in time, Alzheimer’s disease (AD) remains one of the most pressing public health problems [...]

We have characterized the magnetization easy-axis of ultra-thin Co films (2–5 atomic layers, AL) grown on Ru(0001) when they are capped with a monolayer of Pd. The addition of a Pd monolayer turns the magnetization of 3 and 4 AL-thick Co films from an in-plane to an out-of-plane alignment, but not that of a 5 AL-thick film. These observations are explained in terms of an enhancement of the surface anisotropy. The exposure of the sample to hydrogen, CO or a combination of both gases does not overcome this effect.

Nanoparticle uptake by cells is a key parameter in their performance in biomedical applications. However, the use of quantitative, non-destructive techniques to obtain the amount of nanoparticles internalized by cells is still uncommon. We have studied the cellular uptake and the toxicity of core-shell maghemite-silica magnetic nanoparticles (MNPs), with a core diameter of 9 nm and a shell thickness of 3 nm. The internalization of the nanoparticles by mouse neuroblastoma 2a cells was evaluated by sensitive and non-destructive Superconducting Quantum Interference Device (SQUID) magnetometry and corroborated by graphite furnace atomic absorption spectroscopy. We were thus able to study the toxicity of the nanoparticles for well-quantified MNP uptake in terms of nanoparticle density within the cell. No significant variation in cell viability or growth rate was detected for any tested exposure. Yet, an increase in both the amount of mitochondrial superoxide and in the lysosomal activity was detected for the highest concentration (100 μg ml−1) and incubation time (24 h), suggesting the onset of a disruption in ROS homeostasis, which may lead to an impairment in antioxidant responses. Our results validate SQUID magnetometry as a sensitive technique to quantify MNP uptake and demonstrate the non-toxic nature of these core-shell MNPs under our culture conditions.

The evolution towards Smart Cities is the process that many urban centers are following in their quest for efficiency, resource optimization and sustainable growth. This step forward in the continuous improvement of cities is closely linked to the quality of life they want to offer their citizens. One of the key issues that can have the greatest impact on the quality of life of all city dwellers is the quality of the air they breathe, which can lead to illnesses caused by pollutants in the air. The application of new technologies, such as the Internet of Things, Big Data and Artificial Intelligence, makes it possible to obtain increasingly abundant and accurate data on what is happening in cities, providing more information to take informed action based on scientific data. This article studies the evolution of pollutants in the main cities of Castilla y León, using Generative Additive Models (GAM), which have proven to be the most efficient for making predictions with detailed historical data and which have very strong seasonalities. The results of this study conclude that during the COVID-19 pandemic containment period, there was an overall reduction in the concentration of pollutants.

Background: Prehospital emergency medical services (EMS) are the main gateway for trauma patients. Recent advances in point-of-care testing and the development of early warning scores have allowed EMS to improve patient classification. We aimed to identify patients presenting with major trauma involving life-saving interventions (LSI) using the modified Sequential Organ Failure Assessment (mSOFA) score in the prehospital scenario, and to compare these results with those of other trauma scores. Methods: This was a prospective, ambulance-based, multicenter, training-validation study in trauma patients who were treated in a prehospital setting and subsequently transported to a hospital. The study involved six Advanced Life Support units, 38 Basic Life Support units, and four hospitals. The primary outcome was LSI performed at the scene or en route and intensive care unit (ICU) admission and all-cause two-day in-hospital mortality. We collected epidemiological variables, creatinine, lactate, base excess, international normalized ratio, and vital signs. Discriminative power (area under the receiver operating characteristic curve [AUC]), calibration (observed vs predicted outcome agreement), and decision-curve analysis (DCA, clinical utility) were used to assess the reliability of the mSOFA in comparison to other scores. Results: Between January 1, 2020–April 30, 2022, a total of 763 patients were selected. The mSOFA score’s AUC was 0.927 (95% confidence interval [CI] 0.898–0.957) for LSI, 0.845 (95% CI 0.808–0.882) for ICU admission, and 0.979 (95% CI 0.966–0.991) for two-day mortality. Conclusion: The mSOFA score outperformed the other scores, allowing a quick identification of high-risk patients. The routine implementation in EMS of mSOFA could provide critical support in the decision-making process in time-dependent trauma injuries.

The salinity of soils and water for irrigation is a limitation that influences the productivity of crops that has increased worldwide and affects the morphology and physiology of plants since it causes osmotic stress and ionic toxicity and impairs the absorption of water and nutrients. The effect of salt stress on some morphological and physiological traits in Coccoloba uvifera (L.) L. (sea grape) seedlings from different origins was evaluated and the traits whose behavior under salt stress could be used as an effective criterion of tolerance to salinity were determined. A completely randomized design experiment with ten repetitions was performed. The factors under study were salinity (0, 5, 15, and 25 dS m-1), which was maintained for a period of sixteen weeks, and the second factor was the origin of the plant material. The salinity level and the seedlings’ origin significantly influenced the morphological and physiological variables controlled. However, it is necessary to carry out in situ experiments to obtain more information related to the mechanisms used by sea grape to tolerate salinity conditions, because in the consulted sources no research focused on evaluating the effect of salinity and the origin on the morphology and physiology of C. uvifera seedlings in Cuba has been found. The results of the research provide preliminary information to understand the negative effect of salt stress on this type of plant. The behavior of some controlled traits under salt stress can be used as an effective criterion of tolerance to salinity.

Abstract ATP-citrate lyase is a central integrator of cellular metabolism in the interface of protein, carbohydrate, and lipid metabolism. The physiological consequences as well as the molecular mechanisms orchestrating the response to long-term pharmacologically induced Acly inhibition are unknown. We report here that the Acly inhibitor SB-204990 improves metabolic health and physical strength in wild-type mice when fed with a high-fat diet, while in mice fed with healthy diet results in metabolic imbalance and moderated insulin resistance. By applying a multiomic approach using untargeted metabolomics, transcriptomics, and proteomics, we determined that, in vivo, SB-204990 plays a role in the regulation of molecular mechanisms associated with aging, such as energy metabolism, mitochondrial function, mTOR signaling, and folate cycle, while global alterations on histone acetylation are absent. Our findings indicate a mechanism for regulating molecular pathways of aging that prevents the development of metabolic abnormalities associated with unhealthy dieting. This strategy might be explored for devising therapeutic approaches to prevent metabolic diseases.

La analítica del aprendizaje es objeto de múltiples interpretaciones y ponderaciones, en dependencia del análisis y empleo dado a la misma por cada área científica. El objetivo del trabajo es valorar diferentes conceptos de analítica del aprendizaje, formulados por diversos autores para proporcionar una definición incluyente con aquellos componentes de obligada presencia en dicho concepto. La investigación se sostiene en un enfoque cualitativo. Se clasifica como exploratoria. Emplea los métodos heurísticos, histórico- lógico, analítico-sintético, inductivo-deductivo, la crítica interna, el análisis de documentos, la triangulación y la modelación desde la praxis. Los resultados permiten afirmar que las diferentes acepciones del concepto entregadas por los diversos autores, en su mayoría, descargan su peso en el elemento tecno pedagógico, entiéndase Big Data, sin tomar en cuenta de manera suficiente los demás componentes que intervienen en los procesos docente-educativo y de enseñanza-aprendizaje, en los cuales ocurre el verdadero acto de aprendizaje del alumno como ser psico-biológico-social. Se concluye que la analítica del aprendizaje resulta imprescindible para un mejor manejo de las instituciones educativas y, en particular, para el logro de superiores avances en el proceso de enseñanza-aprendizaje, habida cuenta de que esta debe complementarse con datos de índole cualitativa.

Objective The aim was to explore the association of demographic and prehospital parameters with short-term and long-term mortality in acute life-threatening cardiovascular disease by using a hazard model, focusing on elderly individuals, by comparing patients under 75 years versus patients over 75 years of age.Design Prospective, multicentre, observational study.Setting Emergency medical services (EMS) delivery study gathering data from two back-to-back studies between 1 October 2019 and 30 November 2021. Six advanced life support (ALS), 43 basic life support and five hospitals in Spain were considered.Participants Adult patients suffering from acute life-threatening cardiovascular disease attended by the EMS.Primary and secondary outcome measures The primary outcome was in-hospital mortality from any cause within the first to the 365 days following EMS attendance. The main measures included prehospital demographics, biochemical variables, prehospital ALS techniques used and syndromic suspected conditions.Results A total of 1744 patients fulfilled the inclusion criteria. The 365-day cumulative mortality in the elderly amounted to 26.1% (229 cases) versus 11.6% (11.6%) in patients under 75 years old. Elderly patients (≥75 years) presented a twofold risk of mortality compared with patients ≤74 years. Life-threatening interventions (mechanical ventilation, cardioversion and defibrillation) were also related to a twofold increased risk of mortality. Importantly, patients suffering from acute heart failure presented a more than twofold increased risk of mortality.Conclusions This study revealed the prehospital variables associated with the long-term mortality of patients suffering from acute cardiovascular disease. Our results provide important insights for the development of specific codes or scores for cardiovascular diseases to facilitate the risk of mortality characterisation.

En el contexto del cambio de paradigma educativo causado por la pandemia de COVID-19, las principales dificultades que enfrentaron los docentes fue la implementación de los recursos didácticos digitales en la presencialidad. La investigación tuvo como objetivo identificar las dificultades específicas desde la perspectiva y experiencia de los docentes para propiciar la planificación, implementación y evaluación de la enseñanza. La metodología aplicada se fundamenta en el enfoque cualitativo descriptivo, se utilizó los métodos hermenéutico fenomenológico y se aplicó la técnica de la entrevista semi estructurada, cuyo instrumento tuvo su validación de contenido por juicio de expertos sobre la pertinencia, claridad e importancia del tema tratado. La muestra para este estudio fue no probabilística por conveniencia en la que se seleccionó a ocho docentes de Educación General Básica Superior pertenecientes a dos instituciones educativas. Los resultados analizados se clasificaron en tres categorías: Dificultades en la planificación y uso de recursos didácticos digitales, desafíos en la implementación, limitaciones técnicas y el avance en la interacción y rendimiento académico. Se concluye que la implementación de recursos didácticos digitales en la enseñanza presencial surge como resultado de la modalidad de educación virtual durante la pandemia, transformando el enfoque tradicional y permitiendo una educación más flexible en consonancia con los cambios sociales.

This work presents a methodology to solve optimization problems with dynamic-size solution vectors containing continuous and integer variables. It is achieved by reformulating the original problem through a bilevel optimization approach and implementing metaheuristic techniques to solve it. In the selected case study, the optimization problem corresponds to tuning a neuro-fuzzy controller (NFC) that operates in a biodiesel production system for controlling temperature. The NFC performs well and is especially robust to disturbances, but due to its complexity, it is difficult to determine the best set of parameters for its use. This has led to biased searches based on criteria such as the experiences of designers. With the proposed method, it was possible to obtain a tuning that—when implemented in a simulation—led to results that surpassed those documented in the literature. Finally, the proposal offers flexibility for implementation with other controllers that have similar architectures and can be integrated into various other plants or processes.

Aim: The development of predictive models for patients treated by emergency medical services (EMS) is on the rise in the emergency field. However, how these models evolve over time has not been studied. The objective of the present work is to compare the characteristics of patients who present mortality in the short, medium and long term, and to derive and validate a predictive model for each mortality time. Methods: A prospective multicenter study was conducted, which included adult patients with unselected acute illness who were treated by EMS. The primary outcome was noncumulative mortality from all causes by time windows including 30-day mortality, 31- to 180-day mortality, and 181- to 365-day mortality. Prehospital predictors included demographic variables, standard vital signs, prehospital laboratory tests, and comorbidities. Results: A total of 4830 patients were enrolled. The noncumulative mortalities at 30, 180, and 365 days were 10.8%, 6.6%, and 3.5%, respectively. The best predictive value was shown for 30-day mortality (AUC = 0.930; 95% CI: 0.919–0.940), followed by 180-day (AUC = 0.852; 95% CI: 0.832–0.871) and 365-day (AUC = 0.806; 95% CI: 0.778–0.833) mortality. Discussion: Rapid characterization of patients at risk of short-, medium-, or long-term mortality could help EMS to improve the treatment of patients suffering from acute illnesses.

Exploring the realm of extreme weather events is indispensable for various engineering disciplines and plays a pivotal role in understanding climate change phenomena. In this study, we examine the ability of 10 probability distribution functions—including exponential, normal, two- and three-parameter log-normal, gamma, Gumbel, log-Gumbel, Pearson type III, log-Pearson type III, and SQRT-ET max distributions—to assess annual maximum 24 h rainfall series obtained over a long period (1972–2022) from three nearby meteorological stations. Goodness-of-fit analyses including Kolmogorov–Smirnov and chi-square tests reveal the inadequacy of exponential and normal distributions in capturing the complexity of the data sets. Subsequent frequency analysis and multi-criteria assessment enable us to discern optimal functions for various scenarios, including hydraulic engineering and sediment yield estimation. Notably, the log-Gumbel and three-parameter log-normal distributions exhibit superior performance for high return periods, while the Gumbel and three-parameter log-normal distributions excel for lower return periods. However, caution is advised regarding the overuse of log-Gumbel, due to its high sensitivity. Moreover, as our study considers the application of mathematical and statistical methods for the detection of extreme events, it also provides insights into climate change indicators, highlighting trends in the probability distribution of annual maximum 24 h rainfall. As a novelty in the field of functional analysis, the log-Gumbel distribution with a finite sample size is utilised for the assessment of extreme events, for which no previous work seems to have been conducted. These findings offer critical perspectives on extreme rainfall modelling and the impacts of climate change, enabling informed decision making for sustainable development and resilience.

Objective To compare the predictive value of the quick COVID-19 Severity Index (qCSI) and the National Early Warning Score (NEWS) for 90-day mortality amongst COVID-19 patients. Methods Multicenter retrospective cohort study conducted in adult patients transferred by ambulance to an emergency department (ED) with suspected COVID-19 infection subsequently confirmed by a SARS-CoV-2 test (polymerase chain reaction). We collected epidemiological data, clinical covariates (respiratory rate, oxygen saturation, systolic blood pressure, heart rate, temperature, level of consciousness and use of supplemental oxygen) and hospital variables. The primary outcome was cumulative all-cause mortality during a 90-day follow-up, with mortality assessment monitoring time points at 1, 2, 7, 14, 30 and 90 days from ED attendance. Comparison of performances for 90-day mortality between both scores was carried out by univariate analysis. Results From March to November 2020, we included 2,961 SARS-CoV-2 positive patients (median age 79 years, IQR 66–88), with 49.2% females. The qCSI score provided an AUC ranging from 0.769 (1-day mortality) to 0.749 (90-day mortality), whereas AUCs for NEWS ranging from 0.825 for 1-day mortality to 0.777 for 90-day mortality. At all-time points studied, differences between both scores were statistically significant (p

The present work aimed to establish the influence of self-reported trait anxiety on computerized and self-reported measures of executive control, and speed of processing in young adults using latent variable modeling. One hundred and six participants completed the State-trait anxiety questionnaire (STAI-t), the Attentional Control Scale (ACS), and a set of computerized tasks of executive control, tapping into the updating, inhibition, and shifting components. Higher scores in the latent variable of trait anxiety were negatively associated with the self-reported latent variable of attentional control. Notably, self-reported and performance-based indicators of executive control showed no associations at the latent level. Contrary to our hypotheses, higher trait anxiety did not affect any performance-based executive component but was associated with an increase in response times. We show that self-reported trait anxiety is related to a lower self-perceived sense of attentional control and does not affect executive functioning in non-clinical samples. In turn, trait anxiety is mainly associated with a slowed speed of processing. In conclusion, the tendency to experience a negative mood is related with cognitive processing by reducing its speed even in the absence of threatening stimuli.

El número de obras dedicadas al terrorismo vasco es ya muy amplio. En este artículo repasaremos un grupo de trabajos que aborda un problema concreto: la relación entre esa forma de violencia política y los procesos de nacionalización de masas. La mayoría de ellos son microanálisis, que es donde aún cabe aportar más investigación original, ya sea desde la historia o desde otras disciplinas. Nos detendremos en un caso concreto aún por analizar: la evolución de aquellas localidades vascas y navarras donde el tradicionalismo, con su componente católico militante y nacionalista español, obtenía en la década de 1930 unos excelentes resultados electorales. Tras el franquismo, en muchas de ellas se había pasado a votar ampliamente a una opción abertzale e izquierdista como HB, el brazo político de ETA.

This study presents a detailed comparative analysis of different methods for evaluating seismic response in structures, focusing on maximum displacements and collapse assessment. The results obtained through modal spectral analysis, non-linear dynamic analysis, and the incremental pushover analysis applied to a specific structure are compared. It has been found that the choice of time step and the consideration of ductility are critical for obtaining accurate predictions. The results of the non-linear dynamic analysis of the building’s response indicate that an earthquake equivalent to the one that affected the city of Lorca (southeast Iberian Peninsula) in 2011 would have a devastating impact on the studied structure, highlighting the importance of the finite element method modelling in predicting the formation of plastic hinges and assessing structural safety. These findings highlight the importance of utilising multiple analysis approaches and detailed modelling to fully understand the seismic behaviour of structures and ensure adequate resistance and stability to extreme events.

El objetivo de este estudio fue analizar las oscilaciones de la actividad cardíaca parasimpática (ACP) en un mesociclo de una atleta keniata. La variabilidad de la frecuencia cardiaca (VFC) se midió durante tres semanas. En la primera semana (W1) el volumen de entrenamiento fue 120,55 km, en la segunda (W2) 96,71 km y en la tercera (W3) 79,45 km. Se analizó la media semanal de los intervalos (R-R), la expresión logarítmica (Ln) del cuadrado de la raíz media de la unión de los intervalos R-R adyacentes (LnrMSSD), la desviación estándar de los intervalos R-R (LnSDNN), la frecuencia cardíaca media (FC) de cada sesión y las fluctuaciones diarias de LnrMSSD (LnrMSSDCV). Se observaron incrementos significativos en LnrMSSD y LnSDNN de W1 a W3. El LnrMSSDCV fue mayor en W1 comparado a W2 y W3. Este estudio de caso demostró que tanto el volumen como la intensidad de entrenamiento afectaron la ACP de la atleta. Esta monitorización podría ser una valiosa herramienta para prevenir el sobreentrenamiento.

La familia Bromeliaceae en México está integrada por 422 especies, de las cuales 18 se encuentran en Zacatecas. El objetivo fue describir los usos actuales en el Valle de Juchipila y contribuir al conocimiento de la flora estatal. Se colectaron ejemplares en tianguis, fiestas religiosas, huertos y vegetación natural. Se entrevistó a 41 informantes en tres municipios. La identificación se realizó con claves dicotómicas y comparación con ejemplares de herbario. Se registraron 5 especies y 2 géneros, incluyendo el primer registro del género Bromelia L. para Zacatecas. Tillandsia usneoides destaca como la especie de mayor valor económico. Las bromelias en el Valle de Juchipila son utilizadas principalmente con fines ornamentales. Se sugiere realizar estudios para estimar los efectos de la recolección y documentar las prácticas de manejo en poblaciones silvestres. El registro de un nuevo género confirma la importancia de continuar con exploraciones etnobotánicas en la región sur de Zacatecas.

BackgroundNowadays, there is no gold standard score for prehospital sepsis and sepsis-related mortality identification. The aim of the present study was to analyze the performance of qSOFA, NEWS2 and mSOFA as sepsis predictors in patients with infection-suspected in prehospital care. The second objective is to study the predictive ability of the aforementioned scores in septic-shock and in-hospital mortality.MethodsProspective, ambulance-based, and multicenter cohort study, developed by the emergency medical services, among patients (n = 535) with suspected infection transferred by ambulance with high-priority to the emergency department (ED). The study enrolled 40 ambulances and 4 ED in Spain between 1 January 2020, and 30 September 2021. All the variables used in the scores, in addition to socio-demographic data, standard vital signs, prehospital analytical parameters (glucose, lactate, and creatinine) were collected. For the evaluation of the scores, the discriminative power, calibration curve and decision curve analysis (DCA) were used.ResultsThe mSOFA outperformed the other two scores for mortality, presenting the following AUCs: 0.877 (95%CI 0.841–0.913), 0.761 (95%CI 0.706–0.816), 0.731 (95%CI 0.674–0.788), for mSOFA, NEWS, and qSOFA, respectively. No differences were found for sepsis nor septic shock, but mSOFA’s AUCs was higher than the one of the other two scores. The calibration curve and DCA presented similar results.ConclusionThe use of mSOFA could provide and extra insight regarding the short-term mortality and sepsis diagnostic, backing its recommendation in the prehospital scenario.

Salicylic acid and Azospirillum brasilense stimulate plant growth and productivity. In some environments, plant physiology similarly responds to both bioactive products. Considering this, a field experiment was conducted to study the physiological effect of Salicilic acid and A. brasilense on growth and grain yield of maize plants. The experiment involved three treatments consisting of imbibed seeds in an aqueous solution of SA (0.01 mM), inoculated seeds with A. brasilense and a control treatment. Seed imbibition in SA and inoculation with A. brasilense improved vegetative growth in the early stages of crop ontogeny, increasing leaf growth, plant height, stem diameter and biomass accumulation. Spikelet length and weight were greater in plants first inoculated with A. brasilense and then treated with SA. Results indicated that SA stimulated biomass partitioning towards leaves, root and stem, while A. brasilense mainly affected leaf growth, plant height, ear dimensions and grain yield. Such results turn crucial for biological fertilization strategies aimed at reducing pollutant loads that accompany chemical fertilizers. Both products can be part of maize management practices given competitive economic advantages and sustainability. Highlights: • Seed imbibition in SA and inoculation with brasilense improved vegetative growth in the early stages of crop ontogeny, increasing leaf growth, plant height, stem diameter and biomass accumulation. • Salicylic Acid stimulated biomass partitioning towards leaves, root and stem in maize plants. • Azospirillum brasilense stimulates leaf growth, plant height, as well as ear dimensions and grain yield in corn plants.

Background: The introduction of species with tolerance to salinity is one of the strategies to reduce the harmful effect of salts in the eastern region of Cuba. The species Vigna unguiculata L., shows rusticity and capability of adaptation, however, it is necessary to search for cultivars with greater tolerance and symbiotic nitrogen fixation possibilities to increase yields. Objective: To determine the behavior of the bradyrizobium-cowpea bean relationship under salinity conditions, based on variables related to symbiotic nitrogen fixation, growth and development. Methodology: An experiment was carried out under controlled glass house conditions at the CSIC, Madrid, Spain. Two cultivars were used; IITA-Precoz and IT 86 D-715, which were inoculated with Strain VIBA-1 of Bradyrhizobum liaoningense. Treatments were Hoagland nutrient solution (control) and nutrient solution with 150 mM NaCl (saline). A completely randomized design with eight replications was used. At 40 days after germination, variables related to symbiotic nitrogen fixation, growth and development, protein concentration of the cytosolic soluble fraction of leaves and nodules were evaluated. Results: Although salinity negatively affected both cultivars, the damage did not manifest with the same intensity. IT 86 D-715 was less affected by showing less damage on the variables number of nodules, ARA, protein concentration in nodules and leaves, accumulation of leaf and root biomass, so its tolerance was greater. The IITA-Precoz cultivar was more susceptible, all the variables were notably affected under stress conditions, therefore, its tolerance level is lower. Implications: The cultivar IT 86 D-715 can be used in salinized soils due to its high tolerance, which is evidenced in variables of growth development and atmospheric nitrogen fixation. Conclusions: The cultivar IT 86 D-715 presents a greater capacity for symbiotic nitrogen fixation under salinity conditions and the tolerance index in all the growth and development variables evaluated was higher than IITA-Precoz, for which it presents a high susceptibility level.

The multidimensionality of the stress response has shown the complexity of this phenomenon and therefore the impossibility of finding a unique biomarker among the physiological variables related to stress. An experimental study was designed and performed to guarantee the correct synchronous and concurrent measure of psychometric tests, biochemical variables and physiological features related to acute emotional stress. The population studied corresponds to a group of 120 university students between 20 and 30 years of age, with healthy habits and without a diagnosis of chronic or psychiatric illnesses. Following the protocol of the experimental pilot, each participant reached a relaxing state and a stress state in two sessions of measurement for equivalent periods. Both states are correctly achieved evidenced by the psychometric test results and the biochemical variables. A Stress Reference Scale is proposed based on these two sets of variables. Then, aiming for a non-invasive and continuous approach, the Acute Stress Model correlated to the previous scale is also proposed, supported only by physiological signals. Preliminary results support the feasibility of measuring/quantifying the stress level. Although the results are limited to the population and stimulus type, the procedure and methodological analysis used for the assessment of acute stress in young people can be extrapolated to other populations and types of stress.

IntroductionCOVID-19 has initially been studied in terms of an acute-phase disease, although recently more attention has been given to the long-term consequences. In this study, we examined COVID-19 as an independent risk factor for long-term mortality in patients with acute illness treated by EMS (emergency medical services) who have previously had the disease against those who have not had the disease.MethodsA prospective, multicenter, ambulance-based, ongoing study was performed with adult patients with acute disease managed by EMS and transferred with high priority to the emergency department (ED) as study subjects. The study involved six advanced life support units, 38 basic life support units, and five emergency departments from Spain. Sociodemographic inputs, baseline vital signs, pre-hospital blood tests, and comorbidities, including COVID-19, were collected. The main outcome was long-term mortality, which was classified into 1-year all-cause mortality and 1-year in- and out-of-hospital mortality. To compare both the patients with COVID-19 vs. patients without COVID-19 and to compare survival vs non-survival, two main statistical analyses were performed, namely, a longitudinal analysis (Cox regression) and a logistic regression analysis.ResultsBetween 12 March 2020 and 30 September 2021, a total of 3,107 patients were included in the study, with 2,594 patients without COVID-19 and 513 patients previously suffering from COVID-19. The mortality rate was higher in patients with COVID-19 than in patients without COVID-19 (31.8 vs. 17.9%). A logistic regression showed that patients previously diagnosed with COVID-19 presented higher rates of nursing home residency, a higher number of breaths per minute, and suffering from connective disease, dementia, and congestive heart failure. The longitudinal analysis showed that COVID-19 was a risk factor for mortality [hazard ratio 1.33 (1.10–1.61); p < 0.001].ConclusionThe COVID-19 group presented an almost double mortality rate compared with the non-COVID-19 group. The final model adjusted for confusion factors suggested that COVID-19 was a risk factor for long-term mortality.

Moral decision-making is influenced by various factors, including personality and language. In this cross-sectional study, we investigated the Foreign-Language effect (FLe) in early, highly proficient, Catalan-Spanish bilinguals and examined the role of several personality dimensions in their responses to moral dilemmas. We obtained a multilevel data structure with 766 valid trials from 52 Catalan-dominant undergraduate students who read and responded anonymously to a computerized task with 16 standardized moral dilemmas, half in Catalan and half in Spanish. Results of a multilevel multivariate logistic regression analysis showed that consistent with previous research, participants gave more utilitarian responses to impersonal than personal dilemmas. The language of the dilemma had no effect on the response (dichotomous: utilitarian vs. deontological), decision time, or affective ratings, contradicting the hypothesis of shallower emotional processing of the information in the second language. Interestingly, cruelty features of psychopathy were significantly associated with an enhanced proportion of utilitarian decisions irrespective of the language or the nature of the dilemmas. Furthermore, cruelty features interacted with participants' assessment of dilemma aspects like vividness and verisimilitude. Overall, our findings suggest that early bilinguals immersed in a dual-language context using close Romance languages do not show the FLe and that personality traits like cruelty can modulate moral decisions regardless of language or dilemma type.

The identification and appropriate management of patients at risk of suffering from acute chest pain (ACP) in prehospital care are not straightforward. This task could benefit, as occurs in emergency departments (EDs), from cardiac enzyme assessment. The aim of the present work was to derive and validate a scoring system based on troponin T (cTnT), N-terminal pro B-type natriuretic peptide (NT-proBNP), and D-dimer to predict 1-year mortality in patients with ACP. This was a prospective, multicenter, ambulance-based cohort study of adult patients with a prehospital ACP diagnosis who were evacuated by ambulance to the ED between October 2019 and July 2021. The primary outcome was 365-day cumulative mortality. A total of 496 patients fulfilled the inclusion criteria. The mortality rate was 12.1% (60 patients). The scores derived from cTnT, NT-proBNP, and D-dimer presented an AUC of 0.802 (95% CI: 0718-0.886) for 365-day mortality. This AUC was superior to that of each individual cardiac enzyme. Our study provides promising evidence for the predictive value of a risk score based on cTnT, NT-proBNP, and D-dimer for the prediction of 1-year mortality in patients with ACP. The implementation of this score has the potential to benefit emergency medical service care and facilitate the on-scene decision-making process.

The utility of classical drugs used to treat psychiatric disorders (e.g., antidepressants, anxiolytics) is often limited by issues of lack of efficacy, delayed onset of action or side effects. Psychoactive substances have a long history of being used as tools to alter consciousness and as a gateway to approach the unknown and the divinities. These substances were initially obtained from plants and animals and more recently by chemical synthesis, and its consumption evolved toward a more recreational use, leading to drug abuse-related disorders, trafficking, and subsequent banning by the authorities. However, these substances, by modulation of certain neurochemical pathways, have been proven to have a beneficial effect on some psychiatric disorders. This evidence obtained under medically controlled conditions and often associated with psychotherapy, makes these substances an alternative to conventional medicines, to which in many cases the patient does not respond properly. Such disorders include post-traumatic stress disease and treatment-resistant depression, for which classical drugs such as MDMA, ketamine, psilocybin and LSD, among others, have already been clinically tested, reporting successful outcomes. The irruption of new psychoactive substances (NPS), especially during the last decade and despite their recreational and illicit uses, has enlarged the library of substances with potential utility on these disorders. In fact, many of them were synthetized with therapeutic purposes and were withdrawn for concrete reasons (e.g., adverse effects, improper pharmacological profile). In this review we focus on the basis, existing evidence and possible use of synthetic cathinones and psychedelics (specially tryptamines) for the treatment of mental illnesses and the properties that should be found in NPS to obtain new therapeutic compounds.

Este trabajo indaga de forma exploratoria en las concepciones de los/as estudiantes del Máster en Profesor/a de Educación Secundaria (Geografía e Historia) sobre la Historia del Arte y su enseñanza y aprendizaje. El principal objetivo es analizar dichas concepciones para caracterizar el conocimiento académico profesional previo de los/as participantes y ser el referente de partida en el proceso de formación inicial. Para ello, se ha diseñado y aplicado un cuestionario en el momento previo al desarrollo del módulo en la didáctica de esta materia. Los resultados muestran unas concepciones duales que en buena medida se mantienen cercanas a una concepción formalista-teleológica de la disciplina, con una finalidad eminentemente culturalista y con unas estrategias de enseñanza y aprendizaje enmarcadas en la transmisión de contenidos. La formación inicial docente debería partir de estas concepciones para su reestructuración, apostando por la alfabetización audiovisual crítica de la ciudadanía.

Abstract Background Polytrauma is a major clinical problem due to its impact on morbidity and mortality, especially among the younger population. Its pathophysiology is not completely elucidated, and the study of the involvement of certain cell populations with therapeutic potential, such as mesenchymal stromal cells (MSCs), is an area of growing interest, as mesenchymal cells have anti-inflammatory, immunoregulatory, and osteogenic potential. Methods In the present preliminary work, we have evaluated the characteristics of MSCs in terms of proliferation, immunophenotype, cell cycle, clonogenic capacity, and multilineage differentiation ability in a series of 18 patients with polytrauma and compared them to those from otherwise healthy patients undergoing elective spinal surgery. Results MSCs from polytrauma patients displayed higher proliferative potential with significantly higher cumulative population doublings, increased expression of some important cell adhesion molecules (CD105, CD166), and an early pre-osteogenic differentiation ability compared to those of the control group. Conclusions MSCs could potentially be of help in the repair process of polytrauma patients contribute to both cell-tissue repair and anti-inflammatory response. This potential should be further explored in larger studies.